Implementing Universal Adult Depression Screening In A Rural Maine Free Medical Clinic, Karen Hussion

Doctor of Nursing Practice Scholarly Projects

Abstract

BACKGROUND: Depression in adults is a leading cause of disability, morbidity and mortality worldwide with an estimated prevalence of 20% in the US population. Despite estimates that one out of every five Americans suffers from depression, less than 50% of adult primary care patients with depression are identified, and less than 5% of all adult primary care patients are screened. To increase early detection and management of depression, the United States Protective Service Task Force (USPSTF) recommends routine depression screening for adults older than 18 years in primary care settings.

LOCAL PROBLEM: This project site was a rural, free, …

Cellular Host Response Sepsis Test For Risk Stratification Of Patients In The Emergency Department: A Pooled Analysis, Hollis R. O'Neal, Roya Sheybani, Chadd K. Kraus, Wesley H. Self, Ajay M. Shah, Christopher B. Thomas, Henry T.K. Tse, Robert Scoggins

School of Medicine Faculty Publications

Objectives: Sepsis is one of the most common, costly, and misdiagnosed conditions in U.S. emergency departments (EDs). ED providers often treat on nonspecific signs, subjective suspicion, or presumption of infection, resulting in over- and undertreatment. An increased understanding of host response has opened a new direction for sepsis diagnostics. The IntelliSep test is a U.S. Food and Drug Administration–cleared cellular host response diagnostic that could help distinguish sepsis in ED settings. Our objective was to evaluate the potential of the cellular host response test to expedite appropriate care for patients who present with signs of infection. Methods: We performed a …

Evidence-Based Practice - Oral Mucositis Prevention In Chemotherapy Patients: A Benchmark Project, Carrie Davenport

MSN Capstone Projects

The purpose of this implementation project is to help decrease the rates of mucosal barrier injuries (MBI’s) and oral mucositis (OM) in patients receiving chemotherapy on the oncology unit. In 2022, it was reported that seven MBI’s occurred on an oncology unit in a large county hospital in an urban area. This secondary infection has the potential to increase morbidity, increase treatment costs, lengthen hospital stays, and can have a devastating impact on quality of life (Correa et al., 2019). There is currently no protocol in place at the proposed location for this intervention that will help reduce this potential …

Patient Throughput In The Emergency Department, Daniel Alanis

MSN Capstone Projects

In response to ongoing overcrowding in emergency departments, it is imperative to explore effective strategies for mitigating the capacity crises. The purpose of this project is to investigate and implement throughput strategies for a large level 1 trauma emergency department in Houston’s Texas Medical Center. The proposal involves launching a process improvement project to identify opportunity potential for two main interventions: 1. Patient classification for split clinical pathways 2. Dedicated liaison role for throughput responsibilities. The review aims to answer the question: In emergency department patients, how does the implementation of a dedicated throughput liaison compared to a split flow …

The Reduction Of Pain Perception Through Music Therapy In Surgical Patients, David Collier

MSN Capstone Projects

The control of pain perceptions of surgical patients is an ongoing problem in trying to control the pain with enough narcotics while not giving too much to depress their respiratory status. Using narcotics increases the risks of several side effects which can negatively impact the patient’s recovery (Fu et. al., 2019). Perioperative music is a nonpharmacological method used to decrease the need for pain medication (Fu et. al, 2019; Kahloul et. al., 2016). The patient is in an anxiety state that causes a heightened state of arousal of the sympathetic system, which in turn releases catecholamines to act on the …

The Impact Of Kangaroo Care On Exclusive Breastfeeding In Premature Infants, Colleen Larue

MSN Capstone Projects

This benchmark project emphasizes the crucial imperative of promoting exclusive breastfeeding among preterm and low birth weight infants in neonatal intensive care units (NICUs). Despite the well-documented benefits, exclusive breastfeeding rates remain disappointingly low. This evidence-based project focuses on early intervention through kangaroo care to bolster exclusive breastfeeding rates, with the overarching aim of enhancing infant outcomes and mitigating risks of mortality and morbidity. Engaging key stakeholders, including NICU leadership, nursing staff, lactation consultants, and families, is paramount for the successful implementation of the program. The project presents a detailed implementation plan encompassing various phases, from admission procedures to sustainability …

Loneliness As A Predictor For Problematic Social Media Use Associated With Sleep Disruption, Kaylee Mercer

Honors Projects

Social media is growing in popularity and with this new phenomenon could come impacts on a cognitive level. Loneliness is a robust predictor of mental and physical health issues. Loneliness is widely defined as discrepancy between actual and desired levels of social connection. Previous research has found that one impact lonely individuals face may be disruptions to sleep. Loneliness increases the likeliness of problematic social media use, both of which occur in college age and adolescent individuals at a disproportionately high rate. Problematic social media use has been previously found to be associated with less sleep. The current study seeks …

Increasing Faculty Knowledge Of Competency-Based Education: A Quality Improvement Project, Lindsay O'Sullivan

DNP Projects

Background: The nursing academic-to-practice knowledge gap creates systems-based and patient outcomes issues. The changing demands of healthcare require the advancement of the discipline of nursing through the improvement of nursing education. The American Association of Colleges of Nursing (AACN) requires all nursing programs to implement Competency-Based Education (CBE) evaluations and assessments into existing nursing curricula to respond to changing healthcare demands. The aim of this project was to improve the knowledge of nursing educators regarding the use of CBE at a mid-sized university in the southeast.

Methods: The Diffusion of Innovation Theory was used as a framework for this project. …

The Impact Of An Educational Video On Physician Confidence And Comfort Level In Discussing Autopsies, Joy N. Owings, Laura Gray, David Phillippi

DNP Projects

Background: Autopsy rates have declined since the 1970s despite the procedure's benefit to families and medical science. Two well-documented reasons for the declining autopsy rate are physicians’ lack of knowledge about autopsies and lack of confidence in offering them. Objective: The primary aim of this study was to evaluate the impact of a brief educational video on physicians' comfort level, confidence, and knowledge regarding autopsy discussions. The objective was to address the declining autopsy rates by enhancing physicians' confidence and comfort level in offering autopsies to families. In addition, this study aimed to investigate physicians’ practices of consenting for an …

Stimulator Of Interferon Genes Pathway Activation Through The Controlled Release Of Stingel Mediates Analgesia And Anti-Cancer Effects In Oral Squamous Cell Carcinoma, Minh Phuong Dong, Neeraja Dharmaraj, Estela Kaminagakura, Jianfei Xue, David G Leach, Jeffrey D Hartgerink, Michael Zhang, Hana-Joy Hanks, Yi Ye, Bradley E Aouizerat, Kyle Vining, Carissa M Thomas, Sinisa Dovat, Simon Young, Chi T Viet

Faculty, Staff and Student Publications

Oral squamous cell carcinoma (OSCC) presents significant treatment challenges due to its poor survival and intense pain at the primary cancer site. Cancer pain is debilitating, contributes to diminished quality of life, and causes opioid tolerance. The stimulator of interferon genes (STING) agonism has been investigated as an anti-cancer strategy. We have developed STINGel, an extended-release formulation that prolongs the availability of STING agonists, which has demonstrated an enhanced anti-tumor effect in OSCC compared to STING agonist injection. This study investigates the impact of intra-tumoral STINGel on OSCC-induced pain using two separate OSCC models and nociceptive behavioral assays. Intra-tumoral STINGel …

The Effect Of Emotional Intelligence On Relationships: Examining The Correlation Between Teique Score And Support System Health, Anna Lowes-Cannizzaro

Honors Theses

Emotional intelligence (EI), or the ability to monitor one’s own and others’ feelings, and the ability to step outside of these feelings in order to use information to guide thinking and actions, has been shown to affect many aspects of a person’s life. Through prior research, EI has been linked to aspects such as marital satisfaction, job performance, and life satisfaction. This study examines how trait emotional intelligence affects the health of one’s support system. The association between trait EI and support system health, including other demographic variables, was measured with two separate questionnaires: one questionnaire measuring trait EI, the …

Evidence-Based Practice Recommendations For The Use Of A Cardiac Optimization Algorithm In Patients Undergoing A Whipple Procedure, Jarrod Genther

Doctor of Nursing Practice Scholarly Projects

A fundamental responsibility of a certified registered nurse anesthetist includes intraoperative fluid and hemodynamic management. While Enhanced Recovery After Surgery protocols advocate goal-directed fluid therapy, the methodology remains controversial. An algorithmic approach systematically optimizes cardiac function and fluid volume status based on stroke volume variation, cardiac index, and mean arterial pressure. This project aims to evaluate the effects of placing intraoperative guidelines for patients undergoing a Whipple procedure when using a cardiac optimization algorithm to guide fluid and vasopressor management. The outcomes evaluated included the amount of fluids delivered intraoperatively, vasoactive medication administration, urine output, amount of blood transfusions, cardiac …

Implementing Fall Prevention Safety Agreement And Fall Tips To Improve Patient Safety With Postoperative Cancer Patients, Marguerite Ndoko

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This quality improvement project aimed to implement targeted fall prevention interventions within an oncology surgical unit to reduce the rate of patient falls by 30%.

BACKGROUND

Hospital patient falls are a major safety concern, particularly in oncology surgical patients due to postoperative weakness and altered mobility. Consistent high fall rates in the unit prompted targeted interventions to address this risk.

METHODOLOGY

Two interventions were implemented over 14 weeks using PDSA cycles. Patient Fall Safety Agreements (PFSA) were initiated between patients and bedside nurses upon admission, while fall Tailoring Interventions for Patient Safety (TIPS) were posted in patient rooms to …

A Review Of Consanguinity In The Iraqi Population: A Call To Action To Prevent A Future Health Catastrophe, Zaid Ali Hawi, Kealan Pugsley, Atefeh Namipashaki, Walied Samarrai, Ziarih Hawi

Publications and Research

Although not uncommon worldwide, consanguinity has been a part of Arab culture and tradition as a means to strengthen tribal blood relations. However, this type of union has been linked to inherited diseases, particularly those of a recessive nature (e.g., hemoglobinopathies). Furthermore, several recent studies have documented highly significant associations between consanguineous parentage and common multifactorial diseases, including but not limited to hypertension, mental disorders, and several cardiovascular diseases. In Iraq, the prevalence of consanguinity is very high and still on the rise. This has resulted in an increased prevalence of inherited diseases and has significant negative impacts on Iraq’s …

Assessing Socioeconomic Patterns Of Excessive Alcohol Consumption In Ohio: A County-Level Analysis, Tate Barney, Dev Patel

Scholarship in Medicine - All Papers

Background: Excessive alcohol consumption poses significant public health challenges, with complex socioeconomic factors influencing drinking behaviors. Understanding the relationship between socioeconomic determinants and excessive drinking patterns at the state and county levels is crucial for informing targeted interventions. Objective: To investigate the associations between excessive drinking (binge or heavy drinking) and socioeconomic factors, including median household income, mental health provider availability, health insurance coverage, educational attainment, and unemployment rates across counties in Ohio. Methods: We analyzed data from the 2023 County Health Rankings for 88 counties in Ohio. Spearman correlations were used to assess associations between excessive drinking and socioeconomic …

Adding Ofirmev: The Effectiveness Of Multimodal Treatment, Kimberly R. Bilal-Williams

MSN Capstone Projects

This project is on enhancing pain management in total knee arthroplasty (TKA) clients via the intravenous (IV) administration of acetaminophen (Ofirmev) by multimodal regimen. The patient, intervention, comparison, outcome, and time (PICOT) question shaping this initiative looks at frequency and intensity of patients’ pain scores as well as practical outcome measures such as healing and physical therapy during the recovery period ending with discharge. After a thorough literature synopsis, it is evident that multimodal pain management strategies including IV acetaminophen provide a better prospectus in comparison to the ones that solely employ opioids. Research repeatedly demonstrates the use of IV …

Reducing Central Line-Associated Bloodstream Infections (Clabsi) With Chlorhexidine-Impregnated Dressings, Sara Garcia

MSN Capstone Projects

Mitigating and eradicating central line-associated bloodstream infections (CLABSI) is a vital patient safety priority. These healthcare-associated infections lead to patient fatalities and incur costly, preventable expenses. Therefore, it is imperative to assess central venous catheter (CVC) maintenance protocols to mitigate the likelihood of infection. Federal guidelines advocate using chlorhexidine (CHG) dressings to lower this risk (Centers for Disease Control and Prevention, 2017). A comprehensive central line maintenance bundle includes incorporating a CHG dressing as a critical measure in reducing the risk of CLABSI (Buetti et al., 2022). Consequently, the escalating infection rates underscore the necessity for implementing CHG dressings (Buetti …

Evidence And Sources Of Placebo Effects In Transcranial Direct Current Stimulation During Visuospatial Working Memory Training, Andrew Hooyman, Nicole K. Haikalis, Peiyuan Wang, Heidi M. Schambra, Keith R. Lohse, Sidney Y. Schaefer

Physical Therapy Faculty Articles and Research

Transcranial direct current stimulation (tDCS) can be used to non-invasively augment cognitive training. However, the benefits of tDCS may be due in part to placebo effects, which have not been well-characterized. The purpose of this study was to determine whether tDCS can have a measurable placebo effect on cognitive training and to identify potential sources of this effect. Eighty-three right-handed adults were randomly assigned to one of three groups: control (no exposure to tDCS), sham tDCS, or active tDCS. The sham and active tDCS groups were double-blinded. Each group performed 20 min of an adapted Corsi Block Tapping Task (CBTT), …

The Dual-Targeted Fusion Inhibitor Clofazimine Binds To The S2 Segment Of The Sars-Cov-2 Spike Protein, Matthew Freidel, Pratiti Vakhariya, Shalinder Sardarni, Roger Armen

College of Pharmacy Faculty Papers

Clofazimine and Arbidol have both been reported to be effective in vitro SARS-CoV-2 fusion inhibitors. Both are promising drugs that have been repurposed for the treatment of COVID-19 and have been used in several previous and ongoing clinical trials. Small-molecule bindings to expressed constructs of the trimeric S2 segment of Spike and the full-length SARS-CoV-2 Spike protein were measured using a Surface Plasmon Resonance (SPR) binding assay. We demonstrate that Clofazimine, Toremifene, Arbidol and its derivatives bind to the S2 segment of the Spike protein. Clofazimine provided the most reliable and highest-quality SPR data for binding with S2 over the …

The Impact Of Outpatient Supportive Oncology On Cancer Care Cost And Utilization, Brooke Worster, Yifan Zhu, Gregory Garber, Sawyer Kieffer, Aaron Smith-Mclallen

Department of Medical Oncology Faculty Papers

BACKGROUND: Supportive oncology (SO) care reduces symptom severity, admissions, and costs in patients with advanced cancer. This study examines the impact of SO care on utilization and costs.

METHODS: Retrospective analysis of utilization and costs comparing patients enrolled in SO versus three comparison cohorts who did not receive SO. Using claims, the authors estimated differences in health care utilization and cost between the treatment group and comparison cohorts. The treatment group consisting of patients treated for cancer at an National Cancer Institute-designated cancer center who received SO between January 2018 and December 2019 were compared to an asynchronous cohort that …

Th2 Cells Are Associated With Tumor Recurrence Following Radiation, Mohamed K Abdelhakiem, Riyue Bao, Phillip M Pifer, David Molkentine, Jessica Molkentine, Andrew Hefner, Beth Beadle, John V Heymach, Jason J Luke, Robert L Ferris, Curtis R Pickering, Jing H Wang, Ravi B Patel, Heath D Skinner

Faculty, Staff and Student Publications

The curative treatment of multiple solid tumors, including head and neck squamous cell carcinoma (HNSCC), utilizes radiation. The outcomes for HPV/p16-negative HNSCC are significantly worse than HPV/p16-positive tumors, with increased radiation resistance leading to worse locoregional recurrence (LRR) and ultimately death. This study analyzed the relationship between immune function and outcomes following radiation in HPV/p16-negative tumors to identify mechanisms of radiation resistance and prognostic immune biomarkers. A discovery cohort of 94 patients with HNSCC treated uniformly with surgery and adjuvant radiation and a validation cohort of 97 similarly treated patients were utilized. Tumor immune infiltrates were derived from RNAseq gene …

Evidence And Sources Of Placebo Effects In Transcranial Direct Current Stimulation During A Single Session Of Visuospatial Working Memory Practice, Andrew Hooyman, Nicole K Haikalis, Peiyuan Wang, Heidi M Schambra, Keith R Lohse, Sydney Y Schaefer

2020-Current year OA Pubs

Transcranial direct current stimulation (tDCS) can be used to non-invasively augment cognitive training. However, the benefits of tDCS may be due in part to placebo effects, which have not been well-characterized. The purpose of this study was to determine whether tDCS can have a measurable placebo effect on cognitive training and to identify potential sources of this effect. Eighty-three right-handed adults were randomly assigned to one of three groups: control (no exposure to tDCS), sham tDCS, or active tDCS. The sham and active tDCS groups were double-blinded. Each group performed 20 min of an adapted Corsi Block Tapping Task (CBTT), …

Short-Term Effects Of Caffeine Supplementation On Cardiac Dynamics And Anaerobic Strength Output In Collegiate Male Athletes, Tyler Clum, Katelyn Messner, Alyssa Jagger, Caeden Gurganus, Kylie Miller, Rema Suniga

ONU Student Research Colloquium

ABSTRACT. Caffeine, a widely consumed drug, has been shown to significantly increase heart rate (HR) and blood pressure (Geethavani et al., 2014), but had only insignificant changes in these cardiovascular measurements (Alhabeeb et al., 2022); while Matsumara and his colleagues (2023) reported that caffeine decreased 100-meter sprint times indicating that caffeine may improve anaerobic performance. The current study investigated the short-term effects of caffeine on heart rate (HR, beats per minute), blood pressure (mmHg), and 20-yard sprint performance time (seconds; Dashr Sprint Timing System). These parameters were measured in triplicate before and at 45-minutes after caffeine supplementation at a dose …

Locally Tailored Knowledge, Attitude And Practice Towards Diet Sustainability Questionnaire: Development And Validation Among Uaeu Adults, Asma Bahaaldeen Numan

Thesis/ Dissertation Defenses

Food production is a major contributor to global environmental change and sustainability. Sustainable diets can be defined as “diets with low environmental impacts which contribute to food and nutrition security and healthy life for present and future generations”. The United Arab Emirates (UAE) aims to enhance its food security to meet the current local demand and future needs of an increasing population. Before determining a sustainable diet pattern for the UAE population, it is foremost more important to understand the perception of sustainable diet production and consumption. A thorough comprehension of the knowledge, attitudes, and practices of the United Arab …

Antibiotic Prophylaxis In Surgical Patients, Rebekah Muselin

ONU Student Research Colloquium

Problem: Post operative surgical site infections continue to be an issue that hospitals face. Although there is not one specific root cause of postoperative surgical site infections, there are steps that can be taken that potentially decrease the risk of acquiring an infection. By initiating prophylactic antibiotics prior to surgery, the incidence of postoperative infections may be decreased. Purpose:The purpose of this project is to compare the occurrence of postoperative surgical site infection rates when using prophylactic preoperative antibiotics to postoperative antibiotics. Methods: This project will be a retrospective chart review. There will be a review of the rate of …

Cultural Education Interventions Impact On Cultural Competence, Kaylie V. Griffin Ms

ONU Student Research Colloquium

Problem: In the United States, there is a substantial increase in diversity. This increase in diversity poses multiple challenges for healthcare workers and healthcare systems. Because nurses care for patients with various cultural backgrounds, health beliefs and practices, and languages, cultural competency plays a pivotal role in providing patient-centered care. There is a need to enhance cultural education for healthcare workers to ensure that healthcare workers have the skills and knowledge to effectively engage with all patient populations. Implementing cultural education interventions seeks to increase healthcare workers' competency, communication, and patient outcomes. Purpose: The purpose of this research question is …

Evaluating The Effect Of Skipping Ticagrelor Doses And Need For Bolus Doses Upon Treatment Resumption Through Population Pk/Pd Simulation, Hiroyoshi Matsui, Le Thien Truc Pham, Eyob D. Adane

ONU Student Research Colloquium

Ticagrelor (Brilinta (R)) is the first reversibly binding oral P2Y12 receptor antagonist. It is used, mostly in combination with aspirin, in patients with acute coronary syndromes to reduce thrombosis. The manufacturer of ticagrelor recommends discontinuing it at least 5 days before any surgery when possible. While the effect of dose interruptions on the risk of thrombosis is not directly studied, it is important to understand the impact of skipping doses on ticagrelor's PK/PD profile for clinical-decision making. The objectives of the current study were to simulate the impact of therapy interruption on the PK/PD of ticagrelor and examine the need …

Differential Behavioral Responses In Male And Female Mice Lacking Either Rgs2 Or Rgs4 Proteins After Acute Administration Of Antidepressants And Anxiolytics, Hiroyoshi Matsui, Sarah Seeley, Manoranjan S. D'Souza

ONU Student Research Colloquium

The overall objective of the study was to assess the acute behavioral effects of currently used antidepressants and anxiolytics in male and female mice lacking regulator of G protein-signaling (RGS) proteins 2 and 4 and their wild-type counterparts. RGS 2 and 4 proteins negatively modulate signaling pathways of G protein-coupled receptors (GPCRs), which play an important role in mediating the effects of monoamine neurotransmitters such as dopamine, norepinephrine, and serotonin. These neurotransmitters in turn play an important role in the action of antidepressant and anxiolytic medications. The study was undertaken because no studies till date have systematically assessed the behavioral …

Body Mass Index Of Male And Female Athletes At Onu From 2000-2023, Sydney Kilgore, Hunter King, Scott Swanson

ONU Student Research Colloquium

Title: Body Mass Index of Male and Female Athletes at ONU from 2000-2023

Introduction/Background:

Body Mass Index (BMI) is a quick and simple measurement examining the ratio of body mass to height. Many athletes are larger than their non-athlete counterparts due to increased muscle mass and may have elevated BMI’s. The NCAA’s Division III has the largest number of athletes (>200,000 participants) and comprises nearly 40% of all the athletes in the three NCAA athletic Divisions. Despite the number of athletes participating in Division III athletics, little is known about their overall physical characteristics and BMI.

Purpose:

Determine …

Pharmacokinetic/Pharmacodynamic Modeling And Simulation Of Various Bolus And Infusion Doses Of Cangrelor, Le Thien Truc Pham, Eyob Adane

ONU Student Research Colloquium

Background: Cangrelor (Kengreal(R) is a non-thienopyridine parenteral antiplatelet drug approved as an adjunct for the reduction of periprocedural myocardial infarction and stent thrombosis risk in patients undergoing percutaneous coronary intervention (PCI). It is also used off-label for bridging in patients who are off their antiplatelet agents prior to surgery. Cangrelor blocks the binding of adenosine diphosphate (ADP) by reversibly binding to P2Y12 receptors on platelet surfaces. In comparison to other P2Y12 antagonists, cangrelor has a rapidly reversible platelet inhibition effect with a short half-life of approximately 3-5 minutes. Data on simultaneous PK/PD modeling of cangrelor are, however, lacking. The aims …