MEDICA@MUSC (Medical University of South Carolina)
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Calpain Activation Regulates Rho-ROCK Pathway in Parkinson’s Disease
Get PDFParkinson’s disease (PD) is a progressive neurodegenerative disease resulting in difficulty with motor coordination, balance, and speaking. Although the cause of PD remains unknown, oxidative damage, environmental toxins, genetic factors and accelerated aging have been implicated as potential causes for the disease. In addition, there is an aggregation of alpha-synuclein ( -syn), known as Lewy bodies, that activate an immune response involving microgliosis, inflammatory cytokines, and T-cell infiltration. These inflammatory immune responses may result in the activation of the Rho/Rho-associated coiled-coil containing protein kinase (Rho- ROCK) pathway, causing subsequent dopaminergic neuronal death in the substantia nigra (SN). Post-translational modification, truncation of -syn by an activated neutral cysteine protease, calpain, could promote the aggregation of -syn in the SN. Our laboratory has shown activation of calpain in the nigrostriatal pathway in animal models of PD, which promotes inflammatory pathways leading to neuroinflammation and neurodegeneration. In PD patients, increased expression of calpain is also detected in the brain and spinal cord, and that might cause aggregation of -syn and activation of inflammatory pathways. The activation of RhoA-/ROCK pathway by angiotensin II may also regulate actin cytoskeleton, further activating microglia and inflammatory cytokines/chemokines causing inflammation and neuronal death. Thus, blocking calpain activation may attenuate neuroinflammation which may further block activation of RhoA-ROCK pathway and neurodegeneration in PD
Emergency Department Utilization by South Carolina Patients with Type 2 Diabetes: A Needs Assessment to Inform Primary Care Access and Telehealth Improvement
Get PDFBACKGROUND: Type 2 diabetes (T2D) is a major population health issue that affects 9.4% of the United States (US) while disproportionately affecting minority populations. T2D is highly prevalent and correlated with increased morbidity as well as early mortality rates, making it the seventh leading cause of death in the US in 2019. There is a high prevalence of T2D in the US and approximately 7 million people are undiagnosed.
OBJECTIVE: To assess if race plays a role in ED utilization and identify geographic areas where improvement in primary care and support by telehealth would be of greatest value.
RESEARCH DESIGN: This is an exploratory research design that used an all-payer claims database (APCD) to explore all SC ED visits in 2019 for AAs and whites.
RESULTS: The overall findings demonstrate that in SC, AAs per 1000 with a presence of T2D utilized the ED more than Whites regardless of the county designation of rural or high SVI.
CONCLUSION: ED utilization across the total adult SC population was higher for AAs than Whites
Optimizing Neurologic Recovery in Acute Care: A Focus on Addressing Rehabilitation Needs at the Medical University of South Carolina
Get PDFCognitive-Motor Dual Tasking in Acute Care with Neurological Patients: Inservice Training and Framework
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Camp Cardiac: A Pediatric Inpatient Camp Program Aimed to Improve and/or Remediate Psychosocial Difficulties through Play
No full textPediatric patients with congenital heart defects have on average longer lengths of stay and an increased number of stays when compared to pediatric patients without congenital heart defects. This qualitative capstone project was completed to improve and/or remediate psychosocial difficulties these children potentially face through play. The qualitative improvement capstone project included the development and implementation of “Camp Cardiac”, a biweekly in person and “on the go” day camp in a Children’s Hospital Heart Center. The outcomes of the project resulted in increased emotional states of patients on the unit, increased quality of life, and increased social engagement
Yoga and Wellness-Based Interventions with Marginalized Populations
No full textIn the realm of mental health, the intersection of addiction, trauma, and various behaviors represents a complex and multifaceted landscape that requires specialized understanding and treatment approaches. Upward Inertia is a nonprofit organization whose mission is to improve the mental, physical, and social-emotional health and wellbeing of marginalized populations through the use of therapeutic yoga and mind-body based interventions. Ongoing programming is currently offered at five Idaho prisons, both men\u27s and women\u27s facilities, ranging from minimum to maximum security. This capstone project explores the possibility of expansion to other marginalized populations including pediatrics. After investigation, there are stakeholders that are interested in assisting with the expansion of Upward Inertia, however, more communication and research needs to be done to establish the next steps towards expansion. The more populations and participants that have the opportunity to participate in Upward Inertia\u27s programming, there is potential to increase mental health outcomes and reduce recidivism rates
Identification of Facilitators and Barriers for the Management of Pediatric Asthma
Get PDFAsthma is the most prevalent chronic disease of childhood. Understanding what factors impact access to asthma health care is important. The focus of this dissertation study was to understand the facilitators and barriers to asthma health care as viewed by pediatric primary care providers and caregivers of school-aged children with asthma. This dissertation consists of 3 manuscripts, the first is an integrative review based on the socioecological model that identified the facilitators and barriers to using telehealth for the management of asthma. The second is a quantitative study using electronic surveys to understand caregivers’ and pediatric primary care providers’ perception of facilitators and barriers to accessing asthma health care, including school-based health clinics (SBHCs) and telehealth. The third is a qualitative study that further expounds upon these facilitators and barriers of the pediatric primary care provider. The findings of these studies uncovered new perceived barriers to the provision of asthma care by providers and revealed that there is a misunderstanding of the functions of SBHCs in the provision of primary care services within the school setting. Additionally, opportunities exist to enhance pediatric asthma health care access through the development of a collaborative relationship between community providers, SBHC providers, and caregivers within the SBHC setting
Police Officer Perceptions of Mental Wellbeing Needs: A Multi-Methods Study
Get PDFPolice officers are exposed to repeated traumatic exposures (e.g., deaths, abuse, threats to personal and community member safety) and organizational stressors (e.g., poor leadership and support, low job control) throughout their careers. These job-related exposures and stressors have been shown to increase the officers’ risk for developing physical (e.g., cardiovascular disease, sleep deprivation) and mental health issues (e.g., depression, anxiety, hypervigilance, post-traumatic stress disorder, hopelessness, substance abuse, self-isolation, suicidal ideations). Outside of their work environment and duties, factors and stressors related to the officer (e.g., beliefs, values, coping strategies, personality, life experiences), interpersonal relationship dynamics (e.g., work-family demands, conflict, support), and public policy (e.g., laws, policies) can mitigate or amplify officer stress. Regardless of the known mental wellbeing risk factors officers face, they have been found to underutilize mental wellbeing resources due to existing barriers (e.g., police culture, fear of being viewed as weak, stigma).
This dissertation evaluated police officers\u27 use of coping strategies, current help seeking behaviors and stereotyping, knowledge of available mental wellbeing resources (departmental and community-based), officer valence of perceptions (positive, neutral, negative) of those resources using a multi-methods approach. The Socioecological Model (SEM) was used as the theoretical framework for the manuscripts in this dissertation due to its understanding of the five influential areas (intrapersonal, interpersonal, organizational, community, and public policy) that can affect a person. The first manuscript was an integrative review to identify and gain a comprehensive understanding of the types of coping strategies used by police officers in relationship to the five influential levels of the SEM. Since people deal with stressors utilizing various coping strategies, this review evaluated 33 studies assessing officers’ use of adaptive (positive), maladaptive (negative), and ones that could fall into both categories. This search revealed various coping strategies (n=79) that officers utilized. Strategies were arranged within the SEM levels, with the intrapersonal level (n=79) leading, followed by interpersonal (n=19), organizational (n=16), community (n=7), and public policy (n=1). Adaptive coping strategies (n=40) outnumbered maladaptive (n=28) and both (n=11) categories, showing officers were choosing more positive ways to deal with stress.
The second manuscript was a cross-sectional quantitative study aimed at evaluating police officers’ current mental health help seeking attitudes and intentions (intrapersonal), and stereotyping of others (interpersonal) who seek mental health help using three comparison groups based on the officer’s mental distress level. The statistical data was compared using three mental distress level groups (low, moderate, and high). Findings revealed officers reported more positive views regarding themselves and others seeking mental health help. These results contradict previously known research studies.(1,2) Most of the officers (n=244, 96.8%) fell within the low (n=141) and moderate (n=103) versus the high (n=8) mental distress groups. Statistical significance was found in 1) age and mental distress level, 2) gender on mental health help seeking attitudes, intentions, and stereotyping, and 3) years of experience and mental distress levels. Though the relationship between gender and help seeking attitudes was found to be statistically significant, it was not found to be clinically relevant.
The third manuscript was a qualitative study using a phenomenological approach and template analysis style for thematic analysis aimed at understanding police officer knowledge of available departmental and community-based mental wellbeing resources and perceptions of a variety of mental wellbeing resources (e.g., peer mentoring/support, critical incidence stress management, professional counseling, self-help using one-on-one semi-structured interviews. Results provided the officers valence of perceptions (positive, neutral, negative) regarding the mental wellbeing resources and reasons behind these perceptions, intrapersonal factors, barriers and facilitators to help seeking and resource participation. To our knowledge, this is the first time police officers 1) were asked about their perceptions regarding seven to nine mental wellbeing resources currently known to be used within the police population, and 2) three quantitative scales measuring help seeking behaviors and stereotyping within the police population
Broadening Access: Digitization and Transcription of the Waring Inaugural Theses since 2015
Get PDFThis presentation provides background to previous digital projects that were developed to provide richer context and to broaden access to the Waring Historical Library Inaugural Theses collection. As the project manager for a 2015 digitization project, which was funded by the National Network of Libraries of Medicine’s Express Digitization Award for the Waring to digitize inaugural theses written on the subject of yellow fever, Samuel discusses the outcome of this project and her development of an online platform to crowdsource the transcription of the theses digitized under the 2015 grant