Medicine and Health Sciences Commons^™

Social Participation Program For Older Adults With Dementia Residing In Long Term Care Facilities, Keri Mcclelland

Student Capstone Papers

Social participation is characterized by activities that involve social interaction with others and supports social interdependence; individuals engage in this occupation through a variety of contexts including with their community, family, friends, and peers (American Occupational Therapy Association, 2020). Social participation has been discovered to influence general health and well-being, cognitive health, risk of dementia, and stress (Sommerlad et al., 2023). Dementia is a prevalent disease affecting approximately 50 million individuals worldwide (Sommerlad et al., 2023) causing increased dependence and disability among the older adult population and is shown to be growing as the aging population increases in number (Wang …

Co-Occurrence Of Mental Illness And Substance Use Among Us Pregnant Individuals, 2012-2021, Zhong Li, Curisa M. Tucker Phd, Rn, Cassie L. Odahowski Phd, Mph, Kacey Y. Eichelberger, Jiajia Zhang Ph.D., Peiyin Hung Ph.D

Publications

Aim: Substance use disorders are increasingly prevalent among pregnant individuals, with evident risks of adverse perinatal outcomes. This study examines substance use (tobacco, alcohol and marijuana) among pregnant individuals with mental illness. Methods: A national representative sample of pregnant individuals were derived from 2012 to 2021 National Survey of Drug Use and Health data. Associations of past-year mental illness with past-month polysubstance use and each substance use were analyzed by logistic regression models, with complex sampling weights and survey year. Results: Among 6801 pregnant individuals, 16.4% reported having any mental illness (AMI) in 2012 and 2013, increasing to 23.8% in …

Delayed Onset Of Neonatal Compartment Syndrome Associated With Compound Fetal Presentation, Nicholas Manini, Hayato Unno

Department of Medicine Faculty Papers

Neonatal compartment syndrome, although rare, has a classic presentation with sentinel skin findings and development of swelling, erythema, and tenderness of the affected extremity. Neonatal compartment syndrome requires prompt surgical intervention to preserve the affected limb and ensure its normal growth and development. Our patient was born at term via vaginal delivery complicated by a compound presentation involving the left upper extremity. No physical exam abnormalities were noted at birth, but she developed signs of neonatal compartment syndrome by 15 h of life. She was surgically treated at 22 h of life and recovered well. At one year of age, …

The Role Of Acgme-International In Enhancing Opportunities Of Residents For Advanced Subspecialty Training, James A. Arrighi, Lorraine C. Lewis, Thomas J. Nasca

Department of Medicine Faculty Papers

No abstract provided.

No, You Can't Just Peek In Their Brain To See Their Future, Alia Barcus

Tredway Library Prize for First-Year Research

This paper argues against the use of predictive cognitive neuroscience research in judicial processes. Barcus argues that, because predictive models do not adequately address the “whys” of behavior and are better suited to macro-scale processes rather than individual-level predictions, they can only provide “a crude idea of future behavior” at best and will be bias-laden and inaccurate at worst. Meanwhile, neuroscience brain imaging is a newly-developing field and relies on small-scale studies, a combination that creates little replicability and presents deeply-flawed outcomes when this research is used as a basis for criminal prosecution. Barcus concludes that this scholarship, while holding …

Recommendations For Sugammadex Administration In Standard And Special Populations, Kristen E. Mattson, Alexa Brummund

Doctor of Nursing Practice Projects

The purpose of this project was to collect evidence-based information regarding sugammadex administration in both standard and selected special populations. Special populations included renal failure, breastfeeding, pregnancy, and pediatrics. The objectives of the project were to collect and present current research to the host facility, define barriers to the use of sugammadex, and assess the participants’ knowledge of sugammadex use in special populations. A guideline for sugammdex administration was created and presented to the host facility through a poster presentation and quick reference guide. A voluntary post-implementation survey was implemented, and the results were recorded, analyzed, and displayed in the …

Shivering In Postpartum Women: Development Of A Perioperative Protocol For Women Undergoing Cesarean Section, Lindsay Dawson, Kara Peters

Doctor of Nursing Practice Projects

In obstetric patients undergoing a cesarean section, a spinal anesthetic is the most common form of anesthesia (Hannallah, 2016). An intrathecal (or spinal) block is not benign. Postpartum shivering is a potential risk with any neuraxial procedure, with an incidence of 40-80% specifically following a spinal anesthetic (Feng et al., 2021). Patients who experience shivering are at a greater risk for postoperative complications, impaired mother-newborn bonding, and decreased patient satisfaction. Both nonpharmacological and pharmacological treatment options exist for prevention and treatment of postpartum shivering. The objective of this project was to introduce a standardized, evidence-based protocol to decrease the incidence …

Anesthesia Management For The Preeclampsia Or Hypertensive Parturient, Britanie Sumpter

Doctor of Nursing Practice Projects

Preeclampsia is a placental disease characterized by abnormal maternoplacental blood vessels and placental dysfunction resulting in fetoplacental hypoperfusion and maternal multi-system organ dysfunction (Wang et al., 2019). Expectant management of a hypertensive or preeclamptic parturient includes antihypertensive medications, magnesium sulfate for seizure prophylaxis, and early delivery of the fetus (ACOG, 2020). Neuraxial anesthetic-induced sympathectomy combined with circulating antihypertensives, magnesium sulfate therapy, and intravascular volume depletion in preeclampsia is thought to contribute to exaggerated hypotension.

Persistent refractory hypotension after neuraxial anesthesia in parturients with preeclampsia or hypertension has been an ongoing issue affecting obstetric providers at the host facility. This project …

Diversity, Equity, & Inclusion In Nurse Anesthesia: Bridging The Gap, Aminat Yusuff-Akinbo

Doctor of Nursing Practice Projects

The nurse anesthetist plays a crucial role in the healthcare system. Through intensive training, they provide safe and effective anesthesia care to patients across various healthcare settings. Currently, the nurse anesthesia field lacks diversity, with underrepresentation of minority groups such as Black, Hispanic, and Indigenous individuals. The United States Census revealed that there are more than 325 million residents. Yet only 10.9% of nurse anesthetists are of diverse racial backgrounds. This lack of diversity limits the cultural perspectives and experiences brought to patient care and perpetuates disparities in healthcare outcomes. An increase in diversity can improve care for individuals and …

Integrating Psychotherapy In A Psychiatric Outpatient Clinic, Ayesha Baluch

Doctor of Nursing Practice Projects

Mental illness is common in the United States, affecting millions of people. Although there are effective medications for mental illness, psychotherapy in addition to pharmacotherapy provides the best outcomes. This project aimed to improve providers' psychotherapy screening and education of patients about psychotherapy utilization. A pre-implementation survey was conducted to evaluate psychotherapy screening and the barriers faced by providers to utilize psychotherapy screening. An education session was provided to the providers about the importance of psychotherapy screening and education. Data showed that the providers discussed psychotherapy with eight patients (40%) and educated four patients (20%) pre-implementation. Data showed that the …

Improving Depression Screening In Primary Care, Grace Wilson, Annmarie O'Connor

Doctor of Nursing Practice Projects

Depression remains an increasingly prevalent and underdiagnosed disorder affecting approximately 21 million adults in the United States with only 66% seeking treatment (NIMH, 2022). Untreated depression can lead to worsening mental and physical health which negatively impacts a person’s quality of life. The implementation of routine depression screening in primary care is recommended by the US Preventive Services Task Force (USPSTF) to improve early detection leading to improved outcomes (USPSTF, 2023). Despite increased depression prevalence and USPSTF recommendation, there remained an absence of routine depression screening in a primary care practice in Midwest Illinois which led to the development of …

Nurses' Experience Implementating Weighted Blankets In Inpatient Psychiatric Unit, Michael Ragen

Doctor of Nursing Practice Projects

The complexity of treating sleep difficulties in patients with concurrent psychiatric disorders continues to be a struggle for the medical community. The mechanism that causes psychiatric disorders can induce insomnia or hypersomnia (Khurshid, 2018). There is also a growing interest in disturbed sleep ability to induce psychiatric episodes (Verkhratsky et al., 2020). This classic “Chicken or Egg Scenario” meets the modern focus on creating the best outcome for patients with the least medication, spurring interest in the holistic management of sleep disorders. The literature has little information on the use of weighted modalities for sleep management and anxiety in an …

Lung Cancer Screening In A Primary Care Clinic For Coal Mine, Glenda Mills, Sarah Cobb

Doctor of Nursing Practice Projects

Lung cancer is the leading cause of mortality for both men and women in the United States. Guidelines are set by the American Cancer Society for annual screenings of at-risk patients. Early identification of lung cancer risk and screening with low-dose CT scans can increase detection and treatment thereby reducing risk of death or disability. Coal miners are exposed to numerous cancer-causing agents, such as toxic chemicals, dust pollution from coal, and diesel exhaust fumes. However, primary care clinics serving coal miners lack lung cancer screenings despite the increased risk miners face. Patients were screened using criteria set forth by …

Establishing Routine Multiple Micronutrient Supplementation During Pregnancy In An Impoverished Guatemalan Community, Marissa Schuette, Erin Brueggemann

Doctor of Nursing Practice Projects

Pregnant and breastfeeding women in impoverished settings face heightened nutritional demands, placing them and their children at increased risk of inadequate nutrition's detrimental effects. Existing literature suggests that supplementing with multiple micronutrients (MMS) may offer superior protection against morbidity and mortality compared to traditional iron and folic acid (IFA) formulations. This research is set in the Land of Hope (LOH) clinic, located in Escuintla, Guatemala, a community served by the non-profit organization ER Abroad. The study aims to assess the feasibility of standardizing MMS provision to pregnant women at LOH, coupled with supplementary education on pregnancy and nutrition. The team …

Enhanced Recovery After Surgery (Eras) Protocol For Bariatric Surgery, Krista Bunch

Doctor of Nursing Practice Projects

Bariatric surgery has been utilized in treating severe obesity and offers several benefits, such as sustainable weight loss, treatment of various metabolic comorbidities, and improved life expectancy (Sundbom et al., 2017). With these benefits and procedural improvements, there has been a marked increase in the demand for bariatric surgery and increased interest in shifting some of these procedures to an ambulatory care setting (Stenberg et al., 2022). However, postoperative complications such as pain, nausea, and inability to tolerate oral intake can cause patients to experience an increased length of stay in the hospital and suboptimal outcomes (King et al., 2018). …

Improvement In Patient Compliance For Gynecological Care, Tracee Williams

Doctor of Nursing Practice Projects

This quality improvement project implemented the patient-initiated follow-up (PIFU) pathway in a gynecology clinic setting. PIFU has potential to lead to decreased no-show appointments and increased patient autonomy in outpatient healthcare practices. Barriers that influence compliance with plans of care include lower socioeconomic status, racial and ethnic minorities, and unmet social needs such as food insecurity, healthcare travel and cost, and child/adult care needs. In addition to higher rates of no-show appointments, individuals facing these barriers have increased comorbidities. Prior to implementing the PIFU model, patients between the ages of 18 and 42 completed a patient satisfaction survey to better …

Accurate Characterization Of Binding Kinetics And Allosteric Mechanisms For The Hsp90 Chaperone Inhibitors Using Ai-Augmented Integrative Biophysical Studies, Chao Xu, Xianglei Zhang, Lianghao Zhao, Gennady M. Verkhivker, Fang Bai

Mathematics, Physics, and Computer Science Faculty Articles and Research

The binding kinetics of drugs to their targets are gradually being recognized as a crucial indicator of the efficacy of drugs in vivo, leading to the development of various computational methods for predicting the binding kinetics in recent years. However, compared with the prediction of binding affinity, the underlying structure and dynamic determinants of binding kinetics are more complicated. Efficient and accurate methods for predicting binding kinetics are still lacking. In this study, quantitative structure–kinetics relationship (QSKR) models were developed using 132 inhibitors targeting the ATP binding domain of heat shock protein 90α (HSP90α) to predict the dissociation rate …

Role Of Mechanoregulation In Mast Cell-Mediated Immune Inflammation Of The Smooth Muscle In The Pathophysiology Of Esophageal Motility Disorders, Raj Goyal, Satish Rattan

Division of Gastroenterology and Hepatology Faculty Papers

Major esophageal disorders involve obstructive transport of bolus to the stomach, causing symptoms of dysphagia and impaired clearing of the refluxed gastric contents. These may occur due to mechanical constriction of the esophageal lumen or loss of relaxation associated with deglutitive inhibition, as in achalasia-like disorders. Recently, immune inflammation has been identified as an important cause of esophageal strictures and the loss of inhibitory neurotransmission. These disorders are also associated with smooth muscle hypertrophy and hypercontractility, whose cause is unknown. This review investigated immune inflammation in the causation of smooth muscle changes in obstructive esophageal bolus transport. Findings suggest that …

A Narrative Review On The Impact Of Online Health Misinformation On Patients’ Behavior And Communication, Shih-Han Lan, Sara Mahmoud, Kari L. Franson

Pacific Faculty Work

Objectives: Online health information is readily available and can be a favored by patients as a source of information for convenience. Despite the positive belief on the availability of information, it does not improve health outcomes. Online information can be false and complicated, leading to anxiety and excessive dissemination of misinformation. The objective of this study is to provide a review on the current evidence about the various perspectives on online health misinformation. Methods: This is a meta-narrative systematic review developed based on the RAMESES publication standards. We classified reviewed articles into 5 main categories: patient and healthcare professionals’ perspective, …

The Scoop, Vol. 11 Issue 1, April 2024, Health Sciences Library

Volume 11

Latest news and updates from the Health Sciences Library in our monthly newsletter for April 2024.

Finger Contracture Relief Sensorized Splint, Katia Campos, Alfonso Gonzalez, Olivia Rojas

Posters - 2024

Hand traumas may result from an accident, a burn, or even something far more common like a jammed finger. Due to the pain, the hand is immobilized and this lack of movement, in addition to the healing processes, can lead to a deformity. The specific deformity addressed in this project is a Proximal Interphalangeal Joint Flexion Contracture, which is when the middle knuckles of the fingers are stuck in a flexed position. Contractions can occur after trauma or certain illnesses. It is the shortening of muscles, tendons, skin, and nearby soft tissues that causes the joints to become very stiff. …

The Quantification Of Essential Oils And Bixin In Annatoo Seeds, Alycia C. Johnson, Susan Oxley

Posters - 2024

Bixa orellana (also known as annatto or achiote) originates from South America but it can be found nearly everywhere in the world. The seeds of this species make for an excellent natural coloring. It is applied to makeup, food, and textiles; some of the biggest commercial industries.1 Of the 50+ phytochemicals identified, there are a large number of essential oils and other compounds that have been shown to have beneficial properties. Four of these compounds will be used to determine which traditional processing method results in the biggest loss of phytochemicals. Annatto is often either fried, left whole, or powdered …

Improving Frequency Of Peer Review Of Abnormal Genital Exam Findings In Patients Undergoing Sexual Abuse Evaluation, Lyndsey Hultman, Terra N. Frazier, Jennifer Hansen

Presentations

Background/Objectives: 2023 Child Advocacy Center (CAC) accreditation standards require that “all medical professionals providing services to CAC clients must demonstrate that 100% of all findings deemed abnormal or “diagnostic” of trauma from sexual abuse have undergone expert review by an advanced medical consultant”. Prior to program implementation, scheduled Case Review occurred among the authors’ institution child abuse pediatricians (CAPs), but typical practice was to review cases upon CAP request. The authors’ institution faced practice standard implementation barriers of high case volumes and collaboration with multiple different CACs. Our primary aim was to increase peer review of abnormal exams from a …

Antimicrobial Duration Stewardship Project: A Qi Approach, Joshua Saucedo, Rana El Feghaly, Amanda Nedved, Leslie Hueschen, Marsha Dannenburg, Tanis Stewart, Patty Philips, Jennifer Floyd

Presentations

A QI project aimed at increasing the percentage of children discharged home from the emergency department with a diagnosis of community acquired pneumonia (CAP) or acute bacterial rhinosinusitis (ABRS) treated with an optimal antibiotic duration (5 days or less for CAP, 7 days or less for ABRS) from 22% to 70% by July 2025. Additionally, assess for differences in care based on demographic and socioeconomic factors such as the area deprivation index. National guidelines and CMH clinical pathways recommend short antibiotic durations (5-7 days) for most infections (5 days for community acquired pneumonia, 5-7 days for acute bacterial rhinosinusitis). At …

Inhibition Of Carbohydrate Metabolism Potentiated By The Therapeutic Effects Of Oxidative Phosphorylation Inhibitors In Colon Cancer Cells, Lichao Guo, Baochen Zhang, Wen Zhang, Yanqi Xie, Xi Chen, Xueke Sun, David S. Watt, Chunming Liu, H. Peter Spielmann, Xifu Liu

Markey Cancer Center Faculty Publications

Cancer cells undergo a significant level of “metabolic reprogramming” or “remodeling” to ensure an adequate supply of ATP and “building blocks” for cell survival and to facilitate accelerated proliferation. Cancer cells preferentially use glycolysis for ATP production (the Warburg effect); however, cancer cells, including colorectal cancer (CRC) cells, also depend on oxidative phospho- rylation (OXPHOS) for ATP production, a finding that suggests that both glycolysis and OXPHOS play significant roles in facilitating cancer progression and proliferation. Our prior studies identified a semisynthetic isoflavonoid, DBI-1, that served as an AMPK activator targeting mitochondrial com- plex I. Furthermore, DBI-1 and a glucose …

Relative Adrenal Insufficiency Is A Risk Factor For Pediatric Sepsis: A Proof-Of-Concept Study, Dan Hao, Ling Guo, Qian Wang, Misa Ito, Bin Huang, Chieko Mineo, Philip W. Shaul, Xiang-An Li

Markey Cancer Center Faculty Publications

Glucocorticoid (GC) therapy had been strongly recommended for pediatric sepsis (grade 1A). However, the recommendation was changed to grade 2C in 2020 due to weak evidence. About 32.8% of patients with pediatric septic develop relative adrenal insufficiency (RAI). But whether GC therapy should be determined by RAI status is controversial. This study utilized 21-day- old SF1CreSRBIfl/fl mice as the first pediatric RAI mouse model to assess the pathogenesis of RAI and evaluate GC therapy. RAI mice exhibited a substantially higher mortality rate in cecal ligation and puncture and cecal slurry–induced sepsis. These mice featured persistent inflammatory responses and were effectively …

The Nonvesicular Sterol Transporter Aster-C Plays A Minor Role In Whole Body Cholesterol Balance, Ranjan Banerjee, Rachel C. Hohe, Shijie Cao, Bryan M. Jung, Anthony J. Horak, Iyappan Ramachandiran, William J. Massey, Venkateshwari Varadharajan, Natalie I. Zajczenko, Amy C. Burrows, Sumita Dutta, Maryam Goudarzi, Kala Mahen, Abigail Carter, Robert N. Helsley, Scott M. Gordon, Richard E. Morton, Christopher Strauch, Belinda Willard, Camelia Baleanu Gogonea, Valentin Gogonea, Matteo Pedrelli, Paolo Parini, J. Mark Brown

Markey Cancer Center Faculty Publications

Introduction: The Aster-C protein (encoded by the Gramd1c gene) is an endoplasmic reticulum (ER) resident protein that has been reported to transport cholesterol from the plasma membrane to the ER. Although there is a clear role for the closely-related Aster-B protein in cholesterol transport and downstream esterification in the adrenal gland, the specific role for Aster-C in cholesterol homeostasis is not well understood. Here, we have examined whole body cholesterol balance in mice globally lacking Aster-C under low or high dietary cholesterol conditions.

Method: Age-matched Gramd1c^+/+ and Gramd1c^−/− mice were fed either low (0.02%, wt/wt) or high (0.2%, …

Patient Experience Of Head And Neck Surgery With Free Flap Reconstruction., Lillian W. Dattilo, Trinity I. Russell, Chloe B. Warinner, Heather Starmer, Donald J. Annino, Laura A. Goguen, Rosh K. V. Sethi, Ravindra Uppaluri, Melina Windon, Regan W. Bergmark, Eleni M. Rettig

Markey Cancer Center Faculty Publications

IMPORTANCE: Major head and neck surgery with microvascular free tissue transfer reconstruction is complex, with considerable risk of morbidity. Little is known about patients' experiences, including decision-making prior to, and regret following, free flap surgery.

OBJECTIVE: To characterize patient experiences and decision regret of patients undergoing head and neck reconstructive free flap surgery.

DESIGN, SETTING, AND PARTICIPANTS: This mixed-methods cohort study comprising semistructured interviews was conducted June to August 2021 at a single tertiary academic cancer center. Participants underwent head and neck reconstructive surgery with microvascular free tissue transfer (flap) more than 3 months before recruitment (range, 3 months to …

A Dynamic Model Of Inorganic Arsenic-Induced Carcinogenesis Reveals An Epigenetic Mechanism For Epithelial–Mesenchymal Plasticity, Matthew Rea, Greg Kimmerer, Shania Mittendorf, Xiaopeng Xiong, Megan Green, Darrell Chandler, Wesley Saintilnord, Jessica S. Blackburn, Tianyan Gao, Yvonne N. Fondufe-Mittendorf

Markey Cancer Center Faculty Publications

Inorganic arsenic (iAs) causes cancer by initiating dynamic transitions between epithelial and mesenchymal cell phenotypes. These transitions transform normal cells into cancerous cells, and cancerous cells into metastatic cells. Most in vitro models assume that transitions between states are binary and complete, and do not consider the possibility that intermediate, stable cellular states might exist. In this paper, we describe a new, two-hit in vitro model of iAs-induced carcinogenesis that extends to 28 weeks of iAs exposure. Through week 17, the model faithfully recapitulates known and expected phenotypic, genetic, and epigenetic characteristics of iAs-induced carcinogenesis. By 28 weeks, however, exposed …

A Single Hydrogen Bond That Tunes Flavin Redox Reactivity And Activates It For Modification, Debarati Das, Anne-Frances Miller

Markey Cancer Center Faculty Publications

Electron bifurcation produces high-energy products based on less energetic reagents. This feat enables biological systems to exploit abundant mediocre fuel to drive vital but demanding reactions, including nitrogen fixation and CO₂ capture. Thus, there is great interest in understanding principles that can be portable to man-made devices. Bifurcating electron transfer flavoproteins (Bf ETFs) employ two flavins with contrasting reactivities to acquire pairs of electrons from a modest reductant, NADH. The bifurcating flavin then dispatches the electrons individually to a high and a low reduction midpoint potential (E°) acceptor, the latter of which captures most of the energy. Maximum efficiency …