Medicine and Health Sciences Commons^™

Memantine For Preservation Of Neurocognitive Function During Reirradiation Of Recurrent Glioblastoma, Yeun Hiroi

Yale School of Medicine Physician Associate Program Theses

Glioblastoma is the most common malignant primary brain tumor in adults. This disease has a dismal prognosis with a median overall survival between 12-18 months. Recent analyses of salvage therapies for recurrence suggest that reirradiation may improve survival. A possible adverse effect is radiation-induced neurocognitive decline. There is a dearth of literature investigating neuroprotective strategies, like using memantine. Our aim is to investigate whether memantine protects neurocognitive function in this population, with an additional goal to show that memantine does not reduce overall and progression free survival. Subjects were randomly assigned to reirradiation plus memantine or reirradiation alone, and the …

Prolonged Metformin For Managing Postpartum Weight Retention In Women With Gestational Diabetes, Ashley Manning

Yale School of Medicine Physician Associate Program Theses

Gestational diabetes is one of the most common obstetric complications and causes both intrapartum issues and increased long-term cardiometabolic risk of type 2 diabetes. Overweight and obese populations are more likely to develop gestational diabetes, which manifests as increased gestational weight gain and postpartum weight retention, perpetuating the cycle of obesity and diabetes in future pregnancies leading to further type 2 diabetes risk. Metformin has become more widely accepted for use during pregnancy and has been associated with decreased gestational weight gain; however, its long-term effects in the postpartum period remain poorly understood. This randomized controlled trial seeks to determine …

Evidence-Based Recommendations For The Use Of Neostigmine Versus Sugammadex In Patients Undergoing Thoracic Surgery, Ostap Dvorakevych

Doctor of Nursing Practice Scholarly Projects

Neuromuscular blocking agents play a vital role in the safe delivery of modern anesthetic practice. These medications provide patient paralysis for anesthesia staff to perform tracheal intubation and for surgeons to have a motionless surgical field. At the end of surgery, the effects of these paralytic agents must be fully reversed by reversal agents. Incomplete reversal impairs the patient’s ability to maintain an airway, which can lead to various postoperative pulmonary complications such as respiratory failure, pneumonia, and atelectasis. Patients undergoing thoracic surgery are at high risk for this incomplete reversal due to deep levels of paralysis required to keep …

Improving Patients’ Perception Of Provider Trust And Communication With Birth Plans, Christelle Reeves, Nicole Tenzel, Timothy Kremer

North Texas GME Research Forum 2024

Objective: Birth plans are an effective tool for a pregnant person to express their desires and expectations for labor and postpartum. Shortcomings of birth plans can be found whenever there is a lapse in communication between provider and patient. In the management of labor and emergent situations, it has been observed by patients that obstetric providers can communicate in authoritarian and dismissive manners. In response to this, birth plans were developed to serve as a guide in these scenarios. Birth plans allow a pregnant person to design a thoughtful plan of action with their healthcare provider before giving birth, rather …

2024 North Texas Research Forum Program, Hca Healthcare

North Texas GME Research Forum 2024

No abstract provided.

Assessing The Need For A Mental Health Task Force For Aviation Science Students At Bridgewater State University, Cooper Castellone

Honors Program Theses and Projects

In the current landscape of aviation, the issue of mental health is of great concern, particularly among flight training students who have shown to grapple with depression in silence. A report issued by the Pilot Mental Health Aviation Rulemaking Committee in April 2024 underscored seven significant barriers impeding pilots from seeking necessary support for mental health concerns. Consequently, we completed a study aimed at understanding the prevailing mental health challenges among flight training students and identify strategies for institutions such as Bridgewater State University (BSU) to offer meaningful assistance. Our study consisted of a survey distributed to 14 institutions in …

With Great Power: A Content Analysis Of Masculinities And Appearance-Related Themes In The Marvel Cinematic Universe, Ryan Maxim

Honors Program Theses and Projects

Comic book characters and superheroes have served as Hollywood’s biggest cash cow of the last two decades, dominating box office records, over-saturating the release schedules of major movie studios, and influencing the cultural consciousness in a way that is historically unprecedented. The most notable and financially successful example of this trend can be seen in the form of the Marvel Cinematic Universe (MCU), a franchise that has grossed an estimated $29.8 billion in box office revenue since its inception in 2008. Due to their immense popularity and global reach, superhero characters serve as role models for young boys and adult …

Evidence-Based Recommendations For The Use Of Neostigmine Versus Sugammadex In Patients Undergoing Thoracic Surgery, Ostap Dvorakevych

Doctor of Nursing Practice Scholarly Projects

Neuromuscular blocking agents play a vital role in the safe delivery of modern anesthetic practice. These medications provide patient paralysis for anesthesia staff to perform tracheal intubation and for surgeons to have a motionless surgical field. At the end of surgery, the effects of these paralytic agents must be fully reversed by reversal agents. Incomplete reversal impairs the patient’s ability to maintain an airway, which can lead to various postoperative pulmonary complications such as respiratory failure, pneumonia, and atelectasis. Patients undergoing thoracic surgery are at high risk for this incomplete reversal due to deep levels of paralysis required to keep …

Development Of Evidence-Based Practice Guidelines For Perioperative Multimodal Analgesia During Spine Surgery, Jonathan Wagner

Doctor of Nursing Practice Scholarly Projects

The most common cause of adult disability is chronic back pain. As medication maintenance therapy becomes ineffective, surgical intervention is the last resort for treatment. Patients with chronic pain often rely on pain medication such as opioids for relief. The exposure and dependency of opioids can create unique challenges for anesthesia providers to deliver safe and adequate anesthesia for surgery. Patient’s dependent on chronic opioids develops many adverse effects including sleep disordered breathing, suppression of the immune system, and higher risk of developing cardiovascular events under stress. There is a lack of consistent perioperative guidelines for patients undergoing spinal surgery …

Rebuilding Lives: Occupational Therapy's Crucial Role In Community Reintegration To Reduce Recidivism Rates, Julie Burgoon, Kari Joyce

MOT Student Capstones

The integration of occupational therapy (OT) in the criminal justice system provides a promising and unique approach for addressing community reintegration, thereby contributing to the reduction of recidivism rates in the United States. OT impacts recidivism rates by addressing three main areas; occupational deprivation, mental health, and community reintegration. OT addresses the negative consequences of incarceration by promoting engagement in meaningful activities, establishing routine, and assisting individuals in achieving a variety of skills necessary for successful reintegration. OTs can provide valuable interventions that support mental and occupational engagement to decrease recidivism rates. OT led community reintegration program not only improves …

Sexual Health Education Scope And Sequence, Sara Wadsworth

Honors Projects

Based on a significant amount of prior research, comprehensive sexuality education (CSE) has been identified to be the most effective method of teaching sexual health education (SHAPE America, 2021; World Health Organization, 2023). Comprehensive sexual health education improves healthy behaviors and outcomes, provides useful information, and is positively perceived by students (Gardner, 2015; Kirby, 2002; Robinson et al., 2022). However, the United States’ current sexual health education has not implemented this ideal method, which is shown through state laws, students’ experiences, underdeveloped skills and flawed understanding of concepts, and – most importantly – a lack of resources for teachers (Foley, …

Implementing Caregiver Resources Handout And Enhancing Parent And Caregiver Appreciation Week, Sidney Coolidge

OTD Capstone Projects

This doctoral capstone project was completed in partnership with MOVE Inclusive Dance, an inclusive dance studio that empowers individuals of all ability levels to learn life skills through dance. The aim of this project was to provide parents and caregivers resources that would introduce them to different businesses and groups around the greater Nashville area. As a result, a parent and caregiver resource document was created to benefit families from early diagnosis in childhood to adulthood and included financial aid opportunities, respite care, support groups, legal planning, and many others. The project culminated with parent and caregiver appreciation week where …

Voices Beyond Bars: A Qualitative Study Examining Occupational Participation For Formerly Incarcerated Women, Brianna Correia, Mary Smith Otd, Otr/L, Cynthia Simons Rps, Mhps

Spring 2024 Virtual OTD Capstone Symposium

This capstone project addressed the research question: “What are the systemic, societal, and personal barriers and facilitators to occupational participation and engagement that formerly incarcerated women experience in Texas?” The project aimed to advocate for formerly incarcerated women living in Texas by interviewing and collaborating with them to create an advocacy booklet highlighting their lived experiences. Following USAHS IRB approval, recruitment, and screening, 20 participants engaged in a semi-structured interview via Zoom. Insights on their experience post-incarceration in Texas regarding housing, employment, family, healthcare, and change were explored. The data obtained was analyzed and codes and themes were identified. When …

Healing Right Way Randomised Control Trial Enhancing Rehabilitation Services For Aboriginal People With Brain Injury In Western Australia: Translation Principles And Activities, Neil Drew, Meaghan Mcallister, Juli Coffin, Melanie Robinson, Judith Katzenellenbogen, Elizabeth Armstrong

Research outputs 2022 to 2026

Background: This report provides the theory, method and practice of culturally secure translation and knowledge exchange in the Healing Right Way Clinical Trial (2017–2022), outlining activities to date. Healing Right Way was a stepped wedge cluster randomised controlled trial conducted in Western Australia, aimed at enhancing rehabilitation services and quality of life for Aboriginal Australians following acquired brain injury. The trial translation plan was aspirational and action-oriented, with its implementation iterative and ongoing. Translational activities aimed to inform service and research planning for Aboriginal people with brain injury. Situated in the intercultural space, the work guards against undertaking activities that …

Multimodal 7t Imaging Reveals Enhanced Functional Coupling Between Salience And Frontoparietal Networks In Young Adult Tobacco Cigarette Smokers, Alan N. Francis, Sophie Sebille, Susan Whitfield Gabrieli, Joan Camprodon

School of Medicine Publications

Tobacco cigarette smoking is associated with disrupted brain network dynamics in resting brain networks including the Salience (SN) and Fronto parietal (FPN). Unified multimodal methods [Resting state connectivity analysis, Diffusion Tensor Imaging (DTI), neurite orientation dispersion and density imaging (NODDI), and cortical thickness analysis] were employed to test the hypothesis that the impact of cigarette smoking on the balance among these networks is due to alterations in white matter connectivity, microstructural architecture, functional connectivity and cortical thickness (CT) and that these metrics define fundamental differences between people who smoke and nonsmokers. Multimodal analyses of previously collected 7 Tesla MRI data …

Systematic Review On The Impacts Of Agricultural Interventions On Food Security And Nutrition In Complex Humanitarian Emergency Settings, Melodie Al Daccache, Berthe Abi Zeid, Leila Hojeij, Ghassan Baliki, Tilman Brück, Hala Ghattas Ph.D.

Faculty Publications

Complex humanitarian emergencies are a main driver of food and nutritional insecurity. Agricultural interventions are key to improving nutrition and food security, and their positive impacts are well-documented in stable developing countries. However, it is unclear if their positive effects on food security hold in complex emergency settings, too. In this paper, we systematically review empirical articles that apply rigorous designs to assess the causal impacts of agricultural interventions on food security, nutrition, or health outcomes in complex humanitarian emergencies. We only find six articles matching these criteria, which have mixed results on dietary diversity and food security, and little …

Effects Of Postural Position, Eeg Asymmetry, And Temperamental Style On Cognitive Task Performance, Taylor Cops, Christy D. Wolfe

Undergraduate Theses

The literature shows hemispheric asymmetry in individuals corresponding with temperamental style. Those with greater right-frontal activation tend towards withdrawal/inhibition and those with greater left-frontal activation tend towards approach/activation (e.g., Davidson, 1992). Other literature suggests that greater right-parietotemporal activation is associated with increased arousal (Heller, 1993; Wolfe & Bell, 2014). Temperamental style has been linked with cognitive performance with approach-oriented temperaments being associated with both higher and lower performance depending on the task requirements (Khan et al., 2024; Wolfe & Bell, 2007). Literature further suggests that postural position (e.g., sitting, standing, lying down) may influence feelings of approach/withdrawal and cognitive processing. …

Investigation Of The Anticancer Activity Of Phenylbismuthbis(4-Carboxychalcone), Megan Baker

Undergraduate Theses

Cancer is currently the second leading cause of death in the US. While much progress has been made, there is still a significant need for novel therapies. Chalcones are privileged, natural products that have shown cytotoxic activity and potential as chemotherapeutics in multiple cancerous cell lines. Additionally, bismuth complexes of small organic molecules have been shown to have anti-tumor activity. The anti-proliferative activity of phenylbismuthbis(4-carboxychalcone), a bismuth-coordinated chalcone was assessed in multiple cancer cell lines using MTS assays. The compound demonstrated micromolecular inhibition. Additionally, mechanism of action studies were performed to assess if the anti-proliferative activity seen is due to …

Investigating The Impact Of Outpatient Mental Health Follow-Up Care On Continued Adolescent Suicidality: An Evidence-Based Change Project Proposal, Kimberly Feifel

MSN Capstone Projects

The escalating rates of adolescent suicide globally, coupled with the surge in pediatric hospitalization rates, underscore the urgent need for effective intervention strategies. Despite hospitalization, many patients persist in experiencing suicidal ideation and behaviors, often leading to readmissions. A significant portion of these individuals do not receive adequate outpatient mental health follow-up care post-discharge. As a leading pediatric healthcare institution committed to delivering exemplary care, particularly to those struggling with mental health challenges, the organization’s commitment demands proactive measures.

The attached proposal aims to establish an organizational policy to reduce 30-day readmission rates among adolescents with persistent suicidal thoughts and …

Discharge Preparedness For The Type 1 Diabetic Patient, Nathan W. Sewell

MSN Capstone Projects

The purpose of this paper is to highlight the individual who suffers from type 1 diabetes, because there appears to be a disparity in the equity of their healthcare needs as compared to other chronic illness. Type 1 diabetes is a progressive illness that places a tremendous burden on the person inflicted with it, including emotional, physical, and financial strains, and these burdens contribute to an emotional condition known as diabetic distress (Orben et al., 2022). This distress impacts the individual’s self-efficacy, and they see more frequent exacerbations of their diabetes like diabetic ketoacidosis (DKA) (Fisher et al., 2018; Hood …

Development And Implementation Of A Training Manual For Increased Utilization Of The Universal Exercise Unit (Ueu), Anya Marie Jones

OTD Capstone Projects

This doctoral capstone project was completed in partnership with Rehab Without Walls (RWW) Neuro Solutions in Hendersonville, TN; an outpatient clinic dedicated towards serving adults with various neurological conditions, including stroke, spinal cord injury, traumatic brain injury, cerebral palsy, and more. The focus of this project was to develop a training manual for the therapists at RWW to improve occupation-based utilization of the Universal Exercise Unit (UEU). Through the lens of the Ecology of Human Performance (EHP) model and Albert Bandura’s theory of behavior change, each therapist’s performance range (i.e., ability to perform tasks) depended on both the context (the …

Privileges, Immunities, And Affirmative Action In Medical Education, Gregory Curfman

Journal of Law and Health

In Students for Fair Admissions v. President & Fellows of Harvard College and Students for Fair Admissions v. University of North Carolina, the Supreme Court ruled that affirmative action in university admissions, in which an applicant of a particular race or ethnicity receives a plus factor, is unconstitutional. This ruling was based on both the Equal Protection Clause of the Fourteenth Amendment and Title VI of the Civil Rights Act of 1964. This article argues that a more natural fit as the basis for constitutional analysis would be a different clause in the Fourteenth Amendment, the Privileges or Immunities …

Nonfinancial Conflict Of Interest In Medical Research: Is Regulation The Right Answer, Nehad Mikhael

Journal of Law and Health

Medical research plays a vital role in advancing human knowledge, developing new therapies and procedures, and reducing human suffering. Following the atrocities committed in the name of medical research by German physicians during the Nazi era, the Nuremberg trials were held, and an ethical code was created to establish the limits within which medical research can operate. Consequently, legal regimes built upon this ethical foundation to develop laws that ensure the integrity of medical research and the safety of human subjects. These laws sought to protect human subjects by minimizing conflicts of interest that may arise during the process. Furthermore, …

An Adapted Yoga Program For Adults With Neuromuscular Impairments Designed To Improve Balance, Mood, Quality Of Life, And Engagement In Daily Occupations, Hayes Miller, Mary Smith Otd, Otr/L, Christienne Parten Otd, Med, Otr

Spring 2024 Virtual OTD Capstone Symposium

Neuromuscular impairments such as Parkinson's disease (PD) and Multiple Sclerosis (MS) affect an individual's balance, mood, and ability to engage in daily occupations, ultimately impacting their quality of life. Yoga is a practice that is adaptable to any level of function and is holistic in its goal of mind-body unity. However, there has been minimal research regarding yoga's efficacy as a modality for populations with neuromuscular impairments. This study aimed to improve these factors as well as proprioception and interoceptive awareness through the delivery of a 6-week community-based yoga program. The program involved 5 participants, 4 with PD and 1 …

Hippocampus Diffusivity Abnormalities In Classical Trigeminal Neuralgia, Shaun Andrew Hanycz, Alborz Noorani, Peter Shih-Ping Hung, Matthew R. Walker, Ashley B. Zhang, Timur H. Latypov, Mojgan Hodaie

Student Papers, Posters & Projects

INTRODUCTION: Patients with chronic pain frequently report cognitive symptoms that affect memory and attention, which are functions attributed to the hippocampus. Trigeminal neuralgia (TN) is a chronic neuropathic pain disorder characterized by paroxysmal attacks of unilateral orofacial pain. Given the stereotypical nature of TN pain and lack of negative symptoms including sensory loss, TN provides a unique model to investigate the hippocampal implications of chronic pain. Recent evidence demonstrated that TN is associated with macrostructural hippocampal abnormalities indicated by reduced subfield volumes; however, there is a paucity in our understanding of hippocampal microstructural abnormalities associated with TN.

OBJECTIVES: To explore …

Mapping Of Alzheimer’S Disease Related Data Elements And The Nih Common Data Elements, Xubing Hao, Rashmie Abeysinghe, Fengbo Zheng, Paul E Schulz, The Alzheimer’S Disease Neuroimaging Initiative, Licong Cui

Faculty, Staff and Student Publications

Background

Alzheimer’s Disease (AD) is a devastating disease that destroys memory and other cognitive functions. There has been an increasing research effort to prevent and treat AD. In the US, two major data sharing resources for AD research are the National Alzheimer’s Coordinating Center (NACC) and the Alzheimer’s Disease Neuroimaging Initiative (ADNI); Additionally, the National Institutes of Health (NIH) Common Data Elements (CDE) Repository has been developed to facilitate data sharing and improve the interoperability among data sets in various disease research areas.

Method

To better understand how AD-related data elements in these resources are interoperable with each other, we …

Medication Errors: The Radonda Vaught Case, Nayeli Guandique-Benitez

Honors Theses

We can recognize that to err is human, yet it may cost us great things, such as our jobs, licenses, and peace of mind. In nursing, 40% percent of the time is spent administering medication (Wolters Kluwer, 2022, p.15-17), which puts nurses and nursing students at an increased rate of making medication administration errors (MAE). The National Coordinating Council for Medication Error Reporting and Prevention (NCCERP,2023) says medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer." …

Nurse Anesthetists’ Perceptions And Experiences Of Managing Emergence Delirium: A Qualitative Study, Yi Xin, Fu-Cai Lin, Chen Huang, Bin He, Ya-Ling Yan, Shuo Wang, Guang-Ming Zhang, Rui Li

Faculty, Staff and Student Publications

BACKGROUND: This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium (ED), a common and complex postoperative complication in the post-anesthesia care unit. The role of nurses in managing ED is critical, yet research on their understanding and management strategies for ED is lacking.

AIM: To investigate anesthetic nurses' cognition and management experiences of ED in hopes of developing a standardized management protocol.

METHODS: This study employed a descriptive phenomenological approach from qualitative research methodologies. Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research …

When They Just Don’T Sleep: Differential Impacts Of Reduced Child Sleep On Depression, Anxiety, And Stress Among Caregivers Of Children With And Without Neurogenetic Syndromes, Kimberly Galvez-Ortega, Kristine Marceau, Dan Foti, Bridgette Kelleher

Purdue University Libraries Open Access Publishing Fund

Introduction: Children with neurogenetic syndromes commonly experience significant and pervasive sleep disturbances, however, associations with caregiver mental health remains unclear. Previous studies have linked sleep disturbances with increased caregiver depression in typically developing populations, and heightened caregiver stress among neurogenetic populations. The present study expands on findings by exploring the longitudinal association between child sleep duration and caregiver mental health (depression, anxiety, stress) throughout development (infancy to school-aged children) in dyads with and without a child affected by a neurogenetic syndrome.

Methods: Participants were drawn from the Purdue Early Phenotype Study, including 193 caregivers (Age: M = 34.40 years, SD …

Messaging About Very Low Nicotine Cigarettes (Vlncs) To Influence Policy Attitudes, Harm Perceptions And Smoking Motivations: A Discrete Choice Experiment, Reed M. Reynolds, Lucy Popova, David L. Ashley, Katherine C. Henderson, Charity A. Ntansah, Bo Yang, Emily E. Hackworth, James Hardin, Jim F. Thrasher Ph.D., Ma, Ms

Faculty Publications

Background To reduce smoking and the harms it causes, countries, including the USA, are considering policies to reduce nicotine in combustible tobacco to minimally addictive levels. Effective messages about very low nicotine cigarettes (VLNCs) and this policy are crucial in combating misperceptions threatening the policy’s effectiveness.

Data and methods A discrete choice experiment assessed messages about VLNCs. Participants were 590 adults who smoked exclusively, 379 adults who both smoked and used e-cigarettes, 443 adults who formerly smoked and 351 young adults who never smoked (total n=1763). Seven message attributes were varied systematically (source, harm, chemicals, nicotine, satisfaction, addictiveness and quitting …