Medicine and Health Sciences Commons^™

Volume 15, Connor Thompson, Emily Steffenhagen, Emily Robertson, Luis Fernando Dos Reis, Emily Farmer, Samuel Villa, Robert Allison, Zachary Chessor, Megan Borden, Austin Burnett, Larry W. Grant Jr., Tristan Marowski, Emma Moore, Pearl Siff

Incite: The Journal of Undergraduate Scholarship

Introduction Dr. Amorette Barber, Director, Office of Student Research

From the Editor Dr. Hannah Dudley-Shotwell

Artist’s Statement Connor Thompson

On Mentorship Dr. John Miller

The Meat of the Matter: Alien, Human, and Animal in Terry Bisson’s “They’re Made Out of Meat” by Emily Steffenhagen

“Please REBLOG!”: An Ethical Analysis of Doxxing, Internet Vigilantism and Racists Getting Fired by Emily Robertson

Journaling: Paper Has More Patience Than People by Luis Fernando Dos Reis

The Effects of Climate Change on the Archaeological World by Emily Farmer

Lowered Seat Height Does Not Impair Wingate Performance in Untrained Cyclists by Samuel Villa, Robert Allison, …

Deconstruction Of Body Representation Of The Back In Healthy Back Pain-Free Individuals And People With Chronic Low Back Pain, Simon Pratt

Theses

Changes in various body representations have been increasingly investigated and subsequently posited to be potentially important factors in the development and maintenance of chronic low back pain. Three main domains of body representation are considered here: body model, body schema (comprising superficial and postural schema), and body image. Most studies informing our contemporary understanding of these body representations have been undertaken in areas such as the hand and forearm, with a comparative dearth of studies performed on the low back. Consequently, this thesis consists of a comprehensive investigation of body representation initially in healthy back pain-free individuals and then in …

Uncovering The Link Between Diabetes And Pulmonary Hypertension, Nishant Nundlall

Theses

Background

Diabetes is a common disorder in the general population with most studies focusing on its role on the left ventricle and coronary artery disease, however it effects on pulmonary hypertension (PH) have not been fully studied. There is a pressing need to more completely explore the cardiovascular impacts of diabetes. The impact of diabetes might vary according to the various forms of PH, their predominant contribution is likely to be in PH due to left heart disease (group II, the most common form of PH).

Thus far, most studies have offered a focussed perspective with data from specialised referral …

Optimising Care For Musculoskeletal Conditions To Reduce Burden On Hospital Emergency Department And Orthopaedic Services, Piers Truter

Theses

Worldwide health care systems are under increasing pressure due to aging amongst ever growing populations with increasing co-morbidity and treatment options (WA DoH, 2019). Furthermore, how people choose to engage with health care and access and literacy for health information is also changing, as is understanding of the factors associated with good health outcomes. These changes are driving evolution in health care delivery. There is a need for high quality and sustainable models of care accompanied by judicious evaluation of impact in terms of health services deliverables and the consumer experience of care. This thesis explores the feasibility and applicability …

An Investigation Into The Nature Of The Knee Pain Experience In People With Knee Osteoarthritis, Gemma Mary Orange

Theses

Knee osteoarthritis poses a substantial and escalating socioeconomic burden globally, exacerbated by demographic trends towards an aging population, sedentary lifestyles and increasing obesity rates. Defined by knee pain and functional limitations (Wood et al., 2023; Zhang, Doherty, et al., 2010), traditional approaches have viewed knee OA related pain and disability primarily through a biomedical lens, linking symptoms directly to structural damage and advocating surgical interventions such as total knee arthroplasty to address presumed causative pathology (Bunzli et al., 2019; Darlow et al., 2018). Despite the capacity of surgery to ameliorate structural pathology, patient centred outcomes vary considerably. Up to 30% …

The Impact Of Treatment Dosage On Cognitive-Linguistic Outcomes Of Patients With Aphasia: An Investigation Of Three Service Delivery Models, Adele J. Derendinger

Graduate Student Theses, Dissertations, & Professional Papers

This study addresses the gap in literature by directly comparing the effectiveness of Intensive Comprehensive Aphasia Programs (ICAPs) and modified ICAPs (mICAPs) to usual care service delivery models for people with aphasia. Through a prospective study design, cognitive-linguistic function change scores across different service delivery models were examined. The findings reveal significant within-group improvements in cognitive-linguistic function for participants in ICAPs, with some improvement seen in mICAPs and usual care conditions. Intensive models demonstrated greater improvement compared to non-intensive usual care models, particularly evident in the Western Aphasia Battery – Revised and the Boston Naming Test – Second Edition. …

Perspectives On Using Pharmacogenomics To Guide Tobacco Cessation: Survey Results From An American Indian Community, Daniela Mariana Wall

Graduate Student Theses, Dissertations, & Professional Papers

Pharmacogenomics research has predominantly focused on populations of European ancestry, limiting the application for diverse populations such as American Indian and Alaska Native (AIAN) communities. Our community-centric study aims to understand perspectives of utilizing pharmacogenomics to guide tobacco cessation in an AIAN community using a survey with qualitative and quantitative components. We assessed participant (n=273) tobacco usage and cessation history, pharmacogenomics knowledge, and perceptions of utilizing pharmacogenomics in the context of tobacco cessation. We found that the majority of participants (92%) were aware of risks associated with tobacco usage and believe it to be a problem within their community (76%). …

Work Characteristics, Workplace Support, And Mental Ill-Health In A Canadian Cohort Of Healthcare Workers During The Covid-19 Pandemic, Nicola Cherry, Anil Adisesh, Igor Burstyn, Quentin Durand-Moreau, Jean-Michel Galarneau, France Labrèche, Shannon Ruzycki, Tanis Zadunayski

Études primaires

Objective The aim of the study was to identify determinants of mental health in healthcare workers (HCW) during the COVID-19 pandemic. Methods A cohort of Canadian HCW completed four questionnaires giving details of work with patients, ratings of workplace supports, a mental health questionnaire, and substance use. Principal components were extracted from 23 rating scales. Risk factors were examined by Poisson regression. Results A total of 4854 (97.8%) of 4964 participants completed ratings and mental health questionnaires. Healthcare workers working with patients with COVID-19 had high anxiety and depression scores. One of three extracted components, 'poor support,' was related to …

The Influence Of Relational Frames On Climate Purchasing And Policy, Lauren Rose Hutchison

Graduate Theses/Dissertations

Evaluative conditioning refers to the effect that occurs when two stimuli are paired together, resulting in a change in the evaluation or function of one of the stimuli. Evaluative conditioning has been researched in various fields of study, such as advertisement and public administration, but synthetization efforts of these results with a relational frame theory approach, and vice versa, have been limited. This thesis used de-identified data from prior approved research to integrate and discusses two manuscripts that provide a relational frame theory perspective to evaluative conditioning effects. Study 1 extends a previous experiment by Matthews et al. (2022) through …

Effect Of P2y2 Receptors On Leukocyte Behavior Under Acute Inflammation In Transgenic Male Mice In Vivo, Corynn D. Knight

Graduate Theses/Dissertations

P2Y₂ receptors, G-protein coupled receptors and transmembrane proteins, are present on most cells in the body and hold a wide variety of roles. Previous research indicates that under resting conditions, P2Y₂ receptors suppress the movement of leukocytes but it is unknown how inflammation will alter this in the body. The objective of this project was to determine the effect of P2Y₂ receptors on leukocyte behavior in vivo under acute inflammation using Intravenous Microscopy (IVM) in post-capillary venules of the cremaster skeletal muscle. Lipopolysaccharide was injected into the scrotum of transgenic male mice to cause localized acute inflammation. …

Management Protocol For Uncomplicated Peritonsillar Abscess: Standardizing Care And Improving Emergency Medicine Resident Confidence., John Casey, Scott Keidel, Marissa Kudo, Miriam Chan

Medical Education Articles

INTRODUCTION: A peritonsillar abscess (PTA) is a frequent reason for a visit to the emergency department. As there are no current published guidelines for medical versus surgical management, attending physicians vary among management tendencies, generating uncertainty among resident physicians. This project established a standard of care for managing patients with PTA and provided clear management guidelines to the emergency department, in collaboration with the otolaryngology department, at a community academic hospital.

METHODS: Pre- and post-interventional, anonymous surveys were given to assess resident physician confidence in the management of PTA. A proposed management protocol was developed based on existing literature and …

Family Medicine Resident Scholarly Activity Infrastructure, Output, And Dissemination: A Cera Survey., Bryce A Ringwald, Michelle Taylor, Dean A Seehusen, Jennifer L Middleton

Medical Education Articles

PURPOSE: Meeting scholarly activity requirements continues to be a challenge in many family medicine (FM) residency programs. Studies comprehensively describing FM resident scholarship have been limited. We sought to identify institutional factors associated with increased scholarly output and meeting requirements of the Accreditation Council for Graduate Medical Education (ACGME).

OBJECTIVES: Our goals were to: (1) describe scholarly activity experiences among FM residents compared with ACGME requirements; (2) classify experiences by Boyer's domains of scholarship; and (3) associate experiences with residency program characteristics and scholarly activity infrastructure.

METHODS: This was a cross-sectional survey. The survey questions were part of an omnibus …

Impact Of Repeated Reimbursement Penalties On Hospital Total Quality Scores, Alice Brewer, M. Courtney Hughes, Kunal N. Patel

Faculty Articles, Papers, and Other Scholarship

Objectives

The incidence of hospital-acquired conditions (HACs) is a serious public health issue with implications ranging from patient morbidity and mortality to negative financial impacts on patients and health care systems. Despite substantial efforts to address and reduce HACs, research into the effect of quality improvement programs is inconclusive. This study seeks to better understand the relationship between repeated reimbursement penalties and improvement in HAC quality scores.

Methods

A quantitative comparative analysis of U.S. health care data was conducted. Data on quality outcomes and hospital characteristics were sourced from the Hospital-Acquired Condition Reduction Program from fiscal years 2018 and 2019 …

Always Politically Correct: Supporting Seriously Ill Older Populations And Their Families, M. Courtney Hughes, Erin Vernon

Faculty Articles, Papers, and Other Scholarship

We have been researching outcomes related to seriously ill individuals for over a decade, critically examining countless research articles from around the world, and extensively interviewing various stakeholders in this space, including hospital leaders, hospice leaders, lobbyists, nurses, social workers, and informal caregivers. We have also experienced firsthand the heartwrenching difficulty of caring for seriously ill loved ones. While we have learned a tremendous amount along the way, two specific observations consistently stand out. First, regardless of culture, income level, or politics, most people can personally identify with caring for seriously ill individuals. Second, the research evidence indicates that not …

Financial Strain, Health Behaviors, And Psychological Well-Being Of Family Caregivers Of Older Adults During The Covid-19 Pandemic, Yujun Liu, M. Courtney Hughes, Heng Wang

Faculty Articles, Papers, and Other Scholarship

Objectives

Methods

Results

Hospice Capacity To Provide General Inpatient Care: Emergency Department Utilization And Live Discharge Among Cancer Patients, Kyusuk Chung, M. Courtney Hughes, Sara Rahmanian Koushkaki, Mia Richelle Risberg, Michelle Alcantara, Jennifer M. Amico

Faculty Articles, Papers, and Other Scholarship

General inpatient (GIP) hospice care is used only minimally for hospice patients, and more than a quarter of Medicare hospice facilities do not provide GIP care. To determine the impact of hospices’ capacity to provide on emergency department use during hospice enrollment and live discharge from hospice, we used Surveillance, Epidemiology, and End Results-Medicare linked data and CMS Provider of Services data from 2007 to 2013 from ten states and two metropolitan regions. Grouping hospices into three GIP care provision categories: 1) no-GIP; 2) GIP-contract; and 3) GIP-IHF where hospices directly provide GIP care in their own inpatient hospice facility …

Students Engaging In Public Health Research: An Opportunity To Enhance Education, M. Courtney Hughes, Sadia Afrin

Faculty Articles, Papers, and Other Scholarship

Society is on the heels of one of the largest public health crisis the world has experienced in over a century, the COVID-19 pandemic. Developing the next generation of adept public health researchers is paramount to protecting the world against future health threats and addressing legacy public health challenges. This article explores the transformative influence of research experience on education, presenting three major points: (1) students engaging in public health research is timely, (2) students can develop a variety of critical thinking skills and data-driven decision-making capabilities that prepare them for future careers, and (3) faculty and universities benefit from …

The Role Of Altered Cell-Cell Communication Between Glia And Neurons In Alzheimer’S Disease, Tabea Marga Soelter

All ETDs from UAB

Alzheimer’s disease is the most prevalent neurodegenerative disease and is characterized by progressive memory loss and cognitive decline, affecting behavior, speech, and motor abilities. The neuropathology includes the formation of extracellular amyloid-β plaques and intracellular neurofibrillary tangles of phosphorylated tau. Additionally, neurons become functionally impaired before degenerating and dying. While neuronal loss is a disease hallmark, glia maintain neuronal health and homeostasis through cell-cell communication with neurons. Cellular crosstalk is mediated through the release of chemical intermediates (i.e., ligands), which are taken up by cell surface membrane receptors. Previous studies have shown dysregulation of global cell-cell communication patterns and communication …

Modeling The Effect Of Observational Social Learning On Parental Decision-Making For Childhood Vaccination And Diseases Spread Over Household Networks, Tamer Oraby, Andras Balogh

School of Mathematical & Statistical Sciences Faculty Publications

In this paper, we introduce a novel model for parental decision-making about vaccinations against a childhood disease that spreads through a contact network. This model considers a bilayer network comprising two overlapping networks, which are either Erdős–Rényi (random) networks or Barabási–Albert networks. The model also employs a Bayesian aggregation rule for observational social learning on a social network. This new model encompasses other decision models, such as voting and DeGroot models, as special cases. Using our model, we demonstrate how certain levels of social learning about vaccination preferences can converge opinions, influencing vaccine uptake and ultimately disease spread. In addition, …

The Modification Of Single Domain Antibody Framework And Variable Regions To Impart Novel Pharmacodynamic And Pharmacokinetic Properties, Lucinda Ann Hall

All ETDs from UAB

In recent years, nanobodies have become important theranostic molecules, and research has focused on improving their pharmacokinetics and binding for novel targets. Nanobodies are characterized by their high kidney uptake, leading to potentially unsafe exposure of the kidneys when delivering cytotoxic payloads. Researchers hypothesize that positively charged amino acids contribute to this kidney uptake. To address this, we assessed the impact of substituting lysine residues within the 2Rs15d HER2 nanobody scaffold to alanine on its in vivo pharmacokinetics using positron emission tomography (PET) imaging. We found that nanobodies bearing lysine-to-alanine substitutions maintained their affinity for HER2. Characterization of the K88A …

The Clinical Inquiry Process Diagram (V. 5), Roy E. Brown

VCU Libraries Faculty and Staff Publications

This updated edition of The Clinical Inquiry Process Diagram improves on the 2023 version. It provides a depiction of the steps involved in the clinical inquiry process, covering research, performance improvement, and evidence-based practice. The revisions in this version emphasize the importance of alerting users to the iterative nature of clinical inquiry and the ongoing need to assess the situation or patient based on evolving evidence. It's crucial to recognize that the clinical inquiry process does not follow a linear, sequential progression. Instead, individuals may find themselves concurrently addressing different aspects of the process or revisiting prior steps as they …

The Clinical Inquiry Process Diagram Question Development Checklist, Roy E. Brown

VCU Libraries Faculty and Staff Publications

This updated handout, previously published in 2023, serves as a reference for those who are either in an EBP course or are practicing healthcare providers involved in questioning practices to improve patient care. The handout guides the user from identifying and developing a question to determining whether the clinical question, based on evidence, will be an evidence-based practice project/initiative, a performance improvement project, or a research project. It aligns with the fifth version of the Clinical Inquiry Process Diagram and now includes several different formats that can be used when trying to create a focused clinical question.

• Update of The …

Evidence-Based Decision Making At The Bedside Process, Roy E. Brown

VCU Libraries Faculty and Staff Publications

Evidence-based practice (EBP) is crucial in healthcare for improving care and organizational outcomes. However, there is a lack of consensus among various health professions regarding the definition and implementation of evidence-based practice in the clinical environment. This lack of consensus centers on whether EBP is project-based or if it occurs primarily at the bedside. This diagram illustrates how evidence is utilized to inform bedside decision-making. It demonstrates that the process is iterative and the intervention or decision made is contingent upon the evidence, one’s clinical experience, and the patient/situation.

The purpose of the diagram is to help those involved in …

The Effect Of Calcium Channel Blockers On Digital Ulcers In Systemic Sclerosis: Data From A Prospective Cohort Study, Laura Ross, Dylan Hansen, Nancy Maltez, Kathleen Morrisroe, Kimti Kumar, Jennifer Walker, Wendy Stevens, Joanne Sahhar, Gene-Siew Ngian, Lauren Host, Mandana Nikpour, Susanna Proudman

Faculty, Staff and Student Publications

Digital ulcers (DU) are a common, severe vascular manifestation of systemic sclerosis (SSc) with few effective treatment options. Using data from the Australian Scleroderma Cohort Study (ASCS), we sought to evaluate the effect of calcium channel blockers (CCB) on the treatment and prevention of DU.Using data from 1953 participants, with a median of 4.34 years of follow-up, we used generalised estimating equations to evaluate the clinical characteristics associated with CCB use and ascertain the risk factors for the presence of DU at subsequent study visits. A time-dependent Cox-proportional hazard model was applied to evaluate the risk of future occurrence of …

The Sewage Microbiome Dynamics Of Different Serving Neighborhoods In Charleston, Illinois, Sandra Chiamaka Okoye

Masters Theses

The complex microbial ecosystem within sewage systems holds significant implications for environmental and public health. Unlike studies on wastewater treatment plant microbiomes, upstream sewage systems have not been studied widely. This research investigated the dynamic sewage microbiome across diverse serving neighborhoods in Charleston, Illinois, encompassing residential, hospital, industrial, and university areas. Drawing upon recent advancements in microbiome research, the study aimed to unravel the spatial and temporal variations in microbial structures. Three times between June to December 2023 sewage samples were collected from manholes in the areas mentioned above. Community DNA was extracted and sequenced for the V4-V5 region of …

Automated Hiv Case Identification From The Mimic-Iv Database, Kai Jiang, Tru Cao

Faculty, Staff and Student Publications

Automatic HIV phenotyping is needed for HIV research based on electronic health records (EHRs). MIMIC-IV, an extension of MIMIC-III, contains more than 520,000 hospital admissions and has become a valuable EHR database for secondary medical research. However, there was no prior phenotyping algorithm to extract HIV cases from MIMIC-IV, which requires a comprehensive knowledge of the database. Moreover, previous HIV phenotyping algorithms did not consider the new HIV-1/HIV-2 antibody differentiation immunoassay tests that MIMIC-IV contains. Our work provided insight into the structure and data elements in MIMIC-IV and proposed a new HIV phenotyping algorithm to fill in these gaps. The …

Baseline Characteristics Of Sars-Cov-2 Vaccine Non-Responders In A Large Population-Based Sample, Ashraf Yaseen, Stacia M Desantis, Rachit Sabharwal, Yashar Talebi, Michael D Swartz, Shiming Zhang, Luis Leon Novelo, Cesar L Pinzon-Gomez, Sarah E Messiah, Melissa Valerio-Shewmaker, Harold W Kohl, Jessica Ross, David Lakey, Jennifer A Shuford, Stephen J Pont, Eric Boerwinkle

Faculty, Staff and Student Publications

INTRODUCTION: Studies indicate that individuals with chronic conditions and specific baseline characteristics may not mount a robust humoral antibody response to SARS-CoV-2 vaccines. In this paper, we used data from the Texas Coronavirus Antibody REsponse Survey (Texas CARES), a longitudinal state-wide seroprevalence program that has enrolled more than 90,000 participants, to evaluate the role of chronic diseases as the potential risk factors of non-response to SARS-CoV-2 vaccines in a large epidemiologic cohort.

METHODS: A participant needed to complete an online survey and a blood draw to test for SARS-CoV-2 circulating plasma antibodies at four-time points spaced at least three months …

Exploring The Relationship Between Vaccine Hesitancy And Mothers’ Perspectives On Covid-19 Vaccines For Children Ages 5–11 Years During The Omicron Predominant Period 2021–2022: A Qualitative Study, Tiffany A Suragh, David Adzrago, Marlyn A Allicock, Paul G Yeh, Paula Cuccaro

Faculty, Staff and Student Publications

Background: The United States Food and Drug Administration authorized COVID-19 vaccines for children ages 5-11 years in October 2021 during the Omicron predominant period. Parental vaccine hesitancy was prevalent during this time, resulting in low childhood COVID-19 vaccine uptake. Most studies exploring factors influencing parental vaccine hesitancy have focused on racial and ethnic minorities and lower socioeconomic populations; however, there is little knowledge of the drive drivers of vaccine hesitancy among White parents with higher education and socioeconomic statuses.

Methods: We conducted semi-structured interviews with a sample of 15 White mothers of children ages 5-11 years in Atlanta, GA, between …

Work As A Social Determinant Of Maternal Health: A Qualitative Exploration Of College-Educated Black Women’S Experiences At Work During Pregnancy And Postpartum, Serwaa S Omowale, Laurenia C Mangum, Andrea Joseph-Mccatty, Cherell Cottrell-Daniels, Kaiya A Farris, Rashon King, Brittany C Slatton

Faculty, Staff and Student Publications

BACKGROUND: Black women are disproportionately impacted by higher rates of maternal mortality in the United States (US). Limited research has focused on adverse maternal health outcomes among college-educated Black women, although research has found these outcomes persistent among this population.

OBJECTIVES: This study aimed to fill a critical gap in current research by elucidating the nuanced experiences of college-educated Black women in the workplace during pregnancy and postpartum. By exploring this under-researched area, our study contributes to the academic discourse on Black maternal health disparities within the scope of occupational health. It offers practical insights for enhancing workplace gender equity, …

Identification Of Novel 3d-Genome Altering And Complex Structural Variants Underlying Retinitis Pigmentosa Type 17 Through A Multistep And High-Throughput Approach, Suzanne E De Bruijn, Daan M Panneman, Nicole Weisschuh, Elizabeth L Cadena, Erica G M Boonen, Lara K Holtes, Galuh D N Astuti, Frans P M Cremers, Nico Leijsten, Jordi Corominas, Christian Gilissen, Anna Skowronska, Jessica Woodley, Andrew D Beggs, Vasileios Toulis, Di Chen, Michael E Cheetham, Alison J Hardcastle, Terri L Mclaren, Tina M Lamey, Jennifer A Thompson, Fred K Chen, John N De Roach, Isabella R Urwin, Lori S Sullivan, Susanne Roosing

Faculty, Staff and Student Publications

INTRODUCTION: Autosomal dominant retinitis pigmentosa type 17 (adRP, type RP17) is caused by complex structural variants (SVs) affecting a locus on chromosome 17 (chr17q22). The SVs disrupt the 3D regulatory landscape by altering the topologically associating domain (TAD) structure of the locus, creating novel TAD structures (neo-TADs) and ectopic enhancer-gene contacts. Currently, screening for RP17-associated SVs is not included in routine diagnostics given the complexity of the variants and a lack of cost-effective detection methods. The aim of this study was to accurately detect novel RP17-SVs by establishing a systematic and efficient workflow.

METHODS: Genetically unexplained probands diagnosed with adRP …