Other Medicine and Health Sciences Commons^™

Implementation Of An Opioid Risk Assessment Tool, Stacey Cuomo

Seton Hall University DNP Final Projects

The increased prevalence of opioid use in society has led to an increase in surgical patients with a history of such use. Patients who use or are addicted to opioids have different tolerances and responses to anesthesia than non-opioid users, and will require different care than non-users both pre- and post-operatively. The means to identify this population prior to a surgical procedure is needed as a way to organize, plan and manage patient care during the perioperative period. An Opioid Risk Assessment Tool (ORAT) was used as a way to streamline the process of identifying these patients. This paper addresses …

A Gut Pathobiont Synergizes With The Microbiota To Instigate Inflammatory Disease Marked By Immunoreactivity Against Other Symbionts But Not Itself, João Carlos Gomes-Neto, Hatem Kittana, Sara Mantz, Rafael R. Segura Munoz, Robert J. Schmaltz, Laure B. Bindels, Jennifer L. Clarke, Jesse M. Hostetter, Andrew K. Benson, Jens Walter, Amanda Ramer-Tait

Department of Food Science and Technology: Faculty Publications

Inflammatory bowel diseases (IBD) are likely driven by aberrant immune responses directed against the resident microbiota. Although IBD is commonly associated with a dysbiotic microbiota enriched in putative pathobionts, the etiological agents of IBD remain unknown. Using a pathobiont-induced intestinal inflammation model and a defined bacterial community, we provide new insights into the immune-microbiota interactions during disease. In this model system, the pathobiont Helicobacter bilis instigates disease following sub-pathological dextran sulfate sodium treatment. We show that H. bilis causes mild inflammation in mono-associated mice, but severe disease in the presence of a microbiota, demonstrating synergy between the pathobiont and microbiota …

Using Social Narratives To Improve The Healthcare Experiences Of Children Diagnosed With Autism Spectrum Disorder, Margaret Spindel

Senior Honors Projects, 2010-2019

Children with Autism Spectrum Disorder (ASD) often experience significant emotional stress when they visit a healthcare provider. The focus of this research project was to explore the use of social narratives to help reduce stress associated with this environment. Social narratives are short stories designed to walk a child through a potential situation that they will encounter, that they may not be familiar with, or that they are not currently handling properly. As part of an initial literature review, evidence for the need for additional intervention in the healthcare setting for children with ASD was established. Continuing literature review then …

Next Generation Sequencing Technologies For Real-Time Genotyping And Targeted Sequencing For Precision Medicine, Priyanka Rawat

Biomedical Engineering ETDs

Astounding success of Human genome project and accelerating success of sequencing technologies have enabled $ 1000 genome goals possible. But, this is still far-fetched from the reach of many resource refrained populations with high genetic variations causing lethal genetic diseases. Based on present technology principles, I have developed prototypes for affordable, scalable and customizable point-of-care genotyping and targeted sequencing. Ion-sensitive field effect transistors with novel read-out and signal amplification techniques are used for laying foundation of possible ISFET based allele-arrays. Sequencing-by-synthesis based full-fledge sequencer is made with novel immobilization, flow-cell and data acquisition methods for massive sequenciing.

A Novel Model Of “Remedy And Elimination Of Tuberculosis”, Akanksha Mishra

Master's Theses

Tuberculosis (TB), is one of the top ten causes of death worldwide. TB is commonly linked to poverty and creates poverty as it is the single largest cause of death in the 15-49-year-old age group in South-East Asia (WHO, 2017). It is also linked to the HIV population, and its leading cause of death. TB is effected by socio-economic factors, cultural factors, and health policy. My goal of this dissertation is to identify systematic approaches that shall support the mission set by World Health Organization (WHO): to eliminate TB globally by the year 2050. Measures might include addressing social barriers …

Improving Transitions In Care For People With Dementia: The Cared Tool, Yuwen Deng, Jamie Bisset, Silk Lim, Maryssa Edwards

Community Engaged Learning Final Projects

Transitions in Care are challenging for people with dementia due to impairments in communication and disorientation from being in a foreign environment. Transitions in care have lead to incidents of unnecessary physical and chemical restraints of this vulnerable population. To investigate how to optimize care transitions, qualitative descriptive information was collected through three personal interviews to gain a broader understanding of mechanisms of care transitions in London, ON. After conducting interviews and literature review, the CARED Tool was developed. The CARED Tool promotes social inclusion of patients with dementia through recognizing that people with dementia have complex needs, thereby allowing …

Subanesthetic Ketamine For Postoperative Analgesia: An Evidenced-Based Project, Jeremy Vance

Doctoral Projects

Roughly 100 million surgical procedures are performed in the United States (U.S.) each year and more than 80% of these patients experience acute postoperative pain. Pain costs the U.S. an estimated $560 to $635 billion annually and is a significant contributor to national rates of mortality, morbidity, and disability. Despite these findings, patients continue to receive suboptimal postoperative pain relief.

The adjunct administration of subanesthetic ketamine is opioid-sparing and can improve the effectiveness of a multimodal pain management approach. This project used an exploratory descriptive design to examine how an evidence-based presentation impacted the clinical practice of certified registered nurse …

Simulation As A Multidisciplinary Team Approach In Health Care Programs In An Urban University Setting, Geraldine Fike, Dawn Blue, Guillermo Escalante, Phoebe (Yeon) S. Kim, Jose A. Munoz

Health Science and Human Ecology Faculty Publications

The poster provided here showcases results from a simulation study that began in the Spring Quarter of 2017 at CSU San Bernardino. The results presented here are based on four simulations conducted on campus in our nursing lab space. We incorporated the participation of 44 students in our study.

Patients are cared for by a nurse and multidisciplinary teams which may include physical therapists, social workers, and public health workers; however, students in health care programs usually will not experience necessary scenarios developing needed skills. Although needed skills are learned within the walls of the university they remain in a …

The Correlation Of Size Of Core Network And Frequency Of Contacts With Agitation And Positive Affect In Elderly With Dementia, Amal Ali Al Ghassani

Theses and Dissertations

In the country of Oman, care needs of older adults are primarily provided by family members in the home. The study was guided by socioemotional selectivity theory, the environmental vulnerability hypothesis, and the need-driven dementia-compromised behavior theories. The central premise was that the size of the person’s activities of daily living (ADL) core network and frequency of contact with the ADL core network would predict agitation and affect. A smaller core network with a higher frequency of contact may be better at identifying and treating the person’s unmet needs. A secondary premise was that the emotional closeness of the core …

Alumni Journal - Volume 88, Number 3, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Features
10 | A Letter to Alumni
12 | The Alumni Association’s Historical Ties to Research
13 | The Opera Singer
15 | Interview: It All Began with a Bald Mouse, Gerald G. Krueger ’66
18 | Graduation 2017
32 | The Art of Unconventional Connections
34 | A Balancing Act
36 | When I Am Not Rewarded

Departments
2 | From the Editor
4 | From the President
6 | From the Vice Dean
7 | The Student Fund
8 | School of Medicine News
38 | Placement and Classified Ads
39 | Alumni News
40 | In Memoriam …

A Quality Improvement Initiative To Increase Statin Therapy Adherence Among Patients With Diabetes Aged 65 Years And Older, Kelly Nunemaker

Doctor of Nursing Practice

The purpose of this project was to improve statin therapy adherence among diabetic patients aged 65 and older treated at a small family practice clinic in western San Antonio. Additionally, the project aimed to decrease LDL cholesterol (LDL-C) levels in this patient population as recommended to 70 mg/dl or less. Diabetic patients are more likely to die from a cardiac event than patients without diabetes. Statin therapy is an important factor in lowering cholesterol, which reduces the patient’s risk for atherosclerosis. Educating patients aged 65 and older about the role of statin therapy in preventing cardiovascular events, stroke, and vascular …

Improving Service Delivery Through Provider Training: A Process Evaluation Of The Veterans Affairs Palo Alto Health Care System “Commitment To Serve” Workshop, Ismael Barrera

Master's Projects

As the customer-focused management strategies gradually advances into all of the VISNs [Veterans Integrated Service Networks], the Veterans Health Administration in Palo Alto, California implemented a customer service training program for employees to meet the diverse and complex needs of its customers. This research will analyze whether participants in this training, known as Commitment to SERVE, believe that it is achieving its goal. In other words, does the Veterans Affairs Palo Alto Health Care System (VAPAHCS) staff perceive the Commitment to SERVE workshop as a beneficial customer service training program?

The Pathway To The Use Of A Structured And Supported Approach To Debriefing, Anne H. Zachry, S. B. Lancaster

Faculty Presentations

Debriefing plays a critical role in the transfer of knowledge in simulation education. Various methods are used in the debriefing process based on a variety of factors; this presentation sheds light on the pathway to the use of a structured and supported approach as traversed in the Department of Occupational Therapy at the University of Tennessee Healthcare Center as well as reflections and lessons learned along the way. Engagement in this session will allow learners to further develop their debriefing skills through exposure to information about strategies to use in the debriefing process that can be used as part of …

Measuring The Impact Of Patient-Engaged Research: How A Methods Workshop Identified Critical Outcomes Of Research Engagement, Ellis C. Dillon, Leah Tuzzio, Sarah Madrid, Heather Olden, Robert T. Greenlee

Journal of Patient-Centered Research and Reviews

Purpose: While strategies to evaluate the influence of engaging patient partners in research, such as the Patient-Centered Outcomes Research Institute (PCORI) WE-ENACT surveys, are beginning to emerge, a systematic set of measures for assessing the impact of patient engagement in research (PER) on study approaches and outcomes is lacking. This article describes a workshop and process used to identify and develop Critical Outcomes of Research Engagement (COREs). It proposes preliminary measures for assessing the impact of PER on the research process and outcomes of research studies.

Methods: A group of 24 researchers and 5 patient partners participated in a PCORI-funded …

Positive Impact On Patient Satisfaction And Caregiver Identification Using Team Facecards: A Quality Improvement Study, Nicole M. Martin, Khalil Odeh, Lamya Boujelbane, Marvi V. Rijhwani, Susan Olet, Aijaz Noor, Colleen Nichols, Richard Battiola

Journal of Patient-Centered Research and Reviews

Background: Patients satisfaction is an increasingly important metric in measuring the quality of care that hospitals and physicians provide. It can be difficult for patients to remember their providers and their roles, all of which may potentially impact a patient’s overall satisfaction.

Purpose: To see if giving facecards with pictures and names of caregivers and description of roles improved patient satisfaction and identification of care team members.

Methods: Team facecards were designed and distributed to the patients during the interventional period of the study. Patients’ identification of team members, the role of each physician and overall satisfaction was measured using …

College Students, Experiences On Smart Phone Technology Usage: A Qualitative Content Analysis Study, Fatemeh Jafarzadeh-Kenarsari, Parand Pourghane

The Qualitative Report

Besides many benefits of the cell phone technology, numerous arguments are raised on the different and important negative effects of such a technology. This qualitative content analysis study explored the common usages of smart phone technology, its challenges, and benefits among Iranian college students. Participants were 32 bachelor degree students who were recruited using purposive sampling method with maximum variation. Data were collected through 11 individual semi-structured interviews and 3 focus group discussions (5-8 students in each group). Data analysis was done based on a conventional content analysis approach. Data analysis resulted in 3 main themes and 12 sub-themes. The …

Reducing Medication Errors In Pneumonia Patients During Transitions Of Care, Laressa Bethishou, Noah Fang, Lisa Shieh

Pharmacy Faculty Articles and Research

Purpose: At Stanford Health Care, as part of a hospital-wide initiative to reduce pneumonia readmission rates, an interdisciplinary collaborative effort was created between physicians and transitions of care (ToC) pharmacists to optimize discharge planning and medication management for pneumonia patients. The purpose of this study was to describe the impact of the ToC pharmacist in identifying and reducing medication errors on discharge for pneumonia patients.

Methodology: Retrospective chart review was conducted on patients discharged with a pneumonia diagnosis between December 2015 to Feb 2016. Patients were stratified based on whether they received ToC pharmacist medication review vs. standard …

Evaluating Patient Preferences For Different Incentive Programs To Optimize Pharmacist-Provided Patient Care Program Enrollment, Daniel M. Tomaszewski, Tim Cernohaus, Rajiv Vaidyanathan

Pharmacy Faculty Articles and Research

BACKGROUND: Employers have increased efforts to engage employees in health and wellness programs. Providing employees with incentives to participate in these programs has been shown to improve overall enrollment and engagement. One program that has had challenges with enrollment and engagement is medication therapy management (MTM).

OBJECTIVES: To (a) determine how individuals evaluate different financial incentives to improve participation in an MTM program and (b) measure the effect of participant characteristics on incentive preference.

METHODS: This study was composed of a paper-based survey administered to participants after focus group sessions. Participants included MTMeligible beneficiaries from 2 employer groups and included …

Student Pharmacists And Street Children: A Mutually Beneficial Relationship, Mario A. Hoyos, Monica L. Miller, Ellen M. Schellhase, C. Ryan Tomlin, Sonak Pastakia, Samuel Kimani, Tim Mercer

Purdue Journal of Service-Learning and International Engagement

The Tumaini Children’s Drop-In Center is a daytime drop-in center for the street children of Eldoret, Kenya. It is part of a partnership between the Purdue University College of Pharmacy, the Academic Model Providing Access to Healthcare program, Eldoret community members, and numerous individuals in both Kenya and the US. Through the efforts of local staff and Purdue student pharmacists, who work at the local hospital on an eight-week clinical rotation, the center has helped a population of nearly 400 local street children by providing a safe haven from life on the streets. Purdue student pharmacists aid the center by …

Weight-Loss Treatment-Induced Physical Activity Associated With Improved Nutrition Through Changes In Social Cognitive Theory Variables In Women With Obesity, James J. Annesi, Nicole Mareno

Health Behavior Research

Behavioral weight-loss treatments have typically been unsuccessful and a theoretical. Even when treatments were scientifically derived, theory has rarely been used to decompose, and understand the bases of, their effects. This 2-year study evaluated mediation of the prediction of nutritional changes by changes in physical activity, through social cognitive theory variables. Data from women with Class 1–2 obesity, classified as “insufficiently active” (N = 50; Mage = 47.6 years), were extracted from 2 initial trials of a new cognitive-behavioral intervention. That treatment sought to improve self-regulation, mood, and self-efficacy through increased physical activity, to then induce improved eating …

Managing The Cost Of Diabetes, Laressa Bethishou

Pharmacy Faculty Articles and Research

"This is of concern to health care providers because inadequate management of diabetes results in short- and long-term complications. Patients with diabetes and no health insurance have fewer physician visits and are prescribed fewer medications for management of their diabetes. Patients with diabetes make up 11.9% of all emergency department visits in the United States.Hispanic and non-Hispanic blacks are at greater risk for developing diabetes and serious associated health complications, including chronic kidney disease. This may be attributed to a combination of genetics, diet, and exercise. However, access to health care resources may also play an important role."

Drawbacks Of Utilizing The Logit Link In Propensity Score Weighting Adjustment, Evrim Oral

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.

Mathematical Modeling For Predicting Chemotherapy And Nanoparticle Treatment Efficacy In Breast Cancer, Terisse Arielle Brocato

Biomedical Engineering ETDs

Breast cancer treatment response varies by subtype, treatment regiment, and additionally by vasculature characteristics. For this reason, breast cancer is a model disease for the development of both targeted therapy and prognostic and predictive biomarkers. Mathematical modeling allows for personalized patient specific prediction of treatment outcome based on parameters found to be important to the cancer type. Mathematical modeling is beneficial in providing insight into why cancer treatment fails and in what cases, additionally determining what characteristics result in a successful treatment. Presented in Chapter 1 is a scientific introduction and discussion focusing on representative modeling works specified towards breast …

International Black-Market Organ Trade, Marni E. Granzow

Student Publications

The human organ trade is a global epidemic as citizens of developed-countries look to developing-countries to find organ donors, specifically exploiting the poor for their own personal gain. The impoverished organ donors are treated in an inhumane manner, as they are often left with serious medical complications and are not treated equally in the transaction.

Yawns Are Cool, Andrew C. Gallup, Omar T. Eldakar

Biology Faculty Articles

Although we yawn each and every day, most people have little understanding of why we do it. In fact, the function of yawning has remained mysterious for centuries, even among scientists, and this has only changed quite recently. Contrary to what people have believed for a long time, it is now understood that yawns have nothing to do with breathing or the amount of oxygen we are taking in. Instead, new and growing research has revealed that yawns serve as a brain cooling mechanism. This new perspective on yawning as a response to elevated brain temperature has transformed our understanding …

Indicators Of Simulated Driving Skills In Adolescents With Attention Deficit Hyperactivity Disorder, Sherrilene Classen, Miriam Monahan, Kiah Brown

Miriam Monahan

Adolescents with attention deficit hyperactivity disorder (ADHD) have an increased risk for committing traffic violations, and they are four times more likely than neurotypical peers to be crash involved, making them a potentially high risk group for driving. We used a two-group design to measure differences in demographics, clinical off-road tests, and fitness to drive abilities in a driving simulator with nine adolescents with ADHD (mean age = 15.00, SD ± 1.00) compared to 22 healthy controls (HC) (mean age = 14.32, SD ±..716), as evaluated by an Occupational Therapist Certified Driving Rehabilitation Specialist (OT-CDRS). Despite few demographic differences, the …

Identifying The Factors For Acute Cardiac Arrest For Establishing A New Recognition Protocol In Detecting Pre-Arrest Symptoms, Sarah Power

Grace Peterson Nursing Research Colloquium

Abstract

Background: Worsening physiological symptoms can easily go overlooked or unmanaged. The early detection of clinical signs that precede cardiac arrest can reduce the risk of worsening condition or death. Determining a nursing protocol to recognize pre-arrests symptoms would allow a systematic way to evaluate patients and their health status before adverse events occur.

Objectives: The purpose of an integrative literature review was to identify signs and symptoms that precede cardiac arrest, and to specify a recognition protocol that ameliorates patient care outcomes.

Method: An integrative literature review was conducted undergoing an extensive search to identify acute cardiac arrest and …

The Roles Of Ecdysoneless In Endoplasmic Reticulum Stress And Oncogenesis, Appolinaire A. Olou

Theses & Dissertations

Tumor cells are well known to exhibit ER stress as a result of their altered environment characterized by redox and calcium imbalance, deregulation of protein synthesis to meet their oncogenic demands, and decreased vascularization associated with nutrient limitation and hypoxia, all of which are conducive of ER stress. Accordingly, markers of ER stress signaling response are up-regulated in various cancers. The outcome of ER stress signaling response varies from survival and adaption to apoptosis. Although pro-apoptotic ER stress signaling molecules are up-regulated in cancer, the mechanisms by which cancer cells seem refractory to, or evade, their apoptotic signaling are not …

Investigating The Needs Of Parents Of Premature Infants’ Interaction In The Neonatal Intensive Care Unit, Maureen A. Rinehimer

Seton Hall University Dissertations and Theses (ETDs)

Parents and/or caregivers of premature infants provide the interaction needed to promote better outcomes for these challenged infants at risk for developmental delays. This descriptive, exploratory study utilized convenience sampling. Inclusion criteria consisted of parents/caregivers who were at least 18 years of age and older with infants born 35 weeks gestation or less and currently in the NICU. This study focused on the research question: What do parents perceive they need in the NICU to enjoy interacting with their infant in the home? To collect the data needed to capture the perceptions of parent’s needs of infants in the NICU, …

Traceable Peo-Poly(Ester) Micelles For Breast Cancer Targeting: The Effect Of Core Structure And Targeting Peptide On Micellar Tumor Accumulation, Shyam M. Garg, Igor M. Paiva, Mohammad R. Vakili, Rania Soudy, Kate Agopsowicz, Amir H. Soleimani, Mary Hitt, Kamaljit Kaur, Afsaneh Lavasanifar

Pharmacy Faculty Articles and Research

Traceable poly(ethylene oxide)-poly(ester) micelles were developed through chemical conjugation of a near-infrared (NIR) dye to the poly(ester) end by click chemistry. This strategy was tried for micelles with poly(ε-caprolactone) (PCL) or poly(α-benzyl carboxylate-ε-caprolactone) (PBCL) cores. The surface of both micelles was also modified with the breast cancer targeting peptide, P18-4. The results showed the positive contribution of PBCL over PCL core on micellar thermodynamic and kinetic stability as well as accumulation in primary orthotopic MDA-MB-231 tumors within 4–96 h following intravenous administration in mice. This was in contrast to in vitro studies where better uptake of PEO-PCL versus PEO-PBCL micelles …