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Improving Heart Failure Education Prior To Discharge: An Emmi Implementation Project, Elizabeth Mccord

The Eleanor Mann School of Nursing DNP Capstone Projects

Background: Heart failure is one of the leading causes of hospitalizations and increased health care costs in the United States. Many patients are readmitted within 30 days of discharge, resulting in increased costs. Purpose of Capstone Project: The purpose of this capstone project was to improve heart failure education for patients admitted with heart failure to Mercy Medical Center by utilizing Emmi educational videos in order to decrease the risk of hospital readmissions, improve quality of life, and decrease costs. Methods: The project focused on educating nurses about the importance of utilizing the video. It was asked of the nurses …

Phoenix Ink: Psychodynamic Motivations For Tattoo Attainment By Survivors Of Trauma, December Renee Maxwell

Graduate Theses and Dissertations

Tattoos adorn people from all over the world and date back as far as the Stone Age. Tattoos adorn people from all over the world and motivations for tattoo attainment have been studied recently. Still, there remains limited research on the potential therapeutic properties of tattoo attainment, particularly for survivors of sexual trauma. The purpose of this study was to investigate the experience of the tattoo process for survivors of sexual trauma and their motivations for tattoo attainment. This qualitative exploratory study interviewed both survivors of sexual trauma (N=10) and tattoo artists (N=7) to gain a wider perspective on the …

Ophthalmic Manifestations Of Congenital Zika Syndrome In Colombia And Venezuela, Juan B. Yepez, Felipe A. Murati, Michele Petitto, Carlos F. Peñaranda, J. Fernando Arevalo, Gladys E. Maestre

School of Medicine Publications

IMPORTANCE The ocular manifestations and sequelae of Zika virus infection are not well known. Recently, the World Health Organization changed the declaration of Zika as a public health emergency and designated the viral outbreak and related microcephaly clusters as a long-term program of work. This change indicates the urgent need to evaluate and document ophthalmic manifestations in patients for timely management of this disease. In addition, confirmation whether the public health problem in Brazil extends to other regions in South America is needed.

OBJECTIVE To report the ocular manifestations of congenital Zika syndrome with microcephaly in Colombia and Venezuela.

DESIGN, …

Concurrent Surgery And Informed Consent, Andrew M. Weller

College Honors Program

This thesis seeks to construct an ethical course of action for concurrent surgery, a practice brought into the public eye by The Boston Globe, which argued against allowing one attending surgeon to oversee two cases on separate patients in different operating rooms. First, the common morality and its four main principles relevant to biomedical ethics will be described which will be subsequently used to show that concurrent surgery is allowed according to non-violation of the principle of non-maleficence through current empirical evidence, and supported by the principle of beneficence and justice. Next, the principle of respect for autonomy will be …

Unmet Need For Surgery In South Asia, Sanjay Nagral, Maharra Hussain, Sarder A. Nayeem, Ranjan Dias, S. Ather Enam, Samiran Nundy

Section of Neurosurgery

No abstract provided.

Physical Activity Levels & Successful Aging, Ryan R. Bourque

Thinking Matters Symposium Archive

Hypothesis: Greater levels of physical activity have a positive correlation with greater levels of independence as well as better outcomes with respect to self-perceived health-related quality of life for elderly individuals (65+ years of age).

Perceptions Of Successful Aging Among Maine Elders With Physical Limitations: Insights From Qualitative Interviews, Madeline Minor, Rebecca Knight

Thinking Matters Symposium Archive

Research Question: How do elders living with a disability perceive the aging process?

Unmet Need For Surgery In South Asia, Sanjay Nagral, Maharra Hussain, Sarder A Nayeem, Ranjan Dias, S. Ather Enam

Department of Surgery Docs

No abstract provided.

Physician Satisfaction With Integrated Behavioral Health In Pediatric Primary Care., Jeffrey F. Hine, Allison Q. Grennan, Kathryn M. Menousek, Gail Robertson, Rachel J. Valleley, Joseph H. Evans

Manuscripts, Articles, Book Chapters and Other Papers

As the benefits of integrated behavioral health care services are becoming more widely recognized, this study investigated physician satisfaction with ongoing integrated psychology services in pediatric primary care clinics. Data were collected across 5 urban and 6 rural clinics and demonstrated the specific factors that physicians view as assets to having efficient access to a pediatric behavioral health practitioner. Results indicated significant satisfaction related to quality and continuity of care and improved access to services. Such models of care may increase access to care and reduce other service barriers encountered by individuals and their families with behavioral health concerns (ie, …

What Is The Contribution Of Ia-Afference For Regulating Motor Output Variability During Standing?, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Motor variability is an inherent feature of all human movements, and describes the system‘s stability and rigidity during the performance of functional motor tasks such as balancing. In order to ensure successful task execution, the nervous system is thought to be able to flexibly select the appropriate level of variability. However, it remains unknown which neurophysiological pathways are utilized for the control of motor output variability. In responding to natural variability (in this example sway), it is plausible that the neuro-physiological response to muscular elongation contributes to restoring a balanced upright posture. In this study, the postural sway of 18 …

The Art And Skill Of Delivering Culturally Responsive Trauma-Focused Cognitive Behavioral Therapy In Tanzania And Kenya., Briana Woods-Jaeger, Christine M. Kava, Christopher F. Akiba, Leah Lucid, Shannon Dorsey

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: This study explored the facilitators, barriers, and strategies used to deliver a child mental health evidence-based treatment (EBT), trauma-focused cognitive behavioral therapy (TF-CBT), in a culturally responsive manner. In low- and middle-income countries most individuals with mental health problems do not receive treatment due to a shortage of mental health professionals. One approach to addressing this problem is task-sharing, in which lay counselors are trained to deliver mental health treatment. Combining this approach with a focus on EBT provides a strategy for bridging the mental health treatment gap. However, little is known about how western-developed EBTs are delivered in …

Motivating And Demotivating Factors For Community Health Workers Engaged In Maternal, Newborn And Child Health Programs In Low And Middle-Income Countries: A Systematic Review., Leah Shipton, Aysha Zahidie, F. Rabbani

Community Health Sciences

This systematic review aimed to synthesize primary research on motivating factors of community health workers (CHWs) for maternal, neonatal, and child health (MNCH) in low and middle-income countries (LMICs). Peer-reviewed literatures were systematically searched in five databases. Identified studies were then screened and selected for inclusion. The eligibility criteria were reported primary qualitative, quantitative, or mixed methods research, with participants being CHWs in LMICs who address MNCH, which investigated motivation or related concepts of retention, attrition, and performance. A thematic synthesis process was used to analyze findings of motivating factors, reported by included studies. Seventeen qualitative, quantitative, or mixed methods …

Professional Practices, Training, And Funding Mechanisms: A Survey Of Pediatric Primary Care Psychologists, Kathryn W. Hoffses, Andrew R. Riley, Kathryn M. Menousek, Kriston B. Schellinger, Allison O. Grennan, Chrissy Cammarata, Jason L. Steadman

Department of Pediatrics Faculty Papers

The integration of mental health services in primary care settings has expanded rapidly in recent years with psychologists being at the forefront of efforts to promote healthy behaviors, reduce disease, and care for behavioral, emotional, and developmental needs to promote overall health and well-being for children and families (Asarnow, Kolko, Miranda,&Kazak, 2017; Stancin& Perrin, 2014). While there are many psychologists working in pediatric primary care (PPC), little is known about the specific activities that these psychologists engage in, the training they receive, or funding mechanisms that support their work. This study sought to address this gap in the literature through …

Childhood Obesity: The Role Of The Mental Health Professional, Barry Panzer

NYMC Faculty Publications

This work consists of two major components: understanding the nature of childhood obesity and providing clinical services. Factors responsible for the current epidemic will be outlined, as will the current definition of the disorder. Statistical data regarding the epidemiology of weight disorders in childhood will be provided in order to give a perspective of the problem. Various obesity trajectories and their differential diagnostic and treatment issues will be thoroughly explored. The intervention section intends to help clinicians to evaluate salient factors in assessing the obese child and to identify appropriate goals and treatment methods. The course will provide vital information …

Interdisciplinary Care Of Children With Severe Bronchopulmonary Dysplasia., Steven H. Abman, Joseph M. Collaco, Edward G. Shepherd, Martin Keszler, Milenka Cuevas-Guaman, Stephen E. Welty, William E. Truog, Sharon A. Mcgrath-Morrow, Paul E. Moore, Lawrence M. Rhein, Haresh Kirpalani, Huayan Zhang, Linda L. Gratny, Susan K. Lynch, Jennifer Curtiss, Barbara S. Stonestreet, Robin L. Mckinney, Kevin C. Dysart, Jason Gien, Christopher D. Baker, Pamela K. Donohue, Eric Austin, Candice Fike, Leif D. Nelin, Bronchopulmonary Dysplasia Collaborative

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Developing Morally Sensitive Policy In The Nicu: Donation After Circulatory Determination Of Death, Michael Van Manen, Nicole Kain

The Qualitative Report

Policy development is an important activity for the practice of healthcare. Policies, after all, may cultivate common practices and ensure that best available evidence is employed in clinical decision making. Qualitative research and individuals with expertise in qualitative research methods have much to offer policy makers. We were confronted with the situation of developing policy for donation after circulatory death (DCD) for our newborn intensive care program. Due the moral-ethical complexities surrounding DCD, and the limited experience with DCD in this context, we approached policy development from an iterative design perspective employing qualitative methods. We describe our experience in employing …

End-Of-Life Training In Us Internal Medicine Residency Programs: A National Study, Derek Cegelka, Timothy R. Jordan, Jiunn-Jye Sheu, Joseph A. Dake, Ragheb Assaly

Faculty Publications

Background: End-of-life care is a required and important component of medical training for internal medicine residents; many of whom will go on to provide care for adults at the end-of-life stage. Although a body of past research suggests that physician training in end-of-life care needs significant improvement, a comprehensive national study of end-of-life education within US internal medicine residency programs has never been published.

Objective: To determine the status of end-of-life education in internal medicine residency programs in the United States.

Method: The study was a cross-sectional, observational study of all internal medicine Residency Program Directors in the US as …

Meeting Aging-Related Needs In 2016, Edward F. Ansello

Director's Editorials from Age in Action

Our Virginia Center on Aging has four program focuses. These programs are: dementia, elder abuse and domestic violence in later life, geriatrics education, and lifelong learning. Each achieved substantially in calendar 2016.

Oral Health And Aging, Edward F. Ansello

Director's Editorials from Age in Action

The sooner we recognize the importance of oral health to our well-being as older adults, the better we age. We need to consider our dentist as part of our health care team. For those of us in health professions, we should work together more to incorporate oral health into primary care.

Integrating Geriatrics In Primary Care: Progress And Prospects, Daniel A. Bluestein, Ryan M. Diduk-Smith

Case Studies from Age in Action

Educational Objectives

1. Demonstrate the need for primary care redesign to better meet the needs of older patients.

2. Identify prospective redesign solutions.

3. Appreciate educational implication that redesign engenders.

Training Us Health Care Professionals On Human Trafficking: Where Do We Go From Here?, Clydette Powell, Kirsten Dickins, Hanni Stoklosa

Pediatrics Faculty Publications

Some 21 million adults and children are labor-trafficked or sex-trafficked through force, fraud, or coercion. In recognition of the interface between trafficking victims and the healthcare setting, over the last 10 years there has been a notable increase in training of health care professionals (HCPs) on human trafficking (HT) and its health implications. Many organizations have developed curricula and offered training in various clinical settings. However, methods and content of this education on trafficking vary widely, and there is little evaluation of the impact of the training. The goal of this study was to assess the gaps and strengths in …

Implementing Integrated Care In Family Medicine: Description And Outcomes In An Underserved Population, Zach Radcliff

Theses and Dissertations

Introduction: Family physicians provide access to medical and behavioral healthcare for many underserved populations. Integrating behavioral health clinicians into primary care practices has been proposed as one of the most effective ways to increase access to necessary behavioral health services for many Americans. Integrated behavioral healthcare (IBHC) has begun to be implemented in family medicine practices but there is limited research examining the impact for patients and clinic staff. This study begins to fill this gap in the literature by examining the effects of implementing integrated behavioral healthcare in an urban family medicine clinic in a medically underserved area.

Objective: …

The Impact Of Maternity Healthcare Employees Professional Development On Pregnant Teen Health, Patricia.Kelley Kelley

Walden Dissertations and Doctoral Studies

Knowledge gaps exist related to the care and education of pregnant teens. This project study addressed the problem of an inadequate amount of professional development (PD) and training for healthcare professionals (HCPs) caring for pregnant teens at a maternity clinic in the Southeastern United States. Unless HCPs are appropriately trained, the ability to meet the needs of pregnant teens is deficient and negative health outcomes for these patients are likely to be exacerbated. The humanistic learning theory was used in this phenomenological exploratory study to explore perception of 9 HCPs who had the responsibility for patient teaching, clinical care, and …

Self-Care Among Older Adults With Heart Failure, Sumayya Attaallah, Kay Klymko, Faith Pratt Hopp

Social Work Faculty Publications

Background: It is estimated that 5.7 million Americans are living with heart failure (HF) today. Despite the fact that HF is one of the most common reasons people aged 65 years and older are admitted into the hospital, few studies describe the self-care in this older adult population. Purpose: The purpose of the study was to review the current literature on self-care in this population to better understand the influence of selected factors on self-care and health outcomes. Methods: A literature search was completed and resulted in including 28 studies. Results: Multiple factors have been reported as barriers to self-care …

Decreasing Cost Associated Medication Nonadherence, Shawn E. Raymond

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Shawn E. Raymond

Medication cost is a major contributor for patient medication nonadherence. Take in the fact that a large population lives in poverty, many cannot afford to pay the retail prices associated with purchasing their medications. By incorporating wholesale medications into a charitable health clinic, the reduced cost of medications for treatment of both acute and chronic illnesses could be passed on to those in need thereby decreasing cost associated medication nonadherence. Nurse Practitioners in the state of Kansas are not afforded the privilege to purchase, repackage and distribute or resell wholesale …

Staff Responses When Parents Hit Children In A Hospital Setting., Sarah A. Font, Elizabeth T. Gershoff, Catherine A. Taylor, Amy Terreros, Monica Nielsen-Parker, Lisa Spector, Rebecca H. Foster, Ann Budzak Garza, Denyse Olson-Dorff

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Physical punishment of children is a prevalent practice that is condemned by most medical professionals given its link with increased risk of child physical abuse and other adverse child outcomes. This study examined the prevalence of parent-to-child hitting in medical settings and the intervention behaviors of staff who witness it.

METHOD: Staff at a children's medical center and a general medical center completed a voluntary, anonymous survey. We used descriptive statistics to examine differences in the experiences of physicians, nurses, and other medical staff. We used logistic regression to predict intervention behaviors among staff who witnessed parent-to-child hitting.

RESULTS: …

Medical Center Staff Attitudes About Spanking., Elizabeth T. Gershoff, Sarah A. Font, Catherine A. Taylor, Rebecca H. Foster, Ann Budzak Garza, Denyse Olson-Dorff, Amy Terreros, Monica Nielsen-Parker, Lisa Spector

Manuscripts, Articles, Book Chapters and Other Papers

Several medical professional organizations, including the American Academy of Pediatrics, recommend that parents avoid hitting children for disciplinary purposes (e.g., spanking) and that medical professionals advise parents to use alternative methods. The extent to which medical professionals continue to endorse spanking is unknown. This study is the first to examine attitudes about spanking among staff throughout medical settings, including non-direct care staff. A total of 2580 staff at a large general medical center and 733 staff at a children's hospital completed an online survey; respondents were roughly divided between staff who provide direct care to patients (e.g., physicians, nurses) and …

Academic Medicine Responds To The Opioid Crisis, John Prescott

Marshall Journal of Medicine

Opioid dependence has devastated communities across the nation particularly in rural states and academic medicine has responded in a variety of ways. Through its tripartite mission of education, research, and clinical care, creative solutions are being implanted. Medical schools and teaching hospitals are partnering with public health and law enforcement agencies, as well as local healthcare providers to address the clinical, social, and rehabilitative challenges. Academic medicine continues to adapt to the needs of the nation and teach, train, and prepare the next generation of physicians to be at their best when things are at their worst.

Women’S Experiences With Prenatal Care: A Mixed-Methods Study Exploring The Influence Of The Social Determinants Of Health, Karen A. D'Angelo, Janelle K. Bryan, Brenda Kurz

Journal of Health Disparities Research and Practice

Background & Purpose: Racial and ethnic disparities pervade birth outcomes in the United States and the state of Connecticut. While Connecticut’s infant mortality rate is less than the national average, rates for the state’s Black/African American and Hispanic/Latino communities exceed it. This study explored how prenatal care in Connecticut may be enhanced to address these disparities.

Methods: In spring 2013, seven focus groups and two semi-structured interviews were conducted (n=47). Participants also self-administered brief surveys. Recruited by local service providers, participants were 18 or older, pregnant and/or in the first year post-partum at the time. Most self-identified as …

Helping Navigate The Complex Web Of Community Medicine: How Dedicated Social Services Support In The Ed Can Prevent Unnecessary Ed Visits And Hospital Readmissions, Adam Kennah

Learning Showcase 2016: A Celebration of Discovery, Transformation and Success

A hospital's Emergency Department (ED) serves as its front door to the community. The vast majority of admitted patients present initially to the ED, and even more still begin and end their hospital visit in the ED. A hospital's ED will deal with every societal ill facing that community. However, most hospitals reserve dedicated Social Service resources to admitted patients who have had prolonged inpatient hospital stays. EDs around the country are being overburdened with patients who present to the ED for non-emergent conditions. Access to community based healthcare is daunting even for well-connected individuals. It can be downright impenetrable …