Medicine and Health Sciences Commons^™

Phase I Study Of Bevacizumab And Temsirolimus Combination Therapy In Advanced Malignancies: Safety, Efficacy, And Ovarian Cancer Expansion, Sarina A Piha-Paul, Chieh Tseng, Emily Thompson, R Jason Stafford, Hung Le, Siqing Fu, George Blumenschein, Jordi Rodon Ahnert, John M Slopis, David Hong, Aung Naing, Funda Meric-Bernstam, Chaan S Ng, Shannon Westin, Anil K Sood

Faculty, Staff and Student Publications

Background: Bevacizumab and temsirolimus target angiogenic and mTOR pathways in cancer progression.

Methods: This phase I study enrolled 48 heavily pretreated patients with advanced solid tumors, including an ovarian cancer expansion cohort. Patients received bevacizumab biweekly plus temsirolimus weekly in a 3 + 3 design to assess safety, maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs). Exploratory analyses included tumor genomic profiling and dynamic contrast-enhanced MRI (DCE-MRI).

Results: Patients had a median age of 59 and median four prior therapies. Common tumor types were ovarian (27%) and head and neck (15%). Treatment-related adverse events occurred in 93.8%, with 31.3% ≥grade …

Pain Prevalence And Pain Management At The End Of Life: Regional And Urban-Rural Differences From A National-Representative Survey Of Chinese Older Adults, Yaolin Pei, Xiang Qi, Zexi Zhou, Yifan Lou, Jing Wang, Bei Wu

Faculty, Staff and Student Publications

Background: Effective pain management is essential for improving quality of life at the end of life. However, challenges persist globally, particularly in China, where palliative care remains underdeveloped. This study investigates pain prevalence and the associations between pain severity, place of death, and the quality of pain management among older adults in China, with a focus on regional and urban-rural disparities.

Methods: We used data from the 2014, 2016, 2018, and 2020 waves of the China Longitudinal Aging Social Survey. The final sample included 1,525 older adults who died during the study period. We conducted OLS regression analyses to examine …

The Setd2 L1609p Mutation Found In Leukemia Disrupts Methyltransferase Activity And Reduces Histone H3k36 Trimethylation, Christina Michail, Jérémy Berthelet, Ariel E Mechaly, Linh-Chi Bui, Haopeng Yang, Amira Al Mahi, Valeria Bisio, Valentina Sirri, Jean-Marie Dupret, Fabien Guidez, Ximing Xu, Nicolas Joly, Leslie Regad, Mireille Viguier, Frédérique Deshayes, Nicolas Dulphy, Michael R Green, Ahmed Haouz, Fernando Rodrigues Lima

Faculty, Staff and Student Publications

SETD2 is the primary methyltransferase responsible for generating H3K36me3, an epigenetic mark that is essential for transcriptional regulation and chromatin integrity. SETD2 mutations are frequently observed in various cancers and tend to cluster within its catalytic SET domain. Despite the clinical relevance of SETD2 missense mutations in cancer, their biochemical and structural consequences remain insufficiently characterized. Here, we present the enzymatic and structural characterization of the SETD2 L1609P mutant enzyme identified in leukemia. The L1609 residue is located in the SET domain within a conserved hydrophobic pocket that is involved in substrate H3K36 recognition. Interestingly, site-directed mutagenesis of residues within …

Endothelial Oncogenic Kras Mutation Drives The Dynamics Of Microglia And Macrophages In Brain Arteriovenous Malformation, Hyejin Park, Jung-Eun Park, Bridger H Freeman, Bosco Seong Kyu Yang, Shun-Ming Ting, Jude Pj Savarraj, Jakob Körbelin, Huimahn Alex Choi, Sean P Marrelli, Jaroslaw Aronowski, Peng Roc Chen, Eunhee Kim, Eun S Park

Faculty, Staff and Student Publications

Mutation of KRAS in endothelial cells (KRAS-EC) leads to intracerebral hemorrhage (ICH) in brain arteriovenous malformations (bAVM), resulting in severe disabilities or even death. However, it is unclear what causes this hemorrhagic conversion of bAVM. Here, using a locally established, clinically-relevant sporadic bAVM mouse model, created by overexpressing mutant KRAS (KRASG12V) in the brain EC, we demonstrate that KRAS-EC act as trigger for microglia (MG) activation and infiltration of macrophages (Mϕ). Using three-dimensional immunostaining approach with cleared human and mouse bAVM tissues, we demonstrate an abundance of MG/Mϕ around the bAVM nidus. The presence of MG/Mϕ are correlated to the …

Identification Of A Cytokine Biomarker For Prognostic Modeling Of Breast Cancer-Related Lymphedema, Alison J Wu, Neil Lin, Jie Su, Cherie Lin, Madison-Shira Hossack, Farnoosh Abbas-Aghababazadeh, Benjamin Haibe-Kains, Simona F Shaitelman, Melissa B Aldrich, Fei-Fei Liu, Jennifer Y Y Kwan

Faculty, Staff and Student Publications

Lymphedema is a chronic complication of breast cancer treatment, and early intervention is crucial to reduce morbidity. This study evaluated the role of blood-based cytokine biomarkers in the prognostication of breast cancer-related lymphedema (BCRL) to improve risk prediction. A secondary analysis of inflammatory biomarkers for BCRL was performed using a previously published cohort of 147 breast cancer patients who had undergone serum cytokine profiling during their treatment at the Princess Margaret Cancer Centre from 2010-2014. Prognostic cytokine variables for lymphedema were selected by regression analysis and independence from known clinical risk factors. Regression-based modeling was employed to integrate prognostic variables …

Transient Protein Structure Guides Surface Diffusion Pathways For Electron Transport In Membrane Supercomplexes, Chun Kit Chan, Jonathan Nguyen, Corey F Hryc, Chitrak Gupta, Kevin Redding, Matthew L Baker, Eugenia Mileykovskaya, Abhishek Singharoy

Faculty, Staff and Student Publications

The exact biological role of mitochondrial supercomplexes remains debated, particularly their role in guiding redox proteins across membranes during energy conversion. We integrate multiscale modeling and single particle cryo-electron microscopy (cryo-EM) to examine electron transfer in mitochondrial supercomplexes composed of complexes III and IV (CIII and CIV). Using bioinformatic and entropy-based methods, we generated structural ensembles capturing conformations of CIII's disordered QCR6 hinge within the yeast CIII2CIV2 supercomplex. Molecular and Brownian Dynamics simulations reveal that these negatively charged hinge states electrostatically couple with redox proteins, promoting their binding and directional diffusion across the membrane on millisecond timescales. Rather than hindering …

Evidence-Based Team Intervention To Reduce Diagnostic Errors In Anaemia And Ckd Diagnoses In Primary Care: Protocol For A Stepped-Wedge Cluster Rct, Zhanna Novikov, Nikhilesh Mehra, Xiao Li, Rebecca Wells, Madelene Ottosen, Kevin Hwang, Elenir B C Avritscher, Charles Green, Kyung Hyun Lee, Xochitl Oguin, Mariesa Janecka, Mary Espinoza, Bolanle Adebowale, Alejandro Araya, Amer Wahed, Eric Thomas

Faculty, Staff and Student Publications

Introduction: Diagnostic errors in primary care are common, particularly in the interpretation and follow-up of abnormal haemoglobin (Hgb) and estimated glomerular filtration rate (eGFR) results. These errors frequently result in missed or delayed diagnoses of serious conditions such as anaemia and chronic kidney disease. This protocol describes a stepped-wedge cluster randomised controlled trial designed to evaluate a novel, evidence-based, team-based intervention aimed at improving diagnostic safety and efficiency.

Methods and analysis: The study will be conducted across 12 University of Texas Physicians (UTPs) primary care clinics in Houston, Texas, USA. Adult patients (≥18 years) with newly identified abnormal Hgb or …

Zingiber Officinale-Mediated Zinc Oxide Nanoparticles: Antimicrobial Activity Against Multidrug-Resistant Bacteria, Maureen Bakor Tabe, Ovgu Isbilen, Jennifer N Walker, Ender Cinar

Faculty, Staff and Student Publications

Background: The fight against infectious diseases has transformed over the past century with the emergence of multidrug-resistant bacteria, where pathogens that exhibit resistance to multiple antibiotic classes leading to significant challenges to modern medicine. Zingiber officinale is well-documented to exhibit diverse biological activities, including strong antioxidant, antimicrobial, and anti-neuroinflammatory effects. Zinc oxide nanoparticles can be synthesized cost-effectively and are widely utilized in biomedical applications, including their use as anticancer agents and drug-delivery systems, as well as for their intrinsic antibacterial and anti-inflammatory properties. In this study, we aimed to take a combinatorial approach to investigate the antimicrobial effects of Z. …

Staff Education To Improve Medication Adherence Among Nurses, Philip Nkemgang

Walden Dissertations and Doctoral Studies

Medication nonadherence among individuals with severe mental illness (SMI) contributes to relapse, hospital readmissions, and poor patient outcomes. Psychiatric nurses are central to promoting adherence, yet many lack standardized, evidence-based training. This Doctor of Nursing Practice project evaluated the effect of a structured nurse education program on medication adherence strategies, including psychoeducation and motivational interviewing, on nurses’ knowledge and confidence. Using the Johns Hopkins nursing evidence-based practice model, an online educational intervention was developed and implemented with 18 psychiatric nurses. Pre- and post-education surveys measured changes in knowledge and self-reported confidence, with data analyzed using descriptive statistics. Results demonstrated significant …

Ecologic Factors Contributing To West Nile Virus Hyperendemicity In Central South Carolina: An Integrated Vector–Human–Environmental Study, Elba S. Fridriksson, Ahayla Muraleedharan, Kyndall C. Dye-Braumuller, Madeleine M. Meyer, Kia Zellars, Hiuxuan Li, Melissa S. Nolan Ph.D., Mph

Faculty Publications

West Nile virus (WNV) is an endemic arboviral infection in the United States that has undergone phyloge-netic evolution since its introduction 25 years ago. An integrated vector–human–pathogen study was conducted in the summer of 2023 to unearth contemporary Culex quinquefasciatus habitat patterns and human transmission spillover foci in South Carolina, a state with historically little WNV data. A serosurvey revealed WNV seroprevalence 10 times the national average (22% versus 2%, respectively), with unusual epidemiologic risk factors. Female Culex quinquefas-ciatus WNV positivity was low (2.7%), with viral phylogenetics 100% homologous to the WN02 clade. Mosquito vectors clustered in affluent urban neighborhoods …

Sclerostin Deficiency Sensitizes White Adipocytes To Thermogenic Signals That Induce Beiging In Mice, Gillian M Choquette, Soohyun P Kim, Kevin J Wilkinson, Belen C Avelar, Sushrut Pathy, Zhu Li, Jasmine Wu, Susan Aja, Daniel L J Thorek, Michael J Wolfgang, Ryan C Riddle

2020-Current year OA Pubs

Maintenance of bone mass is coordinated with adipose tissue function through the secretion of hormones and endocrine factors that act on the opposing tissue. Sclerostin, a small glycoprotein produced by osteocytes embedded within the bone matrix, potently suppresses bone formation by antagonizing Wnt/β-catenin signaling while stimulating adipose tissue accumulation via the same mechanism of action. Since sclerostin-deficient mice develop pockets of multilocular adipocytes in subcutaneous adipose, we investigate the influence of sclerostin on thermogenic and β3-adrenergic stimuli-induced white adipose tissue beiging. Here, we report that Sost gene expression in bone and serum sclerostin levels are induced by β3-adrenergic agonists via …

Bi-Allelic Variants In Neuronal Adhesion Molecule Astrotactin 1 Gene Astn1 Cause Diverse Neurodevelopmental Disorders, Haowei Du, Ahmed Saad, Jasmin Lisfeld, Tatjana Bierhals, Jonas Denecke, Eyyup Uctepe, Merve Yoldas Celik, Ahmet Yesilyurt, Hilal Yildiz Er, Elif Yilmaz Gulec, Aziza Mushiba, Naif Almontashiri, Pawel Gawlinski, Wojciech Wiszniewski, Ender Karaca, Lama Alabdi, Davut Pehlivan, Dana Marafi, Maha S Zaki, Fowzan S Alkuraya, Joseph G Gleeson, Shalini N Jhangiani, Richard A Gibbs, Jennifer E Posey, Kinga M Bujakowska, James R Lupski

Faculty, Staff and Students Publications

ASTN1 encodes astrotactin 1, a neuronal-glial ligand in the developing brain that promotes neuronal migration along radial glia in brain structures with laminar organization, such as the cerebral cortex, hippocampus, and cerebellum. In mouse models, disruption of Astn1 results in neuronal migration deficits, a mild reduction in cerebellar volume, and balance and coordination deficits. In humans, bi-allelic ASTN1 variants have been identified in nine individuals with neurodevelopmental disorders (NDDs) with or without brain malformations. ASTN1 additionally interacts with astrotactin 2 (ASTN2) to implement neuronal migration; ASTN2 deletions associate with NDDs with reduced penetrance. Here, we describe eighteen individuals with NDDs …

Staff Education To Improve Detection And Treatment Of Adult Adhd In An Outpatient Psychiatric Clinic, Eveline Manyie Fohtung

Walden Dissertations and Doctoral Studies

Summary Adult attention-deficit/hyperactivity disorder (ADHD) remains significantly underdiagnosed in outpatient psychiatric settings despite its substantial impact on functioning and long-term mental health outcomes. At the project site, inconsistent screening practices, limited clinician familiarity with DSM-5-TR adult diagnostic criteria, and variable application of the Adult ADHD Self-Report Scale (ASRS) contributed to delayed or missed diagnoses, representing a clear practice gap. This Doctor of Nursing Practice (DNP) project implemented a structured, nurse-led staff education program to improve clinician knowledge, diagnostic accuracy, and standardized workflow adoption for adult ADHD screening using the ASRS. Guided by national evidence-based guidelines, the intervention emphasized DSM-5-TR criteria, …

Staff Education To Stop The Bleed Training, Sherron L. Butler

Walden Dissertations and Doctoral Studies

Uncontrolled hemorrhage remains a leading cause of preventable mortality, and timely intervention is critical to improving patient outcomes. The purpose of this Doctor of Nursing Practice staff education project was to evaluate the effect of a standardized Stop the Bleed (STB) education program on emergency department and outpatient clinic nursing staff readiness and confidence in managing hemorrhage emergencies. A pre- and post-education design was used to assess changes in participants’ knowledge, confidence, and technical proficiency related to hemorrhage-control skills, including tourniquet application, wound packing, and direct pressure techniques. Data were collected using pre- and post-training surveys and skills-demonstration assessments and …

Staff Education Program To Improve Pediatric Medication Adherence Knowledge In Primary Care, Coby Anderson

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was focused on a staff education program aimed at addressing the knowledge gaps of primary healthcare providers regarding pediatric medication adherence. Nonadherence among pediatric patients is a significant issue leading to adverse health outcomes and increased healthcare costs. The project underscores the necessity of enhancing provider knowledge and communication skills, alongside implementing systematic strategies to promote adherence. My objective with the project was to elevate primary healthcare providers’ understanding and practical application of pediatric adherence techniques through targeted, evidence-based education. I developed the practice-focused question to examine whether this tailored staff education could bolster …

Lgbtq+ Cultural Competency Training For Mental Health Care Workers, Shyla Noelle Herndon-Dye

Walden Dissertations and Doctoral Studies

The purpose of the staff education project was to address a noticeable gap in training regarding lesbian, gay, bisexual, transgender, and queer (LGBTQ+) cultural competencies for the multidisciplinary mental health care workers of an inpatient child and adolescent psychiatry unit. LGBTQ+ individuals commonly encounter discriminatory barriers to care, resulting in mental health disparities and medical distrust; thus, mental health care workers must engage in professional allyship and improve their capability to sufficiently care for this population. The practice question that guided this project was the following: Will a staff education program designed to educate multidisciplinary mental health care workers on …

Staff Education In Standardizing A Nurse-Led Fall Prevention Bundle To Reduce Inpatient Falls In Teleneurology Units, Tiffany Scott

Walden Dissertations and Doctoral Studies

Due to complex neurological deficits that raise the risk of falls, falls among persons admitted to inpatient tele-neurology units represent a substantial and continuous problem in nursing practice. A preliminary evaluation conducted at the project site revealed inconsistent fall prevention procedures, inconsistent use of risk assessments, and a lack of a standardized, evidence based strategy to lower fall risk in this especially susceptible group. A practice focused investigation into whether the adoption of a standardized, nurse led fall prevention bundle would improve staff adherence to fall prevention protocols and lower the incidence of inpatient falls over a six month period …

Staff Education To Reduce The Incidence Of Bias In Managing Patients With Opioid Use Disorder In A Rehabilitation Center, Almarie Alison Mclaren

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed stigma and implicit bias toward individuals with opioid use disorder (OUD) within a rehabilitation subacute care setting. OUD remains a significant public health concern and at the project site, inconsistent staff education was identified as a practice gap requiring intervention. The purpose of this practice-focused DNP project was to evaluate the impact of a structured staff education intervention on healthcare staff knowledge, attitudes, and confidence in caring for patients with OUD. The project was guided by a thorough evidence search. The project was implemented using brief, unit-based educational sessions delivered to interdisciplinary …

Körperliche Und Psychische Aspekte Der Menstruation, Sarah Grossman

COD in Lingua

This text provides an overview of menstruation, its physiological processes, and its physical and psychological effects. It explains the menstrual cycle, including the follicular and luteal phases, hormone regulation, and ovulation. Common symptoms such as cramps, fatigue, mood swings, and breast tenderness are discussed, as well as the importance of understanding hormonal changes. The text also highlights social issues, including unequal access to menstrual products, and emphasizes the significance of education and awareness for managing menstruation and promoting health.

Effects Of Bungee-Based Training On Physical Performance And Arch Jump Kinematics In Female College Rhythmic Gymnasts, Nasser Abouzeid, Mariola Gepfert, Abdulrahman I. Alaqil, Abdulmalek K. Bursais, Hussein Hashoos, Mohammed S. Alibrahim, Labeeb Z. Moseekh, Amr S. Hamza

Baltic Journal of Health and Physical Activity

Background: The purpose of this study was to examine the effects of an eight-week bungee-based training program on selected physical performance variables and arch jump kinematics in female college rhythmic gymnasts. Material and methods: Eighteen female college students (age: 18.1 ± 0.9 years) were randomly assigned to an experimental group (EG; n = 9) or a control group (CG; n = 9). The EG completed a bungee workout training program three times per week for eight weeks, while the CG followed a traditional rhythmic gymnastics training program. Physical performance variables included vertical jump, leg strength, back strength, standing long jump, …

Predicting The Prognosis Of Primary And Substance-Associated Psychoses Using Urine Drug Screens: A 5-Year Retrospective Longitudinal Study Using Medical Records, Erich J. Aschenbrenner, Andrew C. Voluse

Psychiatry Publications

Substance use is frequently implicated in psychosis. However, the prognostic assumptions guiding differential treatment decisions between substance-induced and primary/affective psychoses have received inconsistent support. Substance-induced psychosis research has often been limited by aggregating substances or using diagnosis as both a grouping variable and an outcome (i.e., diagnostic conversion). The current study examined medical records for 1379 patients for 5 years following their first presentation with psychosis after January 2013 to a regional medical center. Clinically relevant outcomes were compared across groups defined by the substances detected in patients' urine at their initial presentation. Initial drug screen results predicted the initial …

Mutations Altering The Dna Binding Domains Of The Human Rad52 Protein Exert Distinct Effects On Homologous Recombination Repair In Saccharomyces Cerevisiae, Glenn M. Manthey, Elise W. Wolf, Jason Xu, M. Cristina Negritto, Renee A. Bouley, Ruben C. Petreaca, Adam M. Bailis

College of Health Professions Faculty Papers

RAD52 is a conserved member of the homologous recombination repair (HRR) apparatus from yeast to humans. Mutating conserved amino acids in the internal and external DNA binding domains of the human RAD52 protein (HsRAD52) has discrete effects in vitro. Previous studies have shown that HsRAD52 supports multiple mechanisms of HRR in budding yeast, suggesting the utility of this model system for exploring the correspondence between losses of HsRAD52 function in vitro and their impact in vivo. We report that disrupting the internal and external DNA binding domains of HsRAD52 produced distinct effects on the repair of genomic DNA double-strand breaks …

The Heart’S Hidden Influencer: Epicardial Adipose Tissue In The Pathogenesis Of Heart Failure, Aobo Li, Avilash Mondal, Jianli Zhao, John Zhang, Xin-Liang Ma

Department of Emergency Medicine Faculty Papers

Abstract – Heart failure (HF) is a complex, multifactorial clinical syndrome with diverse etiologies and phenotypic manifestations, affecting millions of people globally. HF is broadly classified into 3 subtypes: HF with reduced ejection fraction, HF with mildly reduced ejection fraction, and HF with preserved ejection fraction. Each subtype exhibits distinct pathophysiological mechanisms, clinical trajectories, and therapeutic responses, posing significant challenges in terms of diagnosis and management. Epicardial adipose tissue (EAT), a metabolically active visceral fat depot situated in close proximity to the myocardium, plays a dual role in physiological and pathological states, offering potential utility as a biomarker and therapeutic …

Proned But Not Pressured: Saving Skin One Turn At A Time, Sophie Despres, Brandon Evans, Hannah Keetch, Destiny Lane

2025

No abstract provided.

Gain Of Function Notch4 Variants Disrupt Angiogenesis In Systemic Sclerosis, Urvashi Kaundal, Pei-Suen Tsou, Mousumi Sahu, Mengqi Huang, Steven E Boyden, Curtis M Woodford, Daniel Shriner, Emilee Stenson, Sarah Ayla Safran, Yuechen Zhou, Taylor A Talley, Kaavya Gudapati, Xuetao Zhang, Yosuke Kunishita, Janet Wang, Ami A Shah, Maureen D Mayes, Ayo P Doumatey, Amy R Bentley, Robyn Domsic, Thomas A Medsger, Paula S Ramos, Richard M Silver, Virginia Steen, John Varga, Vivien Hsu, Lesley Ann Saketkoo, Elena Schiopu, Jessica K Gordon, Lindsey A Criswell, Heather Gladue, Chris Derk, Elana J Bernstein, S Louis Bridges, Victoria Shanmugam, Lorinda Chung, Suzanne Kafaja, Reem Jan, Marcin Trojanowski, Avram Goldberg, Benjamin D Korman, James Mullikin, James W Thomas, Stefania Dell'orso, Davide Randazzo, Adebowale Adeyemo, Elaine F Remmers, Pamela L Schwartzberg, Ivona Aksentijevich, Charles Rotimi, Fredrick M Wigley, Rong A Wang, Francesco Boin, Dinesh Khanna, Robert Lafyatis, Daniel L Kastner, Pravitt Gourh

Faculty, Staff and Student Publications

Objectives: Vasculopathy and fibrosis are central to the pathogenesis of systemic sclerosis (SSc) and their genetic underpinnings are largely unknown. Here, we sought to examine the aetiology of severe vascular phenotypes and poorer outcomes in African American (AA) patients with SSc.

Methods: The study focuses on AA patients with SSc who have more severe vascular phenotypes and poorer outcomes and combines genetics, single-cell RNA sequencing, functional assays, and a mouse model to explore the role of NOTCH4 in SSc vasculopathy and the potential for NOTCH4-directed therapies.

Results: Gene-based testing identified NOTCH4 association at an exome-wide significance with SSc (P = …

Multiparent Recombinant Inbred Lines Crossed To A Tester Provide Novel Insights Into Sources Of Cis And Trans Regulation Of Gene Expression, Patricka Williams-Simon, Paul Schmidt, Elizabeth King, Lauren M Mcintyre

Faculty, Staff and Student Publications

To understand the relative importance of cis and trans effects on regulation, we crossed multi-parent recombinant-inbred lines (RILs) to a common tester and measured allele-specific gene expression in the offspring. Testing the difference of allelic imbalance between two RIL × Tester crosses is a test of cis or trans, depending on the RIL alleles compared. The study design also enables to separation of two sources of trans variation, genetic and environmental, detected via interactions with cis effects. We demonstrate the effectiveness of this approach in a long-read RNA-seq experiment in female abdominal tissue at two time points in Drosophila melanogaster. …

Durability Of Sars-Cov-2 Immunity Across Vaccination Strategies, Naim Che Kamaruddin

Student Works (2020-2029)

The coronavirus disease 2019 (COVID-19) pandemic has led to a complex immunological landscape shaped by combinations of SARS-CoV-2 infection and vaccination. Immune imprinting, wherein initial antigenic exposure may limit response breadth, poses a significant barrier to achieving durable and broad immune protection. This study aimed to evaluate humoral and cellular immune responses elicited by different SARS-CoV-2 vaccination strategies. The study hypothesized that an individual’s prior SARS-CoV-2 exposure history differentially influences the magnitude, durability, and functional profile of their immune response. A 12-month longitudinal sampling was conducted involving 267 participants, categorized into five groups based on their sequence of vaccination and …

Social, Environmental And Policy Contexts Affecting The Feasibility And Acceptability Of Improving Household Flooring For Better Health In Rural Kenya, Ulrike Fillinger, Victoria A. Ochwal, Hugo Legge, Sharon Muli, Karisa Kazungu, Carlos Mcharo, Jacinta Mwongeli, Charles Mwandawiro, Katherine Halliday, Doris Njomo, Rachel Pullan, Lynne Elson, Stella Kepha

All Peer-Reviewed Publications

BACKGROUND: Homes with unimproved floors (earth, sand, or clay) are associated with increased risks of soil-transmitted parasites and enteric infections, leading to higher morbidity and reduced quality of life. This study explored the enablers and barriers to adopting improved flooring (sealed, washable, and durable) in three culturally diverse regions of Kenya - Narok, Bungoma, and Kwale - to mitigate disease burdens. METHODS: Between August 2021 and July 2022, we conducted 24 focus group discussions with homeowners, stratified by age, gender, and floor type. Additionally, 28 key informant interviews with local government officials, microfinance representatives, and masonry trainers in Kwale and …

Staff Education Project To Improve Hypertension Medication Adherence In An Underserved Clinic, Margaret Mboe Etukeni

Walden Dissertations and Doctoral Studies

Hypertension is one of the most common chronic conditions managed in primary care. The identified practice problem for this staff education project was the lack of structured staff training and inconsistent provider knowledge regarding evidence-based strategies to improve medication adherence among patients with hypertension. Poor medication contributes to preventable complications such as stroke, heart failure, and kidney disease. The purpose was to evaluate if an educational intervention could improve provider knowledge related to medication adherence strategies in an underserved clinical setting. The practice question guiding the project was: In clinical staff working in an underserved clinic, does a staff education …

Multimodal Education To Improve Metabolic Monitoring Knowledge Among Psychiatric Nurse Practitioners, Tania Alfonso

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project was a multimodal educational intervention to improve outpatient psychiatric nurse practitioner (PNP) knowledge of metabolic monitoring guidelines for patients prescribed second-generation antipsychotics (SGAs). The project addressed low adherence to national monitoring standards that contribute to increased cardiometabolic risks associated with SGAs. The project question was: Does staff education regarding metabolic monitoring guidelines improve nursing knowledge as compared pre- to posteducation? The purpose was to enhance PNP knowledge of metabolic monitoring guidelines. Guided by the Johns Hopkins evidence-based practice (JHEBP) model, I conducted a focused literature search and identified 28 peer-reviewed articles …