Medicine and Health Sciences Commons^™

Penicillin Allergy De-Labeling: Evaluating A Health System’S Implementation Of The Pen-Fast Tool Within An Infectious Disease Clinic., Jennifer Mccarthy Pharmd, Ms

Pharmacy Residency

Presented at the Great Lakes Pharmacy Residents Conference. West Lafayette, IN: April 2024.

This retrospective, post-implementation study found that 81% of patients with a documented penicillin allergy could be de-labeled, and that the majority could theoretically tolerate a penicillin challenge.

Identifying Improvement Opportunities For The Utilization Of Carbapenems At A Community Health System., Kendra Yarian Pharmd

Pharmacy Residency

Presented at the Great Lakes Pharmacy Resident Conference. West Lafayette, IN: April 2024.

This study found opportunities to improve utilization of carbapenems, such as by delabeling inappropriate penicillin and cephalosporin allergies, modifying order sets, providing education, and initiating alerts to prompt de-escalation.

Association Between Psychosocial Acuity And Glycemic Control In A Pediatric Type 1 Diabetes Clinic., Joseph Wardell, Dana K. Albright Phd, Claire Chang, Melissa A Plegue, Jung Eun Lee, Emily Hirschfeld, Ashley Garrity, Joyce M Lee, Melissa Dejonckheere

Health Services and Informatics Research

PURPOSE: The purpose of this study was to describe the frequency of psychosocial risk and its associations with glycemic levels in youth with type 1 diabetes (T1D) seen by social work staff during regular clinical care.

METHODS: A retrospective longitudinal analysis of observational clinical data was conducted. Individuals (1-26 years) with known T1D who were seen at a pediatric diabetes clinic in a US academic medical center between 2014 and 2021 were included. Variables included psychosocial acuity, A1C, and demographic characteristics. Chi-square tests, Wilcoxon rank sum tests, and mixed linear regressions were used to examine associations between demographic variables, psychosocial …

Developmental Programming Of Normal Versus Metabolically Altered Pancreas In Rat: Effect Of Gestational Diabetes, Sanabil Ali Ahmed

Dissertations

Diabetes Mellitus (DM) is a chronic condition characterised by pancreatic β-cell dysfunction and consistently elevated blood glucose levels (hyperglycaemia), either due to the inability of the body to produce any or adequate amounts of insulin or the inability of the body to effectively utilise the produced insulin (i.e., insulin resistance). DM can be classified into 3 main types: Type 1 DM (T1DM), Type 2 DM (T2DM), and Gestational Diabetes Mellitus (GDM). GDM is defined as “hyperglycaemia that is first diagnosed during pregnancy with glucose levels below those considered diagnostic of overt diabetes outside of pregnancy”.

The mature pancreas is a …

Prevalence And Risk Factors Of Hikikomori In Young Adults In The Middle East, Harshil Paresh Shah

Theses

Hikikomori, a form of severe social withdrawal that can occur without the presence of any other psychological disorder, was once thought to be a Japanese culture-bound phenomena. However, studies have emerged from several parts of the world showing that this may be a global issue. Extant literature suggests associations between hikikomori and behavioral addictions such as gaming addiction and Problematic Social Media Use (PSMU). Since there is a relative paucity of research examining this phenomenon in the Middle Eastern context, this study aimed to determine the prevalence and risk factors of hikikomori in young adults of the Middle East. It …

Lamina Cribrosa Insertions Into The Sclera Are Sparser, Narrower, And More Slanted In The Anterior Lamina, Fengting Ji, Mohammad R. Islam, Bingrui Wang, Yi Hua, Ian A. Sigal

Mechanical Engineering Faculty Publications

Purpose: The lamina cribrosa (LC) depends on the sclera for support. The support must be provided through the LC insertions. Although a continuous insertion over the whole LC periphery is often assumed, LC insertions are actually discrete locations where LC collagenous beams meet the sclera. We hypothesized that LC insertions vary in number, size, and shape by quadrant and depth.

Methods: Coronal cryosections through the full LCs from six healthy monkey eyes were imaged using instant polarized light microscopy. The images were registered into a stack, on which we manually marked LC insertion outlines, nothing their position in-depth and quadrant …

Preventing And Responding To Workplace Violence In The Emergency Department, Janina La Porte, Stefanie Lai, Alicia Rodriguez

Articles, Abstracts, and Reports

No abstract provided.

Fall Prevention Quality Initiative: Implementation Of Fall Ambassador Safety Team (F.A.S.T.), Jerome Codilla, Joanna Arraiza, Joanna Felix-Mendez, Grace Marie Rillorta, Isabel Shellburne-Vargas

Articles, Abstracts, and Reports

No abstract provided.

Perceived Moral Distress Among Patient-Facing Healthcare Professionals During The Covid-19 Pandemic, Sarah Sumner, Karen Colorafi, Teresa Rangel

Articles, Abstracts, and Reports

No abstract provided.

Multicenter Study Of Long-Term Outcomes And Quality Of Life In Phace Syndrome After Age 10., Mitchell Braun, Ilona J. Frieden, Dawn H. Siegel, Elizabeth George, Christopher P. Hess, Christine K. Fox, Sarah L. Chamlin, Beth A. Drolet, Denise Metry, Elena Pope, Julie Powell, Kristen Holland, Caden Ulschmid, Marilyn G. Liang, Kelly K. Barry, Tina Ho, Chantal Cotter, Eulalia Baselga, David Bosquez, Surabhi Neerendranath Jain, Jordan K. Bui, Irene Lara-Corrales, Tracy Funk, Alison Small, Wenelia Baghoomian, Albert C. Yan, James R. Treat, Griffin Stockton Hogrogian, Charles Huang, Anita Haggstrom, Mary List, Catherine C. Mccuaig, Victoria Barrio, Anthony J. Mancini, Leslie P. Lawley, Kerrie Grunnet-Satcher, Kimberly A. Horii, Brandon D. Newell, Amy J. Nopper, Maria C. Garzon, Margaret E. Scollan, Erin F. Mathes

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To characterize long-term outcomes of PHACE syndrome.

STUDY DESIGN: Multicenter study with cross-sectional interviews and chart review of individuals with definite PHACE syndrome ≥10 years of age. Data from charts were collected across multiple PHACE-related topics. Data not available in charts were collected from patients directly. Likert scales were used to assess the impact of specific findings. Patient-Reported Outcomes Measurement Information System (PROMIS) scales were used to assess quality of life domains.

RESULTS: A total of 104/153 (68%) individuals contacted participated in the study at a median of 14 years of age (range 10-77 years). There were infantile hemangioma …

Policymaker's Perspectives And Student Experiences Of Bullying At Schools In The Uae: A Mixed-Method Approach, Alfan Saghayir Alketbi

Dissertations

Bullying is a significant issue in schools worldwide, including Abu Dhabi, the UAE. This dissertation aims to explore the dynamics of school bullying and improve anti-bullying interventions through a mixed-method approach. The primary goal is to investigate current anti-bullying efforts in the UAE and develop a comprehensive framework for school-based bullying intervention, considering policymaker perspectives and student experiences.

The study includes a systematic scoping review, qualitative studies with policymakers, a SWOT analysis of Abu Dhabi's anti-bullying approaches, and a cross-sectional survey of students' perceptions, attitudes, and awareness in Al-Ain City. These methods provide an integrated view of bullying in the …

Public Health Emergency Management For Interprofessional Learners: Development Of A Curriculum, Terry D. Cooper

Health Science Doctoral Thesis

In our world, hazards and disasters are becoming more frequent and destructive. The impacts that disasters have on physical, mental, and environmental health are substantial and can be devastating. Responding to and recovering from disasters with increasing complexities requires interdisciplinary teams with the knowledge, skills, and attitudes that transcend several fields. This thesis aims to investigate the essential educational factors of interprofessional education (IPE) to inform the development of an effective curriculum that implements IPE for education in public health emergency management (PHEM). The thesis was supported by a quantitative survey with open-ended questions. Curriculum development followed the Kern 6-step …

Understanding The Role Of Adverse Childhood Experiences On Resilience In Police Officers, Wayne F. Handley

Counseling & Human Services Theses & Dissertations

Police officers are subject to a variety of stressors not only from job-related events resulting from direct or vicarious trauma exposure (Andersen & Papazoglou, 2014; Brown et al., 1999; Iversen et al., 2008) but also from family and personal concerns (Burke, 1998; Page & Jacobs, 2011), and administrative pressures originating from within their own agencies (Violanti et al., 2018; White et al., 2016). Prior to their careers as police officers, individuals may also be exposed to traumatic events early in life. Adverse Childhood Experiences (ACEs) are described as negative events related to emotional, physical, or sexual abuse or neglect, exposure …

The Design Of A Quality Improvement Dashboard For Monitoring Spinal Cord And Column Injuries, Zahra Azadmanjir, Mohsen Sadeghi-Naini, Mohammad Dashtkoohi, Maziar Moradi-Lakeh, Jalil Arabkheradmand, James Harrop, Vafa Rahimi-Movaghar

Department of Neurosurgery Faculty Papers

Background: Interactive dashboards are a powerful tool for dynamic visualization and monitoring of patient performance and serve as a useful to for optimal decision-making. The National Spinal Column and Cord Injury Registry of Iran (NSCIR-IR) was designed to efficiently display and broadcast important patient care data. This has been achieved through an electronic dashboard display (graph and visual displays), rather than traditional static paper reports (text). Objectives: The objective of this study was to design and develop an electronic visual dashboard as a display system to monitor the quality of care in the NSCIR-IR collaborating centers. Methods: The indicators chosen …

Exploring The Experiences Of School Counselors Advocating For Social Justice Within Urban Pk-12 Charter Schools, Betsy Marina Perez

Counseling & Human Services Theses & Dissertations

School counselors serve students’ academic, career, and social/emotional needs through a comprehensive school counseling program, and center their work on concepts of equity, advocacy, social justice, and systemic change, to remove barriers and increase opportunities for all PK-12 students. Charter schools are also unique public school settings as they offer flexibility, innovation, and autonomy to staff to create individualized experiences for their students. Held in common by these two educational services is the commitment to serving the needs of historically marginalized populations (Black, Indigenous, People of Color [BIPOC] and those from low socioeconomic backgrounds) and the opportunity to advocate for …

Supervision Needs Of Novice Behavioral Health Providers In Integrated Primary Care Settings: A Delphi Study, Nicholas D. Schmoyer

Counseling & Human Services Theses & Dissertations

The integration of behavioral health providers (BHPs, i.e., clinical mental health counselors, clinical psychologists, clinical social workers, marriage and family therapists) into primary care settings has developed as a healthcare practice associated with enhanced patient clinical outcomes, enhanced patient satisfaction, reduced healthcare expenditures, and enhanced provider wellness and satisfaction, known together as the Quadruple Aim. For BHPs practicing in integrated primary care (IPC) settings, researchers have highlighted a variety of challenges they experience when integrating in these settings, with a consistent challenge being a lack of satisfactory training and supervision. Clinical supervision has been hailed as the “signature pedagogy” for …

Consensus On Best Practices In Neuroscience-Informed Treatment Of Combat-Related Posttraumatic Stress In Military Veterans: A Delphi Study Of Experts In The Field Of Mental Health, Danielle Lauren Winters

Counseling & Human Services Theses & Dissertations

The purpose of this study was to capture consensus among mental health professionals who work with combat trauma-afflicted veterans and/or utilize a neuroscience-informed counseling approach, about a set of best practices for uniting neuroscience-informed treatment modalities with the treatment of veterans who present with Post Traumatic Stress (PTS). A multi-round Delphi study was used to elicit information from mental health professionals, which led to the proposition of ways in which mental health professionals may more efficiently work with combat veterans while utilizing neuroscience-informed treatments such as Prolonged Exposure Therapy, Eye Movement Desensitization and Reprocessing (EMDR) neuro-informed Cognitive Behavioral therapy (nCBT), …

The Lived Experiences Of Counselors-In-Training Completing Practicum And Internship During Covid-19, Shelby Lauren Dillingham

Counseling & Human Services Theses & Dissertations

COVID-19’s classification as a pandemic in March 2020 changed numerous professions as they adjusted to social distancing expectations. Mental health providers particularly encountered transitions that included higher acuity caseloads, working different hours, and increased exposure to COVID-19. Counselors-in-training (CIT) faced the dilemma of earning their clinical hours in a safe manner, especially CITs working within integrated healthcare settings, such as hospitals or clinics. Despite some research with licensed professional counselors, limited research exists examining CITs' experiences working during the COVID-19 pandemic. This study sought to understand the lived experiences of CITs who completed their clinical hours in an integrated behavioral …

Partners In Crisis: A Phenomenological Exploration Of Collaboration Between Crisis Intervention Team Officers And Mental Health Professionals, Jessica L. Huffman

Counseling & Human Services Theses & Dissertations

Law enforcement officers (LEOs) are often the first responders to crisis situations, which increasingly include mental health crises. Collaborating with mental health professionals and organizations increases the likelihood that individuals will receive a response that is contextually and culturally informed by an understanding of mental health needs and considerations. For this reason, Crisis Intervention Teams (CIT) have been established to train LEOs and to unite efforts with mental health professionals, advocates, and community constituents. While there is existing and ongoing literature exploring the responses provided by CIT, there is limited research on the experiences of CITs related to their unique …

Palliative Care And Length Of Icu Admission, Grace Howard Rn, Briana Kramer Rn, Chloe Heslin Rn, Kyle Cleary Rn

Nurse Residency

Does incorporating palliative care influence the length of stay in intensive care patients?

Passenger Traits That Predict The Bystander Intervention Model Steps During An Inflight Assault On A Flight Attendant, Michael Pettit

Doctoral Dissertations and Master's Theses

Every major U.S. airline has experienced a violent inflight assault on one of their flight attendants. The problem is becoming more widespread, but industry leaders have few coping strategies. The first step toward addressing the issue is understanding the various aspects of the event, including the actions of other passengers (bystanders) who may witness the assault. There is ample literature on bystander reactions to similar events such as bullying, medical emergencies, injuries, and violent attacks, but none dedicated to a flight attendant assault or passenger reactions to it.

At the core of bystander action is the bystander effect, which postulates …

Effects Of Balance Training On Spinal Reflexive Excitability Modulation, Corticospinal Excitability, And Balance Performance In Individuals With Chronic Ankle Instability, Sunghoon Chung

Rehabilitation Sciences Theses & Dissertations

Chronic ankle instability (CAI) is a neurophysiologic deficit resulting in diverse sensorimotor impairments. Following acute ankle sprains, pain, mechanical instability, and joint deafferentation reduce sensory input to the central nervous system (CNS). In response, the CNS sends altered motor signals to lower extremity muscles. These CNS changes contribute to various neuromuscular impairments in CAI patients, the most common of which is reduced balance performance. Specifically, CAI patients struggle to modulate spinal reflex excitability of the soleus muscle when progressing from simpler to more complex balance tasks. This overreliance on spinal reflexes results in inconsistent activation of the ankle stabilizing muscle. …

Evaluation Of Dietary Probiotic Supplements On Methamphetamine-Induced Impulsive Action In Rats Maintained On A Differential Reinforcement Of Low Rate Schedule, Kaitlyn Steck

Masters Theses

Substance Use Disorder (SUD) is a chronic, debilitating condition often comorbid with anxiety and depression. Both SUD and affective disorders are characterized by cognitive dysfunction, including impaired decision-making and impulsivity. A mounting body of research implicates gut microbiome alterations as a contributing factor to the pathophysiology of affective disorders. No published studies have assessed behavioral effects of dietary interventions targeting psychostimulant-induced gut microbiome changes. The present study utilized a differential reinforcement of low rate responding schedule (DRL 18 s) as a behavioral index of drug-induced impulsive action to determine if a dietary probiotic supplement alters the behavioral effects of (+)-methamphetamine …

Toward A Patient-Partnered Model Of Clinical Trial Design: A Qualitative Descriptive Case Study Of The Duchenne Muscular Dystrophy Clinical Research Partnership, Jennifer Catena Davis

Doctor of Philosophy in Translational Health Sciences Dissertations

To provide actionable information about the safety and efficacy of new medications, clinical trials should be designed to test outcomes that patients find meaningful. This imperative is increasingly acknowledged by the scientific community and regulatory authorities and in recent years has been enshrined in regulatory guidance documents for industry; however, clinical trials often fail to adequately address patient priorities. Evidence suggests that partnerships between researchers and patient communities may result in clinical trials that better reflect the patient experience, but there are few successful models of such partnerships. Within the clinical research landscape, the Duchenne Muscular Dystrophy (DMD) community has …

Influence Of Novel Cyp2c-Haplotype On Proton Pump Inhibitor Pharmacokinetics In Children., Kathyrn Kyler, Andrea Gaedigk, Susan Abdel-Rahman, Vincent S. Staggs, Robin E. Pearce, Paul C. Toren, J Steven Leeder, Valentina Shakhnovich

Manuscripts, Articles, Book Chapters and Other Papers

In this brief report, we provide an analysis of the influence of a novel CYP2C haplotype (CYP2C:TG) on proton pump inhibitor (PPI) pharmacokinetics (PK) in children. The CYP2C:TG haplotype has been proposed to be associated with increased CYP2C19 activity. We sought to determine if this CYP2C:TG haplotype resulted in similar alterations in metabolism for proton pump inhibitors, which are primarily metabolized by CYP2C19. In a cohort of 41 children aged 6-21 participating in a PPI pharmacokinetic study, effects of the CYP2C:TG allele were assessed by fitting two linear regression models for each of the six PK outcomes assessed, the second …

Anesthesia Management For The Preeclampsia Or Hypertensive Parturient, Britanie Sumpter

Doctor of Nursing Practice Projects

Preeclampsia is a placental disease characterized by abnormal maternoplacental blood vessels and placental dysfunction resulting in fetoplacental hypoperfusion and maternal multi-system organ dysfunction (Wang et al., 2019). Expectant management of a hypertensive or preeclamptic parturient includes antihypertensive medications, magnesium sulfate for seizure prophylaxis, and early delivery of the fetus (ACOG, 2020). Neuraxial anesthetic-induced sympathectomy combined with circulating antihypertensives, magnesium sulfate therapy, and intravascular volume depletion in preeclampsia is thought to contribute to exaggerated hypotension.

Persistent refractory hypotension after neuraxial anesthesia in parturients with preeclampsia or hypertension has been an ongoing issue affecting obstetric providers at the host facility. This project …

Lung Cancer Screening In A Primary Care Clinic For Coal Mine, Glenda Mills, Sarah Cobb

Doctor of Nursing Practice Projects

Lung cancer is the leading cause of mortality for both men and women in the United States. Guidelines are set by the American Cancer Society for annual screenings of at-risk patients. Early identification of lung cancer risk and screening with low-dose CT scans can increase detection and treatment thereby reducing risk of death or disability. Coal miners are exposed to numerous cancer-causing agents, such as toxic chemicals, dust pollution from coal, and diesel exhaust fumes. However, primary care clinics serving coal miners lack lung cancer screenings despite the increased risk miners face. Patients were screened using criteria set forth by …

Enhanced Recovery After Surgery (Eras) Protocol For Bariatric Surgery, Krista Bunch

Doctor of Nursing Practice Projects

Bariatric surgery has been utilized in treating severe obesity and offers several benefits, such as sustainable weight loss, treatment of various metabolic comorbidities, and improved life expectancy (Sundbom et al., 2017). With these benefits and procedural improvements, there has been a marked increase in the demand for bariatric surgery and increased interest in shifting some of these procedures to an ambulatory care setting (Stenberg et al., 2022). However, postoperative complications such as pain, nausea, and inability to tolerate oral intake can cause patients to experience an increased length of stay in the hospital and suboptimal outcomes (King et al., 2018). …

Improvement In Patient Compliance For Gynecological Care, Tracee Williams

Doctor of Nursing Practice Projects

This quality improvement project implemented the patient-initiated follow-up (PIFU) pathway in a gynecology clinic setting. PIFU has potential to lead to decreased no-show appointments and increased patient autonomy in outpatient healthcare practices. Barriers that influence compliance with plans of care include lower socioeconomic status, racial and ethnic minorities, and unmet social needs such as food insecurity, healthcare travel and cost, and child/adult care needs. In addition to higher rates of no-show appointments, individuals facing these barriers have increased comorbidities. Prior to implementing the PIFU model, patients between the ages of 18 and 42 completed a patient satisfaction survey to better …

A Decade Of Churn Prediction Techniques In The Telco Domain: A Survey, Annalisa Barsotti, Gabriele Gianini, Corrado Mio, Jianyi Lin, Himanshi Babbar, Aman Singh, Fatma Taher, Ernesto Damiani

All Works

This work surveys the research contributions of the last decade to the prediction of customer churn and adds a perspective toward what is yet to be reached. The main objective of this article is to report on (1) the methods and algorithms studied, the evaluation metrics adopted, and the results achieved, (2) the data used, and (3) the issues and limitations identified. Furthermore, the work highlights the gaps in the current literature and suggests a direction for future research.