Medical Specialties Commons^™

Implementation Of Mental And Substance Misuse Screenings Into Routine Prep Therapy Encounters, Kieran Talkiewicz

Capstone Showcase

It has been well documented over the years that lesbian, gay, bisexual, transgender, queer/ questioning (LGBTQ+) populations are disproportionately affected by a higher burden of mental health illnesses, alcohol abuse, and illicit substance abuse when compared to heterosexual populations. This article will recommend utilizing routine Pre-Exposure Prophylaxis (PrEP) therapy encounters, a common point of contact for primary care for sexual minority populations, to perform screening for mental health and substance use. Due to men who have sex with men (MSM) being the highest utilizing population of this therapy, and disproportionately burdened by psychiatric and substance use disorders, this article will …

The Program To Reduce Implicit Bias In Carroll Hospital Center Using The Implicit Association Test, Katherine E. Traynor

Capstone Showcase

Natural brain processes make all individuals susceptible to unconscious bias; however, stressful, fearful, or anger-evoking situations as well as the negative influence of media and social surroundings increase the risk of holding obstructive bias, and there is a greater risk of being negatively impacted by this phenomenon when belonging to a minority population (Rose & Flores, 2020). As a result, high rates of infant mortality (10.2 deaths per 1,000 live births for the Non-Hispanic Black population compared to 4.1 in the White population) and cardiovascular related diseases (190.0 cases per 1,000 in the Non-Hispanic Black population compared to 161.3 in …

Quality Of Life Before And After Cosmetic Surgery: Should Body Dysmorphic Disorder Be Considered An Absolute Or Relative Contraindication For Cosmetic Surgery?, Lindsay Conlisk

Capstone Showcase

Body Dysmorphic Disorder (BDD) has historically been regarded as a strong contraindication for cosmetic plastic surgery. New research now suggests that the contraindications to cosmetic surgery in patients with BDD may not be so absolute. This paper reviews diagnostic criteria, diagnostic challenges, and current standard of treatment of BDD. It then presents the idea of insight analysis in the BDD patient as a significant factor in determining if patients with BDD may or may not benefit from cosmetic surgery or procedures.

Impact Of Psychosocial, Behavioral And Lifestyle Factors On Subjective Cognitive Complaints And Perceived Quality Of Life In A Large Cohort Of Italian Breast Cancer Patients, Thomas West, Corrado Cavallero, Rita Ceccherini, Silva Foladore, Daniele Generali, Francesco Versace, Bruna Scaggiante

Faculty, Staff and Student Publications

The impact of psychosocial and behavioral factors on Cancer Related Cognitive Impairment manifestations is still under debate. Study's purpose is to determine the prevalence rate of cancer related cognitive impairment in a cohort of Italian breast cancer patients and to evaluate the implication of specific behavioral factors. For these purposes, a total of 233 women (106 breast cancer patients and 127 age-matched controls without oncological diagnosis) completed a questionnaire investigating cognitive functionality (FACT-Cog v3.0), sociodemographic characteristics, clinical information, psychosocial and behavioral factors (cognitive reserve, sleep quality, dietary habits, physical activity). The results indicated a higher prevalence rate of subjective cognitive …

Auto- Ethnography With A Deep Dive Into Changes Mental Health During The Pandemic And A Look Into The Way The Pandemic Has Shaped Nursing Protocols For Recent Nursing College Graduates, Audrey Shaffer, Sarah Bereznay

Williams Honors College, Honors Research Projects

In this project we completed a deep dive into how the Covid-19 pandemic reshaped our mental health and has affected our preparation for careers as registered nurses through a series of auto- ethnographic narrative journals using scholarly articles to support this idea. By utilizing personal narratives, we analyzed and reflected upon the cognitive and mental changes we experienced throughout this pandemic. We fulfilled this by comprising two personal narratives with inquiries pertaining to each shared narrative by utilizing the common themes of being nursing students and living through a pandemic. Within these personal narratives, we discussed how the pandemic influenced …

Perspectives Of Child Life Specialists On Their Role Supporting Pediatric Psychiatric Boarders, Kerri Sellers

EWU Masters Thesis Collection

No abstract provided.

Kidney Disease After Heart And Lung Transplantation, Carlos M Zapata, Hassan N Ibrahim

Faculty, Staff and Student Publications

Chronic kidney disease (CKD) is not only common after lung and heart transplantation but also is associated with increased morbidity and mortality due to multiple pre-, peri- and post-transplant factors. While the exact incidence of CKD in this population is not well-defined, it seems to have gradually increased over the years as older recipients are more frequently considered. The increasing success of the procedure and expanding transplant candidate pool has allowed many with comorbid conditions to receive a transplant, which was considered prohibitive in the past. This review presents risk factors that have been linked to CKD as well as …

Multi-Center, Single-Blind Randomized Controlled Trial Comparing Functional Electrical Stimulation Therapy To Conventional Therapy In Incomplete Tetraplegia, Kim D Anderson, Radha Korupolu, Kristin E Musselman, Jacqueline Pierce, James R Wilson, Nuray Yozbatiran, Naaz Desai, Milos R Popovic, Lehana Thabane

Faculty, Staff and Student Publications

BACKGROUND: Loss of upper extremity function after tetraplegia results in significant disability. Emerging evidence from pilot studies suggests that functional electrical stimulation (FES) therapy may enhance recovery of upper extremity function after tetraplegia. The aim of this trial was to determine the effectiveness of FES therapy delivered by the Myndmove stimulator in people with tetraplegia.

METHODS: A multi-center

RESULTS: Between June 2019 to August 2021, 51 participants were randomized to FES (

CONCLUSION: Forty sessions of FES therapy delivered by the MyndMove stimulator are as effective as conventional therapy in producing meaningful functional improvements that persist after therapy is completed. …

The Effect Of Education On The Nida Modified Assist (Nmassist) Tool On Knowledge And Screening For Substance Use Disorder Among Clinicians, Victoria Page Arnold

DNP Projects

Background: Substance use disorder (SUD) is a disparity affecting nearly 24 million individuals in the U.S., nearly 10% of the total population. Oftentimes, the emergency department (ED) is the only medical care this population receives. There is often a lack of screening for SUD in ED’s, therefore referred care may be limited for these individuals. The National Institute on Drug Abuse Modified Assist (NMASSIST) is an evidence-based tool developed to educate and screen for SUD. This tool can be completed in a timely manner and aid in the recommended referral of care for this select population.

Purpose: The purpose of …

Psychosocial Factors Of Covid-19 Impact Oral Health, Neeru Ramaswami Bds, Ms, Mph

The Journal of the Michigan Dental Association

The impact of psychosocial factors on oral health during the COVID-19 pandemic necessitates an interdisciplinary approach to patient care. This article, part of National Children’s Dental Health Month, focuses on adolescent oral health and eating disorders, authored by experts from the University of Michigan. With a dramatic increase in eating disorders among Michigan adolescents during the pandemic, especially affecting transgender and diverse youth, identifying such issues is crucial. General dentists, in an ideal position for interaction, can play a vital role in addressing these challenges, emphasizing the need for continued education and collaboration.

Eating Disorders In Adolescents: Facts And Recommendations For The Oral Health Care Team, Catherine A. Miller Md, James R. Boynton Dds, Ms, Terrill Bravender Md, Mph

The Journal of the Michigan Dental Association

Eating disorders typically begin during the adolescent years. These disorders are a spectrum of thoughts and behaviors related to food, weight and exercise that lead to significant psychological and physical morbidity. Medical complications of eating disorders are common and can be life-threatening. Dental providers can play an important role in care by recognizing oral signs and symptoms associated with eating disorders, giving advice on mitigating these issues, and helping patients and families connect with appropriate care. In this article, we provide key information about eating disorders, the complications including oral health issues, and advice for dental providers regarding care and …

Education And Awareness Of Workplace Hazards: An Educational Intervention For First Responder Trainees, Emily Portune

All Master's Theses

First responder paramedics, emergency medical technicians (EMTs), and firefighters provide emergency services to communities everywhere, often in life-threatening circumstances. At the same time, these first responders face high-stress life and death situations and may also endure unique workplace hazards like racism, sexual harassment and discrimination, verbal and physical patient assault, and extreme sleep deprivation. These hazards make prehospital providers vulnerable to mental illness, a fact proven by preexisting research that found more than 85% of first responders reported negative mental health symptoms and outcomes directly related to their career. Not only are prehospital providers at high risk of mental illness; …

Perceptions Of Physical Activity Guidelines Among Wheelchair Users With Multiple Sclerosis, Stephanie L Silveira, Brenda Jeng, Gary Cutter, Robert W Motl

Faculty, Staff and Student Publications

BACKGROUND: Physical activity guidelines provide prescriptive resources for population-level promotion of behavior change to improve health outcomes. The National Multiple Sclerosis Society (NMSS) recently created and disseminated physical activity guidelines for persons with multiple sclerosis (MS) across the disease spectrum.

OBJECTIVE: This study aimed to assess perceptions of the updated NMSS Physical Activity Guidelines among wheelchair users with MS.

METHODS: One hundred thirty-four wheelchair users with MS participated in a cross-sectional study examining health behaviors. Outcomes were measured using an online questionnaire that included items related to demographic and clinical characteristics and a battery of questions regarding perceptions of the …

A Qualitative Investigation Of Organizational Challenges And Facilitators To Screening Individuals Experiencing Homelessness For Hepatitis C Virus (Hcv) In Houston, Texas, Alane Celeste-Villalvir, J Michael Wilkerson, Christine Markham, Lourdes Rodriguez, Vanessa Schick

Faculty, Staff and Student Publications

BACKGROUND: Individuals experiencing homelessness may be at a disproportionately high risk for hepatitis C (HCV) because they may be more likely to engage in HCV risk behaviors. Community organizations that provide services to these vulnerable individuals can effectively screen, diagnose, and navigate them into HCV care. However, screening people experiencing homelessness for HCV at such organizations is limited by various challenges that remain understudied, including budgetary considerations and strategies to improve teamwork and communication. Accordingly, this study investigated the organizational challenges and facilitators to HCV screening of individuals experiencing homelessness as reported by homeless services providers.

METHODS: Staff (N = …

The Neighborhood Environment And Hispanic/Latino Health, Natalia I Heredia, Tianlin Xu, Minjae Lee, Lorna H Mcneill, Belinda M Reininger

Faculty, Staff and Student Publications

PURPOSE: Hispanic/Latino adults on the Texas-Mexico border have high rates of chronic disease. Neighborhoods can influence health, though there is a limited research on neighborhood environment and health in Hispanics/Latinos. The purpose of this study was to assess the relation of neighborhood environment with health variables in Hispanic/Latino adults, including physical activity [PA], depression, anxiety, and lab-assessed conditions (type 2 diabetes, metabolic syndrome, and chronic inflammation).

METHODS: Participants were randomly-selected from a Hispanic/Latino cohort on the Texas-Mexico border. Neighborhood environment, self-reported PA, anxiety, and depression were assessed through questionnaires. Laboratory values determined Type 2 diabetes, metabolic syndrome, and C-reactive protein …

Methodology To Estimate Natural- And Vaccine-Induced Antibodies To Sars-Cov-2 In A Large Geographic Region, Stacia M Desantis, Luis G León-Novelo, Michael D Swartz, Ashraf S Yaseen, Melissa A Valerio-Shewmaker, Yashar Talebi, Frances A Brito, Jessica A Ross, Harold W Kohl, Sarah E Messiah, Steve H Kelder, Leqing Wu, Shiming Zhang, Kimberly A Aguillard, Michael O Gonzalez, Onyinye S Omega-Njemnob, David Lakey, Jennifer A Shuford, Stephen Pont, Eric Boerwinkle

Faculty, Staff and Student Publications

Accurate estimates of natural and/or vaccine-induced antibodies to SARS-CoV-2 are difficult to obtain. Although model-based estimates of seroprevalence have been proposed, they require inputting unknown parameters including viral reproduction number, longevity of immune response, and other dynamic factors. In contrast to a model-based approach, the current study presents a data-driven detailed statistical procedure for estimating total seroprevalence (defined as antibodies from natural infection or from full vaccination) in a region using prospectively collected serological data and state-level vaccination data. Specifically, we conducted a longitudinal statewide serological survey with 88,605 participants 5 years or older with 3 prospective blood draws beginning …

Associations Between Physical Activity And Alcohol Consumption In Rural Cancer Survivors, Scherezade K Mama, Natalia I Heredia, Hannah Johnston, David E Conroy

Faculty, Staff and Student Publications

PURPOSE: Rural adults and cancer survivors are more likely to be physically inactive and exceed recommendations for alcohol use. Physical activity and alcohol use are positively associated in adults and cancer survivors but associations between physical activity and alcohol use in rural cancer survivors is unknown. This cross-sectional study explored associations between physical activity, sitting time, and alcohol use in rural cancer survivors.

METHODS: Cancer survivors residing in central Pennsylvania were recruited to the Partnering to Prevent and Control Cancer (PPCC) study and completed mailed questionnaires assessing physical activity (low, moderate, high), sitting time (≥6 hours/day), and alcohol use (0 …

Blood Metabolites Predicting Mild Cognitive Impairment In The Study Of Latinos-Investigation Of Neurocognitive Aging (Hchs/So), Shan He, Einat Granot-Hershkovitz, Ying Zhang, Jan Bressler, Wassim Tarraf, Bing Yu, Tianyi Huang, Donglin Zeng, Sylvia Wassertheil-Smoller, Melissa Lamar, Martha Daviglus, Maria J Marquine, Jianwen Cai, Thomas Mosley, Robert Kaplan, Eric Boerwinkle, Myriam Fornage, Charles Decarli, Bruce Kristal, Hector M Gonzalez, Tamar Sofer

Faculty, Staff and Student Publications

INTRODUCTION: Blood metabolomics-based biomarkers may be useful to predict measures of neurocognitive aging.

METHODS: We tested the association between 707 blood metabolites measured in 1451 participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), with mild cognitive impairment (MCI) and global cognitive change assessed 7 years later. We further used Lasso penalized regression to construct a metabolomics risk score (MRS) that predicts MCI, potentially identifying a different set of metabolites than those discovered in individual-metabolite analysis.

RESULTS: We identified 20 metabolites predicting prevalent MCI and/or global cognitive change. Six of them were novel and 14 were previously reported as …

Can Implicit Measures Augment Suicide Detection In Youth? The Feasibility And Acceptability Of The Death Implicit Association Test Among Pediatric Medical Impatients, Annabelle M. Mournet, Daniel S. Powell, Elizabeth C. Lanzillo, Sandra Mcbee-Strayer, Emory Bergdoll, Catherine R. Glenn, Alexander Millner, Maryland Pao, Matthew K. Nock, Lisa M. Horowitz, Jeffrey A. Bridge

Psychology Faculty Publications

Background: Medically ill youth are at increased suicide risk, necessitating early detection. This study aimed to assess the feasibility of administering the Death Implicit Association Test (Death IAT) to pediatric medical inpatients. Methods: Participants completed measures including the Ask Suicide-Screening Questions (ASQ) and the Death IAT. Results: Over 90% of participants found the Death IAT to be acceptable and more than 75% of participants were comfortable completing the task. There was a small, but statistically significant, improvement from pre-survey to post-survey reports of mood (t(174) = 3.02, p = 0.003, d = 0.15). Participants who endorsed a past suicide attempt …

In- And Out-Group Effects On Social Perception And Empathy In Cocaine Use Disorder, Tatjana Aue, Ann-Kathrin Kexel, Bruno Kluwe-Schiavon, Stephanie Bührer, Markus R Baumgartner, Leila M Soravia, Boris B Quednow

Faculty, Staff and Student Publications

Earlier research revealed that cocaine users display impairments in emotional but not necessarily in cognitive empathy. However, no study to date has tested whether empathy is generally altered or whether impairments are restricted to specific social targets. The current investigation addresses this open question. In addition, we examined whether attributions of warmth and competence as well as personal future expectancies differed between cocaine users and substance-naïve controls. Twenty-two chronic cocaine users and 40 stimulant-naïve controls specified their perceived warmth and competence for four social targets [in-group member, opposite consumption out-group member (cocaine user for controls and non-user for cocaine user), …

Emotion Regulation, Parasympathetic Function, And Psychological Well-Being, Ryan L Brown, Michelle A Chen, Jensine Paoletti, Eva E Dicker, E Lydia Wu-Chung, Angie S Leroy, Marzieh Majd, Robert Suchting, Julian F Thayer, Christopher P Fagundes

Faculty, Staff and Student Publications

The negative emotions generated following stressful life events can increase one's risk of depressive symptoms and promote higher levels of perceived stress. The process model of emotion regulation can help distinguish between adaptive and maladaptive emotion regulation strategies to determine who may be at the greatest risk of worse psychological health across the lifespan. Heart rate variability (HRV) may affect these relationships as it indexes aspects of self-regulation, including emotion and behavioral regulation, that enable an individual to dynamically adapt to the changing demands of both internal and external environments. In this study, we expected individual differences in resting vagally …

Palliative Endoscopic Salvage Of A Functionally Obstructed Gastrojejunostomy - Report Of Technique, Elias A Chamely, Bryan Hoang, Nadim S Jafri, Melissa M Felinski, Kulvinder S Bajwa, Peter A Walker, Jaideep Barge, Erik B Wilson, Putao Cen, Shinil K Shah

Faculty, Staff and Student Publications

BACKGROUND: Gastric outlet obstruction secondary to foregut gastrointestinal malignancies can be managed with a variety of medical, endoscopic, and surgical options. Laparoscopic gastrojejunostomy is an option for those patients who are able to tolerate an operation as a long-term palliative option. This operation may be associated with some significant postoperative technical and nontechnical complications, including delayed gastric emptying. This paper describes an incision-less, endoscopic option that we propose can be used to salvage a functionally obstructed gastrojejunostomy.

CASE DESCRIPTION: A 57-year old male patient had a history of pancreatic adenocarcinoma causing gastric outlet obstruction and underwent a previously created surgical …

Dysphagia Is Associated With Worse Clinical Outcomes In Geriatric Trauma Patients, Heather R Kregel, Mina Attia, Claudia Pedroza, David E Meyer, Michael W Wandling, Shah-Jahan M Dodwad, Charles E Wade, John A Harvin, Lillian S Kao, Thaddeus J Puzio

Faculty, Staff and Student Publications

INTRODUCTION: Dysphagia is associated with increased morbidity, mortality, and resource utilization in hospitalized patients, but studies on outcomes in geriatric trauma patients with dysphagia are limited. We hypothesized that geriatric trauma patients with dysphagia would have worse clinical outcomes compared with those without dysphagia.

METHODS: Patients with and without dysphagia were compared in a single-center retrospective cohort study of trauma patients aged ≥65 years admitted in 2019. The primary outcome was mortality. Secondary outcomes included intensive care unit (ICU) length of stay (LOS), hospital LOS, discharge destination, and unplanned ICU admission. Multivariable regression analyses and Bayesian analyses adjusted for age, …

Renal Disease And The Heart, Hassan N Ibrahim

Faculty, Staff and Student Publications

No abstract provided.

Structure Of The Hsp110:Hsc70 Nucleotide Exchange Machine, Yusra Ahmed, Jeremy Miciak, W Pat Taylor, David J Francis

Faculty, Staff and Student Publications

We evaluate the direct and inferential mediation (DIME) model for reading comprehension with a sample of struggling readers in Grades 3 to 5 (N = 364) in the context of a large-scale randomized controlled trial (RCT) investigating two theoretically distinct reading interventions (text processing + foundational skills [n = 117] or text processing only [n = 120]) and a control condition (n = 127). We investigate whether the intervention affects not just reading comprehension levels, but also how variables within the reading system interrelate. This approach allows the focus to shift from intervention as influencing a …

Novel Oppositional Defiant Disorder 6 Months After Traumatic Brain Injury In Children And Adolescents, Daniel S Lowet, Anish Kolan, Florin Vaida, John R Hesselink, Harvey S Levin, Linda Ewing-Cobbs, Russell J Schachar, Sandra B Chapman, Erin D Bigler, Elisabeth A Wilde, Ann E Saunders, Tony T Yang, Olga Tymofiyeva, Hattan Arif, Jeffrey E Max

Faculty, Staff and Student Publications

OBJECTIVE: The investigators aimed to assess predictive factors of novel oppositional defiant disorder (ODD) among children and adolescents in the first 6 months following traumatic brain injury (TBI).

METHODS: Children ages 5-14 years who experienced a TBI were recruited from consecutive admissions to five hospitals. Testing of a biopsychosocial model that may elucidate the development of novel ODD included assessment soon after injury (baseline) of preinjury characteristics, including psychiatric disorders, adaptive function, family function, psychosocial adversity, family psychiatric history, socioeconomic status, injury severity, and postinjury processing speed (which may be a proxy for brain injury). MRI analyses were also conducted …

Circadian Stabilization Loop: The Regulatory Hub And Therapeutic Target Promoting Circadian Resilience And Physiological Health, Eunju Kim, Seung-Hee Yoo, Zheng Chen

Faculty, Staff and Student Publications

The circadian clock is a fundamental biological mechanism that orchestrates essential cellular and physiological processes to optimize fitness and health. The basic functional unit is the cell-autonomous oscillator, consisting of intersecting negative feedback loops. Whereas the core loop is primarily responsible for rhythm generation, auxiliary loops, most notably the secondary or stabilization loop, play pivotal roles to confer temporal precision and molecular robustness. The stabilization loop contains opposing nuclear receptor subfamilies REV-ERBs and retinoic acid receptor-related orphan receptors (RORs), competing to modulate rhythmic expression of the basic helix-loop-helix ARNT like 1 (Bmal1) genes in the core loop as …

Detecting Primary Progressive Aphasia Atrophy Patterns: A Comparison Of Visual Assessment And Quantitative Neuroimaging Techniques, Stephanie Franczak, Jessica Pommy, Greta Minor, Chandler Zolliecoffer, Manav Bhalla, Mohit Agarwal, Andrew Nencka, Yang Wang, Andrew Klein, Darren O'Neill, Jude Henry, Glass Umfleet

Faculty, Staff and Student Publications

BACKGROUND: There are now clinically available automated MRI analysis software programs that compare brain volumes of patients to a normative sample and provide

OBJECTIVE: To address this gap in the literature, we examined Neuroreader

METHODS: lvPPA or aMCI patients who underwent MRI with Neuroreader

RESULTS: Cohen's Kappa coefficients were significant in 10 of the 28 computations (

CONCLUSION: Overall, our results indicated moderate to low interrater reliability, and raters never agreed that left asymmetry was present. While lower

Sulfhemoglobinemia And Methemoglobinemia Following Acetaminophen Overdose, Justin A Seltzer, Irvan Bubic, Garret A Winkler, Nathan A Friedman, Jessica Bagby, Christian A Tomaszewski, Richard F Clark, Allyson Kreshak, Daniel R Lasoff

Faculty, Staff and Student Publications

INTRODUCTION: Though acetaminophen overdoses are common, acetaminophen induced methemoglobinemia is rare and it is thought to be due to oxidative stress from reactive metabolites. However, few prior cases of sulfhemoglobinemia in the setting of acetaminophen overdose have been reported. We report a case of mixed methemoglobinemia and sulfhemoglobinemia in the setting of a large, isolated acetaminophen ingestion.

CASE REPORT: A 30-year-old African American male presented after intentionally ingesting 50 tablets of 500 mg acetaminophen two days prior. He was cyanotic and tachypneic. Peripheral oxygen saturation was 78 % on room air and minimally improved with high-flow oxygen. He was noted …

Distinguish Bipolar And Major Depressive Disorder In Adolescents Based On Multimodal Neuroimaging: Results From The Adolescent Brain Cognitive Development Stud, Yujun Liu, Kai Chen, Yangyang Luo, Jiqiu Wu, Qu Xiang, Li Peng, Jian Zhang, Weiling Zhao, Mingliang Li, Xiaobo Zhou

Faculty, Staff and Student Publications

BACKGROUND: Major depressive disorder and bipolar disorder in adolescents are prevalent and are associated with cognitive impairment, executive dysfunction, and increased mortality. Early intervention in the initial stages of major depressive disorder and bipolar disorder can significantly improve personal health.

METHODS: We collected 309 samples from the Adolescent Brain Cognitive Development study, including 116 adolescents with bipolar disorder, 64 adolescents with major depressive disorder, and 129 healthy adolescents, and employed a support vector machine to develop classification models for identification. We developed a multimodal model, which combined functional connectivity of resting-state functional magnetic resonance imaging and four anatomical measures of …