Medicine and Health Sciences Commons^™

Improving Advance Care Planning Among Native Americans, Jasjit Kaur Pataria

Walden Dissertations and Doctoral Studies

A staff education project was created in a tribal health system of primary care clinics to improve advance care planning (ACP) conversations between care providers and Native American tribal patients. ACP conversations and advance directive documentation occurrences were found to be low or negligible in the project site despite primary care clinics being an ideal place to start these conversations. The purpose of the staff education project was to improve the knowledge and attitudes of providers toward initiating ACP conversations in a rural underserved community of Native Americans. The knowledge-to-action model was used to frame the project. Pretests and posttests …

How Being Aware Of Military Culture Influences Social Work Practice With Female Military Personnel, John Raymond Gonzalez

Walden Dissertations and Doctoral Studies

Active-duty women in the military seek help through the Family Advocacy Program (FAP) on military bases from social workers with a master’s degree in social work (MSW) who are hired by the federal government or by firms that contract with social workers to serve military personnel. Most of those social workers have no military background per se, which brings into question how being aware of the military culture might influence their practice with female military personnel. Grounded in self-awareness theory, which places focus on one's awareness relative to one's culture and environment at any time, the purpose of this action …

Staff Education On Self-Care Management For Bipolar Patients To Prevent Readmission, Dorthy Igbonagwam

Walden Dissertations and Doctoral Studies

Bipolar disorder is a chronic mental disorder that can negatively affect an individual’sreadmission to bipolar patients. The purpose of the doctor of nursing practice project was to develop a staff education program to empower the staff to educate the patients by increasing the staff’s knowledge about evidence-based, self-care management strategies. The focus of the educational content was on the approaches to improving patients’ adherence to their medications, promote follow-up care and prevent suicide. The theory that informed this project was Knowles’s theory of adult learning. One source of evidence generated during the project was the evaluation conducted by four content …

Experimental Elucidation Of The Life Cycle Of Drepanocephalus Spathans (Digenea: Echinostomatidae) With Notes On The Morphological Plasticity Of D. Spathans In The United States, Neely R. Alberson, Thomas G. Rosser, Tommy King, Ethan T. Woodyard, Lester Khoo, Wes A. Baumgartner, Daviod J. Wise, Linda M. Pote, Fred L. Cunningham, Matt J. Griffin

United States Department of Agriculture Wildlife Services: Staff Publications

The echinostomatid Drepanocephalus spathans (syn. Drepanocephalus auritus) parasitizes the doublecrested cormorant Phalacrocorax auritus. In North America, the marsh rams-horn snail Planorbella trivolvis and ghost rams-horn snail Biomphalaria havanensis serve as snail intermediate hosts, both of which inhabit catfish aquaculture ponds in the southeastern United States. Studies have demonstrated D. spathans exposure can be lethal to juvenile channel catfish Ictalurus punctatus. Two studies were undertaken to elucidate the life cycle of D. spathans to establish a developmental time line. In both studies, D. spathans cercariae collected from naturally infected P. trivolvis individuals were used to infect channel catfish …

Scavenging Vs Hunting Affects Behavioral Traits Of An Opportunistic Carnivore, Mitchell A. Parsons, Andrew Garcia, Julie K. Young

United States Department of Agriculture Wildlife Services: Staff Publications

Background. Human-induced changes to ecosystems transform the availability of resources to predators, including altering prey populations and increasing access to anthropogenic foods. Opportunistic predators are likely to respond to altered food resources by changing the proportion of food they hunt versus scavenge. These shifts in foraging behavior will affect species interactions through multiple pathways, including by changing other aspects of predator behavior such as boldness, innovation, and social structure. Methods. To understand how foraging behavior impacts predator behavior, we conducted a controlled experiment to simulate hunting by introducing a prey model to captive coyotes (Canis latrans) and compared their behavior …

Influence Of Landscape Attributes On Virginia Opossum Density, David A. Bernasconi, Wesley C. Dixon, Matthew T. Hamilton, James L. Helton, Richard B. Chipman, Amy T. Gilbert, James C. Beasley, Olin E. Rhodes Jr., Guha Dharmarajan

United States Department of Agriculture Wildlife Services: Staff Publications

TheVirginia opossum (Didelphis virginiana), North America's only marsupial, has a range extending from southern Ontario, Canada, to the Yucatan Peninsula, Mexico, and from the Atlantic seaboard to the Pacific. Despite the Virginia opossum's taxonomic uniqueness in relation to other mammals in North America and rapidly expanding distribution, its ecology remains relatively understudied. Our poor understanding of the ecology of this important mesopredator is especially pronounced in the rural southeastern United States. Our goal was to estimate effects of habitat on opossum density within an extensive multiyear spatial capture‐recapture study. Additionally, we compared the results of this spatial capture‐recapture …

Multidisciplinary Engagement For Fencing Research Informs Efficacy And Rancher-To-Researcher Knowledge Exchange, Matthew Hyde, Stewart W. Breck, Alex Few, Jared Beaver, Joshua Schrecengost, Jim Stone, Cameron Krebs, Russell Talmo, Kari Eneas, Rae Nickerson, Kyran E. Kunkel, Julie K. Young

United States Department of Agriculture Wildlife Services: Staff Publications

Across much of the Western United States, recovery of large carnivore populations is creating new challenges for livestock producers. Reducing the risks of sharing the landscape with recovering wildlife populations is critical to private working lands, which play an vital role in securing future energy, water, food, and fiber for an ever-expanding human population. Fencing is an important mitigation practice that many ranchers, land managers, and conservationists implement to reduce carnivore-livestock conflict. While fencing strategies have been reviewed in the literature, research seldom incorporates knowledge from the people who utilize fencing the most (i.e., livestock producers). Incorporating producers and practitioners …

Time For Tobacco-Free Generations In The Western Pacific?, Gianna Gayle H. Amul, Suan Ee Ong, Azrul Mohd Khalib, Joanne Su-Yin Yoong

Ateneo School of Government Publications

No abstract provided.

Intolerance Of Uncertainty And Self-Compassion In Medical Students: Is There A Relationship And Why Should We Care?, Maria Poluch, Jordan Feingold-Link, Dimitrios Papanagnou, Jared Kilpatrick, Deborah Ziring,, Nethra S. Ankam, Md

Student Papers, Posters & Projects

Managing the uncertainty of clinical practice represents a significant source of stress for clinicians, including medical students transitioning into the clinical workplace. Self-compassion, a strategy to better cope with stress and burnout, may represent a skill that can be leveraged to better prepare learners for the uncertainty inherent in clinical practice. A negative correlation between intolerance of uncertainty and self-compassion has been demonstrated in undergraduate students and in the general population. An examination of this relationship in medical students may help inform future curricular development for addressing burnout in undergraduate medical education. We electronically administered the Intolerance of Uncertainty Short …

The Use Of Two Types Of Suture And Stainless-Steel Wire Tension Banding For The Fixation Of Olecranon Fractures: A Biomechanical Comparison, Stuart Drew, Samer Al-Humadi, David Komatsu, Ann M. Meo

Stony Brook Orthopaedic and Musculoskeletal Journal

Purpose: Tension band constructs are commonly used for olecranon fracture fixation. The purpose of this study was to determine if a tension band constructed of No. 2 Dynacord suture, a silicone and salt-filled core within a UHMWPE sheath that expands radially and shortens axially when exposed to saline aqueous environment will provide constant initial static ompression forces compared to No. 2 FiberWire and stainless 18-gauge metal wire tension band.

Methods: A transverse osteotomy was placed in two sawbones models. Two 1.6 K-wires were placed across the osteotomy site and a Tekscan pressure sensor placed into the osteotomy site. The figure …

Relation Of Neurovascular Structures Of The Elbow To An Accessory Anterolateral Approach To The Capitellum: A Cadaveric Study, Michael Okoli, Ryan Tantone, Chidi Okolo, Samantha Muhlrad, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Purpose: The purpose of this study is to describe an anterolateral portal technique to the capitellum and to investigate its anatomic relationship nearby neurovascular structures in the elbow.

Methods: The study included 6 arm-to-fingertip adult cadavers. The demographic information of the cadavers was recorded. We initially dissected the elbows using a lateral approach to the capitellum. Next, a 1.5-cm anterolateral portal to the radiocapitellar joint was made and tagged with heavy suture and passed through the lateral elbow wound, with the elbow and forearm in an extended, supinated position. We then dissected out neurovascular structures around the elbow and measuring …

Non-Weightbearing In Cam Boots After Foot/Ankle Fracture Fixation: Are Patients Compliant?, Amos Z. Dai, Michelle Regan, Megan Paulus

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: The controlled ankle motion (CAM) boot has become an integral part of the management of both operative and nonoperative foot and ankle conditions. Similar to casts, CAM boots are used to immobilize the foot and ankle after injury or surgery. However, unlike casts, CAM boots can be readily removed for showering and range of motion (ROM) exercises. While CAM boots are well-designed for ambulation and are frequently utilized in early weightbearing (WB) and early ROM protocols, their usage in non-weightbearing (NWB) protocols is less clear.

Purpose: The purpose of the current study is to determine the patient compliance rate …

Comparison Of Early Active Range Of Motion In Primary Reverse Shoulder Arthroplasty Based On Indication: A Single Center Retrospective Review, Michael E. Doany, Kenny Ling, Rosen Jeong, Alireza K. Nazemi, David E. Komatsu, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Reverse shoulder arthroplasty (RSA) is commonly used in the treatment of rotator cuff arthropathy.  Indications for RSA have expanded to include complex proximal humerus fractures. Studies directly comparing outcomes between traumatic and traditional elective indications are limited. The purpose of this study was to compare early active range of motion (aROM) within the first two years postoperatively between traumatic and non-traumatic primary RSA, as well as compare ASES scores, and patient satisfaction at final follow-up.

Methods: A retrospective analysis was conducted of all RSA performed by a single surgeon between January 2000 and December 2018. Patients were grouped by …

Defining And Assessing Sentience, Barry O. Hughes

Animal Sentience

Precisely what is meant by the term sentience and how does it overlap with being conscious? We accept that animals have feelings but how do we know what they are and can we measure them? It is important that we clarify the terminology underlying these difficult concepts. Over the last 50 years a scientific discipline has developed to tackle these questions in a systematic way. We have to avoid thoughtless anthropomorphism yet we have to try to relate sentience in animals, as appropriate, to corresponding experiences in humans.

Tooth Agenesis, Thomas Labarias

Graduate Student Dissertations, Theses, Capstones, and Portfolios

In this literature review, I will discuss tooth agenesis, which is a congenital absence of one tooth or more, and the terminology associated. I will then discuss and compare the studies regarding the etiology and the prevalences of tooth agenesis throughout the world population. The second half of the paper will cover tooth agenesis from a clinical standpoint. I will describe the capital different complications and phenotypes that tooth agenesis creates. In the last section, I will explain how tooth agenesis is medically treated, and the multidisciplinary management needed to improve the patient’s quality of life.

How To Hospital: Barriers To Developing A Patient 'Hospital Survival Guide' To Support Information Transfer During Ward-Rounds On The Patient Journey From Admission To Hospital To Discharge, Swyn Lewis, Gwenlli Mai Jones, Paul Barach, Hawys Tomos, Mari Davies, Buddug Eckley, Hannah Rebecca Dowell, Christian Peter Subbe

College of Population Health Faculty Papers

Clinicians can enable patients to actively participate in their care but communication with patients is often poor and highly variable. The aim of this study was to explore patients' understanding of their current illness while in hospital and using a codesign process to create prototype tools to facilitate better communication during ward rounds. A mixed-methods, multistep design with step 1: Application of a questionnaire addressing domains of care in the acute medical unit; step 2: Development of communication aids that were codesigned with active help of patients, students and a specialist in user centric design to address patient needs and …

Mental Illness As A Vulnerability For Sexual Assault: A Retrospective Study Of 7,455 Sexual Assault Forensic Medical Examinations, Leslie Miles, Julie L. Valentine, Linda Mabey, Nancy R. Downing

Faculty Publications

Background: Persons with severe mental illness (MI) are at a high risk of becoming victims of sexual assault (SA). Vulnerability for SA with any type of MI is unknown. This study aimed to identify the prevalence of preexisting MI and other significant factors in patients reporting preexisting MI at the time of their SA medical forensic examinations (SAMFEs).

Method: A retrospective SAMFE chart review of patients ( N = 7,455) from 2010 to 2020 was conducted. Sexual assault nurse examiners completed SAMFEs. Inclusion criteria included (a) aged 14 years and older, (b) completed SAMFE with SA kit evidence collection, and …

Krabbe Disease: A Personal Perspective And Hypothesis, Mohammad Rafi

Department of Neurology Faculty Papers

Introduction: Krabbe disease (KD) or globoid cell leukodystrophy (GLD) is one of the lysosomal disorders affecting central and peripheral nervous systems (CNS and PNS). It is caused by mutations on the galactocerebrosidase (GALC) gene. Affected individuals accumulate undegraded substrates and suffer from neuroinflammation. Methods: Hematopoietic stem cell transplantation (HSCT) has been partially successful in treating patients with KD when accomplished prior to the onset of symptoms. The success is credited to the ability of the hematopoietic stem cells in providing some GALC enzyme to the CNS and eradicating potential neuroinflammation. Combination of the HSCT with some other GALC-providing strategies has …

Severity Assessment Of Impairment In Spinal Cord Injury; A Systematic Review On Challenging Points About International Standards For Neurological Classification Of Spinal Cord Injury, Mahmoud Yousefifard, Mostafa Hosseini, Alireza Oraii, Alex R. Vaccaro, Vafa Rahimi-Movaghar

Department of Orthopaedic Surgery Faculty Papers

Objective: Assessment of spinal cord injuries (SCI) severity is usually done according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). However, a limitation of ISNCSCI has not been thoroughly evaluate; therefore, a systematic review was performed to gather current evidence on the limitations of the ISNCSCI for assessing SCI. Methods: An extensive literature search was performed using Medline, Embase, Web of Science, Cochrane library, and Scopus for all articles up until the end of 2017 and then was updated to the end of 2020. Data was summarized by two independent reviewers and limitations of the ISNCSCI …

Protein Charge Parameters That Influence Stability And Cellular Internalization Of Polyelectrolyte Complex Micelles, Rachel A. Kapelner, Rachel S. Fisher, Shana Elbaum-Garfinkle, Allie C. Obermeyer

Advanced Science Research Center

Proteins are an important class of biologics, but there are several recurring challenges to address when designing protein-based therapeutics. These challenges include: the propensity of proteins to aggregate during formulation, relatively low loading in traditional hydrophobic delivery vehicles, and inefficient cellular uptake. This last criterion is particularly challenging for anionic proteins as they cannot cross the anionic plasma membrane. Here we investigated the complex coacervation of anionic proteins with a block copolymer of opposite charge to form polyelectrolyte complex (PEC) micelles for use as a protein delivery vehicle. Using genetically modified variants of the model protein green fluorescent protein (GFP), …

Systematic Review To Evaluate Algorithms For Reboa Use In Trauma And Identify A Consensus For Patient Selection., Amelia Walling Maiga, Rishi Kundi, Jonathan James Morrison, Chance Spalding, Juan Duchesne, John Hunt, Jonathan Nguyen, Elizabeth Benjamin, Ernest E Moore, Ryan Lawless, Andrew Beckett, Rachel Russo, Bradley M Dennis

Trauma and Acute Care Articles

BACKGROUND: Patient selection for resuscitative endovascular balloon occlusion of the aorta (REBOA) has evolved during the last decade. A recent multicenter collaboration to implement the newest generation REBOA balloon catheter identified variability in patient selection criteria. The aims of this systematic review were to compare recent REBOA patient selection guidelines and to identify current areas of consensus and variability.

METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic review of clinical practice guidelines for REBOA patient selection in trauma. Published algorithms from 2015 to 2022 and institutional guidelines from a seven-center …

B-Sure (Bereavement Support Research): The Differential Experiences Of Peer And Professional Support In Grief, Andrea Crowley

Theses and Dissertations (Comprehensive)

Abstract

The project aimed to investigate the differential experiences of those who have received peer or professional support for grief and bereavement. Although much is known with regards to the perceived impacts of peer and professional support in general, there is little research surrounding these support types in the context of grief and bereavement, the potential for these support types to be complementary, and how the COVID-19 pandemic may have impacted the experiences of those receiving these forms of support. The main goal of this project was to address a significant gap in the literature by investigating the following questions: …

The Impact Of Preoperative Neurological Symptom Severity On Postoperative Outcomes In Cervical Spondylotic Myelopathy, Gregory R Toci, Jose A Canseco, Brian A Karamian, Michael Chang, Giovanni Grasso, Kristen Nicholson, Emily M Pflug, Glenn S Russo, Daniel Tarazona, I David Kaye, Mark Kurd, Alan S. Hilibrand, Barrett I. Woods, Jeffrey A Rihn, D Greg Anderson, Kris E Radcliff, Christopher K Kepler, Alex R. Vaccaro, Gregory D. Schroeder

Department of Orthopaedic Surgery Faculty Papers

Study design: The study design is a retrospective cohort study.

Objective: To compare patient-reported outcomes between patients with mild versus moderate-to-severe myelopathy following surgery for cervical spondylotic myelopathy (CSM).

Summary of background data: Recent studies have demonstrated that decompression for CSM leads to improved quality of life when measured by patient-reported outcomes. However, it is unknown if preoperative myelopathy classification is predictive of superior postoperative improvements.

Materials and methods: A retrospective review of patients treated surgically for CSM at a single institution from 2014 to 2015 was performed. Preoperative myelopathy severity was classified according to the modified Japanese Orthopaedic Association …

Autonomous And Non-Autonomous Requirements For The C-Jun N-Terminal Kinase Signaling Pathway In Early Forebrain Development, Jessica G. Cunningham

Graduate Theses, Dissertations, and Problem Reports (ETD)

The cerebral cortex is responsible for a wide variety of high-level functions including cognition, sensory perception, fine motor control, and the orchestration of body movements. The cortex is comprised of cortical excitatory neurons and inhibitory interneurons, which are arranged in a highly organized fashion into different layers and regions. These two types of cells operate in a delicate balance between excitation and inhibition, which is critical for proper cortical circuitry. In order for the cortex to execute its numerous functions, it must both send and receive input to other brain regions through axonal connections. The organization within the cortex and …

Monitoring The Systemic Immune System To Understand And Improve The Efficacy Of Immunotherapy For Metastatic Osteosarcoma, Justin Edward Markel

Graduate Theses, Dissertations, and Problem Reports (ETD)

Osteosarcoma (OS) is a complex tumor with no effective targeted therapies due to its genomic heterogeneity and pleomorphism. The immune response it creates, particularly against metastatic lesions, is considerable; however, various suppressive mechanisms induced by the tumor prohibit its effectiveness. The presence of infiltrating lymphocytes suggests that therapeutic disinhibition through checkpoint blockade could increase antitumor immunity, though none have been successful in clinical trials. The complexities of the immune response to OS tumors have yet to be unraveled; however, there is evidence to suggest that cell-mediated immunity (CMI, specifically T cells, Natural Killer [NK] cells, and myeloid-lineage cells [MLCs]) plays …

Implementation Of Standardized Handoff Reporting To Improve Communication Among Certified Registered Nurse Anesthetists And Postanesthesia Care Unit Nurses In The Postanesthesia Care Unit, Lauryn G. Macfawn

Graduate Theses, Dissertations, and Problem Reports (ETD)

Standardization of handoff reporting has been proven to increase the quality of information being transferred and improve patient safety. Poor quality handoff between providers increases morbidity and mortality, hospital length of stay, healthcare costs, as well as decreases patient satisfaction The aim of this Doctor of Nursing Practice quality improvement (QI) project was to implement the situation, background, assessment, recommendation (SBAR) handoff reporting tool in the postanesthesia care unit (PACU) at a hospital in Western Maryland. There was no standardized handoff process in place between certified registered nurse anesthetists (CRNAs) and PACU registered nurses (RNs) at the facility. The participants …

Implementation Of A Nonverbal Scrub Cap Identification System To Improve Communication And Perception Of Patient Safety Among Unfamiliar, De-Identified Staff Members In The Operating Room., Keri Ann Roskowinski

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Operating room (OR), professionals deliver patient care with brief introductions, and roles were not always identified, and although team members wear identification (ID) badges, they were usually covered by sterile gowns and other routine personal protective equipment (PPE). Purpose: The aim of this Doctor of Nursing Practice (DNP) project was to determine if a simple intervention to apply the individual’s name and role to a scrub cap could improve identification, OR team communication, and consequently, patient safety. The participants in this project consisted of nurses, physicians, anesthesia providers, scrub technicians, students, medical sales representatives, and those that identified as …

Prenatal And Pediatric Oral Health Education Among Dental Hygiene Programs In The United States, Denise M. Claiborne, Shillpa Naavaal

Dental Hygiene Faculty Publications

Purpose: Health care and dental providers must be prepared to address the oral health needs of mothers and children in order to reduce the burden of dental disease in these populations. The purpose of this study was to describe the curriculum and clinical experiences related to prenatal and pediatric oral health in the university and community college dental hygiene programs in the United States (US).

Methods: Dental hygiene program directors (PDs) from across the US were invited to participate in a cross-sectional electronic survey regarding the prenatal and pediatric oral health curriculum at their institution. In addition to program characteristics, …

Tumor-Targeted Ph-Sensitive Manganese Oxide Nanoparticle For Enhanced Detection Of Breast Cancer Using Mri, Celia Martinez De La Torre

Graduate Theses, Dissertations, and Problem Reports (ETD)

In the United States, approximately 287,850 new cases of invasive breast cancer will be diagnosed, and over 43,000 women will die because of it in 2022. Currently, mammography is the gold standard for breast cancer surveillance. Although this detection technique is relatively cheap and fast, it misses about 1 in 5 breast cancers in younger women with dense breast tissue, causing a delay in treatment. Compared to mammography, magnetic resonance imaging (MRI) has superior soft-tissue contrast that elucidates structural differences within soft tissue to detect more breast cancers. However, MRI still misses

NEMO particles were produced by synthesizing manganese oxide …

Implementation Of An Amiodarone Infusion Nurse Practice Guideline To Reduce The Incidence Of Phlebitis: A Quality Improvement Project, Kristen N. Cottrill

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Patients have an increased risk of developing phlebitis when amiodarone is delivered through a peripheral intravenous catheter. In a 32-bed cardiac surgery step-down unit, patients experienced phlebitis at a rate of 28.57% despite following manufacturer recommendations. Individual interventions targeted at amiodarone-related phlebitis have presented mixed results, however, when an amiodarone infusion practice guideline was established, the rate and severity of phlebitis consistently decreased across studies. Purpose: This project aimed to implement an evidence-based amiodarone infusion guideline to reduce phlebitis development or severity in cardiac-surgery step-down patients without a central venous catheter who received a peripheral intravenous infusion of amiodarone. …