Medicine and Health Sciences Commons^™

Central Modulation Of Postural Control In Response To Task Demands And Fatigue In Individuals With And Without A History Of Low Back Pain, Jolene Kay Soliman, Jo Armour Smith

Student Scholar Symposium Abstracts and Posters

Background During voluntary limb movement, feedforward postural activation of the trunk and hip musculature occurs to maintain postural stability. This is called an anticipatory postural adjustment (APA). Onset of trunk muscle APAs is delayed in symptomatic individuals with persistent low back pain (LBP). It is not clear how spatial APA organization is affected, or if adaptations in APAs persist between symptomatic episodes. We used two versions of a supine active leg raise task to examine central modulation of APAs. One version of the task, the supported leg raise (SLR) does not elicit trunk/hip APAs. The other, the unsupported leg raise …

Mindfulness Meditation As A Complementary Therapy For Chronic Migraines, Isaac Min, Manjari Murali

Student Scholar Symposium Abstracts and Posters

Migraine headaches, the most common neurological disease across all age groups, affect over one billion individuals worldwide, with symptoms ranging from moderate to severe. Migraines differ in intensity and are accompanied by secondary symptoms, such as neck pain, nausea, and vomiting. Current efforts in treating migraines focus on preventative drug therapy to reduce the frequency of migraine attacks. Although mindfulness-based approaches such as MBSR may serve as an alternative method of reducing the severity of migraine attacks, studies investigating the efficacy of MBSR are limited.

A meta-analysis provides insights into the pathogenesis of migraines through the identification of three genes …

Sexual Dimorphism In Bidirectional Sr-Mitochondria Crosstalk In Ventricular Cardiomyocytes, Richard T Clements, Radmila Terentyeva, Shanna Hamilton, Paul M L Janssen, Karim Roder, Benjamin Y Martin, Fruzsina Perger, Timothy G Schneider, Zuzana Nichtova, Anindhya S Das, Roland Veress, Beth S Lee, Do-Gyoon Kim, Gideon Koren, Matthew S Stratton, György Csordás, Federica Accornero, Andriy E Belevych, Sandor Gyorke, Dmitry Terentyev

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Calcium transfer into the mitochondrial matrix during sarcoplasmic reticulum (SR) Ca²⁺ release is essential to boost energy production in ventricular cardiomyocytes (VCMs) and match increased metabolic demand. Mitochondria from female hearts exhibit lower mito-[Ca²⁺] and produce less reactive oxygen species (ROS) compared to males, without change in respiration capacity. We hypothesized that in female VCMs, more efficient electron transport chain (ETC) organization into supercomplexes offsets the deficit in mito-Ca²⁺ accumulation, thereby reducing ROS production and stress-induced intracellular Ca²⁺ mishandling. Experiments using mitochondria-targeted biosensors confirmed lower mito-ROS and mito-[Ca²⁺] in female rat VCMs challenged …

The Effect Of Implementing Behavioral Counseling For Elevated Ldl Levels, Blake L. Hansen

Evidence-Based Practice Project Reports

Hyperlipidemia is a key risk factor in cardiovascular mortality, and is prevalent in approximately 38% of American adults (CDC, 2022b). Cholesterol levels are intensified by unhealthy lifestyle choices, which means a change in lifestyle behaviors could prevent cardiovascular related deaths (WHO, 2022). The PICOT question for this project was: In adults aged 20 years or older in the primary care setting who have elevated low-density lipoprotein (LDL) levels (P), does the implementation of behavioral counseling on lifestyle modifications (I) compared to current practice (C) decrease LDL levels (O) over a 10- to 12- week period (T)? Fourteen participants from a …

Association Of Prenatal Depression With New Cardiovascular Disease Within 24 Months Postpartum., Christina M Ackerman-Banks, Heather S Lipkind, Kristin Palmsten, Mariah Pfeiffer Rn, Mph, Catherine Gelsinger Rn, Katherine Ahrens Mph, Phd

Population Health

No abstract provided.

Occupational Therapy In Family Education: Fourth Trimester Wellness To Kindergarten Readiness, Gabrielle Madeline Hagen

Occupational Therapy Capstone Presentations

Early intervention programs provide unique opportunities for children to develop cognitive, socioemotional, behavioral, and executive functioning skills which are necessary for success in the school environment. The purpose of this 14-week capstone experience was to integrate trauma-informed occupational therapy principles into an early childhood family education course and to advocate for the role of occupational therapy in postpartum and postnatal wellness. Methods included facilitating play-based interactions between caregivers and children, preparing and presenting educational materials, completing an annotated bibliography, and developing a freely accessible webpage with information about fourth trimester support. The outcomes of this project demonstrate that implementation of …

Promoting Successful Discharges From Skilled Nursing Rehabilitation Units Among Older Adults, Melissa A. Tweet

Occupational Therapy Capstone Presentations

Older adults may face occupational limitations that serve as a barrier to maintaining independence in their homes for various reasons, including the onset of illness, injury, or age-related generalized weakness. When individuals are admitted to the hospital and require ongoing rehabilitation to improve their functional abilities, they require effective and client-centered discharge planning to promote a successful transition from the rehabilitation unit. There is a continued need to explore how occupational therapists can provide quality discharge planning throughout the patient’s therapeutic process and methods to facilitate the carryover of skilled interventions after discharge. This capstone project aimed to obtain in-depth …

Occupation-Based Sexual Health Education For Adolescents With Disabilities, Elizabeth J. Klocke

Occupational Therapy Capstone Presentations

Individuals with intellectual and developmental disabilities experience barriers to learning about sexual health education even though there is documented interest in this subject. Additionally, caregivers of children with disabilities lack experience and knowledge of their children’s sexual developmental needs. My capstone project aimed to provide comprehensive sexual education to adolescents with disabilities and education on childhood sexual development to healthcare professionals, educators, and parents. The literature and needs assessment indicated a need for sexual health education for both students with intellectual and developmental disabilities and caregivers. Due to viewing clients in a holistic manner, occupational therapy is uniquely qualified to …

Implementation Of A Comprehensive Diabetic Foot Care Program In Primary Care, Peguy Sylvain

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Diabetes Mellitus is a growing health problem in America. Uncontrolled diabetes can result in vascularcomplications. One of the most common complications of diabetes is diabetic peripheral neuropathy. Early foot carescreening can help prevent Diabetic peripheral neuropathy and other complications such as skin injuries, burns, falls,infection, lower- extremity amputations, and peripheral arterial disease. Interventions that have been shown to improve theidentification of diabetes foot complications include staff education, screening and assessment, use of monofilament,tuning fork for diabetic foot assessment, patient education/ self-care, standardization, and use of electronic medical records(EMR)/electronic reminders.

METHODS: The Plan Do Study Act method of quality improvement …

Introduction Of Hiv Point-Of-Care Testing In Adolescent Primary Care: A Quality Improvement Project, Jennifer Quinn Belfry

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: HIV, first identified in 1981, remains a persistent public health problem affecting 1.1 million Americans today. Detection is a critical first step to ending the HIV epidemic and the CDC recommends universal HIV screening for all patients 13-64 years of age regardless of risk factors. HIV screening rates are suboptimal especially in adolescent and young adult populations who face unique barriers to screening. The aim of this project was to improve HIV screening rates in adolescent and young adult patients at a large, urban FQHC.

LOCAL PROBLEM: In the state of Rhode Island, 1 in 10 persons living with …

Tele-Sim For Nurse Practitioner Clinical Education: An Online, Real-Time, Educational Innovation Using Simulation And Telehealth For Learning Physical Assessment Skills, Kat Tremblay

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Background: Increasing numbers of nurse practitioner (NP) educational programs are being offered online, with little or no face-to-face contact among students and instructors. Students express lack of confidence in their physical examination skills and want live instructor demonstrations, observed practice, and real-time feedback from their clinical instructors.

Significance: NP students need to acquire physical examination skills to increase competency in assessing patients for enhanced clinical judgment and improved patient outcomes.

Purpose/Aims: to improve and measure the competency and confidence in the performance of advanced physical assessment skills of NP students in an advanced health assessment (AHA) clinical course with an …

3-Year Outcomes After Transcatheter Or Surgical Aortic Valve Replacement In Low-Risk Patients With Aortic Stenosis., John K Forrest, G Michael Deeb, Steven J Yakubov, Hemal Gada, Mubashir A Mumtaz, Basel Ramlawi, Tanvir Bajwa, Paul S Teirstein, Michael Defrain, Murali Muppala, Bruce J Rutkin, Atul Chawla, Bart Jenson, Stanley J Chetcuti, Robert C Stoler, Marie-France Poulin, Kamal Khabbaz, Melissa Levack, Kashish Goel, Didier Tchétché, Ka Yan Lam, Pim A L Tonino, Saki Ito, Jae K Oh, Jian Huang, Jeffrey J Popma, Neal Kleiman, Michael J Reardon

Heart and Vascular Articles

BACKGROUND: Randomized data comparing outcomes of transcatheter aortic valve replacement (TAVR) with surgery in low-surgical risk patients at time points beyond 2 years is limited. This presents an unknown for physicians striving to educate patients as part of a shared decision-making process.

OBJECTIVES: The authors evaluated 3-year clinical and echocardiographic outcomes from the Evolut Low Risk trial.

METHODS: Low-risk patients were randomized to TAVR with a self-expanding, supra-annular valve or surgery. The primary endpoint of all-cause mortality or disabling stroke and several secondary endpoints were assessed at 3 years.

RESULTS: There were 1,414 attempted implantations (730 TAVR; 684 surgery). Patients …

Examining The Accuracy Of Two Commercially Available Global Positioning System Enabled Watches In Two Trail Conditions, Allison Tripure

Undergraduate Theses

The purpose of this investigation was to determine the accuracy of the GNSS (global navigation satellite system) in the Coros® Vertix 2 and Garmin® Fēnix 6 during two trail running conditions in a group of recreational trail runners. Six participants completed four self-paced, one-mile trail runs. Accuracy of the two watches in measuring distance were compared across two trail conditions, heavy and light tree coverage. Both watches were worn simultaneously and then switched to the opposite wrists for the next trial. Distance measured by the watches was reported every quarter mile. Mean and standard deviation of the distance measured by …

Relaxation As An Intervention For Military Service Members Experiencing Ans Dysregulation Following Mtbi, Tori Julianne Vanvelzen

Occupational Therapy Capstone Presentations

Current evidence indicates that a mild traumatic brain injury (MTBI) can negatively impact autonomic nervous system (ANS) regulation, leading to decreased occupational performance (Belchamber, 2022; Frueh et al., 2020). This project aimed to support military service members in ANS regulation following an mTBI to enhance the quality of life (QoL) and occupational performance. The Person Environment Occupation (PEO) Model, Psychological Model of Stress, and Cognitive Behavioral Theory (CBT) provided a theoretical foundation for the capstone project. Clinical practice, the development of a standardized pilot manual with a relaxation-based curriculum, and education for the interdisciplinary healthcare team were implemented to achieve …

05-09-2023 Hsc Committee Agenda, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Meditation-Type Exercise For The Management Of Chemotherapy Related Cognitive Impairment In Breast Cancer Patients, Christine Cain

Evidence-Based Practice Project Reports

Chemotherapy-related cognitive impairment (CRCI), or “chemobrain”, is one of the most troublesome side effects of chemotherapy (Dijkshoorn et al., 2020). Ongoing CRCI may negatively affect relationships, confidence, sleep, fatigue, anxiety, and the ability to return to work activities leading to a decreased quality of life (Johns et al., 2016; Gokal et al., 2018). The purpose of this evidence-based practice (EBP) project was to assess the efficiency of a meditation-type exercise intervention, chair yoga, on decreasing perceived cognitive impairment (PCI) in breast cancer patients. The PICOT question for this project was: In breast cancer patients with chemotherapy related cognitive impairment (P), …

Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska

Evidence-Based Practice Project Reports

The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …

Prognostic Value Of Echocardiographic Parameters In Congenital Diaphragmatic Hernia: A Systematic Review And Meta-Analysis, Mohan Pammi, Yashaswini Kelagere, Sara Koh, Amy Sisson, Joseph Hagan, Joshua Kailin, Caraciolo J Fernandes

Library Staff Publications

BACKGROUND: Prognostication of mortality and decision to offer extracorporeal membrane oxygenation (ECMO) treatment in infants with congenital diaphragmatic hernia (CDH) can inform clinical management.

OBJECTIVE: To summarise the prognostic value of echocardiography in infants with CDH.

METHODS: Electronic databases Ovid MEDLINE, Embase, Scopus, CINAHL, the Cochrane Library and conference proceedings up to July 2022 were searched. Studies evaluating the prognostic performance of echocardiographic parameters in newborn infants were included. Risk of bias and applicability were assessed using the Quality Assessment of Prognostic Studies tool. We used a random-effect model for meta-analysis to compute mean differences (MDs) for continuous outcomes and …

Whole-Exome Sequencing Prioritizes Candidate Genes For Hereditary Cataract In The Emory Mouse Mutant, Thomas M Bennett, Yuefang Zhou, Kacie J Meyer, Michael G Anderson, Alan Shiels

2020-Current year OA Pubs

The Emory cataract (Em) mouse mutant has long been proposed as an animal model for age-related or senile cataract in humans-a leading cause of visual impairment. However, the genetic defect(s) underlying the autosomal dominant Em phenotype remains elusive. Here, we confirmed development of the cataract phenotype in commercially available Em/J mice [but not ancestral Carworth Farms White (CFW) mice] at 6-8 months of age and undertook whole-exome sequencing of candidate genes for Em. Analysis of coding and splice-site variants did not identify any disease-causing/associated mutations in over 450 genes known to underlie inherited and age-related forms of cataract and other …

Frequency Of Hepatic Metastatic Disease In Patients With Stage Iv Breast Cancer Is Similar For Steatotic And Non-Steatotic Livers, Adeel Haq, Tyler J Fraum, Yu Tao, Farrokh Dehdashti, Maverick Leblanc, Mark J Hoegger, Jingqin Luo, Katherine Weilbaecher, Lindsay L Peterson

2020-Current year OA Pubs

BACKGROUND: Breast cancer is the most common non-cutaneous malignancy and the second leading cause of cancer mortality in the United States. Breast cancer is a heterogeneous disease; diagnosis at an early stage renders it potentially curable, whereas advanced metastatic disease carries a worse prognosis.

OBJECTIVES: To investigate whether hepatic steatosis (HS) is associated with liver metastases in patients with newly diagnosed stage IV female breast cancer patients (either de novo metastatic breast cancer or recurrent metastatic breast cancer) using non-contrast computed tomography (CT) as a marker of HS.

DESIGN: Retrospective analysis.

METHODS: We retrospectively identified 168 patients with stage IV …

State-Level Macro-Economic Factors Moderate The Association Of Low Income With Brain Structure And Mental Health In U.S. Children, David G Weissman, Mark L Hatzenbuehler, Mina Cikara, Deanna M Barch, Katie A Mclaughlin

2020-Current year OA Pubs

Macrostructural characteristics, such as cost of living and state-level anti-poverty programs relate to the magnitude of socioeconomic disparities in brain development and mental health. In this study we leveraged data from the Adolescent Brain and Cognitive Development (ABCD) study from 10,633 9-11 year old youth (5115 female) across 17 states. Lower income was associated with smaller hippocampal volume and higher internalizing psychopathology. These associations were stronger in states with higher cost of living. However, in high cost of living states that provide more generous cash benefits for low-income families, socioeconomic disparities in hippocampal volume were reduced by 34%, such that …

Katp Channels Are Necessary For Glucose-Dependent Increases In Amyloid-Β And Alzheimer's Disease-Related Pathology, John Grizzanti, William R. Moritz, Molly Stanley, Emily E. Caesar, Maria S. Remedi, Celeste M. Karch, Colin G. Nichols, David M. Holtzman, Et Al.

2020-Current year OA Pubs

Elevated blood glucose levels, or hyperglycemia, can increase brain excitability and amyloid-β (Aβ) release, offering a mechanistic link between type 2 diabetes and Alzheimer's disease (AD). Since the cellular mechanisms governing this relationship are poorly understood, we explored whether ATP-sensitive potassium (KATP) channels, which couple changes in energy availability with cellular excitability, play a role in AD pathogenesis. First, we demonstrate that KATP channel subunits Kir6.2/KCNJ11 and SUR1/ABCC8 were expressed on excitatory and inhibitory neurons in the human brain, and cortical expression of KCNJ11 and ABCC8 changed with AD pathology in humans and mice. Next, we explored whether eliminating neuronal …

Examining The Utility Of The Canadian Occupational Performance Measure (Copm) Vs. Cognitive Mapping And Motivational Interviewing (Cm/Mi) To Provide Person-Centered Care (Pcc) For People With Parkinson’S Disease (Pwpd), Mary Lagasca, Karen Aranha

Spring 2023 Virtual OTD Capstone Symposium

Background: Parkinson’s disease (PD) limits occupational engagement and quality of life. Clinicians need tools to help understand the lived experiences of people with PD to provide more person-centered care (PCC). The Canadian Occupational Performance Model (COPM) is one tool used with this population, but its predetermined categories may be limiting. In contrast, Cognitive Mapping and Motivational Interviewing (CM/MI) is a non-standardized method that may provide more insight. Objective: To identify the benefits of the COPM to CM/MI in delivering more person-centered care (PCC). Methodology: A qualitative phenomenological self-study was used. Data collection compared the assessments and reflected on determining if …

Best Practice For Post-Operative Surgical Site Infection Prevention, Scott Cavinder

Evidence-Based Practice Project Reports

It is estimated that 300 million surgical procedures take place annually throughout the globe (Gillespie et al., 2021). However, the incidence of surgical site infections (SSI) developing in surgical patients within 30 days of surgery have been estimated to be upwards of 11% (Gillespie et al., 2021). The purpose of this evidence-based practice project was to address the PICOT question: In patients who have undergone cardiothoracic or vascular surgery (P) does implementation of an evidence based post-operative care bundle (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period …

Inpatient Epidemiology, Healthcare Utilization, And Association With Comorbidities Of Turner Syndrome: A National Inpatient Sample Study, Jirat Chenbhanich

Faculty Scholarship

We aimed to investigate the prevalence, resource utilization, and comorbidities of patients with Turner syndrome (TS) hospitalized in the United States. We identified patients within the Nationwide Inpatient Sample database from the year 2017 to 2019. A propensity-matched cohort of non-TS patients from the same database was constructed to serve as comparators. There were 9845 TS patients, corresponding to inpatient prevalence of 10.4 per 100,000 admissions. The most common admission diagnosis was sepsis (27.9%). TS patients had higher inpatient mortality (adjusted odds ratio 2.16, 95% confidence interval 1.57–2.96) and morbidity, including shock, ICU admission, acute kidney injury, systemic inflammatory response …

Spatial Transcriptomics Depict Ligand-Receptor Cross-Talk Heterogeneity At The Tumor-Stroma Interface In Long-Term Ovarian Cancer Survivors, Sammy Ferri-Borgogno, Ying Zhu, Jianting Sheng, Jared K Burks, Javier A Gomez, Kwong Kwok Wong, Stephen T C Wong, Samuel C Mok

Faculty, Staff and Student Publications

Advanced high-grade serous ovarian cancer (HGSC) is an aggressive disease that accounts for 70% of all ovarian cancer deaths. Nevertheless, 15% of patients diagnosed with advanced HGSC survive more than 10 years. The elucidation of predictive markers of these long-term survivors (LTS) could help identify therapeutic targets for the disease, and thus improve patient survival rates. To investigate the stromal heterogeneity of the tumor microenvironment (TME) in ovarian cancer, we used spatial transcriptomics to generate spatially resolved transcript profiles in treatment-naïve advanced HGSC from LTS and short-term survivors (STS) and determined the association between cancer-associated fibroblasts (CAF) heterogeneity and survival …

Dense & Attention Convolutional Neural Networks For Toe Walking Recognition, Junde Chen, Rahul Soangra, Marybeth Grant-Beuttler, Y. A. Nanehkaran, Yuxin Wen

Physical Therapy Faculty Articles and Research

Idiopathic toe walking (ITW) is a gait disorder where children’s initial contacts show limited or no heel touch during the gait cycle. Toe walking can lead to poor balance, increased risk of falling or tripping, leg pain, and stunted growth in children. Early detection and identification can facilitate targeted interventions for children diagnosed with ITW. This study proposes a new one-dimensional (1D) Dense & Attention convolutional network architecture, which is termed as the DANet, to detect idiopathic toe walking. The dense block is integrated into the network to maximize information transfer and avoid missed features. Further, the attention modules are …

Perceptions Of Nursing Staff On Restraint Alternatives, Adelia S. Perea

Doctor of Nursing Practice Scholarly Projects

Physical restraint is often used as a nursing intervention for patients with behavioral issues despite current evidence that indicates their use is actually more harmful than helpful. Nursing staff at UNMH are required by policy to use other methods such as restraint alternatives before placing patients in restraint. However, they do not have the necessary resources or tools to comply with the policy. The NPCU conducted a quality improvement project that introduced 5 restraint alternatives followed by a survey focused on nursing perceptions. The results revealed 2 alternatives (Gamewright GoPOP sensory toy & Playtivity sensory disc) were perceived by nursing …

Cancer Stem Cell Assay-Guided Chemotherapy Improves Survival Of Patients With Recurrent Glioblastoma In A Randomized Trial, Tulika Ranjan, Soma Sengupta, Michael J. Glantz, Richard M. Green, Alexander Yu, Dawit Aregawi, Rekha Chaudhary, Ricky Chen, Mario Zuccarello, Christine Lu-Emerson, Hugh D. Moulding, Neil Belman, Jon Glass, Aaron Mammoser, Mark Anderson, Jagan Valluri, Nicholas Marko, Jason Schroeder, Steven Jubelirer, Frances Chow, Pier Paolo Claudio, Anthony M. Alberico, Seth T. Lirette, Krista L. Denning, Candace M. Howard

Department of Neurosurgery Faculty Papers

Therapy-resistant cancer stem cells (CSCs) contribute to the poor clinical outcomes of patients with recurrent glioblastoma (rGBM) who fail standard of care (SOC) therapy. ChemoID is a clinically validated assay for identifying CSC-targeted cytotoxic therapies in solid tumors.

In a randomized clinical trial (NCT03632135), the ChemoID assay, a personalized approach for selecting the most effective treatment from FDA-approved chemotherapies, improves the survival of patients with rGBM (2016 WHO classification) over physician-chosen chemotherapy. In the ChemoID assay-guided group, median survival is 12.5 months (95% confidence interval [CI], 10.2-14.7) compared with 9 months (95% CI, 4.2-13.8) in the physician-choice group (p = …

Combining Frameworks To Improve Military Health System Quality And Cybersecurity, Dr. Maureen L. Schafer, Dr. Joseph H. Schafer

Military Cyber Affairs

Existing conceptual frameworks and commercially available technology could be considered to rapidly operationalize the use of Quality Measures (QM) within military health systems (Costantino et al. 2020). Purchased healthcare as well as digital healthcare services have paved the way for data collection from multiple information systems thus offering stakeholders actionable intelligence to both guide and measure healthcare outcomes. However, the collection of data secondary to Smart Devices, disparate information systems, cloud services, and the Internet of Medical Things (IOMT) is a complication for security experts that also affect clients, stakeholders, organizations, and businesses delivering patient care. We have combined three …