Medicine and Health Sciences Commons^™

The Ethical Justification Of Increasing Awareness Of Preventive Medicine Among Healthcare Professionals, Patients And The General Public In The United States, Karishma Ether Moazzam

Electronic Theses and Dissertations

While practiced for centuries, preventive medicine has received increased attention during the recent times. Preventive medicine has a distinct mission to protect, promote, and maintain health as well as to prevent diseases, disabilities, and premature deaths. It aims to fulfill its mission through the combined form of clinical intervention and health promotion. In the recent years, preventive medicine has begun to lean more towards the clinical interventions, taking away from the health promotion. This imbalance has caused preventive medicine to lose its effectiveness in fulfilling its mission. One of the leading causes for such imbalance is the lack of proper …

The Use Of Probiotics To Prevent Ventilator-Associated Pneumonia In Adults, Michael Roper, Paige Douthett

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the efficacy and safety of preventing the acquisition of ventilator- associated pneumonia with the use of probiotic supplementation, as compared to a placebo, among hospitalized adult men and women receiving more than 24 hours of mechanical ventilation. Design: Systematic Literature Review. Methods: Systematic searches were conducted through PubMed and Scopus using the search terms “ventilator”, “probiotics”, and “prevention”. Records were excluded from the analysis if they were published before 2015, full text was not available, studies other than randomized control trial or cohort studies, and if the study population was less than 18 years old. Results: Of …

Preventive Strategies For Acute Kidney Injury Among Patients Undergoing Abdominal Aortic Aneurysm Repair, Michaela Fernandes

Electronic Thesis and Dissertation Repository

Strategies for preventing acute kidney injury (AKI) in patients undergoing abdominal aortic aneurysm (AAA) repair were explored in a secondary data analysis of 601 patients from a randomized controlled trial (RCT). Bivariate analyses identified an association between intraoperative hypotension and postoperative AKI and suggested IV fluids as the best treatment option over inotropes/vasopressors which increased the odds of AKI (OR_crude=2.5 95%CI 1.2-5.0), however, our multivariable analysis was non-significant (OR_adjusted=1.7 95%CI 0.8-3.7). Further analysis found angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker use within 24 hours prior to repair were not associated with postoperative AKI (OR …

Managing Childhood Obesity In A Primary Care Clinic, Linda Nnajiofor

Doctor of Nursing Practice

Background: Childhood obesity and overweight have increased health burdens on health care systems, and contribute to chronic diseases such as diabetes, heart disease, asthma, and cancer. Childhood obesity is very complex for healthcare providers to manage in primary care settings.

Purpose: To improve childhood overweight and obesity approach and management in a selected primary care practice (Clinic A) in a large east Texas urban community.

Objectives: 1. Increase the percentage of children and adolescents ages 2 to 19 years seen in Clinic A, who received adequate weight management and obesity counseling, to 75%. 2. Increase the number of referrals to …

Midwife’S Role In The Mother-To-Child Transmission Prevention Program In Primary Health Care In Yogyakarta, Niken Meilani, Nanik Setiyawati, Sammy Onyapidi Barasa

Kesmas

Curing and eradicating Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) are to the core principles of the United Nations’ Sustainable Development Goals (SDGs). The incidence of HIV in the world remains high. Although midwives play a pivotal role in PMTCT implementation, the factors associated with midwives’ role in its implementation are not well understood. The aim of this study was to determine factors associated with midwives’ role in implementation of PMTCT. This study used a cross-sectional design. The subjects were 80 midwives at 14 primary health care in Yogyakarta City, Indonesia. The study was conducted from April to August 2017. …

Feasibility Pilot Outcomes Of A Mammography Decision Support And Navigation Intervention For Women With Serious Mental Illness Living In Supportive Housing Settings., Lara Weinstein, Marianna Lanoue, Katelyn Hurley, Colleen Payton, Randa Sifri, Ronald Myers

Department of Family & Community Medicine Faculty Papers

Objective: People with serious mental illness (SMI) experience significant disparities in morbidity and mortality from preventable and treatable medical conditions. Women with SMI have low mammography screening rates. SMI, poverty, and poor access to care can have a significant effect on a woman’s opportunity to learn about and discuss breast cancer screening with health care providers. This study examines the feasibility pilot outcomes of mammography decision support and patient navigation intervention (DSNI) for women with SMI living in supportive housing settings. The primary research question was: Does the DSNI increase knowledge, promote favorable attitudes, and decrease decisional conflict relating to …

Getting To Zero: Creating An Infrastructure To Support Fall Prevention In A Medical–Surgical Unit, Krys Elgarico

Master's Projects and Capstones

Problem: Hospital falls are a growing national patient safety concern that cause anxiety, pain, distress, serious injuries, and increased health care utilization. Despite the presence of a well-developed falls prevention protocol since 2017. Internal data from an inpatient medical-surgical telemetry (MST) unit indicate the largest number of fall-related events among the hospital’s departments.

Context: Practice improvement project was initiated in a 217-bed community hospital to determine barriers and potential success factors. This MST is a dynamic, 48-bed unit providing care to mainly geriatric patients who require continuous telemetry monitoring and complex medical, trauma, and surgical services. Senior leaders in the …

The Use Of Simulation To Practice Pre-Exposure Prophylaxis Sexual Health Risk Screening, Management, And Follow-Up Within A Doctor Of Nursing Practice Program., Skyler K. Frye

Doctor of Nursing Practice Papers

Introduction: Incidence and prevalence for human immunodeficiency virus (HIV) has yet to experience a significant decline. Increasing provider knowledge regarding use of Pre-Exposure Prophylaxis, an HIV prevention drug, correlates with increased provider risk screening & prescribing PrEP. Standardized patient (SP) simulation is an effective teaching method for healthcare students to increase knowledge and confidence in providing sexual healthcare.

Purpose: The purpose of this project was to evaluate an educational program aimed at increasing participant knowledge attainment and self-confidence in the ability to ascertain a sexual health history and advance the participant’s ability to manage PrEP candidates in a primary …

Predictors And Missed Opportunities For Blood Glucose Screening Among African Americans: Implications For Church-Based Populations, Alexandria G. Bauer, Jannette Berkley-Patton, Carole Bowe Thompson, Kelsey Christensen

Journal of Health Disparities Research and Practice

African Americans (AAs) are disproportionately diagnosed with prediabetes, diabetes, and related complications. Guidelines for prediabetes/diabetes screening emphasize reaching at-risk adults. The AA church has potential to increase reach of BGS with AA church members and community members. The current study identified predictors of blood glucose screening (BGS) and individuals with missed opportunities for BGS among church-affiliated AA adults. Participants were drawn from a previous pilot study (Project Faith Influencing Transformation) conducted in six AA churches over eight months. Eligibility criteria included self-identifying as AA and being aged 18 or older. Participants who had previously been diagnosed with diabetes were excluded, …

Nicotine Replacement Therapies To Decrease Withdrawal Symptoms And Improve Patient Experience, Cheryl Pawloski, Holly Stewart, Devon Gillis, Dena Whitesell, Maya Bulman, Christopher Racine, Raymond Serrano, Leslie Gatcombe-Hynes, Elizabeth Mullany, Amy Mcauliffe, Jayne Weisberg, Amy Sparks, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

Operations Transformation

Smoking is one the leading causes of preventable death in the United States. Patient centered care revolves around encouraging patients to reduce their chances of preventable disease and death. To that end, nicotine replacement therapy (NRT) prescribed within 24 hours of hospital admission increases the chance of quitting and decreases the chance of nicotine withdrawal.

A pilot performance improvement project was initiated on two cardiac units at an academic tertiary medical center. The goal the project was to have NRT ordered within 24 hours of admission 100% of the time. Baseline metrics demonstrated admission NRT orders were below acceptable levels …

Human Papillomavirus, Alexandra Irwin

Nursing Student Class Projects (Formerly MSN)

The Human Papillomavirus (HPV) is a sexually transmitted infection that is not curable. HPV can damage cell DNA which increases the risk of oncogene expression; this leads to an increased risk of cancer. HPV is one of the leading causes of cervical cancer, among other types of cancers. Prevention is key because HPV is usually asymptomatic. The population at risk is anyone sexually active, including participation in oral sex. The health care provider should advocate for preventative measures against HPV. There are vaccinations that prevent the contraction of HPV that should be given before a person is sexually active for …

Using Physician Champions To Extend The Reach Of The Let’S Go! 5-2-1-0 Obesity Prevention Program In Clinical Practice, Michael Dedekian, Jackie Vine, Jonathan Fanburg, Naomi Anderson Schucker, Victoria Rogers

Journal of Maine Medical Center

ABSTRACT

Introduction: There is limited evidence for large scale interventions to address childhood obesity. Let’s Go! is a Maine-based obesity prevention program that deploys a consistent message across multiple community settings to encourage children and families to make healthy choices. This report describes implementation of Let's Go! in primary care offices.

Methods: Consideration for physician champion recruitment included previous involvement with Let’s Go! and ensuring statewide geographic coverage. Champions received standardized training and became local leaders in obesity prevention and treatment. 13 champions engaged 99 practices at baseline; 71 practices were engaged all 4 years (2012-2015). Data were analyzed on …

A Coordinated School Health Approach To Obesity Prevention Among Appalachian Youth: Middle School Student Outcomes From The Winning With Wellness Project, William T. Dalton Iii, Karen Schetzina, Elizabeth Conway-Williams

Karen E. Schetzina

The Winning With Wellness (WWW) project was a school-based obesity prevention program that was developed to promote healthy eating and physical activity in youth residing in rural Appalachia. The project was based on the Coordinated School Health model (Centers for Disease Control and Prevention (CDC), 2013a) and used a community-based participatory research approach with an emphasis on feasibility and sustainability. The purpose of this study was to examine self-reported health outcomes for middle school students across the course of the intervention. Sixth grade middle school students (N = 149; 52% girls) from four schools in Northeast Tennessee completed a …

The Roles Of An Evidence-Based Weight Management Protocol In Hypertension Control, Belinda Akakpo Maxwell

Doctor of Nursing Practice Final Manuscripts

The Roles of an Evidence-Based Weight Management Protocol in Hypertension Control

Abstract

Purpose: The purpose of this project is to evaluate the impact of a healthcare provider-led protocol for patients with hypertension (HTN) and weight loss needs to improve weight control, cardiovascular risk and quality of life.

Background: Evidence shows that a 1.2-kg weight loss can reduce systolic blood pressure (SBP) by 3.8mmHg. Thus, a 10kg (22lbs) weight loss is likely to yield a SBP decrease of as much as 32mmHg. Such results would positively impact quality of life and costs. The simple approach of instructing patients to eat less …

Supporting Marin County Youth Suffering From Anxiety And Depression, Victoria L. Grajeda

Counseling Psychology | Master's Theses

This toolkit was created to help shed light on the impact a stressful high school environment can have on today’s youth, and provide teachers, students, and parents with up-to-date information on what resources are available within the county of Marin. When working with adolescents, it is important to consider environmental threats to their mental health (i.e., lack of sleep) in order to make proper referrals and treatment plans. A study done by Kelley, Lockley, Kelley, & Evans (2017) implemented a 10:00 a.m. start time at an urban school in England. By delaying school start times, Kelley et al., found that …

Promoting Resilience In Economically Disadvantaged Adolescents Through School-Based Expressive Arts Groups, Bailey Knox

Expressive Therapies Capstone Theses

Since 2013, the majority of students served by the public school system in the United States have been considered “low-income” by the federal government. The stressors associated with low socioeconomic status significantly increase risk for social, emotional and behavioral challenges at all age levels, but can be particularly damaging to adolescents coping with heightened stress levels related to the intense multi-dimensional changes that define this developmental period. As the correlation between economic disadvantage and negative socio-emotional and academic outcomes is increasingly evidenced, schools have begun to recognize their responsibility for providing preventative mental health care to high-risk students. Over the …

Improving Perioperative Warming Of Surgical Patients: Implementation Of A Warming Protocol, Maghy Schrage

Doctor of Nursing Practice Projects

Despite the ample amount of knowledge and interventions available to keep patients warm in the operating room, the issue of inadvertent perioperative hypothermia continues to be a problem affecting surgical patients. Unfortunately, even a mild degree of hypothermia can increase a patient’s chance for negative outcomes such as surgical site infections, bleeding, and higher risk for mortality. The project involved development of a warming protocol/guideline for a small community hospital. The implementation process consisted of two separate presentations tailored to educate both nursing and anesthesia staff about the importance of warming patients, reimbursement initiatives, and appropriate interventions.

The project study …

An E-Learning Adaptation Of An Evidence-Based Media Literacy Curriculum To Prevent Youth Substance Use In Community Groups: Development And Feasibility Of Real Media, Anne E. Ray, Kathryn Greene, Michael L. Hecht, Sarah C. Barriage, Michelle Miller-Day, Shannon D. Glenn, Smita C. Banerjee

Communication Faculty Articles and Research

Background: There is a need for evidence-based substance use prevention efforts that target high school-aged youth that are easy to implement and suitable for dissemination in school and community groups. The Youth Message Development (YMD) program is a brief, four-lesson, in-person curriculum that aims to prevent youth substance use through the development of youth media literacy. Specifically, YMD aims to increase understanding of advertising reach and costs, along with the techniques used to sell products; develop counterarguing and critical thinking skills in response to advertisements; and facilitate application of these skills to the development of youth-generated antisubstance messages. Although …

Muscle Circumference And Tendon Width Correlation In Rotator Cuff Tears, Michael Marcinko, Michael Bamimore, Mark Ujevic

Research Day

Introduction: Rotator cuff tears are a common pathology presenting in much of the population especially those with repetitive overhead activity. There are many papers that looked at the supraspinatus as the most commonly torn rotator cuff muscle, however, there is a lack of research on the correlation between muscle morphology and injury. This was the framework for our anatomical study using cadavers, in which the circumference of the muscle bellies and tendon widths of the supraspinatus and infraspinatus muscles were measured.

Methods: 27 Cadavers provided by the Physician assistant program and first-year Osteopathic students in their respective anatomy …

Implementing Routine Hiv Testing And Prevention In A Primary Care Setting, Michelle Bassett

Doctor of Nursing Practice Projects

Evidenced-based research has identified that routine HIV testing and education is pivotal in identifying new infections, providing access to treatment, and decreasing the rates of transmission. In 2006, the CDC implemented new guidelines recommending that all persons aged 13-64 years be tested yearly for HIV regardless of risk factors. Despite these recommendations, the CDC estimated that less than 37% of people were tested in 2017 and in the years prior. In this project, a protocol for routine testing and education was developed and implemented in a private Southern Illinois primary care practice. Providers and staff were educated on HIV and …

A Review Of The Treatment And Prevention Options For Medial Tibial Stress Syndrome, Samantha Yamasaki

Senior Honors Theses

Medial Tibial Stress Syndrome (MTSS) is a chronic lower-limb injury that effects a large population of athletes and exercisers. There is no definitive knowledge on what causes this injury, making prevention and treatment difficult. The purpose of this thesis is to identify the prevention and treatment methods for MTSS that seem the most promising. The risk factors of MTSS and possible preventative methods are first presented. Following this is an overview of both traditional and cutting-edge treatment options. One of the major conclusions reached in this thesis is that prevention of MTSS is often easier than treating it after onset. …

Identifying Patients At Risk For Cardiovascular Disease.Docx, Shealyn Berry

Shealyn Berry

Social Determinants Of Child Trafficking Addressed By Government And Non-Government Strategies In South And Southeast Asia: An Integrate Review, Pragya Gautam Poudel, Cristina S. Barroso

Public Health Publications and Other Works

Aims: Child trafficking in South and Southeast Asia is widespread and deeply troubling. While several agencies have initiated anti-child trafficking interventions, it is unknown if they address the 21 social determinants of child trafficking identified by Perry and McEwing (2103). The aim of this integrative review was to explore the anti-child trafficking strategies employed by governments and non-government organizations (NGOs) that target the social determinants of child trafficking in South and Southeast Asia, and identify which levels of the Socio-Ecological Model (SEM) they address.

Methods: The authors performed a literature search for journal articles and reports by researchers, local or …

Butting Heads: Tackling Football Concussion And Prevention, Mandy Mcdaniel

BU Well

Hundreds of thousands of sports concussions occur each year in the United States, and almost half of them are the result of a football injury. Even though they may not initially appear serious, concussions can lead to extreme cognitive impairments in those affected. This article highlights the importance of treating concussions properly and educating coaches, parents, and athletes on the value of allowing young athletes to take the time they need to fully recover.

A Multi-Faceted Intervention To Improve Diagnosis And Treatment Rates Of Overweight And Obesity By Nurse Practitioners In Primary Care, Susan Disser

Evidence-Based Practice Project Reports

The United States is amid an obesity epidemic (Institute of Medicine, 2012). Indiana ranks as the tenth most overweight state. (America’s Health Rankings, 2018). Despite guidelines outlining the treatment of obesity, primary care providers seldom use these guidelines (Hayes et al., 2017). In a 2010 study, only 28.9% of obese patients received a diagnosis of obesity and less than 25% of these patients received counseling on diet, exercise, or weight loss (Bleich, Pickett-Blackely, & Cooper, 2011). The purpose of this evidence-based practice (EBP) project is to determine if a multi-faceted intervention consisting of academic detailing, reminders, audit with feedback, and …

Increasing Prevention And Recognition Of Delirium In A Non-Icu Acute Care Population, Anne Gembrowski

Doctoral Projects

Delirium is associated with increased mortality, nosocomial complications, increased length of hospital stay, and greater chance of readmission, increased hospital costs, and a need for skilled nursing aid after discharge from the hospital. In a hospital, delirium can affect up to 50 percent of older patient 65. The solution is to prevent delirium from occurring and to regularly screen for its presence. The purpose of this paper is to explore the best prevention strategies and screening tool for delirium and to successfully implement a delirium bundle on a medical surgical unit. The question this paper attempts to answer is if …

The Implications Of Ace Science: A Call To Respond, Valerie Norcross

The Diana McDonald Writer's Challenge

In “The Implications of ACE Science: A Call to Respond,” Valerie Norcross employs a professional format for writing in the field of psychology. Her essay cites studies linking Adverse Childhood Experiences (ACEs) with higher mortality rates due to a range of causes. Norcross explains some of the scientific theories for why childhood traumas contribute to shorter life expectancies. She describes efforts to screen children for ACEs and interventions for diminishing the long-term detrimental health effects of ACEs.

Fall Prevention Education Training For Older Adults With Serious Mental Illness And Previous Homelessness, Alex Manwaring, Bs, Tina Deangelis, Edd, Otr/L, Elizabeth Brooks, Bs

Department of Occupational Therapy Posters and Presentations

Purpose: To examine the effect of an occupational therapy education and training program on fall risk awareness and fear of falling (FOF) with older adults who reside in one permanent supportive housing site, Project HOME (Housing. Opportunity. Medical. Education.), who have a history of serious mental illness and chronic homelessness.

Methods: Seven individuals aged 55+ from Project HOME, a permanent supportive housing non-profit organization in the Northeast, participated in a six-week pre-post occupational therapy education and training group program aimed to decrease FOF. Fear of falling was measured using the Fear of Falling Efficacy Scale –International (FES-I) with cut-off scores …

The Ability Of The U.S. Military’S Wbgt-Based Flag System To Recommend Safe Heat Stress Exposures, David R. Almario

USF Tampa Graduate Theses and Dissertations

The U.S. military currently uses a flag system based on wet-bulb globe temperature (WBGT) and metabolic rate to recommend heat stress exposure limits. This paper addresses the ability of the flag system to recommend safe heat exposures in a non-military population.

Two progressive heat stress studies provided data on 528 observations of safe or unsafe exposures of 4 hours over a range of WBGT conditions and metabolic rates using 29 participants wearing woven cotton clothing. For the two studies, range of WBGT conditions was 25 to 42C, and the range of metabolic rates was 100 to 650 watts. These exposures …

Primary Prevention Of Cardiovascular Diseases In Uzbekistan, E. R. Urazaliyeva, A. K. Ermatova, D. Y. Ramanova

Central Asian Problems of Modern Science and Education

Every year, an estimated 17 million people globally die of cardiovascular diseases (CVD), particularly heart attacks and strokes. CVDs occur almost equally in men and women. Although heart attacks and strokes are major killers in all parts of the world, 80% of premature deaths from these causes could be avoided by controlling the main risk factors: tobacco, unhealthy diet and physical inactivity. By 2015, the total number of cardiovascular disease (CVD) deaths (mainly coronary heart disease, stroke, and rheumatic heart disease) had increased globally to 17.5 million from 14.4 million in 1990.