Medicine and Health Sciences Commons^™

A Case Study For Integration Of Legacy Healthcare Electronic Medical Records Into A Trusted Data Warehouse Utilizing Master Data Management, Michael Greer

Theses and Dissertations

This dissertation is focused in the case study of how a large academic, medical, research centers used the principles of master data management to design, build, and implement an enterprise data warehouse. Data governance, stewardship, entity resolution, and strong supporting metadata programs are at the center of a successful enterprise data warehouse. Migrating legacy clinical and research data in structured, unstructured, text, images, signature, pictures, and multimedia format into a single trusted data warehouse is a significant task. On March 23, 2010, President Obama signed into law one of the most comprehensive revisions to our nation’s health care system in …

The Effect Of Teaching Strategies And Learning Environment On Certification Exam Pass Rates In Dietetic Education, Debra Head

Theses and Dissertations

The obligation for preparing competent graduates begins with an educational experience in an environment that promotes optimal learning. An important outcome of successful health professions education is the passage of the certification exam. The objective of this study was to evaluate learning outcomes and teaching strategies and the effect on certification exam pass rate in dietetic education programs. A non-experimental associational cross-sectional mixed methods design was chosen for the study in order to gather objective data through the use of the previously validated Constructivist Learning Environment Survey. A 30 item electronic survey was administered to faculty in dietetic education programs …

Examining Contraceptive Knowledge, Attitude, Intentions And Willingness To Use Contraceptive Among Adolescents Girls In Ghana, West Africa: Applying The Theory Of Reasoned Action And Theory Of Planned Behavior, Rosina Amenebede

Theses and Dissertations

The primary purpose of this study was to examine contraceptive knowledge, attitude, intentions and willingness to use contraceptives among adolescents’ girls in Ghana, West Africa, by applying the Theory of Planned Behavior. A cross-sectional survey was conducted. Results: 85.3% of the respondent had knowledge of condoms. 88.34% of the adolescent girls intended to use contraceptives during sex and 25.5% of the variance observed in intentions to use contraceptives is explained by subjective norms and attitudes toward behavior. Discussion and Conclusions: 79.05% of the entire sample of adolescents’ girl’s did not have any knowledge of any other contraceptive method aside from …

Childhood Abuse Types And Adult Relational Violence Mediated By Adult Attachment Behaviors And Romantic Relational Aggression In Couples, Tabitha Nicole Webster

Theses and Dissertations

The current study investigated how three distinct types of childhood abuse—witnessing of parental domestic violence, experiencing physical abuse and total in-home violence, and experiencing sexual abuse—predicted partner reports of relational violence through the mediating factors self-perceptions of attachment and partner reports of relational aggression. The study used paired dyadic data from 1,658 couples who had completed the RELATionship Evaluation (RELATE). The Family Violence, the Brief Accessibility and Responsiveness, Couples Relational Aggression and Victimization, and the Conflict Tactics scales were the measures used. Data was analyzed by using structural equation modeling to estimate an actor-partner interdependence model exploring these relationships. Results …

Critical-Care Nurses' Suggestions To Improve End-Of-Life Care Obstacles: Minimal Change Over 17 Years, Kacie Hart Hadley

Theses and Dissertations

Background: Critical-care nurses (CCN) provide end-of life (EOL) care on a daily basis as one in five patients dies while in Intensive Care Units (ICU). CCNs overcome many obstacles to perform quality EOL care for dying patients. Objectives: The purposes of this study were to collect CCNs' current suggestions for improving EOL care and determine if EOL care obstacles have changed by comparing results to data gathered in 1998. Methods: A 72-item questionnaire regarding EOL care perceptions was mailed to a national, geographically dispersed, random sample of 2,000 members of the American Association of Critical-Care Nurses. Nurses were asked for …

Interprofessional Collaboration: Aac, Michelle Bird, Anna Kusior

Theses and Dissertations

No abstract provided.

Structural And Dynamic Analysis Of Wild And Splice Variants Human Μ-Opiod Receptors In Complex With Morphine And Ibntxa And Human Topoisomerase Ii Alpha Mutational Basis Of Amsacrine Resistance, Safaa Sader

Theses and Dissertations

Morphine prescribing is limited by its high addiction tendency and other serious effects. Recent animal’s biological studies on Mu 6TM splice variants, which mainly include G1, G2 and Mu3, supported a high safety and potency profiles of IBNtxA as potential alternative of Morphine. Nevertheless, there is no high-resolution structures of these 6TM variants, and the detailed structural features and dynamic characteristics of these splice variants remain elusive. We applied homology modeling and MD simulation to probe the structural, dynamic and ligand binding differences between the wild type (7TM) and two major truncated 6TM variants (G1 and G2). MD results underscored …

The United States Medical Licensing Exam (Usmle) And Medical Student Wellness: An Ethnographic Qualitative Study At Cooper Medical School Of Rowan University, Patricia Davis Vanston

Theses and Dissertations

Research indicates that medical students experience unusually high levels of stress, anxiety, depression, and loss of empathy while in medical school. As the number of medical students rises and residency positions remain stagnant, the USMLE receives greater emphasis as a barometer to determine residency placement and future career paths thereby increasing levels of stress among students. Stress is associated with diminished self-care, potentially leading to a negative impact on well-being. This ethnographic, qualitative study sought to examine the extent to which the anticipation of, preparation for, and implications of the USMLE contribute to medical student stress, wellness, and self-care. Through …

Synthetic And Biological Exploration Of (+)-Boldine - Identification Of Potential Cns Receptor Ligands, Sujay Joseph

Theses and Dissertations

(+)-Boldine, an aporphine alkaloid, is reported to be biologically active at various Central Nervous System(CNS) receptors. However, only a few Structure Activity Relationship(SAR) studies have been conducted using boldine’s aporphine scaffold. A library of novel analogs was synthesized from boldine to understand the effect of bisbenzylation at C2 and C9 positions on the affinity and selectivity at the serotonin receptors.

Implementing A Pain Toolkit To Improve Pain Management, Kathleen R. Atkins Dnp, Mary J. Dyck Phd, Nancy L. Novotny Phd, Karen S. Delong Msn

Theses and Dissertations

Abstract

OBJECTIVES: The purpose of this study was to evaluate the effect of a pain toolkit to improve pain management.

BACKGROUND: The World Health Organization and Joint Commission state effective pain management is a basic human right.

METHODS: Patients’ ratings of pain management on a 25-bed orthopedic/neurology unit three months before and after implementation of a toolkit were compared. The toolkit included bedside report, care board, purposeful hourly rounding, pain algorithm, pain status indicator, and complex pain interventions. The data are comprised of patient responses to the following Hospital Consumer Assessment of Healthcare Providers and Systems survey questions: pain control …

A Study On The Effect Of Higher Education Branding On Student's College Decision, David E. Garcia

Theses and Dissertations

All around us we are inundated by brand marketing. Logos and labels with trademarks surround our lives. With marketing being part of our society, higher education institutions have created a brand marketing scheme all their own. This new form of branding has caused many students to make their decision based on the logo, mascot or social lifestyle. The purpose of this study was to test whether attitudinal brand loyalty has a statistically significant effect on college decision through academic and athletic factors. Based on multiple regression analysis, results show that attitudinal brand loyalty does have a significant effect on college …

Hispanic Bilingual Learners' Perceptions And Educational Experiences Of Spanish-Speaking In South Texas, Isela B. Stephens

Theses and Dissertations

The present study focuses on a subset of data obtained from a larger interdisciplinary project, Proyecto Posible, which investigates how sociocultural and instructional factors predict positive outcomes among Spanish- and English-speaking Hispanic bilingual learners. As one part of Proyecto Posible, interviewers asked learners to speak in their language of preference about their experiences in school and feelings developed during interactions with others, as bilinguals. This study examines the qualitative component on bilingual learners’ perceptions of their own language proficiency in English and Spanish, perceptions of language use across a broad range of contexts including school, home, and community, …

The Importance Of Data Quality In Using Health Information Exchange (Hie) Networks To Improve Health Outcomes: Case Study Of A Hie Extracted Dataset Of Patients With Congestive Heart Failure Participating In A Regional Hie, Marie-Astrid L. Cartron-Mizeracki

Theses and Dissertations

Expenditures on health information technology (HIT) for healthcare organizations are growing exponentially and the value of it is the subject of criticism and skepticism. Because HIT is viewed as capable of improving major health care indicators, the government offers incentives to health care providers and organizations to implement solutions. However HIT implementation is still subject to numerous technical, financial and organizational barriers. Health Information Exchange (HIE) networks are examples of HIT implementations that have been shown to assist healthcare providers in exchanging data and facilitating patient care through the circulation of critical clinical information between health care organizations statewide and …

A Mechanical Study Of Cancer Drug-Receptor Interactions, Specifically In G-Quadruplex Dna And Topoisomerase I Enzymes, Kelly Ann Mulholland

Theses and Dissertations

Computational methods are becoming essential in drug discovery as they provide information that traditional drug development methods lack. Using these methods to understand drug-receptor interactions in detail, researchers are able to efficiently design promising drug candidates. In this study, extra precision Glide docking, molecular dynamics simulations and MMGBSA binding energy calculations provided information about the binding behavior of small molecules to two specific targets for current cancer therapeutics: G-quadruplex DNA and Topoisomerase I enzyme. The first study focuses on the compound Telomestatin, which induces apoptosis of various cancer cells with a relatively low effect on somatic cells due to its …

Implementing Prophylactic Amiodarone In Heart Surgery To Reduce Post -Operative Atrial Fibrillation, John M. Russell Msn, Apn, Fnp-Bc, Denise Wilson Phd, Apn, Fnp, Cde

Theses and Dissertations

Purpose: The purpose of this project is to evaluate a practice change of implementing peri-operative amiodarone infusion for cardiac surgical patients at a large northern Illinois hospital to reduce the incidence of post-operative atrial fibrillation. Evidence supports use of prophylactic amiodarone as a strategy to reduce its incidence. The sequelae of untreated post-op atrial fibrillation include increased risk of embolic stroke, extended hospitalization, and increased healthcare costs.

Data Sources: The Society of Thoracic Surgeons (STS) Adult Cardiac Surgical Database is a validated research tool used to collect comprehensive data on its member surgeons. A pre/post intervention case-controlled retrospective study design …

The Effect Of Marital Therapy On Physical Affection, Tiffany Ann Migdat

Theses and Dissertations

Research indicates that marital satisfaction is associated with levels of physical affection between partners. This is important because there is evidence of physical and mental health benefits of physical affection. Although past research has shown that marital therapy increases levels of marital and sexual satisfaction, the association between marital therapy and physical affection has not been explored. This study used a treatment group and a control group of 108 married couples to assess the relationship between marital therapy and physical affection over a course of 12 weeks. Using structural equation modeling and an actor partner analytic model, results indicated that …

Does Self-Esteem Mediate The Effect Of Attachment On Relationship Quality, Alexis Lee

Theses and Dissertations

The purpose of this study was to examine the possible mediating effect of self-esteem on the relationship between attachment security and relationship quality. Previous studies have found a positive association between attachment style and relationship quality. One possible explanation for this link may be self-esteem, which has been shown to consistently predict relationship quality. Therefore, I hypothesized that self-esteem may mediate the relationship between attachment and relationship quality. A sample of 680 married couples that completed the sections on attachment, self-esteem, marital satisfaction, marital stability, and problem areas in the relationship of the RELATE questionnaire between 2011 and 2013 was …

Pathways To Marriage: Relationship History And Emotional Health As Individual Predictors Of Romantic Relationship Formation, Garret Tyler Roundy

Theses and Dissertations

The process of forming a committed, romantic relationship is described as a developmental phenomenon that cannot be accurately viewed without the context of prior relationship experiences because the social competencies that facilitate successful navigation of the tasks of relationship formation are developed in relationships. Furthermore, a cumulative relationship history that has a negative influence may lead to poor emotional health, further disrupting relationship formation processes through that mechanism. Hypotheses were tested using data from a prospective longitudinal study of participants (218 women, 174 men) who were not in a romantic relationship at initial data collection and reported on their relationship …

Comparison Of Iron Supplementation And Albendazole On Anemia In Ghanaian Children, Megan M. Zitting

Theses and Dissertations

Half a billion school aged children suffer from anemia, with the majority of anemia caused by iron deficiency. Researchers have shown a strong correlation between low hemoglobin levels and presence of intestinal parasites in children with anemia. Childhood anemia has profound negative effects on physical growth, maturation, and cognitive development leading to poorer educational achievement. Using hemoglobin as a measure of anemia, this quasi-experimental study investigated impact of either iron supplementation or an antiparasitic medication on hemoglobin levels in two groups of children in a rural region of Eastern Ghana. Surprisingly, after a 6-month intervention period, hemoglobin levels in both …

Passion And Sexuality In Committed Relationships, Emilie Iliff

Theses and Dissertations

Researchers have noted the important role which passion plays in people's lives. This study investigated an existing theoretical framework of passion and suggests an additional construct, inhibition, to this framework in regards to sexual passion. Additionally, this study investigated the constructs of passion and how they relate to sexual and relationship satisfaction. A sample of 1,429 men and women completed the Sexual Passion Scale, the Sexual Satisfaction Scale, and the Relationship Satisfaction Scale. Confirmatory factor analyses revealed that sexual passion may represent three distinct approaches (harmonious, obsessive, inhibited). In terms of sexual and relationship satisfaction, data analyses revealed that the …

A Content Analysis And Status Report Of Adolescent Development Journals: How Are We Doing In Terms Of Ethnicity And Diversity?, Jason Bernard Lefrandt

Theses and Dissertations

Ethnic minority research in the U.S. is important to study because of the increase of ethnic minorities over the past several decades. Content analyses help to track the progress of ethnic minority research and guide researchers to future areas of study. Journals of adolescence have been analyzed and coded in the following areas of methodology of the article: article topic, article funding by topic, funding agencies, geographic location of sample, and measures used. A steady increase in ethnic minority research by article topic, funding, and measures was found for some groups.

U.S. Ethnic Groups In The Journal Of Family Psychology: A Content Analysis, Jessica Croft Gilliland

Theses and Dissertations

Articles published in the Journal of Family Psychology over a 23-year period (1990-2012) were analyzed for their attention to ethnic groups in the United States. Articles were analyzed in terms of their ethnic population of interest, topic of study, funding sources, sample characteristics, and use of measures. Findings indicated that the journal has showed an increased focus on and sensitivity to issues relevant to ethnic groups in the U.S. However, there are several gaps in research for some groups, especially for Native American populations. Recommendations are offered to family science researchers, psychologists and other mental health professionals and educators.

Pediatric Icu Nurses' Suggestions Forimproving End-Of-Life Care, Jeremy Ratliff

Theses and Dissertations

Of the 34,000 children who die annually, over 28,000 are four years old or younger. Nurses working in pediatric intensive care units (PICU) provide end of life (EOL) care before, during, and after death of these children. The purpose of this study was to determine thesuggestions PICU nurses have for improving EOL care for dying pediatric patients and their families. A sample of 1047 PICU nurses, who were members of the American Association of Critical-Care Nurses (AACN), were sent a 70-item questionnaire. One open ended item asked nurses to offer a suggestion for improving EOL care for dying PICU patients. …

Story Retell Narratives In Five School-Aged Children With Language Impairment, Megan Bradshaw Deere

Theses and Dissertations

Many children identified with Language Impairment (LI) demonstrate difficulty comprehending and producing narratives. Their narratives are often structurally less complex and of overall poorer quality than those produced by their typically developing peers. These difficulties may negatively impact the academic and social success of children with LI. This thesis evaluates the performance of five school-aged children with LI on a story retell probe embedded within an intervention designed to address their social and emotional language abilities. During the 10-week intervention, participants completed a series of story retell probes using wordless picture books. The story stimuli were taken from the Edmonton …

Exploring The Effect Of An Interdisciplinary Teamwork Intervention In Acute Rehabilitation, Julie K. Cope

Theses and Dissertations

Purpose: The purpose of this study was to explore the efficacy of an interdisciplinary intervention on interdisciplinary teamwork and patient functional outcomes in an acute inpatient rehabilitation unit at a mid-sized regional hospital. Design: Pilot mixed-methods pre-post intervention study. Methods: Interdisciplinary teamwork and patient functional outcomes were measured before and after a teamwork intervention. Interdisciplinary teamwork was measured with the Healthcare Team Vitality Instrument (HTVI) and a qualitative staff questionnaire developed by a content expert. Patient functional outcomes were measured by aggregated Functional Independence Measure (FIM®) scores. Findings: Post-intervention FIM® gain scores increased significantly (p = .008). Staff questionnaire revealed …

Emodin Regulates Macrophage Polarization: Application In Breast Cancer Treatment, Stephen Iwanowycz

Theses and Dissertations

Macrophages are pleiotropic cells capable of performing a broad spectrum of functions. Their phenotypes are classified along a continuum between the extremes of pro-inflammatory M1 macrophages and anti-inflammatory M2 macrophages. The seemingly opposing functions of M1 and M2 macrophages must be tightly regulated for an effective inflammatory response to foreign molecules or damaged tissue. Excessive activation of either M1 or M2 macrophages contributes to the pathology of many diseases. Infiltration of macrophages into breast tumors correlates with increased metastasis and decreased patient survival. Tumors recruit macrophages to the primary site as well as pre-metastatic niches, and educate them to adopt …

The Effect Of Depression And Antidepressants On Cost, Survival And Adherence To Hormone Therapy In Breast Cancer, Virginia Noxon

Theses and Dissertations

Introduction: Breast cancer patients with a depression diagnosis before or after cancer diagnosis have increased cost, shorter survival time and reduced adherence to hormone therapy. Treating depression in these patients should improve these outcomes; however, there is scarce literature on this topic. Currently, no study has determined the association of concurrent depression while adjusting for a history of depression or treating depression with antidepressants with cost, survival and adherence to hormone therapy. This study has two objectives: 1) to determine the association of concurrent depression with cost, survival and adherence to hormone therapy adjusting for a history of depression 2) …

Chlor-Amidine, A Novel Pad Inhibitor, As An Effective Drug For The Treatment Of Ulcerative Colitis And Prevention Of Colorectal Cancer, Erin Witalison

Theses and Dissertations

Ulcerative colitis (UC) is a chronic inflammatory bowel disease that affects the quality of life of millions of patients worldwide. This disease is associated with inflammation and ulceration of the colonic epithelium, leading to an increased risk for the development of UC-associated colorectal cancer (CRC). Current UC medications are designed to manage the symptoms and induce remission; however, several challenges are faced with current treatment options. 5-aminosalicyclic acid and corticosteroids have few side effects, but have limited efficacy and often the disease becomes refractory. Biologics are introduced after initial treatments fail, but serious side effects are often associated with these …

Unaffected Women’S Decisions To Have Prophylactic Risk-Reducing Mastectomies, Stephanie N. Galloway

Theses and Dissertations

When a woman is at an increased risk of developing breast cancer due to a pathogenic mutation or a significant family history of the disease, she will be faced with choosing from among multiple management options, including risk-reducing mastectomy (RRM). The relative rate of RRM for both diagnosed and unaffected high-risk women has increased in recent years. Previous research has investigated the factors that influence women diagnosed with the disease to undergo RRM, but has not fully addressed how unaffected women make their decisions to choose RRM as an option when they are still healthy. This study was designed to …

Frequency Of Colonoscopy Surveillance In Average-Risk Adults Relative To Guideline Recommendations, Meng-Han Tsai

Theses and Dissertations

Colorectal cancer (CRC) is the third leading cancer in the United States with an estimated 132,700 new cases and 49,700 deaths in 2015. Well-performed screening colonoscopies prevent cancer by allowing visualization of the entire colon and removal of precancerous polyps (adenomas). Persons with high-risk polyps at screening are therefore advised to undergo periodic surveillance colonoscopy. Screening and surveillance colonoscopy guidelines were updated by the U.S. Multi-society Task Force (USMSTF) in 2006, which emphasized risk stratification by polyp features at screening colonoscopy.

This is a retrospective cohort study of patients with screening colonoscopy at an endoscopy center in South Carolina between …