Medicine and Health Sciences Commons^™

Directly Comparing Handoff Protocols For Pediatric Hospitalists, Elizabeth H. Lazzara, Robert Riss, Brady Patzer, Dustin C. Smith, Y. Raymond Chan, Joseph R. Keebler, Sarah D. Fouquet, Evan M. Palmer

Publications

BACKGROUND AND OBJECTIVES: Handoff protocols are often developed by brainstorming and consensus, and few are directly compared. We hypothesized that a handoff protocol (Flex 11) developed using a rigorous methodology would be more favorable in terms of clinicians’ attitudes, behaviors, cognitions, or time-on-task when performing handoffs compared with a prevalent protocol (Situation Background Assessment Recommendation [SBAR]).

METHODS: Using a between-groups, randomized control trial design (Flex 11 versus SBAR) during a pilot study in a simulated environment, 20 clinicians (13 attending physicians and 7 residents) received 3 patient handoffs from a standardized physician, managed the patients, and handed off the patients …

A Complex Systems Framework Approach Towards Multidisciplinary Tumor Boards, Rahul Salla, Robert Pahle, Ashish Amresh

Publications

Multidisciplinary tumor boards (MTBs) are universally recommended and have been used in treatment of late stage cancers. Tumor boards have the advantage of including all the stakeholders in the decision making process and improving quality of care, however several studies have pointed to their lack of efficiency and tend to be lackluster while not producing the desired benefits for the participants. In this paper we present the design of a web based immersive framework for collaborative decision making that has the potential to improve several inefficiencies in conducting tumor boards and improve overall clinical outcomes. We present the design of …

Understanding Teamwork In The Provision Of Cancer Care: Highlighting The Role Of Trust, Elizabeth H. Lazzara, Joseph R. Keebler, Soosi Day, Deborah Diazgranados, Minggui Pan, Michael A. King, Shin-Ping Tu

Publications

Team science research has indicated that trust is a critical variable of teamwork, contributing greatly to a team’s performance. Trust has long been examined in health care with research focusing on the development of trust by patients with their health care practitioners. Studies have indicated that trust is linked to patient satisfaction, adherence to treatment, continuity of care, and improved outcomes. We explore the construct of trust using a case example of a patient who received a surgical procedure for a precancerous polyp. We apply the principle of trust to the case as well as present the literature on trust …

Electronic Cigarettes In The Indoor Environment, Cheri Marcham

Publications

"E-cigarettes should be considered a source of volatile organic compounds (VOCs) and particulates in the indoor environment that have not been thoroughly characterized or evaluated for safety."--NIOSH

Interleukin-17a Promotes Cd8 T Cell Cytotoxicity To Facilitate West Nile Virus Clearance, Amber M. Paul, Dhiraj Acharya, Penghua Wang, Jianfeng Dai, David Gate

Publications

CD8 T cells are crucial components of immunity and play a vital role in recovery from West Nile virus (WNV) infection. Here, we identify a previously unrecognized function of interleukin-17A (IL-17A) in inducing cytotoxic-mediator gene expression and promoting CD8 T cell cytotoxicity against WNV infection in mice. We find that IL-17A-deficient (Il17a/) mice are more susceptible to WNV infection and develop a higher viral burden than wild-type (WT) mice. Interestingly, the CD8 T cells isolated from Il17a/ mice are less cytotoxic and express lower levels of cytotoxic-mediator genes, which can be restored by supplying recombinant IL-17A in vitro and in …

Hazcom 2012, Cheri Marcham

Publications

This presentation reviews changes to the OSHA Standard called HazCom 2012. Old and new definitions for "health hazards" are discussed as well as labeling requirements.

Design, Implementation And Evaluation Of A Game-Based Intervention Targeting Latino Children For Improving Obesity Outcomes, Ashish Amresh, Rahul Salla, Madhumita Sinha, Rebecca Birr

Publications

This paper presents the design, implementation and evaluation of a hybrid clinic plus home based intervention targeting Latino children to improve obesity outcomes. The intervention applies motivational game based learning and behavior change theories during design. Latino American children are the main target group for this study as they have significantly high obesity rates due to socio-economic conditions and lack of awareness. There have been several interventions that have targeted game based strategies in the clinic to promote health outcomes and some have even targeted obesity problems, however to our knowledge this is the first effort that adds an inhome …

Application Of Bioinstrumentation In Developing A Pressure Suit For Suborbital Flight, Pedro Llanos, Erik Seedhouse

Publications

This presentation features Embry-Riddle Aeronautical University's U-2 pressure suit. Built to be light and cost-effective, this suit is comfortable, comes in multiple sizes, operates in pressures up to 5 PSID, has an active airflow-based cooling system, and features bio-instrumentation to measure heart rate, breathing rate, skin temperature and other vitals.

An Ultrasensitive Electrogenerated Chemiluminescence-Based Immunoassay For Specific Detection Of Zika Virus, Amber M. Paul, Dhiraj Acharya, Pradip Bastola, Linda Le, Estenfani Fernandez, Michael S. Diamond, Wujian Miao, Fengwei Bai

Publications

Zika virus (ZIKV) is a globally emerging mosquito-transmitted flavivirus that can cause severe fetal abnormalities, including microcephaly. As such, highly sensitive, specific, and cost-effective diagnostic methods are urgently needed. Here, we report a novel electrogenerated chemiluminescence (ECL)-based immunoassay for ultrasensitive and specific detection of ZIKV in human biological fluids. We loaded polystyrene beads (PSB) with a large number of ECL labels and conjugated them with anti-ZIKV monoclonal antibodies to generate anti-ZIKV-PSBs. These anti-ZIKV-PSBs efficiently captured ZIKV in solution forming ZIKV-anti-ZIKV-PSB complexes, which were subjected to measurement of ECL intensity after further magnetic beads separation. Our results show that the anti-ZIKV-PSBs …

A Comparison Of Cervical And Trunk Musculoskeletal Characteristics Between Female And Male Army Helicopter Pilots, Takashi Nagai, Karen A. Keenan, John P. Abt, Timothy C. Sell, Brian W. Smalley, Michael D. Wirt, Scott M. Lephart

International Journal of Aviation, Aeronautics, and Aerospace

Introduction: Neck pain (NP) and low back pain (LBP) are prevalent among military helicopter pilots. Although there have been few studies on sex differences in the NP/LBP prevalence in this population, females are shown to be at a greater risk of NP/LBP in civilian studies. This disparity may be due to musculoskeletal characteristics differences that predispose females for NP/LBP. The purpose of this study was to compare cervical and trunk musculoskeletal characteristics between male and female pilots. Methods: A total of 8 female pilots (Age: 27.6 ± 4.2yrs, HT: 166.1 ± 7.7cm, WT: 67.9 ± 10.6kg) were tested, and they …

A Review Of Studies Of Ventilation And Indoor Air Quality In New Homes And Impacts Of Environmental Factors On Formaldehyde Emission Rates From Composite Wood Products, Francis (Bud) Offermann, Cheri Marcham

Publications

• While increasing outdoor air ventilation rates does reduce the indoor concentrations of air contaminants with indoor sources, the actual reductions in concentrations can differ significantly from those calculated with the assumption of a constant indoor emission rate.
• The ratio of actual to predicted concentration reductions for the low to high outdoor air ventilation modes ranged from 0.59 for formaldehyde to 1.37 for benzaldehyde.
• Increases in emission rates for compounds such as formaldehyde are consistent with mass transfer theory for emissions from materials such as composite wood where mass transfer is limited by gas-phase diffusion across the boundary layer.
• Decreases in …

Exploits Of A Helicopter Tv Journalist, Jerry Foster

ERAU Prescott Aviation History Program

Jerry Foster was the first TV helicopter pilot/reporter in the country; the first to go live over the scene of a breaking story. High speed police chases; devastating floods and daring rescues now splashed all over cable TV, started in the early 1970s in Phoenix. Hear this fascinating story from a remarkable aviator who won the Harmon Trophy for his flying exploits. What he pioneered would later be copied by medical and law enforcement agencies throughout the country leading to the saving of countless lives.

Error Reporting Behaviors, Agnes S. Fagerlund, Elizabeth H. Lazzara, Deborah Diazgranados

Human Factors and Applied Psychology Student Conference

Although patient safety is a focus with medical care, it has been influenced by the lack of safety culture in the environment (Vincent et al., 2000). Preventable medical errors continue to plague healthcare and cost close to $1 trillion annually (Andel et al., 2012). Despite the prevalence of medical errors, only one of seven errors are reported (Levinson, 2010). Understanding the behaviors that influence reporting is imperative to developing patient safety reporting initiatives. Ajzen’s theory of planned behavior identifies behaviors as based on a combination of beliefs, intentions, and social control (1988). Applying this model to error reporting, we hypothesize …

Applying A Team Performance Framework To Better Understand The Handoff Process: Part 1, Agnes S. Fagerlund, Joseph Keebler, Victoria Kerwina Lew, Kristen Welsh, Elizabeth H. Lazzara

Human Factors and Applied Psychology Student Conference

Handoffs require critical information transfers that are clear, comprehensible, and correct from receiver to sender. There are many factors that influence the reliability of the information in a handoff procedure, and impact the subsequent choices that are made that affect patient care. Using the Input – Mediator – Output – Input model multiple factors that influence the information transfer process have been identified to better handoff communication and in turn, lead to better patient care. The IMOI model is a recently developed theory that claims the productivity and value of interaction among team members can be influenced by cognitive, affective, …

Designing A Mobile Space Habitat Analog, Victor Kitmanyen, Matthew Burkhard, Timothy Disher

Human Factors and Applied Psychology Student Conference

No abstract provided.

Under The Needle: Ergonomic Issues With Lethal Injection Protocols, Gabriella Hancock

Human Factors and Applied Psychology Student Conference

The institution of capital punishment represents one of the most contentious issues affecting societies today; and while the practice is only implemented in 58 countries, the controversy affects the world at large as over 60% of the human population lives in nations that condone the death penalty (Hali, 2015). In the United States, people who support capital punishment believe the practice to be an effective crime deterrent for potential criminals and therefore a prospective protective measure for law abiding citizens. Moreover, advocates defend their position by forwarding the argument that executions are ‘humane’; that use of lethal injection ensures that …

Evaluating Virtual Reality Simulators As A Training Tool For Minimally Invasive Surgery, Jennifer F. Louie, Misa Shimono

Human Factors and Applied Psychology Student Conference

Minimally invasive surgery offers a number of advantages over traditional open surgeries, including faster patient recovery time, fewer side effects, and improved cosmesis. However, there are also a number of difficulties involved with performing this type of surgery, including poor visuo-spatial mapping, poor depth perception, and mechanical difficulties (e.g., the fulcrum effect). Considering the decrease in residency training hours required for surgical trainees in 2011 (Rajaram et al., 2014), it is essential that surgical trainees employ training methods that would best result in high accuracy and efficiency.

Simulator-based training addresses many of the issues of traditional master-apprentice surgical training methods …

Musculoskeletal Disorders In The Nursing Profession: A Case Study, Kaitlin A. Kee-Dayton

Human Factors and Applied Psychology Student Conference

Musculoskeletal Disorders in the Nursing Profession: A Case Study

Kaitlin Kee-Dayton

Beth Blickensderfer, Ph.D.

Embry-Riddle Aeronautical University

Daytona Beach, FL

This ergonomics assessment focused on a female Licensed Practical Nurse (LPN) and her life inside and outside of her job. In particular, this case study assessed how working as a nurse may affect the human body in terms of Musculoskeletal Disorders (MSDs). The researcher first conducted an in-depth interview with the nurse about her workplace layout, typical daily work schedule, work habits, physical challenges, MSD injuries she has sustained, and the workplace environment/organizational culture. Next, the researcher conducted three MSD …

Development And Use Of A Tablet-Based Resuscitation Sheet For Improving Outcomes During Intensive Patient Care, Wasif Bokahri, Vimla L. Patel, Ashish Amresh, Ayan Sen

Publications

Data documentation from resuscitation events in hospitals, termed "code blue" events, utilizes a paper form, which is institution-specific. Problems with data capture and transcription exists, due to the challenges of dynamic documentation of patient, event and outcome variables as the code blue event unfolds. We hypothesize that an electronic version of code blue real-time data capture would lead to improved resuscitation data transcription, and enable clinicians to address deficiencies in quality of care. To this effect, we present the design of a tablet-based application and its use by 20 nurses at the Mayo Clinic hospital. The results showed that the …

Closed-Loop Cfd Analysis Of The Fontan Cardiovascular Circulation, Marwan Hameed

Doctoral Dissertations and Master's Theses

One out of 150 newborn babies born with congenital heart disease, approximately 7.5% of those infants have a single ventricle (SV). The Fontan operation, which is a procedure to create a harmonious circulation in SV patients, has been performed for a long time to save the newborn patients. In this procedure the superior vena cava and inferior vena cava, which carry the oxygen-poor blood from the upper and lower body back to the heart, are linked directly to the pulmonary arteries, bypassing the atrial connection. Even though this operation has been around for years, the patients who have undergone this …

Highlighting Trust In The Provision Of Cancer Care, Elizabeth Lazzara, Joseph Keebler, Soosi Day, Deborah Diazgranados, Minngui Pan, Mike King, Shin-Ping Tu

Publications

Slides:

• Patient Case
• Definition & Explanation of Trust
• Application of Trust to Cancer Case
• Implications for Clinical Care
• Implications for Research

Aiha White Paper Findings: Emissions, Exposures And Health Risks, Cheri Marcham

Publications

Part of Seminar 51: Electronic Cigarettes: An Emerging Issue for ASHRAE.

• Introduction to e-cigarettes
• Components and potential health effects
• Current regulatory status
• AIHA white paper findings and recommendations
• ANSI/ASHRAE 62.1 and addenda

Aiha White Paper: Electronic Cigarettes In The Indoor Environment, Cheri Marcham

Publications

This presentation covers the effects of different volatile organic compounds released by electronic cigarettes which can cause health problems. More research on the effects of electronic "smoke" should be conducted on the generally recognized as safe (GRAS) ingredients in electronic cigarette exhaust.

Impact Of Electronic Health Records On Patient Outcomes, Lilian Ndifon, Jude E. Edwards, Leila Halawi

Publications

With the passing of the HITECH Act, EHRs have come into prominence and sharper focus, due to efforts by the government to push for a national adoption of EHRs into our healthcare system. This push for a national adoption of EHRs is based on the premise that it will help improve the quality delivery of health care services and reduce costs. However, this push for a “national adoption” has experienced mixed results. This study was designed to assess the impact of EHRs post-2009, the year of the HITECH Act, to review some of the key contributing factors to this mixed …

Design And Commissioning Of A Community Scale Solar Powered Membrane-Based Water Purification System In Haiti, Shavin Pinto, Yung Wong, Kyle Fennesy, Yan Tang, Marc Compere

Publications

This paper presents the design and commissioning of a solar powered water purification system at the Ryan Epps Home for Children (REHC) in Michaud, Haiti. This system supplies clean drinking water to the 200 children who live and go to school at REHC and also to the community in the form of a micro-business. This micro-business is the mechanism for income generation for sustainable system operation. The purifier uses a three stage filtration system with a disc-type sediment filter, a 0.1 micron ultrafiltration membrane, and an ultraviolet light for disinfection. The backwash cycle extends the life of the ultrafiltration membrane …