Medicine and Health Sciences Commons^™

Percutaneous Management Of Pelvic Fluid Collections: A 10-Year Series, Chidumebi Alim

Yale Medicine Thesis Digital Library

ABSTRACTTitle: Percutaneous Management of Pelvic Fluid Collections: A 10-Year Series Authors: Chidumebi Alim, BSc1; Chinenye Okafor, MBBS, MPH2; Joshua Cornman-Homonoff, MD3

1Yale School of Medicine, New Haven, CT2Department of Neurology, Yale School of Medicine, New Haven, CT 3Section of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT

Percutaneous image-guided drainage has emerged as the preferred treatment for infected and symptomatic fluid collections of adequate size, particularly those in the pelvis. Despite this, the optimal approach to catheter placement and management remains unknown. The purpose of this study was to retrospectively evaluate a large …

Initial Refugee Health Assessment Educational Session, Yolondra Cochnan

Doctor of Nursing Practice Projects

The initial refugee health assessment presents an excellent opportunity to identify communicable diseases in newly arriving refugees. As the number of refugee arrivals increases, so will the need for nurses who possess the skills necessary to conduct the initial refugee health assessment. Prior to the pandemic, the United States was facing a nursing shortage. The impact of the pandemic devastated the nursing community, leaving them exhausted and burnt out, which led many nurses to retire and leave the field of nursing (National Council of State Boards of Nursing [NCSBN], 2023). Skilled nurses are needed to prevent the spread of communicable …

Improving Parental Communication With Adolescents About Sex, Amanda Blanton

Doctor of Nursing Practice Projects

In 2018, 68 million people in the United States were infected with a sexually transmitted infection. Of those 68 million, 26 million cases were newly diagnosed, and of that 26 million, half were youth aged 15-24 (Centers for Disease Control and Prevention [CDC], 2022a). The approaches to educating our youth about sexual health are inconsistent, leading to misconceptions about the dangers associated with risky sexual behavior. However, parents have the upper hand in discussing sexual health information with their children by being the child’s first contact and source of information. Teens who report talking with their parents about sex are …

Increasing Organ Donation In A University Setting, Zachary Hatton

Doctor of Nursing Practice Projects

The literature shows a strong correlation between education on organ donation and increased organ donation registration. Society has depicted a description of organ donation that is hostile and untrue. Increasing organ donation registration with knowledge sets the foundation of a grassroots movement to increase understanding and change society’s viewpoint(s) on organ donation. An education session on organ donation was developed and presented to the targeted population of 18–24-year-old students at a university in the foothills of the Appalachian Mountains. The focal point of the presentation was to dispel myths, educate on facts, and create a better understanding of organ donation …

Community Education: Impact On Earlier Recognition Of Stroke, Lauren Kahn

Doctor of Nursing Practice Projects

Cerebrovascular disease was identified as the fourth leading cause of death in Cleveland County, North Carolina from 2014 to 2018 (Cleveland County Public Health Center, 2020). Community education was identified as a potential solution to decreasing the number of community members affected by cerebrovascular disease and resulting death and disability. Five community classes were taught with 97 participants. Pre-, post-, and 1-week post-class surveys were distributed to assess baseline knowledge, knowledge gain, and knowledge retention, with 74 pre-class, 72 post-class, and 28 1-week post-class surveys returned. Of these surveys, after exclusionary criteria were used, 40 pre-class, 53 post-class, and 22 …

Implementing A Strategic Reporting Model Among Public Health Nurse Consultants To Increase Communication, Heather Willis

Doctor of Nursing Practice Projects

Public health has seen a drastic amount of turnover post-pandemic. There was an estimated 44% turnover rate for public health registered nurses, with a vacancy rate that doubled from 12.7% in March 2020 to 23.2% in July 2022 (Skinner, 2022). With this high turnover rate, many nurses are new to North Carolina (NC) public health departments and health districts. Public Health Nurse Consultants (PHNCs) are expected to train and guide these new nursing staff members. With the turnovers continuing at the local health departments (LHDs), new nurses are not given the recommended training because of communication breakdowns. This project helped …

Bridging The Gap: Strategies To Enrich The Clinical Experience Of Undergraduate Nursing Students To Improve Clinical Judgment Skills, Gabrielle Hope

Doctor of Nursing Practice Projects

Introduction: The lack of competent clinical judgement among new graduate nurses contributes to poor patient outcomes, negatively impacting patient satisfaction scores, and subsequently raising the cost of healthcare for consumers. This project explores how reflective journaling and cooperative learning activities contribute to the development of critical thinking of nursing students during their Nursing Fundamentals clinical practicum.

Methods: Seventeen students enrolled in a private university nursing program were selected as the sample. The students were introduced to the recommended learning strategies and invited to anonymously participate in a pre-survey and post-survey. The surveys were identical in content and consisted …

Improving Sexually Transmitted Infections (Sti) Education And Access To Education For Healthcare Workers In A Rural Ambulatory Clinic, Savannah Elmore

Doctor of Nursing Practice Projects

Sexually transmitted infections (STIs) are prevalent across the United States, with one in five people diagnosed in 2018, resulting in nearly $16 billion in medical costs. The prevention and treatment of STIs have been identified as a priority area for improvement, with healthcare providers playing a critical role in education, diagnosing, and treating STIs. The aim of this capstone project was to improve STI education and access to education for healthcare workers in a rural ambulatory clinic. Through a needs assessment and the development of objectives and a timeline, the project identified and addressed gaps in STI education and resources, …

Fostering Relationships Between New Graduate Nurses And Leadership To Increase Retention, Michelle Cotton

Doctor of Nursing Practice Projects

Objective: To implement weekly one-on-one touch bases between nursing leaders, such as managers and directors, with newly hired, new graduate nurses, up to 1 year after graduation to improve retention of those employees. The intent is to improve retention from a baseline of 23% in 2022.

Results: 35.8% of the newly hired nurses plan to remain in their current role for the next 2-3 years.

Conclusions: Almost 55% said that they strongly agreed with the touch base contributing to development/growth. This was the lowest scoring question and the most concerning related to retention. An overwhelming majority felt …

Combating The Opioid Crisis: Opioid And Naloxone Training In A Rural School District, Phadra K. Murray

Doctor of Nursing Practice Projects

Background: The opioid epidemic is plaguing North Carolina and has crept its way into the academic setting of many elementary, middle, and high schools in the state, causing school nurses to scramble and search for ways to keep students safe. This DNP project was designed to educate school nurses in a rural county in eastern North Carolina about opioid education and naloxone administration. This project intended to increase the knowledge and confidence level of school nurses in case of an opioid overdose emergency within the school. As more and more children and adolescents experiment with opioids, there is an urgent …

Influence Of Human And Viral Il-6 On Kshv Infection In Human Tonsil Lymphocytes, Wajd Zakir

Pharmaceutical Sciences (MS) Theses

Infection of B cells by the lymphotropic gamma-herpesvirus Kaposi sarcoma-associated herpesvirus (KSHV) causes Multicentric Castleman Disease, Primary Effusion Lymphoma, and the newly-identified inflammatory syndrome designated KICS. Despite proven connections to lymphoproliferative disorders, little is known about how KSHV invades the human immune system or the early events governing infection in B lymphocytes. IL-6 signaling plays a critical role in KSHV-mediated disease, where elevated hIL-6 levels are positively associated with KSHV viral load and disease progression. This dynamic is even more complex due to the co-existence of human IL-6 (hIL6) and KSHV-encoded viral IL-6 (vIL6) in these diseases. Although the impact …

Impact Of Opioid-Free Analgesia On Pain Severity And Patient Satisfaction After Discharge From Surgery: Multispecialty, Prospective Cohort Study In 25 Countries, Tabish Chawla, Aliya Aziz, Anoosha Marium, Ayesha Akbar Waheed, Faiqa Binte Aamir, Faiza Qureshi, Hammad Ather, Iqra Fatima Munawar Ali, Izza Tahir, Maha Ghulam Akbar, Ronika Devi Ukrani, Sajjan Raja, Sehar Salim Virani, Shahryar Noordin, Saif Ur Rehman, Shalni Golani, Syed Roohan Aamir, Syed Musa Mufarrih, Usama Waqar, Maliha Taufiq

Section of General Surgery

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.
Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview …

A Comprehensive And Comparative Examination Of Healthcare Data Breaches: Assessing Security, Privacy, And Performance, Mohammed Al Kinoon

Graduate Thesis and Dissertation 2023-2024

The healthcare sector is pivotal, offering life-saving services and enhancing well-being and community life quality, especially with the transition from paper-based to digital electronic health records (EHR). While improving efficiency and patient safety, this digital shift has also made healthcare a prime target for cybercriminals. The sector's sensitive data, including personal identification information, treatment records, and SSNs, are valuable for illegal financial gains. The resultant data breaches, increased by interconnected systems, cyber threats, and insider vulnerabilities, present ongoing and complex challenges. In this dissertation, we tackle a multi-faceted examination of these challenges. We conducted a detailed analysis of healthcare data …

An Exploration Of Medical Mistrust In Urban African American Adolescents With High Risk Asthma, Meghna Shukla

Wayne State University Dissertations

Problem: Little is known about the relationship between medical mistrust and health outcomes in adolescents, particularly minority adolescents with chronic illness. There is also a paucity in knowledge on the relationship between caregivers’ trust or mistrust in a provider and if this is similar or dissimilar in their adolescent’s beliefs. To address this critical gap in research, this study aims to explore medical mistrust in AA adolescents with high-risk asthma and their caregivers. Asthma is currently the leading pediatric chronic respiratory condition in the United States, with a reported 60% had uncontrolled asthma symptoms. Asthma disproportionately affects urban, disadvantaged, minority …

Inequalities In Use Of Hospitals For Childbirth Among Rural Women In Sub-Saharan Africa: A Comparative Analysis Of 18 Countries Using Demographic And Health Survey Data., Manuela Straneo, Claudia Hanson, Thomas Van Den Akker, Bosede Afolabi, Anteneh Asefa, Alexandre Delamou, Mardieh Dennis, Luis Gadama, Nyika Mahachi, Welcome Mlilo

Centre of Excellence in Women and Child Health

Introduction; Rising facility births in sub-Saharan Africa (SSA) mask inequalities in higher-level emergency care— typically in hospitals. Limited research has addressed hospital use in women at risk of or with complications, such as high parity, linked to poverty and rurality, for whom hospital care is essential. We aimed to address this gap, by comparatively assessing hospital use in rural SSA by wealth and parity.

Methods; Countries in SSA with a Demographic and Health Survey since 2015 were included. We assessed rural hospital childbirth stratifying by wealth (wealthier/poorer) and parity (nulliparity/high parity≥5), and their combination. We computed percentages, 95% CIs and …

Disease Footprints: Understanding Basic Pathophysiology, Jeff Vasiloff, Md, Mph

OHIO Open Faculty Textbooks

Basic pathophysiology explained by Jeffrey Vasiloff, MD, MPH, Associate Clinical Professor, PA Program; Adjunct Professor, PT Program, College of Health Sciences and Professions, Ohio University Dublin Medical Campus; Physician Consultant: Ohio Association of Physician Assistants; Physician Volunteer: Franklin County & Columbus Medical Reserve Corps; Board Certification: Internal Medicine & Diabetes and Endocrinology.

Molecular Study Of The Agr Gene In Multidrug-Resistant (Mdr) And Extensively Drug-Resistant (Xdr) In The S. Aureus, Mays Ali Salim, Estabraq Ali Maklef, Montaha Abdul-Karim Al-Saffar

Al-Esraa University College Journal for Medical Sciences

Staphylococcus aureus a gram-positive coccus and one of the most important opportunistic bacteria that can lead to nosocomial infections. The purpose of this study is to explore the distribution and prevalence of the Agr gene in multidrug-resistance (MDR) and extensively drug-resistant (XDR) S. aureus. 62 isolates performed antibiotic sensitivity test. The isolates showed 66.12% resistance to clindamycin with MIC at range≥4, erythromycin 77.41% with MIC at range≥8, ciprofloxacin 19.35% with MIC at range≥4, oxacillin 75.80% with MIC at range≥4, cefoxitin 45.16% with MIC at range≥8, gentamycin 29.03% with MIC at range≥16, nitrofurantoin 14.51% and MIC at range≥128, and tetracycline …

Report: Evaluation Of Seal!Nd: School Year 2022-2023, Shawnda Schroeder, Jordan Jaeger

Indigenous Health Faculty Publications

The North Dakota school-based sealant program (SEAL!ND) prioritizes providing preventive oral health care to underserved students by targeting schools with 45% or greater of their students enrolled in the free and reduced fee school lunch program (these are considered qualifying schools). Although schools with a larger proportion of youth who are from lower-income households are prioritized by federal funding, additional schools participate and receive care from local dental providers (these are referred to as non-qualifying). During the 2022-23 school year, 58 schools participated in SEAL!ND; 40 qualifying schools (Q) and 18 non-qualifying (NQ); 55 of the 58 schools had two …

Infographic: How Well Do North Dakota Third-Grade Students Take Care Of Their Teeth?, Shawnda Schroeder

Indigenous Health Faculty Publications

93% of the third-grade students had visited the dentist at least once in their life. Children who report never seeing a dentist have a significantly higher need for urgent dental care.

Relationship Between Genotype And Disease Phenotype For Gluten-Related Disorders, Michael Roberts, Nadine Grzeskowiak, Stephen Bricher

Faculty Publications

We investigated gluten-related disorders (GRD) in intestinal biopsy-proven subjects to determine the relation between genotype (i.e., Human Leukocyte Antigen (HLA) DQ alleles) and phenotype (i.e., antibody levels and clearly defined symptoms). Subjects had known DQ genotypes, information on IgA anti-Endomysial antibodies (EMA) and/or anti-tissue Trans Glutaminase (tTG) antibodies (tTGA). Subjects also answered a survey characterizing gastrointestinal, skin, and neural symptoms. Though all were biopsy-proven, HLA genotypes included all combinations of DQ2.5, DQ2.2, DQ8, DQ7.5, DQ5, and DQ6. Subject antibody levels were proportional to the number of DQ2.5 haplotypes, and subjects with non-CD-associated haplotypes did not have positive antibody scores (despite …

East Marshall Street Well Project: Reparative Work And The Policy For Human Remains, Rome Kamarouthu

East Marshall Street Well Project Symposium Posters

This poster introduces the public to the history of medical exploitation tied to the East Marshall Street Well in the 19 th century, as well as the reparative efforts of the East Marshall Street Well Project, a partnership between VCU and a community group known as the Family Representative Council. It stresses that the Family Representative Council has called upon VCU to bury the remains found in the well, as well as to support research and memorialization efforts. The poster highlights the work of student fellows in fulfilling those recommendations, specifically in conducting and processing oral history interviews, and in …

Nanoscale Characterization Of Interaction Of Nucleosomes With H1 Linker Histone, Ahmed Yesvi Rafa, Shaun Filliaux, Yuri L. Lyubchenko

Journal Articles: Pharmaceutical Sciences

In eukaryotic nuclei, DNA is wrapped around an octamer of core histones to form nucleosomes. H1 binds to the linker DNA of nucleosome to form the chromatosome, the next structural unit of chromatin. Structural features on individual chromatosomes contribute to chromatin structure, but not fully characterized. In addition to canonical nucleosomes composed of two copies each of histones H2A, H2B, H3, and H4 (H3 nucleosomes), centromeres chromatin contain nucleosomes in which H3 is replaced with its analog CENP-A, changing structural properties of CENP-A nucleosomes. Nothing is known about the interaction of H1 with CENP-A nucleosomes. Here we filled this gap …

Reducing Falls In Adults On A Neurology Unit: An Evidence Based Quality Improvement Project, Kari Congenie, Sandra Scheidenhelm, Rachel Zastrow

DNP Scholarly Projects

BACKGROUND: Falls are a common concern in hospitalized adult patients affecting quality of life, length of stay, and cost.

LOCAL PROBLEM: A quality audit at a community hospital identified increased falls/falls with injury rates on a medical-surgical unit.

METHODS: A quality improvement initiative was implemented using a fall prevention toolkit to understand its effect on total fall/fall with injury rates, nursing knowledge, and nurse perceived efficacy.

INTERVENTIONS: The Fall Tailoring Interventions for Patient Safety (TIPS), an evidence-based toolkit, was implemented over five months.

RESULTS: Knowledge quiz scores were similar pre- and post-education. Fall rates and calls to the …

Collapsed Ear Canal And Sudden Sensorineural Hearing Loss, Emily Adelman

AuD Capstone Projects - Communication Sciences and Disorders

No abstract provided.

Neuroimmune Response And Neurodegeneration In Adolescent Rats Following Binge Alcohol Exposure, Catherine Van Doorn

Theses and Dissertations--Pharmacy

Studies of adolescent drinking show a distinct prevalence of binge drinking, including at extreme levels, and this type of drinking has been identified as increasing risk of developing an Alcohol Use Disorder (AUD). Additionally, females suffer greater levels of harm from binge drinking and AUD and in an abbreviated timeline compared to males. Neuroimmune reactivity, specifically with microglial reactivity following binge drinking, may influence the sex differences seen in negative alcohol-related health disparities.

The first set of experiments sought to examine a marker of microglial reactivity, TSPO, in adolescent females and males and found the sexes displayed different temporal and …

Understanding Social Dynamics In Toxic Conversations And Public Health Intervention Acceptance On Social Media, Ana Aleksandric

Computer Science and Engineering Dissertations - Archive

Social media is now central to daily life, offering users a space to share content and opinions. However, these platforms also facilitate the spread of hate speech and misinformation, which can negatively impact public health. This dissertation develops methodologies to analyze social media data for insights that could inform health interventions. The research first examines user responses to toxic content, focusing on behavioral and emotional reactions, as well as group dynamics and bystander effects in toxic interactions. Another key focus is public opinion toward health interventions, particularly COVID-19 vaccination, using geolocated posts and analyzing factors such as race, ethnicity, and …

Impact Of Traditional Education And Learner-Centered Education On Standardized Tests, Courtney Marie Winslow

Walden Dissertations and Doctoral Studies

There is a current shortage of approximately 45,000 nurses and nursing faculty to train student nurses, a number that is projected to grow. One proposed method to combat the shortage is to transition from traditional lecture-based classrooms to a learner-centered approach. Asking or requiring faculty to transition an entire nursing program from one teaching method to another without supporting data could be a waste of valuable time and resources. It could also prove detrimental to a program if students were unable to pass the NCLEX-RN exam, and a program was forced to close. The current study examined whether there was …

A Multidisciplinary Approach To Managing Financial Toxicity In Oncology Patients, Katelin Muse

Walden Dissertations and Doctoral Studies

Patients with a cancer diagnosis are counseled at length about the standard of care treatment options, which may include surgery, radiation, anticancer medications, and chemo/immunotherapy through an informed consent process. Unfortunately, the potential economic burden and the accompanying psychological burden is seldom discussed up front. There is a significant need for routine screening and a multidisciplinary approach to the prevention of financial toxicity for the oncology patient. The purpose of this doctoral project was to lead an interprofessional team in the development of a clinical practice guideline for routine financial screening using the Comprehensive Score for Financial Toxicity (COST) tool …

Lung-Delivered Il-10 Therapy Elicits Beneficial Effects Via Immune Modulation In Organic Dust Exposure-Induced Lung Inflammation, Aaron D. Schwab, Todd A. Wyatt, Amy J. Nelson, Angela Gleason, Rohit Gaurav, Debra J. Romberger, Jill A. Poole

Journal Articles: Pulmonary & Critical Care Med

Efficacious therapeutic options capable of resolving inflammatory lung disease associated with environmental and occupational exposures are lacking. This study sought to determine the preclinical therapeutic potential of lung-delivered recombinant interleukin (IL)-10 therapy following acute organic dust exposure in mice. Here, C57BL/6J mice were intratracheally instilled with swine confinement organic dust extract (ODE) (12.5%, 25%, 50% concentrations) with IL-10 (1 μg) treatment or vehicle control intratracheally-administered three times: 5 hr post-exposure and then daily for 2 days. The results showed that IL-10 treatment reduced ODE (25%)-induced weight loss by 66% and 46% at Day 1 and Day 2 post-exposure, respectively. IL-10 …

Single-Cell Profiling Reveals A Conserved Role For Hypoxia-Inducible Factor Signaling During Human Craniotomy Infection, Zachary Van Roy, Gunjan Kak, Lee E. Korshoj, Joseph P. Menousek, Cortney E. Heim, Rachel W. Fallet, James Campbell, Carol Reynolds Geary, Bo Liu, Santhi Gorantla, Larisa Y Poluektova, Bin Duan, Walter S. Campbell, William Thorell, Tammy Kielian

Journal Articles: Pathology and Microbiology

Neurosurgeries complicated by infection are associated with prolonged treatment and significant morbidity. Craniotomy is a common neurosurgical procedure; however, the cellular and molecular signatures associated with craniotomy infection in human subjects are unknown. A retrospective study of over 2,500 craniotomies reveals diverse patient demographics, pathogen identity, and surgical landscapes associated with infection. Leukocyte profiling in patient tissues from craniotomy infection characterizes a predominance of granulocytic myeloid-derived suppressor cells that may arise from transmigrated blood neutrophils, based on single-cell RNA sequencing (scRNA-seq) trajectory analysis. Single-cell transcriptomic analysis identifies metabolic shifts in tissue leukocytes, including a conserved hypoxia-inducible factor (HIF) signature. The …