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A Systematic Literature Review On Long-Term Care Quality Improvement Initiatives In The United States, Daisy D. Pang

Capstone Experience: Master of Public Health

As the number of people 65 and older increases due to the baby boomer population, there will be a greater demand for long-term care (LTC) services. Quality improvement in LTC is essential to ensure positive health outcomes, patient satisfaction, and reduction in healthcare costs. The purpose of this systematic literature review is to identify the current quality initiatives for LTC in the United States and evaluate the outcomes, effects, and values of each quality initiative identified to support the claim that current the quality initiatives have a limited effect on quality improvement in LTC settings. The Preferred Reporting Items for …

Phase I Trial Of Autologous Rna-Electroporated Cmet-Directed Car T Cells Administered Intravenously In Patients With Melanoma And Breast Carcinoma, Payal D Shah, Alexander C Huang, Xiaowei Xu, Robert Orlowski, Ravi K Amaravadi, Lynn M Schuchter, Paul Zhang, Julia Tchou, Tina Matlawski, Amanda Cervini, Joanne Shea, Joan Gilmore, Lester Lledo, Karen Dengel, Amy Marshall, E John Wherry, Gerald P Linette, Andrea Brennan, Vanessa Gonzalez, Irina Kulikovskaya, Simon F Lacey, Gabriela Plesa, Carl H June, Robert H Vonderheide, Tara C Mitchell

Faculty, Staff and Student Publications

PURPOSE: Treatments are limited for metastatic melanoma and metastatic triple-negative breast cancer (mTNBC). This pilot phase I trial (NCT03060356) examined the safety and feasibility of intravenous RNA-electroporated chimeric antigen receptor (CAR) T cells targeting the cell-surface antigen cMET.

EXPERIMENTAL DESIGN: Metastatic melanoma or mTNBC subjects had at least 30% tumor expression of cMET, measurable disease and progression on prior therapy. Patients received up to six infusions (1 × 10e8 T cells/dose) of CAR T cells without lymphodepleting chemotherapy. Forty-eight percent of prescreened subjects met the cMET expression threshold. Seven (3 metastatic melanoma, 4 mTNBC) were treated.

RESULTS: Mean age was …

National Cancer Control Plan Of The Korea: Current Status And The Fourth Plan (2021-2025), Kyu-Tae Han, Jae Kwan Jun, Jeong-Soo Im

Faculty, Staff and Student Publications

Cancer management has become a major policy goal for the government of the Korea. As such, the government introduced the National Cancer Control Plan (NCCP) to reduce the individual and social burdens caused by cancer and to promote national health. During the past 25 years, 3 phases of the NCCP have been completed. During this time, the NCCP has changed significantly in all aspects of cancer control from prevention to survival. The targets for cancer control are increasing, and although some blind spots remain, new demands are emerging. The government initiated the fourth NCCP in March 2021, with the vision …

Cervical Collars And Dysphagia Among Geriatric Tbis And Cervical Spine Injuries: A Retrospective Cohort Study, Stephanie Jarvis, Alexandre P. Sater, Jeffrey Gordon, Allan Nguyen, Kaysie Banton, David Bar-Or

GME Publications

Introduction:

Dysphagia, a complication of traumatic brain injuries (TBIs), can lead to death. Cervical collar (c-collar) restriction may increase the risk for dysphagia. The objective was to determine how c-collars affect dysphagia rates.

Methods:

This retrospective cohort study included geriatric TBIs or cervical spine injuries (January 2016 to December 2018) at a Level 1 trauma center. Outcomes (dysphagia, aspiration, and respiratory failure) were compared by c-collar placement.

Results:

There were 684 patients: 21.5% had a c-collar and 78.5% did not. Demographics, injury severity score, and Glasgow Coma Scale were comparable. Dysphagia (53.7% vs. 39.3%, p = .002) and respiratory failure …

Family Caregiver Reports Of Their Own And Patient Symptoms In Cancer Home Hospice Approaching End-Of-Life, Maija Reblin, Eli Iacob, Djin L Tay, Hui Li, Megan C Thomas Hebdon, Anna Beck, Gary Donaldson, Kristin G Cloyes, Lee Ellington

Faculty, Staff and Student Publications

Context: Family caregivers assume the primary responsibility of assessing and managing hospice cancer patient symptoms while simultaneously managing their own wellbeing and symptoms. Objectives: Describe caregivers' assessment of hospice cancer patient and their own symptoms during the last 60 days of patient life, and assess the relationship between patient and caregiver symptoms over time.

Methods: Caregiver symptom report of self and cancer home hospice patient symptom data were collected via telephone in the final 60 days of patient life. Descriptive data on symptom severity and prevalence were summarized. Exploratory Factor Analysis was used to group individual symptoms. …

Chronic Overlapping Pain Conditions And Long-Term Opioid Treatment, Maria Ukhanova, Robert W Voss, Miguel Marino, Nathalie Huguet, Steffani R Bailey, Daniel M Hartung, Jean O'Malley, Irina Chamine, John Muench

Faculty, Staff and Student Publications

OBJECTIVES: One in 5 people in the United States lives with chronic pain. Many patients with chronic pain experience a subset of specific co-occurring pain conditions that may share a common pain mechanism and that have been designated as chronic overlapping pain conditions (COPCs). Little is known about chronic opioid prescribing patterns among patients with COPCs in primary care settings, especially among socioeconomically vulnerable patients. This study aims to evaluate opioid prescribing among patients with COPCs in US community health centers and to identify individual COPCs and their combinations that are associated with long-term opioid treatment (LOT).

STUDY DESIGN: Retrospective …

The Medicine Of Memes: An Exploration Of Humor Styles, Memes, And Dark Humor, Theodor Napp

Electronic Theses and Dissertations

The usage of humor as a coping strategy is one that has been well-studied in the realm of psychology (Abel, 2002). However, research into the usage of dark humor as a coping mechanism, as well as dark humor expressed in memes, is not nearly as well-studied. This study (N = 50) replicated previous findings on humor and personality and expanded the research on self-directed humor and dark humor by comparing it to humor styles outlined by Martin et al. (2003) and Tsukawaki and Imura (2020). Replication results were mixed, with some findings supporting previous research between the Big Five personality …

Reflections On Co-Creating Nature-Based Virtual Reality Experiences For Adults Living With Severe Copd, Olivia Mcanirlin

All Dissertations

This dissertation focused on studying the lived experience of working with and for people living with severe chronic obstructive pulmonary disease (COPD) to co-create a personalized nature-based virtual reality (VR) experience. People with severe COPD have issues with being able to breathe clearly and deeply, which then influences their ability to visit outdoor places. Outdoor places have been shown to have many positive effects on multi-dimensional health outcomes. Severe COPD can also make traveling to faraway destinations and even visiting nearby outdoor spaces difficult. Therefore, the purpose of this dissertation was to develop personalized nature-based VR experiences as an alternative …

A Nurse Led Heart Failure Education For Self-Care Symptom Monitoring And Management, Lynda Browning

Doctoral Projects

Title

Nurse-led education heart failure education for symptom monitoring and management

Abstract

Problem Statement: Over six million adults in the United States have heart failure (CDC.gov,2020). According to the Agency for Healthcare Research and Quality (AHRQ), almost 20% of heart failure patients hospitalized are readmitted under 30 days (AHRQ, 2013). The American Heart Association (AHA) (2022) recommends a visual symptom tracking tool for self-care symptom monitoring to increase patient adherence and reduce readmissions. Despite this recommendation, the AHA tool for symptom monitoring is not fully incorporated into the discharge of every heart failure patient often because of nursing management …

Exploring Undergraduate Medical Student Perceptions Of Hospice And Palliative Medicine, Nuha Cebeci Md

Department of Family Medicine

No abstract provided.

Physician Assisted Suicide, Alexa Setteducati

Academic Festival

Death is inevitable. An individual can hope to live a long healthy life and end it peacefully. However, the reality of death is much different for some individuals. Death can be a painful and grueling process that hinders oneself from feeling any morsel of dignity. Patients with terminal illnesses can instate advanced directives, in which they can choose their preference of life saving resuscitation and comfort measures. However, these interventions in patients with terminal illnesses are not available until the patient has fully deteriorated. An article claims, “As the end-oflife approaches, the ability of medicine to heal and prolong life …

Does Voluntary Euthanasia Fulfill Or Contradict A Physicians’ Oath To “Do No Harm”, Sarah Margaret Carr

Academic Festival

Voluntary Euthanasia, or VE, is a practice which has been medically, and ethically, debated for decades. VE is a medical procedure in which a physician, with the explicit and informed consent of the patient, administers a lethal agent for the purpose of relieving a patients intolerable and incurable suffering (Euthanasia, 2022). The availability of this practice as an option for terminally diagnosed patients, to allow them to choose to die on their own terms, has been debated for its ethicality. Through my research, I strove to answer the question of whether VE fulfills, or contradicts, a physician’s oath to “do …

An Interdisciplinary View On The Legalization Of Physician-Assisted Suicide, Alis Koroglu

Academic Festival

When an individual has a terminal illness, death may not always come rapidly or peacefully. More times than not, the individual with a terminal illness goes from being a well, able-bodied individual, to then slowly degenerating into an individual living with unbearable chronic pain and dependence on others to survive. This paper evaluates the reasons why a procedure called Physician-Assisted Suicide (PAS) should be legalized in all 50 states to give individuals with a terminal illness the right to die without struggling to stay alive. For those in the state of a terminal illness, who are essentially forced to slowly …

Impact Of Inhaled Epoprostenol In Patients On Covid-19 Acute Respiratory Distress Syndrome (Ards), Stacey Nguyen, Stephen Chromi, Mark Decerbo, Surajit Dey, Joseph Mccoy, Jeffrey Murawsky

HCA Healthcare Journal of Medicine

Background

Coronavirus disease 2019 (COVID-19), a novel respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can progress to critical illness and the development of acute respiratory distress syndrome (ARDS). Variability in clinical presentation has led to 2 distinct theoretical classifications of COVID-19 ARDS based on different phenotypical presentations. The first of which follows closely to traditional ARDS presenting as severe hypoxemia with markedly reduced lung compliance, whereas the second presents as severe hypoxemia with preserved to high lung compliance. With uncertainty surrounding the specific pathological and mechanistic nature of COVID-19, we designed this study to elucidate the …

Scheduled Opioid Administration In Hospice Patients Before And After Targeted Caregiver Education, Katherine G. Hood, Eve B. Woodum, Rebeccah J. Collins

HCA Healthcare Journal of Medicine

Background

Hospice and palliative care have been shown to increase patient satisfaction and improve symptom control at the end of life. Opioid analgesics are typically given around the clock at the end of life to maintain symptom control and prevent the need for larger doses later. Many hospice patients have some degree of cognitive impairment, putting them at risk of being undertreated for pain.

Methods

This was a retrospective, quasi-experimental study at a 766-bed community hospital with hospice and palliative care services. Adult patients admitted to inpatient hospice care with active orders for scheduled opioids for at least 12 hours …

Clinical Impact Of Oral Step-Down Therapy For Gram-Negative Bacteremia: A Retrospective Study, Nhi Nguyen, Ashitha Jayachandran, Minhhang Mui, Kelsey Olson

HCA Healthcare Journal of Medicine

Background

In recent years, there has been a growing body of evidence that supports oral step-down therapy for the treatment of gram-negative bacteremia. The purpose of this study was to compare outcomes for hospitalized patients who received intravenous-only (IV-only) therapy versus oral step-down therapy with low, moderate, and highly bioavailable antimicrobials for the treatment of gram-negative bacteremia.

Methods

In this retrospective, single-center, observational study, we examined data from adult patients hospitalized with gram-negative bacteremia in a 1-year period. Data analysis was performed using information collected from electronic medical records and a clinical surveillance system.

Results

A total of 199 patients …

An Update Is Required To Continue Using This Regulation: Why The Hipaa Privacy Rule Should Be Modified To Protect A Broader Range Of Health Data, Lauren Caverly Pratt

Belmont Health Law Journal

While there is no constitutional right to privacy of information, general public sentiment leans in favor of keeping personal health data private. More precisely, individuals would like information known only to the individual and other parties to whom he or she chooses to disclose the information. This is because public knowledge of sensitive personal data may harm the individual economically, socially, or in other intangible ways. The benefits of public knowledge of such individually identifiable health data do not outweigh these potential harms. Privacy should be the default.

To achieve this, HIPAA must be expanded to protect private health data …

Rare Presentation Of Primary Malignant Peripheral Nerve Sheath Tumor Of The Femur In Neurofibromatosis-1, Akshaj Pole, Danielle Ford, Elizabeth Pollard

North Texas GME Research Forum 2023

Malignant peripheral nerve sheath tumors (MPNSTs) are rare sarcomas, most commonly seen in patients with Neurofibromatosis type 1 (NF1), that are characterized as aggressive with high rate of local recurrence. Among NF1 patients, the risk of developing MNPSTs is approximately 8-13% over a lifetime. Primary MPNST is exceedingly rare, of which the vast majority are concentrated in the head and neck region. Here, we present a case of a 40-year-old male with NF1 who presented with a giant MPNST that originated in the right proximal femur. The mass was treated with complete surgical resection with right hip disarticulation. In a …

Organ Music By Japanese Composers, Featuring Thunder & Wind, April 28, 2023 [Program], University Of Northern Iowa. School Of Music.

Music Recital Programs

Program of a music recitals given by faculty, students, or guest artists from the School of Music at the University of Northern Iowa.

Women Caregivers Of Palliative Care Patients: The Arogyakeralam Project In Kerala, India, Florence Jose

Journal of International Women's Studies

Palliative care is primarily holistic care given to the patient and their family where the caregiver plays a significant role in the patient’s health and wellbeing. This research studies the perception of the caregivers on the functioning of the Arogyakeralam palliative care project in Kerala, India, in order to understand the challenges faced by women caregivers of this type of patient. In this descriptive and analytical study, the researcher used the multi-stage random sampling methodology. A structured interview schedule was used to obtain data from 54 primary caregivers of palliative care patients who were randomly and proportionately selected from two …

Compassion Fatigue In Nursing, Madeline Bragaw

Academic Festival

What started as the reason nurses chose the field has now become the reason many nurses are choosing to leave. Empathy and compassion are two qualities that make nurses so special, but when nurses begin to take on the emotional stress of their patients’ pain and illnesses, they can grow burnt out and fatigued. Compassion fatigue is defined as, “apathy or indifference towards the suffering of others” (Oxford University Press, 2021). As a protective mechanism, nurses can begin to become apathetic to suffering when they are constantly seeing people go through emotional and physical pain. While nurses are protecting themselves, …

Older Adults And Opioids, Elba L. Scherer

Morehead State Theses and Dissertations

A thesis presented to the faculty of the Caudill College of Arts, Humanities and Social Sciences at Morehead State University in partial fulfillment of the requirements for the Degree Master of Arts by Elba L. Scherer on April 27, 2023.

When We Pause: On The Discontinuation Of Enteral Feeding In Head And Neck Cancer A Case Report, Kyle Fisk, Ana Sanchez

South Atlantic Division GME Research Day 2023

No abstract provided.

Timing Of Dual Antiplatelet Therapy (Dapt) Initiation Post Mechanical Thrombectomy With Stent Placement In Acute Ischemic Sroke, Mallory R. Stringer, Eric Shaw, Osman Perez, Emily G. Bowers

South Atlantic Division GME Research Day 2023

No abstract provided.

The Melody Of Memory: Exploring The Effect Of Music Therapy On Language And Memory Recall In Adults With Alzheimer’S Disease, Ariel Nicole Furgat

Theses and Dissertations

Background: Music is an important part of life for the lives of many seniors. Priorresearch has indicated that music is beneficial to adults with Alzheimer’s disease. Purpose: With the intent to advocate for music therapists working in memory care, the purpose of this study was to investigate the effect of music therapy intervention on language and memory in people with Alzheimer’s disease. Three research questions were addressed in this study: (1) Of the three conditions (music therapy, recorded music, control), which appear to result the most change in MMSE scores in adults with moderate Alzheimer’s disease? What differences are observed …

Communication And Cultural Agility/Competence Skill Training In Medical Education, Stephanie Patten, Elijah Wade, Abagail Furth, Abigail Widmer

Celebrating Scholarship and Creativity Day (2018-)

No abstract provided.

You Never Really Leave, John Kuligowski

Department of English: Dissertations, Theses, and Student Research

YOU NEVER REALLY LEAVE is a thesis which consists in a critical introduction that broadly explores my experience of creating a short story collection, as well as the ensuing collection of five short stories. The critical introduction examines the form and content of the following stories, as well as the influences that have been instrumental to my writing. It furnishes details about themes and subject matter which have been consistent in my fiction thus far, and it depicts some of the motivations behind it. The stories themselves range from a realist mode to what has been labeled by other writers …

God Will Wipe Away Every Tear - A Phenomenological Study Of Two Faith-Based, Grief Support Groups, Cynthia Velerianee White

Doctoral Dissertations and Projects

The purpose of this phenomenological, qualitative study was to describe the impact of GriefShare, a faith-based, grief support initiative for the participants at Diamondhead, Mississippi and Gulfport, Mississippi. The theory guiding this study was Robert Neimeyer’s social constructionist theory as it explains the meaning found in GriefShare’s narrative processes. The study participants were nine females and one male who attended at least three GriefShare sessions. The researcher interviewed and audio-recorded all participants using Otter ai. live transcription. The researcher used the constant comparison method and member checking to analyze the data collected during the interviews. As participants described their lived …

An Examination Of Secondary Marching Band Directors’ Self-Efficacy And Music Curriculum: A Phenomenological Study, Jonathon Allen

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore how high school band directors prepare their students for college marching band programs. The theory guiding this study was Bandura’s self-efficacy theory to address the personal characteristics and traits of marching band directors’ qualities relating to teaching. The phenomenological research design examined teachers' self-efficacy levels and ability to prepare their marching band students for college. I used snowball sampling to select the participants and gain insight into various perspectives. Data were collected by three different methods: document analysis, semi-structured individual interviews, and a focus group. I triangulated and analyzed data by …

Equipping Covenant Baptist Church To Defend The Bible In A Skeptical World, Harlan Grant Mclain

Doctoral Dissertations and Projects

The thesis of this research project is “If Covenant Baptist Church members are taught the reliability of the Bible, they will be equipped to defend their faith to a skeptical world.” The goals of this doctoral thesis are two-fold: to train adequate believers regarding the Bible’s reliability in a skeptical world, and honor God in the process through the equipping ministry of the church in accordance with Ephesians 4:11-16. Seven lessons were researched, formulated, and presented to a small group of believers in Covenant Baptist Church who desired to become more confident in defending the Bible to a skeptic. Entrance …