Medicine and Health Sciences Commons^™

Social Determinants Of Health, Telehealth, And Hiv/Aids: Implications For Public Health Research And Practice In The State Of Virginia, Sonal S. Sathe, Adati Tarfa

Virginia Journal of Public Health

Purpose: The purpose of this commentary is to assert the importance of addressing the social determinants of health to support HIV/AIDS control efforts, to describe the importance of telehealth in HIV/AIDS control, and to recommend courses of action to support HIV/AIDS control efforts within the state of Virginia.

Discussion: We provide an overview of the social determinants of health and their role in HIV/AIDS control, telehealth and its uptake within the HIV/AIDS community, and issues in Virginia facing HIV/AIDS control.

Conclusion and Recommendations: We conclude that addressing social determinants of health, especially stigma, is an important measure of HIV/AIDS control …

Restorative Recreation: A Medical Humanities Course Relating Nature Prescription, Avocation, And Creation Care To Human And Ecosystem Health, Patrick C. Swanson, Keirien L. Taylor, Thomas J. Schechter

Jesuit Higher Education: A Journal

Although there is increasing awareness of the relationships between ecosystem health, access to and interaction with nature, and human wellness, examples of instructional activities to convey these issues in medical education are limited. To address this need, P.C.S. developed a five week elective course for up to twelve students within a medical humanities curriculum. Students discuss themes covered in multi-media assignments, hike at a regional nature center, and write a final reflection essay. Discussion topics include nature-deficit disorder, nature immersion, nature prescription, creation care, social determinants of nature access and environmental health, and restorative recreation as an avocation. Follow-up surveys …

The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban

Master of Science in Nursing Family Nurse Practitioner

This review explores the effectiveness of Nurse Practitioner (NP) residency programs in addressing role strain, burnout, and retaining new graduates. It emphasizes the factors contributing to NP resignations and proposes formal residency programs to improve job satisfaction and retention rates. Research highlights benefits such as enhanced preparedness, credibility, and better patient care, advocating for increased program accessibility and funding. Additionally, the application of the theory of planned behavior underscores compliance with regulations, evidence-based practice, and environmental influences for patient safety in advanced practice registered nursing. The literature review on NP residency programs draws from six empirical articles, focusing on job …

Evaluation Tools For Undergraduate Nursing Student Performance In Simulated Learning Experiences: A Literature Review, Katie Pettibone

Nursing Masters Papers

Simulated learning experiences (SLEs) are an increasing aspect of clinical experiences in undergraduate nursing programs. Formative student evaluation is a critical component of SLEs as it promotes student growth and demonstrates student learning outcomes. The 2021 International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: Simulation for Student Evaluation of Learning and Performance [INACSL Standards] provide specific guidelines that aim to ensure the best experiences for SLEs participants. With many formative evaluation tools for overall student performance available, it is important that educators utilize evaluation tools that meet the most recent 2021 INACSL Standards.

An integrative …

Sodium-Glucose Cotransporter 2 Inhibitor (Sglt2-I) In The Prevention Of Diabetic Kidney Disease Progression, And Its Role As An Antihypertensive Agent In The African American Population, Aran Michael G. Manalang, Justin Gambini

Doctor of Medical Science (DMSc)

Introduction:

Needs Assessment:

Originally used as antidiabetic medications, later clinical trial data showed beneficial effects in reducing the onset and progression of renal complications in people with and without diabetes. 13 Randomized clinical trials and ‘real world’ observational studies involving mostly type 2 diabetes patients showed that SGLT2-i can slow the decline in glomerular filtration rate (GFR), and reduce the onset of microalbuminuria and slow or even reverse the progression of proteinuria.13 Additionally, with diabetes being one of the many chronic conditions still primarily managed by primary care providers (PCP), it falls upon these professionals to have the knowledge and …

Surgical Fire Prevention And Management: An Objective Structured Clinical Examination For Nurse Anesthesia, Tate Fazio, Kaleb Killens

Doctoral Projects

Sentinel events in health care are rare events, often corresponding with permanent injury or death. Fires in the operating room (OR) are one type of sentinel event. Although rare due to possible life-threatening injuries to patients and staff, appropriate surgical fire education is critical in nurse anesthesia education, as anesthesia providers play a significant role in surgical fires (Wunder et al., 2020). The development of simulation exercises has the potential for students to experience and become competent in managing high-acuity, low-frequency events, such as surgical fires (Wunder et al., 2020). The Nurse Anesthesia Program (NAP) at The University of Southern …

Secondary Electrons And Compton X-Ray Generation In Solid And Heated Biological Sample In The Presence Of Radiologic Contrast Media, Vanessa Robinson, Daler Djuraev, Fatima Ahmed

Publications and Research

Our goal is identification of secondary electrons and Compton photons when externally infused radiological contrast from iodine and gadolinium interferes with calcium and iron in tissues. This could help develop next generation of x-ray methods as well as mechanistic understanding of toxic effects of radiology contrast materials on living tissue and agriculture. Changes in tissue minerals over time, aging and heat stress are manipulated in our experiments by infusing imaging contrast agents that consist of large atoms like Gadolinium and Iodine. These have chelation properties to alter electron distribution of proteins and carbohydrates of biological matrix. Our experiments try to …

Chronic Jet Lag Alters Gut Microbiome And Mycobiome And Promotes The Progression Of Mafld In Hfhfd-Fed Mice, Ruoyi Zheng, Xingwei Xiang, Ying Shi, Anqi Qiu, Xin Luo, Junyan Xie, Ryan D. Russell, Dongmei Zhang

Health & Human Performance Faculty Publications

Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common chronic liver disease worldwide. Circadian disruptors, such as chronic jet lag (CJ), may be new risk factors for MAFLD development. However, the roles of CJ on MAFLD are insufficiently understood, with mechanisms remaining elusive. Studies suggest a link between gut microbiome dysbiosis and MAFLD, but most of the studies are mainly focused on gut bacteria, ignoring other components of gut microbes, such as gut fungi (mycobiome), and few studies have addressed the rhythm of the gut fungi. This study explored the effects of CJ on MAFLD and its related microbiotic …

Health Care Organizations’ Research Capacity And Culture’S Effect On Nurses’ Evidence-Based Practice Implementation, Tamela Marie Fonseca

Walden Dissertations and Doctoral Studies

No abstract provided.

Allergic Bronchopulmonary Aspergillosis: Radiological And Microbiological Profile Of Patients Presented In An Outpatient Pulmonary Clinic In A Developing Country, Nousheen Iqbal, Muhammad Irfan, Mustafa Bin Ali Zubairi, Maaha Ayub, Safia Awan, Kauser Jabeen, Ali Bin Sarwar Zubairi

Section of Pulmonary & Critical Care

There is limited data available about allergic bronchopulmonary aspergillosis (ABPA) in Pakistan. The aim of the study was to describe the radiological and microbiological profile of ABPA patients presenting to the outpatient pulmonary clinic of a tertiary care hospital in Karachi, Pakistan. A retrospective study was conducted on ABPA patients who presented to the pulmonary outpatient clinic at Aga Khan University Hospital, Karachi, Pakistan, from January 2017 to December 2019. Data was collected on microbiology and radiology features on predesigned proforma. A total of 7759 asthmatic patients presented at the outpatient pulmonology clinic during the study period. Of the 245 …

12-07-2023 Hsc Committee Minutes, Helen Maestas

HSC Committee (A subcommittee of the UNM Board of Regents)

12-07-2023 HSC Committee Meeting Minutes

The Ai Revolution: Transforming Upper Gastrointestinal Endoscopy, Nakul Ganju, Shaunak Ganju, Luis Dominguez, Andrew Meltzer

URGENT Matters

No abstract provided.

Anatomy Of The Ankle And Ankle Injuries In Athletes, Isabelle G. West

Honors Capstones

The purpose of this project was to learn about the anatomy of the ankle joint, explore common ankle injuries in athletes, and research how they are treated overall and in a physical therapy setting. To do so, a dissection of the ankle joint was completed with Mrs. Kara Coffman-Rea in the cadaver lab as well as an exploration of plastinated models. Additionally, a literature review of current research on the ankle was completed. Though many structures of the ankle joint were identified through dissection, the focus of the literature review is on the structures of the lateral ankle and the …

Safe Patient Care Act Advocation, Julia Rhodes

Honors Theses

This paper discusses advocating for the Safe Patient Care Act and how it affects people in society. This topic is very relevant because it affects a vast majority of people including nurses, patients, and the healthcare systems as a whole. Methods used to advocate for this bill include grass roots activism, composing and presenting speeches, scheduling and attending meetings, presenting to different nursing school cohorts, collaborating with the Michigan Nurses Association, and participating in hearings held by the Michigan House of Representatives. Results consisted of positive feedback from representatives and their word to vote for the Safe Patient Care Act. …

Covid-19 Breakthrough Infections In Type 1 Diabetes Mellitus: A Cross-Sectional Study By The Covid-19 Vaccination In Autoimmune Diseases (Covad) Group, Suhrud Panchawagh, Naveen Ravichandran, Bhupen Barman, Arvind Nune, Mahnoor Javaid, Abraham Edgar Gracia-Ramos, Jessica Day, Mrudula Joshi, Masataka Kuwana, Sreoshy Saha

Medical College Documents

To investigate the frequency, profile, and severity of COVID-19 breakthrough infections (BI) in patients with type I diabetes mellitus (T1DM) compared to healthy controls (HC) after vaccination. The second COVID-19 Vaccination in Autoimmune Diseases (COVAD-2) survey is a multinational cross-sectional electronic survey which has collected data on patients suffering from various autoimmune diseases including T1DM. We performed a subgroup analysis on this cohort to investigate COVID-19 BI characteristics in patients with T1DM. Logistic regression with propensity score matching analysis was performed. A total of 9595 individuals were included in the analysis, with 100 patients having T1DM. Among the fully vaccinated …

Continuity Of Care In The Post-Partum Period, Ashley Quezada

MSN Capstone Projects

Maternal mortality rates in the United States have been a growing concern over the past decade, with rates continuing to climb as recent studies have been published. The total maternal mortality rate in the United States in 2018 was 17.4 and has increased to 32.9 as of 2021, while other developed countries continue to decline (Hoyert, 2023). The maternal mortality rate is the number of deaths per 100,000 live births. More than 50% of pregnancy-related deaths in the United States occur after delivery, in the post-partum period (Melillo, 2020). The purpose of this report is to not only bring light …

Rab1a Haploinsufficiency Phenocopies The 2p14-P15 Microdeletion And Is Associated With Impaired Neuronal Differentiation, Jonathan J Rios, Yang Li, Nandina Paria, Ryan J Bohlender, Chad Huff, Jill A Rosenfeld, Pengfei Liu, Weimin Bi, Kentaro Haga, Mitsunori Fukuda, Shayal Vashisth, Kiran Kaur, Maria H Chahrour, Michael B Bober, Angela L Duker, Farah A Ladha, Neil A Hanchard, Kristhen Atala, Anas M Khanshour, Linsley Smith, Carol A Wise, Mauricio R Delgado

Faculty, Staff and Student Publications

Hereditary spastic parapareses (HSPs) are clinically heterogeneous motor neuron diseases with variable age of onset and severity. Although variants in dozens of genes are implicated in HSPs, much of the genetic basis for pediatric-onset HSP remains unexplained. Here, we re-analyzed clinical exome-sequencing data from siblings with HSP of unknown genetic etiology and identified an inherited nonsense mutation (c.523C>T [p.Arg175Ter]) in the highly conserved RAB1A. The mutation is predicted to produce a truncated protein with an intact RAB GTPase domain but without two C-terminal cysteine residues required for proper subcellular protein localization. Additional RAB1A mutations, including two frameshift mutations and …

Mitochondrial Dna Variants At Low-Level Heteroplasmy And Decreased Copy Numbers In Chronic Kidney Disease (Ckd) Tissues With Kidney Cancer, Yuki Kanazashi, Kazuhiro Maejima, Todd A Johnson, Shota Sasagawa, Ryosuke Jikuya, Hisashi Hasumi, Naomichi Matsumoto, Shigekatsu Maekawa, Wataru Obara, Hidewaki Nakagawa

Faculty, Staff and Student Publications

The human mitochondrial genome (mtDNA) is a circular DNA molecule with a length of 16.6 kb, which contains a total of 37 genes. Somatic mtDNA mutations accumulate with age and environmental exposure, and some types of mtDNA variants may play a role in carcinogenesis. Recent studies observed mtDNA variants not only in kidney tumors but also in adjacent kidney tissues, and mtDNA dysfunction results in kidney injury, including chronic kidney disease (CKD). To investigate whether a relationship exists between heteroplasmic mtDNA variants and kidney function, we performed ultra-deep sequencing (30,000×) based on long-range PCR of DNA from 77 non-tumor kidney …

Alt Free Flap Coverage After Carotid Endarterectomy In The Setting Of Severe Radiation Changes, Richard F. Guidry, Hannah E. Doran, Mark W. Stalder

School of Medicine Faculty Publications

Carotid endarterectomy with patch angioplasty is commonly performed for severe atherosclerotic disease to reduce stroke risk. After neck radiation, loss of tissue planes; reactive fibrosis of skin; contraction; and rarely, necrosis of skin may occur, leading to severe wound complications and possible exposure of carotid artery reconstruction. Historically, local myocutaneous flaps have been performed to provide soft tissue coverage; however, these procedures may be associated with increased donor site morbidity and can be affected by radiation changes. This report describes the novel use of a fasciocutaneous free flap for durable vascularized soft tissue, and the associated secondary benefit of improved …

Novel Urine Cell-Free Dna Methylation Markers For Hepatocellular Carcinoma, Selena Lin, Wei Xia, Amy Kim, Dion Chen, Shelby Schleyer, Lin Choi, Zhili Wang, James Hamilton, Harry Luu, Hie-Won Hann, Ting-Tsung Chang, Chi-Tan Hu, Abashai Woodard, Terence Gade, Ying-Hsiu Su

Division of Gastroenterology and Hepatology Faculty Papers

An optimized hepatocellular carcinoma (HCC)-targeted methylation next generation sequencing assay was developed to discover HCC-associated methylation markers directly from urine for HCC screening. Urine cell-free DNA (ucfDNA) isolated from a discovery cohort of 31 non-HCC and 30 HCC was used for biomarker discovery, identifying 29 genes with differentially methylated regions (DMRs). Methylation-specific qPCR (MSqPCR) assays were developed to verify the selected DMRs corresponding to 8 genes (GRASP, CCND2, HOXA9, BMP4, VIM, EMX1, SFRP1, and ECE). Using archived ucfDNA, methylation of GRASP, HOXA9, BMP4, and ECE1, were found to be significantly different (p < 0.05) between HCC and non-HCC patients. The four markers together with previously reported GSTP1 and RASSF1A markers were assessed as a 6-marker panel in an independent training cohort of 87 non-HCC and 78 HCC using logistic regression modeling. AUROC of 0.908 (95% CI, 0.8656-0.9252) was identified for the 6-marker panel with AFP, which was significantly higher than AFP-alone (AUROC 0.841 (95% CI, 0.778-0.904), p = 0.0026). Applying backward selection method, a 4-marker panel was found to exhibit similar performance to the 6-marker panel with AFP having 80% sensitivity compared to 29.5% by AFP-alone at a specificity of 85%. This study supports the potential use of methylated transrenal ucfDNA for HCC screening.

Abstinence Restores Cardiac Function In Mice With Established Alcohol-Induced Cardiomyopathy, Joshua M. Edavettal, Nicholas R. Harris, Sarah E. Cohen, Janos Paloczi, Bysani Chandrasekar, Jason D. Gardner

School of Graduate Studies Faculty Publications

Alcohol-induced cardiomyopathy (ACM) has a poor prognosis with up to a 50% chance of death within four years of diagnosis. There are limited studies investigating the potential of abstinence for promoting repair after alcohol-induced cardiac damage, particularly in a controlled preclinical study design. Here, we developed an exposure protocol that led to significant decreases in cardiac function in C57BL6/J mice within 30 days; dP/dt max decreased in the mice fed alcohol for 30 days (8054 ± 664.5 mmHg/s compared to control mice: 11,188 ± 724.2 mmHg/s, p < 0.01), and the dP/dt min decreased, as well (−7711 ± 561 mmHg/s compared to control mice: −10,147 ± 448.2 mmHg/s, p < 0.01). Quantitative PCR was used to investigate inflammatory and fibrotic biomarkers, while histology was used to depict overt changes in cardiac fibrosis. We observed a complete recovery of function after abstinence (dP/dt max increased from 8054 ± 664 mmHg/s at 30 days to 11,967 ± 449 mmHg/s after abstinence, p < 0.01); further, both inflammatory and fibrotic biomarkers decreased after abstinence. These results lay the groundwork for future investigation of the molecular mechanisms underlying recovery from alcohol-induced damage in the heart.

Fluorescent Peptide For Detecting Factor Xiiia Activity And Fibrin In Whole Blood Clots Forming Under Flow, Yue Liu, Jennifer Crossen, Timothy J. Stalker, Scott L. Diamond

Cardeza Foundation for Hematologic Research

Background

During clotting, thrombin generates fibrin monomers and activates plasma-derived transglutaminase factor (F) XIIIa; collagen and thrombin-activated platelets offer thrombin-independent cellular FXIIIa (cFXIIIa) for clotting. Detecting fibrin on collagen and tissue factor surfaces in whole blood clotting typically uses complex reagents like fluorescent fibrinogen or antifibrin antibody.

Objectives

We want to test whether the peptide using the α2- antiplasmin crosslinking mechanism by FXIIIa is a useful tool in both monitoring FXIIIa activity, and visualize and monitor fibrin formation, deposition, and extent of crosslinking within fibrin structures in whole blood clots formed under flow.

Methods

We tested a fluorescent peptide derived …

Implicit Bias Among Health Professionals, Kimora H. Toussaint, Javiela Evangelista

Publications and Research

Racism and implicit bias are prevalent in healthcare, which may affect patient well-being. One way implicit bias is most evident is in language. Negative descriptors, such as “sickler”—a term used for those diagnosed with Sickle Cell Disease (SCD), influence how health providers view their patients and determine pain medication prescriptions (Goddu et al.). Patient experience, such as prior use of opioids or using words that imply substance abuse, may block patients from accessing prescriptions and proper care. Black, Indigenous, and People of Color (BIPOC) are disproportionately affected by such negative descriptors (Sun et al., 2022). Among other adverse impacts, treating …

Online Relational Database For Department Of Nursing: An Evidence-Based Practice Project, Denise L. Rismeyer

Doctoral Dissertations and Projects

Departmental nursing leaders and their support staff manage large amounts of data in their daily work and have reported inefficiencies, manual labor, and dissatisfaction with previous electronic tools. Cognitive overload occurs when the amount of data exceeds the brain’s ability to process it and leads to negative consequences such as errors, burnout, anxiety, and poor productivity. Use of technology aligns with nurse leader competencies for business skills and principles along with utilizing evidence-based data for goal setting and decision-making. An online relational database (ORD) allows multiple users at one time, web-based access, ability to hold a large capacity of data …

Church Of Christ's Organizational Involvement Related To Human Trafficking: Awareness, Knowledge, And Prevention, Veronica D. Jackson

Doctoral Dissertations and Projects

The purpose of this quantitative correlational study was to determine if any relationship exists, and to what extent, between human trafficking and prevention measures taken by Churches of Christ located along Highway 20 corridor between Birmingham, Alabama, and Atlanta, GA. The goal of this study brings awareness to any gaps identified in Churches of Christ organizations related to their awareness, knowledge base, prevention, service to community, youth, and victims related to trafficking. The researcher also examined whether there is a relationship with local law enforcement related to human trafficking prevention and making basic referrals for medical services. Human trafficking is …

The Effect Of Stroboscopic Vision On The Y-Balance Test, Alex Habegger

Doctoral Dissertations and Projects

The purpose of this study was to determine if stroboscopic vision significantly effects performance on the YBT-LQ in athletes 12-18 years old, as well as investigating if age or sex effect performance. Previous research has demonstrated the clinical use of stroboscopic vision for athletic performance and rehabilitation, but no study had yet established the effect of stroboscopic vision on dynamic balance. Subjects performed the Y-Balance Lower Quarter (YBT-LQ) and then repeated the YBT-LQ with stroboscopic vision at a rate of 4 hertz (Hz). A repeated measures factorial ANOVAs were used identify significant differences in performance on the YBT-LQ with and …

Integrating Stakeholder Feedback Into The Design Of A Peer-Delivered Primary Care Wellness Program: A Rapid Qualitative Study, Emily M. Johnson, Kyle Possemato, Matthew Chinman, Gala True, Jacob Hedges, Brittany N. Hampton, E. Jennifer Edelman, Stephen A. Maisto

School of Medicine Faculty Publications

Background: Individuals seen in Primary Care with behavioral health concerns who decline behavioral health treatment may benefit from the support of peers (consumers in recovery from behavioral health concerns employed to support other consumers). Whole Health STEPS is a new intervention for Veterans in Primary Care with behavioral health concerns which combines essential elements of peers’ role and the Whole Health model using a stepped-care design. We incorporated stakeholder feedback in the Whole Health STEPS design to improve fit with Veterans, peers, and primary care settings. Methods: We conducted semi-structured qualitative interviews with VA staff using questions derived from the …

Lessons Learnt In The First Year Of An Australian Pediatric Cardio Oncology Clinic., Claudia Toro, Ben Felmingham, Mangesh Jhadav, David S. Celermajer, Andre La Gerche, John O'Sullivan, Sanjeev Kumar, Marion K. Mateos, Joy M. Fulbright, Dinisha Govender, Lane Collier, Michael Cheung, David D. Eisenstat, Peter W. Lange, Julian Ayer, David A. Elliott, Rachel Conyers

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Modern oncological therapies together with chemotherapy and radiotherapy have broadened the agents that can cause cardiac sequelae, which can manifest for pediatric oncology patients while on active treatment. Recommendations for high-risk patients who should be monitored in a pediatric cardio-oncology clinic have previously been developed by expert Delphi consensus by our group. In 2022 we opened our first multidisciplinary pediatric cardio-oncology clinic adhering to these recommendations in surveillance and management.

OBJECTIVES: Our pediatric cardio-oncology clinic aimed to: (i) Document cardiovascular toxicities observed within a pediatric cardio-oncology clinic and. (ii) Evaluate the applicability of the Australian and New Zealand Pediatric …

Methicillin Resistant Staphylococcus Aureus In The United Arab Emirates: A 12-Year Retrospective Analysis Of Evolving Trends, Jens Thomsen, Najiba M. Abdulrazzaq, The Uae Amr Surveillance Consortium, Godfred Antony Menezes, Carole Ayoub Moubareck, Dean B. Everett, Abiola Senok

All Works

IntroductionMethicillin resistant Staphylococcus aureus (MRSA) is a major contributor to the global burden of antimicrobial resistance (AMR). As MRSA continues to evolve, the need for continued surveillance to evaluate trends remains crucial. This study was carried out to assess MRSA trends in the United Arab Emirates (UAE) based on analysis of data from the national AMR surveillance program.MethodsWe carried out a 12-year (2010–2021) retrospective analysis of MRSA demographic and microbiological data collected as part of the UAE national AMR surveillance program. Participating centers from across the country routinely submit AMR surveillance data collected by trained personnel to the National AMR …

Carbapenem Resistant Enterobacterales In The United Arab Emirates: A Retrospective Analysis From 2010 To 2021, Jens Thomsen, Najiba M. Abdulrazzaq, The Uae Amr Surveillance Consortium, Dean B. Everett, Godfred Antony Menezes, Abiola Senok, Carole Ayoub Moubareck

All Works

Carbapenem-resistant Enterobacterales (CRE) are spreading in the United Arab Emirates (UAE) where their dissemination is facilitated by international travel, trade, and tourism. The objective of this study is to describe the longitudinal changes of CRE as reported by the national AMR surveillance system of the UAE. In this study, we retrospectively describe CRE isolated from 317 surveillance sites, including 87 hospitals and 230 centers/clinics from 2010 to 2021. The associated clinical, demographic, and microbiological characteristics are presented by relying on the UAE national AMR surveillance program. Data was analyzed using WHONET microbiology laboratory database software (http://www.whonet.org). A total of 14,593 …