Medicine and Health Sciences Commons^™

Ewing Sarcoma Transcriptome: Identification Of Foxn3 As A Novel Target Of Ews-Fli1, Natasha Kreiling

Theses & Dissertations

Ewing Sarcoma is an aggressive cancer characterized by a fusion gene formed from a chromosomal translocation between a RNA binding protein and a transcription factor. The most common fusion gene is EWS-FLI1 a potent oncogenic transcription factor responsible for initiating genome instability. EWS-FLI1 promotes tumor growth by dysregulating several genes and pathways. We have identified FOXN3, an important gene in cell cycle control and development, as being suppressed by EWS-FLI1. In the future, a better understanding of FOXN3 and its ability to act as a tumor suppressor in EWS will unravel novel mechanisms of EWS pathogenesis, potential biomarker and drug …

Optimizing Antiretroviral Therapy With Modern Rifapentine Containing Tb Treatment, Anthony T. Podany

Theses & Dissertations

In the past decade there has been a multitude of phase 3 clinical trials targeting treatment shortening for tuberculosis (TB). The synthetic rifamycin derivative rifapentine (RPT) has been at the forefront of many of the treatment shortening approaches. RPT possesses greater potency and a longer pharmacokinetic (PK) half-life (t_1/2) as compared with the long used rifamycin, rifampin (RIF). For TB preventative treatment, a 3-month, once weekly regimen of RPT and isoniazid (INH; 3HP) was shown to be as effective as 9-months of daily INH therapy in the PREVENT TB trial. Similarly, a 4-week course of daily RPT and …

Youth Climate Change Activism: How Activism In Youth Can Be Encouraged To Help Combat Climate Change And Reduce Youth Health Impacts, Lorely M. Ruiz

Master's Projects and Capstones

While the effects of climate change are already affecting populations throughout the world, youth will have to deal with the full array of consequences due to the inaction of people in power and environmental regulation failures. Climate change is an issue that needs to be dealt with urgently due to the disproportionate burden it has on youth and future generations. A scoping literature review was conducted to analyze existing literature on climate change activism among youth throughout the globe. Research, practice, and policy recommendations were made to help address gaps in existing literature such as limited research on youth climate …

Behind Closed Doors: A Look Into Access To Supportive Resources And Women Experiencing Intimate Partner Violence (Ipv), Ashley Lauren Holloway

Master's Projects and Capstones

Introduction Intimate Partner Violence (IPV) is a preventable health disparity that remains an underrepresented health issue due to survivors' comfortability in reporting violence within their most intimate relationships; in addition to providers' comfortability in addressing intimate partner violence. The high prevalence of IPV-related incidents highlights the importance of early intervention to prevent victims from experiencing violence again and dying.

Methods A systematic review was conducted to look into intimate partner violence against women. Key words such as intimate partner violence or domestic violence, women, utilization of care services or services, socioecological model were searched through pubmed and other scholarly search …

Reducing The Digital Divide: Why Culturally Relevant Ehealth Interventions Can Reduce Latino Health Disparities, Blanca Flor Garcia-Silva

Master's Projects and Capstones

Objectives: This paper systematically reviews the recent literature on incorporating culturally relevant material in electronic health (eHealth) tools for Latinos. Latinos are a fast-growing ethnic population set to reach 119 million individuals by 2060 (Velasco-Mondragon et al., 2016). Latinos are also disproportionately affected by comorbidities and other poor health outcomes. Developing a culturally sensitive eHealth tool can lead to positive health outcomes among Latinos. Methods: Peer-reviewed articles and analyses were extracted to identify whether eHealth was associated with positive health outcomes among Latino adults. Four literature databases were used to extract English-language articles published from 2001 to 2022. …

Visual Factors Associated With Physical Activity In Schoolchildren, Síofra Harrington, John Kearney Prof, Veronica O'Dwyer Dr

Articles

Clinical relevance Physical activity is an essential part of childhood physical and mental development. Recent research identified visual problems associated with a sedentary lifestyle in children in Ireland.

Background This study explored the association between visual function in children and their engagement with physical activities outside school.

Methods Participants were 1,626 schoolchildren (728 aged 6–7 years, 898 old 12–13 years) in randomly selected schools in Ireland. Before data collection, parents/legal guardians of participants completed a standardised questionnaire reporting physical activity as no activity (mostly on screens), light activity (occasional walking/cycling), moderate activity (/week engaged in sports), or regular activity ( …

Improving Moisture Associated Skin Damage In A Veteran Unit, Beverly Chen

Master's Projects and Capstones

Problem: Moisture-associated skin damage (MASD) has always been a problem, regardless of the setting is an I.C.U., Med-Surg, or long-term care. Evidence suggests prevalence rates can range from 5.2% to 46%, depending on the facility. The highest rates of incontinence-associated damage (IAD) occurred in long-term acute settings (Kayser et al., 2019).

Context: The veterans of the Community Living Center (CLC) have an increased risk for skin breakdown. Currently, of the fifteen residents, six residents (40%) have MASD, two of which have chronic MASD (13%). MASD can be a common occurrence for adults with limited mobility or cognitive diseases. MASD may …

Tepezza: Improving Delays In Treatment, Rebecca D. Page

Master's Projects and Capstones

Problem: There is gap in time from when a Tepezza (teprotumumab) order is placed until the time a patient receives their first infusion.

Context: Delays in the initiation of Tepezza infusions result in worsening symptoms and a decrease in quality of life for patients diagnosed with thyroid eye disease.

Interventions: Interventions included scheduling regular meetings with involved departments, following each patient who has been prescribed Tepezza through the initiation of therapy, and improving staff and patient education.

Measures: Outcome measures include decreasing days from order placement to first infusion from an average of 61 days to 30 days or less …

Understanding Diagnostic Pathways In Systemic Sclerosis And Systemic Sclerosis-Associated Interstitial Lung Disease: A Retrospective Cohort Study, Shervin Assassi, Nan Shao, Ziwei Yin, Elizabeth R Volkmann, Donald F Zoz, Thomas B Leonard

Faculty, Staff and Student Publications

Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is usually detected in a patient known to have SSc but may be diagnosed prior to SSc. We probed an insurance database to investigate documentation of ILD prior to SSc. Using Optum's Clinformatics® Data Mart Database, we identified patients with an SSc index date between January 1, 2010, and September 30, 2015, based on International Classification of Diseases (ICD)-9-Clinical Modification (CM) codes, ≥2 medical claims associated with SSc on different dates within 1 year, and ≥3 years of continuous enrollment prior to SSc index date (ICD-9-CM cohort). We identified an ICD-10-CM cohort comprising patients …

Self-Regulation As A Protective Factor For Diabetes Distress And Adherence In Youth With Type 1 Diabetes During The Covid-19 Pandemic., Alison L Miller, Dana K. Albright Phd, Katherine W Bauer, Hurley O Riley, Marisa E Hilliard, Julie Sturza, Niko Kaciroti, Sharon L Lo, Katy M Clark, Joyce M Lee, Emily M Fredericks

Health Services and Informatics Research

OBJECTIVE: The COVID-19 pandemic increased economic, social, and health stressors for families, yet its impacts on families of youth with chronic conditions, such as type 1 diabetes (T1D), are not well understood. Self-regulation (SR)-or the capacities to control emotions, cognition, and behavior in response to challenge-is known to support T1D management and coping in the face of stress. Strong SR may have protected youth with T1D from the impacts of pandemic-related stressors. This study compared youth and parent emotional functioning and T1D management before and after the pandemic's onset in relation to family pandemic-related stress and youth SR.

METHODS: Parents …

Agrichemicals (Nitrate And Atrazine) In Drinking Water And Adverse Health Outcomes In Children In Nebraska, Balkissa S. Ouattara

Theses & Dissertations

Objectives: This research was conducted to (1) determine the concentrations of atrazine, and nitrate, in Nebraska watersheds and counties; (2) calculate the incidence of pediatric cancers and prevalence of birth defects in Nebraska counties and watersheds, respectively; (3) assess the relationship between the contaminant levels and the incidence rate of pediatric cancers and birth defects prevalence.

Methods: Pediatric cancers and birth defects data were obtained from the Nebraska Department of Health and Human Services. Water quality data were collected and retrieved from the Water Quality Portal and the Nebraska Groundwater Quality Clearinghouse. Geospatial and statistical analyses were conducted at the …

Improving Medication Side Effects Documentation And Clinician Understanding In Home Health, Katherine Bales

Master's Projects and Capstones

Abstract

Problem: In home healthcare services, care experience scores are increasingly the strategy for evaluating the continuity of care to patients who require post-hospital follow up and guidance on medication management. Clinician understanding of how to use the available medication education tools impacts how well patients are able to manage their own care.

Context: The organization’s Home Health clinicians have not done well providing medication education on side effects as evidenced by low survey scores. The focus of the project is improving the medication education provided to patients and documentation thereof. The project takes place in a home health microsystem …

Improved Data Communication With Frontline Staff, David Sprecher

Master's Projects and Capstones

Problem: Frequently, communication from the Quality Department (QD) needs to be filtered through several organizational layers without first-hand knowledge of what message was given to frontline staff. Current mechanisms of communication between the QD and front-line microsystem teams have barriers preventing them from being consistent and reliable.

Context: Research has found that collaborating with and supporting frontline staff was key to establishing a culture that supports change and a focus on safety. Establishing open communication and effective teamwork with individuals on the frontline leads to shared values within a team and better collaboration which drives performance improvement.

Interventions: For trended …

Preventing Hospital-Acquired Pressure Injury In High-Risk Patients, Sahara Thapa

Master's Projects and Capstones

Hospital-Acquired Pressure Injury (HAPI) can be costly for Skilled Nursing Facilities (SNFs) and painful for the patients. Most pressure injuries are considered preventable, but many patients die each year from complications from pressure injuries. Pressure injury treatment costs millions of dollars annually, which could be spent on other treatments. A quality improvement (QI) project was formulated to address pressure-related injuries and improve patient care outcomes in one skilled nursing facility in Northern California. Based on a review of current evidence, HAPI prevention education was implemented for all patient care staff. The education focused on skin assessment, risk factors, staging of …

Instituting A Preceptor Program In Home Health, Abbi Arnold

Master's Projects and Capstones

Problem: Staff being unfamiliar with the role of being a preceptor impacts their ability to perform the job well. Insufficient understanding of a new role creates stress and uncertainty which can lead to poor employee retention or high job dissatisfaction.

Context: The setting for this project is a large hospital-based home health agency that has an average daily census of 375 patients. The project was a collaboration between home health management and the quality department.

Measures: A measurement strategy was developed to meet the outcome measure, process measure, and balancing measure. The outcome measure was increasing the nurses’ understanding of …

Improving The Delivery Of Discharge Instructions On The Postpartum Unit By Increasing The Nurses' Knowledge, Judy Anne Settles

Master's Projects and Capstones

Abstract

The field of nursing prides itself on two critical functions: safety and patient education. One of the mechanisms for both education and safety is the discharge process. Improvements in the discharge process have been shown to increase patient comprehension and safety. This study is grounded in the (Barach & Johnson, 2006) healthcare organizational framework called the 5 Ps microsystems assessment to explore the impacts and improvements in the discharge instruction process on a postpartum unit in a large organization. It was found that HCAHPS scores regarding discharge instructions were 55-60%, which is below what is considered satisfactory. Utilizing the …

Digital Health Companies - Efforts To Innovate For Health Equity, Patricia Martell

Master's Projects and Capstones

INTRODUCTION: To achieve greater health equity, we should look to the ways in which digital technology can positively impact healthcare service and delivery. While there is an incredible opportunity to improve healthcare with digital technology, the potential to exacerbate existing health inequities also must be considered. One important and influential player in the healthcare ecosystem is the digital health innovator. These are companies looking to improve how healthcare is performed and delivered. It is imperative that while they respond to the market forces driving change, they also work to deliver products that can benefit everyone.

METHODS: A literature review was …

Save The Date: An Analysis Of Interventions On Teen Dating Violence, Elizabeth Maestretti

Master's Projects and Capstones

Domestic violence or interpersonal violence (IPV) is a serious public health issue in the United States. IPV is commonly considered to be an issue that occurs in adult relationships. However, most victims of IPV first experience some form of IPV during adolescence, which is known as teen dating violence (TDV). In the United States, TDV impacts about 26% of female and 15% of male adolescents. In Southern California (Orange County) approximately two thirds of adolescents have experienced some form of TDV. This paper examined the literature on existing interventions and strategies which focused on TDV prevention at individual, interpersonal, community/organizational, …

Interventions To Support Teen Mothers In California And Reduce The Disparities Related To The Effects Of Teen Pregnancy, Shanelle Christine Sanchez

Master's Projects and Capstones

The US teen birth rate has slowly been declining; however, teenage pregnancy is still prevalent. In 2018 the US teen birth rate was 17.4 births per 1,000 girls aged 15-19 years, totaling 179,871 births (National Vital Statistic Report). California’s most recent birth rate was 13.6 births per 1,000 girls aged 15-19 years in 2020 (CDC, 2020). Few studies focus on teen mothers’ health, life needs, and outcomes as a result of adolescent pregnancy and subsequently, adolescent parenting. Additionally, few studies have looked at the cultural differences and views of adolescent pregnancy and parenting within the Hispanic population, which are greatly …

Improving Outreach With Stroke Patients After Discharge, Marsha Belen

Master's Projects and Capstones

Problem: The 90-day mRS post discharge call project aimed to improve the outreach in stroke patients treated with thrombolytics alone or in combination with mechanical endovascular reperfusion (MER) therapy. An audit of calls was completed and revealed a gap that a number of patients were not reached or did not receive a call attempt. Having a higher outreach provides useful feedback on the patient’s progress within 90-days of being discharged in relation to the effectiveness of the stroke treatment received according to the mRS.

Context: The Neuro Coordinator was responsible for making the 90-day post discharge call and worked in …

Reframing Culturally Competent Care To Improve Mental Health Outcomes Among African Americans, Jaelen Kennedy-Valdez

Master's Projects and Capstones

African Americans are continuously disadvantaged when it comes to interacting with mental health services which has been evident in the utilization of services, treatment engagement, and quality of services compared to their White counterparts (Alang, 2019). Many researchers and providers have called for culturally competent care and tailored treatment for African Americans to address barriers to access and quality of health care (Alang, 2019). In this paper, a systematic review will be conducted to assess several models that have been integrated in the U.S. healthcare settings and services. In addition, we will define the components of culturally competent care and …

Interventions For Healthcare Provider Burnout: A Systematic Literature Review, Parisa Broomandkhoshbacht

Master's Projects and Capstones

Burnout, an occupational syndrome resulting from chronic stress and emotionally intense work demands, is highly prevalent among healthcare providers (HCPs). Burnout among HCPs is associated with negative consequences for provider health, patient care, and the healthcare system. There is a lack of clear guidelines on how to assist U.S.-based healthcare organizations develop interventions for HCP burnout, including effective intervention types and preferred metrics for quantifying burnout. To address this, this author conducted a systematic literature review. The literature review identified U.S.-based interventions for HCP burnout as well as measures used to assess burnout. The studies included in the literature review …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Ask Your Doctor About: Prescribing Activism For Eco-Anxiety In Adolescents, Lexi Nutkiewicz

Master's Projects and Capstones

Climate change is an ongoing public health crisis. Efforts to protect future generations' physical and mental health are more urgent than ever. Youth, in particular, are experiencing eco-anxiety, a specific form of anxiety relating to stress or distress caused by environmental changes and one’s knowledge of them due to the climate crisis. This scoping review provides a better understanding of the value of youth climate change activism as a strategy to mitigate eco-anxiety. This review evaluates the current definitions of eco-anxiety, the risk factors for eco-anxiety among adolescents, and considers the benefits and drawbacks of youth activism. To identify relevant …

Modern Day Colonization: Gentrification As A Public Health Emergency And Its Impact On Health, Safety, And Wellbeing, Theresa Hayes

Master's Projects and Capstones

This paper analyzes the impact of gentrification in the San Francisco Bay Area, specifically in Oakland, and its relationship to the health and wellbeing of communities. It highlights the public health consequences of gentrification, presents recommendations for policies that will mitigate this impact, and encourages behavior change among newcomers as well as long-term residents. To provide an understanding of gentrification and the Bay Area landscape in which it occurs, a comprehensive literature review was conducted and an exhaustive web search was undertaken to obtain all pertinent information related to the topic. Based on the research, recommendations to combat gentrification now …

College Of Public Heath News, Georgia Southern University

College of Public Health: News & Publications

• Georgia Southern offers new online bachelor's and master's degrees in public health

Improved Sars-Cov-2 Sequencing Surveillance Allows The Identification Of New Variants And Signatures In Infected Patients, Antonio Grimaldi, Francesco Panariello, Patrizia Annunziata, Teresa Giuliano, Michela Daniele, Biancamaria Pierri, Chiara Colantuono, Marcello Salvi, Valentina Bouché, Anna Manfredi, Maria Concetta Cuomo, Denise Di Concilio, Claudia Tiberio, Mariano Fiorenza, Giuseppe Portella, Ilaria Cimmino, Antonio Sorrentino, Giovanna Fusco, Maria Rosaria Granata, Pellegrino Cerino, Antonio Limone, Luigi Atripaldi, Andrea Ballabio, Davide Cacchiarelli

Duncan NRI Faculty and Staff Publications

Background: Genomic surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the only approach to rapidly monitor and tackle emerging variants of concern (VOC) of the COVID-19 pandemic. Such scrutiny is crucial to limit the spread of VOC that might escape the immune protection conferred by vaccination strategies or previous virus exposure. It is also becoming clear now that efficient genomic surveillance would require monitoring of the host gene expression to identify prognostic biomarkers of treatment efficacy and disease progression. Here we propose an integrative workflow to both generate thousands of SARS-CoV-2 genome sequences per week and analyze host …

Design And Formative Evaluation Of A Virtual Voice-Based Coach For Problem-Solving Treatment: Observational Study, Thomas Kannampallil, Corina R Ronneberg, Nancy E Wittels, Vikas Kumar, Nan Lv, Joshua M Smyth, Ben S Gerber, Emily A Kringle, Jillian A Johnson, Philip Yu, Lesley E Steinman, Olu A Ajilore, Jun Ma

2020-Current year OA Pubs

BACKGROUND: Artificial intelligence has provided new opportunities for human interactions with technology for the practice of medicine. Among the recent artificial intelligence innovations, personal voice assistants have been broadly adopted. This highlights their potential for health care-related applications such as behavioral counseling to promote healthy lifestyle habits and emotional well-being. However, the use of voice-based applications for behavioral therapy has not been previously evaluated.

OBJECTIVE: This study aimed to conduct a formative user evaluation of Lumen, a virtual voice-based coach developed as an Alexa skill that delivers evidence-based, problem-solving treatment for patients with mild to moderate depression and/or anxiety.

METHODS: …

Making The Rounds: Exploring The Role Of Circulating Tumor Dna (Ctdna) In Non-Small Cell Lung Cancer, Misty Dawn Shields, Kevin Chen, Giselle Dutcher, Ishika Patel, Bruna Pellini

2020-Current year OA Pubs

Advancements in the clinical practice of non-small cell lung cancer (NSCLC) are shifting treatment paradigms towards increasingly personalized approaches. Liquid biopsies using various circulating analytes provide minimally invasive methods of sampling the molecular content within tumor cells. Plasma-derived circulating tumor DNA (ctDNA), the tumor-derived component of cell-free DNA (cfDNA), is the most extensively studied analyte and has a growing list of applications in the clinical management of NSCLC. As an alternative to tumor genotyping, the assessment of oncogenic driver alterations by ctDNA has become an accepted companion diagnostic via both single-gene polymerase chain reactions (PCR) and next-generation sequencing (NGS) for …

Sound And Silence: The Effects Of Environmental Conditions On State Boredom In An Online Study During The Covid-19 Pandemic, Alana J Anderson, Claire E Mcmeen, Sammy Perone, Elizabeth H Weybright

2020-Current year OA Pubs

Boredom is a negative emotion commonly experienced in mundane situations. Boredom is thought to arise from a mismatch between individuals and their expectation for environmental stimulation. People attempt to reduce boredom by increasing the stimulation in their environment (e.g., turning on TV or music). Theories of boredom suggest external stimulation may cue the individual to expect more stimulation than the mundane task offers-thereby increasing boredom. Researchers adapted lab-based tasks to online during the COVID-19 pandemic, which allowed participants to set the study's environmental conditions. Our method involved data collected online during the COVID-19 pandemic. We tested whether 137 college-age participants …