Medicine and Health Sciences Commons^™

Temporal Gene Expression Of Mesenchymal Cells In The Pediatric Lung, Quinlen F. Marshall, Soumyaroop Bhattacharya, Gautam Bandyopadhyay, Ravi Misra, Thomas Mariani, Gloria Pryhuber

Chemistry Student Work

INTRODUCTION: The newborn lung undergoes vast biochemical and physiological changes during adaptation from the intrauterine to the extrauterine environment. Lung morphogenesis continues from birth into early childhood, mediated by dynamic gene expression and a diversity of pulmonary cell types (Whitsett, JA. et al. Physiol. Rev, 2019). Murine models demonstrate that pulmonary mesenchymal cells exhibit remarkable heterogeneity in function and morphology during development, however, confirmation of their role is lacking in human neonates and early childhood (Guo, M. et al. Nat. Comm, 2019). In addition, many current human genomic studies of lung maturation suffer from limited sample size, limiting …

Implementation Of A Heart Failure Risk Screening Tool In A Primary Care Setting., Paige Abell

Doctor of Nursing Practice Papers

Introduction: Heart failure (HF) is a progressive disease that is difficult to identify in its early stages. The Health ABC HF screening tool allowed primary care providers to identify and target interventions at their highest risk patients.

Purpose: The purpose of this project was to introduce providers to the Health ABC HF screening tool and assess the feasibility of using this tool in a primary care setting.

Intervention: Six primary care providers used the Health ABC screening tool for 4 weeks on their patients over age 65 with a diagnosis of hypertension, diabetes mellitus, or atherosclerosis. Providers then completed …

Meox2 Haploinsufficiency Accelerates Axonal Degeneration In Dba/2j Glaucoma, Rebecca A Buchanan, Kate E Foley, Keating W Pepper, Alaina M Reagan, Kelly J Keezer, Amanda A Hewes, Cory A Diemler, Christoph Preuss, Ileana Soto Reyes, Simon W M John, Gareth R Howell

College of Science & Mathematics Departmental Research

Purpose: Glaucoma is a complex disease with major risk factors including advancing age and increased intraocular pressure (IOP). Dissecting these earliest events will likely identify new avenues for therapeutics. Previously, we performed transcriptional profiling in DBA/2J (D2) mice, a widely used mouse model relevant to glaucoma. Here, we use these data to identify and test regulators of early gene expression changes in DBA/2J glaucoma.

Methods: Upstream regulator analysis (URA) in Ingenuity Pathway Analysis was performed to identify potential master regulators of differentially expressed genes. The function of one putative regulator, mesenchyme homeobox 2 (Meox2), was tested using a combination of …

Out-Of-Pocket Expenditure For Home And Facility Based Delivery Among Rural Women In Zambia: A Mixed-Methods, Cross-Sectional Study, Jeanette L. Kaiser, Kathleen L. Mcglasson, Peter C. Rockers, Rachel M. Fong, Thandiwe Ngoma, Davidson H. Hamer, Taryn Vian, Godfrey Biemba, Jody R. Lori, Nancy A. Scott

Nursing and Health Professions Faculty Research and Publications

Purpose: Out-of-pocket expenses associated with facility-based delivery are a well-known barrier to health care access. However, there is extremely limited contemporary information on delivery-related household out-of-pocket expenditure in sub-Saharan Africa. We assess the financial burden of delivery for the most remote Zambian women and compare differences between delivery locations (primary health center, hospital, or home).

Methods: We conducted household surveys and in-depth interviews among randomly selected remote Zambian women who delivered a baby within the last 13 months. Women reported expenditures for their most-recent delivery for delivery supplies, transportation, and baby clothes, among others. Expenditures were converted to …

High Stakes Require More Than Just Talk: What To Do About Corruption In Health Systems, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Reluctance to talk about corruption is an important barrier to action. Yet the stakes of not addressing corruption in the health sector are higher than ever. Corruption includes wrongdoing by individuals, but it is also a problem of weak institutions captured by political interests, and underfunded, unreliable administrative systems and healthcare delivery models. We urgently need to focus on corruption as a health systems problem. In addition to supporting research to better understand the context and implications of corruption in health systems, this article suggests actions that public health professionals can do now to fight corruption.

Educating Primary Care Providers On Assessment Of Herbal Supplements Used By Latino Patients., Elizabeth Arnold

Doctor of Nursing Practice Papers

Background: Latino population health care practices are rich in heritage and deeply rooted in ideas and traditions (CDC, 2008). Complementary and alternative medicine (CAM), specifically herbal supplement use, is widely practiced among this population. Literature suggests that there is a significant gap in provider-patient communication regarding herbal supplement use (Malika et al., 2017).

Aims: The purpose of this project was to assess commonly used herbal supplements or vitamins and implement a population-specific education for providers in a primary care clinic predominantly serving Latino patients. The project aim was to increase provider assessment and documentation of herbal supplement and vitamin use …

Improving Caregiver Coping And Reducing Recidivism With A Pediatric Burn Discharge Education Toolkit., Lindsay Hack

Doctor of Nursing Practice Papers

In 2015, 4,506 children from 0-19 years of age were hospitalized with burn injuries in the United States (Center for Disease Control and Prevention, 2017). From 2013-2014, 325 out of 11,940 pediatric burn patients discharged from US facilities had unscheduled readmissions within 30 days (Wheeler et al., 2018). Adequate discharge education and quality of transitions from hospital to home will help prevent negative health outcomes and readmissions (Braet, Weltens, Bruyneel, & Sermeus, 2016). In this quality improvement project, caregivers of pediatric burn patients were assessed on their day of discharge with the Readiness for Hospital Discharge Scale (RHDS)- Parent Form …

Natural Autoantibodies: Origin, Function And Utility For Diagnosis Of Disease, Abhirup Sarkar

Graduate School of Biomedical Sciences Theses and Dissertations

Autoantibodies (aAbs) by the simplest definitions have been described as antibodies against self-antigens and were exclusively associated with autoimmune diseases. Eventually, studies demonstrated that they are abundant in the blood of all human sera, regardless of age, gender, or the presence or absence of disease, and were thus named as ‘natural autoantibodies’. The underlying reason for their ubiquity has remained elusive, but we have hypothesized that they are responsible for clearing blood-borne cell and tissue debris generated under conditions of health and disease. To test this, we chose to use two widely different disease model systems, namely neurodegenerative diseases and …

Obgyn Surgical Prep Standardized Process Presentation, Cortney Hartman Mba-Hm, Cst, Crcst, Cis

Posters & Presentations

OBGYN Surgical Prep Presentation.

To lower the occurrences of SSIs and standardize the process of surgical preparation across Parkview Health System, the following changes were adopted on August 15, 2019.

This is version 2.0

• Infection Prevention Bundle
• Vaginal Prep Instructions
• Abdominal Prep Instructions
• Chlorohexidine-alcohol (Chloraprep)

Proteomics And Biological Evaluation Of Marshmallow (Althea Officinalis) Seeds, Mahshid Amini

Pharmaceutical Sciences (MS) Theses

Marshmallow (Althaea officinalis) belongs to family Malvaceae, a medicinal plant used in traditional and alternative medicine in various parts of the world. Marshmallow is one of the seven medicinal plants that are collectively known as Joshanda. It is a herbal preparation which has been used traditionally as a home remedy for the treatment of common cold, coughs, nasal congestion, and fever. Previous studies showed that crude extract and/or purified compounds from flowers, root, and leaves from Marshmallow have anti-microbial, anti-inflammatory, and other pharmacological effects. However, there is no data reported on the biological activity and the structure of proteins isolated …

Offspring From Maternal Nutrient Restriction In Mice Show Variations In Adult Glucose Metabolism Similar To Human Fetal Growth Restriction., B N Radford, V K M Han

Paediatrics Publications

Fetal growth restriction (FGR) is a pregnancy condition in which fetal growth is suboptimal for gestation, and this population is at increased risk for type 2 diabetes as adults. In humans, maternal malnutrition and placental insufficiency are the most common causes of FGR, and both result in fetal undernutrition. We hypothesized that maternal nutrient restriction (MNR) in mice will cause FGR and alter glucose metabolism in adult offspring. Pregnant CD-1 mice were subjected to MNR (70% of average ad libitum) or control (ad libitum) from E6.5 to birth. Following birth, mice were fostered by mothers on ad libitum feeds. Weight, …

Classification Criteria For Autoinflammatory Recurrent Fevers., Marco Gattorno, Michael Hofer, Silvia Federici, Federica Vanoni, Francesca Bovis, Ivona Aksentijevich, Jordi Anton, Juan Ignacio Arostegui, Karyl Barron, Eldad Ben-Cherit, Paul A Brogan, Luca Cantarini, Isabella Ceccherini, Fabrizio De Benedetti, Fatma Dedeoglu, Erkan Demirkaya, Joost Frenkel, Raphaela Goldbach-Mansky, Ahmet Gul, Veronique Hentgen, Hal Hoffman, Tilmann Kallinich, Isabelle Kone-Paut, Jasmin Kuemmerle-Deschner, Helen J Lachmann, Ronald M Laxer, Avi Livneh, Laura Obici, Seza Ozen, Dorota Rowczenio, Ricardo Russo, Yael Shinar, Anna Simon, Nataša Toplak, Isabelle Touitou, Yosef Uziel, Marielle Van Gijn, Dirk Foell, Claudia Garassino, Dan Kastner, Alberto Martini, Maria Pia Sormani, Nicolino Ruperto

Paediatrics Publications

BACKGROUND:
Different diagnostic and classification criteria are available for hereditary recurrent fevers (HRF)-familial Mediterranean fever (FMF), tumour necrosis factor receptor-associated periodic fever syndrome (TRAPS), mevalonate kinase deficiency (MKD) and cryopyrin-associated periodic syndromes (CAPS)-and for the non-hereditary, periodic fever, aphthosis, pharyngitis and adenitis (PFAPA). We aimed to develop and validate new evidence-based classification criteria for HRF/PFAPA.

METHODS:
Step 1: selection of clinical, laboratory and genetic candidate variables; step 2: classification of 360 random patients from the Eurofever Registry by a panel of 25 clinicians and 8 geneticists blinded to patients' diagnosis (consensus ≥80%); step 3: statistical analysis for the selection of …

Brain Activity Associated With Dual-Task Performance Of Ankle Motor Control During Cognitive Challenge., Sue Peters, Janice J Eng, Teresa Liu-Ambrose, Michael R Borich, Elizabeth Dao, Ameen Amanian, Lara A Boyd

Physical Therapy Publications

INTRODUCTION: Skilled Ankle motor control is frequently required while performing secondary cognitively demanding tasks such as socializing and avoiding obstacles while walking, termed "Dual tasking." It is likely that Dual-task performance increases demand on the brain, as both motor and cognitive systems require neural resources. The purpose of this study was to use functional MRI to understand which brain regions are involved in resolving Dual-task interference created by requiring high levels of Ankle motor control during a cognitive task.

METHODS: Using functional MRI, brain activity was measured in sixteen young adults during performance of visually cued Ankle plantar flexion to …

Effectiveness Of High-Intensity Interval Training For Fitness And Mobility Post Stroke: A Systematic Review., Joshua C. Wiener, Amanda Mcintyre, Scott Janssen, Jeffrey Ty Chow, Cristina Batey, Robert Teasell

Epidemiology and Biostatistics Publications

OBJECTIVE: To evaluate the evidence on the effectiveness of high-intensity interval training (HIIT) in improving fitness and mobility post stroke. TYPE: Systematic review.

LITERATURE SURVEY: Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for articles published in English up to January 2018.

METHODOLOGY: Studies were included if the sample was adult human participants with stroke, the sample size was ≥3, and participants received >1 session of HIIT. Study and participant characteristics, treatment protocols, and results were extracted.

SYNTHESIS: Six studies with a total of 140 participants met inclusion criteria: three randomized controlled trials and three pre-post studies. HIIT protocols ranged …

Methodological Consensus On Clinical Proton Mrs Of The Brain: Review And Recommendations, Martin Wilson, Ovidiu Andronesi, Peter B. Barker, Robert Bartha, Alberto Bizzi, Patrick J. Bolan, Kevin M. Brindle, In Young Choi, Cristina Cudalbu, Ulrike Dydak, Uzay E. Emir, Ramon G. Gonzalez, Stephan Gruber, Rolf Gruetter, Rakesh K. Gupta, Arend Heerschap, Anke Henning, Hoby P. Hetherington, Petra S. Huppi, Ralph E. Hurd, Kejal Kantarci, Risto A. Kauppinen, Dennis W.J. Klomp, Roland Kreis, Marijn J. Kruiskamp, Martin O. Leach, Alexander P. Lin, Peter R. Luijten, Małgorzata Marjańska, Andrew A. Maudsley, Dieter J. Meyerhoff, Carolyn E. Mountford

Medical Biophysics Publications

© 2019 International Society for Magnetic Resonance in Medicine Proton MRS (1H MRS) provides noninvasive, quantitative metabolite profiles of tissue and has been shown to aid the clinical management of several brain diseases. Although most modern clinical MR scanners support MRS capabilities, routine use is largely restricted to specialized centers with good access to MR research support. Widespread adoption has been slow for several reasons, and technical challenges toward obtaining reliable good-quality results have been identified as a contributing factor. Considerable progress has been made by the research community to address many of these challenges, and in this paper a …

An Educational Intervention On Daily Chlorhexidine Gluconate Bathing And Central Venous Catheter Infection Rates In The Pediatric Population: A Quality Improvement Initiative., Jennifer Cothern

Doctor of Nursing Practice Papers

The use of Central Venous Catheters (CVCs) in the healthcare setting is essential to patient survivability. While convenient, the utilization of such devices places patients at risk for Central Line- Associated Bloodstream Infections (CLABSI). The US spends nearly $2 billion dollars annually treating CLABSIs. The utilization of CLABSI bundles has shown to be effective in infection prevention. Daily bathing with Chlorhexidine Gluconate (CHG) is recommended by the Centers for Disease Control and Prevention (CDC) and is often included in CLABSI bundles. In an attempt to reduce the incidence of CLABSIs at a metropolitan pediatric hospital in the Southern US, a …

A Flavor Perception Game Designed To Introduce Basic Chemical Sensation Of Taste Modalities To Undergraduate Nursing And Exercise Sciences Students, Angela L. Mahaffey

Nursing: School of Nursing Faculty Publications and Other Works

The Flavor Perception Game was designed with the goals of developing an interactive and hands-on activity, providing a platform to review chemical senses of the five tastes, promoting student investment in the course material, and providing a basis for discussion on chemical senses of the five tastes. Knowledge of taste sensation is useful for nursing and exercise sciences students, as human physiology is integral to both baccalaureate curricula. The game is inexpensive, easy to incorporate into a 50-minute lecture period, and free of chocolate allergens. Student participants (N=34) tasted three candies and completed a voluntary anonymous poll regarding their detection …

Narratives Of Expert Speech-Language Pathologists: Defining Clinical Expertise And Supporting Knowledge Transfer, Natalie F. Douglas, Katie Squires, Jacqueline Hinckley, Erline V. Nakano

HPD Articles

Clinical expertise is a component of evidence-based practice; however, relatively little attention has been paid to this phenomenon in the professional literature of speech-language pathology. This may have negative impacts on the training of pre-professional and novice speech-language pathologists. The purpose of this study was to examine professional narratives of expert Speech-Language Pathologists (SLPs) to consider applications for knowledge transfer between expert clinicians and novice clinicians. Collection of the professional narratives of 10 expert SLPs were obtained through in-depth interviews. Interviews were transcribed and coded for themes. Themes that impacted expertise in SLP included: training; work sites; individual and clinician …

Office Of Equity Diversity Report Annual Report Fy 2018-19, Children's Mercy Hospital

Equity & Diversity Annual Reports

A report on equity and diversity at Children's Mercy Hospitals & Clinics, in the care it provides, the people it serves, and in its workforce. Specifically discusses the Equity & Diversity Leadership Structure, Employee Demographics, Patient Demographics, and the work being done to help realize the great potential that lies ahead.

Meox2 Haploinsufficiency Accelerates Axonal Degeneration In Dba/2j Glaucoma., Rebecca A Buchanan, Kate E Foley, Keating W. Pepper, Alaina M Reagan, Kelly J Keezer, Amanda A Hewes, Cory A Diemler, Christoph Preuss, Ileana Soto, Simon W M John, Gareth R Howell

Faculty Research 2019

Purpose: Glaucoma is a complex disease with major risk factors including advancing age and increased intraocular pressure (IOP). Dissecting these earliest events will likely identify new avenues for therapeutics. Previously, we performed transcriptional profiling in DBA/2J (D2) mice, a widely used mouse model relevant to glaucoma. Here, we use these data to identify and test regulators of early gene expression changes in DBA/2J glaucoma.

Methods: Upstream regulator analysis (URA) in Ingenuity Pathway Analysis was performed to identify potential master regulators of differentially expressed genes. The function of one putative regulator, mesenchyme homeobox 2 (Meox2), was tested using a combination of …

Rapid Growth Is A Dominant Predictor Of Hepcidin Suppression And Declining Ferritin In Gambian Infants., Andrew E Armitage, Schadrac C Agbla, Modupeh Betts, Ebrima A Sise, Momodou W Jallow, Ellen Sambou, Bakary Darboe, Archibald Worwui, George M. Weinstock, Martin Antonio, Sant-Rayn Pasricha, Andrew M Prentice, Hal Drakesmith, Momodou K Darboe, Brenda Anna Kwambana-Adams

Faculty Research 2019

Iron deficiency and iron deficiency anemia are highly prevalent in low-income countries, especially among young children. Hepcidin is the major regulator of systemic iron homeostasis. It controls dietary iron absorption, dictates whether absorbed iron is made available in circulation for erythropoiesis and other iron-demanding processes, and predicts response to oral iron supplementation. Understanding how hepcidin is itself regulated is therefore important, especially in young children. We investigated how changes in iron-related parameters, inflammation and infection status, seasonality, and growth influenced plasma hepcidin and ferritin concentrations during infancy using longitudinal data from two birth cohorts of infants in rural Gambia (n=114 …

An In Vitro Enrichment Strategy For Formulating Synergistic Synbiotics, Car Reen Kok, David Fabian Gomez Quintero, Clement Niyirora, Devin Rose, Amanda Li, Robert Hutkins

Food for Health: Publications

ABSTRACT Research on the role of diet on gut and systemic health has led to considerable interest toward identifying novel therapeutic modulators of the gut microbiome, including the use of prebiotics and probiotics. However, various host responses have often been reported among many clinical trials. This is in part due to competitive exclusion as a result of the absence of ecological niches as well as host mediated constraints via colonization resistance. In this research, we developed a novel in vitro enrichment (IVE) method for isolating autochthonous strains that can function as synergistic synbiotics and overcome these constraints. The method relied …

It’S All About Trust And Respect: Cultural Competence And Cultural Humility In Mobile Health Clinic Services For Underserved Minority Populations, Arelis Moore De Peralta, Melinda Gillispie, Catherine Mobley, Lynette M. Gibson

Publications

To explore participants' perceptions of cultural competence and cultural humility in mobile health clinic (MHC) service delivery, using the Cultural Competence Model (CCM) as an organizing framework. Methods. We conducted five focus groups with an ethnically diverse group of English-and Spanish-speaking men and women, ages 20–67, residing in five underserved neighborhoods in a Southeastern U.S. city. Data analysis followed a thematic approach and iterative qualitative content analysis. Results. Participants expressed a desire for well-trained and caring staff who practice cultural humility. Conclusions. By applying the CCM's five-pronged constellation of cultural abilities, health care personnel could ultimately be more responsive to …