Other Medicine and Health Sciences Commons^™

Modified Early Warning Scoring (Mews) Versus Epic Deterioration Index (Edi): Battle Royale For Which Has The Best Patient Outcomes In The Inpatient Setting, Dirk A. Church

DNP Projects

Abstract

Background: The increased workload bedside nurses face today requires new tools to assist with the identification of deteriorating patients during hospitalization. The Modified Early Warning Score (MEWS) tool has formed the background of early warning tools. Newer, more complex tools, like Epic’s Deterioration Index (EDI), have been developed to identify patient deterioration earlier. There is lack of evidence in the literature comparing different early warning tools, implementation, and patient outcomes.

Objective: The purpose of the study was to examine models for EWS notification for RRT and patient outcomes between the use of the MEWS and EDI in an adult, …

Supervised Cancer Rehabilitation: Applications For Utilizing Existing Cardiopulmonary Rehabilitation Facilities For Cancer Patients And Survivors, Nancy A. Condit

Graduate Student Theses, Dissertations, & Professional Papers

Currently, the NIH reports there are approximately 18 million Americans with a history of cancer. Cancer statistics are projected to rise to 22.1 million by 2030. In addition to cancer, cardiovascular diseases are globally the leading causes of mortality and morbidity. The body of research in this area clearly demonstrates that greater amounts of physical activity correspond with a lower risk of cancer recurrence and all-cause mortality, including cardiovascular disease (CVD). Exercise rehabilitation success in cancer patients, both during and after treatment, is limited by several barriers, including the lack of facilities, trained personnel and financial resources. In response to …

Antibacterial Effect Of Various Irrigants Against Enterococcus Faecalis, Morgan N. Kesecker

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction:

One of the goals of endodontic therapy is to debride infected pulps of teeth and return the tooth to a state of health in preparation of restorative care and return to function. Chemically cleansing of the canal system augments mechanical debridement by flushing out debris, dissolving tissue, and disinfecting the root canal system. The purpose of this research is to compare the efficacy of five irrigants: 0.008% HOCl acid (Endocyn®), 0.03% HOCl (Vashe®), 6% and 8.25% sodium hypochlorite (NaOCl), and Ozone against a typical bacterial species found in infected pulps, Enterococcus faecalis (E. faecalis).

Methods:

After 24 hours …

Secondary Traumatic Stress Is An Occupational Hazard For Pet Hospice Support Staff: Psychoeducational Support Groups Provide The Cure, Kari Hayden

DSW Capstone Projects

There are three separate yet interrelated products presented in this final capstone product. The completed product is focused on pet hospice veterinary support staff and the need for an evidence-based social work intervention to combat secondary traumatic stress. This capstone uses the andragogical approach to adult learning theory as the foundation to construct a psychoeducational peer support group specific to this population. Implications for clinical social work in veterinary medicine are presented within this project.

The first scholarly product presented is the Systematic Literature Review (SLR). The SLR utilizes a scoping review process in an attempt to locate prior research …

Factors Associated With Improved Outcome Of Inhaled Corticosteroid Use In Covid-19: A Single Institutional Study, A. Manfra, Claire Chen, Kavita Batra, Kyaw Min Tun, Mutsumi Kioka

Department of Internal Medicine Faculty Research

Asthmatics seem less prone to adverse outcomes in coronavirus disease 2019 (COVID-19) and some data shows that inhaled corticosteroids (ICS) are protective. We gathered data on anecdotal ICS and outcomes of patients hospitalized with COVID-19, given there is literature supporting ICS may reduce risk of severe infection. In addition, we fill gaps in current literature evaluating Charlson Comorbidity Index (CCI) as a risk assessment tool for COVID-19. This was a single-center, retrospective study designed and conducted to identify factors associated intubation and inpatient mortality. A multivariate logistic regression model was fit to generate adjusted odds ratios (OR). Intubation was associated …

Spatial Single-Cell Identification Of Cell Layers Within Mouse Brain Using A Novel Spatially Resolved Transcriptomics Technology, Radha Swaminathan

Biomedical Engineering ETDs

Spatially resolved transcriptomics technologies investigate gene expression in the context of a tissue. While imaging-based technologies enable gene expression quantification at a single-cell level, only two NGS-based technologies are currently capable of single-cell resolution. Both Stereo-seq and Seq-Scope involve two rounds of sequencing: one to sequence the location of spatial barcodes and the other to obtain sequence of cDNA. Thus, the objective of the research study is to develop a technology that can capture transcripts from every cell of a tissue without the need for two rounds of sequencing. To this end, a capture surface or barcoded array (similar to …

Injuries In Manual And Mechanical Cpr, Macon Spruill, Malik Bangura

Physician Assistant Capstones, 2020-current

Objective: To compare the rate of injuries during cardiopulmonary resuscitation (CPR) using manual versus mechanical chest compressions with the Lund University Cardiopulmonary Assist System (LUCAS™).

Design: Systematic literature review

Methods: We investigated the use of 2 different CPR methods, manual and mechanical, in order to determine if one was more likely to cause injury in individuals during a cardiac arrest. PubMed searches were conducted using the terms “cardiopulmonary resuscitation,” “adverse effect,” “classification,” “method,” “mortality,” “statistical and numerical data,” “trends,” “complication,” “epidemiology,” and “etiology.” Studies were excluded if they took place before the year 2000, included individuals under 18 …

Pharmacotherapy For Opioid Use Disorder In Mississippi, Amanda Michelle Whitacre

Doctoral Projects

The opioid epidemic is affecting Mississippi’s young to middle-aged adult population in a profound way. Pharmacotherapy for opioid use disorder (OUD) is the gold standard treatment. Despite the FDA-approved evidence-based treatment of pharmacotherapy for OUD, rural areas often lack providers available who will initiate and provide maintenance of this life-saving medication. For this doctoral project, a 36-question survey was developed based on a preliminary literature review. The survey was disseminated to advanced practice registered nurses (APRNs) in the family and psychiatric specialties across Mississippi to assess the barriers to APRNs filling the gap in pharmacotherapy prescribing for OUD. A continuing …

Telehealth Acceptance Among Appalachian Respondents During Covid 19: A Secondary Data Analysis, Victoria Hood-Wells, Florence M. Weierbach, Amy Wahlquist, Janet M. Keener, Manik Ahuja, Hadii M. Mamudu

ETSU Faculty Works

Purpose: The purpose of this study is to examine the relationship between telehealth use, telehealth satisfaction, and chronic medical conditions among residents living in Appalachian and non-Appalachian communities.

Sample: A COVID-19 public health survey was distributed via social media and healthcare clinics in the tri-state region of central Appalachia. Survey responses were limited to adults aged ≥18 years who consented to participate in the survey that self-identified as an individual with one or more chronic medical conditions (n=195).

Method: Simple descriptive statistics including frequencies, percentages, means, and standard deviations (SDs) were calculated for variables of interest both overall and by …

Comparison Of A Dynamic Ankle Orthosis To A Walking Boot For Preserving Ankle Joint Motion And Reducing Tibial Bone Load And Strain, Perri Johnson Jr.

Theses and Dissertations (ETD)

Tibial stress fractures are a common overuse injury accounting for 21.9 – 69% of stress fractures among runners and 24 – 51.2% of stress fractures in military cadets. Current treatment involves wearing a walking boot for 3 – 12 weeks, which limits ankle motion and causes lower limb muscle atrophy. A Dynamic Ankle Orthosis (DAO) provided a distractive force that offloaded the ankle and retained sagittal ankle excursion during walking. It remains unclear how tibial loading is affected by a walking boot or the DAO. This thesis presents a feasibility study confirming the offloading effects of the DAO on tibial …

Impact Of Social Distancing On Physical Activity In College Students During The Covid-19 Pandemic, Carrington E. Brown

Honors Theses

The COVID-19 pandemic was one that affected everyone in some way. From mandatory lockdowns to vaccinations, the pandemic took a toll on everyone. This study focused on the impact of the COVID-19 pandemic’s mandates on undergraduate college students’ rate of physical activity prior, during, and after the pandemic. A sample of 41 college students was recruited via student email. Participants were of all races, ages, and male and female, and they answered questions determining how the pandemic affected them in their physical activity routine, if applicable. As hypothesized, many individuals’ physical activity routine was interrupted because of the mandates from …

Seeing The Big Picture: System Architecture Trends In Endoscopy And Led-Based Hyperspectral Subsystem Intergration, Craig M. Browning

Graduate Theses and Dissertations (2019 - present)

Early-stage colorectal lesions remain difficult to detect. Early development of neoplasia tends to be small (less than 10 mm) and flat and difficult to distinguish from surrounding mucosa. Additionally, optical diagnosis of neoplasia as benign or malignant is problematic. Low rates of detection of these lesions allow for continued growth in the colorectum and increased risk of cancer formation. Therefore, it is crucial to detect neoplasia and other non-neoplastic lesions to determine risk and guide future treatment. Technology for detection needs to enhance contrast of subtle tissue differences in the colorectum and track multiple biomarkers simultaneously. This work implements one …

Effects Of Expiratory Muscle Strength Training On Oropharyngeal Swallow Physiology In Persons With Obstructive Sleep Apnea (Osa): A Pilot Study, Ankita Murlidhar Bhutada

Graduate Theses and Dissertations (2019 - present)

Obstructive sleep apnea (OSA) is characterized by frequent narrowing of the upper airway during sleep. The estimated prevalence of swallowing impairments (dysphagia) in OSA patients ranges up to 80% and comprises approximately 50% of the caseload of practicing speech-language pathologists in the United States. Despite the high prevalence of dysphagia, there is a paucity of evidence supporting behavioral intervention(s) for ameliorating swallowing impairments in OSA. This pilot study assessed oropharyngeal swallowing physiology in persons with OSA and the feasibility and acceptability of a behavioral dysphagia intervention that specifically targets upper airway musculature – Expiratory Muscle Strength Training (EMST). A total …

Health Effects Of Indigenous Language Use And Revitalization: A Realist Review, D. H. Whalen, Melissa E. Lewis, Stefanie Gillson, Brittany Mcbeath, Bri Alexander, Kate Nyhan

Publications and Research

Background: Indigenous populations across the world are more likely to suffer from poor health outcomes when compared to other racial and ethnic groups. Although these disparities have many sources, one protective factor that has become increasingly apparent is the continued use and/or revitalization of traditional Indigenous lifeways: Indigenous language in particular. This realist review is aimed at bringing together the literature that addresses effects of language use and revitalization on mental and physical health.

Methods: Purposive bibliographic searches on Scopus were conducted to identify relevant publications, further augmented by forward citation chaining. Included publications (qualitative and quantitative) described health …

Thank You To Our 2021-2022 Reviewers, Paul B. Freeman Od

Optometric Clinical Practice

Thank you 2021-2022 Reviewers!

Book Review: Applied Concepts In Vision Therapy 2.0, Paul B. Freeman Od

Optometric Clinical Practice

Press LJ, Taub MB, Schnell PH. Applied Concepts in Vision Therapy 2.0. Santa Ana: Optometric Extension Program; 2022, $159.00, 543 pages, Paperback, ISBN: 9780929780542

Occult Adenocarcinoma Presenting As Presumed Periorbital Cellulitis, Kirk Halvorson Od, Jonathon Thomas Od, Jennifer Prunty Od, Omaya H. Youssef Md, Mba

Optometric Clinical Practice

Background: Orbital tumors are uncommon entities seen by optometrists. They may initially present as common, benign conditions, but if not appropriately diagnosed can lead to devastating results.

Case Report: This case report demonstrates an atypical presentation of adenocarcinoma that was initially diagnosed as preseptal cellulitis. The patient in this case was ultimately referred for imaging and biopsy to reveal the correct diagnosis. Despite treatment, this patient died about 1 year after his clinical presentation.

Conclusion: The detection of orbital tumors and the subsequent management of patients with orbital tumors can be challenging. When considering orbital tumors as a possible diagnosis, …

Diagnosis And Excision Of A Solitary Trichoepithelioma, Leonid Skorin Jr., Do, Od, Ms

Optometric Clinical Practice

Abstract

Background: Solitary trichoepithelioma is a rare benign tumor of hair follicle origin. Although trichoepithelioma has a predilection for the face and neck, it is not usually found on the eyelids. It has similar clinicopathological features to basal cell carcinoma. Surgical excision and histopathologic analysis is helpful for correct diagnosis.

Case Report: A 59-year-old Caucasian female presented with a raised, reddish oval mass on the right lower eyelid. The mass had telangiectatic blood vessels on its surface, was non-pigmented and slightly umbilicated. It was in close approximation of the eyelid margin causing distortion and poor apposition of the lid to …

A Reactivation Of Ocular Toxoplasmosis During Pregnancy, Brett Garee Od, Ms, Sarah Dieter Od, Pete Liette Od

Optometric Clinical Practice

Background: Toxoplasma gondii is a parasite estimated to affect over 500 million people worldwide. The feline is the definitive host for the parasite and infection may be acquired or congenital via maternal transmission. Humans may acquire the infection by ingestion of raw or undercooked meats and vegetables, contaminated water, or exposure to infected cat feces. The infection is often benign, self-limiting, and asymptomatic for humans, but potentially life threatening to infants or the immunocompromised patient.

Case Report: A 22 year-old Caucasian female, pregnant at 12 weeks gestation, presented to the optometry service with acute symptoms of hazy vision …

Minimum Rim Width And Lamina Cribrosa Depth In Non-Glaucomatous And Glaucomatous U.S. Veterans, Jacob Hillard Od, Rachel Druckenbrod Od, Baharak Asefzadeh Od

Optometric Clinical Practice

Purpose: Assess the utility of the MRW and lamina cribrosa depth measurements for detecting differences between non-glaucomatous and glaucomatous U.S. Veterans. Compare inter-eye differences of individuals with glaucoma.

Method: 38 subjects were recruited per group: Group 1 included one eye of non-glaucomatous participants, and Group 2 included each qualifying eye of participants with glaucoma. Analysis compared Group 1 with the more affected eye only of Group 2 participants, and separately between the more and less affected eyes of group 2 participants. MRW measurements were obtained with Heidelberg Eye Explorer© (HEYEX). Average lamina cribrosa depths were measured manually utilizing HEYEX.

Results: …

Just When You Thought It Was Safe To Go Back In The Water, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor

Factors Influencing Fellowship Training Among Ophthalmology Residents: A Pilot Study, Craig Czyz, Rahul Kashyap, Laura L. Wayman

HCA Healthcare Journal of Medicine

Objective

There has been an increase in ophthalmology fellowship training programs and applicants. The current ophthalmology literature lacks any recent study examining factors influencing residents' decisions to pursue subspecialty fellowship training.

Methods

An anonymous, 16-item survey was distributed to residents from a convenience sample of ophthalmology residency programs by their program directors or administrators.

Results

A total of 72 residents and 9 interns from 9 distinct programs completed the survey. Eighty-two percent of respondents reported they have either applied or will apply for a fellowship position. Gender and race showed no significant association with fellowship application. Respondents perceived that obtaining …

Care Of The Heart, Loma Linda University Health

Scope

Table of Contents

Features
14 | Campus of cardiac care
18 | The hearts of women
22 | Cardiopulmonary rehab
24 | Robotic surgery at LLUH
26 | Interventional procedures
28 | St. Paisley Day
30 | Heart health through nutrition

Departments
4 | From the President: Health care
8 | News: Clinical and campus news
38 | Alumni: Serving our world
44 | Annual Report: The year's people and stats

Alumni Journal - Volume 93, Number 3, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Editorials
2 | From the Editor
4 | From the President
6 | From the Dean

News
8 | Alumni News + This and That
10 | APC 2023 Preview
12 | School of Medicine News
14 | Students
16 | Department Reports: Family Medicine

Bioethics
18 | What Does the Lord Require of Us?

Features
26 | Alumni Mission Stories
28 | Malawi
30 | Kenya
34 | Nigeria
36 | Ukraine
41 | Alumni Trips 2022
46 | Life After Medicine
48 | Historical Snapshot

In Memoriam
51 | Alumni Remembered

The Social Determinants Of Ideal Cardiovascular Health: A Global Systematic Review, Farah Qureshi, Kelb Bousquet-Santos, Sakurako S. Okuzono, Elaine Tsao, Scott Delaney, Anne-Josie Guimond, Julia K. Boehm, Laura D. Kubzansky

Psychology Faculty Articles and Research

This systematic review synthesizes research published from January 2010-July 2022 on the social determinants of ideal cardiovascular health (CVH) carried out around the world and compares trends in high-income countries (HICs) to those in low- and middle-income countries (LMICs). 41 studies met inclusion criteria (n = 28 HICs, n = 13 LMICs). Most were from the United States (n = 22) and cross-sectional (n = 33), and nearly all evaluated associations among adults. Among studies conducted in LMICs, nearly all were from middle-income countries and only one was carried out in low-income country. Education (n = …

Health Profession Student’S Readiness Towards Online Learning As A Component Of Blended Learning, Narasimman Swaminathan, Latha Ravichandran, Ramachandran Sivakumar, Steve Milanese

Internet Journal of Allied Health Sciences and Practice

Objectives: The objectives of this study were to identify the entry-level health profession students’ perception and readiness to adopt online learning as a component of blended learning (BL). Methods: A cross sectional survey using a structured questionnaire was administered using Google forms. Entry level Health professionals’ education (HPE) graduate students of a higher education institute in India completed the survey (N= 628). The questionnaire was developed from the literature and content validated by experts. Ethics clearance was obtained from the Institutional ethics committee. Results: Out of 628 responses, 603 fully completed questionnaires were included for analysis. Of the participants, 98 …

Changing Stem To Steam: An Analyzation On The Effects Of Art Integration Up To The University Level, Elizabeth Richmond

Honors Projects

This Honors Project is a combination of an artistic, creative project and a research driven analysis. The focus of this project is to research and understand the effects the arts have on both general students and STEM students in particular, what benefits come from art education and art integration, and if STEM students benefit from art integration. This goal was accomplished through a literature review and annotated bibliography featuring 18 sources. Another goal of the project was to understand where I fit into the research. In my creative portion of the project, I explored and analyzed how the arts affected …

Urban Monitoring Of Antimicrobial Resistance During A Covid-19 Surge Through Wastewater Surveillance, Anthony Harrington, Van Vo, Katerina Papp, Richard L. Tillett, Ching-Lan Chang, Hayley Baker, Shirley Shen, Amei Amei, Cassius Lockett, Daniel Gerrity, Edwin C. Oh

Nevada Institute of Personalized Medicine Faculty Research

During the early phase of the COVID-19 pandemic, infected patients presented with symptoms similar to bacterial pneumonias and were treated with antibiotics before confirmation of a bacterial or fungal co-infection. We reasoned that wastewater surveillance could reveal potential relationships between reduced antimicrobial stewardship, specifically misprescribing antibiotics to treat viral infections, and the occurrence of antimicrobial resistance (AMR) in an urban community. Here, we analyzed microbial communities and AMR profiles in sewage samples from a wastewater treatment plant (WWTP) and a community shelter in Las Vegas, Nevada during a COVID-19 surge in December 2020. Using a respiratory pathogen and AMR enrichment …

Pgc-1Α Overexpression Is Not Sufficient To Mitigate Cancer Cachexia In Either Male Or Female Mice, Francielly Morena Da Silva, Megan Rosa-Caldwell, Eleanor R. Schrems, Lauren Martinez, Madeline G. Amos, Seongkyun Lim, Ana Regina Cabrera, Jacob L. Brown, Tyrone A. Washington, Nicholas P. Greene

Health, Human Performance and Recreation Faculty Publications and Presentations

Cancer cachexia (CC) accounts for 20%–40% of cancer-related deaths. Mitochondrial aberrations have been shown to precede muscle atrophy in different atrophy models, including cancer. Therefore, this study investigated potential protection from the cachectic phenotype through overexpression of peroxisome proliferator-activated receptor γ coactivator-1 α (PGC-1α). First, to establish potential of mitochondria-based approaches we showed that the mitochondrial antioxidant MitoTEMPO (MitoT) attenuates myotube atrophy induced by Lewis lung carcinoma (LLC) cell conditioned media. Next, cachexia was induced in muscle-specific PGC-1α overexpressing (MCK-PCG1α) or wildtype (WT) littermate mice by LLC implantation. MCK-PCG1α did not protect LLC-induced muscle mass loss. In plantaris, Atrogin mRNA …

Effects Of Telesimulation On The Health Literacy Knowledge, Confidence And Application Of Nursing Students, Susan Patton

Dissertations, Theses, and Capstone Projects

Background: Assessing and addressing health literacy (HL) in patients is an essential role of the nurse and a critical component of nursing student education. Yet, large gaps exist within nursing school curricula with regard to the development of HL knowledge and skills, and the confidence to implement practices that target HL. Furthermore, effective training modalities that examine the transformation of nursing students’ knowledge into practice through the development of confidence during experiential learning have not been well explored.

Purpose: Evaluate the effectiveness of a HL information and a HL telesimulation intervention on the HL Knowledge, Application and Confidence of first-semester …