Medicine and Health Sciences Commons^™

Improving Firefighter Health Through Education In Sleep Science, Elisabeth J. Filiss

Master's Projects and Capstones

Sleep impacts all aspects of life, from mental health to physical well-being to job performance. Nowhere is this more important than in the fire service, where extreme working conditions are the norm. One of 44 stations in a large fire department (XFD), Firehouse X, has 21 full-time members, six on duty per shift. A microsystem assessment of Firehouse X revealed poor sleep habits and environmental factors that are not conducive to quality sleep. The role of sleep in the fire service has recently been examined, and interventions aimed at improving firefighters’ sleep have been recommended.

This quality improvement project implemented …

Decreasing Inappropriate Wound Consults, Arpita Hinton

Master's Projects and Capstones

Abstract

Background: This project was centered around the wound nurses and their workload. It also highlighted the opportunity for education for frontline staff. The wound nurses at this northern California hospital are a group of five nurses that support the whole hospital. Usually there are two staffed per day to support a facility that continues to have three to four overflow areas open to accommodate its high census.

Problem: My project focused on decreasing inappropriate wound consults. There are many consults places that do not need the intervention of a skilled wound nurse. These consults lead to time that is …

Implementing The "Baby Drop Bundle", Natalie Aguirre

Master's Projects and Capstones

Problem: Falls are a preventable type of trauma that may lead to serious injury, prolonged hospital stays, and non-reimbursable costs to the organization. While there are established fall prevention policies for ambulatory patients, infants dropped by their caregivers are largely excluded.

Context: This quality improvement project aims to decrease newborn drops by implementing the “Baby Drop Bundle”. The bundle allows caregivers and bedside providers to partner in creating a safe environment for the patient.

Interventions: The Clinical Nurse Leader (CNL) will provide a brief in-service during the morning safety huddle to introduce the bundle to staff. The bundle includes educational …

Addressing Rural Food Insecurity: A Flexible Approach Using Evidence-Based Practices, Alison Clayshulte

Master's Projects and Capstones

Food insecurity is a major public health problem in the United States that can lead to worse physical and mental health outcomes for millions of Americans. Rural communities struggle with food insecurity at a higher rate, leading to disproportionately higher levels of chronic conditions, obesity, and stress. Food insecurity is a symptom of many factors including underlying social, economic, and institutional obstacles that affect the quantity and quality of available food. Examples of evidence-based programs implemented to address these factors abound, however rural communities have unique challenges that must be considered to ensure programmatic success. This paper explores these challenges …

Optimizing Geriatric Care: A Niche-Driven Daily Implementation Of The 5ms Geriatric Assessment Tool To Minimize Length Of Stay, Lori Ann Aston-Dixon

Master's Projects and Capstones

Abstract

Background: This project's microsystem was a 32-bed medical-surgical telemetry unit at a small community hospital in Marin County. The unit needed a framework that focused on the unique needs of the geriatric population and daily activities that enhanced physical and cognitive activities to mitigate risks for any issues that created a prolonged Length of Stay (LOS).

Problem: The microsystem is a medical-surgical telemetry unit where the average length of stay (LOS) is five days, surpassing the organization's goal of four days. Reducing LOS can enhance patient satisfaction and meet organizational targets.

Context: This project aims to reduce the extended …

Exploring The Impact Of Weekly Farmers’ Market In The City Of Carson, Ca In Promoting Equitable Access To Locally Grown Fruits And Vegetables, Daisy Lopez Valdez M.P.H.

Master's Projects and Capstones

Despite their many benefits to the community, farmers’ markets suffer from several important limitations. This paper will provide guidance on practices and interventions that can improve the effectiveness of the local Carson, California farmers’ market, known as the South Bay Pavilion Farmer’s Market, in increasing equitable access to and consumption of locally grown fruits and vegetables with the goal of reducing obesity and diabetes rates among residents.

The needs and assets assessment developed will evaluate the success of the City of Carson South Bay Pavilion Farmers’ Market and provide recommendations based on the findings. The proposed research will follow an …

Proximity Analysis Of Native Proteomes Reveals Phenotypic Modifiers In A Mouse Model Of Autism And Related Neurodevelopmental Conditions, Yudong Gao, Daichi Shonai, Matthew Trn, Jieqing Zhao, Erik J Soderblom, S Alexandra Garcia-Moreno, Charles A Gersbach, William C Wetsel, Geraldine Dawson, Dmitry Velmeshev, Yong-Hui Jiang, Laura G Sloofman, Joseph D Buxbaum, Scott H Soderling

Faculty, Staff and Students Publications

One of the main drivers of autism spectrum disorder is risk alleles within hundreds of genes, which may interact within shared but unknown protein complexes. Here we develop a scalable genome-editing-mediated approach to target 14 high-confidence autism risk genes within the mouse brain for proximity-based endogenous proteomics, achieving the identification of high-specificity spatial proteomes. The resulting native proximity proteomes are enriched for human genes dysregulated in the brain of autistic individuals, and reveal proximity interactions between proteins from high-confidence risk genes with those of lower-confidence that may provide new avenues to prioritize genetic risk. Importantly, the datasets are enriched for …

The Impact Of Bariatric Surgery On Glutathione Synthesis In Individuals With Severe Obesity, Hong Chang Tan, Jean W Hsu, E Shyong Tai, Shaji Chacko, Jean-Paul Kovalik, Farook Jahoor

Faculty, Staff and Students Publications

Glycine is deficient in individuals with obesity but improves following bariatric surgery. Glycine deficiency could impair glutathione (GSH) synthesis and worsen oxidative stress. We examined the impact of obesity-associated glycine deficiency and bariatric surgery on GSH synthesis. Twenty-one participants with severe obesity and twenty-one healthy weight controls were recruited. [1,2-13C2] glycine was infused to measure the erythrocyte (RBC) GSH synthesis rate. Participants with obesity underwent bariatric surgery, and 19 were restudied six months post-surgery. Compared to healthy weight controls, individuals with obesity had significantly lower concentrations of RBC GSH (2.43 ± 0.23 vs. 2.63 ± 0.26 mmol/L, p < 0.01). However, there were no differences in GSH fractional synthesis rate [78.0 (51.4–123.7) vs. 76.9 (49.3–110.1) % pool/day, p = …

Single Cell Dual-Omic Atlas Of The Human Developing Retina, Zhen Zuo, Xuesen Cheng, Salma Ferdous, Jianming Shao, Jin Li, Yourong Bao, Jean Li, Jiaxiong Lu, Antonio Jacobo Lopez, Juliette Wohlschlegel, Aric Prieve, Mervyn G Thomas, Thomas A Reh, Yumei Li, Ala Moshiri, Rui Chen

Faculty, Staff and Students Publications

The development of the retina is under tight temporal and spatial control. To gain insights into the molecular basis of this process, we generate a single-nuclei dual-omic atlas of the human developing retina with approximately 220,000 nuclei from 14 human embryos and fetuses aged between 8 and 23-weeks post-conception with matched macular and peripheral tissues. This atlas captures all major cell classes in the retina, along with a large proportion of progenitors and cell-type-specific precursors. Cell trajectory analysis reveals a transition from continuous progression in early progenitors to a hierarchical development during the later stages of cell type specification. Both …

Kat2a And Kat2b Prevent Double-Stranded Rna Accumulation And Interferon Signaling To Maintain Intestinal Stem Cell Renewal, Mai-Uyen Nguyen, Angela Halstead, José B Sáenz, Et Al.

2020-Current year OA Pubs

Histone acetyltransferases

Left Atrial Venoarterial Extracorporeal Membrane Oxygenation Strategy In Postcardiotomy Cardiogenic Shock: A Case Series, Daniel Manzur-Sandoval Md, Gian Manuel Jiménez-Rodríguez Md, José Luis Elizalde-Silva Md, Meredith Fernanda Sánchez-Torres Md, Uriel Encarnación-Martínez Md, Cristhian Josué Gaytán-García Md, José Octavio Salazar-Delgado Md, Guadalupe Lisseth Hernández-González Md, Gustavo Rojas-Velasco Md

The VAD Journal

Postcardiotomy cardiogenic shock is a rare complication with high mortality. When patients do not respond to the placement of an intra-aortic balloon pump or pharmacological treatment, therapy with peripheral venoarterial extracorporeal membrane is a viable option that allows active resuscitation. The adjunct use of Impella® (Abiomed, Danvers, MA, USA) allows active unloading of the dysfunctional left ventricle. However, left atrial venoarterial extracorporeal membrane oxygenation (LAVA-ECMO) is an appealing and effective strategy in cases of aortic dissection, aortic valve replacement, or bioprosthesis of the aorta. Insertion of an extraction cannula that can discharge both atria or only the left atrium allows …

Improving Patient Care: Expansion Of Access To Free Clinics, Anahis H. Davidian, Gail M. Bloom

Patient Experience Journal

Free clinics provide free or reduced-fee healthcare services for uninsured, underserved, and marginalized populations. Free clinics may be the only source of primary care for socioeconomically disadvantaged individuals lacking health insurance. However, consistently understaffed and underfunded free clinics are struggling to meet growing needs. The demand for services results in long waitlists with long wait times. Most free clinics rely on volunteer providers and staff due to limited financial resources. This case study proposes recommendations that can address the challenges of funding limitations while improving free clinics' ability to offer more accessible and equitable care to serve a greater proportion …

Foundational Patient Experience: Analyzing 10 Years Of Patient Experience Research, Geoffrey A. Silvera Phd, Mha, Courtney Haun Phd, Mph, Varun Natarajan

Patient Experience Journal

In this study, we seek to provide a critical examination of the field of Patient Experience (PX) by using citation analysis to determine the foundational keystones of the PX knowledge base. This study will employ a systematic citation analysis to evaluate the articles published in the Patient Experience Journal (PXJ), focusing on citation frequency as evidence of impact on the field. To achieve this, we examine the entire corpus of article citations published in the PXJ from 2014–2023 (Volumes 1–10). By examining a corpus consisting of 515 independent articles (N=515) that include over 12,000 references (n=12,712) over the course of …

Patient Experiences With An Mhealth App For Complex Chronic Disease Care: Connections Despite Lack Of Traditional Clinical Interactions, Jenney Lee, Melissa Cheyney, Michael A. May, Marit L. Bovbjerg

Patient Experience Journal

Chronic diseases are costly to treat and burdensome for patients. Mobile health (mHealth) technologies might reduce costs of care and increase patient self-efficacy in chronic disease management, but the patient experience of mHealth is poorly understood. Our objective, therefore, was to evaluate patient experiences with using an mHealth app for complex chronic disease management, within a U.S. population of low-income patients. We used nurse/patient text messages from an mHealth complex chronic disease management tool, and exit interviews from patients, to assess qualitatively Medicaid patients' experiences with a remote monitoring mHealth app. Salient themes about the patient experience included: (1) Visibility …

Patient Experience And Virtual Reality: The Use Of An Mri Exam Simulator, Jaqueline Maria Da Silva Jms, Marcus Antonio Medeiros De Souza Mams, Mônica Augusta Reis Dos Santos Mars, Milena Loureiro De Melo Mlm, Lorena De Fátima Lucena Almeida Lfla, Alayde Ricardo Da Silva Ars, Êmilly Vitória Dos Santos Vieira Evsv, Alessandra Nascimento Pontes Anp, Jandson De Oliveira Soares Jos

Patient Experience Journal

Magnetic resonance (MR) imaging is a safe diagnostic method of high accuracy detection and characterization of various pathological conditions. However, due to the very closed aspect of the apparatus, the high sound amplitude emitted and the need to remain motionless for a significant time, some patients experience discomfort and high levels of anxiety, compromising time and image quality management that can impair the clinical outcome of the patient or even give up the performance of this procedure. Therefore, this study aimed to validate, with patients, the use of Virtual Reality (VR) as a humanized practice of exposure to magnetic resonance …

Examining The Impact Of Telehealth Visits On Patient And Family Experience In A Pediatric Emergency And Urgent Care Center, Abigail Gauthier Md, Callie Krentz Md, Shiran Chan Ms, Michelle Widecan Dnp, Aprn, Cpnp, Ac/Pc, Adam A. Vukovic Md, Med

Patient Experience Journal

Providers and healthcare organizations have created novel ways of evaluating patients using telehealth. Patient volumes in urgent cares (UCs) and emergency departments (EDs) continue to climb, contributing to longer wait times and suboptimal patient and family experiences (PFEs). Optimizing use of telehealth may not only impact PFE of those evaluated virtually, but also reduce crowding in EDs and UCs, indirectly impacting PFE in those spaces as well. The purpose of this study is to identify any association between telehealth encounters and PFE scores. This is a retrospective review of patients seen via telehealth in virtual urgent care, UC, or the …

Accompanying People Affected By Cancer In Their Return To Life After Treatment: A Report On An Experiment Conducted In Canada, Christine Arsenault, Saskia Hazout, John Calogerinis, Françoise Poirier, Louise Normandin, Cécile Vialaron, Monica Iliescu Nelea, Marie-Pascale Pomey

Patient Experience Journal

This study aims to assess family doctors' perceived needs for improved patient follow-up post-acute treatment in oncology departments, specifically focusing on the Patient Oriented Discharge Summary (PODS) for individuals living with cancer. A cross-sectional quantitative survey targeted family doctors, and a before/after exploratory study was conducted with patients to measure their needs pre- and post-PODS implementation. Twenty-one out of 42 family doctors participated in the survey (50%). Patient data was collected at three points in time: prior to PODS implementation (T1, n = 20/30; 77%), one month later (T2, n = 20/26; 77%), and six months later (T3, n = …

We Did Our Best!: The Experience Of Frontline Workers In Long-Term Care During Covid-19 Outbreaks, Jillian M. Gratton, Lenora Duhn, Rosemary Wilson, Pilar Camargo-Plazas

Patient Experience Journal

In Canada, the COVID-19 pandemic had devastating effects for those living in long-term care (LTC) homes, yet little is known about the experiences of the frontline workers who endured in those settings with COVID-19 outbreaks. Specialized knowledge will improve our understanding of the effects of the pandemic on frontline workers (FW), enabling the development of stronger practices. The purpose of this research was to gain a deeper understanding of the experiences of FW caring for residents in LTC homes during a COVID-19 outbreak, using narrative inquiry. The methods used for data collection include interviews, field notes, and photovoice. Participants were …

Investigating The Perceived Impact Of Surgeons' Burnout On Surgical Physician Associates' Wellness In United States Ambulatory Surgery Centers, Rhionna J. Smith, Lihua Dishman, John W. Fick, Kathleen M. Thomas

Patient Experience Journal

Surgeons are the de facto leaders of surgical teams with surgical physician associates (SPAs) as integral members who function in all areas of the peri-operative environment. Surgeons often supervise SPAs. Ambulatory surgery centers (ASCs) provide patients with same-day diagnostic and preventive procedures as more convenient alternatives to hospital-based outpatient procedures. This qualitative, national, and cross-sectional study explored the perceived impact of surgeons' burnout on SPAs' wellness in U.S. ASCs during global health crises. Primary demographic and qualitative data were collected using a self-developed, three-section survey instrument: (1) information regarding informed consent; (2) 10 short demographic questions; and (3) two open-ended …

Is Timing Everything?: The Role Of Time On The Relationship Between Patient-Centered Communication And Provider Empathy, Shanequa S. Roscoe-Nelson, Geoffrey A. Silvera Phd, Mha

Patient Experience Journal

Several studies have indicated that providers that successfully implement patient-centered communication (PCC) practices related to health literacy and exemplify higher levels of empathy improve patient health outcomes. Time is frequently noted as a barrier when implementing PCC practices. The purpose of this study was to examine the role of time on the relationship between PCC and provider empathy. A cross-sectional study design was employed utilizing data from the 2019 Medical Expenditure Panel Survey-Household Component (MEPS-HC) and a supplemental survey, Self-Administered Questionnaire (SAQ), including a total of 6,459 patient respondents (N = 6,459). Structural Equation Modeling (SEM) was utilized for the …

Primary Care Productivity And Patient Satisfaction Community Practice: What Is The Relationship?, Thomas G. Howell Jr.

Patient Experience Journal

Research has shown a consistent positive association between patient and provider experience and improved patient outcomes and safety. There is a belief that patient satisfaction and physician productivity are competing interests. The relationship for primary care physicians, in a Midwest Health system was evaluated as part of this project. Data from Press Ganey patient satisfaction surveys on likelihood of recommending the practice and the physician were compared between primary care physicians in the top quartile of average monthly patient visits and those that were in the three lower quartiles. A secondary analysis of patient satisfaction scores related to continuous years …

The Perceived Usefulness Of Patient Narrative Feedback In Primary Care Settings, Sasmira Matta, Yuna S.H. Lee, Rachel Grob, Mark Schlesinger, Ingrid Nembhard

Patient Experience Journal

Research suggests that insights from patient narratives – stories about care experiences in patients' own words – contain information that can be used to improve care. However, assessments of narratives reported by clinical personnel have been mixed. This is the first study, to our knowledge, to systematically measure how useful personnel in primary care perceive patient narratives to be. We surveyed 276 clinical and administrative personnel in nine primary care clinics in a large health system in the United States. We found that perceived usefulness of patient narratives is generally high, but varies by individual characteristics such as level of …

Listening To The Unsaid: Utilizing Patient-Reported Outcome Measures (Proms) To Manage The Dental Anxiety Of A Special Child, Asiya Attar, Kasturi Shukla

Patient Experience Journal

This article is the journey of a dentist who adopted the additional role of a healthcare manager and embarked on a transformative journey to enhance the realm of pedodontics. The story describes how the care process and related experiences were improved for a special child who came anxious and worried to a dental office for treatment and returned with better outcomes. Dental anxiety is a known barrier to smooth dental care which is further amplified in children and more so for the special children. In addition to providing the best treatment, we ensured a worry-free environment to release the anxiety …

Research Imitates Life: Researching Within Your Lived Experience, Bethany Donaghy, Delane Linkiewich

Patient Experience Journal

This personal narrative article seeks to bring awareness to and provide an overview of the various aspects that come with being a lived experience researcher including the host of benefits and challenges that come with conducting research within one's own area of lived experience. Throughout this narrative, we (Bethany Donaghy, an autistic person, and Delane Linkiewich a person living with chronic pain) share our perspectives on what it is like to be lived experience researchers. Our narratives discuss how the many identities we hold both improve the impact and relevance of our research while also posing challenges for us like …

A Commitment To Experience Must Reach Across The Continuum Of Care, Jason A. Wolf Phd

Patient Experience Journal

A conversation on patient experience is not restricted to one care setting, nor should it be. People's healthcare journeys are not singular instances, but most often a series of encounters that while perhaps separate operationally from the delivery side of care, all weave together to frame one experience for a patient, their family members and care partners. This special issue purposefully takes us outside the traditional conversation space for experience, looking at segments of the care continuum including primary care, ambulatory care, free clinics and even dental care and the use of non-traditional care methods such as telehealth and app-based …

Occupational Therapy’S Role In The Success And Positive Outcomes Of Youth Within The Foster System, Cassidy Solomon

Student Capstone Papers

This capstone paper will discuss the development of an occupational therapy program to support the needs of youth within the foster system and prepare this population to live independently. Background information including statistics, the need for occupational therapy, and the program specifics such as rationale, significance, and objective are discussed. The development of an occupational therapy program to aid in the success of children within the foster care system helps close a gap in research that will contribute to this population's success and positive outcomes. The purpose of this capstone was to develop a program for children in the foster …

Educating Nursing Staff On Urinary Tract Infections, Eldarada Rosamay Searcy

Walden Dissertations and Doctoral Studies

The primary objective of this doctor of nursing practice (DNP) project was to educate staff on urinary tract infection (UTI) prevention. A gap in practice was identified among nursing staff at an assisted-living facility who lacked current, evidence-based knowledge. This project was conducted to determine whether educating staff on UTI prevention increased their knowledge. Knowles’s adult learning theory and the analysis, design, development, implementation, and evaluation model were used as the theoretical framework that guided this project. Eighty-eight healthcare workers at the project site voluntarily participated in this project. Before the education session, a 10-question, multiple-choice pretest was administered to …

Anti-Cdk Inhibitors For Cancer Treatment, Venkata M. Yenugonda

Technology Transfer - Patents

No abstract provided.

Enpp1 Enzyme Replacement Therapy Improves Ectopic Calcification But Does Not Rescue Skeletal Phenotype In A Mouse Model For Craniometaphyseal Dysplasia, Ernst Reichenberger, Kevin O'Brien, Ayano Hatori, Thomas Carpenter, Koen Van De Wetering, Lisa Flaman, Jennifer Howe, Daniel Ortiz, Yves Sabbagh, I-Ping Chen

Jefferson Institute of Molecular Medicine Papers and Presentations

Craniometaphyseal dysplasia (CMD) is a rare genetic bone disorder, characterized by progressive thickening of craniofacial bones and flared metaphyses of long bones. Craniofacial hyperostosis leads to the obstruction of neural foramina and neurological symptoms such as facial palsy, blindness, deafness, or severe headache. Mutations in ANKH (mouse ortholog ANK), a transporter of small molecules such as citrate and ATP, are responsible for autosomal dominant CMD. Knock-in (KI) mice carrying an ANK_F377del mutation (Ank^KI/KI) replicate many features of human CMD. Pyrophosphate (PPi) levels in plasma are significantly reduced in Ank^KI/KI mice. PPi is a potent inhibitor of …

"I Just Assumed This Was Already Being Done": Canadian Patient Preferences For Enhanced Data Sharing For Precision Oncology, Samantha Pollard Pollard, Morgan Ehman, Anna Hermansen, Deirdre Weymann, Emanuel Krebs, Cheryl Ho, Howard J. Lim, Steven Jones, Yvonne Bombard, Tania M. Bubela

Office of the Provost

Purpose: In Canada, health data are siloed, slowing bioinnovation and evidence generation for personalized cancer care. Secured data-sharing platforms (SDSPs) can enable data analysis across silos through rapid concatenation across trial and real-world settings and timely researcher access. To motivate patient participation and trust in research, it is critical to ensure that SDSP design and oversight align with patients' values and address their concerns. We sought to qualitatively characterize patient preferences for the design of a pan-Canadian SDSP.
Methods: Between January 2022 and July 2023, we conducted pan-Canadian virtual focus groups with individuals who had a personal history of cancer. …