Digital Commons Network^™

An Explainable Artificial Intelligence Framework For The Predictive Analysis Of Hypo And Hyper Thyroidism Using Machine Learning Algorithms, Md. Bipul Hossain, Anika Shama, Apurba Adhikary, Avi Deb Raha, K. M. Aslam Uddin, Mohammad Amzad Hossain, Imtia Islam, Saydul Akbar Murad, Md. Shirajum Munir, Anupam Kumur Bairagi

Electrical & Computer Engineering Faculty Publications

The thyroid gland is the crucial organ in the human body, secreting two hormones that help to regulate the human body's metabolism. Thyroid disease is a severe medical complaint that could be developed by high Thyroid Stimulating Hormone (TSH) levels or an infection in the thyroid tissues. Hypothyroidism and hyperthyroidism are two critical conditions caused by insufficient thyroid hormone production and excessive thyroid hormone production, respectively. Machine learning models can be used to precisely process the data generated from different medical sectors and to build a model to predict several diseases. In this paper, we use different machine-learning algorithms to …

Dental Hygiene And Dental Assistant Students' Simulated Dvi Radiographic Match Accuracy: A Pilot Study, Samantha C. Vest, Brenda T. Bradshaw, Marsha A. Voelker, Ann M. Bruhn, Tara L. Newcomb, Sinjini Sikdar

Dental Hygiene Faculty Publications

Purpose Allied dental health care professionals have served on disaster victim identification (DVI) teams; however, the literature is void of statistical measures regarding transferable skills and disaster preparedness. The purpose of this study was to assess second year dental hygiene and dental assistant students’ match accuracy for simulated DVI radiographs and compare the match accuracy between the student groups.

Methods Five patient cases were chosen at random to retrospectively collect sets of digital bitewing radiographs from two time periods. The five retrospectively selected sets of images served as simulated antemortem (AM) and postmortem (PM) radiographs. A convenience sample of second …

Patterns Of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 And Older, 2010-2017, Yvonne Jonk Phd, Heidi O'Connor Ms, Amanda Burgess Mppm, Carly Milkowski Mph

Access / Insurance

The purpose of this study was to examine rural-urban differences in health care use among Medicare beneficiaries age 85+. Understanding these differences, and the socioeconomic characteristics that contribute to them, can have important implications for Medicare policies aimed at serving the age 85+ population. Using the Medicare Current Beneficiary Survey 2010-13 Cost and Use and 2015-17 Cost Supplement Files, we examined whether and how rural and urban Medicare beneficiaries age 85+ differ in terms of their:

1. socioeconomic and health characteristics that may inform health care use;
2. trends in health care use, including use of inpatient and emergency department (ED) care; …

Executive Summary: Driving The Southern Nevada Health Economy Forward, Tripp Umbach

Policy Briefs and Reports

The University of Nevada, Las Vegas (UNLV) plans to develop an integrated academic health center within the Las Vegas Medical District (LVMD).1 The academic health center includes UNLV’s five health science schools and mental and behavioral health, which is distributed among several colleges (medicine, liberal arts, urban affairs, and education) in the university. University Medical Center (UMC), a major teaching hospital, will also be an important driver of the academic health center. For the purposes of this report, UNLV’s medical and health science entities along with UMC are referred to collectively as the UNLV Academic Health Center.

Driving The Southern Nevada Health Economy Forward: Benefits Of A Transformational Unlv Academic Health Center, Tripp Umbach

Policy Briefs and Reports

The University of Nevada, Las Vegas (UNLV) plans to develop an integrated academic health center within the Las Vegas Medical District (LVMD). The academic health center includes UNLV’s five health science schools and mental and behavioral health, which is distributed among several colleges (medicine, liberal arts, urban affairs, and education) in the university. University Medical Center (UMC), a major teaching hospital, will also be an important driver of the academic health center. For the purposes of this report, UNLV’s medical and health science entities along with UMC are referred to collectively as the UNLV Academic Health Center. Additional academic health …

Variations In Schedule Iii Prescription Patterns In A Medicaid Population Pre- And Post-Policy, Radhakrishnan Nagarajan, Jeffery C. Talbert, Craig S. Miller, Jeffrey Ebersole

Pharmacy Practice and Science Faculty Publications

The present study investigated variations in patient movement patterns between prescribers before and after House Bill 1 (HB1) implementation in Kentucky using network abstractions (PPN: prescriber-prescriber networks) from a one-month cross-sectional Schedule III prescription data in a Medicaid population. Network characteristics such as degree centrality distribution of PPN was positively skewed and revealed Dental Practitioners to be the highly connected specialty with opioid analgesic hydrocodone-acetaminophen to be the most commonly prescribed drug. Taxonomy enrichment of the prescriber specialties in PPN using chi-square test revealed a reduction in the enriched taxonomies Post-HB1 compared to Pre-HB1 with Dental practitioners being constitutively enriched …

Health Insurance Literacy Among International College Students: A Qualitative Analysis, Adebola Adegboyega, Chigozie Nkwonta, Jean Edward

Nursing Faculty Publications

In this qualitative descriptive study, we examine health insurance literacy among a group of international college students. They were recruited from a public, co-educational Southeastern university in the United States during the fall semester of 2016 to participate in semistructured interviews. Data were gathered through a demographic questionnaire, two focus group discussions, and individual interviews. Interview sessions were audio-recorded, transcribed, and analyzed using a thematic analysis approach. Three themes emerged, including knowledge of health insurance options and benefits information, affordability, and unmet expectations. These findings show the need for higher education institutions to develop a plan to integrate international students …

Improving Cultural Competency Among Healthcare Providers Working With Refugee Patients, Tena Chau

Doctor of Nursing Practice (DNP) Projects

Background: Increased diversity of the United States population has resulted in the presence of greater disparities in healthcare. One way to address factors contributing to health disparities has been to increase cultural competency in healthcare. Evidence from a review of the literature supports the idea that understanding aspects of cultural competency that are lacking among specific healthcare organizations are helpful to develop programs to address the areas of need. Purpose: The purpose was to complete a quality improvement project to evaluate if an educational intervention based on a specific model would lead to increased level of cultural competence among healthcare …

A Provider-Driven Approach To Preventative Oral Care In Nursing Home Facilities, Molly Anderson, Brandon Mccrossin, Kary Franchetti, Ruth Hanselman, Suneela Nayak, Stephen Tyzik, Amy Sparks

Operations Transformation

Oral care is an essential part of preventative medicine as it minimizes risk for pneumonias and other infections. In nursing home settings, often oral health care is not routinely provided due to a number of issues. A health care system that either owns or contracts nursing home facilities initiated a performance improvement plan to address this patient care concern.

The first goal of this project was to reduce the variation in oral care between nursing home facilities within the system. The second goal was 100% of their patients will have one oral health care exam documented in EPIC once a …

Exploratory Qualitative Study To Understand The Underlying Motivations And Strategies Of The Private For-Profit Healthcare Sector In Urban Bangladesh, Alayne Mary Adams, Rushdia Ahmed, Tanzir Ahmed Shuvo, Sifat Shahana Yusuf, Sadika Akhter, Iqbal Anwar

Faculty Publications

Objectives This paper explores the underlying motivations and strategies of formal small and medium-sized formal private for-profit sector hospitals and clinics in urban Bangladesh and their implications for quality and access.

Methods This exploratory qualitative study was conducted in Dhaka, Sylhet and Khulna City Corporations. Data collection methods included key informant interviews (20) with government and private sector leaders, in-depth interviews (30) with clinic owners, managers and providers and exit interviews (30) with healthcare clients.

Results Profit generation is a driving force behind entry into the private healthcare business and the provision of services. However, non-financial motivations are also emphasised …

Network Analysis Approaches To Collaborative Information Seeking In Inter-Professional Health Care Teams, J. David Johnson

Communication Faculty Publications

Introduction: It is widely believed that interprofessional health care teams can improve patient care and increase safety; however, intra-team communication has often proven to be problematic. One particularly important aspect of this problem is how teams collaborate to seek the information needed to address the issues they are confronting. Network analysis offers a rich set of concepts for tackling this problem.

Method: Review essay.

Analysis and results: Network analysis approaches offer the promise of more nuanced approaches and diagnostic tools that could address these issues by focusing on its elements: reciprocity, centrality, density, fault lines, multi-team systems, …

Trans, Gender Non-Conforming, And Non-Binary Experiences With The Us Health Care System, Brenna Wyffels

Honors Projects

This research aims to identify health care obstacles faced by members of the trans, gender non-conforming, and non-binary community. Through a literature review and a Qualtrics survey distributed to university students in the target community via email, obstacles to health care access and solutions to the obstacles were identified. Data collected from survey participants included demographic information, anecdotes about inclusive and exclusive health care experiences, and proposed solutions to health care obstacles. Obstacles to health care access stemmed from many sources, including from biases of health care providers. Solutions ranged from changes that individual providers could make to nation-wide education …

Mid-Atlantic Ethics Committee Newsletter, Fall 2017

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Medicaid And Children With Special Health Care Needs, 2016-2017 Cohort Of New Hampshire-Maine Leadership Education In Neurodevelopmental And Related Disabilities (Nh-Me Lend) Program Trainees

Policy Analysis

Medicaid funds vital services for children and youth with special health care needs and disabilities (CYSHCN). Proposed changes to the structure of Medicaid would significantly reduce federal funding for this important program. The most concerning are the proposed structural changes including per capita caps and block grants, as well as threats to Early and Periodic Screening, Diagnostic and Treatment (EPSDT) and Medicaid Waiver services. Restructuring would have devastating effects on benefits for low-income children and individuals with disabilities, and their families, putting this very vulnerable population at additional risk.

Telehealth And Ehealth In Nurse Practitioner Training: Current Perspectives, Carolyn M. Rutledge, Karen Kott, Rebecca Poston, Christianne Fowler, Tina S. Haney

Nursing Faculty Publications

Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth. Specifically, this …

Decisions, Decisions: Factors That Influence A Patient's Medical Tourism Choices, Louis K. Falk, Thomas J. Prinsen

Faculty Work Comprehensive List

In the digital age, the amount of information and sources concerning Medical Tourism is overwhelming. Knowledge is power in an era of healthcare uncertainty. As health care options have grown in global proportions, it has become more difficult for potential patients to locate the material necessary to make informed decisions or to even know which factors to consider during their information search. Individual financial circumstances vary greatly. This paper suggests how medical tourism makes financial sense for many patients and payers. Proximity and culture play roles in that medical tourists may prefer locations that are not too far from home. …

Decisions, Decisions: Factors That Influence A Patient's Medical Tourism Choices, Louis K. Falk, Thomas J. Prinsen

Communication Faculty Publications and Presentations

In the digital age, the amount of information and sources concerning Medical Tourism is overwhelming. Knowledge is power in an era of healthcare uncertainty. As health care options have grown in global proportions, it has become more difficult for potential patients to locate the material necessary to make informed decisions or to even know which factors to consider during their information search. Individual financial circumstances vary greatly. This paper suggests how medical tourism makes financial sense for many patients and payers. Proximity and culture play roles in that medical tourists may prefer locations that are not too far from home. …

Mid-Atlantic Ethics Committee Newsletter, Fall 2016

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Sexual Minority (Lgbtq) Youth And Role Of Health Care Provider, Mandakini Sadhir, Stephanie J. Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

Adolescence is a time period of physical, psychological and cognitive changes. It is an important phase for an individual to discover who they really are (self-identity), how they are perceived (social identity) and how they fit into the environment they live in.¹ One of the major tasks of adolescence is sexual maturation and sexual and /or gender identity development.² Adolescents who are developing as gay, lesbian, bisexual or transgender face a tremendous challenge of establishing their identity which is often complex.³ They cope with the feelings of being different and are in constant dilemmas about revealing their …

Mid-Atlantic Ethics Committee Newsletter, Winter 2016

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Translating Research To Practice For Children With Autism Spectrum Disorder: Part 2: Behavior Management In Home And Health Care Settings, Margaret W. Bultas, Norah L. Johnson, Karen Burkett, Judy Reinhold

College of Nursing Faculty Research and Publications

Introduction

Managing home and health care for children with autism spectrum disorder can be challenging because of the range of symptoms and behaviors exhibited.

Method

This article presents an overview of the emerging science related to the methods to foster family self-management of common concerns regarding activities of daily living and behaviors, as well as for the health care provider in primary and acute health care settings.

Results

Recommendations are provided to enhance the overall delivery of services, including understanding and managing a child's challenging behaviors, and supporting family management of common activities of daily living and behaviors.

Discussion

Health …

Medical Tourism: How Far Are You Willing To Go To Save Money?, Thomas J. Prinsen, Louis K. Falk, Javier Martinez

Faculty Work Comprehensive List

Medical needs of Americans are increasing as the population is aging and struggling with obesity. The addition of new medical technology and techniques, their widespread availability, and procedural improvements have created a more open market for medical providers. Costly procedures in cardiology and orthopedics serve as examples of increasingly needed medical treatments. Individuals, businesses and insurance companies have struggled to find ways to pay for these necessary procedures. Traditionally, in the U.S. the majority of medical procedures have been performed locally. Because of the rising costs associated with these procedures individuals and some healthcare providers are now looking to foreign …

Vital Sign In Healthcare: Are You Missing It?, Kae Van Engen

Faculty Work Comprehensive List

The ability to listen well, and to be deeply understood, enhances every aspect of our lives. The healthcare field is no different. This Work in Progress seeks to establish an ongoing dialogue.

Medicare Fraud In The United States: Can It Ever Be Stopped?, Chelsea Hill, Alex Hunter, Leslie Johnson, Alberto Coustasse

Management Faculty Research

The majority of the United States health care fraud has been focused on the major public program, Medicare. The yearly financial loss from Medicare fraud has been estimated at about $54 billion. The purpose of this research study was to explore the current state of Medicare fraud in the United States, identify current policies and laws that foster Medicare fraud, and determine the financial impact of Medicare fraud. The methodology for this study was a literature review. Research was conducted using a scholarly online database search and government Web sites. The number of individuals charged with criminal fraud increased from …

Navigating The Health Care Labyrinth: Portraits Of The Socioeconomically Disadvantaged, Thomas C. Crawford Phd

Antioch University Full-Text Dissertations & Theses

In 2010, an estimated population of the 311,212,863 Americans generated approximately 1,014,688,290 physician office encounters (Moore, 2010). The frequency and number of professional interactions between caregivers and patients/family members in medical office settings equated to a staggering 1,931 visits per minute. Based on the massive volume of interactions that occurred between patients of different races, ethnicities, genders, sexual orientations, and socioeconomic standings that generated an average household income of $49,445 in 2010 (United States Census Bureau, 2010a) with a physician workforce that the Association of American Medical Colleges (2010) captured as being 75% White that earned (primary care specialties) in …

Complementary And Alternative Medicine: The History, Current Prevalence, And Future Projections, Melissa J. De Nijs

Senior Honors Theses

Complementary and alternative medicine (CAM) has been used for centuries. Common methods include chiropractic, diet, yoga, and prayer. Though some methods have proven more successful than others, many have insufficient data to support claims of effectiveness.

A survey of medical professionals involving twenty-seven CAM methods was conducted in order to evaluate modern perceptions of complementary and alternative medicine. They were asked their experience with CAM, their personal opinion regarding its effectiveness, and how likely they would be to recommend a CAM treatment to a patient.

It has been hypothesized that more CAM treatments will be utilized in the future. This …

The State Of The Science Of Health And Wellness For Adults With Intellectual And Developmental Disabilities, Lynda Lahti Anderson, Kathy Humphries, Suzanne Mcdermott, Beth Marks, Jasmina Sisirak, Sheryl Larson

Rural Institute Journal Articles

Historically, people with intellectual and developmental disabilities (IDD) have experienced health disparities related to several factors including: a lack of access to high quality medical care, inadequate preparation of health care providers to meet their needs, the social determinants of health (e.g., poverty, race and gender), and the failure to include people with IDD in public health efforts and other prevention activities. Over the past decade, a greater effort has been made to both identify and begin to address myriad health disparities experienced by people with IDD through a variety of activities including programs that address health lifestyles and greater …

A Silent Storm: Hepatitis C In Pakistan, Noureen Jiwani, Raisa B. Gul

School of Nursing & Midwifery

No abstract provided.

Improving The Population’S Health: The Affordable Care Act And The Importance Of Integration, Lorian E. Hardcastle, Katherine L. Record, Peter D. Jacobson, Lawrence O. Gostin

O'Neill Institute Papers

Heath care and public health are typically conceptualized as separate, albeit overlapping, systems. Health care’s goal is the improvement of individual patient outcomes through the provision of medical services. In contrast, public health is devoted to improving health outcomes in the population as a whole through health promotion and disease prevention. Health care services receive the bulk of funding and political support, while public health is chronically starved of resources. In order to reduce morbidity and mortality, policymakers must shift their attention to public health services and to the improved integration of health care and public health. In other words, …

Consumer-Directed Health Insurance Vs. Managed Care: Analysis Of Health Care Utilization And Expenditure Incurred By Employees In A Rural Area, Cecilia M. Watkins, J. White, D. Duncan, D. Wyant, T. Nicholson, J. Khubchandani, C. Lakshminarayana

Public Health Faculty Publications

Consumer-Directed Health Plans (CDHPs) are proposed as an option to control healthcare costs. No research has addressed their applicability in rural settings. This study analyzes three years (2003–2005) of healthcare expenditure and utilization incurred by two employers and a national carrier providing data from a rural state, Kentucky. The study included two measures of expenditures (health care and prescription drugs) and three measures of utilization (physician visits, hospital admissions, and hospital inpatient days). In general, the CDHP successfully controlled the growth of medical costs. These findings suggest that CDHPs may be a viable alternative benefit structure for rural employers.