Digital Commons Network^™

Implementing Clinical Decision Support Aimed At Reducing Co-Prescribing Of Opioids And Benzodiazepines At Adventist Healthcare Maryland, Monica Coley

Translational Projects (Open Access)

Clinical Decision Support (CDS) leverages computerized toolsets to provide condition specific guidance that aids providers in clinical decision making processes (AHRQ, 2019; AMIA, n.d.; ONC, 2018). Research has shown that applying CDS, interruptive within the electronic health record (EHR) prescribing workflow, can assist providers with avoiding unsafe medication prescribing, such as 1) multiple opioids and 2) opioid-benzodiazepine combinations (Malte et al., 2018; Smith et al., 2019, Price-Haywood et al., 2020; Nelson et al., 2022). In an effort to decrease the co-prescribing rate for 1) multiple opioids and 2) opioid-benzodiazepine combinations, Adventist HealthCare Maryland (AHC) launched a performance improvement project in …

Dreams And Dream Work Of Older Adults In Transition: A Review Of The Literature, Tamara J. Hinojosa

All Faculty Scholarship (Archived)

Older adults face unique life transitions related to retirement from paid work, relocation of residence to higher levels of care, and bereavement/end-of-life. Research exploring dream content and dream work for older adults can facilitate understanding about their unconscious experiences and emotions, can promote greater understanding about their mental health needs, and support dream work methods that enhance well-being for older adults in transition. Although studies in this area are minimal, there is more research about the transitions of bereavement and death for older adults as compared to research in the areas of retirement and relocation of residence for older adults. …

Safety And Efficacy Of Apixaban Vs Rivaroxaban: In Nonvalvular Atrial Fibrillation, Cody Dewitt

Physician Assistant Scholarly Project Papers

Nonvalvular atrial fibrillation, the most common cardiac arrhythmia in developed countries, warrants anticoagulation for stroke prevention. Updated guidelines recommend direct oral anticoagulants (DOACs) over historically used warfarin. The purpose of this review is to compare clinical safety and efficacy outcomes between apixaban and rivaroxaban. In patients with nonvalvular atrial fibrillation on a direct oral anticoagulant, is there a significant difference in safety and efficacy between apixaban and rivaroxaban? Does decreased kidney function change safety and efficacy? Does varying BMI such as low weight or obesity change safety and efficacy? A retrospective literature review was conducted utilizing PubMed databases. Articles included …

Dnp Final Report: Preventing Critical Care Nurse Burnout: An Evidence Based Approach To Raising Awareness, Trendalyn S. King

DNP Final Reports

Burnout has affected nurses nationally and globally for decades. Burnout in nurses is characterized by emotional exhaustion, depersonalization, and lack of feelings of personal accomplishment. Consequences of burnout include physical and emotional suffering in nurses, poorer patient outcomes, and lost revenue and increased cost in healthcare organizations. Burnout is prevalent in many healthcare settings, but 81% of critical care nurses have reported severe symptoms of burnout, Because of the high risk of burnout in critical care nurses, raising awareness about burnout and its prevention in those nurses was imperative. The following PICOT question guided the search for evidence to support …

Work-Related Burnout, Compassion Fatigue, And Nurse Intention To Leave The Profession During Covid-19, Jacqueline Christianson, Norah L. Johnson, Amanda Nelson, Maharaj Singh

College of Nursing Faculty Research and Publications

The purpose of this mixed-method study was to understand the relationships between work-related burnout (WRB), compassion fatigue (CF), and intention to leave the nursing profession. The Job Demands-Resources model was used to predict intention to leave as a function of WRB, CF, and caring for COVID-19 patients in a sample of 1299 US nurses. Greater WRB and CF scores were associated with intention to leave the profession. Contrary to prior research, working with COVID-19 patients was associated with greater intention to stay in nursing. Personal finances may represent the rationale for nurses to choose to stay nurses despite burnout.

Targeting Macrophages In Cancer Models Using Natural Compounds, Sierra Jordan Mcdonald

Theses and Dissertations

Cancer remains a leading cause of death worldwide. More specifically, breast cancer (BrCa) and colorectal cancer (CRC) continue to be the most diagnosed cancers and leading causes of cancer-related death worldwide. Given that surgery followed by adjuvant chemotherapy is only effective in 20% of CRC patients, and that there are no preventive agents for BrCa metastasis for hormone receptor negative patients, more effective agents and strategies are needed in both the prevention and treatment of these cancers. As one of the most abundant immune cells in the tumor microenvironment, macrophages help regulate primary tumor growth, angiogenesis, and metastasis in many …

John Reliford "Slim" Lee

African American Funeral Programs

No abstract provided.

Exploring Communication In Healthcare Through Decision-Making Interventions And A Novel Measure Of Clinician Spoken Plain Language, Renata W. Yen

Dartmouth College Ph.D Dissertations

Statement of the Problem

Good communication in clinical encounters is a key component of quality healthcare. Improving clinician communication would benefit all populations, however patients with lower health literacy or who are socially disadvantaged stand to benefit the most due to the complex content in clinical encounters. Shared decision-making can improve outcomes, but shared decision-making cannot occur without good clinician communication. In this dissertation, I reviewed interventions for facilitating shared decision-making for socially disadvantaged patients. Then, I examined the use of spoken plain language, or clinician use of familiar, clear verbal language when communicating with patients, and developed a prototype …

We Are ... Marshall, March 29, 2023, Office Of Marshall University Communication

We Are ... Marshall: the Newsletter for Marshall University 1999-2023

No abstract provided.

Teaching And Learning Interventions Designed To Improve Cultural Competence In Health Profession Students: A Systematic Review, Gloria Nkhoma, Chiao Xin Lim, Gerard A. Kennedy, Ieva Stupans

Internet Journal of Allied Health Sciences and Practice

Purpose: Developing healthcare profession students’ cultural competency knowledge, skills and attributes is critical to meet the needs of culturally and linguistically diverse healthcare service consumers. The purpose of this systematic review was to identify effective cultural competence interventions for healthcare profession students. Methods: A systematic review of peer reviewed articles published from 2010-2021 using PRISMA guidelines was conducted by searching CINAHL, EMBASE, ERIC, PubMed, and Psych INFO databases. Article quality was assessed using the Evaluation Tool for Quantitative Research and Mixed Method Appraisal Tool. Results: The initial search identified 2,261 potentially relevant studies, 41 studies met the inclusion criteria in …

Medicaid Expansion Case Study: Differences Between Florida And New York Medicaid Expansion Policy, Mary R. Zielinski

MUSC Theses and Dissertations

The Affordable Care Act (ACA) expands healthcare coverage and improves healthcare delivery. While the ACA expands Medicaid coverage, many states have yet to expand. This paper utilizes a multi-state comparison case study comparing New York, a Medicaid expansion state, and Florida, a non-expansion state, to better understand Medicaid expansion decisions and influences in states. The case study identifies that the reasons behind these decisions are layered and complex; influences such as state political parties, lobbying, and overall state economics greatly influence Medicaid expansion policy.

Workplace Violence Prevention Training: A Cross-Sectional Study Of Home Healthcare Workers, Tamara F. Small

Dissertations

HHCWs are at increased risk for WPV due to working alone in unsupervised, unpredictable, and potentially dangerous work environments. Similar to healthcare workers employed in institutionalized settings, HHCWs primarily experience Type II, verbal abuse from patients. Little is known about how HHCWs promote personal safety while at work. Guided by Haddon's Matrix, the purpose of this manuscript option dissertation was to estimate WPV exposures and identify interventions and resources used by HHCWs to promote personal safety and mitigate and prevent WPV. For this manuscript option dissertation, there are three distinct projects, all related to HHCWs and exposure to WPV.

Advance Care Planning And Health-Related Quality Of Life In Huntington Disease: Results From A Multicenter National Study, Leonard L Sokol, Jonathan P Troost, Danny Bega, Benzi M Kluger, Holly G Prigerson, Martha Nance, Samuel Frank, Joel S Perlmutter, Praveen Dayalu, David Cella, Noelle E Carlozzi

2020-Current year OA Pubs

OBJECTIVE: With Huntington disease (HD), a fatal neurodegenerative disease where the prevalence of suicidal thoughts and behavior (STB) remains elevated as compared to other neurological disorders, it is unknown whether STB and health-related quality of life (HRQoL) affect plans for the end of life or more broadly, advance care planning (ACP). Conversely, it is unknown whether ACP would provoke future changes to STB and HRQoL. Therefore, we sought to evaluate whether STB and HRQoL patient-reported outcomes (PROs) contribute to ACP and whether ACP relates to changes in STB and HRQoL at 24 months.

METHODS: HD-validated clinician- and patient-assessments (i.e., HRQoL …

Vitreoretinal Lymphoma Presenting As Frosted Branch Angiitis In A Patient With Diffuse Large B-Cell Lymphoma, Tomas Anderson, Charles G. Miller, Tian Xia, Jose S. Pulido, Alexander J. Brucker, Albert M. Maguire

Wills Eye Hospital Papers

Purpose: To describe the evaluation, diagnosis, and treatment of vitreoretinal lymphoma presenting as frosted branch angiitis in a patient with diffuse large B-cell lymphoma (DLBCL).

Observations: A 57-year-old woman with a history of non-Hodgkin lymphoma and recent DLBCL relapse presented with frosted branch angiitis that raised suspicion for an infectious retinitis but was found to be vitreoretinal lymphoma.

Conclusions and Importance: This case primarily highlights the importance of considering vitreoretinal lymphoma on the differential diagnosis of etiologies of frosted branch angiitis. Despite suspicion for vitreoretinal lymphoma, it is also important to treat empirically for infectious etiologies of retinitis in cases …

A Practical Theology Of Created Space: Contextualized Theology For Pastoral Crisis Ministry, Gabriel Fisher

Discernment: Theology and the Practice of Ministry

This is a practical theology of created space that attends to the questions raised by critical incidents and contexts by cultivating dialogue among experiences, beliefs, perceptions, and theology. This confessional approach works from the conviction that God is active and present within our experiences and that we are called to participate in the compassionate ministry of Christ. A created space represents a holding pattern of listening and dialogue where attention is given to the other person’s experiences, beliefs, present concerns, and our own formed center using the resources of spiritual theologies.

Concentrating E. Coli At Initial Low Concentrations By Centrifugation With Phosphate Buffered Saline, Plasma, And Simulated Blood Suspensions, Sarah Williams

Undergraduate Honors Theses

The rapid diagnosis of blood stream infections (BSIs) is limited by the low concentration of bacteria in the blood. Currently, culturing of blood samples is used to increase the concentration of bacteria before the type of bacteria and the best antibiotic to treat the infection can be identified. However, the culturing of blood samples takes tens of hours, and therefore concentrating the bacteria from blood without growth will allow for quicker analysis and is crucial to saving lives. This thesis explored the means of concentrating E. coli suspensions in phosphate buffered saline (PBS), plasma, and simulated blood by centrifuging the …

Spiritual Well-Being And Burnout Syndrome In Healthcare: A Systematic Review, Francesco Chirico, Kavita Batra, Ravi Batra, Giuseppe Ferrari, Pietro Crescenzo, Gabriella Nucera, Lukasz Szarpak, Manoj Sharma, Nicola Magnavita, Murat Yildirim

School of Medicine Faculty Research

Introduction: Burnout syndrome (BOS) among healthcare workers (HCWs) is a widespread phenomenon that leads to poor staff health and diminished quality of medical care. Spirituality has been proposed as a coping strategy against BOS. The relationship between spirituality and BOS needs to be evaluated. Therefore, a systematic review was conducted to synthesize evidence for understanding association between spirituality and BOS.

Methods: The PRISMA guidelines were used to conduct a systematic search of bibliographical databases, including PubMed/Medline, Scopus, and several others in June 2022. Titles. Abstracts, and full-texts of all articles were screened to determine eligibility. The National Heart, Lung, and …

[Excerpt From] Population-Based Public Health Clinical Manual: The Henry Street Model For Nurses (4th Ed.), Patricia M. Schoon, Carolyn M. Porta

Sigma Publications: Book Excerpts

This item record pertains to an excerpt from Population-Based Public Health Clinical Manual, 4th Edition, which is provided free of charge by the publisher.

About this book:

Population-Based Public Health Clinical Manual, 4th edition, has proven to be one of the most important public health texts for students and practitioners alike. Focused on developing evidence-based public health nursing practice in diverse settings, and built on the framework of the Henry Street Consortium's 13 competencies for population-based, entry-level public health nursing, this new, full-color 4th edition is fully revised and updated to include:

– A new competency promoting, assessing, and …

Meditation Time In The Classroom: Mindfulness Dosage And Undergraduate Psychological Distress, Kelsey Evans-Amalu, Becky Beucher, Shiva Jahani, Suat Babayigit

Journal of Contemplative Inquiry

Objectives: The present study examined the differences in participants’ individual psychological distress over four points in time while they received instructions on a guided mindfulness meditation practice differing in practice time between the two groups (20 minutes or 5 minutes). The study took place in an undergraduate yoga course at a large metropolitan university in the Southeastern United States. Data were collected over the four points in time during one continuous semester using the Outcome Questionnaire-45.2 (OQ-45.2) (Lambert et al., 2004; Tabet et al., 2019). Methods: The purpose of this 15-week quantitative study was to compare the differences in individual …

Drawing As A Practice Of Compassion, Rich Curtis

Journal of Contemplative Inquiry

In this reflection I discuss methods of teaching the visual art discipline of drawing as an awareness practice grounded in compassion through service learning projects. With my background in both drawing and performance art, I integrate a focus on process, material, and conceptual meaning-making. As the only professor of art in a humanities division, I focus on strategies that introduce students with little or no art background to the idea of using creativity to mindfully raise awareness of marginalized and under-served populations.

Teresa Gordon-Caldwell

African American Funeral Programs

No abstract provided.

Hiv Stalks Bodies Like Mine: An Autoethnography Of Self-Disclosure, Stigmatized Identity, And (In)Visibility In Queer Lived Experience, Steven Ryder

USF Tampa Graduate Theses and Dissertations

This dissertation examines self-disclosure of Human Immunodeficiency Virus (HIV) status within the context of communication between long-standing friends. For the purposes of my study, I define this type of friendship as those who have known me for at least two years and with whom I communicate regularly. These are friends who tend to know a variety of personal details about me, ranging from superficial to private and trivial to essential. I use autoethnography to ground the study in my lived experience. By doing so, I present intimate accounts of my communication with others across my lifespan to function as background …

The Panama Canal Treaties Were Carter’S Biggest Foreign Policy Win, Bruce Ledewitz

Newspaper Columns

Collected biweekly contributions to the Pennsylvania Capital-Star, a nonpartisan, nonprofit news site.

Not Just For Kids: Child And Dependent Care Credit Benefits For Adult Care, Gabrielle Pepin, Yulya Truskinovsky

Upjohn Institute Working Papers

As the U.S. population ages, family caregivers face substantial out-of-pocket costs and financial risks while providing the majority of long-term care. The Child and Dependent Care Credit (CDCC), a tax credit based on income and care spending, subsidizes caregiving expenses but has low participation among adult caregivers. This paper evaluates the CDCC’s current structure, documenting its limited impact on reducing caregiving costs and examining reforms to increase its utility for adult caregivers. Simulations of proposed changes—higher benefits, refundability, and relaxed eligibility requirements—demonstrate potential to expand access and enhance support for family caregivers within the existing policy framework.

Ic090: Bryant Boutwell Interview, Transcript, Friends Of The Texas Medical Center Library

2023 Oral History Project

See more at Friends of the Texas Medical Center Library Records and its finding aid.

Ic090: Paula Knudson Interview, Transcript, Friends Of The Texas Medical Center Library

2023 Oral History Project

See more at Friends of the Texas Medical Center Library Records and its finding aid.

Social Determinants, Cardiovascular Disease, And Health Care Cost: A Nationwide Study In The United States Using Machine Learning, Feinuo Sun, Jie Yao, Shichao Du, Feng Qian, Allison A Appleton, Cui Tao, Hua Xu, Lei Liu, Qi Dai, Brian T Joyce, Drew R Nannini, Lifang Hou, Kai Zhang

2020-Current year OA Pubs

Background Existing studies on cardiovascular diseases (CVDs) often focus on individual-level behavioral risk factors, but research examining social determinants is limited. This study applies a novel machine learning approach to identify the key predictors of county-level care costs and prevalence of CVDs (including atrial fibrillation, acute myocardial infarction, congestive heart failure, and ischemic heart disease). Methods and Results We applied the extreme gradient boosting machine learning approach to a total of 3137 counties. Data are from the

Medical Floor Confusion Assessment Method: Implementation And Assessment Of Risk Factors, Michaelynn R. Paul

Dissertations

An estimated 50% of older hospitalized patients experience delirium. This has created significant complications costing an estimated $164 billion or more per year worldwide. The ability to identify patients developing delirium would allow the implementation of specific interventions to decrease or eliminate the adverse effects of delirium. The purpose of this quality improvement project was to provide high quality delirium education to determine if medical unit nursing staff could successful implement the Confusion Assessment Method (CAM) screening tool to identify patients experiencing delirium as the first phase of an overall plan. Implementation of the project followed Roger's diffusion of innovations …

Rurality Across The World: An Exploration Of Access To Physicians In The Rural United States And Potential Applications Abroad, Edith-Marie Green

Honors Undergraduate Research Poster Symposium

A sixth of the U.S. population lives in a rural area. Those in rural areas face a disproportionate lack of access to physicians and acute emergency care, along with preventive medicine; one can make the reasonable assumption that those living in rural areas in other countries face similar conditions. This paper is centered around access to medical facilities, rurality, and place of death and utilizes data from the National Longitudinal Mortality Study. Stratified analyses were conducted based on age groups and cause of death. While the measured association between death in a medical facility and rurality in this study is …

Association Between Community-Level Social Risk And Spending Among Medicare Beneficiaries: Implications For Social Risk Adjustment And Health Equity, Brian W Powers, Jose F Figueroa, Melanie Canterberry, Suhas Gondi, Stephanie M Franklin, William H Shrank, Karen E Joynt Maddox

2020-Current year OA Pubs

IMPORTANCE: Payers are increasingly using approaches to risk adjustment that incorporate community-level measures of social risk with the goal of better aligning value-based payment models with improvements in health equity.

OBJECTIVE: To examine the association between community-level social risk and health care spending and explore how incorporating community-level social risk influences risk adjustment for Medicare beneficiaries.

DESIGN, SETTING, AND PARTICIPANTS: Using data from a Medicare Advantage plan linked with survey data on self-reported social needs, this cross-sectional study estimated health care spending health care spending was estimated as a function of demographics and clinical characteristics, with and without the inclusion …