Medicine and Health Sciences Commons^™

Baseline Assessment Of Cervical Cancer Screening And Treatment Capacity In 25 Counties In Kenya, 2022, Valerian Mwenda, David Murage, Catherine Kilonzo, Joan-Paula Bor, Patricia Njiri, Lance Osiro, Mary Nyangasi, Marc Arbyn, Philippe Tummers, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: Cervical cancer is the leading cause of cancer deaths among women in Kenya. In the context of the Global strategy to accelerate the elimination of cervical cancer as a public health problem, Kenya is currently implementing screening and treatment scale-up. For effectively tracking the scale-up, a baseline assessment of cervical cancer screening and treatment service availability and readiness was conducted in 25 priority counties. We describe the findings of this assessment in the context of elimination efforts in Kenya.

Methods: The survey was conducted from February 2021 to January 2022. All public hospitals in the target counties …

The Implementation Of Comfort Medication Kits In Hospice Patients’ Homes To Reduce Hospice Revocations, Brandi J. Parker

Doctor of Nursing Practice Projects

Background: When hospice patients experience a symptomatic crisis at the end of life, unmanaged symptoms can lead to unwanted hospitalizations and the revocation of their hospice benefits. Strategies to reduce the incidents of hospice revocation are needed to improve patient care and quality of life.

Purpose: The quality improvement project aimed to reduce hospice revocation rates by implementing comfort medication kits in eligible hospice patients’ homes.

Methods: The project’s intervention included identifying patients at high risk for revocation, patients with a cancer diagnosis, and patients with a prognosis of two weeks or less. Comfort medication kits were placed in the …

Implementing Delirium Prevention Strategies To Reduce The Need For 1:1 Observation In A Palliative Care Unit, Natalyn Finley

Doctor of Nursing Practice Projects

Background: Delirium is a common complication within the palliative care community that is preventable. Delirium is a condition characterized by confusion and disturbed thought processes. One to one observation was the facility’s intervention used to prevent delirium. The best intervention is non-pharmacological interventions.

Purpose: This quality improvement (QI) project aimed to reduce 1:1 observation hours without increasing patient safety issues.

Methods: The Doctor of Nursing Practice (DNP) student educated nursing staff about the American Nurses Association’s (ANA) evidence-based interventions to help decrease delirium. The staff received the ANA interventions form and the Confusion Assessment Method (CAM) tool. The DNP student …

Reducing The Incidence Of In-Hospital Cardiac Arrests (Ihca) By Utilizing Infographics, Alexis Morgan Pope

Doctor of Nursing Practice Projects

Background: In-hospital cardiac arrests (IHCA) have negative outcomes on patients and can prolong hospitalization or lead to death. The rate of IHCA has been increasing over the past few years in the United States. A medical intensive-care stepdown unit in a level three trauma center has an incidence of IHCA above the national average and a survival-to-discharge rate less than the national average.

Purpose: The project aimed to improve patient outcomes and reduce the rate of IHCA by placing infographics containing evidence-based practice in the unit with the highest incidence.

Methods: A pre-post implementation quality improvement design was used to …

Implementation Of Depression Screening For The Puerperal Woman During The Fourth Trimester, Ashley Tidwell Bowlin

Doctor of Nursing Practice Projects

Background: Postpartum depression is a mental illness that most commonly develops in the first twelve weeks postpartum, known as the “fourth trimester.” Nationally, one in five women suffers from postpartum depression, with 50 percent going undiagnosed and untreated due to fear of stigmatization and lack of consistent screenings among healthcare providers.

Purpose: The evidence-based Doctor of Nursing Practice quality improvement project included screening for postpartum depression between seven to 14 days postpartum to increase the identification of women likely to have postpartum depression before their scheduled postpartum visit over six weeks.

Methods: The project used a quantitative design as the …

Implementing Bedside Shift Reporting On An Adult Medical-Surgical Unit: An Evidence-Based Intervention For Inpatient Fall Reduction, Halie Blackerby

Doctor of Nursing Practice Projects

Background: Patient falls are a continuous issue in healthcare facilities because they increase patient length of stay and hospitals receive no reimbursement for these falls from insurance providers. Falls are a patient safety issue and can result in long-lasting damage for patients in the healthcare facility, including fear of ambulation. Falls in a facility can impact a facility’s ability to meet strategic planning goals and receive state and federal funding.

Purpose: The Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce inpatient falls during shift change by implementing an evidence-based bedside shift reporting (BSR) protocol.

Methods: Quantitative data …

Strengthening Medication Adherence In African Americans Diagnosed With Hypertension, Daphne James

Doctor of Nursing Practice Projects

Background: African Americans have a high rate of hypertension, which varies by region. Additionally, African Americans struggle to understand the risks of uncontrolled high blood pressure and the necessity of medication adherence in lowering strokes, heart attacks, and quality of life.

Purpose: The project aims to implement a patient education program to improve medication adherence and blood pressure control for African American patients in a primary care setting.

Methods: Twenty African Americans ages 18–65 with hypertension (130/80 mm Hg or above) and six months of nonadherence participated in this project. The pre-, mid-, and post-questionnaires assessed medication adherence and blood …

Nutric: Enhancing Surgical Intensive Care Unit Patient Nutrition Consultations, Misty Armstrong

Doctor of Nursing Practice Projects

Background: Daily nutritional screenings in the critical care population can identify patients in need of nutritional modifications during hospital admission. Inadequate nutritional assessments of critically ill patients lead to poor outcomes. Daily nutritional assessments result in the early identification of patients at risk for nutritional compromise compared to weekly assessments.

Purpose: The purpose of this project was to incorporate a daily nutritional assessment using the Nutrition Risk in the Critically Ill (NUTRIC) scores for patients in a surgical intensive care unit to identify patients in need of a referral to a registered dietician.

Methods: The method for this project used …

Improving Early Detection And Treatment Of Chlamydia By Implementing A Routine Chlamydia Screening And Testing In Females Between The Ages Of 18–24, Isabelle Vikumitsi

Doctor of Nursing Practice Projects

Background: Chlamydia Trachomatis is the most frequently reported bacterial sexually transmitted infection in the United States. One in 20 sexually active females between the ages of 15 and 24 have chlamydia. Most people with the infection are asymptomatic and do not seek treatment. Chlamydial infections in women, especially if untreated, increase the risk of infertility and ectopic pregnancy, leading to higher medical costs.

Purpose: The project aimed to implement early screening for chlamydial infections in the young adult population to increase early detection of the disease.

Methods: A pre-post design was used for this project to compare chlamydia diagnosis rates …

Standardization Of Chlorhexidine Gluconate Bathing: A Quality Improvement Project In Central Line Bloodstream Infection Prevention, Faustina Muruako

Doctor of Nursing Practice Projects

Background: Central Line-Associated Bloodstream Infections (CLABSIs) are severe healthcare-related infections that can lead to sepsis, organ failure, and even death. Several healthcare agencies provide guidelines to prevent CLABSIs, with Chlorhexidine Gluconate Bathing (CHGB) as one of the preventive measures for individuals with central venous lines (CVL).

Purpose: The Doctor of Nursing Practice (DNP) project aims to standardize CHGB procedures for maintaining CVLs on a specific unit for CLABSI prevention through evidence-based practice.

Methods: A quality improvement project was implemented at a Central Alabama hospital to standardize CHGB procedures for CVL patients utilizing a CLABSI unit champion monitoring system to establish …

Ekg Is Key: A Quality Improvement Project To Decrease Door-To-Ekg Time In A Rural Emergency Department, Amanda Southwell

Doctor of Nursing Practice Projects

Background: Electrocardiograms (EKGs) are the priority when evaluating patients with chest pain who present to the Emergency Department (ED). The American Heart Association and other governing bodies suggest a 10-minute door-to-EKG (DTE) time. The target facility displayed a delay in DTE times.

Purpose: The Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to decrease the average DTE time for patients over 18 years old with chest pain who presented to the ED registration area.

Methods: The DNP project consisted of an EKG suite to perform EKGs near the ED registration/triage area. Registration and ED staff were educated on …

Increasing Lung Cancer Screenings In A Family Medicine Clinic, Ashley Williams

Doctor of Nursing Practice Projects

Background: Lung cancer is the leading cause of cancer-related deaths worldwide. Although lung cancer screening is an established guideline for intervention in primary care, eligible patients do not receive it. Patients at high risk of developing lung cancer are aged 50 to 80 and currently smoke or have quit smoking within the last 15 years. Obtaining an annual low-dose computed tomography for patients at high risk of developing lung cancer helps detect lung cancer earlier and, therefore, improves patient outcomes.

Purpose: The Doctor of Nursing (DNP) project aimed to increase lung cancer screenings in patients at high risk of developing …

Implementing A Comprehensive Tobacco-Cessation Program For Patients With Tobacco Use Disorder, Jalen Eaton

Doctor of Nursing Practice Projects

Background: Individuals who use tobacco are at an increased risk for the development of heart disease, congestive heart failure, and chronic obstructive pulmonary disease. Tobacco use is one of the most preventable causes of death in the world.

Purpose: The focus of the quality improvement project was to improve access to tobacco cessation resources in patients with tobacco use disorder at a primary care clinic.

Methods: Weekly stakeholder meetings were held to ensure the validity of the project. The plan, do, study, act (PDSA) model of continuous quality improvement guided the project. A comprehensive tobacco-cessation program including informational materials and …

A Quality Improvement Project: Improving The Clinical Practice For Assessing Hemoglobin A1c On Admission In Diabetic Ketoacidosis Patients Admitted To The Intensive Care Unit, Tiara Lawson

Doctor of Nursing Practice Projects

Background: Diabetic ketoacidosis (DKA) is a life-threatening problem that affects people with diabetes. Early treatment and adherence to guidelines are crucial in preventing DKA. The American Diabetes Association (ADA) publishes annual guidelines for effective DKA management, and the Education Recognition Program National Benchmarks program can help maintain adherence to the published guidelines. Improving the intensive care unit (ICU) admission process enhances the quality of care to DKA patients and improves progress towards national benchmarks.

Purpose: This quality improvement project aimed to improve Hemoglobin A1C (HbA1c) evaluations in DKA patients admitted to the ICU.

Methods: The intervention of triggering HbA1c orders …

Reducing No-Show Rates In An Outpatient Gi Endoscopy Lab, Mwaba Chisela

Doctor of Nursing Practice Projects

Background: Patients who do not attend their scheduled appointments cost the healthcare industry approximately $150 billion annually. They are at higher risk of missed diagnoses, delay in care, and increased morbidity and mortality.

Purpose: This quality improvement project aimed to determine the effectiveness of serial reminders using phone calls and electronic messaging to reduce no-shows for patients scheduled for gastrointestinal (GI) endoscopy.

Methods: No-show data was retroactively analyzed from June 2023 to December 2023 and compared to post-implementation data from February 2024 to March 2024. For eight weeks, a trained staff team called patients scheduled for endoscopic procedures seven days …

In Their Voices: Kenyan Women's Experiences With Cancer Treatment–Related Side Effects, Tayreez Mushani, Dinah Kassaman, Sharon Brownie, Peterson Kiraithe, Margaret Barton-Burke

School of Nursing & Midwifery, East Africa

Objective This article reports on a secondary analysis of a qualitative study conducted in Nairobi, Kenya that reported several initial themes. In this article, the authors explore the theme of treatment-related side effect management by women receiving treatment for breast or cervical cancer.

Methods Women were interviewed at three points during their active treatment trajectory. Participants were purposefully selected and saturation was reached when interviews did not yield any new themes. The interviews were transcribed and analyzed for internal consistency, frequency, extensiveness, intensity and specificity. The Nvivo pro 12 software was used in organizing and managing the data to facilitate …

Interdisciplinary Perspectives On Multimorbidity In Africa: Developing An Expanded Conceptual Model, Justin Dixon, Ben Morton, Misheck Nkhata, Alan Silman, Ibrahim Simiyu, Stephen Spencer, Myrna Van Pinxteren, Edna Bosire, Christopher Bunn, Claire Calderwood

Brain and Mind Institute

Multimorbidity is an emerging challenge for health systems globally. It is commonly defined as the co-occurrence of two or more chronic conditions in one person, but its meaning remains a lively area of academic debate, and the utility of the concept beyond high-income settings is uncertain. This article presents the findings from an interdisciplinary research initiative that drew together 60 academic and applied partners working in 10 African countries to answer the questions: how useful is the concept of multimorbidity within Africa? Can the concept be adapted to context to optimise its transformative potentials? During a three-day concept-building workshop, we …

Enabling Cross-Modality Translation Between Single-Cell Rna-Seq And Single-Cell Atac-Seq Through Web-Based Portal, Zhen Lyu, Sabin Dahal, Shuai Zeng, Juexin Wang, Dong Xu, Trupti Joshi

Biomedical Sciences

In recent years, there has been a growing interest in profiling multiomic modalities within individual cells simultaneously. One such example is integrating combined single-cell RNA sequencing (scRNA-seq) data and single-cell transposase-accessible chromatin sequencing (scATAC-seq) data. Integrated analysis of diverse modalities has helped researchers make more accurate predictions and gain a more comprehensive understanding than with single-modality analysis. However, generating such multimodal data is technically challenging and expensive, leading to limited availability of single-cell co-assay data. Here, we propose a model for cross-modal prediction between the transcriptome and chromatin profiles in single cells. Our model is based on a deep neural …

Himmelfarb Library Liaison Letter - July 2024, The George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

A Process Evaluation Of Utah’S Food Security Council, Palak Gupta, Heidi Leblanc

Outcomes and Impact Quarterly

Utah’s Food Security Council (FSC) brings together diverse stakeholders to address food security across the state. As FSC concluded its inaugural year of work, a process evaluation assessed its progress. Findings will inform FSC’s future strategic improvements, partnerships, and community outreach activities.

A National Perspective Of Mental Health Awareness Among Agricultural Workers, Anna Gilliam, Ethan Gilliam

Outcomes and Impact Quarterly

The knowledge and perceptions of mental health resources for agricultural workers were explored at the 2024 American Farm Bureau Federation (AFBF) National Conference. Data were gathered via a voluntary survey conducted at the event. With 137 completed surveys, the study revealed that the participants desired more information regarding agricultural mental health resources and revealed their preferences for receiving this information. These findings will lead USU Extension to create impactful educational resources to better address mental health awareness and education needs in agricultural workers.

Outcomes Of The Emdataresource Cryo-Em Ligand Modeling Challenge, Catherine L Lawson, Andriy Kryshtafovych, Grigore D Pintilie, Stephen K Burley, Jiří Černý, Vincent B Chen, Paul Emsley, Alberto Gobbi, Andrzej Joachimiak, Sigrid Noreng, Michael G Prisant, Randy J Read, Jane S Richardson, Alexis L Rohou, Bohdan Schneider, Benjamin D Sellers, Chenghua Shao, Elizabeth Sourial, Chris I Williams, Christopher J Williams, Ying Yang, Venkat Abbaraju, Pavel V Afonine, Matthew L Baker, Paul S Bond, Tom L Blundell, Tom Burnley, Arthur Campbell, Renzhi Cao, Jianlin Cheng, Grzegorz Chojnowski, K D Cowtan, Frank Dimaio, Reza Esmaeeli, Nabin Giri, Helmut Grubmüller, Soon Wen Hoh, Jie Hou, Corey F Hryc, Carola Hunte, Maxim Igaev, Agnel P Joseph, Wei-Chun Kao, Daisuke Kihara, Dilip Kumar, Lijun Lang, Sean Lin, Sai R Maddhuri Venkata Subramaniya, Sumit Mittal, Arup Mondal, Nigel W Moriarty, Andrew Muenks, Garib N Murshudov, Robert A Nicholls, Mateusz Olek, Colin M Palmer, Alberto Perez, Emmi Pohjolainen, Karunakar R Pothula, Christopher N Rowley, Daipayan Sarkar, Luisa U Schäfer, Christopher J Schlicksup, Gunnar F Schröder, Mrinal Shekhar, Dong Si, Abhishek Singharoy, Oleg V Sobolev, Genki Terashi, Andrea C Vaiana, Sundeep C Vedithi, Jacob Verburgt, Xiao Wang, Rangana Warshamanage, Martyn D Winn, Simone Weyand, Keitaro Yamashita, Minglei Zhao, Michael F Schmid, Helen M Berman, Wah Chiu

Children’s Nutrition Research Center Staff Publications

The EMDataResource Ligand Model Challenge aimed to assess the reliability and reproducibility of modeling ligands bound to protein and protein-nucleic acid complexes in cryogenic electron microscopy (cryo-EM) maps determined at near-atomic (1.9-2.5 Å) resolution. Three published maps were selected as targets: Escherichia coli beta-galactosidase with inhibitor, SARS-CoV-2 virus RNA-dependent RNA polymerase with covalently bound nucleotide analog and SARS-CoV-2 virus ion channel ORF3a with bound lipid. Sixty-one models were submitted from 17 independent research groups, each with supporting workflow details. The quality of submitted ligand models and surrounding atoms were analyzed by visual inspection and quantification of local map quality, model-to-map …

Premenstrual Dysmorphic Disorder/Premenstrual Syndrome Luteal Phase Treatment, Shelby Gawarecki

Physician Assistant Scholarly Project Posters

• PMS/PMDD symptoms affect many women's emotional and physical wellbeing.

• SSRIs, progesterone, and sepranolone are luteal phase treatment options.

• Studies were all peer-reviewed, including randomized control trials or a meta-analysis.

• SSRIs are a consistent primary treatment for symptom alleviation especially cognitive symptoms. SSRIs are the current mainstay, recommended for luteal phase treatment of PMS/PMDD.

• SSRIs, including citalopram, sertraline, escitalopram, and fluoxetine, were examined to determine their efficacy in relieving mood-related symptoms such as irritability, anxiety, and depression during the luteal phase.

• Data on progesterone treatment in the luteal phase is inconclusive. • Allopregnanolone levels and …

Comparing The Efficacy Of Heart-Conserving Measures And Retransplantation For Chronic Rejection In The Pediatric Population, Lacey Zeiszler

Physician Assistant Scholarly Project Posters

Coronary allograft vasculopathy is the leading cause of morbidity and mortality among pediatric heart transplant recipients and faces unsuccessful treatment for prevention and management. Post-transplant immunosuppressive therapy has been modified over the years to determine the most effective regimen for rejection. Tacrolimus has been the superior immunosuppressant used for rejection since the early 2000s. It has been shown to have substantial immunosuppressive effects, least number of adverse effects, and decreased comorbidities compared to other regimens. Despite these advantages, CAV is still prevalent. Heart retransplantation is currently the only curative treatment. We used Google Scholar, PubMed, ClinicalKey, ScienceDirect, Elsevier, Wiley Online …

Legal Governance Of Artificial Intelligence In Healthcare Devices And Services In Singapore, Warren B. Chik, Haran Sugumaran

Research Collection Yong Pung How School Of Law

The use of artificial intelligence (AI) in healthcare applies across a spectrum of goods and services that support the industry. The main benefits of developing and applying AI to healthcare are: (a) the potential for it to perform functions beyond what can be done manually by the natural person; (b) the greater efficiency and accuracy that it can give to detection, diagnosis and medication/recovery; (c) the minimisation of risk and the possible lowering of cost (in the long term); and (d) in appropriate cases, minimal human intervention or involvement, especially in situations or conditions that may present a risk of …

Efektivitas Blood Flow Restriction Exercise Dalam Peningkatan Quadricep Strength Pada Pasien Post Acl Rekonstruksi : Literature Review, Auvin Joe Ginting

Jurnal Fisioterapi Terapan Indonesia

This article aims to evaluate the Effectiveness of Blood Flow Restriction Exercise in Improving Quadriceps Strength in Patients with ACL Reconstruction. This project is a literature study in narrative form. The background for conducting this research is the high incidence of ACL tears, ranging from 78 to 81 cases per 100,000 population worldwide in a year. The most common surgical treatment provided is ACL reconstruction. Quadriceps strength reduction after 6 months post-operation reaches 20% compared to pre-operation. From the symptoms and clinical complaints of quadriceps muscle weakness, one of the interventions that can be performed is Blood Flow Restriction …

Financial Incentives For Smoking Cessation Among Socioeconomically Disadvantaged Adults: A Randomized Clinical Trial, Darla Kendzor, Michael Businelle, Summer Frank-Pearce, Joseph Waring, Sixia Chen, Emily Hébert, Michael Swartz, Adam Alexander, Munjireen Sifat, Laili Kharazi Boozary, David Wetter

Kimmel Cancer Center Faculty Papers

IMPORTANCE: Socioeconomically disadvantaged individuals (ie, those with low socioeconomic status [SES]) have difficulty quitting smoking and may benefit from incentive-based cessation interventions.

OBJECTIVES: To evaluate the impact of incentivizing smoking abstinence on smoking cessation among adults with low SES.

DESIGN, SETTING, AND PARTICIPANTS: This study used a 2-group randomized clinical trial design. Data collection occurred between January 30, 2017, and February 7, 2022. Participants included adults with low SES who were willing to undergo smoking cessation treatment. Data were analyzed from April 18, 2023, to April 19, 2024.

INTERVENTIONS: Participants were randomized to usual care (UC) for smoking cessation (counseling …

Posture And Injury Prevention Program For High School Musicians, Clifford C. Scott, Cassandra Nelson

Summer 2024 OTD Capstone Symposium

Musicians face many musculoskeletal-related injuries due to overuse and repetitive motions (Gembris et al., 2020). These injuries can be mitigated by addressing posture as well as methods to prevent injuries and promote healthier playing. The proposed capstone program is occupationally based and developed to address posture and prevent musculoskeletal injuries among musicians. Occupational therapy can help musicians prevent and treat the development of postural asymmetries and musculoskeletal injuries that inhibit occupational participation and performance in playing their instruments (Ting et al., 2019).

The Role Of Occupational Therapy On Sexuality And Intimacy In Women With Disabilities, Diamond Escobedo, Cassandra Nelson

Summer 2024 OTD Capstone Symposium

This project was developed to provide an educational program to spread advocacy and education about the stigmatization of women with disabilities, who are unable to interact in sexual relationships and intimacy. The occupational therapy perspective would be identified as solving the problem by providing education, resources, and adaptive devices to individuals who have a disability and experience deficits in sexual intimacy through the implementation of a program.

An Occupational Therapy Guide To Promoting Social And Emotional Health Among Youth In A Post Covid-19 Era, Alejandra Olvera, Jazminne Orozco Arteaga

Summer 2024 OTD Capstone Symposium

The COVID-19 pandemic has contributed to a significant rise in mental health challenges among children and adolescents, impacting their daily performance and overall well-being. These psychosocial effects underscore an urgent need for comprehensive support from educators, parents, and communities to effectively address the increasing mental and behavioral health issues among young individuals.

The purpose of this project was to implement a program that would improve the social and emotional health of youth and adolescents, as well as to educate educators and parents. By fostering resilience and promoting mental well-being among youth and adolescents, the program's initiatives seek to mitigate the …