Medicine and Health Sciences Commons^™

Examining Structural Constraints And Electronic Health Record Use In Acute Care Hospitals, David D. Dobrzykowski

Transactions of the International Conference on Health Information Technology Advancement

Electronic Health Record (EHR) use is expected to quickly increase in the USA. It is the hope of the federal government and many hospitals that EHR use will not only increase, but also mature from basic applications such as EHR for results viewing (ERV) to more advanced applications such as Computerized Provider Order Entry (CPOE). Today, considerable heterogeneity exists among hospitals with regard to EHR use and the movement toward advanced EHR applications. Examining this heterogeneity is useful as hospitals move toward advanced EHR. Survey data collected from 297 acute care hospitals in 47 states suggests that critical access hospitals …

Electronic Health Records (Ehr) Implementation And Post Implementation Challenges, Muhammad A. Razi, Christopher Emmert, Dan Mcalpine-Austin, J. Michael Tarn, Khandaker N. Islam

Transactions of the International Conference on Health Information Technology Advancement

The US Healthcare Industry lags behind other industries in its use of technologies for process improvement and improvement in quality of services for its patients. Globally, United States is significantly behind some European and Australian countries in implementation of EHR. While the federal government is now mandating this change and also offering incentive programs, healthcare providers remain slow to comply because of challenges they face regarding EHR implementation. This paper discusses EHR architecture, presents implementation challenges, provides a case study and offers future research ideas. The information provided in this research could be beneficial for successful EHR implementation.

Factors Impacting Use Of Information Technology By Physicians In Private Practice, Jim Demello, Satish P. Deshpande

Transactions of the International Conference on Health Information Technology Advancement

This research examines the impact of various factors on the use of IT in clinical practice, prescriptions, and patient information. This was done using a national sample of 3425 physicians who worked in a solo or group practice in the United States. Besides the extent of use of electronic medical records by physicians and number of physicians in practice, none of the other factors consistently impacted the use of IT in clinical practice, prescriptions, and patient information, respectively. The results of this study highlight the need to develop specific strategies to increase the use of information technology in healthcare.

Towards The National Health Information Network In The United States Of America, Andrew Targowski

Transactions of the International Conference on Health Information Technology Advancement

The Health Infrastructure in the U.S. is called the National Health Information Network (NHIN) which is composed of regional Health Information Exchange (HIE) hubs. This approach has been exercised since 2008. However, there is a lack of one top-down comprehensive architecture of this system, which is being developing by each state individually. This paper provides the top-down model of such architecture, perhaps the first one which is made. The paper defines basic components of that system. Also some issues of security and privacy of stored and exchanged data are disputed. In the end, the paper provides conclusions regarding the issues …

Examining The Use Of Institutionally Designed Documentation Templates As A Vehicle For Changing Values And Practices In Health Care, Doris J. Ravotas

Transactions of the International Conference on Health Information Technology Advancement

Changing values and requirements are common occurrences in today’s health care settings. Institutionally designed documentation templates are often developed to demonstrate that these changes have been incorporated into clinical work. Little research has been completed to examine whether the use of these institutional templates leads to the intended change or whether the changes clash with other influences on clinical work. This paper illustrates how two qualitative methods: think aloud interviews and frame analysis can be combined to examine the use of the templates, the changing values themselves, and the influences on changes in clinical practice. An analysis of local change …

Changing Health Care Business Models And Costs, Thomas Rienzo

Transactions of the International Conference on Health Information Technology Advancement

Changing the health care system has universal support in principal, but has proven contentious in practice. This paper draws upon the theories and publications of three leading business thinkers, and the frameworks they developed for applying business practices to the health care industry: Drs. Clayton Christensen, Robert Kaplan, and Michael Porter of Harvard University. It reviews the disruption theories of Christensen as he has applied them to the health care industry, and connects them with medical costing recommendations of Kaplan and Porter. Two possible disruption possibilities for clinical care and venue are presented.

Psychometric Evaluation Of The Valued Living Questionnaire: Comparing Distressed And Normative Samples, David D. Cotter

Dissertations

The Valued Living Questionnaire (VLQ; Wilson, 2002) was created to measure the extent to which an individual contacts his/her chosen values, an important construct in Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999). The goal of the current study was to contribute to the psychometric evaluation of the VLQ by replicating and extending the first study of the VLQ’s psychometric properties conducted by Wilson, Sandoz, Kitchens, & Roberts (2010). In the present study, the VLQ was administered to a normative collegian sample (n = 171, M age = 19.32) and a distressed sample of collegians who were participating …

The Center For The Study Of Ethics In Society At Twenty-Five, Michael S. Pritchard

Center for the Study of Ethics in Society Papers

Center for the Study of Ethics in Society: Celebrating 25 Years - Presented November 15, 2010.

Reflections On The Role Of The Ethics Center At Wmu, Shirley Bach

Center for the Study of Ethics in Society Papers

Center for the Study of Ethics in Society: Celebrating 25 Years - Presented November 15, 2010

Reflections On The 25Th Anniversary Of The Wmu Center For The Study Of Ethics In Society, Ronald Kramer

Center for the Study of Ethics in Society Papers

Center for the Study of Ethics in Society: Celebrating 25 Years - Presented November 15, 2010.

Center For The Study Of Ethics In Society: Celebrating 25 Years, Center For The Study Of Ethics In Society

Center for the Study of Ethics in Society Papers

Papers presented for the Center for the Study of Ethics in Society Western Michigan University.

Reflections On The Role Of The Ethics Center At Wmu, James A. Jaksa

Center for the Study of Ethics in Society Papers

Center for the Study of Ethics in Society: Celebrating 25 Years - Presented November 15,2010.

A Review Of Literature For Osteology: Cell Biology, Tissue Biology, And The Application Of Synthetic Compounds For The Facilitation Of Bone Tissue Repair, Ryan T. Jones

Honors Theses

Bone is a dynamic matter that provides support, structure, mineral reserves, and stem cell reserves for the body. Important functions range from structural support for the body to roles in maintaining homeostasis. Structure and support for the body is the most obvious role, with the skeletal system as a whole providing a normal force for other tissues and organs to resist gravity. Protection is also inferred for tissues and organs from impacting forces, especially with axial bones covering vital organs in the thoracic cavity. Another function of bone includes the ability to store and release minerals when needed to maintain …

Analysis Of Dental Management Of Those With Physical And Mental Disabilities, Ashley M. Fleck

Honors Theses

Those with physical and mental disabilities are at an increased risk of oral complications such as gingivitis and periodontal disease. In comparison with this risk, this population struggles to access appropriate dental care that accommodates those with disabilities. This thesis reviews the demographics of those with special needs, dental education barriers to working with this population and financial barriers that hinder access to care. An overview of the oral health problems of common disabilities is presented as well as behavioral management techniques that could be easily implemented in the dental office. A general review of good oral hygiene for those …

As Life Stressors Increase, Do Emergency Department Visits Increase?, Catherine L. Kothari

Research and Creative Activities Poster Day

Study goal: To examine whether type of stressor and number of stressors predict emergency department utilization among perinatal women.

Methods: Study data was collected via mixed methods: Telephone survey interviews, retrospective medical chart reviews and secondary data analysis. The 326 study participants were recruited during their postpartum hospital stay. Information was collected assessing stressors across five domains: Basic living needs, relational, social, mental health and health. The outcome variable of interest was number of emergency department visits.

Results: More than four out of five (82.8%) of women experience life stressors, many of them (68.1%) across multiple domains. Only …

The Implementation Of The Recovery Oriented Systems Of Care In Southwest Michigan, Gisele Tchamba

Research and Creative Activities Poster Day

The Recovery Oriented Systems of Care (ROSC) is in part an ecological systems theory that demonstrates comprehensive ways to meet the needs of individuals and families seeking alcohol, drug and mental health services. When compared to its alternative, Acute Care (AC) model, the ROSC provides long-term recovery outcomes, requires the participation of all stakeholders, and facilitates dialogue among service providers and clients. This study intended to increase public knowledge of the ROSC, its feasibility for practice, and its relevance for behavioral health research. Data collection was done using a purposeful sample, which consisted of N = 7 consenting adults currently …

Comparisons Of Three Analytical Techniques For Measuring Absolute And Relative Temperature Changes During Ultrasound Treatment, Michael G. Miller

Dissertations

Ultrasound is a thermal modality that utilizes acoustic energy to promote heating. While there are many factors that affect heating of body tissues, the effects of skinfold thickness and skin temperature upon ultrasound heating have not been studied extensively. In addition, while temperature typically follows a linear trend, past research typically uses ANOVA or regression analysis to examine this relationship; but these models examine the within-subject effects (time) and between effects (usually groups) at the group level, not the individual level. Therefore, the purposes of this study are to determine if skin temperature and skinfold thickness are predictors for intramuscular …

Implementation Of The 2009 Cacrep Standards Addiction Competencies, Tiffany K. Lee

Dissertations

Addiction issues have been and continue to be significant problems affecting the United States. Over the past few decades, substantial scholarly attention has been paid to the lack of addictions training in the counseling profession. The purposes of this mixed-method study were to examine the current status of addiction training among institutions that offer counselor education programs accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP) and determine how institutions plan to integrate the addiction-related competencies outlined in the 2009 CACREP standards.

The quantitative data were obtained from a 15-item online survey completed by 74 CACREP …

The Differentiated Impact Of Bridging And Bonding Social Capital On Economic Well-Being: An Individual Level Perspective, Saijun Zhang, Steven. G. Anderson, Min Zhan

The Journal of Sociology & Social Welfare

Social capital refers to trust, norms, and social networks. One of the most important features of social capital is its claimed capacity of promoting economic well-being. Theorists have assumed that any such effects vary according to the nature of different types of social capital. Using longitudinal data from a nationally representative dataset, this study investigates the differentiated effects of individual bonding and bridging social capital on subsequent personal income and income-to-needs ratios. The analyses demonstrate that bridging capital, indicated by involvement in various voluntary organizations, has small but significant effects on future economic wellbeing. However, bonding capital, indicated by connections …

Generalization Or Specialization In High School Based Health Careers Transition Programs: What Is The Impact On The Health Care Work Force Shortage?, James Wm. Taylor

Dissertations

Background: Health care experts are predicting major shortages of caregivers as a result of aging demographics and anticipated retirements of health workers. Numerous approaches are being used to increase the supply of health care workers, but little, if any, literature demonstrates the role of secondary Career and Technical Education (CTE) programs in helping meet the anticipated demand.

Methods: Data from secondary educational health career programs were obtained from students completing five area programs (Allied Health, Health Occupations, Emergency Medical Technology, Dental Assisting, and Pharmacy Technician). Data analysis was performed on student demographics (chi-square), academic performance on standardized exams (ANOVA), and …

Clinical Social Work And The Biomedical Industrial Complex, Tomi Gomory, Stephen E. Wong, David Cohen, Jeffrey R. Lacasse

The Journal of Sociology & Social Welfare

This article examines how the biomedical industrial complex has ensnared social work within a foreign conceptual and practice model that distracts clinical social workers from the special assistance that they can provide for people with mental distress and misbehavior. We discuss: (1) social work's assimilation of psychiatric perspectives and practices during its pursuit of professional status; (2) the persistence of psychiatric hospitalization despite its coercive methods, high cost, and doubtful efficacy; (3) the increasing reliance on the Diagnostic and Statistical Manual of Mental Disorders, despite its widely acknowledged scientific frailty; and (4) the questionable contributions of psychoactive drugs to clinical …

Living With Bipolar Disorder: A Qualitative Investigation, Richard P. Freedberg

Dissertations

The specific aims of this study were to gain a broader understanding of the lived experience of adults with bipolar disorder and to explore how people diagnosed with bipolar disorder used cognitively, affectively, and spiritually oriented strategies to cope with life stressors and circumstances. The cognitive domain in this investigation was defined as those activities related to how one knows, thinks, or perceives phenomena in a way distinct from emotion. The affective domain referred to the feelings and emotions associated with phenomena that are distinct from cognitive reasoning or knowledge. The spiritual domain was defined as values, attitudes, and beliefs …

Memory And Language: Evidence Of Relationships From Three Studies Of School-Age Children, Michele A. Anderson

Dissertations

The purpose of this three-paper dissertation was to explore the relationship between performance on verbal memory and language assessment tasks in school-age children. Study one used data from whole-class administration of three language assessment tasks to 2nd, 4th, 6th, and 9th graders (N= 187). Studies two and three used data from individualized administration of language assessment and verbal memory tasks to comparable samples of children between the ages of 6 and 18 years with typical language (TL) and language impairment (LI) (n = 37 per group).

The first study addressed practical and theoretical questions regarding memory and language demands of …

Local Public Health System Partnerships: A Mixed Methods Multi-State Study, Priscilla A. Barnes

Dissertations

The purpose of this three-paper dissertation was to conduct a mixed methods multi-state examination of specific partnership-related activities among local public health systems (LPHSs) as well as to explore perceptions of LPHS practitioners regarding partnership practices.

In the first paper, secondary data analysis of questions from the National Public Health Performance Standards Program (NPHPSP, n = 110) was used to determine the frequency that partnership activities were conducted optimally (> 75% of the time) and whether any associations existed between three different partnership capacities. Activities were matched with relational, organizational, and programmatic capacities from the Collaborative Capacity Framework. Overall, 86% …

A Study To Determine The Influence Of Workload On Nursing Personnel, Supreeta G. Amin

Dissertations

The alarming number of adverse medical events and associated costs have placed immense importance toward the safety and health of both patients and medical personnel. A shrinking nurse workforce, an aging patient and nursing population coupled with a mismatch between hospital demands and the available nursing staff have created a situation detrimental to both patient and nursing personnel. Long working hours, working more than one job, low staffing ratios, high patient acuity, minimal social support, low experience level, complicated equipment, complex procedures and varying workload are some factors that may have a negative impact on the quality of care provided …

Contemporary Clothing Issues Of Women Who Are Post-Mastectomy, Carol Beard

Dissertations

The intent of this three-paper format dissertation is to examine three topics germane to the clothing requirements and clothing acquisition of women who are postmastectomy. Each paper’s focus resides within a broader theme of addressing a population that has specialized clothing needs. While each study is independent in nature, they build on each other. The first paper describes the demographics of the population and how those demographics and treatment path for breast cancer provide a different framework for reaction to the retail offerings currently on the market. The next paper focuses on the association between demographics and treatment path of …

Evaluation Of Verbal Behavior In Older Adults, Amy Gross

Dissertations

Older adults make up a large and increasing portion of the population (U.S. apply those assessments to the evaluation of verbal behavior in older adults with and without dementia. The research addressed two questions. First, in what way do verbal behavior problems differ between older adults with and without dementia? Second, does language deteriorate in a pattern compatible with Skinner's analysis of functionally independent verbal operants? Thirty-one participants were categorized into Control (n=15) and Dementia (n=16) Groups based on their score on the Dementia Rating Scale-2. Verbal behavior assessments were administered to participants on two occasions, separated by one week. …

Neuroprotective Effects Of A Nicotinic Acetylcholine Receptor Agonist And Modulator In The Rodent Retina, Kazuhiro Iwamoto

Dissertations

The purpose of this dissertation is to assess the potential neuroprotective effect of an alpha7 nAChR agonist, PNU-282987, and modulator, PNU-120596, in an in vitro model of excitotoxicity and an in vivo model of acute glaucoma. In in vitro studies, retinas obtained from Long Evans rats were cultured using various concentrations of the PNU compounds to analyze neuroprotection against glutamate-induced excitotoxicity. After 3 days in culture, RGCs were identified using an antibody against Thy 1.1, visualized using a fluorescent dye and quantified. In culture, glutamate significantly decreased the number of RGCs. However, if either PNU compound was introduced before the …

Exploring The Well-Being Of Foster Children Of Parents With Substance Abuse Problems In Family Dependency Treatment Courts, Barbara M. Howes

Dissertations

The aim of this three-paper format dissertation is to explore how the well-being of foster children of parents with substance abuse problems is defined and promoted through Family Dependency Treatment Courts (FDTC) within the context of the Adoption and Safe Families Act (ASFA). The benefit to the author of the three-paper method is the task of submitting the findings of the study for publication is eased as the dissertation contains three stand-alone articles. A drawback for the reader of the three paper method is that there is redundancy in reading the same sections in each paper. The reader is encouraged …

The Picture Exchange Communication System: Digital Photographs Versus Picture Symbols, Carmen Jonaitis

Dissertations

The Picture Exchange Communication System (PECS) is an augmentative and alternative system (AAC) used to improve and increase communication for children with Autism Spectrum Disorder (ASD) and other developmental disorders. Research addressing the efficacy of this system is increasing; however, there is limited information published that evaluates the picture type used for PECS instruction. A single-subject alternating treatments design was used to examine the role of iconicity, or how closely a symbol resembles its referent, in the acquisition of picture discrimination in the third phase of PECS. The purpose of this study was to compare how well children were able …