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2023

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Articles 931 - 960 of 27433

Full-Text Articles in Medicine and Health Sciences

Chromosome 10q2432 Variants Associate With Brain Arterial Diameters In Diverse Populations: A Genome-Wide Association Study, Minghua Liu, Farid Khasiyev, Sanjeev Sariya, Antonio Spagnolo-Allende, Danurys L Sanchez, Howard Andrews, Qiong Yang, Alexa Beiser, Ye Qiao, Emy A Thomas, Jose Rafael Romero, Tatjana Rundek, Adam M Brickman, Jennifer J Manly, Mitchell Sv Elkind, Sudha Seshadri, Christopher Chen, Saima Hilal, Bruce A Wasserman, Giuseppe Tosto, Myriam Fornage, Jose Gutierrez Dec 2023

Chromosome 10q2432 Variants Associate With Brain Arterial Diameters In Diverse Populations: A Genome-Wide Association Study, Minghua Liu, Farid Khasiyev, Sanjeev Sariya, Antonio Spagnolo-Allende, Danurys L Sanchez, Howard Andrews, Qiong Yang, Alexa Beiser, Ye Qiao, Emy A Thomas, Jose Rafael Romero, Tatjana Rundek, Adam M Brickman, Jennifer J Manly, Mitchell Sv Elkind, Sudha Seshadri, Christopher Chen, Saima Hilal, Bruce A Wasserman, Giuseppe Tosto, Myriam Fornage, Jose Gutierrez

Faculty, Staff and Student Publications

Background: Brain arterial diameters (BADs) are novel imaging biomarkers of cerebrovascular disease, cognitive decline, and dementia. Traditional vascular risk factors have been associated with BADs, but whether there may be genetic determinants of BADs is unknown.

Methods and results: The authors studied 4150 participants from 6 geographically diverse population-based cohorts (40% European, 14% African, 22% Hispanic, 24% Asian ancestries). Brain arterial diameters for 13 segments were measured and averaged to obtain a global measure of BADs as well as the posterior and anterior circulations. A genome-wide association study revealed 14 variants at one locus associated with global BAD at genome-wide …


Skills To Support Mental Health In Uncertain Times, Part 2: Cultivating Awareness, Heather H. Kelley, Rachel Byers, Ty Aller, Timothy Keady Dec 2023

Skills To Support Mental Health In Uncertain Times, Part 2: Cultivating Awareness, Heather H. Kelley, Rachel Byers, Ty Aller, Timothy Keady

All Current Publications

Uncertainty and worry can be a common struggle for many people, whether they are uncertain about their jobs, health, or relationships. Events such as COVID-19 and the recent wars in Israel and Ukraine increase the stress and uncertainty many people face. This fact sheet discusses awareness, a fundamental part of psychological flexibility, which can help individuals maintain a high quality of life—even when experiencing uncertainty and mental health concerns.


Feasibility Of Electronic Medication Monitoring Among Adolescents And Emerging Adults With Sickle Cell Disease, Aimee Hildenbrand, Katherine Kidwell, Meghan Mcgrady, Constance Mara, Charles Quinn, Lori Crosby Dec 2023

Feasibility Of Electronic Medication Monitoring Among Adolescents And Emerging Adults With Sickle Cell Disease, Aimee Hildenbrand, Katherine Kidwell, Meghan Mcgrady, Constance Mara, Charles Quinn, Lori Crosby

Department of Pediatrics Faculty Papers

Purpose: To examine the feasibility of using MEMS® bottles to assess adherence among adolescents and emerging adults with sickle cell disease.

Patients and Methods: Eighteen non-Hispanic Black participants with HbSS (M = 17.8 years; 61% male) were given a MEMS® bottle to store hydroxyurea (n = 14) or deferasirox (n = 4).

Results: One hundred percent initiated MEMS® use and 61% sustained use through the 18-week study; at follow-up, only 11% returned their bottle on time. Barriers to MEMS® use included medication changes and transition to adult care; facilitators included tip sheets and reminders.

Conclusion: While MEMS® is acceptable to …


An Efficacy And Safety Evaluation Of Montelukast + Fluticasone Propionate Vs Fluticasone Propionate In The Treatment Of Cough Variant Asthma In Children: A Meta-Analysis, Zhengbo Wei, Sheng Li Dec 2023

An Efficacy And Safety Evaluation Of Montelukast + Fluticasone Propionate Vs Fluticasone Propionate In The Treatment Of Cough Variant Asthma In Children: A Meta-Analysis, Zhengbo Wei, Sheng Li

Faculty, Staff and Student Publications

PURPOSE: This study aimed to evaluate the efficacy and safety of montelukast (Mon) + fluticasone propionate (Flu) versus Flu in the treatment of cough variant asthma (CVA) in children.

METHODS: Eligible documents were selected from various databases. Weighted mean difference (WMD) and 95% confidence interval (CI) were used to evaluate continuous variables, and categorical variables were evaluated using risk ratio (RR) and 95% CI. Heterogeneity analysis was performed using Cochran's Q test and I

RESULTS: Nine studies were included, and Flu + Mon was found to significantly improve the total effective rate and reduce cough recurrence compared to Flu. The …


County-Level Cardiologist Density And Mortality In The United States, Abdul Mannan Khan Minhas, Purvi Parwani, Marat Fudim, Salim S Virani, Sadiya S Khan, Michael W Cullen, Arunima Misra, Christie Ballantyne, Vijay Nambi, Dmitry Abramov Dec 2023

County-Level Cardiologist Density And Mortality In The United States, Abdul Mannan Khan Minhas, Purvi Parwani, Marat Fudim, Salim S Virani, Sadiya S Khan, Michael W Cullen, Arunima Misra, Christie Ballantyne, Vijay Nambi, Dmitry Abramov

Faculty, Staff and Students Publications

No abstract provided.


Neonatal Survival After Serial Amnioinfusions For Bilateral Renal Agenesis: The Renal Anhydramnios Fetal Therapy Trial, Jena L Miller, Ahmet A Baschat, Mara Rosner, Yair J Blumenfeld, Julie S Moldenhauer, Anthony Johnson, Mauro H Schenone, Michael V Zaretsky, Ramen H Chmait, Juan M Gonzalez, Russell S Miller, Anita J Moon-Grady, Ellen Bendel-Stenzel, Amaris M Keiser, Radhika Avadhani, Angie C Jelin, Jonathan M Davis, Daniel S Warren, Daniel F Hanley, Joslynn A Watkins, Joshua Samuels, Jeremy Sugarman, Meredith A Atkinson Dec 2023

Neonatal Survival After Serial Amnioinfusions For Bilateral Renal Agenesis: The Renal Anhydramnios Fetal Therapy Trial, Jena L Miller, Ahmet A Baschat, Mara Rosner, Yair J Blumenfeld, Julie S Moldenhauer, Anthony Johnson, Mauro H Schenone, Michael V Zaretsky, Ramen H Chmait, Juan M Gonzalez, Russell S Miller, Anita J Moon-Grady, Ellen Bendel-Stenzel, Amaris M Keiser, Radhika Avadhani, Angie C Jelin, Jonathan M Davis, Daniel S Warren, Daniel F Hanley, Joslynn A Watkins, Joshua Samuels, Jeremy Sugarman, Meredith A Atkinson

Faculty, Staff and Student Publications

IMPORTANCE: Early anhydramnios during pregnancy, resulting from fetal bilateral renal agenesis, causes lethal pulmonary hypoplasia in neonates. Restoring amniotic fluid via serial amnioinfusions may promote lung development, enabling survival.

OBJECTIVE: To assess neonatal outcomes of serial amnioinfusions initiated before 26 weeks' gestation to mitigate lethal pulmonary hypoplasia.

DESIGN, SETTING, AND PARTICIPANTS: Prospective, nonrandomized clinical trial conducted at 9 US fetal therapy centers between December 2018 and July 2022. Outcomes are reported for 21 maternal-fetal pairs with confirmed anhydramnios due to isolated fetal bilateral renal agenesis without other identified congenital anomalies.

EXPOSURE: Enrolled participants initiated ultrasound-guided percutaneous amnioinfusions of isotonic fluid …


Association Between Remote Monitoring And Interstage Morbidity And Death In Patients With Single-Ventricle Heart Disease Across Socioeconomic Groups., Bianca Cherestal, Lori A. Erickson, Janelle R. Noel-Macdonnell Phd, Girish S. Shirali, Hayley S. Hancock, Doaa Aly, Matthew Files, Sarah Clauss, Natalie Jayaram Dec 2023

Association Between Remote Monitoring And Interstage Morbidity And Death In Patients With Single-Ventricle Heart Disease Across Socioeconomic Groups., Bianca Cherestal, Lori A. Erickson, Janelle R. Noel-Macdonnell Phd, Girish S. Shirali, Hayley S. Hancock, Doaa Aly, Matthew Files, Sarah Clauss, Natalie Jayaram

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Despite improvements in survival over time, the mortality rate for infants with single-ventricle heart disease remains high. Infants of low socioeconomic status (SES) are particularly vulnerable. We sought to determine whether use of a novel remote monitoring program, the Cardiac High Acuity Monitoring Program, mitigates differences in outcomes by SES.

METHODS AND RESULTS: Within the Cardiac High Acuity Monitoring Program, we identified 610 infants across 11 centers from 2014 to 2021. All enrolled families had access to a mobile application allowing for near-instantaneous transfer of patient information to the care team. Patients were divided into SES tertiles on the …


Variability In Provider Assessment Of Sepsis And Potential Of Host Response Technology To Address This Dilemma—Results Of An Online Delphi Study, Chadd K. Kraus, Hollis R. O’Neal, Nathan A. Ledeboer, Todd W. Rice, Wesley H. Self, Richard E. Rothman Dec 2023

Variability In Provider Assessment Of Sepsis And Potential Of Host Response Technology To Address This Dilemma—Results Of An Online Delphi Study, Chadd K. Kraus, Hollis R. O’Neal, Nathan A. Ledeboer, Todd W. Rice, Wesley H. Self, Richard E. Rothman

School of Medicine Faculty Publications

Potentially septic patients have a huge clinical and economic impact on hospitals and often present to the emergency department (ED) with undifferentiated symptoms. The triage of these patients is complex and has historically relied heavily upon provider judgment. This study aims to evaluate the consistency of provider judgment and the potential of a new host response sepsis test to aid in the triage process. A modified Delphi study involving 26 participants from multiple specialties was conducted to evaluate provider agreement about sepsis risk and to test proposed actions based on the results of a sepsis test. The participants considered case …


Trends In Ductus Arteriosus Stent Versus Blalock-Taussig-Thomas Shunt Use And Comparison Of Cost, Length Of Stay, And Short-Term Outcomes In Neonates With Ductal-Dependent Pulmonary Blood Flow: An Observational Study Using The Pediatric Health Information Systems Database, Bethan A Lemley, Lezhou Wu, Amy L Roberts, Russell T Shinohara, William O Quarshie, Athar M Qureshi, Christopher L Smith, Yoav Dori, Matthew J Gillespie, Jonathan J Rome, Andrew C Glatz, Sandra Amaral, Michael L O'Byrne Dec 2023

Trends In Ductus Arteriosus Stent Versus Blalock-Taussig-Thomas Shunt Use And Comparison Of Cost, Length Of Stay, And Short-Term Outcomes In Neonates With Ductal-Dependent Pulmonary Blood Flow: An Observational Study Using The Pediatric Health Information Systems Database, Bethan A Lemley, Lezhou Wu, Amy L Roberts, Russell T Shinohara, William O Quarshie, Athar M Qureshi, Christopher L Smith, Yoav Dori, Matthew J Gillespie, Jonathan J Rome, Andrew C Glatz, Sandra Amaral, Michael L O'Byrne

Faculty, Staff and Students Publications

Background: The modified Blalock-Taussig-Thomas shunt is the gold standard palliation for securing pulmonary blood flow in infants with ductal-dependent pulmonary blood flow. Recently, the ductus arteriosus stent (DAS) has become a viable alternative.

Methods and results: This was a retrospective multicenter study of neonates ≤30 days undergoing DAS or Blalock-Taussig-Thomas shunt placement between January 1, 2017 and December 31, 2020 at hospitals reporting to the Pediatric Health Information Systems database. We performed generalized linear mixed-effects modeling to evaluate trends in intervention and intercenter variation, propensity score adjustment and inverse probability weighting with linear mixed-effects modeling to analyze length of stay …


Acss2 Gene Variants Determine Kidney Disease Risk By Controlling De Novo Lipogenesis In Kidney Tubules, Dhanunjay Mukhi, Lingzhi Li, Hongbo Liu, Tomohito Doke, Lakshmi P Kolligundla, Eunji Ha, Konstantin Kloetzer, Amin Abedini, Sarmistha Mukherjee, Junnan Wu, Poonam Dhillon, Hailong Hu, Dongyin Guan, Katsuhiko Funai, Kahealani Uehara, Paul M Titchenell, Joseph A Baur, Kathryn E Wellen, Katalin Susztak Dec 2023

Acss2 Gene Variants Determine Kidney Disease Risk By Controlling De Novo Lipogenesis In Kidney Tubules, Dhanunjay Mukhi, Lingzhi Li, Hongbo Liu, Tomohito Doke, Lakshmi P Kolligundla, Eunji Ha, Konstantin Kloetzer, Amin Abedini, Sarmistha Mukherjee, Junnan Wu, Poonam Dhillon, Hailong Hu, Dongyin Guan, Katsuhiko Funai, Kahealani Uehara, Paul M Titchenell, Joseph A Baur, Kathryn E Wellen, Katalin Susztak

Faculty, Staff and Students Publications

Worldwide, over 800 million people are affected by kidney disease, yet its pathogenesis remains elusive, hindering the development of novel therapeutics. In this study, we used kidney-specific expression of quantitative traits and single-nucleus open chromatin analysis to show that genetic variants linked to kidney dysfunction on chromosome 20 target the acyl-CoA synthetase short-chain family 2 (ACSS2). By generating ACSS2-KO mice, we demonstrated their protection from kidney fibrosis in multiple disease models. Our analysis of primary tubular cells revealed that ACSS2 regulated de novo lipogenesis (DNL), causing NADPH depletion and increasing ROS levels, ultimately leading to NLRP3-dependent pyroptosis. Additionally, we discovered …


Dna Methylation-Mediated Rbpjk Suppression Protects Against Fracture Nonunion Caused By Systemic Inflammation, Ding Xiao, Liang Fang, Zhongting Liu, Yonghua He, Jun Ying, Haocheng Qin, Aiwu Lu, Meng Shi, Tiandao Li, Bo Zhang, Jianjun Guan, Cuicui Wang, Yousef Abu-Amer, Jie Shen Dec 2023

Dna Methylation-Mediated Rbpjk Suppression Protects Against Fracture Nonunion Caused By Systemic Inflammation, Ding Xiao, Liang Fang, Zhongting Liu, Yonghua He, Jun Ying, Haocheng Qin, Aiwu Lu, Meng Shi, Tiandao Li, Bo Zhang, Jianjun Guan, Cuicui Wang, Yousef Abu-Amer, Jie Shen

2020-Current year OA Pubs

Challenging skeletal repairs are frequently seen in patients experiencing systemic inflammation. To tackle the complexity and heterogeneity of the skeletal repair process, we performed single-cell RNA sequencing and revealed that progenitor cells were one of the major lineages responsive to elevated inflammation and this response adversely affected progenitor differentiation by upregulation of Rbpjk in fracture nonunion. We then validated the interplay between inflammation (via constitutive activation of Ikk2, Ikk2ca) and Rbpjk specifically in progenitors by using genetic animal models. Focusing on epigenetic regulation, we identified Rbpjk as a direct target of Dnmt3b. Mechanistically, inflammation decreased Dnmt3b expression in progenitor cells, …


Teacher, Gatekeeper, Or Team Member: Supervisor Positioning In Programmatic Assessment, Janica Jamieson, Simone Gibson, Margaret Hay, Claire Palermo Dec 2023

Teacher, Gatekeeper, Or Team Member: Supervisor Positioning In Programmatic Assessment, Janica Jamieson, Simone Gibson, Margaret Hay, Claire Palermo

Research outputs 2022 to 2026

Competency-based assessment is undergoing an evolution with the popularisation of programmatic assessment. Fundamental to programmatic assessment are the attributes and buy-in of the people participating in the system. Our previous research revealed unspoken, yet influential, cultural and relationship dynamics that interact with programmatic assessment to influence success. Pulling at this thread, we conducted secondary analysis of focus groups and interviews (n = 44 supervisors) using the critical lens of Positioning Theory to explore how workplace supervisors experienced and perceived their positioning within programmatic assessment. We found that supervisors positioned themselves in two of three ways. First, supervisors universally positioned themselves …


From Mother To Infant, From Placenta To Gut: Understanding Varied Microbiome Profiles In Neonates, Riadh Cheddadi, Venkata Yeramilli, Colin Martin Dec 2023

From Mother To Infant, From Placenta To Gut: Understanding Varied Microbiome Profiles In Neonates, Riadh Cheddadi, Venkata Yeramilli, Colin Martin

2020-Current year OA Pubs

The field of human microbiome and gut microbial diversity research has witnessed a profound transformation, driven by advances in omics technologies. These advancements have unveiled essential connections between microbiome alterations and severe conditions, prompting the development of new frameworks through epidemiological studies. Traditionally, it was believed that each individual harbored unique microbial communities acquired early in life, evolving over the course of their lifetime, with little acknowledgment of any prenatal microbial development, but recent research challenges this belief. The neonatal microbiome's onset, influenced by factors like delivery mode and maternal health, remains a subject of intense debate, hinting at potential …


Trends In Ductus Arteriosus Stent Versus Blalock-Taussig-Thomas Shunt Use And Comparison Of Cost, Length Of Stay, And Short-Term Outcomes In Neonates With Ductal-Dependent Pulmonary Blood Flow: An Observational Study Using The Pediatric Health Information Systems Database, Bethan A Lemley, Lezhou Wu, Amy L Roberts, Russell T Shinohara, William O Quarshie, Athar M Qureshi, Christopher L Smith, Yoav Dori, Matthew J Gillespie, Jonathan J Rome, Andrew C Glatz, Sandra Amaral, Michael L O'Byrne Dec 2023

Trends In Ductus Arteriosus Stent Versus Blalock-Taussig-Thomas Shunt Use And Comparison Of Cost, Length Of Stay, And Short-Term Outcomes In Neonates With Ductal-Dependent Pulmonary Blood Flow: An Observational Study Using The Pediatric Health Information Systems Database, Bethan A Lemley, Lezhou Wu, Amy L Roberts, Russell T Shinohara, William O Quarshie, Athar M Qureshi, Christopher L Smith, Yoav Dori, Matthew J Gillespie, Jonathan J Rome, Andrew C Glatz, Sandra Amaral, Michael L O'Byrne

2020-Current year OA Pubs

BACKGROUND: The modified Blalock-Taussig-Thomas shunt is the gold standard palliation for securing pulmonary blood flow in infants with ductal-dependent pulmonary blood flow. Recently, the ductus arteriosus stent (DAS) has become a viable alternative.

METHODS AND RESULTS: This was a retrospective multicenter study of neonates ≤30 days undergoing DAS or Blalock-Taussig-Thomas shunt placement between January 1, 2017 and December 31, 2020 at hospitals reporting to the Pediatric Health Information Systems database. We performed generalized linear mixed-effects modeling to evaluate trends in intervention and intercenter variation, propensity score adjustment and inverse probability weighting with linear mixed-effects modeling to analyze length of stay …


Role Of Sex In The Association Of Socioeconomic Status With Cardiovascular Health In Black Americans: The Jackson Heart Study, Joshua J Joseph, Amaris Williams, Rosevine A Azap, Songzhu Zhao, Guy Brock, David Kline, James B Odei, Randi Foraker, Mario Sims, Laprincess C Brewer, Darrell M Gray Ii, Timiya S Nolan Dec 2023

Role Of Sex In The Association Of Socioeconomic Status With Cardiovascular Health In Black Americans: The Jackson Heart Study, Joshua J Joseph, Amaris Williams, Rosevine A Azap, Songzhu Zhao, Guy Brock, David Kline, James B Odei, Randi Foraker, Mario Sims, Laprincess C Brewer, Darrell M Gray Ii, Timiya S Nolan

2020-Current year OA Pubs

BACKGROUND: Socioeconomic status (SES) is associated with cardiovascular health (CVH). Potential differences by sex in this association remain incompletely understood in Black Americans, where SES disparities are posited to be partially responsible for cardiovascular inequities. The association of SES measures (income, education, occupation, and insurance) with CVH scores was examined in the Jackson Heart Study.

METHODS AND RESULTS: American Heart Association CVH components (non-high-density-lipoprotein cholesterol, blood pressure, diet, tobacco use, physical activity, sleep, glycemia, and body mass index) were scored cross-sectionally at baseline (scale: 0-100). Differences in CVH and 95% CIs (Estimate, 95% CI) were calculated using linear regression, adjusting …


What We Know About School-Based Health Centers: Literature On Outcomes, Cost Impact, Implementation, And Sustainability, Michelle R. Coble, Valerie F. Mcdaniel Dec 2023

What We Know About School-Based Health Centers: Literature On Outcomes, Cost Impact, Implementation, And Sustainability, Michelle R. Coble, Valerie F. Mcdaniel

Pacific Journal of Health

Many children lack access to adequate healthcare in the United States. School Based Health Centers (SBHC) are a useful resource for accessing those needed services. The purpose of this study is to evaluate the available research for the strengths of SBHCs with improving health outcomes and health equity, cost impact of SBHCs, and best practices for implementing and sustaining an SBHC. The focus of this study was on reviewing the current literature on the impact of SBHCs on improving health equity, health outcomes, cost impact, and to establish best practices for implementing and sustaining an SBHC. Although the current literature …


Utilizing Mock Code Simulation To Enhance Nurses’ Confidence A Benchmark Project, Denecia Mark Dec 2023

Utilizing Mock Code Simulation To Enhance Nurses’ Confidence A Benchmark Project, Denecia Mark

MSN Capstone Projects

Each year, about 292,000 adult patients in the United States have an in-hospital cardiac arrest (IHCA), with substantial variance in their rate of survival (Merchant et al., 2020). Graduate nurses must be knowledgeable and prepared to respond to codes. Mock Codes or simulation-based teaching will allow nurses to practice skills, expand their knowledge, and gain self-confidence in a secure and controlled setting with no risk to patients, reducing nurses' anxiety. CPR certification is currently updated every two years, and research has shown that learned skills begin to deteriorate after three months. As a result, if simulated codes are introduced skills …


Prevention Of Medical Device-Related Pressure Injuries: A Quality Improvement Project, Monika Grzelczak Dec 2023

Prevention Of Medical Device-Related Pressure Injuries: A Quality Improvement Project, Monika Grzelczak

DNP Projects

Significance and Background: Hospital-acquired pressure injuries (HAPI) continued to rise, costing the healthcare system about $ 11 billion annually. Medical device-related pressure injuries (MDRPI) account for about 10% of HAPI. They are also noted to be on the rise, especially in the Intensive Care Units (ICU), where multiple medical devices are placed on patients for monitoring and treatment. An intervention to reverse those unfavorable trends is needed. Evidence supports poster education to improve rates of MDRPI.

Purpose: This quality improvement project was conducted to eliminate incidents of MDRPI in the ICU and improve nurses’ perception of the importance of preventing …


Examining The Effect Of Financial Strain On Gpa In College Students​, Dayanara S. Sanchez-Nunez Dec 2023

Examining The Effect Of Financial Strain On Gpa In College Students​, Dayanara S. Sanchez-Nunez

[Archive] Belmont University Research Symposium (BURS)

The problem to be addressed in this study is the lack of attention to financial stress among college students. The purpose of this study was to examine the effect of financial strain on a college student’s GPA. The study had two aims: 1) to assess financial stress, including loans and the ability to pay for college, impact academic performance and 2) examine causes of financial strain including aid and loans. A cross-sectional survey assessed the effect of financial strain on academic performance among undergraduate students enrolled at Belmont University during the Fall 2023-2024 semester. The sample consisted of undergraduate students …


Developing A Blueprint For Health Equity Programs And Investigating Interventions And Metrics, Belita Strudwick Dec 2023

Developing A Blueprint For Health Equity Programs And Investigating Interventions And Metrics, Belita Strudwick

MUSC Theses and Dissertations

Racial and ethnic minority groups and rural and low-income populations are examples of populations who continue to experience health disparities despite policy mandates to eliminate them. This doctoral project will provide a foundational blueprint to aid health plans in addressing and improving health equity internally and with external stakeholders. The blueprint will be based on research comparing the robust health equity initiatives of four states to the NCQA national guidelines. The barriers to achieving and recommendations for advancing the field of health equity by implementing and analyzing policies and data that target health disparities through improved access to quality care …


Palliative Care Referral Protocol: Best Practice Toolkit For Improving Early Referral Rate For Adult Cancer Patients, Linda Dinh Nguyen Dec 2023

Palliative Care Referral Protocol: Best Practice Toolkit For Improving Early Referral Rate For Adult Cancer Patients, Linda Dinh Nguyen

Student Scholarly Projects

Despite the benefits of palliative care being well-documented in studies and early palliative care services being strongly recommended by reputable organizations, such as the American Society of Clinical Oncology, many patients did not receive or received late referrals (Pigni et al., 2022). This mainly occurs because oncologists commonly base their referrals on perceived needs and clinical judgment (Smith et al., 2017). Thus, this program development project aimed to create a toolkit to improve early identification and referral to palliative care for adult patients who would benefit from palliative care services. The PICO question that guides this program is: In ambulatory …


Agreement Between Published Reference Resources For Neurofilament Light Chain Levels In People With Multiple Sclerosis., Elias S Sotirchos, Chen Hu, Matthew D Smith, Hannah-Noelle Lord, Anna L Duval, Georgina Arrambide, Xavier Montalban, Katja Akgün, Tjalf Ziemssen, Robert T Naismith, Carrie M Hersh, Megan Hyland, Lauren B Krupp, Jacqueline A Nicholas, Robert A Bermel, Ellen M Mowry, Peter A Calabresi, Kathryn C Fitzgerald Dec 2023

Agreement Between Published Reference Resources For Neurofilament Light Chain Levels In People With Multiple Sclerosis., Elias S Sotirchos, Chen Hu, Matthew D Smith, Hannah-Noelle Lord, Anna L Duval, Georgina Arrambide, Xavier Montalban, Katja Akgün, Tjalf Ziemssen, Robert T Naismith, Carrie M Hersh, Megan Hyland, Lauren B Krupp, Jacqueline A Nicholas, Robert A Bermel, Ellen M Mowry, Peter A Calabresi, Kathryn C Fitzgerald

Neuroscience Articles

OBJECTIVES: To examine the agreement between published reference resources for neurofilament light chain (NfL) applied to a large population of people with multiple sclerosis (MS).

METHODS: Six published reference resources were used to classify NfL in participants in the Multiple Sclerosis Partners Advancing Technology and Health Solutions (MS PATHS) network as elevated or normal and to derive age-specific NfL

RESULTS: NfL measurements were assessed from 12,855 visits of 6,687 people with MS (median 2 samples per individual [range 1-7]). The mean ± SD age was 47.1 ± 11.7 years, 72.1% of participants were female, disease duration was 15.0 ± 10.6 …


Impact Of Self-Management Education On The Self-Efficacy Of People With Chronic Pain, Tanya Jones Dec 2023

Impact Of Self-Management Education On The Self-Efficacy Of People With Chronic Pain, Tanya Jones

Doctor of Nursing Practice Projects

Self-efficacy is a critical element in the self-management of chronic pain. Despite the traditional approaches to managing chronic pain, such as opioids, traditional methods have proven ineffective and often lead to addiction and misuse, contributing to the overwhelming and devastating opioid crisis. This quality improvement project aimed to reduce the knowledge gap among individuals between the ages of 18 and 75 who have chronic pain by producing data that illustrates that providing individuals with self-management education empowers them to understand and self-manage their pain. The concept of self-management education is grounded in Bandura's Social Cognitive Theory, which highlights the role …


Prevalence, Faunal Composition, And Vertical Distribution Of Bioluminescence In The Pelagic Gulf Of Mexico: Fishes, Crustaceans, Cephalopods And Gelatinous Megaplankton, Devynne M. Brown Dec 2023

Prevalence, Faunal Composition, And Vertical Distribution Of Bioluminescence In The Pelagic Gulf Of Mexico: Fishes, Crustaceans, Cephalopods And Gelatinous Megaplankton, Devynne M. Brown

All HCAS Student Capstones, Theses, and Dissertations

Bioluminescence is the phenomenon of light emission by living organisms. It occurs through a chemical reaction within an organism and serves various purposes. The diversity of bioluminescent capabilities and occurrence in unrelated taxa suggest that bioluminescence has evolved independently numerous times amongst taxa thriving in certain environments. One such environment is the deep ocean, where little to no sunlight penetrates the water column, specifically in the mesopelagic (200-1000 m depth) and bathypelagic (> 1000 m) zones. The mesopelagic and bathypelagic zones have been extensively sampled and well documented in the Gulf of Mexico (GoM), one of the few places globally …


Evaluating The Effectiveness Of The Internal Transcribed Sequences (Its) As Dna Barcodes To Estimate Fungal Diversity, Jailisa Linares Dec 2023

Evaluating The Effectiveness Of The Internal Transcribed Sequences (Its) As Dna Barcodes To Estimate Fungal Diversity, Jailisa Linares

All HCAS Student Capstones, Theses, and Dissertations

Universal phylogenetic markers such as the nuclear ribosomal internal transcribed sequences (ITS), specifically ITS1 and ITS2, are routinely used to estimate fungal diversity in environmental samples. However, numerous studies report differences in the performance and efficacy of ITS1 and ITS2 in documenting fungal diversity. To better understand the implications of using ITS1 versus ITS2, a comprehensive representation of the diverse fungal taxa was necessary to conduct a meta-analysis of their use across multiple fungal taxa. In order to address this, a thorough literature review was conducted to compare and contrast the use of ITS1 and ITS2 as effective DNA barcodes. …


Benchmark Study Of Early Palliative Care In End-Stage Liver Disease, Pebble Ward Dec 2023

Benchmark Study Of Early Palliative Care In End-Stage Liver Disease, Pebble Ward

MSN Capstone Projects

Patients with ESLD in general have high rates of healthcare utilization, resulting in more than 250,000 hospitalizations at $9.8 billion annually in the United States (Ufere et al., 2019). Liver disease is a rising cause of death worldwide, affecting younger people, but palliative care is largely absent for these patients (Kimball et al. 2018). Early readmissions are common for patients with ESLD and in the U.S. alone, over 25% of patients are readmitted within 30 days of their initial diagnosis, rates that now exceed those seen for patients with CHF and COPD (Ufere et al. 2019). Evidence shows that early …


Implementing A Foot Screening Project For Diabetic Patients In An Assisted Living Facility, Beatrice L. Bailey Dec 2023

Implementing A Foot Screening Project For Diabetic Patients In An Assisted Living Facility, Beatrice L. Bailey

Doctor of Nursing Practice Projects

Diabetes impacts around 422 million individuals globally, resulting in 1.5 million reported annual deaths. Type 2 diabetes affects approximately 35.4% of the population in the United States, with 1.4 million new cases identified each year. When not managed properly, diabetes can spiral into a long list of complications. Among the various challenges in diabetes management, foot complications stand out as significant and often avoidable. Without proper attention, these complications can lead to severe health issues. To address this concern, this project focuses on resolving standard foot inspection practices within an assisted living facility in central Mississippi. The goal is to …


Improving Outcomes For Women Following Gynecological Surgery Through Implementation Of Multimodal Analgesia As Part Of An Enhanced Recovery After Surgery (Eras) Protocol, Shannan M. Case Dec 2023

Improving Outcomes For Women Following Gynecological Surgery Through Implementation Of Multimodal Analgesia As Part Of An Enhanced Recovery After Surgery (Eras) Protocol, Shannan M. Case

Doctor of Nursing Practice Projects

The opioid epidemic in the United States has been a continuous public health crisis, as opioid-associated overdose has become one of the leading causes of death. The risk of opioid misuse increases following exposure to opioids perioperatively. As a result, anesthesia providers are facing a significant shift in practice to decrease opioid administration while adequately managing perioperative pain. While opioids have historically been the mainstream for perioperative pain management, multimodal analgesic (MMA) regimens as part of Enhanced Recovery After Surgery (ERAS) programs are being utilized as alternative methods. With these programs, opioids are reduced by administering non-opioids with neuraxial and …


The Effects Of Diet And Exercise On Menopause Symptoms And Symptom Severity, Nicole Crowder Dec 2023

The Effects Of Diet And Exercise On Menopause Symptoms And Symptom Severity, Nicole Crowder

Doctor of Nursing Practice Projects

Menopause is a phase of life that occurs between the ages of 45-50 years and can last from 7-10 years or longer. The purpose of this quality improvement project was to develop a clinical protocol of assessments not currently completed to decrease the common symptoms of menopause such as hot flashes by implementing dietary changes and exercise as a weekly routine to decrease menopause symptoms. Participation was solicited at a private primary care clinic to women aged 40 and older over a 6-week period. BMI was calculated, documented, and completed surveys were retuned at check-out, with no identifiers and deposited …


Sepsis Criteria On Triage (Scot): Sepsis Alert, Kristie Givens Dec 2023

Sepsis Criteria On Triage (Scot): Sepsis Alert, Kristie Givens

Doctor of Nursing Practice Projects

Sepsis is a serious life-threatening condition that kills hundreds of thousands of patients every year and is a major leading cause of death. Sepsis is a medical emergency where early identification and prompt treatment are crucial for survival. Despite assessment tools for early recognition, a delay in antibiotic therapy remains. A sepsis alert (Code Sepsis) in the emergency department could improve sepsis care, spare countless lives, and save billions of dollars nationwide, annually. The implementation of a Code Sepsis will trigger a team to deliver immediate treatment and ensure one hour antibiotic administration times. The John Hopkins Nursing Evidence-Based Practice …