Medicine and Health Sciences Commons^™

Passenger Traits That Predict The Bystander Intervention Model Steps During An Inflight Assault On A Flight Attendant, Michael Pettit

Doctoral Dissertations and Master's Theses

Every major U.S. airline has experienced a violent inflight assault on one of their flight attendants. The problem is becoming more widespread, but industry leaders have few coping strategies. The first step toward addressing the issue is understanding the various aspects of the event, including the actions of other passengers (bystanders) who may witness the assault. There is ample literature on bystander reactions to similar events such as bullying, medical emergencies, injuries, and violent attacks, but none dedicated to a flight attendant assault or passenger reactions to it.

At the core of bystander action is the bystander effect, which postulates …

A Patient Risk Minimization Model For Post-Disaster Medical Delivery Using Unmanned Aircraft Systems, Mark J. Simpson

Doctoral Dissertations and Master's Theses

The purpose of this research was to develop a novel routing model for delivery of medical supplies using unmanned aircraft systems, improving existing vehicle routing models by using patient risk as the primary minimization variable.

The vehicle routing problem is a subset of operational research that utilizes mathematical models to identify the most efficient route between sets of points. Routing studies using unmanned aircraft systems frequently minimize time, distance, or cost as the primary objective and are powerful decision-making tools for routine delivery operations. However, the fields of emergency triage and disaster response are focused on identifying patient injury severity …

Behavioral Intention Factors For Prescription Deliveries By Small Unmanned Aircraft In Rural Communities, Sarah M. Talley

Doctoral Dissertations and Master's Theses

Nearly half of the U.S. population regularly use and depend on prescription medications; however, pharmacy availability and access to pharmacy services are often lacking, particularly in rural communities. In an effort to meet local healthcare needs, delivery by sUAS is proposed to ensure the nearly 60 million rural residents have access to their prescription medications.

As an emerging technology with little research into home delivery applications, the successful implementation of sUAS for prescription medication delivery requires public acceptance and positive behavioral intention toward its use. At the time of the current research, no prior studies have specifically focused on the …

The Utilization And Validation Of The Human Factors Intervention Matrix And The Companion Assessment Tool Faces In The Development Of Novel Interventions, Victoria Lew

Doctoral Dissertations and Master's Theses

The purpose of the current project was to utilize and validate the Human Factors Intervention Matrix (HFIX) and the companion assessment tool FACES regarding developing and ranking novel interventions. This was completed by 1. Uncovering whether brainstorming with HFIX generated a higher quantity, quality, and broader breadth of ideas compared to traditional brainstorming, and 2. Seeing whether the modality in which HFIX was utilized affected the quantity, quality, and breadth of ideas generated. This research employed a 2x2 between-subjects experimental design (n = 120) where participants were assigned to groups of three in one of the four conditions. Analyses …

Ems To Trauma Care Transitions: An Investigation Of Patient And Handoff Outcomes, Richard Simonson

Doctoral Dissertations and Master's Theses

The helicopter as a method of emergency medical service transportation of trauma patients has a long history of effective use-cases dating back to its inception during the Vietnam war. Compared to ground-based emergency medical transit, helicopters have been able to reach severely injured patients in environments with challenging terrain features that ground-based medical services cannot traverse. Additionally, the helicopter offers quicker and more direct-route transit options that result in both quicker response and shorter transportation times compared to their ground-based alternative. Further, research has indicated that helicopter ambulance teams utilize paramedics with more experience than ground ambulance paramedics. Prior research …

A Meshless Approach To Computational Pharmacokinetics, Anthony Matthew Khoury

Doctoral Dissertations and Master's Theses

The meshless method is an incredibly powerful technique for solving a variety of problems with unparalleled accuracy and efficiency. The pharmacokinetic problem of transdermal drug delivery (TDDD) is one such topic and is of significant complexity. The locally collocated meshless method (LCMM) is developed in solution to this topic. First, the meshless method is formulated to model this transport phenomenon and is then validated against an analytical solution of a pharmacokinetic problem set, to demonstrate this accuracy and efficiency. The analytical solution provides a locus by which convergence behavior are evaluated, demonstrating the super convergence of the locally collocated meshless …

What Factors Predict An Anesthesiologist’S Willingness To Proceed With An Anesthetic?, Nadine K. Ragbir

Doctoral Dissertations and Master's Theses

Anesthesiologists are exposed to higher stress levels than many other physician specialties. They are also at an increased risk for developing mental disorders, alcohol and drug dependencies, sleep disturbances, and suicidal ideations. Therefore, the purpose of this dissertation was to explore the factors that predict an anesthesiologist’s willingness to proceed with an anesthetic. The current study consisted of two stages. The first stage was developing a regression equation that was used to predict anesthesiologists’ willingness to proceed with an anesthetic. During the second stage, additional data was collected to test the model that was developed in the first stage. Six …

In-Vitro And In-Silico Investigations Of Alternative Surgical Techniques For Single Ventricular Disease, Arka Das

Doctoral Dissertations and Master's Theses

Single ventricle (SV) anomalies account for one-fourth of all cases of congenital Heart disease. The conventional second and third stage i.e. Comprehensive stage II and Fontan procedure of the existing three-staged surgical approach serving as a palliative treatment for this anomaly, entails multiple complications and achieves a survival rate of 50%. Hence, to reduce the morbidity and mortality rate associated with the second and third stages of the existing palliative procedure, the novel alternative techniques called “Hybrid Comprehensive Stage II” (HCSII), and a “Self-powered Fontan circulation” have been proposed. The goal of this research is to conduct in-vitro investigations to …

Novel Computational Infant Musculoskeletal Model For Biomechanical Analysis Of Infant Movement, Yeram Lim

Doctoral Dissertations and Master's Theses

Computational musculoskeletal models are increasing in commonality and popularity in the study of biomechanics. These models, however, are mainly used to represent fully developed adults, while infant musculoskeletal models are nonexistent. This study aims to develop a novel computational infant musculoskeletal model for biomechanical analysis of infant movement. For this study, 31 reflective markers were placed on an infant, and marker-based motion capture data was collected. The computational study used a generic GAIT2392 OpenSim musculoskeletal model that was scaled to create a customized subject-specific infant model. By using the motion capture data recorded of the infant during a kicking motion, …

Abduction Contractures Within Infants With Developmental Dysplasia Of The Hip, Nathan Stanton

Doctoral Dissertations and Master's Theses

Developmental Dysplasia of the hip is a condition that affects 1 to 3 of every 1000 infants born globally. It is a pathology that involves the instability, subluxation, or dislocation of the femoral head from the acetabulum. Through a rating system by the International Hip Dysplasia Institute or Graf System, hips are rated based on their level of instability or dislocation and the infant is then prescribed a treatment. While Finite element models of dysplastic hips have been developed previously, a study that seeks to understand the contribution of an abduction contracture of the hip has yet to be performed. …

Computational Model For Pedestrian Movement And Infectious Diseases Spread During Air Travel: A Molecular Dynamics-Like Numerical Approach, Pierrot Derjany

Doctoral Dissertations and Master's Theses

There is direct evidence of the transmission of fatal infectious pathogens in large human gatherings. Air transportation is no exception. The mixing of susceptible and infectious individuals in this high-density man-made environment involves pedestrian movement which is generally not taken into account in modeling studies of disease dynamics. This thesis addresses this problem through a multiscale model that combines pedestrian dynamics with stochastic infection spread models. This generic model is applicable to several directly transmitted diseases. Through this multiscale framework, the effectiveness of certain layout and strategies in suppressing the disease spread in highly crowded locations such as airplanes, airports …

Patient Willingness To Undergo Robotic Surgery: Identification And Validation Of A Predictive Model, Emily C. Anania

Doctoral Dissertations and Master's Theses

INTRODUCTION: The purpose of the current dissertation is to better understand the factors which make an individual willing (or unwilling) to undergo robotic surgery. Though surgical feasibility and provider perceptions are often studied, little research has investigated how patients perceive robotic surgical systems.

METHOD: A two-stage approach was taken in order to build and validate a regression equation in order to predict an individual’s willingness to undergo robotic surgery based on several factors. Stage 1 employed a sample size of 1324 participants in order to build the model. Participants responded to a survey indicating their willingness to undergo robotic surgery, …

Development Of A Descriptive Model Of Flow Disruption Effect On Bypass Time In A Cardiovascular Operating Room, Timothy J. Disher

Doctoral Dissertations and Master's Theses

The current paper proposes utilizing extant flow disruption data, collected from two cardiovascular operating rooms, and utilizing that to develop a mathematical model. Of particular interest is bypass time which is a critical surgical phase, the length of which has been linked to post-operation complications such as hospital-borne infections and readmission. By developing a model that predicts bypass time, the present research can determine the impact by types of flow disruptions – coded based on the RIPCHORD-TWA taxonomy, team member disrupted, and where in the surgery the FD occurs.

After a review of literature, a variety of models were explored …

Multi-Scale Fluid Flow Analysis Of The Cardiovascular System, Zaid Mahmood

Doctoral Dissertations and Master's Theses

The hypoplastic left heart syndrome (HLHS) is one of the rarest congenital heart diseases affecting infants. Out of 150 babies born, one baby suffers from congenital heart disease. Furthermore, nine percent out of those suffering from congenital heart disease specifically suffer from hypoplastic left heart syndrome (HLHS). To this end, the Fontan operation which is a procedure to generate a harmonic blood flow in single functioning ventricle patients has been executed to palliate HLHS patients. In this operation, the inferior vena cava (IVC) and the superior vena cava (SVC), carrying the low-oxygenated blood returning from the lower and upper body …

Human Factors Contributing To Preventable Adverse Drug Events In Healthcare: A Grounded Theory Approach Pilot Study, Thomas Ryan Hilgers

Doctoral Dissertations and Master's Theses

The following thesis details a grounded theory methodology (GT) pilot study of preventable adverse drug events (pADEs) in healthcare. This research used the methodological approach to develop a categorical theory for the chief workplace contributors to intra-hospital intensive care unit (ICU) preventable adverse drug events. While this study represents only a foray into the use of GT to explain pADEs, the results implicate specific areas of concern that may be followed up on in future qualitative or quantitative research. Pursuant of a Straussian grounded theory methodology, this study leaned fundamentally on the interview of individuals with first-hand experience with the …

Computational Investigation Of The Biomechanics Of Babywearing In Regards To Developmental Dysplasia Of The Hip, Gaurav Girish

Doctoral Dissertations and Master's Theses

Developmental Dysplasia of the Hip (DDH) is a congenital condition where an infant’s hip socket is either loose or otherwise unstable. DDH causes a joint instability where the femoral head is not properly situated inside the acetabulum. Etiology of the condition is in part congenital and developmental, with a difference of DDH prevalence between ethnicities. Incidence of DDH is also in some part dependent on cultural practices and activities of the mother and child. The exact nature of this cultural incidence is not clearly understood. A computational approach is hypothesized to identify the impact of babywearing position on the healthy …

Evaluation Of A Scientifically Developed Anesthesiology Handoff Protocol, Kristen Lise Welsh Webster

Doctoral Dissertations and Master's Theses

Communication failures have been cited as the leading cause of avoidable adverse events in healthcare. Specifically, within handoffs, these communication failures can cause error in the transfer of patient information. A multitude of factors can affect the transmission of patient information between providers including transactive memory, power distance, and conversational noise; however, literature suggests that the use of handoff protocols assist in improving communication and efficiency during handoffs. Studies regarding handoffs have typically centered on the content or delivery of the information during the handoff. To date, none have targeted the underlying mechanisms of the communication and their effects on …

A Prospective Investigation To Develop Data-Driven Interventions And Improve Process Efficiency At A Level Ii Trauma Center, Tracy L. Litzinger

Doctoral Dissertations and Master's Theses

The purpose of this investigation was to better understand process inefficiencies in a Level II trauma center through the identification and classification of flow disruptions. Data-driven interventions were systematically developed and introduced in an effort to reduce disruptions threatening the optimal delivery of trauma care.

Medical human factors researchers observed disruptions during resuscitation and imaging in 117 trauma cases. Data was classified using the human factors taxonomy Realizing Improved Patient Care through Human-centered Operating Room Design for Threat Window Analysis (RIPCHORD-TWA). Interdisciplinary subject matter experts (SMEs) utilized a human factors intervention matrix (HFIX) to generate targeted interventions designed to address …

A Human Factors Approach For Identifying Latent Failures In Healthcare Settings, Tara N. Cohen

Doctoral Dissertations and Master's Theses

INTRODUCTION: The purpose of the current research was to assess the utility of the Human Factors Analysis and Classification System (HFACS), a tool that has historically been used reactively to look at accidents and incidents, for classifying observational data from various healthcare venues.

METHOD: Three studies are presented to investigate the reliability of HFACS for classifying observational data. In Study I, HFACS was applied to observational human factors data collected from the cardiovascular operating room (CVOR) at an academic medical university. Three trained analysts categorized the data using HFACS and several approaches were used to evaluate its reliability during the …

Closed-Loop Cfd Analysis Of The Fontan Cardiovascular Circulation, Marwan Hameed

Doctoral Dissertations and Master's Theses

One out of 150 newborn babies born with congenital heart disease, approximately 7.5% of those infants have a single ventricle (SV). The Fontan operation, which is a procedure to create a harmonious circulation in SV patients, has been performed for a long time to save the newborn patients. In this procedure the superior vena cava and inferior vena cava, which carry the oxygen-poor blood from the upper and lower body back to the heart, are linked directly to the pulmonary arteries, bypassing the atrial connection. Even though this operation has been around for years, the patients who have undergone this …

The Identification And Classification Of Flow Disruptions In The Operating Room During Laparoscopic Cholecystectomy And Open Hernia Repair Procedures, Sacha N. Duff

Doctoral Dissertations and Master's Theses

The operating room is one of the most complex work environments in healthcare; it is estimated that at least 7% of adverse events due to medical error occur in the operating room. Flow disruptions are events that cause a "break" in the primary surgical task, or the loss of any team member's situational awareness. An empirical link between flow disruptions and surgical errors in the OR has been established; therefore, identifying and classifying the specific flow disruptions present during different types of procedures should facilitate the development of evidence-based interventions. The goal of this study was to identify and classify …

The Effects Of Energy Beverages In Counteracting The Symptoms Of Mild Hypoxia At Legal General Aviation Altitudes, Daniel Mark Bull

Doctoral Dissertations and Master's Theses

The purpose of this thesis was to conduct preliminary research, in the form of a pilot study, concerning the natural effects of hypoxia compared to the effects of hypoxia experienced after the consumption of an energy beverage. The study evaluated the effects of hypoxia on FAA certificated pilots at a simulated legal general aviation altitude, utilizing the normobaric High Altitude Lab (HAL) located at Embry Riddle Aeronautical University, Daytona Beach, Florida. The researcher tested 11 subjects, who completed three simulated flight tasks within the HAL using the Frasca International Mentor Advanced Aviation Training Device (AATD). The flight tasks were …

The Effects Of Caffeine And Expectancy On Short Term Memory, Sara J. O'Brien

Doctoral Dissertations and Master's Theses

Although caffeine is the most widely used drug in the world, research on the effects of caffeine on mental performance tasks (especially short term memory tasks) is inconclusive. One possible explanation for this limited understanding is the lack of studies accounting for participant expectancy surrounding caffeine. This study examined the effects of caffeine dosage (0mg, 200mg, and 400mg) and expectancy related to past caffeine use (positive, negative) on short term memory span task. A two-way Analysis of Variance showed that the two independent variables (caffeine dose and expectancy), did not significantly influence the short term memory span score. However, the …