Promoting Engagement of Male Individuals with Alzheimer’s in a Memory Day Care

Alzheimer’s and related dementias impact an individual\u27s cognitive, psychological, social, and physical functions resulting in impairments within the engagement of activities. Activities offer many therapeutic benefits including improvements in mood, alertness, communication, socialization, sleep, cognitive function, and quality of life. The focus of this quality improvement capstone project was to address the decreased level of engagement in male members within a memory day care center setting through engaging them in male-tailored activities. The project included the development of a website that provided tailored male-oriented activities and educational resources that were shared with the staff to revise their day care activity program, as well as with caregivers to increase activity engagement at home. The outcomes of the project revealed male participation increased, with observable signs of increased energy level, affect, attention, engagement, and communication. Additionally, all of the staff and the majority of caregivers reported satisfaction with activities provided, and increased comfort and confidence in initiating the implementation of activities in the future. Therefore, successful implementation of male-tailored activity program within the day care and successful distribution of resources to caregivers and staff that promote the engagement of male members in activities occurred

Increasing Social Inclusion and Engagement of Exercise for Individuals with Spinal Cord Injuries: A Universal Resource Development for Wellness Facilities

Individuals with spinal cord injuries (SCIs) are 1.5 times more likely to disengage in exercise one-year post-injury despite 80% of these individuals agreeing that exercise is critical to their overall health and quality of life (Baehr. Et al., 2022). A needs assessment was conducted on why the lack of engagement in exercise exists for individuals with SCIs within fitness facilities to identify barriers preventing participation. A quality improvement program called the Spinal Cord Injury Wellness Toolkit was created based off these findings and implemented at the MUSC Wellness Center. 14 individuals with SCIs participated at wellness center; REDCap surveys were given before and after their visitation. It was found that participant’s overall confidence in the wellness facility, gym equipment, exercise knowledge, and staff awareness of SCI precautions showed a significant increase. Thematic analyses from post-implementation surveys showed that participants agreed the toolkit provided security & safety, showed adaptability, provided various kinds of equipment, versatile, easily understood, catered to a wide variety of injury levels, and increased confidence & quality of life. Feedback was taken into consideration to create a final copy, which was then copyrighted. The wellness program was disseminated to the MUSC Wellness Center and other fitness facilities, hospital-based therapy facilities, MUSC research affiliates, and SCI support groups within SC. This toolkit will further be distributed across the US to increase overall social inclusion and exercise engagement for individuals with SCIs

The Development of Intervention Toolkits for Non-Specialized Personnel and Families of Children with Autism Spectrum Disorder in La Paz, Bolivia

INTRODUCTION: There has been an increase in the understanding of autism-spectrum disorder (ASD) and corresponding occupational therapy (OT) interventions; however, much of this has yet to be implemented in several resource-limited countries, including Bolivia. Parent-mediated interventions (PMIs) are being heralded as a promising approach to address this gap. Through the creation of toolkits for non-specialized personnel (e.g., parents, teachers), the purpose of this quality improvement (QI) project is to enhance the occupational engagement and quality of life for children with ASD and their families in La Paz, Bolivia. METHODS: Pre-surveys were administered to parents of children with ASD at the sites to determine beneficial topics for the toolkits. Post-toolkit development, a self-report questionnaire was administered to healthcare professionals who reviewed and will distribute the toolkits to nonspecialized personnel. These surveys consisted of a variety of question types to acquire data, which was analyzed using both quantitative and qualitative methods. RESULTS: The findings indicate that the toolkits were found to be helpful, and the healthcare providers plan to share them with other non-specialized personnel. Qualitatively, there were reports of the toolkits being useful and easy to replicate; however, concerns were presented for ease of mass dissemination and comprehensibility for parents. CONCLUSION: This toolkit intervention for non-specialized personnel is viewed as a helpful and effective option among healthcare providers in Bolivia for reducing the gaps surrounding access to clinic-based services. The QI project supports the targeted goal for this population, and the sustainability allows for the continuation of this project

Role of Centrosomal P4.1 Associated Protein (CPAP) in Tumor Suppression

In eukaryotic cells, centrosomes are membrane-less organelles that function as the primary microtubules organizing center with a crucial role in cell division. For accurate bipolar spindle assembly and genetic transmission between generations, fidelity in centriolar duplication is critical. Disruption in this process can cause genomic instability, which could then lead to conditions like aneuploidy, a common feature of various cancers. Among the numerous proteins associated with mammalian centrioles, the centrosomal P4.1 associated protein (CPAP) stands out for its essential role in regulating centriole duplication. Dysfunctions in CPAP have been linked to abnormalities in centriole length that can contribute to conditions ranging from ciliopathies, immune dysfunction, and cancer. Recent discoveries in our lab have shed light on CPAP\u27s involvement in endocytic vesicular transport and are investigating its implications in cancer control. Specifically, defective CPAP function in oral cancer cell lines has been associated with constitutive signaling through the epidermal growth factor receptor, heightened epithelial-mesenchymal transition (EMT), and enhanced spontaneous tumorigenic properties, suggesting a potential role for CPAP as a tumor suppressor protein. Building on these findings, my research aimed to investigate the impact of CPAP dysfunction on tumorigenesis, by utilizing a hypomorphic mouse model. We evaluated the EMT features of both, primary and immortalized, lung as well as tongue-derived fibroblasts from these mice. In addition, we have also assessed the CPAP-deficient mice for their susceptibility towards spontaneous and induced tumors. Through my investigation, we seek to deepen our understanding of CPAP\u27s role as a tumor suppressor and its broader implications for cellular health

An Analysis of Inpatient and Outpatient Radiofrequency Cardiac Ablation: Quality Outcomes and Reimbursement

Background Radiofrequency ablation for the treatment of atrial fibrillation currently stands as the first line therapy for the condition. The therapy is a costly means of managing the disease, with both inpatient and outpatient coding options in the hospital. A major determinant ablation readiness and status of the patient still remains in the physician’s discretion, and outcomes may not be aligned with the status of patient at the time of the ablation. Shifting these patients to an outpatient ablation status may create significant savings if the outcomes are equivalent. Results A total of 87 new onset AF patients were sampled and monitored post ablation. Recurrence rates for markedly higher for those in the inpatient setting (14.2%) over the course of a year versus the inpatient cohort (8.2%). Similar findings were observed in readmission rates, whereas the inpatient cohort reflected a higher incident of readmission post ablation within the course of a year versus that of the inpatient cohort (14.2% vs. 2.6%). Conclusion Although there is a need for an inpatient billing paradigm, stabilizing a new onset AF patient and shifting them to the outpatient setting can and create significant savings to Medicare while still maintaining the same quality of care

Home Health Utilization and Health Outcomes for Medicare Fee for Service Survivors of Acute Ischemic Stroke

Not all survivors of acute ischemic stroke (AIS) discharged home after hospitalization with a HH referral receive HH and some survivors discharged home to self-care receive HH. Broad population level HH utilization pattern studies are needed to assure optimal access to HH. Three retrospective observational cohort studies describe HH referral patterns, use, and cost, comparing those discharged home to self-care vs. discharged home with a HH referral. Thirty day hospital readmission rate, demographics, and diagnoses for a subset of 251 survivors are described. Survivors who were older, female, Medicaid eligible, or had a greater comorbidity burden were more likely to receive a HH referral. A subset with HH and a HH referral received HH sooner, had a more complex inpatient stay, and a more severe stroke than those discharged home to self-care. Those with severe strokes referred home to self-care had 5 more HH visits. Hospital readmission rate was 21.9%, averaging $14,046. Approximately half were readmitted prior to receiving HH, 73.3% for recurrent stroke or stroke-related complications. These results show a need to examine referral practices to identify opportunities to improve fit between HH referral and HH use and support future study of hospital discharge and community follow up processes

Assessing the Types of Juvenile Detention Medical Issues: A Focus on Florida

The justice system for young people in the United States has been a source of worry as more people acknowledge the possible adverse outcomes of involvement in the justice system during adolescence. Involvement with law enforcement can lead to various difficulties for young people, such as heightened susceptibility to psychological problems, interruptions in their education, and reduced prospects for achievement in the future. Hence, it is crucial to understand the interplays between the health care for juveniles referred by courts or law enforcement for hospital care to identify opportunities for process and outcome improvements. The interaction between juveniles and the criminal justice system has garnered noteworthy consideration in contemporary times owing to its impact on the welfare and growth of young people. Documenting the trends of juvenile admittance and release between medical care and law enforcement is vital in creating efficient policies and interventions to meet their requirements and diminish their engagement in the legal system. This study aims to provide statistics regarding adolescents taken into custody by law enforcement who required hospital care in Florida. The analysis will concentrate on the instances where these youths, ages 10-18, were brought to the emergency department or admitted to a hospital in 2018