Medicine and Health Sciences Commons^™

Pharmacotherapy For Opioid Use Disorder In Mississippi, Amanda Michelle Whitacre

Doctoral Projects

The opioid epidemic is affecting Mississippi’s young to middle-aged adult population in a profound way. Pharmacotherapy for opioid use disorder (OUD) is the gold standard treatment. Despite the FDA-approved evidence-based treatment of pharmacotherapy for OUD, rural areas often lack providers available who will initiate and provide maintenance of this life-saving medication. For this doctoral project, a 36-question survey was developed based on a preliminary literature review. The survey was disseminated to advanced practice registered nurses (APRNs) in the family and psychiatric specialties across Mississippi to assess the barriers to APRNs filling the gap in pharmacotherapy prescribing for OUD. A continuing …

Using The Social-Ecological Model To Better Understand Sexual Assertiveness Among Undergraduate Women At An Institution Of Higher Education In The Southeastern United States, Lisa Wright

Dissertations

This study examined sexual assertiveness among female undergraduate students at an institution of higher education in the southeastern United States from the context of the social-ecological model. An online survey instrument examined sexual assertiveness, sexual communication self-efficacy, campus climate, and sexual scripts. Structural equation modeling was used to examine the relationships between these variables and all variables significantly predicted sexual assertiveness individually, but when examining the relationships collectively, only sexual communication self-efficacy and campus climate remained significant predictors of sexual assertiveness.

Lateral Decubitus And Prone Positioning: An Objective Structured Clinical Evaluation, David Hesley-Hernandez, James Bailey

Doctoral Projects

Improper positioning of patients in the lateral decubitus or prone positions can lead to significant complications, including but not limited to: airway and invasive line loss, physiologic derangements, soft tissue injury, and peripheral nerve injuries (PNI) (Barash et al., 2017; Butterworth et al., 2018). Chui et al.’s (2018) analysis found that PNIs accounted for 12% of anesthesia malpractice since 1990, making PNIs costly. PNIs effects are not limited to cost and result in increased lengths of stay, increased pain levels, and decreased quality of life (Wojtkiewicz et al., 2015). The massive effect poor positioning can have requires that the anesthesia …

Objective Structured Clinical Examination For Intraoperative Hypotension And Hypertension Management, Andrew Mcginity, James David Ingram

Doctoral Projects

Managing intraoperative hypotension and hypertension is a non-technical skill anesthesia providers need to maintain patient safety. Upon transitioning from didactic training to clinical training, SRNAs may find it difficult to manage a patient’s blood pressure intraoperatively. The ultimate consequence of the delayed or improper treatment of intraoperative blood pressure perturbations is end-organ damage at the patient’s expense. Unintentionally causing a patient harm will lead to an SRNA losing confidence in their abilities. This OSCE is intended to increase SRNA confidence and competence regarding intraoperative hypotension and hypertension management before entering the clinical arena.

The hypotension and hypertension management tools and …

Does The Use Of Mental Health Screenings And Targeted Stress Interventions Improve Mental Health Outcomes In Outpatient Clinic Staff?, Mary Benson

Doctoral Projects

The Perceived Stress Scale (PSS) has been used as a classic stress assessment instrument to evaluate perceived stress across many settings. As stress is the primary phenomenon in this review due to varying stressors, including infectious diseases among healthcare workers, the PSS is the most appropriate scale for evaluating the degree to which a health worker feels stressed. In addition, the PSS is valuable as it encompasses ten items that researchers use to explore how respondents react to stress due to unpredictable events. Thus, this DNP project is based on the postulation that screening with the PSS and applying stress …

Ethical And Moral Imperatives Of 2022, Sheila P. Davis Phd

Journal of Health Ethics

Editor's introduction to the Journal of Health Ethics vol. 18, no. 2

Impact Of Social Distancing On Physical Activity In College Students During The Covid-19 Pandemic, Carrington E. Brown

Honors Theses

The COVID-19 pandemic was one that affected everyone in some way. From mandatory lockdowns to vaccinations, the pandemic took a toll on everyone. This study focused on the impact of the COVID-19 pandemic’s mandates on undergraduate college students’ rate of physical activity prior, during, and after the pandemic. A sample of 41 college students was recruited via student email. Participants were of all races, ages, and male and female, and they answered questions determining how the pandemic affected them in their physical activity routine, if applicable. As hypothesized, many individuals’ physical activity routine was interrupted because of the mandates from …

Blind Spot: Implicit Bias In Health Care And Its Awareness Among Nursing Students At The University Of Southern Mississippi, Debora Skaliks

Doctoral Projects

While prejudice and bias are eminent topics in our society, implicit bias or unconscious bias is not as easily detected. Even though implicit bias may be a familiar concept to many, numerous healthcare workers frequently do not recognize the extent of harm such biases can impose on patients' health and outcomes. The Blind Spot DNP project exposed in this research paper explores the relentless question of the correlation between implicit bias awareness, implicit bias education, and its impact on health care. This Doctor of Nursing Project (DNP) project aimed to analyze whether implicit bias education and testing could increase unconscious …

Discussing The Injustice Of The Covid-19 Vaccine Pass Imposed On Medical Consultation In Public Hospitals In Hong Kong, Fung Kei Cheng

Journal of Health Ethics

The COVID-19 pandemic has devastated public health, economy and social life all over the world, especially wherever a vaccine pass scheme has been implemented. Many countries have begun to relax schedules to return to normal activities. In contrast, Hong Kong continues to tighten the utilisation of a vaccine pass for medical services in order to boost vaccination rates. Such a practice not only significantly challenges ethical and operative concerns but also threatens health equity and social justice for healthcare decision-makers and practitioners, consequently hurting public health and community well-being. This discussion analyses the various arguments, reviews vaccine hesitancy and suggests …

Applying Lessons Learned: Nursing Facility Administrators’ Operational And Ethical Challenges During Covid-19, Mary Eleanor R. Wickersham

Journal of Health Ethics

Operational and ethical challenges for nursing homes across the United States during the COVID-19 pandemic were daunting, that experience perhaps only a forecast of future epidemics that nursing home administrators and operators may face. This article describes administrator-identified challenges and focuses on how nursing homes might learn from their experiences by increasing flexibility to meet evolving needs, improving quality assurance and disaster planning, using ethics policies and ethical decision-making processes to work through difficult decisions, and leading the way in creating new policies that will make nursing home care safer and more appropriate for patients with ever changing needs.

Theory Building As Integrated Reflection: Understanding Physician Reflection Through Human Communication Research, Medical Education, And Ethics, Andrea Vicini, Ashley P. Duggan, Allen F. Shaughnessy

Journal of Health Ethics

Grounded in a presupposition that a single explanatory framework cannot fully account for the expansive learning processes that occur during medical residency, the article examines developing physicians’ reflective writing from three disciplinary lenses. The goal is to understand how the multi-dimensional nature of medical residency translates into assembling educational experiences and constructing meaning that cannot be fully explained through a single discipline. An interdisciplinary research team across medical education, communication, and ethics qualitatively analyzed reflective entries (N=756) completed by family medicine residents (N=33) across an academic year. Results provide evidence for moving toward an integrated thematic explanation across disciplines. The …

Improving Patient Outcomes In Substance Use Disorder Through Behavioral Therapy In Depression Development And Impacts Of Social Determinants Of Health During And After Substance Use Treatment, Jerry Ryan Armstrong, Chyanne Napp

Doctoral Projects

Substance Use Disorder (SUD) is a growing problem in the United States (U.S.) and worldwide and relapse is a common occurrence among those facing SUD. Limited scholarly research has been published addressing evidence-based treatment improvement strategies. This study focused on improving SUD treatment through the incorporation of depression tracking from admission to and discharge from inpatient treatment, as well as the incorporation of social determinants of health education during treatment, with an evaluation of relapse rates 30-days after inpatient treatment discharge. Results indicated a significant improvement in depression scores from admission to discharge. Results also revealed improved knowledge regarding social …

Amniotic Fluid Embolism During Cesarean Section: An Objective Structured Clinical Exam, Mackenzie Acosta, Morgan Self

Doctoral Projects

Amniotic Fluid Embolism is a rare obstetric event that has a high morbidity/mortality rate. It is imperative that the anesthesia provider be properly educated on how to recognize and treat an AFE. Prompt recognition and treatment, including the AOK regimen, increase the patient's chance of survival. The faculty for The University of Southern Mississippi’s Nurse Anesthesia Program acknowledged the need for an objective-based exam on Amniotic Fluid Embolism during the Cesarean section. The need for an educational tool on AFE prompted the creation of this doctoral project and resulted in an AFE OSCE which has been added to the OSCE …

Objective Structured Clinical Evaluation For Volume Control And Pressure Control Ventilator Modes, Brian Bailey, Anthony Newsom

Doctoral Projects

The purpose of this doctoral project was to create a tool to teach student registered nurse anesthetists (SRNAs) in The University of Sothern Mississippi’s (USM’s) anesthesia program about pressure control and volume control ventilator modes, and how to use them. To accomplish this goal an Objective Structured Clinical Examination (OSCE) was developed. The framework used for creating this OSCE was Kolb's Theory. Kolb's Theory uses a four-stage learning cycle in which the learner encounters a new experience, reflects on the observations of said new experience, conceptualizes or modifies a concept based on this experience, and then applies their idea to …

Implementing A Depression Screening Process Within A Primary Care Setting Initiative To Improve Quality Patient-Centered Healthcare, Mark Beech

Doctoral Projects

Depression is more widespread than many people understand. Depression is a common mental disorder involving millions of people from all backgrounds, races, and socioeconomic levels (World Health Organization [WHO], 2020). Depression not only affects one’s mental well-being but can be often linked to one’s physical well-being. Additionally, depression is often misdiagnosed and can many times go undetected. The stigma of depression or any mental health disorder still has many patients feeling shameful and the need to be secretive which can prevent proper treatment. The implementation of a depression screening process by utilizing a tool for early depression detection is essential …

Telemedicine Perception: An Identification And Evaluation Of Factors Contributing To The Use Of Telemedicine Services, Katherine Lewing

Doctoral Projects

A morbidity and mortality report made by the Centers for Disease Control (CDC) on the impact of telehealth services during the COVID-19 pandemic throughout 2020 noted several instances in which telemedicine tools had contributed to improved patient outcomes, including: increasing the availability of care to patients otherwise left with little access to health care, decreasing unnecessary patient visits, and reduced disease exposure to patients and staff directly at risk (CDC, 2020).

As the utilization of telemedicine becomes more important and prevalent in U.S. health care systems, it is important to recognize factors that inhibit patient usage. Factors such as inadequate …

Objective Structured Clinical Examination For Arterial Line Placement, Delorean Calloway

Doctoral Projects

The University of Southern Mississippi (USM) is lacking a uniform guideline for arterial line placement. This DNP project promotes the addition of an objective clinical structured examination into the nurse anesthesia curriculum for future student registered nurse anesthetists (SRNAs) to gain comprehension and clinical experience in a simulation lab prior to practicing on real patients. Peer-reviewed literature and evidence-based practices have been researched and organized into a learning tool and checklist to be used as a step-by-step guideline. Having a guideline such as an OSCE in place can increase student competency and foster a culture of safety leading to better …

The Effects Of An Interprofessional Education Video On Dermatologists’ Understanding Of The Role Of The Dermatology Certified Nurse Practitioner, Danielle Elaine Spelich

Doctoral Projects

Dermatology-certified nurse practitioners (DCNPs) have validated knowledge of a dermatology core curriculum and have at least 3,000 hours of formal or informal dermatology training (Dermatology Nurse Practitioner Certification Board [DNPCB], n.d.a). With their standardized education and training, DCNPs are meeting the benchmarks set out by dermatologists. Subsequently, DCNPs have become the new gold standard for dermatology advanced practice registered nurses (APRNs).

However, there is no mention of DCNPs by the American Academy of Dermatology (American Academy of Dermatology [AAD], 2022), and personal experience with dermatologists is that they lack knowledge about DCNPs. This lack of knowledge could create an impasse …

Quality Improvement For Patients With Alcohol Withdrawal Syndrome Starts With An Evaluation Tool, Jessica Bass

Doctoral Projects

Patients with alcohol withdrawal syndrome (AWS) have adverse outcomes to the traditional methods of assessing for and treating withdrawal within the intensive care unit (ICU), which includes a standardized treatment plan. Some negative outcomes include acquiring costly and dangerous hospital-acquired infections, safety concerns, and traumatic experiences that deter further treatment. More individualized assessments and treatments are needed to prevent or decrease the severity of AWS from occurring in critical care settings, which will facilitate more positive outcomes and experiences for the staff and patients. The Minnesota detoxification scale has been shown to be a more appropriate tool for the critical …

Transmission Roles Of Symptomatic And Asymptomatic Covid-19 Cases: A Modelling Study, Jianbin Tan, Yang Ge, Leonardo Martinez, Jimin Sun, Changwei Li, Adrianna Westbrook, Enfu Chen, Jinren Pan, Yang Li, Wei Cheng, Feng Ling, Zhinping Chen, Ye Shen, Hui Huang

Faculty Publications

Coronavirus disease 2019 (COVID-19) asymptomatic cases are hard to identify, impeding transmissibility estimation. The value of COVID-19 transmissibility is worth further elucidation for key assumptions in further modelling studies. Through a population-based surveillance network, we collected data on 1342 confirmed cases with a 90-days follow-up for all asymptomatic cases. An age-stratified compartmental model containing contact information was built to estimate the transmissibility of symptomatic and asymptomatic COVID-19 cases. The difference in transmissibility of a symptomatic and asymptomatic case depended on age and was most distinct for the middle-age groups. The asymptomatic cases had a 66.7% lower transmissibility rate than symptomatic …

The Impact Of Dieting Culture Is Different Between Sexes In Endurance Athletes: A Cross-Sectional Analysis, Austin J. Graybeal, Andreas Kreutzer, Jada L. Willis, Robyn Braun-Trocchio, Kamiah Moss, Meena Shah

Faculty Publications

Background: Frequent dieting is common in athletes attempting to achieve a body composition perceived to improve performance. Excessive dieting may indicate disordered eating (DE) behaviors and can result in clinical eating disorders. However, the current nutrition patterns that underly dieting culture are underexplored in endurance athletes. Therefore, the purpose of this study was to identify the sex differences in nutrition patterns among a group of endurance athletes.

Methods: Two-hundred and thirty-one endurance athletes (females = 124) completed a questionnaire regarding their dieting patterns and associated variables.

Results: The majority of athletes did not follow a planned diet …

Ethnic/Racial Differences In Alcohol Use: Does Drinking Refusal Self-Efficacy Matter?, P. Priscilla Lui, Savannah M. Krantz, Michael B. Madson

Faculty Publications

Introduction: College students—including those of Hispanic backgrounds—are at risk for hazardous drinking. Research has shown robust group differences between Hispanic and White individuals in alcohol use outcomes. The ability to resist alcohol consumption can be leveraged to reduce hazardous drinking; however, little research has examined Hispanic-White differences and whether drinking refusal self-efficacy accounts for group differences in hazardous drinking. Considering Hispanic individuals make up the largest ethnic/racial minority group in the United States, it is important to identify malleable psychological factors that prevent and reduce drinking problems. Method: Hispanic and White college students at two predominantly White institutions …

Ethical Implications Of Covid-19 Surveillance In Karnataka Using Nancy Kass Framework, Apurva Jain, Lakshya Arora

Journal of Health Ethics

Numerous public health hurdles, including pandemics such as COVID-19, have led to concerns about community health practices in relation, necessitating the application of an ethical perspective. International research ethics guidelines are only used in a restricted range of contexts of public health. As a result, a variety of frameworks have been established to assist ethical analysis of public health concerns. In this study, we have used the Nancy Kass framework for analyzing COVID-19 surveillance in Karnataka state of India, which is a six-step approach that can assist public health practitioners in evaluating the ethical consequences of interventions, policy initiatives, services, …

Reciprocity And Priority Allocation System For Organ Transplant: An Ethical Analysis, Gordon Wong, Chong Ho Yu

Journal of Health Ethics

How to increase the supply of organs donations for transplant is a critical issue in healthcare. Although recently xenotransplantation has received much publicity, it may be years before this becomes clinically viable. The Reciprocity and Priority Allocation (RPA) System currently used in Israel and a few other countries may be a reasonable approach to increase organ donation in the foreseeable future. For this approach to be accepted by the public, a robust analysis on its ethical implications is needed. This paper applies two formal ethics frameworks to analyze the implication of the RPA system.

Ethical Considerations Of Telehealth: Access, Inequity, Trust, And Overuse, Monica O'Reilly-Jacob, Andrea Vicini, Ashley P. Duggan

Journal of Health Ethics

In the U.S. healthcare system, telehealth is increasingly present and demands ethical assessment. On the one hand, telehealth increases access to healthcare services for some at-risk populations (e.g., people suffering from mental illness and addictions) and in specific contexts (e.g., rural). On the other hand, telehealth widens the digital divide and can lead to overuse of services. Furthermore, because it is still unclear how telehealth influences trust between patients and primary care clinicians, connecting relationship science and human communication research can inform critical reasoning. Finally, healthcare policy is advancing toward the wide adoption of telehealth. Hence, it is urgent to …

Financial Incentives And Healthcare: A Critique Of Michael Sandel, Mark Peacock

Journal of Health Ethics

The use of financial incentives in healthcare calls for ethical examination. Michael Sandel's influential work represents such examination and is subject to critical analysis in this paper. Sandel focuses on monetary payments to persuade patients to lose weight, give up smoking etc. but also on the much-discussed case of giving drug addicts money in return for their consent to be sterilized. He offers two separate objections to financial incentives, one based on coercion, the other on corruption. I argue that Sandel's corruption objection to commodification is insufficient to ground the objection he has to financial incentives in healthcare. Whatever strength …

Community Based Rehabilitation Programs For Resettled Muslim Women Refugees, Lori Maria Walton Phd, Dpt, Mscpt, Mph(S), Renee Hakim, Phd, Pt, Ncs, Veena Raigangar, Phd(C), Mscpt, M.Ed., Jennifer Schwartz, Dpt, Ncs, Sjm Ummul Ambia, Mscpt, Najah Zaaeed, Drph, Lmsw, Bassima Schbley

Journal of Health Ethics

According to the 2021 report from the United Nations High Commissioner for Refugees, 82.4 million people were forcibly displaced because of violence, wars, or persecution and over 26.4 million are currently living with refugee status. Displacement and resettlement trauma are associated with chronic disease onset and poor cognitive, physical, and mental health outcomes for refugee populations. To mitigate some of the deleterious effects of resettlement trauma, we propose a community-based rehabilitation program (CBRP) framework that is culturally sensitive, trauma-informed and focused on the vulnerabilities of women. The purpose of this novel CBRP framework is to address health inequities among a …

Improving Diagnosis And Treatment Of Prediabetes Among Primary Care Providers By Increasing Awareness Of Prediabetes Education, Sonia Walker

Doctoral Projects

Prediabetes is a precursor to diabetes and requires treatment most of the time. Prediabetes is a health condition characterized by high blood sugar levels, but it has not developed into type 2 diabetes mellitus (T2DM). According to the Centers for Disease Control and Prevention (CDC) recent estimates, about 88 million Americans have prediabetes (CDC, 2020). This project's main aims were to determine the effectiveness of implementing a structured prediabetes education intervention in diagnosing and screening prediabetes among primary care providers caring for African American females (AA) aged 30 to 60 years. Moreover, to evaluate the outcomes of implementing the educational …

Examining P3 And N2 Amplitudes Following Social Exclusion And Provocation In College Students With High And Low Narcissistic Traits, Kathleen Ramsey

Dissertations

Adults with narcissistic traits are prone to reacting aggressively following provocation due to elevations in emotional reactivity and perceived threat to their grandiose self-views. Prior studies have examined event-related potentials (ERPs) measures in college students with narcissistic traits in the context of risky decision making and facial emotion processing; however, no known studies have examined how those with narcissistic traits react to rejection and provocation at the neurophysiological level during an externally valid social rejection task (i.e., Cyberball). For the purposes of this study, it was predicted that participants with higher levels of narcissistic traits (both total narcissism and grandiose …

Self-Compassion And Perceived Readiness For Practice Among Baccalaureate Nursing Students: A Mixed-Methods Study, Laurie A. Walter

Dissertations

There is increasing concern about how nursing students’ psychological health will impact their future nursing practice. The COVID-19 pandemic has enhanced these concerns. Nurse educators are being challenged with preparing nursing students to provide compassionate, patient-centered care despite the stress and psychological challenges of today’s healthcare environment. Self-compassion is a practice of mindfulness, self-kindness, and common humanity which positively influences and predicts psychological health. The purpose of this study was to explore the relationship between self-compassion and perceived readiness for professional practice among undergraduate nursing students.

A convergent mixed-method design utilizing correlational and directed content analyses explored this relationship. The …