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STUDENT PERCEPTIONS OF MAJOR HEALTH NEEDS OF ADULT REFUGEES FROM UKRAINE
No full textPerceptions of Major Health Needs of Adult Refugees from Ukraine
Neha Makanangot
Mentor: Larson, Kim L
Purpose: This study aimed to examine the perceptions of the health needs of war-affected adult refugees from Ukraine.
Significance: Ukrainian refugees affected by war confront formidable obstacles when attempting to access essential healthcare services and effectively manage chronic health conditions, including cardiac problems and cancer. These challenges are exacerbated by the upheaval caused by displacement, forcing individuals to navigate unfamiliar healthcare systems in their host countries. Moreover, the resources available for healthcare in these settings are often constrained, further impeding refugees' ability to receive timely and comprehensive medical care. Understanding the healthcare needs of this vulnerable population is imperative to prevent potential health crises and ensure the provision of culturally competent care by nurses and healthcare workers in the future.
Methodology: This qualitative descriptive study, conducted as part of a larger mixed-methods research project titled "Intercultural Nursing Care for the Health and Well-being of Ukrainian Refugees." Nursing students from ECU (n=7) and JU (n=11) in Poland met in synchronous class sessions for a Global Health International Virtual Exchange course. Students submitted reflection papers after each of five class sessions, these reflections (180 pages) generated data for this study. Data management included creation of 18 transcripts and a codebook. Analytic techniques included data matrices, content and thematic analysis.
Results: The study identified three primary categories: vaccine-related issues, a compromised healthcare system, and the burden of disease. Vaccine-related issues included concerns like vaccine delays, mandatory vaccines, hesitancy, and the anti-vaccination movement. The weakened healthcare system encompassed challenges such as limited access to free health insurance, inefficiencies in the Polish healthcare system, and a nursing shortage. Lastly, the burden of disease highlighted preventable, communicable, and chronic illnesses affecting Ukrainian adults.
Discussion: The study's findings highlight the multifaceted challenges facing the health of Ukrainian refugees. Vaccine-related issues reveal barriers hindering immunization acceptance, while the recognition of a compromised healthcare system emphasizes systemic deficiencies in healthcare delivery. Additionally, the burden of disease highlights the urgent need for comprehensive healthcare interventions. These results emphasize the importance of implementing targeted strategies to address healthcare access barriers, improve vaccination rates, and alleviate the impact of preventable diseases on the well-being of Ukrainian refugees
Defining the Metabolic and Regulatory Properties of the mdo Operon in Pseudomonas aeruginosa PAO1
No full textPseudomonas aeruginosa PAO1 is an opportunistic human pathogen that is especially problematic for individuals with cystic fibrosis and immunocompromised patients. It is a leading cause of nosocomial infections and is responsible for 10% of all hospital-acquired infections. The CDC classifies the organism as a serious threat mainly due to its emerging development of multidrug resistance. Several virulence factors contribute to P. aeruginosa PAO1 pathogenicity including hydrogen sulfide. Sulfide (HS-) at sub-micromolar concentrations protects P. aeruginosa PAO1 from antibiotic-induced oxidative damage and host-produced reactive oxygen species. However, elevated sulfide levels result in cellular toxicity and affect the organism’s ability to form a biofilm. Therefore, HS- concentrations must be tightly regulated to balance the potential toxicity with bacterial virulence. In several organisms, toxic levels of HS- are converted to usable sulfur forms by the combined actions of dioxygenases and sulfurtransferases. Increased levels of HS- results in the formation of low molecular weight persulfides which are the substrates for the sulfide oxidation enzymes. In P. aeruginosa PAO1, enzymes expressed on the mdo operon have been identified but their mechanism of action and metabolic roles have not been elucidated.
In P. aeruginosa PAO1, the mdo operon expresses 3-mercaptopropionate dioxygenase (MDO) and a sulfurtransferase (ST). MDO was initially characterized as utilizing 3-mercaptopropionate (3MPA) as a substrate; however, P. aeruginosa PAO1 could not utilize 3MPA in microbial growth studies to ascertain the physiological relevance of the thiol substrate. MDO was able to oxidize 3-mercaptopyruvate (3MPR), which is a physiologically relevant substrate and can also be linked with ST activity. Even though MDO is expressed from the same operon as an annotated ST, the functional role of the ST enzyme has not been recognized. ST enzymes have conserved cysteine residues that mediate sulfur transfer from a sulfur donor to a sulfur acceptor. These sulfur donors and acceptors are usually low molecular weight thiols that are ubiquitous in cells. The ST expressed on the mdo operon has four rhodanese domains with two of the domains containing putative catalytic Cys residues (Cys191 and Cys435) with the potential to mediate sulfur transfer through an enzyme cysteine persulfide intermediate. Cys435 was the only accessible thiol in thiol assays. Results from HDX-MS investigations supported a more solvent-accessible region surrounding Cys435. The accessible thiol was identified as Cys435 in HDX-MS investigations, which corresponded to the role of this residue as the sulfide mediator. Only Cys435 formed a persulfide intermediate with either thiosulfate or 3MPR as the sulfur donor in cysteine persulfidation assays. These studies support Cys435 as the catalytic cysteine with thiosulfate and 3MPR serving as the sulfur donor. ST showed a similar affinity for 3MPR and 3MPA suggesting that each substrate could serve as a putative sulfur acceptor for the enzyme to form a persulfide. MDO was able to oxidize the persulfides of 3MPA and 3MPR, suggesting a metabolic link between MDO and ST. Although 3MPA could bind ST and serve as a substrate for MDO, it was not a viable sulfur source in growth studies.
Proteomic studies were performed to identify the changes in protein expression when the organism was grown in sulfur-free media supplemented with sulfide. When P. aeruginosa PAO1 is under sulfide stress, the genes that were high in abundance were those involved in biological processes including amino acid breakdown, arginine deaminase pathway, and tRNA metabolism amongst other pathways. The data from these investigations point to the potential of the enzymes of the mdo operon to mobilize and assimilate sulfide in P. aeruginosa PAO1 thereby enhancing its viability and pathogenicity. Understanding the strategies for the acquisition of sulfur from less preferred sources and their regulation provides insights into the metabolic versatility and pathogenicity of P. aeruginosa PAO1, highlighting potential targets for therapeutic interventions
The Pitt Perspective Podcast
No full textThe Pitt Perspective is an interview-based podcast created to share the stories of minority communities located in Pitt County, North Carolina. Research done by our group showed us that Pitt County’s current local histories often miss important information regarding events that have affected various marginalized communities in the area. Our goal has been to amplify the voices of these communities in order to assist in the healing of those that have faced generations of subjugation
Impact of a Home Telehealth Heart Failure Outpatient Order Set on Veteran Hospitalizations
No full textCongestive heart failure (CHF) admissions are above the national Veterans Affairs (VA) benchmark at a large health care facility serving Veterans in Western North Carolina (WNC)
The VA has outpatient home services, including telehealth, that can manage CHF patients and avoid hospitalizations
This project updated the home telehealth (HT) consultation form to include blood pressure and target weight range goals for Veterans with CHF in the outpatient setting.
After the intervention HT received fewer consults and only 9% of the forms included weight and blood pressure goals
It was discovered that registered nurses can place CHF consultations to HT which increases patient access to care
Providers and nurses need education regarding establishing CHF blood pressure and target weight goals to improve CHF care for VeteransD.N.P
THE BEAMING SUN: THE EFFECTIVENESS OF IMPERIAL JAPANESE RADAR AGAINST UNITED STATES AIRCRAFT DURING THE BATTLE FOR SAIPAN
No full textThis thesis endeavors to examine WWII-era Japanese radar emplacements and decipher the technology used during the battle for Saipan in 1944 in order to understand United States (US) aircraft losses. These Japanese search and fire-control radar emplacements allowed the detection and destruction of dozens of US aircraft through anti-aircraft fire on an unprecedented level. The thesis provides the first narrative of the US's underestimation of the effectiveness of Japanese radar capabilities and how it relates to the location of submerged aircraft. This thesis primarily utilizes archival research, archaeological survey, geographic information system (GIS) analysis, and predictive modeling to locate Japanese radar emplacements and downed US aircraft. The archival research includes obtaining Japanese and US radar technology documentation, US Navy after-action reports, and US and Japanese maps and intelligence reports of Saipan's defensive fortifications. An archaeological survey was conducted in Saipan at "Radar Hill," Naftan Peninsula, Mañagaha Island, and other potential locations of Japanese radar emplacements. Archeological data from the 2019-2023 East Carolina University/Defense POW/MIA Accounting Agency (DPAA) mission was utilized as a part of this research. The locations of lost US aircraft located in Tanapag Harbor and around Saipan were mapped, and a GIS model was created and analyzed to identify specific aircraft and any correlation they may have to the Japanese radar and anti-aircraft emplacements. Ultimately, this research attempts to predict the potential for aircraft losses in relation to radar location and range, thus contributing to site locations and individual site formation. Japanese radar technology is a severely neglected technological innovation in the historical record of the Pacific War, and Saipan and its archaeological signature provides a case study to examine its effectiveness
Optimizing Procedural Room Utilization
No full textSurgical services depend on the efficiency and optimization of each of their surgical suites. Case delays and cases that run-over play a big part in disrupting the scheduling process. The Special Procedure Unit (SPU) services pediatric patients, and it is vital that their procedures are completed on time. Cases must start and end on time to treat the maximum number of patients possible. The SPU must partner with the preoperative unit to identify barriers to patients arriving at the SPU on time for their procedure. A surgical readiness checklist allows the SPU and preoperative unit to identify barriers to patients arriving at the SPU on time. In the electronic medical record (EMR) documentation through EPIC, there are lists of barriers the perioperative unit can fill out that can be captured in reports. Case runover can also create delays in the following cases. Case run-over is an inappropriately scheduled case; with the help of preference cards, EPIC can calculate a provider's last five specific cases and give an accurate posting time for the case to get scheduled. By using the surgical checklist and the preference cards, it was the intention of this project to improve the efficiency of the procedure suites and optimize the scheduled block time to see the maximum number of patients per surgical day. Results from the project showed a reduction in delays by 164 minutes, which was a 23% improvement. There was also a reduction in run-over time by 249 minutes, noting a 57% improvement
THE IMPACT OF CHILDHOOD SOCIAL SUPPORT AND ENVIRONMENTAL UNPREDICTABILITY ON ATTACHMENT STYLES
No full textThis study explores the relationship between perceived childhood social support (pCSS) and unpredictability in childhood environments (i.e., household/school instability) with adult attachment styles among 135 volunteer participants from Introductory Psychology classes at East Carolina University (ECU). Utilizing a confidential online survey, we measured various aspects of participants' childhood experiences, attachment styles, and demographic information, employing established psychological scales. We hypothesize that higher levels of pCSS are positively associated with secure attachment styles in early adulthood. Regression analyses generated by working with ChatGPT 4.0 will be conducted to examine these relationships. The findings, and their implications for psychological interventions targeting attachment-related issues, will be discussed
MADCAM-1 and TNF-α Expression Reduced in GPR4 Knockout Mice Given Immune Checkpoint Inhibitor Immunotherapy
No full textImmunotherapy medications have become very common in the field of oncology as an effective treatment against many forms of cancer. Patients who begin immunotherapy sometimes develop immune adverse-related events (irAEs), such as colitis or inflammation of the colon, forcing them to pause treatment temporarily or indefinitely. The occurrence of inflammation has been linked to pH-sensing G-protein coupled receptors (GPCRs), specifically GPR4, which acts as a pro-inflammatory receptor expressed mainly in vascular endothelial cells and blood vessel-rich tissues. Inflammatory cytokine TNF- is commonly upregulated in inflamed tissues containing the GPR4 receptor. Mucosal adhesion cell adhesion molecule-1 (MAdCAM-1) is also upregulated during inflammatory responses and is only expressed in mucosal or sub-mucosal regions of the colon, making the molecule a desirable target for preventing colitis. MAdCAM-1 interacts with leukocyte integrins on the cell's surface to direct leukocyte infiltration, further exacerbating inflammation.
It was hypothesized that the lack of GPR4 could downregulate inflammatory cytokine TNF- and endothelial cell adhesion molecule MAdCAM-1 expression in inflamed tissues, leading to a decrease in the severity of immunotherapy-mediated colitis. Our results show that mice who contain the GPR4 receptor and were given an immune-checkpoint immunotherapy medication had increased TNF- and MAdCAM-1 expression compared to GPR4 knock-out and immunotherapy control groups. In the absence of GPR4, the severity of colitis was significantly reduced, as well as the levels of TNF-- and MAdCAM-1 expression. Conclusions from this research could be used in developing antagonists specifically targeting the GPR4 receptor as a possible approach to lessen the severity of colitis
ASSOCIATION BETWEEN BINDEX® ULTRASOUND AND DXA BONE PARAMETERS
No full textStudy Design. Observational analytic cohort study
The Bindex® device is a quantitative ultrasound device that calculates cortical thickness of the tibia and provides a density index (DI), which is an estimate of hip bone mineral density (BMD). This study assessed intra- and inter-session reliability of the Bindex® cortical thickness and DI measures at the proximal, mid, and distal tibia in young, physically active women at risk of bone stress injury. Our results indicate within session and between session agreement was good to excellent for tibia cortical thickness and DI measures, with ICC values ranging from .77 to .990. Associations between the Bindex® DI measures and BMD measures by dual-energy x-ray absorptiometry (DXA) were assessed, as well as associations between Bindex® cortical thickness measures and hip structural characteristic measured by DXA. Moderate correlations were found between the DI and whole-body BMD, femoral neck BMD, and total BMD, with ICC values ranging from .504 to .685. Associations between Bindex® derived measures and DXA measures were strongest at the proximal tibia with ICC values from .547 to .713. The results show that the Bindex® device is reliable within and across measurement sessions. With further study, the Bindex® device may be used in a young, physically active female population as s screening tool of bone health characteristics
MINDFULNESS-BASED VIRTUAL REALITY IN COMBINATION WITH EXPRESSIVE WRITING TO DETERMINE THE IMPACT ON ANXIETY AND MENTAL HEALTH IN COLLEGE STUDENTS
No full textAnxiety is not just a diagnosis that an individual can receive, it may be a state of thinking in a specific moment, a perception of how the individual is feeling towards a specific situation, individual, or environment (Wang et al., 2020). Anxiety, if left untreated, may develop into a life-long struggle with mental health disorders. Untreated mental health disorders and increased levels of anxiety may result in elevated blood pressure and increased resting heart rate, which can both in turn, decrease quality of life and expose the individual to increased rates of heart attack, stroke, and even death (Any anxiety disorder, NIMH). Interventions are needed to improve and prevent the development of anxiety-related health disorders. Mindfulness-Based Virtual Reality (MBVR) and Expressive Writing (EW) are both interventions currently used to reduce and minimize symptoms of anxiety. In this randomized controlled study, the efficacy of combining MBVR and EW in reducing symptoms of anxiety in college students was tested by comparing individuals in the experimental group, who received the MBVR/EW intervention compared to a control group who received a nature-audio VR program and objective writing. The State Trait Anxiety Inventory (STAI) was used to measure participants' state and trait anxiety pre- and post-intervention. Results from state measures demonstrated the use of MBVR/EW as a way to reduce and minimize anxiety symptoms. Implications of this study include the potential expansion of applications of the combined interventions as a treatment modality