Digital Commons Network^™

Improving Patients’ Perception Of Provider Trust And Communication With Birth Plans, Christelle Reeves, Nicole Tenzel, Timothy Kremer

North Texas GME Research Forum 2024

Objective: Birth plans are an effective tool for a pregnant person to express their desires and expectations for labor and postpartum. Shortcomings of birth plans can be found whenever there is a lapse in communication between provider and patient. In the management of labor and emergent situations, it has been observed by patients that obstetric providers can communicate in authoritarian and dismissive manners. In response to this, birth plans were developed to serve as a guide in these scenarios. Birth plans allow a pregnant person to design a thoughtful plan of action with their healthcare provider before giving birth, rather …

Systematic Review On The Impacts Of Agricultural Interventions On Food Security And Nutrition In Complex Humanitarian Emergency Settings, Melodie Al Daccache, Berthe Abi Zeid, Leila Hojeij, Ghassan Baliki, Tilman Brück, Hala Ghattas Ph.D.

Faculty Publications

Complex humanitarian emergencies are a main driver of food and nutritional insecurity. Agricultural interventions are key to improving nutrition and food security, and their positive impacts are well-documented in stable developing countries. However, it is unclear if their positive effects on food security hold in complex emergency settings, too. In this paper, we systematically review empirical articles that apply rigorous designs to assess the causal impacts of agricultural interventions on food security, nutrition, or health outcomes in complex humanitarian emergencies. We only find six articles matching these criteria, which have mixed results on dietary diversity and food security, and little …

Sexual Health Education Scope And Sequence, Sara Wadsworth

Honors Projects

Based on a significant amount of prior research, comprehensive sexuality education (CSE) has been identified to be the most effective method of teaching sexual health education (SHAPE America, 2021; World Health Organization, 2023). Comprehensive sexual health education improves healthy behaviors and outcomes, provides useful information, and is positively perceived by students (Gardner, 2015; Kirby, 2002; Robinson et al., 2022). However, the United States’ current sexual health education has not implemented this ideal method, which is shown through state laws, students’ experiences, underdeveloped skills and flawed understanding of concepts, and – most importantly – a lack of resources for teachers (Foley, …

Faith Community Nursing: Ministering To God's People In Ukraine Through Lamentation, Pam Dandre

International Journal of Faith Community Nursing

None

The Effect Of The Covid Pandemic On Parish Nursing In The Uk, Helen Wordsworth

International Journal of Faith Community Nursing

This article describes the impact that the Covid pandemic of 2020/2021 had on the work of UK Parish Nurses and the churches with which they worked. It explains how they adapted to the restrictions imposed by the government, changing the nature of the interventions they were able to make. It concludes that the resilience, flexibility, and creativity of the Parish nurses and of their national umbrella organisation, Parish Nursing Ministries UK, have enabled the emergence of a growing and vibrant ministry.

Creating A Best Practice Model For Reopening Parish Nurse Sites Post-Pandemic, Mary Lynne Knighten Dnp, Rn, Nea-Bc

International Journal of Faith Community Nursing

Abstract

The COVID-19 pandemic brought many changes to the healthcare delivery system. Parish nurses, faith community nurses, and congregational nurses found their practice frequently adapting to comply with government issued restrictions and the changing needs of the community. QueensCare Health & Faith Partnership (QHFP), a parish nurse program which is part of QueensCare, a non-profit public benefit corporation, and St. Dominic Catholic Church in Los Angeles, California designed a replicable model for safely reopening parish nurse sites. QHFP provides supportive healthcare services and case management services at no charge to underserved and vulnerable populations in cooperation with numerous churches, temples, …

Implementation Of Psychiatric Collaborative Care Management In Rural Primary Care Practices, Ryan Dean Kruis

MUSC Theses and Dissertations

Behavioral health (BH) disorders are highly prevalent in the United States and especially concerning in rural communities which disproportionately lack access to BH services. While models for integrating BH into primary care, such as psychiatric collaborative care management (CoCM), have shown promise in mitigating the BH crisis, implementation in rural communities has proved challenging.
This dissertation examines implementation of CoCM nationally and in rural settings through three distinct aims. First, a claims-based retrospective cohort study was used to determine whether commercially insured patients receiving CoCM had lower acute BH care utilization and cost as compared to similar patients not receiving …

A Population Health Approach To Workplace Mental Health: Rationale, Implementation And Engagement, Kaylee T. Woodard, Allison M. Bailey, Aaron I. Esagoff, Maren S. Fragala, Joanna I. Hayward, Jennifer L. Hunter, Yea Jen Hsu, Paul M. Kim, Matthew E. Peters, Susan M. Carr

School of Medicine Faculty Publications

Objectives: To describe a population health-based program to support employee and dependent mental health and learn from engagement trends. Methods: Retrospective analysis of a program utilizing an assessment of mental health risk. For scoring “at risk,” a Care Concierge is offered to connect users with resources. Results: Participation was offered to 56,442 employees and dependents. Eight thousand seven hundred thirty-one completed the assessment (15%). Of those, 4,644 (53%) scored moderate or higher. A total of 418 (9%) engaged the Care Concierge. Factors that negatively influenced the decision to engage care included bodily pain, financial concerns. Positive influences were younger age, …

Family Medicine’S Role In Addressing The Intersections Of Redlining And Climate Change, Daryl O. Traylor, Eboni E. Anderson, Brianna Clark, Alex M. Smith, Cooper K. Allenbrand

Journal of Sustainable Social Impact

Redlining, the practice of discriminating against specific neighborhoods based on race and socioeconomic status, leads to persistent environmental hazards and socioeconomic inequalities that have lasting adverse health effects on their populations. Health disparities are further exacerbated through the concentration of environmental hazards, as well as the escalating impact of climate change, which poses an increased risk of respiratory illness, cardiovascular disease, mental health issues, heat-related illness, infectious diseases, food insecurity, and socioeconomic difficulties in redline neighborhoods.

This paper examines the interplay of redlining, climate change, and health disparities, with an emphasis on the enduring consequences for these marginalized communities. Through …

The King Hygiene Project: Addressing Hygiene Poverty In College Students, Krislynn King

Honors Projects

For my Honors Project, I seek to shine a light on the topic of hygiene insecurity and investigate how it impacts the modern-day college student. In addition, I have taken physical action through a hygiene drive, marketing, and volunteering to better the lives of those who struggle with this issue regardless of whether they are a student at Bowling Green State University.

Dismantling Barriers To Hepatitis B And Delta Screening, Prevention, And Linkage To Care Among The Pwud Community In Philadelphia, Beatrice Zovich, Catherine Freeland, Holly Moore, Kara Sapp, Anousha Qureshi, Rachel Holbert, Jason Zambrano, Daljinder Bhangoo, Chari Cohen, Richard W. Hass, Amy Jessop

College of Population Health Faculty Papers

The prevalence of hepatitis B and delta viruses (HBV/HDV) among people who use drugs (PWUD) remains largely unknown. In the context of one Philadelphia-based harm reduction organization (HRO), this study aimed to assess HBV/HDV prevalence and facilitate linkage to care. Participants completed a demographic HBV/HDV risk factor survey and were screened for HBV and reflexively for HDV if positive for HBV surface antigen or isolated core antibody. Fisher's exact tests and regression were used to understand relationships between risks and HBV blood markers. Of the 498 participants, 126 (25.3%) did not have hepatitis B immunity, 52.6% had been vaccinated against …

Protocols For Postpartum Hemorrhage, Nicole A. Mitchell, Wilbur Greene, Samantha Claxton, Lydia Lester

Student Scholar Showcase

The purpose of this study was to examine the relationship between the protocols for postpartum hemorrhage and lack of implementation, how race may play a role in care, the different effect on maternal lives; physically and mentally, and more effective treatment options. Many women all over the world struggle with postpartum hemorrhaging as it is a life-threatening complication that can follow giving birth. There are standard protocols set in place for different facilities that relay how the healthcare professionals should act in that situation. The PICOT question, “In child-bearing women, how do protocols for postpartum hemorrhage compared with a lack …

Reducing Sexually Transmitted Infection In African American Teenage Adolescents: Developing A Culturally Competent Health Program For Underserved Communities, Brandolyn I. Burks

Doctoral Dissertations and Projects

Proper education and programming can help reduce Sexually transmitted infections (STIs) among adolescents. This research aimed to help lay the framework for determining ways to ensure African American young adult adolescents aged 18–19 years have the necessary information and resources to make healthy decisions regarding their sex lives and experiences. The purpose of this grounded theory study was to understand what lived experiences and gaps of knowledge contribute to the contracting of STIs to develop a culturally competent health program to reduce the high rate of infections among African American 18–19-year-old adolescents living in underserved communities. The theory guiding this …

Exploring The Experience Of Healthcare-Related Epistemic Injustice Among People With Myalgic Encephalomyelitis / Chronic Fatigue Syndrome, Joanne Hunt, Jessica Runacres, Daniel Herron, David Sheffield

The Qualitative Report

Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) is a chronic, disabling yet clinically “contested” condition, previously theorised through a lens of epistemic injustice. Phenomena conceptually close to epistemic injustice, including stigma, are known to have deleterious consequences on a person’s health and life-world. Yet, no known primary studies have explored how people with ME/CFS experience healthcare through a lens of epistemic injustice, whilst a dearth of research explicitly exploring healthcare-related injustice from a patient perspective has been noted. This qualitative study seeks to address this gap. Semi-structured interviews and interpretative phenomenological analysis (IPA) were used to explore the experiences of …

Playing It Sun Safe: A Quality Improvement Project, Sarah P. Tarr, Kathryn K. Dambrino, R. David Phillippi, Ashley Karpinos

DNP Projects

Background: Athletes who play outdoor sports have multiple risk factors for the development of skin cancer. Literature highlights the need for the use of evidence-based strategies to improve the knowledge and utilization of sun protection practices in this high-risk population. Methods: Playing it Sun Safe was a multifaceted skin cancer prevention initiative implemented in a population of collegiate soccer athletes in collaboration with a university athletic department and campus health clinic. Evidence-based interventions were designed through application of the Health Belief Model (HBM) and were implemented using the Institute for Healthcare Improvement (IHI) quality improvement framework. Purpose: The two-fold aim …

Emerging Variants Develop Total Escape From Potent Monoclonal Antibodies Induced By Ba4/5 Infection, Chang Liu, Raksha Das, Aiste Dijokaite-Guraliuc, Daming Zhou, Alexander J Mentzer, Piyada Supasa, Muneeswaran Selvaraj, Helen M E Duyvesteyn, Thomas G Ritter, Nigel Temperton, Paul Klenerman, Susanna J Dunachie, Neil G Paterson, Mark A Williams, David R Hall, Elizabeth E Fry, Juthathip Mongkolsapaya, Jingshan Ren, David I Stuart, Gavin R Screaton

Faculty, Staff and Student Publications

The rapid evolution of SARS-CoV-2 is driven in part by a need to evade the antibody response in the face of high levels of immunity. Here, we isolate spike (S) binding monoclonal antibodies (mAbs) from vaccinees who suffered vaccine break-through infections with Omicron sub lineages BA.4 or BA.5. Twenty eight potent antibodies are isolated and characterised functionally, and in some cases structurally. Since the emergence of BA.4/5, SARS-CoV-2 has continued to accrue mutations in the S protein, to understand this we characterize neutralization of a large panel of variants and demonstrate a steady attrition of neutralization by the panel of …

Adolescent Perceptions Of Weighted Blankets And Quality Of Sleep: A Mixed Method Design, Tara D. S. Summers

The Open Journal of Occupational Therapy

Background: The purpose of this mixed methods case study was to describe the perceived sleep quality experience of an adolescent, without a pre-identified sleep need, when they used a weighted blanket during sleep.

Method: Adolescents (n = 5) 11 to 16 years of age completed a sleep diary for 7 days, sleeping with a self-selected weighted blanket for at least 3 days. A semi-structured individual interview was held after Day 7.

Results: The majority of the participants would like to continue using a weighted blanket for sleep. Eighty percent of the adolescents choose to sleep with a …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

Perceptions Of Patient-Healthcare Provider Relationships In The Management Of Type 2 Diabetes, Desiree D. Lacey

Walden Dissertations and Doctoral Studies

The patient-healthcare provider relationship (PPR) is the foundation of clinical care: it is established as a human relationship and has a profound effect on health outcomes. Though PPR has been studied in multiple health domains, there is very little on its role in managing Type 2 diabetes mellitus (T2DM). The purpose of this phenomenological qualitative research study was to better understand the challenges faced by healthcare providers (HCP) and T2DM patients within the clinical PPR for diabetes selfmanagement. The health belief model served as the theoretical framework and the diabetes self-management education program as the conceptual framework. Participants were recruited …

Childhood Cancer Survivorship: Navigating A New Normal In Middle Tennessee, Karli M. Beaumont

OTD Capstone Projects

Monroe Carell Jr. Children’s Hospital at Vanderbilt in partnership with Vanderbilt-Ingram Cancer Center offers REACH for Cancer Survivorship, a pediatric cancer survivorship clinic. REACH provides a full range of follow-up care designed to meet the physical, emotional, and practical needs of survivors and continuous surveillance of deleterious effects of cancer and its treatments. The purpose of this project was to meet population and agency needs through research of long- and late-term sequela while advocating for occupational therapy’s role in the oncology population through the proactive therapy and prospective surveillance models. The process of creating this project included synthesizing the literature, …

Evaluation Of Seizure Recognition And First Aid Training Course And Improving Self-Efficacy Related To Medical Emergencies In Mississippi, Anna Katherine Herrington, Collin Earl Wayne Crawson, Daniel Robert Zuckerman

Honors Theses

Within recent years, there has been increased attention to the growing physician shortage across the United States. This shortage has placed substantial strain upon regions of lower healthcare access, particularly those of rural regions such as much of the state of Mississippi. As rural healthcare providers are placed under more strenuous conditions, they encounter issues of increased patient volume, lack of a trauma team, or adequate transportation to higher-level care facilities. These issues may exacerbate the present inequities in cost of living, access to adequate healthcare, and the distress caused by these concerns. Individuals with epilepsy are one cohort with …

Ensemble-Based Mutational Profiling And Network Analysis Of The Sars-Cov-2 Spike Omicron Xbb Lineages For Interactions With The Ace2 Receptor And Antibodies: Cooperation Of Binding Hotspots In Mediating Epistatic Couplings Underlies Binding Mechanism And Immune Escape, Nishank Raisinghani, Mohammed Alshahrani, Grace Gupta, Gennady M. Verkhivker

Mathematics, Physics, and Computer Science Faculty Articles and Research

In this study, we performed a computational study of binding mechanisms for the SARS-CoV-2 spike Omicron XBB lineages with the host cell receptor ACE2 and a panel of diverse class one antibodies. The central objective of this investigation was to examine the molecular factors underlying epistatic couplings among convergent evolution hotspots that enable optimal balancing of ACE2 binding and antibody evasion for Omicron variants BA.1, BA2, BA.3, BA.4/BA.5, BQ.1.1, XBB.1, XBB.1.5, and XBB.1.5 + L455F/F456L. By combining evolutionary analysis, molecular dynamics simulations, and ensemble-based mutational scanning of spike protein residues in complexes with ACE2, we identified structural stability and binding …

Latent Classification Of Multi-Model Non-Homogeneous Continuous-Time Markov Chains, Joonha Chang

Dissertations and Theses (Open Access)

The continuous-time Markov chain (CTMC) model and latent clustering models are commonly used to study longitudinal measures of categorical outcomes. Because of its simple but powerful Markovian property, CTMC models have been widely used in medical and public health researches. Due to limitations in the standard CTMC model, there have been some studies on non-homogeneous continuous-time Markov chain (NH-CTMC) that utilized time-dependent rates, but the progresses have been limited. NH-CTMC can be more powerful than CTMC by its default nature of time-dependent rate that can be fitted to a wider range of applications in medical studies. In this study, we …

Leveraging 4-H To Address Emergent Health Needs During The Covid-19 Pandemic: Epidemiology Pilot Project, Anne Marie Iaccopucci, Marcel Horowitz, Dorina Espinoza, Roshan Nayak

Journal of Extension

4-H academics responded to the Covid pandemic by rapidly adapting CDC and other resources for virtual delivery. A statewide epidemiology project was taught to 48 youth with the goal of minimizing fears and confusion, increasing prevention measures, leveraging current topics for education, and bolstering the social-emotional health of youth participants. Results indicated that youth enjoyed the project and adopted behaviors to reduce the spread of infectious diseases, such as increased mask-wearing.

Identifying A Group Of Factors Predicting Cognitive Impairment Among Older Adults, Longgang Zhao, Yuan Wang, Eric Mishio Bawa, Zichun Meng, Jingkai Wei, Sarah Newman-Norlund, Tushar Trivedi, Hatice Hasturk, Roger Newman-Norlund, Julius Fridriksson Ph.D., Anwar T. Nerchant

Faculty Publications

Background

Cognitive impairment has multiple risk factors spanning several domains, but few studies have evaluated risk factor clusters. We aimed to identify naturally occurring clusters of risk factors of poor cognition among middle-aged and older adults and evaluate associations between measures of cognition and these risk factor clusters.

Methods

We used data from the National Health and Nutrition Examination Survey (NHANES) III (training dataset, n = 4074) and the NHANES 2011–2014 (validation dataset, n = 2510). Risk factors were selected based on the literature. We used both traditional logistic models and support vector machine methods to construct a composite score …

Understanding Vaccine Hesitancy: An Analysis Of Caregiver Influences On Pediatric Covid-19 Vaccination Decisions, Neiki Rokni, Shu Zhao Md, Matthew Nguyen, David Liu, Harrison Jordan Do, Jory Parson, Sidharth Sahni Do, Tanner Walsh Md, Ashley Henderson Md, Jennifer Higgins Md

Tower Health Research Day

No abstract provided.

Perceptions Of Dengue Risk And Acceptability Of A Dengue Vaccine In Residents Of Puerto Rico, Coral Rosado-Santiago, Carmen L. Pérez-Guerra, Nicole M. Velez-Agosto, Claudia Colón-Burgos, Karla M. Marrero-Santos, Susanna K. Partridge, Amy E. Lockwood, Cathy Young, Steve H. Waterman, Gabriela Paz-Bailey

Psychological Science Faculty Publications

Dengvaxia is the first dengue vaccine recommended in the United States (U.S.). It is recommended for children aged 9–16 y with laboratory-confirmed previous dengue infection and living in areas where dengue is endemic. We conducted focus groups with parents and in-depth interviews with key informants (i.e. practicing pediatricians, physicians from immunization clinics, university researchers, and school officials) in Puerto Rico (P.R.) to examine acceptability, barriers, and motivators to vaccinate with Dengvaxia. We also carried out informal meetings and semi-structured interviews to evaluate key messages and educational materials with pediatricians and parents. Barriers to vaccination included lack of information, distrust toward …

Nivolumab Plus Chemotherapy In Epidermal Growth Factor Receptor-Mutated Metastatic Non-Small-Cell Lung Cancer After Disease Progression On Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors: Final Results Of Checkmate 722, Tony Mok, Kazuhiko Nakagawa, Keunchil Park, Yuichiro Ohe, Nicolas Girard, Hye Ryun Kim, Yi-Long Wu, Justin Gainor, Se-Hoon Lee, Chao-Hua Chiu, Sang-We Kim, Cheng-Ta Yang, Chien Liang Wu, Lin Wu, Meng-Chih Lin, Jens Samol, Kazuya Ichikado, Mengzhao Wang, Xiaoqing Zhang, Judi Sylvester, Sunney Li, Ann Forslund, James Chih-Hsin Yang

Faculty, Staff and Student Publications

PURPOSE: The phase III CheckMate 722 trial (ClinicalTrials.gov identifier: NCT02864251) evaluated nivolumab plus chemotherapy versus chemotherapy in patients with epidermal growth factor receptor (

METHODS: Patients with disease progression after first- or second-generation EGFR TKI therapy (without

RESULTS: Overall, 294 patients were randomly assigned. At final analysis (median follow-up, 38.1 months), PFS was not significantly improved with nivolumab plus chemotherapy versus chemotherapy (median, 5.6

CONCLUSION: Nivolumab plus chemotherapy did not significantly improve PFS versus chemotherapy in patients with

Patient Characteristics Of, And Remedial Interventions For, Complaints And Medico-Legal Claims Against Doctors: A Rapid Review Of The Literature, Timothy J Schultz, Michael Zhou, Jodi Gray, Jackie Roseleur, Richard Clark, Dylan A Mordaunt, Peter D Hibbert, Georgie Haysom, Michael Wright

Faculty, Staff and Student Publications

BACKGROUND: It is uncertain if patient's characteristics are associated with complaints and claims against doctors. Additionally, evidence for the effectiveness of remedial interventions on rates of complaints and claims against doctors has not been synthesised.

METHODS: We conducted a rapid review of recent literature to answer: Question 1 "What are the common characteristics and circumstances of patients who are most likely to complain or bring a claim about the care they have received from a doctor?" and Question 2 "What initiatives or interventions have been shown to be effective at reducing complaints and claims about the care patients have received …

Post-Modeling Adjustments And Delivered Dose Verification Of The 6fff Beam Model Commissioned For The Monaco Treatment Planning System, Grant C. Debevec

LSU Master's Theses

External beam radiation therapy has been shown to be an effective treatment method for tumors and abnormalities of the spine and vertebral region. Treating the spine using a stereotactic body radiation therapy (SBRT) technique can reduce toxicity to the spinal cord. The 6 MV flattening filter free (6FFF) beam model is currently used to plan and calculate dose for SBRT treatment plans, and the treatment plans are delivered using a linear accelerator (LINAC).

The commissioned beam model represents an invariant component of a LINAC. For volumetric modulated arc therapy (VMAT) treatment plans, the multileaf collimator (MLC) positions are changing throughout …