Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Medication-Assisted Therapy And First Episode Psychosis: Evaluating Treatment And Readmission Rates: A Scoping Review, Whitney Nichole Trotter Ms, Bsn, Rdn/Ldn, Rn, Margaret Carrie Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background:

There is limited research aimed at addressing the reoccurrence of admission rates for first-episode psychosis. Research shows that early interventions for first-episode psychosis lead to remissions and prevention of relapses. Research also estimates that approximately one-half of first-episode clients have a history of cannabis abuse or dependence and one-third have a current cannabis use disorder (Wisdom et al., 2011). This study looks to determine whether Medication-assisted therapy (MAT) impacts readmission rates for patients who have substance use disorder and first-episode psychosis within six months of discharge.

Methods:

A comprehensive literature search was conducted using several electronic databases, including PubMed, …

The Noloco Strategy For Essential Hypertension, F. Matthew Mihelic Md

Faculty Publications

Ninety-nine percent of all “essential” hypertension can be controlled by using the NoLoCo strategy, without causing any significant side-effects and without an increase in insulin resistance. NoLoCo stands for Norvasc (amlodipine), Lozol (indapamide), and Cozaar (losartan), but the medicines are considered and used in reverse order.

The Effects Of Synovial Fluid And Inflammatory Cells On Orthopaedic Implant Alloys, Lisa Phan

Theses and Dissertations (ETD)

Introduction. Total knee arthroplasty (TKA) is a common surgical procedure used to treat end-stage osteoarthritis. The implants used in TKA typically consist of a Cobalt Chromium Molybdenum (CoCrMo) femoral component and a Titanium Aluminum Vanadium (TiAlV) alloy baseplate. These metal alloys are chosen for their mechanical properties, corrosion resistance, high affinity for bone, and biocompatibility. However, they can be susceptible to mechanical and electrochemical wear, leading to the release of metal ions. Osteoarthritis and inflammation can alter the composition of Synovial Fluid (SF), potentially causing implant corrosion and the release of metal ions into the surrounding tissue. These metal ions …

Tcf4 Is A Key Mediator Of Cell Identity And Oncogenesis In Neuroblastoma, Nour Aljouda

Theses and Dissertations (ETD)

Neuroblastomas (NB) are embryonal childhood tumors that derive from the multipotent neural crest cells (NCCs) of the peripheral nervous system. NB accounts for more than 15% of all childhood cancer-related deaths. Despite the most intensive multimodal therapy, more than 50% of patients with high-risk NB relapse with often fatal, resistant disease. Novel therapies are desperately needed to improve cure rates. Previous studies proposed that the deregulation of normal neural crest developmental programs contributes to NB oncogenesis by retaining the highly migratory and proliferative traits of NCCs. Thus, activation or repression of neural crest developmental pathways have been implicated in NB …

Patient Compliance With Colorectal Cancer Screening: A Scoping Review, Peyton Jackson Bsn, Rn, Brandon Crocker Bsn, Rn, Ne-Bc, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

Colorectal cancer (CRC) is a leading cause of cancer deaths for women and men. Routine screening based on current national guidelines can decrease morbidity and mortality. Unfortunately, patient compliance with CRC screening remains low. This scoping review will evaluate the literature and examine the association between colorectal cancer screening modality and patient compliance.

Methods

Individual searches within PubMed, EBSCO, and Medline were completed using MeSh with the following key words: colorectal cancer screening, patient compliance, stool-based screening, direct visualization, and others. A literature review was completed for 10 critically appraised articles published between 2010 and 2020. The association of …

Pkpd-Model Based Preclinical Characterization Of The Activity Of Spectinamide 1599 Against Mycobacterial Subpopulations. And The Identification Of Potential Partners For Combination Therapy, Zaid Hanif Temrikar

Theses and Dissertations (ETD)

Tuberculosis is one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent prior to COVID19. Mycobacterium tuberculosis (Mtb) is the causative agent of TB. The interaction between Mtb and the immune system leads to development of diverse environmental niches and physiology within the lung of the TB patients. Mtb is thought to adapt and thrive in such an environment by transforming to different phenotypic variants. Such variants are difficult to kill and are thought to prolong TB pharmacotherapy. Spectinamide 1599 is a synthetic modification of spectinomycin that has demonstrated excellent …

Extubation And Weaning: Implementing A Standard Weaning Protocol, Anna T. Wilhaucks, Caleb J. Fresh, Mohamed N. Khalil, Victoria K. Johnson, Tracy H. Mcclinton Dnp, Ag-Acnp-Bc

Doctor of Nursing Practice Projects

Purpose The purpose of this project is to determine if implementation of a standardized weaning protocol on mechanically ventilated patients affects reintubation rates and decreases adverse outcomes.

Esmolol Compared To Fentanyl For Hemodynamic Attenuation During Intubation: A Scoping Review, Carlie King, Robert Kirby, Mitchell Groome, Cassidy Gubin, Tracy Mcclinton Dnp, Aprn, Agacnp, Ebp-C, Dwayne Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Endotracheal intubation and laryngoscopy potentiate the cardiovascular response in the form of hypertension, tachycardia, and ventricular arrhythmias. Suppression of this adrenergic response is necessary to ensure patient safety. Currently, anesthesia providers employ many methods to attenuate the sympathetic response without established guidelines. As such, our project aimed to determine the effectiveness of fentanyl compared to esmolol in attenuating the hemodynamic response during laryngoscopy and endotracheal intubation within the first five minutes and throughout the intraoperative period.

Methods

A literature review was completed of ten critically appraised articles from the years 2011-2022. Articles in the review included randomized control studies, …

Impact Of Opioid-Free Anesthesia On Postoperative Nausea & Vomiting: A Scoping Review, Madison Scholl, Miranda Morrison, Abbey Ramsey, Alexandria Sawicki, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Purpose The purpose of this DNP Scoping Review is to compare the current literature regarding the incidence of postoperative nausea and vomiting (PONV) in adult patients who underwent general anesthesia when opioids are used intraoperatively versus a multimodal non-opioid-based intraoperative general anesthetic plan Specific Aims: Incidence of postoperative nausea & vomiting Postoperative rescue antiemetic administration Length of stay in postoperative anesthesia care unit (PACU) Incidence of intraoperative adverse events

Decreasing Postop Delirium With Dexmedetomidine Vs Propofol, Isabel Bannister, Rn, Bsn, Srna, Abigail Kurtz, Rn, Bsn, Srna, Abigail Banko, Rn, Bsn, Srna, Reid Blaylock, Rn, Bsn, Srna, Tracy Mcclinton, Dnp, Aprn, Agacnp-Bc, Epb-C, Caitlan Bradford, Rn, Bsn, Srna

Doctor of Nursing Practice Projects

Postoperative delirium (POD) is a common complication that contributes to increased length of hospital stay, impaired recovery, and can affect long-term outcomes. Recently, research has been conducted to determine if certain anesthetic agents decrease the likelihood of developing POD. However, no clear protocol for prevention exists. This scoping review aimed to analyze the current literature to determine the efficacy of dexmedetomidine versus propofol at preventing POD.

Bi-Weekly Follow-Up Of Adult Patients Diagnosed With Schizophrenia To Increase Treatment Adherence: A Scoping Review, Garrett L. Seaton, Bsn, Rn, Michelle A. Conteh, Bsn, Rn, Shelia L. Jackson, Msn, Bsn, Rn, Sharon H. Little, Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a complex psychiatric disorder that can significantly affect a patient’s psychological state. Because of this, medication nonadherence is reported as one of the most common causes of relapse and rehospitalization in patients diagnosed with schizophrenia. Although long-acting injectable (LAI) antipsychotics can help provide more continuous treatment, they do not address other factors that affect treatment adherence. This scoping review will evaluate existing literature to assess if a multimodal approach, such as increased patient follow-ups in addition to scheduled, current-practice LAI treatment and management, may increase treatment adherence in adult patients diagnosed with schizophrenia.

Methods

A database search …

Icu Delirium: Detection With And Without Cam-Icu Screening, Kiara Nicole Felix, Anita Larkin, Kathryn Lynn, Latoya Reed, Tracy Mcclinton Dnp, Ag-Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Delirium is a form of brain malfunction marked by abnormalities in cognition, disorientation, memory, and awareness. This scoping review's aim is to examine bodies of research on the effects of length of stay (LOS) in the ICU using Confusion Assessment Method-Intensive Care Unit (CAM-ICU).

Methods

Adults age 18 and older admitted to the ICU, of any race or ethnicity, and any gender were all included in the study articles. Nine articles satisfied the search criteria after publications underwent rapid critical appraisal. Results were evaluated for ICU LOS, hospital LOS, mortality, restraint use, medication use, delirium screening tool use, and …

Suicide Screening Among Adolescents With A History Of Mental Or Physical Abuse- Evaluating The Effectiveness Of Suicide Screening: A Scoping Review, Tiffany Nicole Jackson Bsn, Rn, Cody Tyler Cottrell Bsn, Rn, Allison Tucker Mcculley Bsn, Rn, Cen, Sharon Little Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose The purpose of this scoping review is to gather evidence on best practice for the administration of pediatric suicide screening in a variety of healthcare settings.

Long-Acting Injectable Antipsychotics Vs. Oral Antipsychotics In Treatment Adherence: Efficacy And Equity Of Care, Jason P. Peter Msn, Aprn, Fnp-Bc, Ashley F. Walker Bsn, Rn, Sharon Little Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Summary

Background: Compliance with oral antipsychotic medications (OAP) in the treatment of patients with schizophrenia has been a challenge. Challenges to OAP include medication side effects, lack of ability to obtain medications, and missing doses, among other factors. As a result of this non-compliance, those taking oral antipsychotic medication are at greater risk for exacerbation of their illness. The consequence of relapse carries considerable risks with each psychotic event. The study aims to compare if medication treatment adherence is greater in clients with schizophrenia using oral antipsychotics (OAPs) vs. long-acting injectable (LAI) antipsychotic medications.

Methods: In this scoping review, 15 …

How Does School-Based Depression Education Effect Depression Scores: A Scoping Review, Hannah Kliewer Bsn, Rn, Grayson Sheley Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose:

The purpose of this scoping review is to provide a detailed look into depression education courses among adolescents, ages 10-19 years old, and determine if the adolescents’ knowledge, attitudes, and beliefs regarding depression are impacted.

Specific Aims: •Determine the impact of a school-based depression education program •Evaluate programs for early knowledge and prevention of depression •Compare the current school curriculum with the addition of depression education

Effectiveness Of Perioperative Ketorolac Versus Opioids: A Scoping Review, Jamie Smith Bsn, Srna, Ashley Warner Bsn, Srna, Oran Tubre Bsn, Srna, Sherman Stauffer Bsn, Srna, Dwayne Accardo Dnp, Crna

Doctor of Nursing Practice Projects

Abstract

Purpose

The purpose of this project will compare the effectiveness of ketorolac over opioids alone for pain management of patients 72 hours postoperatively.

Background

In recent years, there has been overwhelming evidence of opioid abuse and its adverse effects on patients’ lives. To combat this, significant attention has been paid to multimodal analgesia throughout the perioperative period to decrease patients’ exposure to opioids. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ketorolac, are being administered intraoperatively to reduce the need for opioids in patients' post-surgical procedures.

Methods

A literature review was done on articles that evaluated perioperative adult human patients undergoing …

Impact Of Mobile Text Reminders On Medication Compliance, Paul Weatherly, Haley Russell, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose/Background

Patient noncompliance with medication leads to longer and more frequent infections and health issues. Using mobile reminders, patients can be prompted to take their medication, schedule their followup appointments, or fill their prescription to encourage compliance and better overall health.

Methods

A search of PubMed, LibKey, and EBSCO was conducted. Articles reviewed included meta-analysis, randomized controlled trials, and systematic reviews in the use of mobile reminders on patient compliance, specifically in medication adherence. Then, we reviewed the article methods and outcomes across various health issues addressed. The articles were then reviewed for criteria such as population size, length of …

Teach-Back Method To Reduce Chf Readmissions: A Scoping Review, Briyanna Evans Bsn, Rn, Bre'yocha Dewalt Bsn, Rn, Ccrn, Jessica Mabry Bsn, Rn, Kailee Garrett Bsn, Rn, Crystal Stephens Bsn, Rn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

The purpose of this scoping review is to evaluate the effectiveness of the teach-back method on education as it relates to congestive heart failure readmission rates. Congestive heart failure (CHF) is the most common cause of hospitalizations among those 65 years and older in the United States. CHF readmission rates in Tennessee are higher than the already elevated national average. The current literature suggests a need to reduce 30-day readmissions, improve patient outcomes, and enhance self-efficacy in patients with CHF. The research proposes a correlation between high readmission rates and poor knowledge retention of patients with CHF, but small …

The Effectiveness Of Increasing Frequency Of Central-Line Dressing Changes And Monitoring On Clabsi Rates: A Scoping Review, Jacob Schmidt, Bsn, Rn, Ccrn, Georgia Brown, Bsn, Rn, Laura Dickey, Agpcnp-C, Lauren Faulkner, Bsn, Rn, Margaret Harvey, Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Abstract

Purpose/Background

Central lines provide many benefits to critically ill patients; however, there are additional risks with them, including central line-associated bloodstream infections (CLABSIs). CLABSIs place patients at increased risk for morbidity and mortality, longer length of stay, and higher medical costs. Studies evaluating various methods of reducing CLABSIs have been performed. This scoping review was completed to determine the effectiveness of frequent central-line dressing changes and increased monitoring on the incidence of central-line associated blood stream infections in adults with central-lines.

Methods

An extensive database search through the University of Tennessee Health Science Center (UTHSC) Online Library was performed …

Efficacy Of Distraction Therapy In Reducing Needlestick Pain In Pediatrics: A Scoping Review, Ashlan Ritchie Bsn, Rn, Anne Evans Bsn, Rn, Charlotte Isabel Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac, Chppn, Bmtcn

Doctor of Nursing Practice Projects

Purpose/Background

Pediatric pain management is often overlooked due to time constraints and lack of resources or education on interventions used, such as distraction or pharmacological therapy. Lack of pain management leads to patient and caregiver distress, as well as an increased number of attempts to perform the procedure. This scoping review evaluates the efficacy of distraction therapy compared to nonopioid pharmacological interventions for acute needlestick pain in children ages 6 to 12 years; patient and caregiver levels of distress were also evaluated in most studies.

Methods

The UTHSC (University of Tennessee Health Science Center) Library database was searched for full-text …

The Effects Of Exosomal Derived Tsg-6 On Microglia Activation, Jonathan A. Martinez, Rajashekhar Gangaraju Md

Longitudinal Scholar's Project

Following a traumatic brain injury, microglia become overactive for long periods and display pathologic behavior. We have shown that concentrated conditioned media from adipose tissue-derived mesenchymal stem cells (MSC-CCM) can suppress microglial activation. In this pilot study, we evaluated the efficacy of exosomes containing TNF-stimulated gene 6 (TSG6) derived from MSC-CCM on decreasing microglial activation in vitro via phagocytic activity and pro-inflammatory microglial gene expression.

Hepatitis C Virus Screening Strategies To Improve Early Identification And Treatment: ​ A Scoping Review​, Megan Elizabeth Lyons, Rn, Bsn, Ccrn, Thomas Tyler Bennett, Rn, Bsn, Ccrn, Felicia Ann Gray-Hamilton, Rn, Bsn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

Hepatitis C virus (HCV) is the most common bloodborne infection in the United States (Ludden et al., 2022). Sadly, over half of the individuals living with chronic HCV are unaware of their condition (Halket et al., 2022). Due to rising numbers, HCV screening guidelines have been updated to recommend that every adult be screened at least once (Patel et al, 2021). Despite these guidelines, screening rates remain low. This scoping review aims to examine current research on HCV screening and strategies to improve early diagnosis and treatment.

Methods

This review began with a literature search using CINAHL and PubMed …

Impacts Of Habitat, Resource Addition, And Predator Exclusion On Rodent Community Structure And Hantaviruses In The Neotropics, Briana Spruill-Harrell

Theses and Dissertations (ETD)

Understanding how climate and human land use change impacts trophic interactions is essential in the face of ongoing biodiversity loss and the continued emergence of RNA viruses and zoonosis. Human land use changes such as agricultural expansion, deforestation, and habitat degradation all have been linked to zoonotic disease emergence. Despite these commonalities, our mechanistic understanding of what drives them is lacking. Moreover, genomic surveillance in wildlife populations is critical for risk assessment and mitigation. Herein, using data collected from field studies within the Reserva Natural del Bosque Mbaracayú (RNBM), a protected area of the Interior Atlantic Forest (IAF), I examined …

Multimorbidity In Diverse Populations: Stratified Analysis Of Race/Ethnicity, Age, Obesity, And Healthcare Costs, Manal Alshakhs

Theses and Dissertations (ETD)

This research aims to fill an essential gap in understanding how Body Mass Index (BMI) cutoffs relate to multimorbidity across races in the United States (US). Given the significant and growing rates of obesity and multimorbidity, as well as the known differences in healthy fat distribution among different races, this is an important area of research. BMI is a widely used but imperfect measure of obesity, as it does not account for differences in body composition. However, it is still used as a diagnostic tool. It is vital to ensure that the cutoffs used to define obesity are appropriate for …

A Design, Development, And Evaluation Of Bio-Patch For Myocardial Tissue Repair, Yaya Zhang

Theses and Dissertations (ETD)

Introduction. Ischemic heart disease (IHD) is a major concern of human health issue. The structural repair and functional recovery of injured hearts is a major challenge in the clinical setting. Preclinical studies over last 10 years have demonstrated the potential of using stem cells to treat IHD, but the efficacy of this therapy is jeopardized by uncontrollable migration and low survival of the injected stem cells. An approach based on tissue engineering enabling target-specific stem cell delivery such as cardiac patches has emerged as an alternative solution for stem cell therapy for IHD. It employs scaffold materials to engulf various …

Impact Of Opioid-Free Anesthesia Versus Opioid-Based Anesthesia On Time To Extubation: A Scoping Review, Mary K. Connor Rn, Bsn, Srna, Dexter Browning Rn, Bsn, Srna, Ariel Clark Rn, Bsn, Srna, Erica B. Gates Rn, Bsn, Srna, Madison T. Mccaskill Rn, Bsn, Srna, Dwayne L. Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Opioids during surgery have been clinically proven to lengthen the time between intubation and post-op extubation. Increased time to extubation is associated with negative patient outcomes. This scoping review aims to evaluate the use of ketamine with opioid free analgesia (OFA) versus traditional opioid usage and its outcomes on extubation times.

Methods

From September 2021 to November 2021, we conducted a literature search using the University of Tennessee Health Science Center’s (UTHSC) online library. Through the PubMed, CINAHL, Medline, and Cochrane databases, we identified seventy-one articles that matched our criteria. Of those articles, we selected twenty-five to undergo rapid …

Evaluating The Efficacy Of Medication-Assisted Treatment For First Episode Psychosis: A Scoping Review, Chanel Thomas Msn, Aprn, Fnp-Bc, Rn-Bc, Alexandra Wittenberg Bsn, Rn-Bc, Anttrenika Anderson Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends that individuals with substance use disorder (SUD) receive medicated-assisted treatment (MAT), as a complete approach to substance use treatment (SAMHSA, 2019). However, treatment measures using combination treatment for SUD in individuals experiencing first episode psychosis (FEP) are seldom used. This scoping review assesses the efficacy of MAT in conjunction with antipsychotics compared to the use of antipsychotic monotherapy for FEP individuals on hospital readmission rates.

Methods

The authors conducted a literature review utilizing PubMed, EBSCO, Elsevier, Google Scholar, PsychINFO, and Medline from August 2020 to November 2022. Key phrases …

Investigation Of Clinically Relevant Fluconazole Resistance Mechanisms In The Fungal Pathogen Candida Parapsilosis, Laura Anne Doorley

Theses and Dissertations (ETD)

Invasive candidiasis is a severe fungal infection associated with significant morbidity and mortality, particularly among the critically ill and immunocompromised. Candida parapsilosis is the most common non-albicans species causing invasive Candida infections in pediatric and neonatal populations worldwide and is particularly common in the countries of South America, Western Asia, Mediterranean Europe, and Southern Africa. For many of these countries, fluconazole and other triazoles are the first line antifungal agents used for effective treatment of invasive Candida infection. Until recently, rates of fluconazole resistance among C. parapsilosis isolates were relatively low, therefore the determination of clinically relevant resistance mechanisms in …

Molecular And Cellular Investigations Of Prader-Willi Syndrome, Anna K. Victor

Theses and Dissertations (ETD)

Prader-Willi syndrome (PWS) is a complex multigenic neurodevelopmental disorder resulting in hypotonia, developmental delay, hypogonadism, sleep dysfunction and childhood onset obesity affecting 1 in 10,000 to 30,000 individuals. PWS is an imprinting disorder that is caused by a loss of expression of maternally imprinted genes in the 15q11.2-q13 region including NDN, MAGEL2, SNRPN/SNURF, and a cluster of snoRNAs. The majority of cases are caused by inheriting a paternal allele deletion of this region (65-75%) and a smaller number are caused by chromosome 15 maternal uniparental disomy (UPD) (20-30%) or imprinting center defects (1-3%). Here, we used dental pulp stem cells …

Screening For Social Determinants Of Health In Children With Attention-Deficit/Hyperactivity Disorder, Sarah L. Carter Msn, Aprn, Cpnp-Pc, Ronald Espinal Md, Toni Whitaker Md, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

Increased social determinants of health (SDoH) are associated with poorer health outcomes and decreased treatment compliance. Addressing SDoH can be associated with increased treatment compliance, although currently there is no standard for completing SDoH screening. The WE CARE screening tool is a validated screen that asks about 6 SDoH and whether the family is interested in assistance if the screen is positive. The purpose of this project was to implement the use of the WE CARE screening tool for patients with attention deficit hyperactivity disorder (ADHD) at follow-up visits.

Methods

From October 17, 2022 through November 22, 2022, charts …