Medicine and Health Sciences Commons^™

Marijuana Legalization And Opioid Use Disorder In Ontario, Canada, From 2015 To 2021, Luke Ome Agada

Walden Dissertations and Doctoral Studies

This study examined the trends in opioid-related hospitalizations and deaths in Ontario, Canada, from 2015, to 2021, with a particular focus on the periods before and after cannabis legalization. The social problem addressed was the ongoing opioid crisis, exacerbated by rising opioid-related health issues. Grounded in the harm reduction theory, this research explored whether cannabis legalization could serve as a substitute to mitigate opioid use disorder. Data were extracted from the Discharge Database, Emergency Department Database, National Ambulatory Care Reporting System, and Hospital Morbidity Database. Analysis using the generalized estimation equation (GEE) method revealed a significant increase in opioid-related hospitalizations, …

Umbilical Amniotic Membrane (Am-Uc) As A Skin Substitute In Periocular Reconstruction: A Case Series, Jane Spadaro, Komalpreet Tur, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Characterizing The Progression From Mild Cognitive Impairment To Dementia: A Network Analysis Of Longitudinal Clinical Visits, Muskan Garg, Sara Hejazi, Sunyang Fu, Maria Vassilaki, Ronald C Petersen, Jennifer St Sauver, Sunghwan Sohn

Faculty, Staff and Student Publications

Background: With the recent surge in the utilization of electronic health records for cognitive decline, the research community has turned its attention to conducting fine-grained analyses of dementia onset using advanced techniques. Previous works have mostly focused on machine learning-based prediction of dementia, lacking the analysis of dementia progression and its associations with risk factors over time. The black box nature of machine learning models has also raised concerns regarding their uncertainty and safety in decision making, particularly in sensitive domains like healthcare.

Objective: We aimed to characterize the progression of health conditions, such as chronic diseases and neuropsychiatric symptoms, …

Iodine Contrast Should Be Avoided In Patients With Or At Risk For Thyroid Eye Disease, Jane Spadaro, Brittany Simmons, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Anatomy Of Lower Eyelid Fat Pad Vasculature As Found In Lower Eyelid Blepharoplasties, Irene Lee, Nishita Sheth, Evan Black, Christopher Delmarkarian, Julie Woodward

Conference Presentation Abstracts

No abstract provided.

Evaluation Of A Workshop To Improve Professional Transitions Among Nursing Students And Nurses, Andrew Richards

Achieve

New nurses and nurses experiencing a professional transition often regress through Benner's novice to expert stages and are at risk for transition shock and crisis (Murray et al., 2019). New graduate nurses experience challenges adjusting to their new roles, but educational and organizational factors can help provide support during this time of transition (Baharum et al., 2023). Simulation experiences can enhance students' confidence and help prepare them for practice (Woods et al., 2015). Situational and personal factors influence the professional development and retention of new nurses (Laschinger et al., 2016). Many new nurses struggle with adjusting to the profession and …

Academic Partnerships In Transforming Nursing And Midwifery Education In Africa: A Systematic Scoping Review Protocol, Claudine Muraraneza, Donatilla Mukamana, Godfrey Katende, Oliva Bazirete, Liz Wolvaardt

School of Nursing & Midwifery, East Africa

Background. In recent decades, the literature on global partnerships in nursing and midwifery education, to enhance the quality of education and produce competent graduates in the labor market, is on the rise in Africa. However, there is a gap regarding the best practices and barriers in the African context. This systematic scoping review aims to map the evidence of academic partnerships in transforming nursing and midwifery education in Africa.

Methods. The review will be guided by Arksey and O’Malley’s methodology framework through five stages: (1) Identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, …

Black Women’S Perceptions Of Perinatal Healthcare In New York City Community Health Centers, Asiyah Franklin

Walden Dissertations and Doctoral Studies

The purpose of this qualitative study was to explore the experiences of Black women who have received perinatal care in New York City (NYC) community health centers and the perceived impact on their maternal health behaviors and outcomes. Although maternal health care delivery and outcomes among Black women have been explored in research, socially and economically disenfranchised Black women in NYC who rely on community health centers for perinatal care have not been included in this research. This study involved addressing the lack of knowledge of Black women’s experiences with perinatal care in NYC’s community health system and consisted of …

Abstract Education On Agency For Healthcare Research And Quality Ideal For Health Ministry, Francesse Charles-Cherelus

Walden Dissertations and Doctoral Studies

Education on Agency for Healthcare Research and Quality IDEAL for Health Ministry by Francesse Charles-Cherelus MS, Walden University, 2020 BS, Clayton State University, 2018 Project in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University November 2024 The problem addressed in this project was lack of access to community resources for care of patients with behavioral or mental health conditions. Without adequate resources, patients are at risk for rehospitalization. The purpose of the doctoral project was to develop a staff education program for health ministry staff and evaluate effectiveness to increase staff confidence in …

Connecting With The Counselors: Innovative Approaches To Enhance The Recruitment Of Male Students In Secondary Schools, Andrew Richards, Stephanie Gedzyk-Nieman

Achieve

The American Association of Colleges of Nursing (AACN, 2019) recognized the role of a culturally diverse workforce in improving the quality and cultural competence of care. The AACN identified the need to attract students from underrepresented groups, including men. According to the results of the 2020 National Nursing Workforce Survey, only 9.4% of registered nurses in the United States are men, a 2.8% increase from 2013 (Smiley et al., 2021). The 2020 United States Census reported that 49.5% of the population is male (United States Census Bureau, 2020). A significant effort is needed to increase the percentage of men in …

Evaluation Of Ki-67 Expression And Large Cell Content As Prognostic Markers In Mzl: A Multicenter Cohort Study, Natalie S. Grover, Kaitlin Annunzio, Marcus Watkins, Pallawi Torka, Reem Karmali, Andrea Anampa-Guzmán, Timothy S. Oh, Heather Reves, Montreh Tavakkoli, Emily Hansinger, Beth Christian, Colin Thomas, Stefan K. Barta, Praveen Ramakrishnan Geethakumari, Nancy L. Bartlett, Geoffrey Shouse, Adam J. Olszewski, Narendranath Epperla

Department of Medicine Faculty Papers

Marginal zone lymphoma (MZL) can have varied presentations and pathologic features, including high Ki-67 expression ( > 20%) as well as increased numbers of large B cells (LC). However, there are limited data available demonstrating the prognostic significance of these variables in patients with MZL. In this multi-institutional retrospective cohort study of patients with MZL treated at 10 centers, we evaluated the association between the presence of Ki-67 expression and increased LCs on survival and risk of histologic transformation (HT). A total of 785 patients were included (60% with extranodal MZL, 20% with nodal MZL, and 20% with splenic MZL). Among …

Orbital Perivascular Epithelioid Cell Neoplasm (Pecoma): A Case Report And Systematic Review, Jane Spadaro, Christopher Hysell, Robert Folberg, Alon Kahana

Conference Presentation Abstracts

No abstract provided.

Examining The Relationship Between Employment And Health Status Among Adults With Autism Spectrum Disorder (Asd) In The United States, Winifred Beckles

Walden Dissertations and Doctoral Studies

Autism spectrum disorder (ASD), characterized by challenges in social communication and repetitive behaviors, is a developmental disability that impacts over five million adults in the United States. Despite the significant amount of research literature on the association between health and employment in the general population, there remains a gap in research on the relationship between health and employment in adults with autism. Utilizing the Social Ecological Model (SEM) framework, this study examined whether there is a relationship between employment, current living status, non-paid activities, United States Census regions, type of health insurance, and health status when controlling for age, race, …

Health Risks Associated With Adopting New-Generation Disposable Products Among Young Adults Who Use E-Cigarettes, Shuyao Ran, James J Yang, Megan E Piper, Hsien-Chang Lin, Anne Buu

Faculty, Staff and Student Publications

New-generation disposable e-cigarettes have become increasingly popular among young adults in the USA since the FDA's partial flavor ban. This study aims to examine longitudinal changes in health risks among young adults who adopted these novel products, as well as the health effects of device types beyond the effects of other important e-cigarette characteristics. This study recruited e-cigarette users via voluntary response sampling from three college campuses in the USA to respond to four-wave online surveys conducted in four consecutive semesters. Among the participants who adopted disposables during the study, their health risks (dependence symptoms, respiratory symptoms, combustible tobacco use) …

Association Between Mri Findings Of Facet Arthropathy And Synovitis With Health-Related Outcome And Pain Scores Following Therapeutic Lumbar Facet Injections, Michael Stuart Green, Michele Van Hal, Matthew Onimus, Christopher R. Hoffman, Dhruv K. C. Goyal, Valeria Potigailo, Khuram S. Kazmi

Department of Anesthesiology Faculty Papers

Low back pain is a common complaint among adults. The facet joint is a major source of lumbar pain, and therapeutic facet injections have gained popularity as a minimally invasive treatment option. In addition, magnetic resonance imaging (MRI) utilization for diagnosing low back pain has increased significantly over the past few decades. Facet synovitis is an entity characterized by edema and inflammatory changes affecting the facet joints, adjacent bone marrow, and surrounding soft tissues. Although its underlying etiology remains poorly understood, recent reports suggest a high incidence in patients with arthropathy and arthritis. It is essential to explore potential correlations …

Racial Bias In The Treatment Decision Of Breast Cancer In African American And Caucasian Women, Hayaat Mariette Amara

Walden Dissertations and Doctoral Studies

Breast cancer stands as a formidable health challenge in the United States, ranking as the most prevalent and deadly diagnosed cancer and the second leading cause of cancer-related death among women. Of particular concern is the disproportionate impact on African American women, who experience elevated mortality rates compared to other demographic groups. This quantitative study, grounded in critical race theory, investigated whether there is an association between race as well as comorbidity score and first-course treatment plans for breast cancer among women in the State of Georgia, United States, adjusting for the stage of breast cancer, age, and household income. …

Staff Education To Improve Medication Compliance In Older Patients In Home Settings, Chika Ugoala Okwonna

Walden Dissertations and Doctoral Studies

The Doctor of Nursing Practice (DNP) project was a staff education intervention intended to improve medication adherence at a long-term care facility. The practice gap identified was that staff lacked current evidence-based knowledge in medication compliance. The project addressed whether educating staff on medication compliance would increase knowledge. The purpose of this project was to increase knowledge with the overall goal to improve patient outcomes. Planning strategies included undertaking a strengths, weaknesses, opportunities, and threats (SWOT) assessment of the organization’s readiness. The project involved creating and implementing an in-person 60-minute presentation. Eighteen nursing staff voluntarily participated in the education intervention, …

Post-Transcriptional Methylation Of Mitochondrial-Trna Differentially Contributes To Mitochondrial Pathology, Sunita Maharjan, Howard Gamper, Yuka Yamaki, Thomas W. Christian, Robert Y. Henley, Nan-Sheng Li, Takeo Suzuki, Tsutomu Suzuki, Joseph A. Piccirilli, Meni Wanunu, Erin L. Seifert, Douglas C. Wallace, Ya-Ming Hou

Department of Biochemistry and Molecular Biology Faculty Papers

Human mitochondrial tRNAs (mt-tRNAs), critical for mitochondrial biogenesis, are frequently associated with pathogenic mutations. These mt-tRNAs have unusual sequence motifs and require post-transcriptional modifications to stabilize their fragile structures. However, whether a modification that stabilizes a wild-type (WT) mt-tRNA would also stabilize its pathogenic variants is unknown. Here we show that the N¹-methylation of guanosine at position 9 (m¹G9) of mt-Leu(UAA), while stabilizing the WT tRNA, has a destabilizing effect on variants associated with MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes). This differential effect is further demonstrated, as removal of the m¹G9 …

Nonclinical Profile Of Pf-06952229 (Mdv6058), A Novel Tgfβri/Activin Like Kinase 5 Inhibitor Supports Clinical Evaluation In Cancer, Mausumee Guha, Stephane Thibault, Son Pham, Sebastian Bernales, Rama Pai, Francisco J Herrera, Theodore R Johnson, Allison Vitsky, Tina Fernando, Martin Finkelstein

Faculty, Staff and Student Publications

The development of transforming growth factor βreceptor inhibitors (TGFβRi) as new medicines has been affected by cardiac valvulopathy and arteriopathy toxicity findings in nonclinical toxicology studies. PF-06952229 (MDV6058) selected using rational drug design is a potent and selective TGFβRI inhibitor with a relatively clean off-target selectivity profile and good pharmacokinetic properties across species. PF-06952229 inhibited clinically translatable phospho-SMAD2 biomarker (≥60%) in human and cynomolgus monkey peripheral blood mononuclear cells, as well as in mouse and rat splenocytes. Using an optimized, intermittent dosing schedule (7-day on/7-day off/cycle; 5 cycles), PF-06952229 demonstrated efficacy in a 63-day syngeneic …

A Scoping Review Of Patient Safety Checklists In Dentistry, K Zouaidi, T W Miner, M F Walji, E Kalenderian, D B Rindal, K J Suda

Faculty, Staff and Student Publications

Objectives: Not much is known about safety checklists use in dentistry. We aim to examine, assess, and provide a comprehensive understanding of the current knowledge concerning the use of checklists to improve patient safety in dentistry.

Methods: We conducted a comprehensive literature search using Medline and Embase for studies that use or describe the development of dental patient safety checklists. All study designs were included for citations published through December 2023.

Results: Following abstract and full-text screening, 27 studies remained for data extraction and analysis. Oral surgery emerged as the main dental specialty where the utilization and evaluation of checklists …

The Telehealth Shared Decision-Making Coaching And Navigation In Primary Care (Telescope) Intervention: A Study Protocol For Delivering Shared Decision-Making For Lung Cancer Screening By Patient Navigators, Naomi Q P Tan, Lisa M Lowenstein, Elisa E Douglas, Jeanne Silva, Joshua M Bershad, Jinghua An, Sanjay S Shete, Michael B Steinberg, Jeanne M Ferrante, Elizabeth C Clark, Ana Natale-Pereira, Novneet N Sahu, Shirin E Hastings, Richard M Hoffman, Robert J Volk, Anita Y Kinney

Faculty, Staff and Student Publications

BACKGROUND: Lung cancer screening (LCS) can reduce lung cancer mortality but has potential harms for patients. A shared decision-making (SDM) conversation about LCS is required by the Centers for Medicare & Medicaid Services (CMS) for LCS reimbursement. To overcome barriers to SDM in primary care, this protocol describes a telehealth decision coaching and navigation intervention for LCS in primary care clinics delivered by patient navigators. The objective of the study is to evaluate the effectiveness of the intervention and its implementation potential, compared with an enhanced usual care (EUC) arm.

METHODS: Patients (n = 420) of primary care clinicians (n …

Moving Beyond Wastewater: Perspectives On Environmental Surveillance Of Infectious Diseases For Public Health Action In Low-Resource Settings., Jeseth Delgado Vela, Sarah E. Philo, Joe Brown, Mami Taniuchi, Molly Cantrell, Alexandra Kossik, Maya Ramaswamy, Sitara Sr Ajjampur, Fatma Z. Guerfali, Rochelle H. Holm, John Scott Meschke, Maria Catherine B. Otero, Amy J. Pickering, Mahbubur Rahman, Alexander G. Shaw, Abhilasha Shrestha, Kwanrawee Sirikanchana, Vivi Maketa Tevuzula, Rolf U. Halden, Alexandria B. Boehm, Kyle Bibby

Faculty and Staff Scholarship

No abstract provided.

What Makes An Effective Chief Of Pediatric Cardiology: Insights From Chiefs Of North American Pediatric Programs, Michael E. Kim, Wayne Franklin, Anne M. Dubin, Jeffrey J. Kim, Shubhayan Sanatani, R. Krishna Kumar, Shubhika Srivastava, Thomas R. Kimball, Mark Lewin, Joseph Rossano, Colin J. Mcmahon

School of Medicine Faculty Publications

BACKGROUND: Although the position of a pediatric cardiology chief is often seen as the apex of one's academic career, its roles, responsibilities, and qualifications are not well defined in the literature. This study was done to gain further insight of the role and attributes of a pediatric cardiology chief by surveying those who are currently serving the position across North American centers. METHODS AND RESULTS: This was a mixed-methods study with a survey given to North American pediatric cardiology chiefs at programs with fellowship training programs. The survey was a semistructured questionnaire that was independently reviewed by 3 cardiologists. Smaller …

Short-Term Neurologic Outcomes In Pediatric Extracorporeal Membrane Oxygenation Are Proportional To Bleeding Severity Graded By A Novel Bleeding Scale, Katherine Doane, Danielle Guffey, Laura L Loftis, Trung C Nguyen, Matthew A Musick, Amanda Ruth, Ryan D Coleman, Jun Teruya, Christine Allen, Melania M Bembea, Brian Boville, Jamie Furlong-Dillard, Santosh Kaipa, Mara Leimanis, Matthew P Malone, Lindsey K Rasmussen, Ahmed Said, Marie E Steiner, Deanna T Tzanetos, Heather Viamonte, Linda Wallenkamp, Arun Saini

Center for Medical Ethics and Health Policy Staff Publications

Introduction: This study aimed to characterize the severity of bleeding and its association with short-term neurologic outcomes in pediatric ECMO.

Methods: Multicenter retrospective cohort study of pediatric ECMO patients at 10 centers utilizing the Pediatric ECMO Outcomes Registry (PEDECOR) database from December 2013-February 2019. Subjects excluded were post-cardiac surgery patients and those with neonatal pathologies. A novel ECMO bleeding scale was utilized to categorize daily bleeding events. Poor short-term neurologic outcome was defined as an unfavorable Pediatric Cerebral Performance Category (PCPC) or Pediatric Overall Performance Category (POPC) (score of >3) at hospital discharge.

Results: This study included 283 pediatric ECMO …

Access To Waitlisting And Posttransplant Outcomes In Patients With Failed Kidney Allografts Secondary To Recurrent Glomerulonephritis, Ryan Gately, Germaine Wong, Armando Teixeira-Pinto, Helen Pilmore, Carmel Hawley, Scott Campbell, William Mulley, Wai H. Lim

Research outputs 2022 to 2026

Background. Recurrent glomerulonephritis (GN) is an important cause of allograft loss after transplantation when GN is the primary cause of kidney failure. Retransplantation after allograft loss from recurrent disease requires careful consideration. We aimed to determine the probability of relisting and the risk of allograft loss after retransplantation in recipients with prior allograft loss from recurrent GN. Methods. Using data from the Australia and New Zealand Dialysis and Transplant Registry and multivariable Cox modeling, we compared the probability of waitlisting and allograft loss after second transplantation between those with and without prior allograft loss from recurrent disease. Results. Of 3276 …

Application Of The Estimand Framework For An Emulated Trial Using Reference Based Multiple Imputation To Investigate Informative Censoring, A Atkinson, M Zwahlen, S De Wit, H Furrer, J R Carpenter

2020-Current year OA Pubs

BACKGROUND: The ICH E9 (R1) addendum on Estimands and Sensitivity analysis in Clinical trials proposes a framework for the design and analysis of clinical trials aimed at improving clarity around the definition of the targeted treatment effect (the estimand) of a study.

METHODS: We adopt the estimand framework in the context of a study using "trial emulation" to estimate the risk of pneumocystis pneumonia, an opportunistic disease contracted by people living with HIV and AIDS having a weakened immune system, when considering two antibiotic treatment regimes for stopping antibiotic prophylaxis treatment against this disease. A "while on treatment" strategy has …

Telemedicine In Pediatric Rheumatology: The Video Pediatric Gait, Arms, Legs, And Spine (V-Pgals), Zeynep Balik, Seher Şener, Yağmur Bayindir, Müşerref Kasap Cüceoğlu, Emi̇l Ali̇yev, Özge Başaran, Yelda Bi̇lgi̇ner, Seza Özen, Ezgi̇ Deni̇z Batu

Turkish Journal of Medical Sciences

Background/aim: Video pediatric gait, arms, leg, and spine (v-pGALS) is a virtual application of pediatric gait, arms, leg, and spine (pGALS) examination performed by video. We aimed to verify the applicability, validity, and accuracy of the Turkish translation of the v-pGALS in a large pediatric patient cohort.Materials and methods: Children aged 4-18 years were included between May and June 2022. A hands-on physical examination and v-pGALS were performed. Demographics, active symptoms, physical examination findings, diagnosis, and v-pGALS findings were recorded. The acceptability of v-pGALS by the parent/patient was measured using a visual analog scale (VAS), in terms of additional distress …

Evaluation Of Ki-67 Expression And Large Cell Content As Prognostic Markers In Mzl: A Multicenter Cohort Study, Natalie S Grover, Marcus Watkins, Nancy L Bartlett, Et Al.

2020-Current year OA Pubs

Marginal zone lymphoma (MZL) can have varied presentations and pathologic features, including high Ki-67 expression ( > 20%) as well as increased numbers of large B cells (LC). However, there are limited data available demonstrating the prognostic significance of these variables in patients with MZL. In this multi-institutional retrospective cohort study of patients with MZL treated at 10 centers, we evaluated the association between the presence of Ki-67 expression and increased LCs on survival and risk of histologic transformation (HT). A total of 785 patients were included (60% with extranodal MZL, 20% with nodal MZL, and 20% with splenic MZL). Among …

Direct Targeting Of Mitochondria By Cisplatin Leads To Cytotoxicity In Zebrafish Lateral-Line Hair Cells, David S Lee, Angela Schrader, Jiaoxia Zou, Wee Han Ang, Mark E Warchol, Lavinia Sheets

2020-Current year OA Pubs

Cisplatin is a chemotherapy drug that causes permanent hearing loss by injuring cochlear hair cells. Hair cell mitochondria have emerged as potential mediators of hair cell cytotoxicity. Using

Rapid Cycle Deliberate Practice And The Zeigarnik-Ovsiankina Phenomenon As A Method Of Learning And Achieving Long-Term Retention Of Airway Management – A Longitudinal Observational Study, Kirsten R. Kim Sawtelle, Andrew L. Guymon, Valeriy Kozmenko

Aesculapius Journal (Health Sciences & Medicine)

Introduction: This study investigates the effectiveness of Rapid Cycle Deliberate Practice (RCDP) in preparing medical students for the AAMC's entrustable professional activity of airway management. The best simulation training technique for airway management remains unknown. RCDP is well-suited for simulation-based sequential and algorithmic tasks.

Methods: Sixty-seven second-year medical students participated in three one-hour sessions on Airway Management and IV Induction into Anesthesia. They were randomly assigned to control or test groups, practicing under traditional RCDP or RCDP+ Zeigarnik-Ovsiankina phenomenon (ZOP) learning methods, respectively. The control group completed the entire attempt before debriefing, while the test group restarted immediately after the …