Medicine and Health Sciences Commons^™

The Role Of Epigenetic Aberrations In The Cold Tumor Phenotype And Inflammatory Signaling In High-Risk Neuroblastoma, Pamela Morgan Watson

Alternative Theses and Dissertations (AETDs)

Neuroblastoma (NB) is a highly aggressive, heterogeneous disease that arises from the sympathetic nervous system (SNS) and originates from neural crest cells (NCCs) (1). NB is the most common extracranial cancer in pediatric accounts for 15% of pediatric cancer deaths (2). This high mortality rate is the result of the metastatic, immune evasive, and treatment resistant characteristics of the disease (3). It has been proposed that NB arises from blocks in differentiation during development, resulting in a mixture of two distinct cell types within the tumor: mesenchymal and adrenergic (Figure 1.1) (4,5). The adrenergic cell type is more differentiated, and …

The Nurse Faculty Compassion Instrument: A Methodological Study, Nancy Pritchard

Dissertations

As nursing shortages rise, nursing faculty have the important responsibility of increasing the number of nursing school graduates that enter the nursing profession. Unfortunately, attrition and retention continue to prevent nursing students from graduating on time or at all. Nursing faculty compassion has been identified as one important factor that could decrease nursing student attrition and increase nursing student retention and program completion. Compassion is a concept built upon the constructs of forming connections, empathetic behaviors, student suffering and faculty recognition of needs, and alleviation of suffering. No existing instruments measure all of these constructs. Some existing tools that measure …

A Scoping Review Of The Prevalence Of Polypharmacy In Dementia Patients In Correlation To Increased Falls And Hospitalizations, Julie Ward, Travis Adelman, Erica Barber, Elizabeth Upton

Doctor of Medical Science (DMSc)

Dementia is a progressive neurodegenerative condition characterized by cognitive decline and behavioral changes, which often necessitates polypharmacy to manage symptoms. There is a negative trade off to polypharmacy in that it increases the risks of falls and hospitalizations. Dementia patients are at an increased risk of falls and hospitalization, making it valuable to examine admission records to identify potentially modifiable risk factors. One of the most prevalent modifiable risk factors is polypharmacy in geriatric populations. Polypharmacy has become prevalent in older adults, not just in dementia. In 2013 a 3-year prospective cohort study of 1,742,336 people >65 years old looked …

Effectiveness Of Lavender Supplementation In Treating The Most Common Mental Health Conditions In Primary Care Settings: A Narrative Review, Taylor Irwin, Heather Justice, Kara Roman, Sophie Tajadod, Carilyn Ellis, Kristy Asbell, Jason Brumitt

Doctor of Medical Science (DMSc)

Primary care providers (PCPs) are increasingly challenged to meet the rising demand for psychiatric care in the United States (U.S.). 1,2 More patients are seeking mental health care from their PCP than ever before. The number of visits for mental health concerns increased by 50% from 11% of all visits in 2006 to approximately 16% of all visits in 2018. 1 Many patients are opting to seek treatment exclusively from PCPs rather than from psychiatric providers. 1 Several factors contribute to this trend, including a shortage of mental health care providers, limited insurance coverage for psychiatric services, and potential reluctance …

Glp-1 Agonists On Reducing The Risk Of Developing Dementia In Patients With Type 2 Diabetes, Alli Guerrero, Emmiline Chou, Erika Mccarthy, Heather Justice, Jason Brumitt

Doctor of Medical Science (DMSc)

Type 2 diabetes mellitus (T2DM) and dementia share a similar pathogenesis of insulin resistance, neuroinflammation, and oxidative stress.¹ Individuals diagnosed with T2DM are at an increased risk of experiencing accelerated cognitive decline, attributed to the underlying disease process, furthermore increasing the likelihood of developing dementia.¹ According to the Centers of Disease Control and Prevention (CDC), dementia was the second leading cause of death, with over 250,000 deaths associated with Alzheimer’s disease alone.² Currently, there are only two classes of drugs available for the symptomatic treatment of dementia: N-methyl D-aspartate (NMDA) antagonist and cholinesterase inhibitors.²However, no …

Deliberate Cold Exposure As Augmentation For Diabetic Management, Joel Graham, Michael Graham, Patrick Clyde, Michael Racine, Jason Brumitt

Doctor of Medical Science (DMSc)

CE has received attention during the past decade as a modality to decrease inflammation, improve mood, increase mental resiliency, and to facilitate physical exercise recovery. This “treatment” has been in use for centuries having been mentioned in ancient Greek texts. CE is also a common cultural practice of Nordic countries, with its traditional uses centering on the therapeutic effects improved health and recovery. These effects are predominantly moderated through the activation of the sympathetic nervous system (SNS) by changes in skin temperature, which subsequently induces the release of catecholamines to conserve body heat and prevent the onset of hypothermia. The …

Analyzing The Efficacy Of Dupilumab On Skin Clearance In Pediatric Patients With Atopic Dermatitis, Naomy Procopoi, Jason Brumitt

Doctor of Medical Science (DMSc)

Severe atopic dermatitis significantly impairs the quality of life for infants and young children, along with their family members and caregivers. Atopic dermatitis is a chronic inflammatory disease of the skin. It is characterized by pruritic, erythematous, and xerotic skin. The prevalence of atopic dermatitis in the pediatric population is much greater than in adults; it is estimated that approximately 15-20% of children worldwide are affected by this condition. Although the majority of these children achieve spontaneous remission in adulthood, mild to moderate disease may often be debilitating and lead to a lower quality of life.

Previously, the only approved …

Review Of Depression Management In Cardiovascular Disease, Kelsey Pangelinan, Kristy Asbell, Erika Mccarthy

Doctor of Medical Science (DMSc)

Introduction

Depression and cardiovascular disease (CVD) are closely interrelated, with depressive symptoms significantly more common in patients with heart disease than in the general population. Several studies have shown that between one-fifth to one-third of patients with severe acute coronary disease exhibit depressive signs, while around 10% meet the standards for major depressive disorder. This heightened occurrence of depression among ACS patients correlates with unfavorable cardiovascular outcomes, an amplified probability of recurrent heart events, and escalating healthcare costs.¹ Despite its acknowledged sway on cardiovascular health, depression often goes undiagnosed and untreated in this group. According to the World Health …

The Effect Of Gratitude On The Mental Health Of Healthcare Workers As Measured By Burnout And Depression, Haley S. Fujimori, Erika Mccarthy, Erika Barber, Jay Jamieson, Jason Brumitt

Doctor of Medical Science (DMSc)

Practicing gratitude has been shown to have a positive effect on both the mental and physical health of the general population and, thus, has been proposed as a means to improve the mental health of HCWs.Practicing gratitude can be defined as appreciating the things one has in life. Self-reflecting on things one is grateful for, listing good things that occurred throughout one’s day, journaling work events one is grateful for, and writing letters to thank someone are ways in which gratitude may be practiced. Existing research suggests that practicing gratitude is associated with improved sleep, blood pressure, and glycemic control, …

The Effect Of Aerobic Exercise On Reducing Drug Craving And Preventing Recurrence Of Methamphetamine Use Disorder, Sydney Skutt, Carilyn Ellis, Daniel Sanders, Jason Brumitt

Doctor of Medical Science (DMSc)

Methamphetamine (MA) is a derivative of amphetamine that is highly addictive and toxic. It is classified as a Schedule II stimulant under the Controlled Substances Act and has limited medical use for treatment of attention deficit hyperactivity disorder and high potential for abuse as a recreational drug. Prior to the 2000s, methamphetamine was derived from ephedrine or pseudoephedrine, a common ingredient in cold medicine, which became controlled in 2005 to combat the methamphetamine epidemic. Current methamphetamine is derived from phenyl-2-propanone, a chemical whose use is regulated for other uses, such as racing fuel, gold mining, perfume, and photography, fundamentally changing …

Re: Proteomic Exploration Of Potential Blood Biomarkers In Haemophilic Arthropathy, Quang D La, David F Lo, Don D Shamilov

Rowan-Virtua School of Osteopathic Medicine Departmental Research

We wish to convey our reflections on the scholarly article titled “Proteomic exploration of potential blood biomarkers in haemophilic arthropathy” [1]. This investigation elucidates significant results concerning the plasma proteome of individuals afflicted with hemophilic arthropathy (HA) across a spectrum of severities, accentuating pivotal variations in protein expression correlated with disease severity and emphasizing the intricate nature of HA pathophysiology.

Assistive Technologies For Internet Navigation: A Review Of Screen Reader Solutions For The Blind And Visually Impaired, Juan Nino, Sherezada Ochoa, Jocelyne Kiss, Geoffreyjen Edwards, Ernesto Morales, James Hutson, Frédérique Poncet, Walter Wittich

Faculty Scholarship

The internet is a critical resource for individuals with visual impairments (VI), including those with low vision or blindness, enabling access to information and fostering independent participation in society. However, despite advancements in screen reader software, challenges persist in navigating complex and dynamic web content. This narrative review evaluates Assistive Technologies (AT), which enhance internet navigation for VI screen reader users, focusing on design strategies and usability outcomes. A systematic search across the ACM Digital Library, IEEE Xplore, JSTOR, and ScienceDirect identified 698 studies, of which 33 met the inclusion criteria, encompassing 502 participants. Key themes were extracted from bibliographic …

Thoughts From The Frontline - December 2024, Tennessee Center For Nursing Advancement, East Tennessee State University

Thoughts from the Frontline Newsletter

No abstract provided.

Advocating For Occupational Therapy Intervention With In-House Athletics, Jatia Littles, Cynthia Haynes

Fall 2024 OTD Capstone Symposium

Occupational therapists (OT) have the opportunity to work with athletes by outsourcing through orthopedic centers with professional leagues such as the National Football League (NFL) (Jobs in Sports, 2022) but rarely do you see OTs within the sports complex working in-house. Although many studies go into great detail on the benefits of occupational therapy during the rehabilitation process, there are only a limited number of studies that explore occupational therapy intervention in athletics (Andreas et al., 2021). This project designed and implemented an occupational therapy-focused advocacy project that involves informing interprofessional sports faculty on the benefits of OTs being a …

Relationship Of Stress, Family, And Social Support, And Job Satisfaction To Burnout Among Family Nurse Practitioners Employed In Primary Care Clinics In Mississippi, Laura-Jean Scott Brooks

Dissertations

In the realm of healthcare, burnout is the invisible monster that has infiltrated every facet of the industry with grossly visible results. From provider turnover to patient errors, burnout has lifelong effects on the healthcare provider and patient care. This researcher seeks to study variables and the relationship to burnout among Family Nurse Practitioners who practice in primary care in Mississippi. The Review of the Literature demonstrated a lack of findings in burnout among family nurse practitioners. Most of the literature reviewed focused on burnout among registered nurses. The guiding hypothesis of the research study was that social and family …

Delinquency And Inadvertent Neglect As Byproducts Of Work-Addicted Parents, Shelley Sasser

Bridges: A Journal of Student Research

Over the past decade, discussions of work addiction throughout academic literature have increased substantially. However, the relationship between childhood outcomes and parental work addiction has yet to be explored. In this study, I set out to identify functions of parent-child relationships and comparisons of situational outcomes stemming from work addiction in relation to social determinants such as income, ethnicity, and gender, along with resulting stratification. The degree to which children benefit from features of lifestyles typically associated with high household incomes, such as financial security, health care benefits, access to educational resources, and neighborhood socioeconomic advantage, wherein parental work-addiction might …

Short-Term And One-Week Follow-Up Of Dry Needling Effects On Shoulder Range Of Motion And Strength With Asymptomatic Individuals, Mark Hecimovich

Master of Science in Kinesiology

Dry needling, a subcutaneous treatment intervention using fine filiform needles, is growing in popularity amongst manual therapists and is used in treating myofascial trigger points, pain, range of motion, and strength, albeit with limited research. This research aimed to measure the effect of dry needling on the shoulder, its impact on external rotation, and abduction range of motion and strength with an asymptomatic cohort of individuals. It is hypothesized that dry needling on a cohort of healthy individuals will not influence both range of motion and strength.

This study consisted of a convenience sample of 20 university students aged 20 …

Emergency Room Treatment And Outcomes Of Patients Experiencing A Mental Health Crisis: A Scoping Review, Tyson Greener, Heather Rollins, Kevin Vandenheuvel, Carilyn Ellis

Doctor of Medical Science (DMSc)

During the past decade, emergency rooms (ER) across the country have become inundated with patients seeking treatment for behavioral health-related concerns. It was found in the United States in 2011 that one in four patients presenting to the emergency room did so with a mental health disorder. Patients present with a range of behavioral health concerns, including depression/anxiety, suicidal ideation, psychosis, substance use disorder, and suicidal attempts. It has been found that 1 in every five patients presenting to the ER with a mental health concern will return within 6 months. Within the same study, over 4 years, 44.8% (4796) …

Determining An Optimal Case Definition Using Mid-Upper Arm Circumference With Or Without Weight For Age To Identify Childhood Wasting In The Philippines, Lyle Daryll Dimaano Casas, Jhanna Uy, Eldridge Ferrer, Charmaine Duante, Paluku Bahwere, Rene Gerard Galera, Alice Nkoroi, Behzad Noubary, Mueni Mutunga, Sanele Nkomani, Roland Kupka, Valerie Gilbert Ulep

Health Sciences Faculty Publications

In resource-limited areas, where accurate weight-for-height Z-scores are hard to obtain, Mid-Upper Arm Circumference (MUAC) is a simple tool to identify wasted children. MUAC alone, however, may miss identification of many wasted children, leading to untimely intervention and potentially death. Our study aimed to identify the best-performing case definition to detect wasting by Weight-for-Height z-scores (WHZ) in Filipino children aged 6-59 months. We analyzed the 2018-2019 Expanded National Nutrition Survey to assess the diagnostic performance of MUAC cutoffs and a case definition combining MUAC and weight-for-age z-score (WAZ) in identifying moderate and severe wasting compared to the WHZ criterion. The …

Population-Based Cross-Sectional Analysis Of Cannabis Use Among Kentucky Adults, 2020– 21, Sydney Shafer, Gunnar Kennedy, W. Jay Christian

UK CARES Faculty Publications

Purpose We conducted this study to assess cannabis use rates in the state of Kentucky relative to socioeconomic, demographic, and geographic factors, as well as reasons for use and modes of use, before the legal medical marijuana market commences in 2025.

Methods We pooled Kentucky Behavioral Risk Factor Surveillance System (BRFSS) data for 2020–2021 and used weighted responses for all analyses. We estimated current cannabis use (at least once in the past 30 days), and heavy use (at least 20 of the past 30 days) prevalence rates for Appalachian, Delta, and Central geographic regions of Ken- tucky. We tabulated descriptive …

The Contributions Of Motor Skill Proficiency To Cognitive And Social Development In Early Childhood, Catherine M. Capio, Norman B. Mendoza, Rachel A. Jones, Rich S.W. Masters, Kerry Lee

Health Sciences Faculty Publications

With limited evidence from intervention studies, causal relationships between motor competence and cognitive and social development have yet to be clearly established. In this research, we investigated whether a targeted training programme to improve fundamental movement skills (i.e., object control, locomotor) in young children would also lead to improvements in the cognitive (i.e., executive function) and social (i.e., socioemotional competence) domains. Using a two-arm group randomised intervention design, 185 children aged 36 to 60 months (mean 47.51, SD 8.11 months) were allocated to a motor skill intervention group or an active control group. The intervention was implemented over one school …

Perceived Patient-Centered Care In Marching Band Artists, A L. Merrill, Z K. Winkelmann, N A. Uriegas

Bakerman Student Research Awards

Objective: Approximately 27,000 college marching band (MB) artists in the United States could benefit from access to healthcare services and patient-centered clinicians. The purpose of this study was to explore HCPs MB artists have access to and their perceptions of patient-centered care (PCC). Methods: We used a cross-sectional web-based survey of MB artists (n=751, age=20±8 years). MB directors from 242 colleges were emailed a survey link to forward to MB artists. Participants indicated which HCPs they could access. Those who reported no access or unsure were prompted to describe what they would do if an injury or illness occurred. Participants …

Caregiver Involvement In Pediatric Speech-Language Pathology, Kathryn Ticknor

Theses & Honors Papers

This study explores how caregivers and speech-language pathologists (SLPs) perceive caregiver involvement in pediatric speech therapy services. The research addresses how and when caregiver input is solicited, and to what extent the services children receive reflect caregivers’ expressed concerns and priorities. Using a two-phase survey design, caregivers and speech-language pathologists from private practices in Virginia provided quantitative responses on the importance, frequency, and effectiveness of collaboration. Overall, caregivers reported moderate levels of involvement (mean score: 3.88/5). Contrary to conventional wisdom, caregivers’ level of involvement was not directly correlated with their level of satisfaction, suggesting other factors, such as communication quality …

Academic Nurse Leaders’ Application Of Bolman And Deal’S Leadership Orientation Framework, Jasmine Bratton

Dissertations

While Academic Nurse Leaders (ANLs) are vital to the functioning and quality of nursing programs in academic settings, many enter their roles with limited or no prior academic leadership and management experience. The inadequate preparation and development of ANLs remains a critical concern. For this reason, ANLs positions can be challenging and hard to fill. Although ANLs can hold various titles and positions across different academic institutions, this study specifically focuses on Deans, Directors, and Department Chairs working in the New York State area. Bolman and Deal’s (2021) four-frame model of leadership offers a framework that can be used to …

Evaluation Of Pain Control In Lobectomies: Before And After The Removal Of Liposomal Bupivacaine From Formulary At An Academic Health System, Kelly Cheng Pharmd, Michael Guerra Pharmd, Rebecca Pulk Pharmd, Ms, Bsp, Amber Zaniewski Pharmd, Mba, Bcps, Ryan Brown Pharmd, Bcps

Posters

• Liposomal bupivacaine is an extended-release formulation of the long-acting traditional local anesthetic, bupivacaine.
• Yale New Haven Health system (YNHHS) removed liposomal bupivacaine from formulary in March 2024.
• This decision was based on primary research and meta-analyses showing little to no clinical or statistical benefit of liposomal bupivacaine over traditional bupivacaine in morphine milligram equivalent use (MME) and median pain score in all surgeries including lobectomies.

Identifying Current Barriers And Optimization Opportunities Of Rapid Access Pathway To Outpatient Care For High-Cost Biologics In An Academic Health System, Avani Topiwala Pharmd, Vincent Do Pharmd, Bcps, Bctxp, Joseph Rosano Bs, Pharmd

Posters

• Inpatient administration of specialty biologic agents can have significant financial impacts on a healthcare system.
• The “Never Administer Inpatient List” (NAIL) is an established reference which contains biologic infusions that should be administered in an outpatient setting when clinically appropriate.
• While outpatient administration may be clinically appropriate, there are many barriers to coordinating outpatient infusions that result in unnecessary inpatient administration. This can result in a prolonged length of stay and increased medication cost.

Host Response To Implantation Of A Poly N-Isopropylarylamide Injectable Cell Therapy Vehicle, Cole Matthew Burk

Master's Theses

There is a need to develop novel and effective therapies targeting end-stage peripheral arterial occlusive disease (PAOD). Inducing collateral arteriogenesis is a possible novel treatment that produces a natural bypass for blood flow, a promising solution to the long-term issues seen with current treatments. Regenerative therapies, and progenitor cells specifically, have demonstrated great promise in repair after injury and disease. While most progenitor or stem cells have poor efficacy in this context, muscle progenitor cells, or myoblasts, have encouraging results. Myoblasts enhance arteriogenesis and secrete cytokines or chemokines that recruit monocytes to injury sites. Implanting these adherent cells in a …

Safeguarding Virtual Healthcare: A Novel Attacker-Centric Model For Data Security And Privacy, Suvineetha Herath, Haywood Gelman, John Hastings, Yong Wang

Research & Publications

The rapid growth of remote healthcare delivery has introduced significant security and privacy risks to protected health information (PHI). Analysis of a comprehensive healthcare security breach dataset covering 2009-2023 reveals their significant prevalence and impact. This study investigates the root causes of such security incidents and introduces the Attacker-Centric Approach (ACA), a novel threat model tailored to protect PHI. ACA addresses limitations in existing threat models and regulatory frameworks by adopting a holistic attacker-focused perspective, examining threats from the viewpoint of cyber adversaries, their motivations, tactics, and potential attack vectors. Leveraging established risk management frameworks, ACA provides a multi-layered approach …

December 2024: Region 10 Emerging Special Pathogen Treatment Center (Resptc) At Providence Sacred Heart Medical Center & Children’S Hospital, Providence - Special Pathogens Program

Special Pathogens Newsletters

REGION 10 SPECIAL PATHOGENS NEWSLETTER

Early Referral For Eye Movement Desensitization And Reprocessing Therapy For Treatment Of Trauma-Induced Anxiety And Emotional Distress, Christa Jones

Doctoral Projects

Trauma, anxiety, and emotional distress are significant health concerns affecting millions globally and resulting in significant healthcare burdens. Despite the considerable efforts in addressing problems, most high-risk cases often go unidentified or unaddressed promptly. Besides standard trauma diagnosis, treatment, and management protocols, some patients often require specialized support. Recently, Eye Movement Desensitization and Reprocessing (EMDR) has emerged as a promising alternative for treating anxiety, trauma, and emotional distress conditions, yet many patients who are at high risk are often not identified early for referral. Additionally, many healthcare facilities, especially those in rural settings, fail to include appropriate screening tools.

This …