eScholarship@UMassChan
eScholarship@UMassChan is a digital archive for UMass Chan Medical School's research and scholarship, including journal articles, theses, datasets and more. We welcome submissions from our faculty, staff, and students. eScholarship@UMassChan is a service of the Lamar Soutter Library, Worcester, MA, USA. See also our open access journal publishing services.
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Recent Publications
Publication Exploring Racial Microaggressions in Baccalaureate Nursing Education: A Qualitative Descriptive Study(2025-06-04)Aim: The purpose of this study was to examine how baccalaureate nursing students who identify as persons of color perceive the impact of racial microaggressions on academic integration, sense of belonging, and persistence to graduation. Background: In the United States, baccalaureate students with historically marginalized racial or ethnic identities experience higher attrition than White students. Racial microaggressions convey discriminatory messages and promote exclusion. Method: Undergirded by Tinto's institutional departure model, a qualitative descriptive study was conducted using semistructured interviews. Data were analyzed using Braun and Clarke's thematic analysis. Results: All participants (n = 15) experienced and/or witnessed racial microaggressions as nursing students, most commonly in the clinical setting by patients. Three themes emerged: microaggressions are common, burden of microaggressions, and desired solutions. Conclusion: Experiencing racial microaggressions leaves students feeling unsafe, unheard, and ruminative. Nurse educators should validate students' experienced reality and lead efforts for intervention.Publication Methods of Piloting an Abstraction Tool to Describe Family Engagement in the Hospital Setting: Retrospective Chart Review(2025-06-03)Background: Family engagement in hospitals is crucial for improving outcomes and ensuring holistic, patient-centered care. However, there is limited understanding of how providers document family engagement in electronic medical records (EMR) and how factors such as race and health disparities influence engagement practices. The absence of standardized EMR templates complicates tracking engagement and assessing its impact on patient outcomes. Retrospective chart review (RCR) is an effective method for investigating clinical practice and how family engagement is documented, using both structured and unstructured data from patient records. Despite its potential, gaps remain in the literature regarding distinctions between the prepilot and pilot phases in RCR studies. Objective: This article describes the prepiloting and piloting stages in the development of an abstraction tool for an RCR study, highlighting how these phases refined the tool for extracting family engagement data from the EMRs. Methods: A cohort of 2032 medical records was selected using the Research Patient Database Registry and EMRs. Initially, a draft tool was tested during the prepilot phase to assess its stability. To optimize diversity, the sample was then stratified by race. The modified tool was subsequently piloted on a subset of the sample. Results: The prepilot phase tested the tool on 9 records. In the pilot phase, the tool was applied to 39 records, representing approximately 10% of the sample. After the prepiloting and piloting phases, 293 of the 405 patient records were deemed eligible for inclusion. More than three-quarters of patients had documentation of presence and communication; whereas, only about one-third had documentation of shared decision-making involving families. Conclusions: The prepilot phase helped standardize the abstraction tool, align it with the EMRs, and address potential biases. The pilot phase provided insights into data availability and highlighted areas for refinement before finalizing the tool for the remaining records. Together, these phases ensured the tool's effectiveness for use in large-scale RCR studies.Publication Antigen persistence and TLR stimulation contribute to induction of a durable HIV-1-specific neutralizing antibody response(2025-06-03)HIV-1 Env glycoprotein (Env) immunogenicity is limited in part by structural instability and extensive glycan shielding and is likely the greatest obstacle to an HIV-1 vaccine. Stabilized Env trimers can elicit serum neutralizing antibodies, but the response is short-lived. Here we use Newcastle Disease Virus-like particle (NDV-VLP) platform to present stabilized versions of HIV-1 Env at high valency and in the context of varied conformational stability, adjuvants, dose, and antigen persistence. Influenza virus hemagglutinin, or SARS-CoV2 Spike-bearing VLPs rapidly induce neutralizing antibodies, in contrast, they were not induced by those bearing Env. A replicating adenovirus type 4 expressing Env rapidly induces autologous neutralizing antibodies. However, durable neutralizing antibodies are induced only when multiple features of a replicating virus infection are combined, with the largest impact from dose and escalating dose. In summary, we show here immunogenicity of HIV-1 Env could be improved by reproducing features of virus infection.Publication Biological rhythms: Living your life, one half-day at a time(2025-06-03)Circadian rhythms play a preeminent role in our life, organizing our physiology and behavior on a daily basis to resonate with our fluctuating environment. However, recent studies reveal that hundreds of mouse and human genes are expressed with a 12-h pattern. We take a close look at mammalian 12-h rhythms, their potential mechanisms and functions, and evidence linking them to circatidal rhythms, which enable marine animals to adapt to tides.Publication Association Between Residents' Perceived Importance of Family Involvement in Overall Care Planning and Rehabilitative Therapy Administration in Nursing Homes(2025-05-30)Objectives: This study examines the association between nursing home residents' perceived importance of family involvement in overall care planning and the administration of physical and occupational therapy. Design: Cross-sectional study. Setting and participants: The study focused on all newly admitted nursing home residents aged 50 years and older who transferred from acute-care facilities in 2019. Methods: We analyzed data from the Minimum Data Set 3.0 for 2,112,330 residents aged 50+ years in US nursing homes. We assessed family involvement in care planning based on the resident's perceived importance of family involvement in care planning, ranging from "Not important at all" to "very important." Exclusions were residents in hospice, comatose, or life expectancy of less than 6 months. The outcome was defined as a sum of physical and occupational therapy minutes. Adjusted linear regression models were used. Results: Residents who reported "very important" family involvement were older (mean age 78 years) and received more therapy minutes compared with other groups. Those with a lesser preference for family involvement were younger and had higher body mass index, better continence, and less functional impairment. Fewer therapy minutes were received by residents with less family involvement. Residents who considered family involvement "Not Important at All" received 15 fewer minutes of therapy (95% CI, -18 to -13) compared with those who deemed it "very important" after adjusting for confounders. Conclusions and implications: The study highlights a link between family involvement in care planning and increased therapy administration in nursing homes. Residents reporting higher preference for family engagement received more therapy minutes, with this pattern consistent across various demographic and health conditions. This finding underscores the importance of family involvement in receipt of therapy and highlights the need for incorporating family engagement strategies in nursing home care planning to ensure equitable and effective care.