Medicine and Health Sciences Commons^™

The Ethical Accountability Of Organizational Leadership To Communities Of Stakeholders In Healthcare, Lisa Martinelli

Electronic Theses and Dissertations

ABSTRACT

THE ETHICAL ACCOUNTABILITY OF ORGANIZATIONAL LEADERSHIP TO COMMUNITIES OF STAKEHOLDERS IN HEALTHCARE

By

Lisa A. Martinelli, JD, MA

October 2020

Dissertation supervised by Professor Gerard Magill

While much is written on organizational ethics in healthcare, this dissertation uniquely links organizational ethics and stakeholder theory to the ethical accountability of leadership to their distinct, vulnerable stakeholder communities. It does so by examining the healthcare organization’s moral agency in relation to stakeholder theory and applies those considerations to three major stakeholder categories: confidentiality and privacy of healthcare information, research and attention to specific pediatric populations, and ethics of care concerning the …

Examining The Intersectionality Of Religious Faith, Spirituality, And Healthcare Communication, Felix Okeke

Electronic Theses and Dissertations

This dissertation is my own contribution in responding to the concern raised by certain communication scholars. Their concern was that little research and few publications have been done in the communication field by communication scholars that trace the relationship among religious faith, spirituality, and healthcare communication. While Parrott (2004) describes this apparent neglect as “collective amnesia,” others label it “religion blindness.” Thus, in trying to trace this relationship, this project uses Christian, biblical, and bioethics backgrounds to establish the value, sacredness, and dignity of human life, since these concepts make healthcare and healthcare communication necessary in the first place. These …

Retrospective Cohort Study Of Patients With Chronic Low Back Pain In An Outpatient Pain Specialist Clinic, Gauri Desai

Electronic Theses and Dissertations

Background: Chronic low back pain (LBP) is a back pain that lasts for three or more than three months in the lumbar region of the spinal cord. A nerve injury or damage in the spinal cord region (neuropathic pain) requires multimodal treatment approach for pain reduction. With various treatment options utilized in the pain management of these patients, identifying demographical and clinical characteristics of patients with chronic LBP utilizing interventional procedures and pharmacologic treatments is imperative.

Objective: (i) To describe the demographics (age, gender, race, ethnicity, smoking status, alcohol consumption status, drug use status) and clinical characteristics (procedures, medications) …

Design And Synthesis Of Pyrimidine Based Fused Heterocyclics In The Potential Treatment Of Cancer And Opportunistic Infection, Farhana Islam

Electronic Theses and Dissertations

Dose-limiting toxicities of clinically used agents and development of resistance are two significant limitations in cancer chemotherapy. Microtubule targeting agents (MTAs) are a structurally diverse set of compounds that disrupt microtubule dynamics and exert their anticancer effect. Combination chemotherapy with antiangiogenic agents and microtubule targeting agents has shown an advantage against both these drawbacks. Single agents with dual antiangiogenic activity and cytotoxicity would afford a therapy that circumvents pharmacokinetic problems of multiple agents, avoid drug-drug interactions, lower the drug dose, decrease overlapping toxicities, and delay or prevent tumor cell resistance. The work in this dissertation reflects the progress of fused …

Facemasks For Source Control: Testing Influenza Transfer To Bedside Tables, Adriane M. Biggio

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

The idea of using facemasks for source control is not new. The concept has been published since 1918 during the Spanish Flu. However, there is limited research testing human subjects on the effectiveness of facemasks in preventing influenza transfer or transmission. The objective of this study was to answer the question, “In influenza-positive Veterans, what is the effect of facemask wearing in comparison to not wearing a facemask on influenza transfer to bedside tables measured for two hours per condition over a ten-week time frame during the 2019/2020 influenza season?” A quasi-experimental evidence-based project pilot study design was used. …

Pulling Heart Strings: Quality Improvement Algorithm For Temporary Epicardial Pacing Wire Removal Post Cardiac Surgery, Jessica Norman

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The placement of temporary epicardial pacing wires (TEPW) is considered standard practice post cardiac surgery and is dependent on the patient’s cardiac function intra-operatively and their electrophysiologic profile after weaning from cardiopulmonary bypass (Reade, 2007; Elmistekawy et al, 2016). Complications associated with TEPW removal include myocardial damage, infection, perforation, tamponade, disruption of anastomoses, ventricular arrythmias, and death (Bojar, 2009; Carroll et al, 1998;Timothy & Rodeman, 2004). Currently there is no standard practice on the removal of TEPW and there is wide variation in removal practices involving patients who are routinely on medications such as dual antiplatelet therapies and systemic anticoagulation. …

Postpartum Depression: Educating The Provider And Staff About The Importance Of Screening, Referrals, Follow-Up And Adherence To The Maternal Mental Health Safety Bundle Toolkit, Natalie Regis

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Background: Postpartum depression (PPD) affects approximately 10%-20% of women after childbirth. PPD is a disabling condition that can have serious health implications on mothers and their infants. Experts estimated that only 50% of women with PPD are diagnosed. Lack of education about screening practices can cause the disorder to go undiagnosed and untreated.

Purpose: The purposes of this quality improvement (QI) project were 1). To increase the provider and staff knowledge about the importance of screening with the implementation of a standardized screening tool 2). To increase PPD screening rates to 100% 3). To increase appropriate referrals to mental …

A Program Evaluation Of Violence Prevention Task Force To Address Type Ii Workplace Violence Utilizing Precede/Proceed Model, Stephanie Autry

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Aim: The primary aim of this project was to complete a program evaluation of the institution’s Violence Prevention Task Force. Evaluation allowed for assessment of outcomes including 1). decrease in assaultive incidents; 2). decrease in assaults leading to injury; 3). increase in team member reporting of assaultive incidents; and 4). demonstrate the program’s adherence to published guidelines on workplace violence prevention.

Background: Violence against healthcare workers has been an increasing problem in our nation’s healthcare system. Type II workplace violence is defined as patient, family member, or visitor as the perpetrator directing violent/aggressive behavior towards healthcare worker and is described …

Applied Molecular Dynamics: From Targeting Viral Helicases, To Understanding The Interactions Of Cucurbituril Complexes In Ionic Solutions, Bryan Raubenolt

University of New Orleans Theses and Dissertations

Molecular Dynamics simulations are a highly useful tool in helping understand the fundamental interactions present in a variety of chemical systems. The work discussed here illustrates it’s use in determining the conformational dynamics of the Zika and SARS-Cov-2 helicase in a physiological environment, largely in an effort to discover inhibitors capable of rendering the protein inert. Additionally, we show how it can be used to understand paradoxical trends in the anion-induced precipitation of Cucurbituril cavitands.

Viral helicases are motor proteins tasked with unwinding the viral dsRNA, a crucial step in preparing the strand to be translatable by host cells. By …

Hips That Harm: When Medical Devices Fail Women, Sophie N. Putka

Capstones

Medical devices that save the lives of thousands of Americans each year advance at a rapid pace - but some of them consistently leave women behind. When it comes to joint replacements and even heart devices, women have worse health outcomes. Behind this preventable problem is a system that overlooks women from start to finish. Female bodies are different from male bodies, but women are often underrepresented in medical trials for device approval. Women’s participation in clinical testing for devices has increased, but there’s rarely a detailed analysis of performance by sex, and even less information on women by race …

The Ethical Challenge For Hipaa’S Privacy Rule In The Genomics Era Of Data Analytics., Reem Shinawi

Electronic Theses and Dissertations

The thesis of this dissertation focuses on the Ethical Challenge for HIPAA’s Privacy Rule in the Genomics Era of Data Analytics. Data Analytics in Genomic Medicine challenges the individuals’ right to privacy. Hence, a balance is needed between the previous centrality of individual privacy and the need for population information to make breakthroughs in Genomic Medicine using Data Analytics. Such a problem demands regulatory solutions. And such solutions require the collaboration of professionals. Genomic Medicine is a field that deals with sensitive genetic information in both medicine, and research, it is essential to view it through HIPAA as it is …

The Contribution Of A Global Ethics Approach To Health And The Environment In The Niger Delta Region, Augustine Wayii

Electronic Theses and Dissertations

ABSTRACT

THE CONTRIBUTION OF A GLOBAL ETHICS APPROACH TO HEALTH AND THE

ENVIRONMENT IN THE NIGER DELTA REGION

By

Augustine Lezorgia Wayii, M. ED, M.A.

May 2020

Dissertation supervised by Gerard Magill, PhD

The dissertation presents a global ethics approach that connects health and the environment in the context of the Niger Delta Region. The people of the Niger Delta region in Nigeria are experiencing major catastrophes that connect health and the environment. In the bid to ameliorate these pivotal problems, this dissertation undertakes an ethical analysis that connects health and the environment. Insofar as these problems can be characteristic …

Development And Implementation Of An Orthopedic Enhanced Recovery After Surgery Protocol, Beth Mccoy

Doctor of Nursing Practice Projects

Abstract

As life expectancy rates have grown and individuals desire a more active lifestyle the number of total hip arthroplasty and total knee arthroplasty surgeries performed has grown significantly. Enhanced recovery after surgery (ERAS) protocols have been shown to decrease the financial impact and improve patient outcomes in total joint surgeries. After a literature review a multidisciplinary team met and developed an ERAS protocol for total joint replacement surgeries to be implemented at a 250-bed community hospital in central Illinois. After an eleven-question pre-test was given to 34 participants consisting of perioperative nursing staff, anesthesia, and surgeons assessing their knowledge …

Through The Screen: Disability, Aging And Technology, Shoshannah E. Buxbaum

Capstones

The Covid-19 pandemic has fundamentally altered what it means to stay connected. These are stories of how technology has shaped the lives of people with disabilities and seniors in Utah. This half-hour audio documentary, accompanying images and text delve into everything from getting hooked up to the internet for the first time, to the hurdles and expanded opportunities of remote work.

https://shoshannah-buxbaum.medium.com/through-the-screen-bb14b1c992ca

A Crisis Of Kelp, Rachel L. Sherman

Capstones

Along with insects and lab-grown meat, for years seaweed has been lauded as a sustainable “food of the future” by the U.N. Food and Agricultural Organization. As the world increasingly turns to alternative foods in pursuit of a healthier Earth, seaweed has all the makings of an ecological savior. It’s plentiful — seaweeds and ocean algae make up roughly nine tenths of all the plant life on Earth — it’s cheap to harvest and get to market, packed with nutrition, and keeps oceans clean, absorbing more carbon dioxide and releasing more oxygen than the world’s rainforests.

But outside of Japanese …

The Gay Men Who Play With Their Hiv Status., Matthew I. Euzarraga

Capstones

• Since the 90’s a group of individuals known as Bug Chasers, predominately gay men have been playing a game of cat and mouse actively wanting to be caught and infected with HIV. This is a dive into the world of bug chasing.

Healthcare Policy Analysis: Next Of Kin Contact Information On Driver's Licensse And Its Use In Emergency Notification, Suzanne Sheaffer

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

In Pennsylvania, there has been a rise in unclaimed decedents within Third-Class and Fifth-Class county coroner offices. Decreasing the number of unclaimed decedents in Third-Class and Fifth-Class Pennsylvania coroners offices is the goal for this healthcare policy analysis project. Using the Bardach’s eight step policy analysis problem solving technique, the data and the project outcomes will be presented to Pennsylvania Department of Transportation (PennDOT). Data collection began with a questionnaire sent to all 67 counties to determine who had access to the Pennsylvania driver’s license database entitled Pennsylvania Justice Network (JNET). Fourteen of 67 counties have partial access and …

Comparing Sugammadex In The Adult And Geriatric Population, Jason Medeiros

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

A comparison of using sugammadex for neuromuscular blockade reversal in adult and geriatric populations, examining time to recovery and adverse outcomes related to residual neuromuscular blockade.

Exploring Accessibility And Social Inclusion For Children With Hearing Impairments In Residential Camps Through The Occupational Therapy Lens, Tiffany Coles

Student Capstone Papers

Children are encouraged to engage in various play, leisure, and social participation activities to enhance the development of life skills, independence, and social skills. A common leisure and social participation activity for children aged 6 to 18-years-old is to attend residential camp. Residential camps provide children a structured opportunity to engage in leisure activities while learning to become independent and self-confident when socializing and making new friends. Attending camp can be a fun and engaging environment to help accelerate growth in key developmental outcomes, such as positive identity, social skills, physical skills, positive values, and spirituality.

Within the residential camp …

Stress Relaxation In Orthodontic Aligner Plastics; An In Vitro Comparison Study, Kristopher J. Keller

Theses & Dissertations

The purpose of this study was to ascertain if repeated stresses from extension cycling would result in accumulated damage in aligner materials and affect force delivery. A secondary goal was to identify potential differences in mechanical behavior present among orthodontic aligner polymers. Four thermoplastic polymers (Essix ACE, Taglus, Zendura, and Zendura FLX) were thermoformed, cut into strips, and extension cycled to 0.4 millimeters in a 37C water bath. Force decay, maximum and minimum force, and elastic modulus were measured during cycling. Additional samples were subjected to controlled tension until failure, allowing the measurement of yield strength, ultimate strength, and elastic …

Rilpivirine-Associated Aggregation-Induced Emission Enables Cell-Based Nanoparticle Tracking, Insiya Mukadam

Theses & Dissertations

Antiretroviral therapy (ART) has improved the quality and duration of life for people living with human immunodeficiency virus (HIV) infection. However, limitations in drug efficacy, the emergence of viral mutations and the paucity of cell-tissue targeting remain. We posit that to maximize ART potency and therapeutic outcomes newer drug formulations that reach HIV cellular reservoirs need to be created. In a step towards achieving this goal we discovered the aggregation-induced emission (AIE) property of the non-nucleoside reverse transcriptase inhibitor Rilpivirine (RPV) and used it as a platform for drug cell and subcellular tracking. RPV nanocrystals were created with endogenous AIE …

Mechanisms By Which Mnte-2-Pyp Suppresses Prostate Cancer Cell Growth, Yuxiang Zhu

Theses & Dissertations

Prostate cancer patients are often treated with radiotherapy. MnTE-2-PyP, is a superoxide dismutase (SOD) mimic and a known radioprotector of normal tissues. Our recent work demonstrates that MnTE-2-PyP also inhibits prostate cancer progression with radiotherapy; however, the mechanisms remain unclear. In this thesis, we identified that MnTE-2-PyP-induced intracellular H2O2 levels are critical in inhibiting growth of prostate cancer cells. We found that MnTE-2-PyP induced protein oxidations in PC3 cells and one major group of oxidized protein targets were involved in energy metabolism. The oxidative phosphorylation rates were significantly enhanced in both PC3 and LNCaP cells with MnTE-2-PyP treatment, but mitochondrial …

Joint Loading Factors Of Articular Cartilage Structure In Healthy And Acl-Injured Knees, Elizabeth Wellsandt

Theses & Dissertations

Articular cartilage structure and chondrocyte health are sensitive and reliant on dynamic joint loading during activities. The risk of osteoarthritis (OA) is high after anterior cruciate ligament (ACL) injury, but mechanisms underlying its development are poorly understood. The overall goals of this work were 1) to determine the association between measures of individual and cumulative knee joint loading with T2 relaxation times in the knee cartilage of young individuals without injury and 2) to determine if these same knee joint loading factors are associated with cartilage T2 relaxation time one month after ACL injury. The central hypotheses was that lower …

Inflammatory Cytokine Expression Of Immune Cells On Exposure To Invisalign® Material: An In Vitro Pilot Study, Alaina M. Allen

Theses & Dissertations

The purpose of this study is to characterize the inflammatory cytokines that are expressed in peripheral blood mononuclear cells (PBMCs) and THP-1 monocytes exposed to Invisalign^® aligner material in vitro. Invisalign^® material was ground into particles, soaked in artificial saliva, and the eluate was collected. Commercially available cryopreserved pooled and individual human PBMCs and THP-1 monocytes were cultured with Invisalign^® material eluate and positive (lipopolysaccharide) and negative controls. The supernatants were collected and used with a BioLegend LEGENDplex^™ multi-analyte flow assay, a sandwich enzyme-linked immunosorbent assay (ELISA), to identify the expression of TNF-α, IL-6, IL-8, IL-10, …

Improving Nurse Resilience, Brandon Hedgspeth

Doctor of Nursing Practice Projects

The national average nurse turnover rate was 18.2% in 2017 (Ackerson & Stiles, 2018). A contributing factor for nursing turnout rates was nurse burnout and compassion fatigue (Barratt, 2018; Cleary, Kornhaber, Thapa, West, & Visentin, 2018; Cope, Jones, & Hendricks, 2016; Magtibay, Chesak, Coughlin, & Sood, 2017; Delaney, 2018; Manomenidis, Panagopoulou, & Montgomery, 2019; Poulsen, 2015). Improvement in nurse resilience was revealed to reduce burnout and compassion fatigue in nurses (Ackerson & Stiles; Delaney). The primary goal of this quality improvement project was to evaluate the use and impact of resiliency education on the resiliency of nurses in the hospital …

Impact Of A Standardized Neurologic Exam On Diagnosis Of And Referral Pattern For Neurologic Disorder In Pediatric Toe Walking, Allison Hotze

Doctor of Nursing Practice Projects

Successful management of toe walking, a common patient complaint addressed by pediatric orthopedic providers, requires detection of concerning neurologic causes for toe walking. However, nurse practitioners in an outpatient orthopedic clinic were not following recommended guidelines for the history and physical exam for children who toe walk, resulting in delayed referrals and poorer patient outcomes. A performance improvement project was initiated that included an educational intervention, chart review, and data analysis. The goal was to improve the performance and documentation of neurologic exam when nurse practitioners saw patients for an initial visit for toe walking. A literature review provided evidence-based …

Comparison Of Cardiac Muscle Between Male And Female Rats With Exercise And Aging: Analyzing Vitals, Gdnf Expression, Ngf Expression, Rna Expression, Sympathetic Innervation, Parasympathetic Innervation, And Sensory Innervation, Katelyn Kurrie

Honors Theses

The direction of my research-based thesis answers the question of how exercise affects the cardiovascular system with aging in male and female rats. My study would highlight the important differences of the cardiovascular system of both sexes which could lead to sex-specific insight on the cardiovascular disease epidemic which prevails as the most common cause of death in the United States. The studies completed will test the hypothesis: neurotrophic factor will be higher in females than males due to the higher presence of estrogen in females. The trophic factor is predicted to increase in both males and females with regular …

The Examination Of Morpho-Syntactic Production In Bahamian Children Exposed To Bahamian Creole English And English, Danielle Moss

Dissertations, 2020-current

Purpose. Information on the morpho-syntax development of children who speak varieties of Bahamian English, such as Bahamian Creole English (BCE), remains understudied. Therefore, speech-language pathologists (SLPs) assessing the expressive language of children who speak BCE encounter challenges in making clinical judgments of language difference, developmental errors, and language disorder because they are unable to judge the morpho-syntactic features of this creole to the rules of another variety of Bahamian English, standard English (SE¹), as both varieties, BCE and SE, are independently rule-governed. This dissertation study investigated the morpho-syntax of typically developing four and six-year-old Bahamian children who speak …

Pandemic Driven Innovation: Development Of An Alternative Respiratory Pathogen Self-Collection Device, Thang Nguyen

Theses & Dissertations

The SARS-CoV-2 virus outbreak has underscored numerous weak links in our biodefense countermeasures against highly communicable diseases. Many believe it was our lack of an effective testing model that allowed the virus to become a global pandemic within a short period. The gold standard collection method for the SARS-CoV-2 virus involves mechanical debridement of the nasopharyngeal cavity with a stiff swab applicator, which has been known to cause pain and injury to patients, subsequently resulting in low patient acceptance of the procedure. Due to the invasive nature of the nasopharyngeal swab collection method, it may not be conducive to the …

Glycemic Variability In Patients With Stage Ii-Iii Colon Cancer, Natalie Mandolfo

Theses & Dissertations

Patients with cancer experience metabolic changes such as hypoglycemia, hyperglycemia, and glycemic variability; collectively termed malglycemia. Glycemic variability, defined as fluctuations in glucose, is a marker of metabolic instability. Higher glycemic variability is associated with adverse health outcomes in the general population and in those with diabetes. Little is known about glycemic variability in patients with cancer, especially those with solid tumor malignancies. Glycemic variability is associated with increased infection, shorter periods of remission, and higher mortality in patients with hematological cancer. This body of work describes the concept and measurement of glycemic variability to assess glycemic control in patients …