MEDICA@MUSC (Medical University of South Carolina)
Not a member yet
1558 research outputs found
Sort by
Impact of the COVID-19 Pandemic on Stress and Burnout Related Experiences of the Infection Preventionists in the Greater Houston Area
Get PDFObjective: With many studies revealing that the pandemic created stress and burnout for physicians and nurses, these same stressors could have created mental and emotional challenges for the Infection Prevention staff at healthcare institutions. Efforts are needed to better understand the stress, anxiety, and burnout-related experiences that the pandemic created for these team members who worked in the greater Houston area between March 2020-September 2022.
Methods: This qualitative study used focus group sessions to obtain data. Two sessions were held in person and two sessions were hosted virtually. All sessions were audio recorded and transcribed. The transcripts were coded using Nvivo software. The general inductive approach as described by Thomas (2006) was the methodology used to develop the thematic framework from the data.
Results: A total of eleven codes were densely represented across all four sessions. From the eleven codes, four themes emerged to help set the framework for the results and serve as the outcome of the study. The four themes are as follows: (1) IP staff experienced drastic changes in their daily workflow, (2) IP staff experienced physiological symptoms and emotions, (3) IP staff supported the emotional state of the healthcare worker staff, and (4) IP staff felt organizational support but were not always direct recipients of appreciation efforts.
Conclusion: From the data we see a positive relationship between the impact of the work of the IP on the stress, anxiety, and burnout-related experiences during the pandemic. While the study participants contributed the change in workload to the feelings of stress, anxiety, and burnout, they also commented that the constant changes and the longevity of the pandemic exacerbated these feelings. In some cases, the IP staff developed physiological symptoms in response to the stress. In addition to managing their workload, they also commented that they were thrust into managing the emotions of the staff caring for the patients
Deciphering the N-Glycomic and Collagen Proteomic Molecular Signatures Towards Breast Cancer Control and Prevention
Get PDFBreast cancer is the most diagnosed cancer among women worldwide and the incidence rates are rising annually. The rates of metastatic breast cancer are projected to increase by 54.3% from 2015 to 2030. Breast stroma plays a significant role in breast cancer risk and progression yet remains poorly understood. In breast stroma, regulation of post-translational modifications (PMTs) is representative of the health state of the local microenvironment. Two abundant PTMs in the extracellular matrix include hydroxylation of prolines (HYP) and N-glycosylation in collagen and non-collagen proteins, respectively. Here, mass spectrometry imaging (MSI) was used to investigate the spatial N-glycomic and collagen proteomic patterns in normal breast microenvironments from women at high risk for breast cancer. N-glycomic analysis of normal breast tissue revealed that specific fucosylated and high-mannose N-glycan structures had intensity patterns and histological distributions in breast tissue that were dependent on body mass index (BMI), breast densities, and genetic-ancestry. Normal breast tissue from black women with heterogeneously dense breast followed fucosylated and high-mannose patterns as seen in primary breast cancer. Application of a linear regression model showed that lifestyle factors differentially associated with fucosylated and high-mannose N-glycans based on ancestry. Further, collagen proteomic analysis from normal breast tissue demonstrated that collagen peptides may be influenced by cell specific signaling within the local microenvironment. Post-menopausal women on aromatase inhibitors and sulindac, a non-steroidal anti-inflammatory drug, showed that changes in mammographic density associated with specific collagen peptide alterations including HYP-modified peptides. Analysis of histology-directed MSI using tumor suppressor PTEN revealed heterogeneous PTEN staining patterns associate with HYP-modified collagen peptides suggestive of potential roles in stromal protein regulation. Overall, the studies presented in this dissertation are the first to detail the N-glycan and collagen peptide spatial distributions on the normal breast microenvironment. Our findings demonstrate the relation between molecular PTM profiles and varying breast cancer risk factors. We anticipate that these studies will give rise to future studies looking at potential biomarkers in the breast NME towards breast cancer control and prevention
Assessing the Involvement of Projections from the Prelimbic Prefrontal Cortex to the Paraventricular Nucleus of the Thalamus in Cocaine Withdrawal-Induced Anxiety
Get PDFWithdrawal from cocaine induces an immediate and powerful negative affective state which is characterized by feelings of agitation and anxiety in humans and anxiety-like behaviors in rodents. It has been hypothesized that the anxiogenic effects associated with cocaine withdrawal play a major role in continued cocaine use and drive relapse to cocaine seeking. The prelimbic (PL) medial prefrontal cortex is not only involved in the processing and regulation of negative emotions such as anxiety but also mediates relapse to cocaine-seeking. Subcortical hubs of the reward system that receive projections from the PL neurons are known to be dysregulated during different stages of cocaine addiction, including withdrawal. One of the emerging and severely understudied subcortical targets of the PL cortex implicated in cocaine reward and relapse to cocaine seeking is the paraventricular nucleus of the thalamus (PVT). PL inputs to the PVT have been implicated in fear-induced anxiogenic behaviors as well as relapse to cocaine seeking. However, little is known about the contribution of PL--\u3ePVT in cocaine withdrawal-induced anxiety. Therefore, in this study, we explored the implications of chemogenetically inhibiting PL--\u3ePVT projections using a combinatorial AAV vector approach in the attenuation of cocaine-induced anxiogenic behaviors during early withdrawal from cocaine using an elevated zero maze (EZM) and an open field test (OFT). We hypothesized that cocaine withdrawal-induced anxiety-like behavior would be greater than that in saline control rats on the EZM and OFT tasks. Further, inhibition of the PL--\u3ePVT projection would attenuate cocaine withdrawal-induced anxiogenic behaviors and therefore decrease the probability of subsequent relapse to cocaine seeking. Additionally, we predicted that PL--\u3ePVT inhibition would not affect anxiety-like behavior in saline control rats. Results from our study demonstrate that PL--\u3epPVT inhibition decreased the latency to enter open arms but increased the number of explorations of the open arms in rats with cocaine experience compared to yoked-saline controls. In the same animals, inhibition of PL--\u3epPVT increased the time spent in the center of the open field in rats with cocaine experience. Together, our results demonstrate that the PL--\u3epPVT projection influences aspects of the anxiety phenotype associated with exploratory behaviors. Inhibition of the PLàPVT pathway during early withdrawal from cocaine attenuated withdrawal-induced anxiogenic behaviors and this inhibition did not affect baseline anxiety-like behaviors in control rats. Therefore, this study provides evidence for the involvement of the PL--\u3ePVT pathway in mediating cocaine withdrawal-induced anxiety
Examining Acute-Care Human Performance Trends During Disruption: A Mixed-Methods Study
No full textThe most important asset in a healthcare organization is the human workforce. Healthcare workers are highly educated and trained knowledge workers who use their skills to provide value to the organization by caring for patients in need. However, the disruption caused by the coronavirus (COVID-19) pandemic has not only changed the way care has been delivered by the healthcare workforce, but it has also changed the way patients perceive their care experience.
This dissertation expands the existing health services literature by exploring how employee engagement and patient experience has changed as a result of the disruption caused by the COVID-19 pandemic. Results from this dissertation pertaining to employee engagement and patient experience are consistent with previous studies. However, this work filled gaps in the literature as it relates to studies analyzing employee engagement and patient experience trends over time, in addition to advancing the literature by identifying best practices for engaging employees during disruptive times
Medicaid Expansion Case Study: Differences Between Florida and New York Medicaid Expansion Policy
Get PDFThe Affordable Care Act (ACA) expands healthcare coverage and improves healthcare delivery. While the ACA expands Medicaid coverage, many states have yet to expand. This paper utilizes a multi-state comparison case study comparing New York, a Medicaid expansion state, and Florida, a non-expansion state, to better understand Medicaid expansion decisions and influences in states. The case study identifies that the reasons behind these decisions are layered and complex; influences such as state political parties, lobbying, and overall state economics greatly influence Medicaid expansion policy