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Predictors of Overall Personal Achievements of Nigerian American Graduates Living in Four Texas Cities
Get PDFThe purpose of this quantitative study was to examine the relationships between some of the variables most cited in literature and the overall achievement level of Nigerian Americans in four Texas cities—Austin, Dallas, Houston and San Antonio. Specifically, this study investigated the variables that significantly affected and predicted overall achievements. The Nigerian American questionnaire (NAQ) was used to gather the data for this study. The NAQ survey instrument was developed using some questions from previously validated survey instruments. These instruments included COPE, CASE, SWLS and JSS, which were used to extract relevant variable-related questions for the present data. The variables covered by the extracted questions included coping skills, spirituality, job satisfaction, social media, parental influence and English proficiency among others.
The NAQ instrument was sent to all Nigerian Americans in the target population using both the traditional paper method and the online method. The research questions were addressed by performing the Pearson correlation, simple and multiple regression, the Kruskal-Wallis, the Mann-Whitney U test, and logistic regressions. The data was analyzed using the statistical software SPSS and R.
Results of the study indicated that coping skills, English proficiency, social media were individually, positively and significantly correlated with overall achievement. Spirituality was found to be significantly but negatively correlated with achievement. Additionally, the regression analysis showed that these variables were significant predictors of achievement. Coping levels and the use of social media were also found to significantly differ based on the field of study and gender. The logistic regression results indicated that the probability of obtaining a graduate degree was influenced by parental level of education and spirituality. There is a need for the results of the study to guide future government policies on Nigerian American migration as well as serve as a guide for future Nigerians panning to settle in the United States of America in understanding factors that affect their achievements in America
Welder’s Maculopathy; a Case Report
Get PDFBackground: Outer retinal damage can occur when excessive ultraviolet (UV) radiation reaches the retina. The most common etiology is from the sun, known as solar retinopathy, especially when individuals observe solar eclipses without appropriate eye protection. Another cause of UV retinopathy that is not frequently encountered in practice is arc welding, causing Welder’s Maculopathy. Fortunately, the prognosis of the UV retinopathies is quite favourable, as many fully recover after the initial insult to the retina. This retrospective case review aims to outline the clinical manifestation of this maculopathy and current opinions on its etiology and diagnosis.
Case Report: A 45-year-old patient presented for a comprehensive eye examination with an occupational history of arc welding. Best corrected visual acuities were 20/20 OD, OS. Dilated fundus examination revealed central red macular retinal pigment epithelium (RPE) disruption in the right and left eyes. Spectral domain optical coherence tomography (SD-OCT) demonstrated no defects OD and foveal loss of the ellipsoid portion of the photoreceptor inner segment (ISe) band with atrophy in the RPE OS.
Conclusion: Welder’s Maculopathy is an established, but infrequently encountered, cause of UV retinopathy. Most cases are self-limiting and cause no long-term functional sequelae. SD-OCT findings from photochemical injury to the photoreceptors and RPE lead to a box-shaped outer retinal hole that can interrupt the ISe band; which is a determinant of visual prognosis. Careful occupational education should be discussed with each patient
Implementing a Cognitive Impairment Care Planning Toolkit to Enhance Dementia Care: A Quality Improvement Project
Get PDFBackground: Alzheimer’s is the most expensive disease in the United States with costs reaching $277 billion a year and affecting 5.7 million Americans. By 2050, 14 million Americans will have Alzheimer’s disease and related dementias (ADRD). This burdensome disease not only affects the individual, but also those who are responsible for their care, making it extremely complex to manage. Purpose: To systematically integrate the Alzheimer’s Association’s Cognitive Impairment Care Planning Toolkit in an outpatient mental health clinic to enhance care by effectively addressing the needs of patients with ADRD and of their caregivers. Objectives: Increase the number of patients with ADRD and/or their caregivers screened using the validated, standardized assessment tools found within the toolkit; increase the number of patients and/or caregivers who were identified as having unmet need(s) that received appropriate follow-up referrals; increase the number of written care plans formulated from the comprehensive assessment; and increase revenue by utilizing billing CPT code 99483. Results: Conducting a person-centered comprehensive assessment and care plan was beneficial in enhancing care by addressing the complex needs of this population. It helped identify needs such as neuropsychiatric symptoms, patient and caregiver depression, functional and environmental safety concerns, and caregiver stress. It also improved documentation for care planning, and increased revenue collection. Implications for practice: This toolkit allowed for holistic management of patient outcomes. Clinicians were able to customize treatment plans to tailor individual patient needs from to the multi-component assessments
Increasing the Incidence of Referrals and Execution of Diabetic Eye Examinations in a South Texas Primary Care Clinic
Get PDFDiabetes is a significant public health problem, decreasing quality of life, causing disability and death (CDC, 2017; Foos et al., 2015; Grover & Joshi, 2015). Uncontrolled diabetes can lead to several eye complications including retinopathy and blindness (ADA, 2013; Liu & Swearingen, 2017). As the number of people afflicted with diabetes rises, the need for diabetic eye examination screenings also increases to prevent disability, improve quality of life and prevent blindness (ADA, 2018; Fisher et al., 2016; Garber et al., 2015; Raman et al., 2016).
The purpose of this project was to increase the rate of diabetic eye examination referrals, completion of diabetic eye examinations and documentation of results in the medical records. The objectives were to improve diabetic eye examination referrals by 30% and increase the referral loop closure by 40%.
Interventions included 2 training changes, 3 clinic processes changes, 4 EMR changes and 4 paper resource changes. Nine of 13 interventions were successfully implemented.
Results showed either a marginal improvement or a regression in the number of diabetic eye examinations. Although this project failed to meet the objectives, a great deal was learned about clinical practice guidelines.
More quality improvement projects are needed to identify strategies that will help increase the number of annual diabetic eye examinations that are performed in the clinical practice setting. Projects like this help identify barriers to improved health care such as patient motivation to adhere to treatment recommendations
Ozone Induced Effects on the Mammalian Visual System
Get PDFResearch Focus. Millions of people who suffer from retinal disease live in air-polluted environments. The impact of the gaseous air pollutant ozone (O3), a strong oxidant, on the retina is unknown. The aim of the present study is to compare the electroretinographic responses between control (no O3 exposure) and O3 -exposed rats and to better understand the effects of O3 on retinal function.
Materials and Methods. Age-matched adult female rats were separated into two groups (N = 6), 3 control and 3 experimental. The experimental group was exposed to 0.4 ppm O3 for 4 hours a day for 7 days in an environmental chamber. Control rats were not exposed to O3. Rats were dark-adapted for a minimum of one hour. ERG recordings were performed under general anesthesia (ketamine 70 mg/kg, xylazine 2.5 kg/mg IP). Active electrodes, which are designed to be used in rats, were placed on each cornea. Reference and ground electrodes were placed subcutaneously in the rat’s forehead and scruff, respectively. Pupils were dilated and a topical anesthetic applied to each eye (2.5% phenylephrine and 1% tropicamide). Lubrication and proper conductance of the active electrodes were maintained with lubricating eye drops (Refresh). Atipamezole 0.8 mg/kg was administered to reverse the effects of the xylazine.
Research Results/Findings. Experimental data indicates, in the scotopic ERG, a sub-chronic exposure to O3 significantly (p \u3c 0.05) decreased Vmax from 361.2 mV in the control group to 323.6 mV after an acute O3 exposure. A 7-day O3 exposure further decreased Vmax to 224 mV (p \u3c 0.05). Amplitudes of the a-wave decreased significantly (p \u3c 0.05) from – 221 mV in the control group to – 145 mV in the 7-day O3-exposed group.
Conclusions from Research. This present study has demonstrated that an acute and sub-chronic exposure to the air pollutant, O3, disrupts retinal function as demonstrated by changes in the ERG response. The rod dominated dark-adapted system appears to be altered as evidenced by the reduced a-wave and b-wave ERG amplitudes. The peak a-wave amplitude mostly reflects rod photocurrents plus postreceptoral contributions, thus O3 exposure appears to decrease rod function. The decreased peak of the b-wave amplitude suggests ozone lowers the currents from depolarizing rod bipolar cells. This clinically significant work demonstrates O3-induced oxidative stress aggravates retinopathies and contributes to vision deficits in sensitive populations living in air-polluted environments
Public High School Principals’ Perceptions of Leadership Strategies for Improved School Performance
Get PDFThe purpose of this study was to explore what leadership behaviors and strategies public high school principals perceived to be most effective in achieving school improvement. The qualitative constructivist grounded theory research methodology used for the study was modeled after the work of Kathy Charmaz (2014), who acknowledges that the researcher is a part of the process, as observer, data collector, analyzer, and interpreter of the data. Data were gathered through one-on-one interviews with six principals from high schools with student populations of 1,200 or more whose schools showed improvement based on state standardized test scores and whose high schools were located in the metropolitan area surrounding the university where the researcher studied. The central research questions were: (1) How do public high school principals, who have been identified by the researcher as achieving school improvement, describe their leadership? and (2) Which of their leadership behaviors and strategies do the public high school principals perceive to be most effective in achieving the desired school improvement? Through coding and analysis, five common themes were identified, based on the converging perspectives of the participants. The common themes form the foundation of the grounded theory that emerged from this study. Fiedler’s Contingency Theory (1967), the theoretical framework for this study, defined leadership effectiveness in terms of group performance and the ability of the group to achieve its goals, and that theory was supported throughout the study. The participating principals facilitated strategies that were carried out by teams of administrators and teachers who were committed to school improvement, and the school improvement was measured by group performance and the ability of the group to achieve its goals. The school improvement theory that emerged from the data presents that five leadership strategies support school improvement and improved student learning and achievement. Those behaviors and strategies include (1) hiring and developing quality teachers; (2) setting and accomplishing campus goals (3) building relationships; (4) employing communication tactics; and (5) building effective teams. Perhaps most significant to this study are the importance of the school environment and culture and the principal’s ability to influence that environment and to facilitate the strategies identified in the common themes. The researcher suggests that building and sustaining a healthy and positive school culture is a collaborative process that is essential to accomplishing and sustaining school improvement. The principal leader is in a position to facilitate the change required to build a student-focused, collaborative culture. The key is to create the vision collaboratively, to define the desired culture together, and to undertake the work required to achieve the desired results as a campus team. As the school’s leader, the principal serves as facilitator. With the theory that the environment and culture create the foundation for school improvement and sustained student achievement, a model, grounded in the data, emerged
Biotransformation of Praziquantel by Cunninghamella elegans, Umbelopsis ramanniana, and Yarrowia lipolytica Metabolism
Get PDFSchistosomiasis is a neglected tropical disease rampant in developing countries. Widespread chemotherapy is reliant on a single drug, praziquantel, which increases the risk of resistance and creates an urgent need for the development of new alternatives for treatment. Fungal biotransformation is a well-documented tool in the pharmaceutical synthesis of new drugs. This study examined the efficacy of four fungal strains, Cunninghamella elegans (ATCC 9245 and ATCC 8688a), Umbelopsis ramanniana, (ATCC 9628) and Yarrowia lipolytica (ATCC 20225), in the biotransformation of praziquantel. Colonies were cultured, dosed with praziquantel, incubated for 5, 10 or 15 days to metabolize, after which the cultures were filtered, metabolites extracted and subjected to HPLC analysis. Once the optimal time for metabolization was ascertained cultures were exposed to variable drug doses, either single or double. C. elegans, ATCC 8688a, fully metabolizes praziquantel after 15 days producing major peaks at 4.7 and 4.3 minutes; and responded more efficiently to a double dose. After 15 days C. elegans, ATCC 9245, had metabolized the majority of praziquantel producing major peaks at 4.7 and 4.3 minutes, and was equally efficient with an increased dose. U. ramanniana, fully metabolizes praziquantel after 10 days producing major peaks at 4.9 and 4.5 minutes, however, failed to produce metabolites with increased dosage. Y. lipolytica, showed negligible metabolic activity. The praziquantel peak remained relatively unchanged at 8.1 minutes for each time course and was not exposed to variable doses. Purification of the mixture and further testing is required to identify the metabolites obtained
Welcome Readers
Get PDFInterim provost would like to welcome you as readers to our new journal, Optometric Clinical Practice
Genetic Screening for Breast Cancer in the Primary Care Setting
Get PDFThe purpose of this project was to increase adherence to the U.S. Preventive Services Task Force and National Comprehensive Cancer Network guidelines for breast cancer screening and genetic testing. Screening for breast cancer risk factors including genetic testing helps reduce the incidence of breast cancer. A protocol was developed based on national clinical guidelines to increase screening and genetic testing for breast cancer. Provider responsibilities included screening all patients 18 years of age and older for risks factors of breast cancer, referring patients with a significant risk based on the screening for genetic testing and providing referrals for genetic counseling once genetic testing was complete. One hundred fifty-four (47%) of the patients meeting inclusion criteria were screened with 25 (19%) having a positive screen. Fourteen (56%) patients with a positive screen opted for genetic testing, one patient was confirmed having a clinically significant mutation in the BRCA1 gene. One of these patients was identified as having a 35% remaining lifetime breast cancer risk and one patient was identified as having a non-clinically significant mutated gene. Three patients were referred to genetic counseling. One patient followed up with a genetic counselor. Ten (25%) patients meeting genetic testing criteria declined testing. BRCA gene mutations are associated with breast cancer as well as ovarian, melanoma, pancreatic, and prostate cancers. Providers and patients need additional education on the benefits of genetic testing in identifying patients at risk for breast cancer. Early detection and implementation of preventative measures can help reduce morbidity and mortality rates
Improving Residential Asthma Assessment Strategies Within a Low Socioeconomic Community
Get PDFBackground: Nationally, there are currently 6 million children under the age of 18 with asthma. There are a variety of social determinants and in-home environmental triggers that can contribute to the development of or exacerbation of asthma in children. Therefore, it is important to recognize and improve the needs of children with asthma in older homes and in households with a lower socioeconomic status.
Aim: The aim of this project was to decrease the number of in-home environmental asthma triggers within at-risk homes in San Antonio, Texas.
Purpose: The purpose of this evidence-based practice project was to improve asthma outcomes for children in lower socioeconomic homes in the Bexar County area.
Key Activities: Three in-home visits, for a total of five families were completed, during which three different assessments were performed. These assessments were completed by using the Environmental Protection Agency Environmental Checklist, a knowledge test pre and post scores, and the total score of the Asthma Control Test. In-home assessment tool will increase surveillance of asthma triggers and ultimately decrease the negative health outcomes related to asthma in children.
Results: Objective one there was a 0% improvement in the Environmental Protection Agency Environmental Checklist scores for all five families. Objective two did not meet the 50% and 75% increase did not occur, as the families all did so well to begin with. Objective three also did not meet the 50% or 75% anticipated changes, but there were changes between each visit in 4 out of the 5 families