Medicine and Health Sciences Commons^™

Sevoflurane: Practice Change Integration Quality Improvement For Pharmacoeconomic Accountability, Kelly Moore Meyers

Graduate Theses, Dissertations, and Problem Reports

Background: Pharmacoeconomic accountability is increasingly of concern to patients, institutions, and healthcare payors alike. Annual sevoflurane expenditure at a large university hospital exceeds $300,000 (personal communication, Eric Likar). Sevoflurane is a liquid, volatile anesthetic delivered from a vaporizer, through a breathing circuit to a patient. Multiple studies focused on reducing sevoflurane use note significant cost savings were attained with a variety of techniques. Moreover, using less sevoflurane reduces the environmental impact of volatile agents which are potent greenhouse gases. Through simple interventions, such as a brief staff education and reminders, Lethbridge et al. (2007) demonstrated over a fifty-percent reduction in …

Association Of Incident Cancer To Low-Value Care And Healthcare Cost Burden Among Elderly Medicare Beneficiaries, Chibuzo Iloabuchi

Graduate Theses, Dissertations, and Problem Reports

In the United States (US), 25% of healthcare spending is considered wasteful because it is spent reimbursing low-value care. Low-value care is the utilization of healthcare services, medical tests, and procedures that have unclear or no clinical benefit to patients but still exposes them to risk. World-wide, low-value care imposes a significant economic burden on patients, payers, governments, and society. Cancer care among older adults > 65 years is one of the biggest drivers of healthcare expenditure in the US and accounts for nearly 40% of all spending, and low-value care among cancer patients is prevalent and contributes to the financial …

Perceptions Of Integrated Mental And Behavioral Health In Pediatric Specialty Care Settings: A Mixed-Methods Study, Desireé Nicole Williford

Graduate Theses, Dissertations, and Problem Reports

Pediatric patients are at an increased risk of experiencing mental and behavioral health concerns, which have direct associations with HRQOL, physiological health, and likelihood that youth will engage in health promoting behavior. Researchers and practitioners have increased their awareness of these concerns and identified strategies for improving the mental and behavioral health of these youth, specifically via implementing organizational efforts (i.e., task forces) and guidelines around integrating psychosocial screening and other services into routine practice. Despite this, there are several identified barriers to families receiving mental/behavioral health care in these settings. These barriers exist at all levels, including at the …

Bypassing The Blood-Brain Barrier: A Physical And Pharmacological Approach For The Treatment Of Metastatic Brain Tumors, Samuel A. Sprowls

Graduate Theses, Dissertations, and Problem Reports

This dissertation (a) provided an in depth literature review of methods to disrupt the BBB/BTB and improve therapeutic distribution to brain tumors, (b) evaluated the use of azacitidine as a single agent therapy for the treatment of brain metastasis of breast cancer and a potential molecular mechanism by which brain tropic cells are sensitized to hypomethylating agents, (c) determined the impact cannabidiol has on P-glycoprotein mediated efflux at the blood-brain barrier and its potential for use as a single agent treatment for metastatic brain tumors, (d) developed a preclinical radiation therapy protocol for use in small animals and in vitro …

Optimizing A Pediatric Dka Protocol In A Tertiary Care Hospital System In Northern West Virginia, Jennifer L. Burky

Graduate Theses, Dissertations, and Problem Reports

Background: Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when the body compensates for insufficient insulin, producing dangerously high levels of ketones. Without proper treatment, DKA can be fatal. For that reason, staff in the pediatric intensive care unit (PICU) at a tertiary care hospital in northern West Virginia expressed concerns about the complexity of and lack of adherence to a poorly referenced and dated DKA treatment protocol.

Objective: The purpose of this project was to assess the feasibility and sustainability of optimizing the DKA protocol in the PICU. The primary objective was to implement an updated, …

Examining Relationships Among Person Factors, Psychosocial Factors, And Coping Patterns In People Living With Type 2 Diabetes Mellitus In North Central Appalachia, Melissa A. Mccoy

Graduate Theses, Dissertations, and Problem Reports

Background: Diabetes is a complex, debilitating illness that imposes disease burden on the individual and society. T2DM is more prevalent in the Appalachian region than in any other Region of the United States. If diabetes is poorly controlled, patients are at risk for negative health outcomes. A gap exists in the literature related to understanding of the relationships among person factors, psychosocial factors, and coping patterns. Another gap in the literature is sex differences among these variables.

Purpose: The purpose of this study is to examining relationships among person factors, psychosocial factors, and coping patterns in people living with T2DM …