Medicine and Health Sciences Commons^™

Comparing Outcomes Of Laparoscopic Adjustable Banding And Laparoscopic Sleeve Gastrectomy Bariatric Surgery, Seth Kojo Ananse Baffoe

Walden Dissertations and Doctoral Studies

Bariatric surgery is an effective procedure type for morbidly obese patients when all else fails. Because obesity is a chronic disease, prolonged assessment and understanding of the credibility of procedure types and their effects on bariatric surgery outcomes are essential, yet current evidence shows decreasing utilization of one of the dominant procedure types. To better compare outcomes of procedure type, this research was designed to control for volume, hospital size, age, gender, season, month, year, and ethnicity. The goal of the study was to compare the outcomes of laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) bariatric surgery …

A Systems Approach To Moral Distress In Long Term Care, Margaret Lemley

Electronic Theses and Dissertations

Abstract: The question that this dissertation seeks to answer is whether or not a Systems Approach to Moral Distress can serve to positively address issues of moral distress within the Long-Term Care setting. Because moral distress has largely been understood as a phenomenon of the individual, efforts to address and reduce incidents of moral distress have focused almost entirely on the individual and his or her reaction to specific triggers. Building upon the existing literature this dissertation argues that previous efforts to understand moral distress within the healthcare setting have been limiting in two very important aspects. The first …

Practicing Sacred Encounters: A Narrative Analysis Of Relational, Spiritual, And Nursing Leadership, Margaret Woodrow Mark

Antioch University Dissertations & Theses

This research examined one large health system that has, through a stated mission outcome that every encounter is a sacred encounter, sought to enhance relationships occurring within the health care environment. Seeking to understand the lived experience of sacred encounters through the lens of nurse leaders in one acute care hospital settings this study examined how nurse leaders experienced their leadership role in realizing sacred encounters. Participants were defined as nurse leaders from one hospital setting and included nurse managers, directors and one vice president. A narrative thematic analysis framed by situational analysis was the method of inquiry. Data was …

Engaging Parents To Promote Children’S Nutrition And Health: Providers’ Barriers And Strategies In Head Start And Child Care Centers, Dipti A. Dev, Courtney Byrd-Williams, Samantha Ramsay, Brent A. Mcbride, Deepa Srivastava, Ashleigh L. Murriel, Chrisa Arcan, Anna M. Adachi-Mejia

Department of Child, Youth, and Family Studies: Faculty Publications

Purpose: Using the Academy of Nutrition and Dietetics benchmarks as a framework, this study examined childcare providers’ (Head Start [HS], Child and Adult Care Food Program [CACFP] funded, and non-CACFP) perspectives regarding communicating with parents about nutrition to promote children’s health.

Design: Qualitative.

Setting: State-licensed center-based childcare programs.

Participants: Full-time childcare providers (n ¼ 18) caring for children 2 to 5 years old from varying childcare contexts (HS, CACFP funded, and non-CACFP), race, education, and years of experience.

Methods: In-person interviews using semi-structured interview protocol until saturation were achieved. Thematic analysis was conducted.

Results: Two overarching themes were barriers and …

What's Happening: December 19, 2016, Maine Medical Center

What's Happening

No abstract provided.

Tobacco Use, Cessation, And Locus Of Control Among College Students, Bernard Ambe

Electronic Theses and Dissertations

ABSTRACT

The purpose of this study was to (a) determine the locus of control among American college students (b) determine if tobacco use or cessation correlate with any demographic variables to better understand the efficacy of tobacco interventions and help design an intervention most effective in the prominent LOC of college students.

The Global Adult Tobacco Survey (GATS) was modified for the purposes of this study and used to determine demographic factors and tobacco usage status. The modified GATS survey also included the LOC questionnaire which yielded the data. Seventy-four responses were recorded. The mean locus of control scores were …

Improving Employee Engagement Through The Development Of An Enterprise Performance Management System, Carlton D. Abner

Doctor of Nursing Practice (DNP) Projects

There is ample evidence of our health care delivery system relying heavily on value-based outcomes. The increased focus on outcomes has required health care organizations to adjust how they approach data and how they successfully implement performance management systems. These performance management systems help the organization identify, measure, and report the organization’s performance at an enterprise level using key performance indicators clearly linked to the organization’s overall strategy. As one organization began implementing an enterprise performance management system, the goal of this project was to show how participating in projects with that level of strategic impact can lead to improved …

Burnout In Radiation Therapy: Examining The Six Leading Influences, Gina C. Passmore

All Theses And Dissertations

Recent studies are highlighting the dangers of burnout amongst healthcare workers, including radiation therapists. Since burnout is associated with an increase in medical errors (Sanchez-Reilly, 2013), it affects both the well-being of the patient and patient satisfaction scores, which are important to a hospital’s reputation. Burnout has a positive correlation with job dissatisfaction and increased employee turnover, making it both a financial and quality issue. Organizations acknowledge that burnout leads to unhappy employees, and unhappy employees are less likely to be engaged in their work, thereby not producing the best “products” (Sehlen, 2009). By examining which components seem to be …

The Impact Of Electronic Health Records On Healthcare Service Delivery, Patient Safety, And Quality, Kate Elizabeth Trout

Theses & Dissertations

The HITECH Act has provided over $30 billion of support through the Meaningful Use program to implement Electronic Health Records (EHRs) with aims to improve healthcare service delivery, efficiency, quality, and patient safety. New healthcare models, such as pay-for-performance and value-based purchasing, were envisioned to aligning quality with reimbursement mediated with the use of EHRs. It is unclear of how EHRs and Meaningful Use have impacted health service delivery, patient safety, and quality of care. Thus, making it difficult to determine if the specific set of objectives for Meaningful Use have had a positive impact on outcomes, which ultimately is …

What's Happening: December 12, 2016, Maine Medical Center

What's Happening

No abstract provided.

Hsc Committee Meeting, 12/06/2016, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

What's Happening: December 5, 2016, Maine Medical Center

What's Happening

No abstract provided.

Quality Improvement Programs’ Contribution To Successful Clinical Practice Changes, Erika O. Bowen

Theses & Dissertations

There is a great deal of healthcare literature on the importance of QI programs and the significant contributions they make toward patient safety and patient satisfaction; however, documentation of outcome measures and predictors of success remains challenging. This study examined the experiences of physician participants who attended a state supported South Texas medical school’s CSE course to gain an understanding of QI education, demonstrate the need for formal QI education, and determine if a change in clinical practice occurred as a result of attending a structured QI course. Kirkpatrick’s (1967) four-level evaluation model was used as a framework to guide …

Impact Of A Student-Scheduled Child Care Program On Parents' Educational Goals, Barbara Carter

Administrative Issues Journal

The purpose of this study is to examine what, if any, impact a Student-scheduled Child Care (SSCC) program had on the families of students completing their higher education goals at a college in the southwestern region of the United States. Student completion rate is a concern for most college and university administrators. Research conducted by the Gates foundation determined that over three quarters of former students surveyed felt that they would have graduated if the college or university had offered child care (Johnson, Ott, & DuPont, 2011). This correlational and descriptive research study revealed what student families thought about the …

Advanced Placement U.S. History And The Application Of Social Justice, Katherine A. Curry, Lou L. Sabina, Jon Loffi

Administrative Issues Journal

Recent changes to Advanced Placement U.S. History have sparked a national debate concerning goals and purposes of college level history courses. Critics suggest that the revisions result in a national curriculum that promotes a revisionist history perspective. Defenders claim that revisions are an important step in preparing students for 21st century citizenship. This document analysis identifies key differences between the 2010 and 2014 AP U.S. History frameworks and considers changes made in 2015 by College Board in response to the national debate. The challenges of applying a social justice lens to curriculum are discussed, and suggestions are made concerning the …

Administrative Issues Journal: Table Of Contents And Letter From The Editor, Jared F. Edwards

Administrative Issues Journal

No abstract provided.

Planning A Library Leadership Retreat On The Cheap: Case Study And Analysis, Stewart Brower

Administrative Issues Journal

Staying ahead of the pitch: an old baseball metaphor that means to anticipate where the ball is going to go so that the batter can score a hit. But to anticipate changes in a field as robust and challenging as information sciences, reflection and contemplation are often key to good planning. With simple day-to-day management of libraries already being a full-time task, true leadership and planning often comes with a real, physical break from the workplace and daily routines. With this in mind, the leadership retreat should be employed by librarians to give themselves the luxury of deep reflection, camaraderie, …

Police Attitudes And Professionalism, Joseph Loftus, Keith Price

Administrative Issues Journal

This quantitative study utilized Richard H. Hall's attitudinal attributes of a professional using a Likert scale. The survey was administered to officers in two similar mid-sized police departments. The first agency had 650 officers, while the second had 350 officers. Agency One requires all applicants to possess a bachelor's degree, while Agency Two does not have this requirement. It was hypothesized that the officers with a bachelor's degree would possess an enhanced attitudinal level of professionalism over those without. It was also hypothesized that officers belonging to an agency that requires a bachelor's degree will have an enhanced attitudinal level …

Motivating Adult Learners: Exploring The Emergence Of Adult Business Students In An East Texas University, Douglas Luke, Madeline Justice

Administrative Issues Journal

Adult enrollment in higher education institutions has grown significantly during the last decade, with students aged 25 and older attending 4-year institutions at higher rates than before. In the 21st century, few can improve their socioeconomic status or advance professionally without higher education. Colleges and universities must consider this diverse student population by identifying new modes of motivation for students to pursue degrees at 4-year institutions. Research suggests that universities focus on the new learners of higher education: nontraditional students who are motivated by their desire to learn and advance professionally. This study examined motivational factors and patterns of students …

Transforming High School Counseling: Counselors' Roles, Practices, And Expectations For Students' Success, Wei-Cheng J. Mau, Jiaqi Li, Kimberly Hoetmer

Administrative Issues Journal

This study examined the current roles and practices of American high school counselors in relation to the ASCA National Model. Expectations for student success by high school counselors were also examined and compared to those of teachers' and school administrators'. A nationally representative sample of 852 lead counselors from 944 high schools was surveyed as part of the High School Longitudinal Study: 2009-2012. Findings are examined in the light of the National Model and advocated practices.

Latina Titans: A Journey Of Inspiration, Velma D. Menchaca, Shirley J. Mills, Filomena Leo

Administrative Issues Journal

This qualitative research examined the journey of renowned female leadership in higher education. Two top level Latina administrators of universities were interviewed extensively to discover their journey to leadership. The theoretical framework used was Latina critical race theory, feminist theory, and counter-storytelling. Themes that surfaced were strong supportive mother, fervent faith, humble beginnings, mentors, intelligence, and challenges not obstacles. These guiding themes serve as a path for Latinas who aspire to higher educational leadership positions.

Cheating In Online Courses For Financial Aid Fraud In The U.S., Robert S. Owen

Administrative Issues Journal

This manuscript reviews issues that differentiate traditional academic cheating from course misconduct that is motivated by a desire to defraud financial aid services in the U.S. Past research on college student cheating has assumed that cheaters are driven by an incentive to obtain undeserved grades in college in order to ultimately obtain a degree. However, researchers on academic dishonesty, professors, and college administrators might not realize that online class members can include virtual "straw" students who are puppets of a financial aid fraud ring leader. Cheating behaviors of straw students differ from cheating behaviors of actual, legitimate students. This has …

Improving The Adherence Of Providers To The American Academy Of Sleep Medicine Guidelines For The Evaluation, Treatment, And Management Of Obstructive Sleep, Heather Miles

Doctor of Nursing Practice

The purpose of this project is to increase the adherence of clinic providers to the American Academy of Sleep Medicine’s Clinical Guidelines for the Evaluation, Management, and Longterm Care of Obstructive Sleep Apnea in Adults. OSA is a chronic condition that effects from 2% to 10% of the U.S. adult population. Implications of undiagnosed OSA include excessive daytime sleepiness, fatigue, irritability, difficulty controlling chronic diseases including diabetes and hypertension, heart arrhythmias, gastroesophageal reflux disease, mood disorders, attention deficit disorder, and an increased potential for dementia if left untreated. A protocol was created to align providers with the clinical guidelines. Provider …

Interventions To Increase Vaccination Rates In Homeless Adults Aged 50 Years And Older In A Shelter-Based Clinic, Rubeena Smith

Doctor of Nursing Practice

Pronounced disparities in adult immunizations exist across the country. In homeless adults over 50 years of age with chronic diseases, coverage rates for influenza and pneumococcal vaccinations falls at 30% as compared to the 60% coverage rate found in the general public. Hepatitis B immunization rates are also significantly lower in the elderly homeless population. Increased prevalence of chronic diseases in the elderly homeless shelter residents’ increase their risk for severe complications following influenza, hepatitis B and meningococcal infections. To prevent disease epidemics and further disability in the homeless population, the need for appropriate and timely vaccinations is critical. Attitudes …

An Initiative To Improve Primary Prevention Of Heart Disease In Adults With Type Ii Diabetes Based On The Acc/Aha (2013) And Ada (2016) Guidelines, Litzie Garza

Doctor of Nursing Practice

Heart disease is the leading cause of death in the United States and in Texas. Hyperlipidemia is a precursor to cardiovascular disease and is a highly manageable and treatable acute and chronic disease in the outpatient primary care setting. This project is designed to increase clinicians’ adherence to the American College of Cardiology/American Heart Association (2013) and American Diabetes Association (2016) clinical practice guidelines for the prevention of heart disease in 40 to 75 year old adults with type II diabetes through interactive education, an electronic alert, and quality improvement sessions on the treatment and management of cholesterol in a …

Implementation Of Quality Improvement Interventions To Increase Provider Adherence To Standards Of Medical Care In Diabetes, Elizabeth A. Betz

Doctor of Nursing Practice

Purpose: To improve a South Texas primary care clinic’s diabetes management system by implementation of a quality improvement intervention to help staff and medical providers increase adherence to the American Diabetes Association standards of care related to screening referrals and orders for urine microalbumin, in order to improve self-care and health outcomes for adult patients with diabetes. Background and Problem: Diabetes is the 7th leading cause of death in the United States and the cause of vision loss, amputations, and end-stage renal disease. The patients at the Wellness Center do not consistently receive routine screenings for neuropathy, retinopathy, nephropathy, microalbumin, …

Volumetry Of Low-Contrast Liver Lesions With Ct: Investigation Of Estimation Uncertainties In A Phantom Study, Qin Li, Yongguang Liang, Qiao Huang, Min Zong, Benjamin Berman, Marios A. Gavrielides, Lawrence H. Schwartz, Binsheng Zhao, Nicholas Petrick

United States Food and Drug Administration: Publications

Purpose: To evaluate the performance of lesion volumetry in hepatic CT as a function of various imaging acquisition parameters.

Methods: An anthropomorphic abdominal phantom with removable liver inserts was designed for this study. Two liver inserts, each containing 19 synthetic lesions with varying diameter (6–40 mm), shape, contrast (10–65 HU), and both homogenous and mixed-density were designed to have background and lesion CT values corresponding to arterial and portal-venous phase imaging, respectively. The two phantoms were scanned using two commercial CT scanners (GE 750 HD and Siemens Biograph mCT) across a set of imaging protocols (four slice thicknesses, …

Does The Electronic Health Record Improve The Timeliness Review And Notification Of Medical Laboratory And X-Ray Test Results?, Ruby Estes

Applied Research Projects

The medical community struggles with timeliness issues throughout the different healthcare environments in many areas of patient care. The demands of meeting patient care needs is great everywhere. One area that can lead to extreme adverse outcomes and affects patient safety is failure to review and follow-up on medical test results timely. In addition the lack of timely follow-up and treatment can lead to medico-legal implications for all healthcare professionals involved in the patients care. Some timeliness issues have been attributed to understaffed healthcare institutions, lack of trained staff, and in many instances inefficient and insufficient processes. This is an …

A Qualitative Analysis Of The Health Informatics Role In Addressing The Public Health Crisis Of Addiction And Overall Effectiveness Of Treatment, Daniel Del Toro

Applied Research Projects

In recent years, the implementation of Health Information Management (HIM) data systems has had significant positive impacts in nearly all aspects of both health and healthcare delivery. However, during this time, there has also been a dramatic increase in the demand for addiction and mental health treatment. The rising number of individuals requiring mental health treatment for addiction has resulted in its declaration as an urgent public health epidemic by the Department of Health and Human Services. The all-encompassing effects of addiction are prevalent in all areas of society, seen in the form of across-the-board rising healthcare costs, addiction related …

Medication Nonadherence, Health Care Utilization, And Safemed Care Transitions Model Impact In Super-Utilizers, Satya Surbhi

Theses and Dissertations (ETD)

BACKGROUND: Super-utilizers are individuals with disproportionately high inpatient and emergency department (ED) use, and mostly have multiple chronic conditions and use multiple concurrent medications. They place a substantial burden on the U.S. healthcare system and have become the focus of policy initiatives aimed at reducing their disproportionate inpatient and ED use. Medication management is critical for these patients since nonadherence to essential chronic medications is associated with poor health outcomes, and higher health care utilization and costs. OBJECTIVES: This dissertation employed a three empirical research papers approach to study the following aims: (1) the prevalence and patterns of medication nonadherence …