Medicine and Health Sciences Commons^™

Cannabinoid Disposition In Oral Fluid After Controlled Smoked, Vaporized, And Oral Cannabis Administration, Madeleine J. Swortwood, Matthew N. Newmeyer, Maria Andersson, Osama A. Abulseoud, Karl B. Scheidweiler, Marilyn A. Huestis

United States Food and Drug Administration: Publications

Oral fluid (OF) is an important matrix for monitoring drugs. Smoking cannabis is common, but vaporization and edible consumption also are popular. OF pharmacokinetics are available for controlled smoked cannabis, but few data exist for vaporized and oral routes. Frequent and occasional cannabis smokers were recruited as participants for four dosing sessions including one active (6.9% Δ⁹-tetrahydrocannabinol, THC) or placebo cannabis-containing brownie, followed by one active or placebo cigarette, or one active or placebo vaporized cannabis dose. Only one active dose was administered per session. OF was collected before and up to 54 (occasional) or 72 (frequent) h …

Certain Dyes As Pharmacologically Active Substances In Fish Farming And Other Aquaculture Products, Eric Verdon, Wendy C. Andersen

United States Food and Drug Administration: Publications

The last 40 years have brought enormous changes to the aquaculture industry. The farming of fish and of seafood products has been continuously increasing from 3.9% by weight in 1970 to 36% in 2006 according to theWorld Health Organization (WHO) and Food and Agriculture Organization (FAO) of the United Nations.¹ The global trend of aquaculture development gaining importance in total fish supply has remained uninterrupted. Farmed food fish contributed a record 42.2% of the total 158 million tonnes of fish produced by capture fisheries and aquaculture in 2012 (Figure 9.1). This compares with just 13.4% in 1990 and 25.7% …

Color And Power Doppler Combined With Fetal Intelligent Navigation Echocardiography (Fine) To Evaluate The Fetal Heart, L. Yeo, R. Romero

United States Food and Drug Administration: Publications

Objective To evaluate the performance of color and bidirectional power Doppler ultrasound combined with Fetal Intelligent Navigation Echocardiography (FINE) in examining the fetal heart.

Methods A prospective cohort study was conducted of fetuses in the second and third trimesters with a normal heart or with congenital heart disease (CHD). One or more spatiotemporal image correlation (STIC) volume datasets, combined with color or bidirectional power Doppler (S-flow) imaging, were acquired in the apical four-chamber view. Each successfully obtained STIC volume was evaluated by STICLoop™ to determine its appropriateness before applying the FINE method. Visualization rates for standard fetal echocardiography views using …

Salmonella Inactivation During Extrusion Of An Oat Flour Model Food, Nathan M. Anderson, Susanne E. Keller, Niharika Mishra, Shannon Pickens, Dana Gradl, Tim Hartter, Galen Rokey, Christopher Dohl, Brian Plattner, Stuart Chirtel, Elizabeth M. Grasso-Kelley

United States Food and Drug Administration: Publications

Little research exists on Salmonella inactivation during extrusion processing, yet many outbreaks associated with low water activity foods since 2006 were linked to extruded foods. The aim of this research was to study Salmonella inactivation during extrusion of a model cereal product. Oat flour was inoculated with Salmonella enterica serovar Agona, an outbreak strain isolated from puffed cereals, and processed using a single-screw extruder at a feed rate of 75 kg/h and a screw speed of 500 rpm. Extrudate samples were collected from the barrel outlet in sterile bags and immediately cooled in an ice–water bath. Populations were determined using …

An Overview Of The Role Of Mathematical Models In Implementation Of Quality By Design Paradigm For Drug Development And Manufacture, Sharmista Chatterjee, Christine M.V. Moore, Moheb M. Nasr

United States Food and Drug Administration: Publications

A model is a representation of an underlying physical–chemical phenomenon. In the pharmaceutical industry, mathematical‐based models can be applied at all stages of development, starting with formulation design, continuing through process development and scale‐up, and extending into process monitoring and control of the commercial process. Implementation of models offers many benefits. These include, but are not limited to, (i) enhanced process understanding, (ii) reduction of experimentation cost, and (iii) improvement of productivity and product quality.

Models can be broadly categorized as either qualitative or quantitative. The focus of this chapter is quantitative models. These can be classified into three broad …

The Mechanism Of Cirp In Inhibition Of Keratinocytes Growth Arrest And Apoptosis Following Low Dose Uvb Radiation, Yi Liao, Jianguo Feng, Yi Zhang, Liling Tang, Shiyong Wu

United States Food and Drug Administration: Publications

UV induces CIRP expression and subsequent Stat3 activation, but the biological function and mechanism of CIRP and Stat3 in mediating UVB-induced skin carcinogenesis have not been fully elucidated. In this study, we demonstrate that CIRP is elevated in all tested melanoma and non-melanoma skin cancer cell lines; and the expression of CIRP is upregulated in keratinocytes after being irradiated with relatively low dose (<5 mJ/cm²), but not high dose (50 mJ/cm²), UVB acutely and chronically. The increased expression of CIRP, either induced by UVB or through overexpression, leads to resistance of keratinocytes to UVB-induced growth arrest and …

Monitoring Harm Perceptions Of Smokeless Tobacco Products Among U.S. Adults: Health Information National Trends Survey 2012, 2014, 2015, Shari P. Feirman, Elisabeth A. Donaldson, Mark Parascandola, Kimberly Snyder, Cindy Tworek

United States Food and Drug Administration: Publications

Introduction: Changes to the U.S. smokeless tobacco landscape in recent years include a change to health warnings on packages, the implementation of bans in some stadiums, and the launch of a federal youth pre- vention campaign. It is unclear whether such changes have impacted consumer beliefs about smokeless tobacco. This study examines relative harm perceptions of smokeless tobacco compared to cigarettes among adults and assesses changes in smokeless tobacco harm perceptions over time.

Methods: We analyzed data from three cycles (2012, 2014, 2015) of the Health Information National Trends Survey (HINTS). Using 2015 data, we assessed bivariate associations between smokeless …

Associations Of Suicidal Ideation With Opioid/Prescription Drug Use, Violence, Food Insecurity, And Community Factors Among New Hampshire High School Students, Emily R. Carbonara, Semra Aytur

Honors Theses and Capstones

Purpose: Suicide is the second leading cause of death for New Hampshire (NH) youth. Evidence-based public health emphasizes the use of data for translating research into practice/policy. We utilized data from the Youth Risk Behavior Survey (YRBS) to support community-academic partnerships and inform suicide prevention interventions. Methods: Data from the 2011 NH YRBS, a cross-sectional survey of 9th-12th grade students, were analyzed. Gender-stratified, adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using logistic regression models (SAS 9.4, ProcSuveylogistic) to evaluate associations between suicidal ideation (seriously considering attempting suicide within the past 12 months), violence (e.g., physical bullying, …

Graduate Bulletin, 2017-2018, Minnesota State University Moorhead

Graduate Bulletins (Catalogs)

No abstract provided.

Healthcare Utilization Awareness And Labor Monitoring Methodology: A Theoretical I.M.S.E. Approach To Risk Minimization And Human Metrics Capturing In The Nursing Workforce, Luis Reyes

Open Access Theses & Dissertations

The healthcare industry is so complex and dynamic that the development of any tool designed to promote positive patient outcomes nearly requires the developer to be an actual healthcare practitioner. Many healthcare tools exists that initially give the perception that there will be no future requirements that may hinder the tools' integrity, but more often than not, the unexpected occurs. The future is one unpredictable element of life that most engineers wish they could capture with optimal precision. I.M.S.E. (Industrial, Manufacturing and Systems Engineering) applications do not assist with fortune telling, but they do assist with creating robust tools designed …

Profit-Bearing Administrators: Exploring The Application Of Economics And Financial Concepts In Healthcare Management, Brandon K. Riddick

Honors Undergraduate Theses

Healthcare managers face an incredible challenge today; understanding and implementing financially and economically sound decisions in the complex healthcare environment of the United States. The pressure to be profitable managers is greater than ever. Considering current research, past studies, and articles focused on the demands of healthcare managers will illuminate the state of health care administration, and the importance of real world application of accounting and economics in healthcare.

This thesis will explore and examine research about industry standards, and the need for preparedness in healthcare finance management. It will also examine the important and complex role of accounting and …

Emergency Department Use Among Asian Adults Living In The United States: Results From The National Health Interview Survey (2006 – 2013), Kathleen M. Sullivan, James Davis, Angela Sy

Asian/Pacific Island Nursing Journal

This paper presents secondary analyses of the National Health Interview Survey data focused on emergency department (ED) utilization among Asian adults residing in the United States. National Health Interview Survey data provided from survey years 2006-2013 was pooled and disaggregated by single-race Asian ethnic subgroups (Filipino, Chinese, Asian Indian, other Asian). We explored trends in reports of an ED visit over the survey years for the purpose of determining whether reports of an ED visit increased or decreased over survey years. We also explored background/biologic, environment, access to care, and behavior factors and their associations with having an ED visit. …

Relationship Between Medicare Alternative Payment Methodology And Hospital Program Service Revenue, Sandra J. Gubbine

Walden Dissertations and Doctoral Studies

Medicare paid $388.7 billion to acute care hospitals in 2014 representing the largest portion of the health care sector in the United States. Medicare implemented an innovative reimbursement model called Value Based Purchasing (VBP) to ensure hospitals provide quality care for the dollars spent. This correlation study used the VBP theoretical framework developed by Dudley as the foundation for the reimbursement model implemented by Medicare in 2013. The data used for this study came from the Centers of Medicare and Medicaid, as well as from Guidestar. The data focused on acute care, nonprofit hospitals located in New Jersey, New York, …

Comparing The Effectiveness Of Masters-Prepared And Non-Masters-Prepared Nurse Leaders, Subha Narasimha Chari

Walden Dissertations and Doctoral Studies

The complex nature of healthcare requires nurse leaders to be skilled in professional practice, communication, teamwork, and problem solving to improve staff satisfaction and patient outcomes. The American Association of Colleges of Nursing and Institute of Medicine promotes graduate education for nurse leaders to enhance the delivery of quality care to the nation's diverse patient populations. Guided by the diffusion of innovation theory, this project explored the differences in nursing care hours, staff turnover, nurse quality indicators, as well as leadership characteristics on units lead by masters-prepared and non-masters-prepared nurses. Forty-eight nurse leaders completed the impact of graduate education among …

Narratives Of Men Living With Systemic Lupus Erythematosus, Kimberly Vandermark Lynch

Walden Dissertations and Doctoral Studies

While systemic lupus erythematosus (SLE) has been traditionally viewed as a woman's disease, SLE impacts men as well. Although most research on SLE has concentrated on how it affected women, little is known about how it impacts men. The purpose of this phenomenological study was to examine how men who live with SLE perceive its psychological impact. Using the lens of the biopsychological theory, common themes were examined pertaining to how men with SLE perceive the impact that SLE has on their cognitive and emotional functioning. Data were collected via interviews with 9 men with SLE, and the data were …

Exploring Job Satisfaction And Preceptorship Capacity Among Applied Epidemiologists, Jessica C. Arrazola

College of Graduate Studies: Theses & Dissertations

Job satisfaction is important to consider when developing strategies for recruitment and retention. The Public Health Workforce Interests and Needs Survey (PH WINS) conducted in 2014 was the first nationally representative assessment of the state public health workforce. Prior to this assessment, the job satisfaction of state agency public health workers and preceptor capacity had not been measured. This study fills the current research gaps by studying the job satisfaction among the applied epidemiology workforce, identifying factors influencing job satisfaction, and the describing the preceptorship capacity among epidemiologists. This research is based on the 2014 PH WINS data. The analysis …

Strategies To Overcome The Nursing Shortage, Edward A. Mehdaova

Walden Dissertations and Doctoral Studies

Nursing shortage is a growing problem in the healthcare industry as hospital leaders are experiencing difficulties recruiting and retaining nurses. Guided by the PESTEL framework theory, the purpose of this case study was to explore strategies healthcare leaders use to overcome a nursing shortage. Participants were 5 healthcare leaders who have the knowledge and experience in recruitment and retention of registered nurses in a healthcare facility in Seattle, Washington. Data were collected through audio-recorded semistructured interviews and document review of the Hospital Employee Education and Training Program. Data analysis consisted of documenting the data, organizing and categorizing the data, connecting …

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. …

Attitudes And Perceptions Of Mental Health Treatment For Native American Clients, Beverly Elaine Johnson

Walden Dissertations and Doctoral Studies

The need for mental health service is increasing in American Indian/Alaska Native (AI/AN) communities. While research has examined the availability, access, and effectiveness of provided services to the AI/AN, very little is known about the influence of the attitude and perceptions of both clinicians and clients in their therapeutic relationship in the treatment process. Using the frameworks of liberation, oppression, and trauma theory, this qualitative phenomenological study explored mental health service delivery and utilization issues within an AI/AN community. Data were collected through semistructured interviews with 14 clinician and client participants. The data were sorted into themes and subthemes and …

Strategies To Reduce Effects Of Organizational Stress In Health Care Workplaces, Kate Chinyere Mbidoaka

Walden Dissertations and Doctoral Studies

Workplace stress has become a frequent occurrence in the race for competitive business advantage. This stress leads to negative physiological consequences in the workplace, causing productivity and profitability to suffer. The purpose of this single case study was to explore the stress management strategies that some health care business leaders used to reduce the effects of work-related stress on their employees to improve productivity. The interview process included 3 managers employed at a health care institution in Houston, Texas, with records of implementing successful strategies for mitigating the effects of workplace stress. The conceptual framework was job demands-resources model, pertinent …

Effects Of Authentic Leadership Style And Nurse Engagement On Patient Satisfaction, Kimberly Dawn Washburn

Walden Dissertations and Doctoral Studies

Ineffective leadership and disengaged nurses reduce the quality of care and patient satisfaction in healthcare organizations. Healthcare leaders can benefit from understanding the factors that improve leadership ability and nurse engagement to improve healthcare outcomes. The purpose of this correlational study was to examine the relationship between the demonstration of authentic leadership characteristics and nurse engagement. The study's population comprised acute care registered nurses in a rural hospital in central Washington State. Authentic leadership theory and engagement theory constituted the theoretical framework. Independent variables were the 4 constructs of authentic leadership theory, self-awareness, balanced information processing, relational transparency, and internalized …

Hospital Administrators' Strategies For Reducing Delayed Hospital Discharges And Improving Profitability, Sheree Boyd

Walden Dissertations and Doctoral Studies

Inefficiencies in leadership and limited leadership strategies in hospitals contribute to delayed hospital discharges and an increased financial burden on a hospital. Three administrators from 2 hospitals who are part of a hospital conglomerate in Chicago, Illinois were selected for interview in this qualitative multiple case study to explore how hospital discharge strategies reduce delayed hospital discharges and improve profitability. Contingency was the primary theoretical theory for this study. The purposive sampling consisted of the selections of individual who were knowledgeable and had experience to organize, manage, and implement processes in an organization. Data collection occurred using face-to-face semistructured interviews, …

Effects Of Lifestyle Changes On The Health Of African Americans With Type 2 Diabetes, Charles Duro

Walden Dissertations and Doctoral Studies

African Americans are adversely affected by Type 2 diabetes at a greater rate than their European American counterparts; however, research on the effects of Type 2 diabetes on African Americans is limited. Lifestyle modifications that include the incorporation of physical activity and dietary changes can help patients with Type 2 diabetes better manage their disease and improve their overall quality of health. The purpose of this phenomenological study was to explore the experiences of African Americans with Type 2 diabetes who incorporated these self-management behaviors, discerning if they had improved health and quality of life. The self-efficacy framework was applied …

Frequent Fall Risk Assessment Reduces Fall Rates In Elderly Patients In Long-Term Care, Omokhele Rosemary Aliu

Walden Dissertations and Doctoral Studies

Falls are a serious issue for the elderly living in long-term care facilities, as falls contribute to signiï¬?cant health problems such as increased dependence, loss of autonomy, confusion, immobilization, depression, restriction in daily activities, and, in some cases, death. An estimated 424,000 fatal falls in elderly patients residing in long-term facilities occur annually in the United States costing $34 billion in direct medical costs. One way to reduce falls among elderly patients in long-term care is to assess for fall risk frequently and implement evidence-based strategies to prevent falls. Patients in this project site facility had been assessed for fall …

Hospital Outcomes Based On Physician Versus Non-Physician Leadership, Collins Yazenga Mkandawire

Walden Dissertations and Doctoral Studies

Hospital performance metrics are an indicator of leadership performance. However, there is inadequate research on whether physician or nonphysician chief executive officers (CEOs) perform better in the U.S. hospitals. The purpose of this study was to examine which type of leaders is better. Leadership trait, situational leadership, and leadership behavior theories constituted the theoretical foundation. The key research question examined the relationship between a hospital's outcomes, which in this study, included hospital net income, patient experience ratings, and mortality rates, and the type of CEO in that hospital: physician or non-physician. A quantitative, causal comparative design was used to answer …

Chronic Kidney Disease Awareness And Quality Of Care In Abuja Nigeria, Patience Eze

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a non-communicable progressive disease that can lead to kidney failure or end-stage renal disease. In Nigeria, many people do not have access to health care due to extreme poverty, which means that those suffering from diabetes or high blood pressure, or both diseases, which have been identified as the 2 main risk factors, may not know their health status. The purpose of this phenomenological study was to explore the level of CKD awareness among Nigerians and if cultural beliefs affect individuals' health seeking behaviors because of the diverse nature of the Nigerian population. The protection …

Leadership Development For The Formal Nurse Leader, Lori Neu

Walden Dissertations and Doctoral Studies

Nurse leaders are essential to the advancement of healthcare because of their ability to bridge the gap of knowledge between clinical practice and the business of healthcare. Developing nurse managers is imperative to the future of nursing given their influential role in healthcare. The central topic of exploration in the project was how nurse managers use the American Organization of Nurse Executives (AONE) Nurse Manger Inventory Tool to assess their management skills after exposure to the leadership development program currently available to them. In this project, the novice to expert theory was used to evaluate the existing leadership development program …

Initial Findings Of A Medicare Annual Wellness Visit Program, Hesper B. Nowatzki

Walden Dissertations and Doctoral Studies

Despite the emphasis of benefits on preventive health, many older adults are not receiving the recommended age specific, evidence based screenings and vaccinations. The Medicare Annual Wellness Visit (AWV) is designed to address modifiable risk factors with aging adults and close gaps in care not captured in routine office visits. Although a free Medicare benefit to patients, and a reimbursable service to health care providers, participation in the AWV is low nationwide. The purpose of the project is to introduce an AWV program to a rural health clinic in Northwest Illinois that has a population consisting of over 25% of …

U.S Marine Corps Veterans' Perceptions Of Screening For Posttraumatic Stress Disorder, Tiffany Lawing Schweitzer

Walden Dissertations and Doctoral Studies

Posttraumatic stress disorder (PTSD) is a serious issue for post-deployment United States Marine Corps (USMC) veterans, especially because PTSD can increase the risk of suicide. Marines are screened post-deployment, yet little is known about Marine veterans' perceptions of the PTSD screening process. The purpose of this phenomenological study was to explore USMC male veterans' perceptions of the Post- Deployment Health Reassessment (PDHRA). The social cognitive theory constructs of a triadic relationship among person, environment, and behavior were the framework for understanding this population's perceptions of the PDHRA and potential stigma. Two research questions focused on how people, culture, and behavior …

Vicarious Trauma Coping And Self-Care Practices Among Trauma Therapists., Annette Zaccari

Walden Dissertations and Doctoral Studies

Therapists who specialize in trauma therapy are indirectly exposed traumatic events presented by clients within the therapeutic relationship. The potential consequences for trauma therapists may be the risk of vicarious trauma. Effective coping and self-care are essential in the practice of trauma work. The research question for this study is: Do coping skills and self-care practices in trauma therapists moderate the disruptive effect of vicarious trauma on the fulfillment of their psychological needs (trust/dependence and control)? The purpose of this research study was to examine quantitatively, the role of trauma therapists' beliefs in the effectiveness of coping skills and time …