Digital Commons Network^™

Factors Associated With Provider Utilization Of The Heath Information Exchange In The State Of Hawaii, Kris K. Wilson

Walden Dissertations and Doctoral Studies

In a context where technology is increasingly being incorporated into health care practice, many U.S. health care providers and organizations are finding it challenging to connect disparate electronic documentation systems to retrieve patient information when coordinating care across providers and heath care entities. Local and regional health information exchange (HIE) systems were created to facilitate collecting information into one integrated patient record to address information transfer between heath care providers. Yet, adoption and use of HIEs have been low. The purpose of this study was to review the predictive factors accounting for physicians' use of a HIE in the U.S. …

Perceived Parental Barriers To Preventive Dental Care Programs For Children, Kim Attanasi

Walden Dissertations and Doctoral Studies

Dental caries is the most prevalent childhood illness and disproportionately affects children from low socioeconomic backgrounds. Dental organizations are collaborating within communities to decrease oral health disparities among children by offering free preventive oral health events. These programs face the problem of low enrollment due to lack of informed parental consent. Also, gaps in the literature indicated the need to examine oral health perceptions and dental-care-seeking practices of culturally diverse low-income parents regarding preventive care for their children. The purpose of this qualitative case study was to explore the reasons why parents are not allowing their children to participate in …

An Evidence-Based Mentorship Program For Experienced Nurses, Roma Allen

Walden Dissertations and Doctoral Studies

Turnover of experienced nurses is a component of the nursing shortage, which has created a lack of expert nurses administering bedside care. The project site is a Chicago suburban hospital with an average first year turnover of experienced nurses at 35%. This rate is above the 27% first year turnover reported by the Metropolitan Chicago Healthcare Council. This project focused on development and evaluation of an evidence-based mentorship program supported by theory that can contribute to an increase in experienced nurse retention. A detailed literature review references causative factors of turnover, such as an increasing workload, a multigenerational and aging …

Educational Module Toolkit To Assist Adult Patients With Type Ii Diabetes Mellitus, Dometrives Armstrong

Walden Dissertations and Doctoral Studies

Diabetes is a challenging chronic disease for adult patients to manage effectively. Poor adherence to prescribed medications treatment is one of the main reasons for poor blood sugar control. Despite healthcare providers' efforts to emphasize the importance of taking medications, adult patients with Type II diabetes frequently present with complications related to persistent failure to adhere to prescribed medication regimen. These patients should thoroughly understand why adhering to a strict medication regimen to maintain control of their blood sugar is so important. The purpose of this project, guided by Orem's self-care deficit nursing theory, was to develop an educational module …

A Critical Assessment Of The “Sterile Womb” And “In Utero Colonization” Hypotheses: Implications For Research On The Pioneer Infant Microbiome, Maria Elisa Perez-Muñoz, Marie-Claire Arrieta, Amanda E. Ramer-Tait, Jens Walter

Department of Food Science and Technology: Faculty Publications

After more than a century of active research, the notion that the human fetal environment is sterile and that the neonate’s microbiome is acquired during and after birth was an accepted dogma. However, recent studies using molecular techniques suggest bacterial communities in the placenta, amniotic fluid, and meconium from healthy pregnancies. These findings have led many scientists to challenge the “sterile womb paradigm” and propose that microbiome acquisition instead begins in utero, an idea that would fundamentally change our understanding of gut microbiota acquisition and its role in human development. In this review, we provide a critical assessment of the …

Identification, Diagnosis, Counseling, And Referral Of Overweight Military Dependent Children To Reverse Early Childhood Obesity, Gerald William Hall

Walden Dissertations and Doctoral Studies

Since 1980, the obesity rate in children 5 to 11 years of age has increased from 7% to 18%. The lack of structured physical activity and poor dietary habits childhood are primary risk factors for obesity related comorbidities in adulthood. Guided by primary care providers, families can reverse childhood obesity by implementing healthy dietary habits and engaging in structured physical activity. The purpose of this quality improvement project was to develop an evidenced-based policy with procedures to standardize the timely and consistent identification of overweight children at a primary care clinic serving military families. With an emphasis on obesity prevention …

Bone Loss Quantification Following Extraction In Rats: A Foundation For Grafting And Regenerative Studies, Emily Willett

Theses & Dissertations

Background: Loss of the alveolar ridge width and height following extraction is well-documented and several techniques, including grafting, have been proposed to reduce bone loss. Purpose: To characterize the pattern of bone turnover and inflammation after extraction and to initiate a study of the effect of grafting and local administration of simvastatin (SIM). Methods: Thirty-two retired-breeder rats underwent extraction of the right maxillary first molar and standard surgical defect creation under inhalation anesthesia. The left side of each animal served as the unmanipulated control. Comparison of groups (n=8, ANOVA) was done at days 0, 7, 14, and …

Adobe Medicus 2016 5 September-December, Unm Hslic

adobe medicus

No abstract provided.

Cost Of Care For Hospitalized Patients With Pulmonary Mycobacterial Diseases In The United States., Mary Beth Wells Allen

Electronic Theses and Dissertations

Background: Pulmonary mycobacterial diseases describe both tuberculosis (TB) and nontuberculous mycobacteria (NTM). Few data are available measuring the cost burden of mycobacterial diseases on the national level. The purpose of this study was to evaluate the cost burden and measure emerging trends in hospitalization of pulmonary TB and NTM in the US from 2001 through 2012. Methods: This study was a retrospective community based cost analysis of hospitalized patients with a principal diagnosis of pulmonary mycobacterial diseases from 2001 through 2012. Data for pulmonary TB and NTM were retrieved from the Healthcare Cost and Utilization Project (HCUP), US Department of …

The Relationship Between Time Of Day, Mood, And Electroencephalography (Eeg) Asymmetry, Morgan Tantillo

Honors Projects

Previous researchers have had success in finding a correlation between exercise and an increase in positive mood. Researchers have also found a correlation between time of day and mood. The current study will explore the relationship between time of day, mood, and electroencephalography (EEG) asymmetry. The study utilized a convenient sample of ten undergraduate students at Bowling Green State University. Participants had baseline EEG recordings taken, and then participated in moderate exercise, followed by another EEG recording. Participants’ mood was assessed through a self-reported mood questionnaire before the condition as well as immediately after. Due to multiple statistical tests, the …

Defining The Value Framework For Prostate Brachytherapy Using Patient-Centered Outcome Metrics And Time-Driven Activity-Based Costing, N. G. Thaker, T. J. Pugh, U. Mahmood, S. Choi, T. E. Spinks, N. E. Martin, T. T. Sio, B. W. Cox, L. Potters, S. J. Frank, +8 Additional Authors

Journal Articles

No abstract provided.

Effect Of The Normalized Prescription Isodose Line On The Magnitude Of Monte Carlo Vs. Pencil Beam Target Dose Differences For Lung Stereotactic Body Radiotherapy, D. Zheng, Q. Zhang, X. Liang, X. Zhu, V. Verma, S. Wang, S. Zhou

Journal Articles

© This work is licensed under a Creative Commons Attribution 3.0 Unported License. In lung stereotactic body radiotherapy (SBRT) cases, the pencil beam (PB) dose calculation algorithm is known to overestimate target dose as compared to the more accurate Monte Carlo (MC) algorithm. We investigated whether changing the normalized prescription isodose line affected the magnitude of MC vs. PB target dose differences. Forty-eight patient plans and twenty virtual-tumor phantom plans were studied. For patient plans, four alternative plans prescribed to 60%, 70%, 80%, and 90% isodose lines were each created for 12 patients who previously received lung SBRT treatments. Using …

Airline Pilots In Recovery From Alcoholism: A Quantitative Study Of Cognitive Change, Heather Christina Hamilton

Walden Dissertations and Doctoral Studies

In order to perform their duties, airline pilots must have no clinical diagnosis of mental illness or any substance use disorder. However, provisions have been in place since the 1970s that provide for a return to work for airline pilots with alcohol problems. To date, over 5,000 airline pilots have undergone rehabilitation for Alcohol Use Disorder (AUD) and successfully returned to work. An important gap in the literature remains with regard to what extent improvements in cognitive performance may be experienced by airline pilots who complete treatment and to what extent age influences the amount of change. This study examined …

Global Mortality Impact Of The 1957–1959 Influenza Pandemic, Cecile Viboud, Lone Simonsen, Rodrigo Fuentes, Jose Flores, Mark A. Miller, Gerardo Chowell

Global Health Faculty Publications

Background. Quantitative estimates of the global burden of the 1957 influenza pandemic are lacking. Here we fill this gap by modeling historical mortality statistics.

Methods. We used annual rates of age- and cause-specific deaths to estimate pandemic-related mortality in excess of background levels in 39 countries in Europe, the Asia-Pacific region, and the Americas. We modeled the relationship between excess mortality and development indicators to extrapolate the global burden of the pandemic.

Results. The pandemic-associated excess respiratory mortality rate was 1.9/10 000 population (95% confidence interval [CI], 1.2–2.6 cases/10 000 population) on average during 1957–1959. Excess mortality rates varied 70-fold …

Methylmercury Exposure Via Canned Tuna Fish Consumption And Breast Cancer, Jennifer Bodenrader

Walden Dissertations and Doctoral Studies

Widespread consumption of canned tuna fish since the 1950s may explain some of the increase in breast cancer prevalence in the United States and Europe. Although canned tuna is the primary source of human exposure to methylmercury, its role as an estrogen activating metalloestrogen has been overlooked in the etiology and incidence of breast cancer. Carcinogenic theory asserts that increased exposure to estrogen elevates the risk of breast cancer. The purpose of this population-based, case control study was to examine the association between canned tuna consumption, total blood mercury, and breast cancer in the NHANES 2003-2006 surveys. A multivariable logistic …

Characteristics Of Adult Icu Patients With Device Associated Nosocomial Infections, Doramarie Arocha

Walden Dissertations and Doctoral Studies

Nosocomial infections are a cause of concern for hospital patients and the incidence rates of these infections are greater in intensive care units (ICUs) due to the invasive nature of treatments, additional risk factors and comorbidities, and therapies used. Invasive devices, such as vascular central lines, Foley catheters, and mechanical ventilators pose a risk for critically ill patients in the ICUs to develop device-related, healthcare-associated infections (HAI). The purpose of this study was to describe the epidemiological characteristics of patients who developed device-related HAIs within 3 ICU units (medical-surgical, cardiovascular, and neurosurgical) of an academic medical facility. The ecosocial theory …

African Americans' Understanding Of The Provisions Of The Affordable Care Act, Ewang Theo Epie-Alobwede

Walden Dissertations and Doctoral Studies

African Americans as a group tend to have numerous health issues, and by the time they seek healthcare, the conditions often advance into more serious ailments. Researchers have shown that cultural distrust of the U.S. healthcare system coupled with some discriminatory practices has hindered African Americans seeking care and taking full advantage of the healthcare system. With the introduction of the Patient Protection and Affordable Care Act (ACA), there is some confusion about the application of the law, resulting in many intended beneficiaries misinterpreting it, and not accessing quality healthcare. This interpretive phenomenological study explored how African Americans in the …

The Spanish-English Bilingual: A Cross-Classfication Comparison Of Maze Use In Children, Jessica Valles

Open Access Theses & Dissertations

With the continual increase of bilingual individuals in the United States, there is a critical need for research that can appropriately identify unique characteristics of language production for these individuals. In particular, maze use, or errors in production have been identified as a characteristic of language that typically occurs more in bilinguals' speech production than in monolingual productions. Research comparing bilingual maze use in individuals who are typically developing with bilingual maze use individuals who are language impaired is limited. To compare these bilingual children with language impairment with to their typically developing peers, children were paired by age, grade, …

The Use Of Lasers For Direct Pulp Capping, Takashi Komabayashi, Arata Ebihara, Akira Aoki

Dental Medicine Faculty Publications

Direct pulp capping helps extend the life of a diseased tooth by maintaining tooth vitality. Nowadays, lasers are more frequently used during direct pulp capping in the clinic, but their use has not been previously reviewed. This review presents the basic properties of currently available lasers, scientific evidence on the effects of laser application on direct pulp capping, and future directions for this technology. An extensive literature search was conducted in various databases for articles published up to January 2015. Original in vitro, in vivo, and clinical studies, reviews, and book chapters published in English were included. Various laser systems …

Normal Glycolytic Enzyme Activity Is Critical For Hypoxia Inducible Factor-1a Activity And Provides Novel Targets For Inhibiting Tumor Growth, Geoffrey Grandjean Phd

Dissertations and Theses (Open Access)

Normal Glycolytic Enzyme Activity is Critical for Hypoxia Inducible Factor-1α Activity and Provides Novel Targets for Inhibiting Tumor Growth

By Geoffrey Grandjean

Advisory Professor: Garth Powis, D. Phil

Unique to proliferating cancer cells is the observation that their increased need for energy is provided by a high rate of glycolysis followed by lactic acid fermentation in a process known as the Warburg Effect, a process many times less efficient than oxidative phosphorylation employed by normal cells to satisfy a similar energy demand ^[1]. This high rate of glycolysis occurs regardless of the concentration of oxygen in the cell and …

Characterization Of Noise Exposure For High-Volume Restaurant Workers, Desiree Gladieux

USF Tampa Graduate Theses and Dissertations

Occupational hearing loss resulting from noise exposures encountered in the workplace affects millions of workers and costs hundreds of millions of dollars annually in Workers’ Compensation costs in the United States alone. Some industries have been well studied, and the presence of hazardous noise in the work environment established and documented. The restaurant industry is one in which little current data exists, but in which there may be cause for concern.

This work sought to quantify noise exposures for cooks, servers, and dishwashers and to determine whether or not any of these workers are at risk for Noise Induced Hearing …

The Experiment Must Continue: Medical Research And Ethics In East Africa, 1940–2014, Melissa Graboyes

Ohio University Press Open Access Books

The Experiment Must Continue is a beautifully articulated ethnographic history of medical experimentation in East Africa from 1940 through 2014. In it, Melissa Graboyes combines her training in public health and in history to treat her subject with the dual sensitivities of a medical ethicist and a fine historian. She breathes life into the fascinating histories of research on human subjects, elucidating the hopes of the interventionists and the experiences of the putative beneficiaries.

Historical case studies highlight failed attempts to eliminate tropical diseases, while modern examples delve into ongoing malaria and HIV/AIDS research. Collectively, these show how East Africans …

Metabolomics Of Transformed Mda-Mb-231 Cell Lines Expressing Different Levels Of Human Arylamine N-Acetyltransferase 1 (Nat1)., Samantha Marie Carlisle

Electronic Theses and Dissertations

Human arylamine N-acetyltransferase 1 (NAT1) is a phase II xenobiotic metabolizing enzyme that is found in almost all tissues of the body. Expression of NAT1 is commonly elevated in several cancers including breast cancer. However, the exact mechanism by which NAT1 expression affects cancer risk and progression remains unclear. Three MDA-MB-231 breast adenocarcinoma cell lines that stably express wild-type, increased, and decreased levels of human NAT1 have been constructed and characterized for NAT1 mRNA, NAT1 acetylation activity, cell doubling rates, and endogenous acetyl-CoA levels. Differences in polar metabolic profile between these three cell lines were investigated using a comprehensive GC×GC−TOF …

The Effect Of Aspirin On Bleeding And Transfusion In Contemporary Cardiac Surgery., Jordan E Goldhammer, Gregary D. Marhefka, Constantine Daskalakis, Mark W Berguson, John E Bowen, James Diehl, Jianzhong Sun

Department of Medicine Faculty Papers

OBJECTIVE: Despite evidence that preoperative aspirin improves outcomes in cardiac surgery, recommendations for aspirin use are inconsistent due to aspirin's anti-platelet effect and concern for bleeding. The purpose of this study was to investigate preoperative aspirin use and its effect on bleeding and transfusion in cardiac surgery.

METHODS: This retrospective study involved consecutive patients (n=1571) who underwent CABG, valve, or combined CABG and valve surgery at a single center between March 2007 and July 2012. Of all patients, 728 met the inclusion criteria and were divided into two groups: those using (n=603) or not using (n=125) aspirin within 5 days …

Space Environmental Factor Impacts Upon Murine Colon Microbiota And Mucosal Homeostasis, Lauren E. Ritchie, Stella S. Taddeo, Brad R. Weeks, Florence Lima, Susan A. Bloomfield, M. Andrea Azcarate-Peril, Sara R. Zwart, Scott M. Smith, Nancy D. Turner

Internal Medicine Faculty Publications

Astronaut intestinal health may be impacted by microgravity, radiation, and diet. The aim of this study was to characterize how high and low linear energy transfer (LET) radiation, microgravity, and elevated dietary iron affect colon microbiota (determined by 16S rDNA pyrosequencing) and colon function. Three independent experiments were conducted to achieve these goals: 1) fractionated low LET γ radiation (¹³⁷Cs, 3 Gy, RAD), high Fe diet (IRON) (650 mg/kg diet), and a combination of low LET γ radiation and high Fe diet (IRON+RAD) in male Sprague-Dawley rats; 2) high LET ³⁸Si particle exposure (0.050 Gy), 1/6 G …

The Impact Of Nursing Hours And Hospital And Patient Characteristics On Medicare Hospital Acquired Conditions: A National Pooled Cross-Sectional Secondary Data Model And Analysis, Terry Kahlert Eng

Graduate Doctoral Dissertations

Background: Previous research and quality improvement initiatives have underscored the prevalence of healthcare acquired conditions (HACs) and their associated costs in American hospitals. In response to these findings, in 2008, The Centers for Medicare and Medicaid Services identified 10 condition categories that they would no longer pay for if acquired during hospitalization. The conditions were selected based on high cost, high volume, or both, assigned to a higher paying medical severity diagnostic related group (MS-DRG), and were deemed preventable through application of evidence-based guidelines. The Health Quality Outcomes Model and a Path Model guided the study.

Objective: To quantify the …

Use Of The Peanut Ball To Decrease First And Second Stages Of Labor, Carol L. Payton

Graduate Theses, Dissertations, and Capstones

The purpose for this capstone project was to use a Peanut Ball, to mimic a sitting or squatting position, for decreasing length of first and second stages of labor. In addition, this project was designed to incorporate qualitative data on women’s perception of using the Peanut Ball during labor. The project question was “For laboring women, will use of a Peanut Ball for positioning, as compared to no use of a Peanut Ball, decrease length of first and/or second stages of labor?” The results included a significantly longer second stage of labor in the intervention group (75.63 minutes) when compared …

H1n1 Influenza Virus, Kail Consford, Drew Patel

Infectious Diseases Project 2015

On April 17, 2009, two patients in the United States were found with Swine-Origin Influenza A (H1N1) virus. This virus was spread to Mexico, Canada, and many other countries. From April 15 through May 5, a total of 642 confirmed cases of H1N1 infection were identified in 41 states. The ages of the patients were from 3 months to 81 years, and 60% of the patients were 18 or younger. Most of these patients recently came from either Mexico or even from school outbreaks. The most common symptoms were fever, cough, and a sore throat. The H1N1 was determined to …

Research Week 2015, Linda Gardiner, David Owerbach

Office of Research Institutional Research and Scholarship

No abstract provided.

Examining Barriers With Implementing Augmentative And Alternative Communication In A Midwest School, Ashley Renee Fields

Walden Dissertations and Doctoral Studies

Many speech-language pathologists (SLPs) in a Midwest urban public school system have experienced barriers that prohibit the effective use of augmentative and alternative communication (AAC). The result has left some students with speech language impairments (SLI) without the communication skills for meaningful relationships and success in and out of school. The purpose of this exploratory case study was to determine the perceived barriers of 8 local school SLPs regarding the successful implementation of AAC and their suggestions for addressing the problem. Data were collected from semi-structured interviews with the SLPs. Data collection and analysis were grounded by Ely's conditions of …