Medicine and Health Sciences Commons^™

Neural Network Based Ensemble Model To Predict Radiation Induced Lymphopenia After Concurrent Chemo-Radiotherapy For Non-Small Cell Lung Cancer From Two Institutions, Yejin Kim, Ibrahim Chamseddine, Yeona Cho, Jin Sung Kim, Radhe Mohan, Nadya Shusharina, Harald Paganetti, Steven Lin, Hong In Yoon, Seungryong Cho, Clemens Grassberger

Faculty, Staff and Student Publications

The use of adjuvant Immune Checkpoint Inhibitors (ICI) after concurrent chemo-radiation therapy (CCRT) has become the standard of care for locally advanced non-small cell lung cancer (LA-NSCLC). However, prolonged radiotherapy regimens are known to cause radiation-induced lymphopenia (RIL), a long-neglected toxicity that has been shown to correlate with response to ICIs and survival of patients treated with adjuvant ICI after CCRT. In this study, we aim to develop a novel neural network (NN) approach that integrates patient characteristics, treatment related variables, and differential dose volume histograms (dDVH) of lung and heart to predict the incidence of RIL at the end …

Temporal Changes In Energy-Balance Behaviors And Home Factors In Adolescents With Normal Weight And Those With Overweight Or Obesity, Senlin Chen, Chelsea L. Kracht, Robbie A. Beyl, Amanda E. Staiano

International Journal of Physical Activity and Health

This study aimed to examine the temporal changes in energy-balance behaviors and home factors in adolescents with normal weight and those with overweight or obesity (OWOB). Adolescents or parent proxies completed survey assessments two to four years before (T0; n = 82), ≤ six months before (T1; n = 68), and ≤ three months after the COVID-19 pandemic outbreak (T2; n = 82), to capture energy-balance behaviors (i.e., physical activity [PA], screen time, sleep) and home factors (i.e., food environment, food worry, parent support for PA). At T0 and T1 (before pandemic), participants visited our laboratory for anthropometric measurements. At …

Potential Public Health Impacts Of Louisiana House Bill 182, Corisandra Leyton-High

Journal of the Louisiana Public Health Association

No abstract provided.

Utilizing Prams And Healthy People 2020 To Examine Black Women’S Breastfeeding Behaviors In Louisiana Prior To The Onset Of The Covid-19 Pandemic, Almetra Granger, Tyra Gross, Amy Thierry

Journal of the Louisiana Public Health Association

Background: Compared to other racial/ethnic groups, Black women have the lowest rates of breastfeeding in the United States and do not reach the Healthy People 2020 goal of 81.9% of infants being breastfed. Black women in Louisiana exhibit lower breastfeeding rates than the national average. Factors contributing to this disparity are under-explored. Methods: Using Louisiana Pregnancy Risks Assessment Monitoring Systems (LaPRAMS) Phase 8 2016-2018 data, a mixed-methods analysis captured both quantitative and qualitative data reflecting Black participants’ breastfeeding experiences. Results: Quantitative results indicated that 58.2% of the sample breastfed, with women who did not breastfeed identifying several breastfeeding barriers. Qualitative …

Vol 3 May '23 Cover, Publishing And Table Of Contents, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Louisiana's 2023 Legislative Session: Bills Impacting Lgbtq+ And Public Health, Adrienne Katner, Harold Paul Katner

Journal of the Louisiana Public Health Association

No abstract provided.

Vol 3 May '23 Full Issue, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Hybrid Group Mentorship For Youth Impacted By Familial Substance Use Disorder, Stephen Phillippi, Helen Lindau, Casey L. Thomas, Kaylin Beiter, Ashley Fenton, Michelle Lawrence Bidwell, Claudia Leonardi, Edmond Bowers

Journal of the Louisiana Public Health Association

Background: Children under the care of individuals with substance use disorders (SUDs) are themselves at risk for developing SUDs and delinquent behavior. Mentorship can be protective for these youth. This preliminary program evaluation study, following a descriptive cross-sectional design, describes Camp Mariposa, a novel peer and group mentoring program for youth affected by familial substance use. Methods: Data were collected from participants across 13 mentoring sites nationwide, with one site in Louisiana. These data include demographics and self-reported information about substance use, juvenile judicial system involvement, and experiences in the mentoring program. Results: Data on 570 youth participants (52% male …

Manual Vacuum Aspiration: Attitudes, Familiarity, And Comfort Among Obgyn Physicians At Louisiana State University New Orleans And Baton Rouge Programs, Alexis Hernandez, Stacey Scheib

Journal of the Louisiana Public Health Association

Background: Manual vacuum aspiration (MVA) uses a hand-held aspirator to generate a vacuum to aspirate uterine contents for management of early pregnancy loss (EPL) or elective abortion prior to 12-weeks gestation. According to the American College of Obstetricians and Gynecologists, MVA is a safe, cost-saving procedure that promotes patient comfort, convenience, and privacy. Despite the advantages of this procedure, it is often overlooked in favor of electric suction or dilation and curettage, more extensive procedures that are associated with increased cost and post-procedural pain and bleeding. The goal of this study is to assess the attitudes, familiarity, and comfort towards …

The Impact Of Public Health Units On Mpox, Covid-19 And Flu Vaccinations In Louisiana, David Holcombe, Arundhati Bakshi, Joshua Mjolsness

Journal of the Louisiana Public Health Association

No abstract provided.

Louisiana Department Of Health Community Engagement For The State Health Assessment And State Health Improvement Plan, Alexander Hayley, Tewabetch Negatu

Journal of the Louisiana Public Health Association

No abstract provided.

Prescription Opioid Exposure During Pregnancy And Associations With Key Birth Outcomes: A Multistate Analysis Of The Pregnancy Risk Assessment Monitoring System (Prams), Andrei Stefanescu, Jennifer Le, Rosaria Trichilo-Lucas

Journal of the Louisiana Public Health Association

No abstract provided.

Kids And Canines: Pawsitively Impacting Occupational Therapy Outcomes, Jessica M. Simon

Occupational Therapy Capstone Presentations

Within the scope of pediatric occupational therapy, Animal-Assisted Therapy (AAT) is a new and emerging area of practice that has shown to have a positive impact in its use with pediatric clients specifically. AAT is formally defined as, “a form of therapy that includes the presence of and/or interaction with an animal to facilitate progress toward some therapeutic goal” (Hardy & Weston, 2020, p. 197). Through the completion of this Capstone, the student aimed to develop in-depth clinical practice skills related to using AAT within pediatric occupational therapy, develop professional leadership skills, and contribute meaningful research regarding the benefits of …

Sensory Integration: Improving Participation, Behavior, And Learning In Individuals With Sensory Processing Disorder, Brooklyn K. Osborne

Occupational Therapy Capstone Presentations

This capstone project encompassed a two-fold focus on advanced clinical practice in the area of sensory integration and research on the effect of sensory integration on the family dynamic. Ayres Sensory Integration was implemented in clinical practice in order to enhance learning, behavior, and participation in individuals with sensory processing disorder and sensory concerns. The research study examined the lived experiences of parents/caregivers of children with sensory processing difficulties to understand how sensory integration has impacted their family dynamic. Qualitative phenomenological methodology was used for data collection and analysis. Sixteen parents were interviewed, and four major themes emerged including family …

The Relevance Of Sensory-Based Intervention In Improving Occupational Performance In Pediatrics, Jasmine M. Fritzemeier

Occupational Therapy Capstone Presentations

The present capstone experience highlights sensory processing differences in relation to occupational performance. Current literature suggests varying evidence on sensory processing differences and effective interventions. This capstone utilizes GAS to measure progress toward functional goals with sensory-based intervention. Results indicate improvements for all five clients in at least one area after 5 to 8 sessions of sensory-based intervention. Improvements noted on GAS demonstrate the effectiveness of sensory-based intervention to address functional differences. The scope of practice for occupational therapy practitioners, therefore, includes sensory-based intervention to improve functional performance and well-being across several settings.

Treating Cognition Through Occupational Performance In Individuals With Neurological Disorders In Home Health, Alcina J. Park

Occupational Therapy Capstone Presentations

Neurological Disorders (ND) like Alzheimer’s Disease, is one of the leading chronic diseases in older adults (National Council on Aging, 2023). One of the most common symptoms of ND is cognitive dysfunction, which prevent individuals with NDs from pursuing their daily occupations (Liu et al., 2019). This makes the exploration of treatment that delays functional decline in NDs imperative. Occupational therapy is valued and recognized in literature, but limited research is specific to cognition in occupational performance in home health. This capstone project used cognitive therapy approaches Cognitive Stimulation Therapy, Cognitive Rehabilitation Therapy, and Cognitive Training, to combat cognitive decline …

The Role Of Occupational Therapy In Meeting Mental Health Needs Of College Students In The South Dakota Regental University System, Molly J. Graesser

Occupational Therapy Capstone Presentations

College students with mental health concerns and disabilities are at risk for poorer academic outcomes. Utilization of student support services (TRIO, disability services, and student counseling services) can mitigate these issues. However, utilization patterns and the service delivery process are not well understood in the South Dakota Board of Regents (SDBOR) system. This study aimed to investigate 1. The extent to which students utilize mental health and disability services in the South Dakota Board of Regent (SDBOR) University system. 2. How service providers deliver those services to students. Utilizing a cross sectional survey and grounded theory design, researchers found that …

Physical And Psychological Impacts Of Burn Injuries On The Pediatric Population And Their Families: An Occupational Therapy Perspective, Sadie E. Anderson

Occupational Therapy Capstone Presentations

Background: Due to the curious nature of the pediatric population, burns are a common and leading cause of non-fatal and fatal injuries among children. Following these injuries, the impacts extend beyond the physical impairments that occur and often result in long-term psychological impacts for the child and their families. With a holistic approach to care, occupational therapy is fully equipped to aid in the mitigating of these impacts. Method: Through advanced clinical practice and the development of various questionnaires, occupational therapy interventions were explored and integrated to facilitate functional outcomes and improve mental health care. Results: With the provision of …

Speech Intelligibility Assessment: Predicting “Noncompliant” Listener Behavior, Briggs Kroff

Undergraduate Honors Capstone Projects

Purpose: When researching speech intelligibility among people with dysarthria, convenience sampling has typically been used to recruit listeners. A new online crowdsourcing method, Mechanical Turk (MTurk), results in ecologically valid results, but outlier results are often removed from the analysis and considered "noncompliant". This study aims to examine whether there is a relationship between age, gender, speech/language/hearing impairment, and whether someone is "noncompliant".

Methods: 16 speakers, both with and without dysarthria, were recorded while they read prewritten sentences. Research participants found through MTurk then listened to the sentences and transcribed them. They also were asked questions including their …

Trends In The Incidence Of Head And Neck Cancer: A Nationwide Population-Based Study, Tzong-Hann Yang, Sudha Xirasagar Mbbs., Ph.D., Yen-Fu Cheng, Chin-Shyan Chen, Wei-Pin Chang, Herng-Ching Lin

Publications

OBJECTIVE: This study aimed to demonstrate the temporal trend in incidence of head and neck cancer (HNC) in Taiwan. MATERIALS AND METHODS: Patients with a HNC were retrieved from the Taiwan's Health Insurance Database. We identified 16,894 patients aged ≥20 years who had received a first-time diagnosis of cancer of the oral cavity, oropharynx, larynx, hypopharynx, nasopharynx, sinonasal, salivary gland or thyroid gland between 2010 and 2018. We calculated the annual incidence rate per 100,000 population, overall, and classified by gender and cancer type. We also used the annual percent change (APC) to characterize trends in head and neck cancer …

Incidence And Risk Factors For Clinically Confirmed Secondary Bacterial Infections In Patients Hospitalized For Coronavirus Disease 2019 (Covid-19), Hiromichi S. Park, Caitlin M. Mccracken, Noah Lininger, Cara D. Varley, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: The true incidence and risk factors for secondary bacterial infections in coronavirus disease 2019 (COVID-19) remains poorly understood. Knowledge of risk factors for secondary infections in hospitalized patients with COVID-19 is necessary to optimally guide selective use of empiric antimicrobial therapy. Design: Single-center retrospective cohort study of symptomatic inpatients admitted for COVID-19 from April 15, 2020, through June 30, 2021. Setting: Academic quaternary-care referral center in Portland, Oregon. Patients: The study included patients who were 18 years or older with a positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) PCR test up to 10 days prior to admission. Methods: …

Expanding On The Solutions To Reduce Neonatal Intensive Care Unit Morbidity And Mortality For Extremely Premature Infants—Looking Out The Hospital Window And Into The Neighborhoods, Christina Jäderholm, Lynne C. Messer

OHSU-PSU School of Public Health Faculty Publications and Presentations

The study from Sullivan et al1 is a valuable contribution to the literature that aims to improve health equity among very preterm infants (and their families). It is to be lauded for its attention to nonclinical factors such as area-level deprivation and racial disparities. By examining communitylevel factors such as area deprivation, this study engages both the medical and public health communities and places infant outcomes directly within the context of housing policy and lack of neighborhood investment. However, it is important that we articulate the connections between area deprivation and adverse outcomes for very preterm infants to even conceive …

Maternal Adverse Childhood Experiences, Child Mental Health, And The Mediating Effect Of Maternal Depression: A Cross-Sectional, Population-Based Study In Rural, Southwestern Uganda, Christine E. Cooper-Vince, Bernard Kakuhikire, Charles Baguma, Justin D. Rasmussen, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives

This study aimed to examine the intergenerational effects of maternal adverse childhood experiences (ACEs) and child mental health outcomes in rural Uganda, as well as the potentially mediating role of maternal depression in this pathway. Additionally, we sought to test the extent to which maternal social group membership attenuated the mediating effect of maternal depression on child mental health.

Methods

Data come from a population-based cohort of families living in the Nyakabare Parish, a rural district in southwestern Uganda. Between 2016 and 2018, mothers completed surveys about childhood adversity, depressive symptoms, social group membership, and their children's mental health. …

Enhancing Communication Pathways Between Care Environments To Improve Patient Outcomes, Heather Tucker

Doctor of Nursing Practice Projects

Conducting hand-off communication among healthcare providers can impact patient outcomes. Lack of communication between healthcare entities at the time of care transition can produce patient harm and lead to adverse events such as medication errors, hospital readmission, and unnecessary emergency department visits. The project goal was to evaluate the impact of communication between acute care and primary practice nurses using a standardized, electronic communication tool within the EHR upon patient discharge from a community-hospital based setting. During implementation, forty-two patients were included in the project based on primary practice follow-up location. Of the 42 eligible patients, the acute care nurses …

Recognizing Barriers In The Elderly Population And Increasing Access To Case Management Services, Loveleena Alex

Doctor of Nursing Practice Projects

Abstract

Implementing case management can lead to fewer hospitalizations in the elderly population. Barriers influencing the number of hospitalizations include low socioeconomic status, transportation needs, health literacy, financial strain, multiple comorbidities, underserved populations, medication availability, availability of community resources, and access to primary care. A review of the available literature revealed that by addressing these barriers in a primary care setting and implementing case management, the number of hospitalizations can be decreased and the quality of life in the elderly population can be improved. This quality improvement project implemented a screening and referral process for chronic care management in the …

Emergency Department Nurse Preceptor Development, Allison Helmerichs

Doctor of Nursing Practice Projects

Abstract

The Emergency Department (ED) new graduate nurse (NGN) requires an orientation to prepare them to work with patients with complex medical issues in a challenging, fast-paced environment. Clinically competent and effective preceptors are essential to prepare an NGN to work in an emergency environment while adopting multiple active learning strategies. Preceptor education and training are necessary to improve the confidence and competence of the ED nurse preceptor. Currently, the project site lacked preceptor training specifically for the ED nurse preceptor.

This project aimed to develop a preceptor workshop to meet the training needs of the ED nurse preceptor. Qualitative …

Just Culture In Undergraduate Nursing Academia, Marcie Leonard

Doctor of Nursing Practice Projects

Understanding the importance of reporting errors, near misses, and good catches by nursing students is not a standard part of the curriculum at the project site. Nursing students lack pre-requisite knowledge of how just culture does not aim to place blame on individuals but focuses on system flaws. Nursing students fear being dismissed from the nursing program if they make and/or report errors. A focus on eliminating the fear of dismissal from a nursing program for error reporting and formally educating how error reporting can help shape practice for many other nursing students and nurses will result in better data …

New Graduate Nurse Professional Development Planning, Cassandra Adkins

Doctor of Nursing Practice Projects

A 150-bed urban hospital in Chicago lacked a formal process to assist new graduate nurses (NGRN) in developing incremental goals as a part of their longitudinal plan during their first year of professional nursing practice. This left NGRNs feeling unsupported in their journey from novice to expert. With many NGRNs choosing to leave the nursing profession within the first year of practice, organizations must invest in programs to support their transition from academia to practice. This project implemented First Year Coaches and regularly scheduled touchpoints with NGRNs to increase intent to stay at the organization, feelings of support, and future …

Adjuncts And Additives To Regional Anesthesia, Kaisi Dye, Kelcie Brunnert

Doctor of Nursing Practice Projects

With regional anesthesia becoming increasingly popular, an emphasis has been placed on choosing appropriate adjunct medications to local anesthetics for prolonging peripheral nerve blocks- lengthening postoperative pain control and decreasing perioperative narcotic usage. This project aimed to increase provider knowledge of the proven efficacy of block and adjunct selection for breast, shoulder, and knee surgeries with intended results being prolonged block duration and increased patient satisfaction post-operatively. A focused lecture along with a Likert-scale questionnaire and quiz were administered to a small sample of anesthesia providers at a rural Illinois hospital. Half (55.6%) of the providers showed evidence of knowledge …

Postdural Puncture Headaches And The Development Of A Treatment Protocol, Matthew Gill

Doctor of Nursing Practice Projects

Roughly 1% of patients receiving an epidural for analgesia will experience an accidental dural puncture (ADP). Of that 1%, half will go on to develop a postdural puncture headache (PDPH) (Apfel, 2010). PDPH presents 24-48 hours after neuraxial anesthesia as a dull, bilateral, throbbing, postural headache that is often accompanied by nausea (Patel et al., 2020). Although PDPH is a fairly common complication associated with neuraxial anesthesia, many facilities offering obstetric services lack a written protocol addressing ADP and PDPH treatment. The purpose of this project was to design and introduce a PDPH evidence-based treatment protocol for a hospital in …