Medicine and Health Sciences Commons^™

Shift To Shift Report: Improving Handoffs In Care In The Nicu, Karen Martin

Theses and Graduate Projects

Shift to shift report in the Newborn Intensive Care Unit (NICU) is an interaction between nurses to share patient information and prepare the next caregiver to provide safe, high quality care to their vulnerable patients. An examination of the research identifies that there are multiple factors that can have a negative effect on the shift to shift report or handoff, creating the potential to not only harm the patient, but create dissatisfaction for both nurses and families as well. The purpose of this project is to create a new shift report process based on the work of theorist Jean Watson …

Picc Education For The Discharging Patient, Angela S. Lowrie

Theses and Graduate Projects

Individualized education, regarding peripherally inserted central catheter (PICC) care, should be provided by nurses to patients who are being discharged with PICCs in order to help patients achieve optimal outcomes. Without proper PICC care, patients are at risk for acquiring a catheter-related bloodstream infection or multiple attempts at venous access which can lead to venous depletion. At a large Midwestern medical center, all maintenance care for PICCs was being transitioned from the unit nurse to the PICC nurse, which created an opportunity to expand the part of the nurse educator role to the PICC nurse. The purpose of this project …

Floattng Through Uncharted Waters, Amanda Moscatelli

Theses and Graduate Projects

The act of floating or flexible staffing is a cost effective way to maintain nursing staffing levels through times of shortages and surplus. While the financial and patient care benefits are abundant, the culture of floating tends to be negative. Nurses cite difficulty adapting to a changed environment, caring for different patient populations, and working with different staff members as the most difficult and anxiety provoking aspects of floating. Although nurses at a large Midwest medical center frequently float across a number of nursing units, they receive no formal education on the practice of floating. Introduction of an online floating …

Creating A Culture Change Through A Unit-Based Coaching Model For Improved Effectiveness Of A Safe Patient Handling Program, Nancy Kirchner

Theses and Graduate Projects

Nurses have one of the highest work-related musculoskeletal injury rates of any profession. Much research has been done to define the high-risk nature of patient handling and further to describe the necessary components of a Safe Patient Handling (SPH) program. Despite the evidence and the purchase of equipment, overall musculoskeletal injury rates remain high among nurses and nursing assistants in the United States. New strategies are needed to incorporate safe patient handling into everyday practices of healthcare providers to create a culture of safety. The purpose of this project is to develop and implement a SPH unit-based coaching metaphor and …

Culturally Appropriate Nursing Care For International Patients, Kate Larson

Theses and Graduate Projects

Cultural competence is a necessary skill for nurses. It requires ongoing learning for continuous improvement in the healthcare setting. Nurses who are knowledgeable in providing culturally appropriate nursing care are able to meet patients' needs by building trust and minimizing cultural pain. Providing nursing care with nurses who have advanced nursing degrees and knowledge of culture and international patient care is an effective model for the ambulatory setting. Trans-global travel for healthcare is increasing therefore a nursing model designed to meet the culture care needs of international patient care is required. This nursing model describes culturally appropriate nursing care in …

Reviving The Dream: Giving Form To A Faith-Based Holistic Clinic At An Urban Lutheran Church, Kathy Leu

Theses and Graduate Projects

To be able to live full, productive lives, all people can benefit from having a consistent, unified team of health care providers who offer emotional, physical, mental, and spiritual support at one health care center. Historically, churches have been involved in health care, and the Christian faith has been integral in holistic healing. Today, the spiritual component of health is often missing in clinic settings. This project will lay the foundation for the establishment of a faith-based holistic clinic in a large charismatic urban Lutheran church. Utilizing Leininger's Culture Care Theory, the transcultural nurse, a key member of the holistic …

Feeding The Homeless Through Collaboration: A Proposal For Consideration, Valetta M. Johnson Massaquoi

Theses and Graduate Projects

The homeless are faced with many challenges of adverse nutritional deficiencies that predispose them to several illnesses commonly associated with the lack of adequate nutrition and the frequent utilizations of health care resources. Provision of nutritious food for the homeless can help decrease the prevalence of these identifiable markers and can be accomplished by u collaborative effort. The purpose of this project is to describe a collaboration between Regions Hospital and the Dorothy Day Center to provide supplemental nutrition for the homeless. Leininger's culture care diversity and universality theory along with culture care accommodation/negotiation are used as a theoretical framework …

Creating A Healing Environment In The Operating Room By Reducing Noise, Emily Grimshaw

Theses and Graduate Projects

The operating room can be a very noisy environment. Noise in this setting can affect patient's physiologically as well as psychologically and it can also affect operating room staff. The review of the literafure shows the effects noise in the operating room has on patients and staff. Patients can become tachycardic and hypertensive due to the exposure to increased noise in the operating room while staff concentration can be impeded as well. The creation of a noise reduction program for the operating room will create a healing environment. The healing environment will help both patients and operating room staff, Patients …

Complex Biological Reconstruction After Wide Excision Of Osteogenic Sarcoma In Lower Extremities, Kashif Abbas, Masood Umer, Haroon Ur Rashid

Section of Orthopaedic Surgery

Wide margin resection of extremity tumor sometimes leaves a huge soft tissue and bony defects in limb salvage surgery. Adequate management of these defects is an absolute requirement when aiming for functional limb. Multidisciplinary management in such cases is an answer when complex biologic reconstruction is desired. We aim to present cases of osteogenic sarcoma of lower extremity requiring combined surgical approach to achieve effective musculoskeletal reconstruction. Patients and Methods. From 2006 to 2010 ten patients were operated on for osteogenic sarcoma of lower extremity requiring complex musculoskeletal reconstruction. Results. Six patients had pathology around knee joint, whereas one each …

Autoclaved Tumor Bone For Skeletal Reconstruction In Paediatric Patients: A Low Cost Alternative In Developing Countries, Masood Umer, Hafiz Muhammad Umer, Irfan Qadir, Haroon Rashid, Rabia Awan, Raza Askari, Shamvil Ashraf

Section of Orthopaedic Surgery

We reviewed in this series forty patients of pediatric age who underwent resection for malignant tumors of musculoskeletal system followed by biological reconstruction. Our surgical procedure for reconstruction included (1) wide en bloc resection of the tumor; (2) curettage of tumor from the resected bone; (3) autoclaving for 8 minutes (4) bone grafting from the fibula (both vascularized and nonvascularized fibular grafts used); (5) reimplantation of the autoclaved bone into the host bone defect and fixation with plates. Functional evaluation was done using MSTS scoring system. At final followup of at least 18 months (mean 29.2 months), 31 patients had …

Traumatic Pancreatic Injury: An Elusive Diagnosis: Experience From A Developing Country Urban Trauma Referral Centre, Ayaz Ahmed Memon, Hasnain Zafar, Rushna Raza, Ghulam Murtaza

Section of General Surgery

Objective: To determine the frequency of pancreatic injury in patients presenting with trauma and to review the mechanism of injury, management, subsequent complications and in-hospital mortality rate associated with these patients.
Methods: The retrospective study included all patients over 18 years of age presenting with pancreatic injury due to trauma at the Aga Khan University Hospital, Karachi, between January 1990 and December 2009. Patients with iatrogenic pancreatic injury were excluded. The severity of the injury was assessed using the Injury Severity Score, while it was graded according to the scale defined by the American Association for the Surgery of Trauma. …

Prevalence And Factors Associated With Maternal Postpartum Haemorrhage In Khyber Agency, Pakistan, N Gani, Tazeen S. Ali

School of Nursing & Midwifery

Background: Postpartum haemorrhage (PPH) is one of the main causes of maternal mortality globally. The objective of this study was to estimate the prevalence of PPH and identify factors associated with PPH in Khyber Agency, Pakistan.
Methodology: A quantitative, cross-sectional study design was selected to estimate the prevalence and associated factors for PPH among married women aged 15–49 years, residing in the Khyber Agency, FATA, Pakistan. A pre-tested structured questionnaire was adapted with some modifications to interview 1,000 women.
Results: Prevalence of PPH was 21.3% in the study population. Factors associated with PPH were age, number of pregnancies, …

Genome-Wide Analysis Reveals Selection For Important Traits In Domestic Horse Breeds, Jessica Lynn Petersen, James R. Mickelson, Aaron K. Rendahl, Stephanie K. Valberg, Lisa S. Andersson, Ernie Bailey, Danika L. Bannasch, Matthew M. Binns, Alexandre S. Borges, Pieter Brama, Artur Da Câmara Machado, Stefano Capomaccio, Katia Cappelli, E. Gus Cothran, Ottmar Distl, Laura Fox-Clipsham, Kathryn T. Graves, Gérard Guérin, Bianca Haase, Telhia Hasegawa, Karin Hemmann, Emmeline W. Hill, Tosso Leeb, Gabriella Lindgren, Hannes Lohi, Maria Susana Lopes, Beatrice A. Mcgivney, Sofia Mikko, Nicholas Orr, M. Cecilia T. Penedo, Richard J. Piercy, Marja Raekallio, Stefan Rieder, Knut H. Røed, June Swinburne, Teruaki Tozaki, Mark Vaudin, Claire M. Wade, Molly E. Mccue

Department of Animal Science: Faculty Publications

Intense selective pressures applied over short evolutionary time have resulted in homogeneity within, but substantial variation among, horse breeds. Utilizing this population structure, 744 individuals from 33 breeds, and a 54,000 SNP genotyping array, breed-specific targets of selection were identified using an F_ST-based statistic calculated in 500-kb windows across the genome. A 5.5-Mb region of ECA18, in which the myostatin (MSTN) gene was centered, contained the highest signature of selection in both the Paint and Quarter Horse. Gene sequencing and histological analysis of gluteal muscle biopsies showed a promoter variant and intronic SNP of MSTN were …

Sleep Experiences Of Hospitalized Antepartum Patients, Andrea M. Erwin

Nursing Dissertations - Archive

For many women, pregnancy can be a time of sleep disturbance. Physiological, hormonal, and emotional changes associated with pregnancy often lead to sleep disturbance. Women who develop antepartum complications frequently are prescribed bed rest and hospitalization. Both pregnancy and hospitalization can influence sleep. This study examined the sleep experience of hospitalized antepartum women. The purposes of this descriptive correlational study were to determine whether being in the hospital affects sleep in pregnant women, gestational age influences sleep while hospitalized, and patient's usual sleep patterns influence sleep during hospitalization. A conceptual model of impaired sleep for the childbearing family provided theoretical …

Scientific Rationale For Study Design Of Community-Based Simplified Antibiotic Therapy Trials In Newborns And Young Infants With Clinically Diagnosed Severe Infections Or Fast Breathing In South Asia And Sub-Saharan Africa., Anita K. M. Zaidi, Abdullah H. Baqui, Shamim Ahmad Qazi, Rajiv Bahl, Samir Saha, Adejumoke I. Ayede, Ebunoluwa A. Adejuyigbe, Cyril Engmann, Fabian Esamai, Antoinette Kitoto Tshefu, Robinson D. Wammanda, Adegoke G. Falade, Adetanwa Odebiyi, Peter Gisore, Adrien Lokangaka Longombe, William N. Ogala, Shiyam Sundar Tikmani, A. S. M. Nawshad Uddin Ahmed, Steve Wall, Neal Brandes, Daniel E. Roth, Gary L. Darmstadt

Paediatrics and Child Health, East Africa

Background: Newborns and young infants suffer high rates of infections in South Asia and sub-Saharan Africa. Timely access to appropriate antibiotic therapy is essential for reducing mortality. In an effort to develop community case management guidelines for young infants, 0–59 days old, with clinically diagnosed severe infections, or with fast breathing, 4 trials of simplified antibiotic therapy delivered in primary care clinics (Pakistan, Democratic Republic of Congo, Kenya and Nigeria) or at home (Bangladesh and Nigeria) are being conducted.

Methods: This article describes the scientific rationale for these trials, which share major elements of trial design. All the trials are …

State Medical Marijuana Implementation And Federal Policy, Karen O'Keefe

Journal of Health Care Law and Policy

No abstract provided.

Medical Marijuana Legislation: What We Know - And Don't, Linda Simoni-Wastila, Francis B. Palumbo

Journal of Health Care Law and Policy

No abstract provided.

A Chronic Problem: Pain Management Of Non-Cancer Pain In America, Sigrid Frey-Revere, Elizabeth K. Do

Journal of Health Care Law and Policy

No abstract provided.

Characteristics Of Health Professionals In A Mandated Ethics Tutorial After Violating Sexual Boundaries With Patients, S. Michael Plaut, Janet Klein Brown, Mira Brancu, Rebecca C. Wilbur, Katherine Rios

Journal of Health Care Law and Policy

No abstract provided.

The Relationships Between Nursing Staff Knowledge Of Personhood And Resident Cognitive Status, Leeanne Compere Yopp

Inquiry: The University of Arkansas Undergraduate Research Journal

The purpose of this pilot study was to explore the relationships between nursing staff knowledge of extended care resident personhood and resident cognitive status. Eighty nursing staff from two similar extended care facilities in Arkansas completed a self-administered questionnaire to assess their knowledge of 21 residents, including information related to residents’ past jobs/careers; likes/dislikes/ interests; family members; other non-specific knowledge; and total knowledge. The Brief Interview for Mental Status (BIMS) was used to evaluate resident cognitive impairment. Results of a Pearson correlation demonstrate a positive correlation between (1) staff knowledge of residents’ families, and (2) total knowledge of residents with …

Mexican Health Paradox, Merit George

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Despite the broad array of research that exists on the Hispanic health paradox, no single explanation has been marked as the dominant reason for the disparities in life expectancy that exist between Mexican Americans and other Hispanic and non-Hispanic ethnic groups. This indicates that researchers must adopt a more open perspective that examines the influence of multidimensional factors that integrate culture, religious tradition, and lifestyle. The purpose of the current study is to 1) readily define the paradox and provide a thorough review of existing literature on the topic; 2) suggest a transition from exploring statistical explanations of the paradox …

Factors That Lead To The Immunotherapy Gap In Multiple Sclerosis Testing, Karthika Solai

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Multiple sclerosis is a disease that affects the central nervous system. Most doctors and scientists believe that it is an autoimmune disease. Simply put, the immune system attacks the nerves in a person’s body, thereby causing myelin damage, inflammation, and neurodegeneration. The plaque that then builds up on the nerves is scar tissue created when the wounds made by the immune system heal. It is this plaque that inhibits communication between the axons in the body and causes the symptoms of MS, which includes problems with movement, pain, vision problems, trouble swallowing, fatigue, and heat sensitivity (Baker et al., 2011, …

Risk Of Childhood Asthma In A Tropical African Urban Setting: A Case - Control Study At The Aga Khan Hospital, Dar-Es-Salaam, Tanzania, Lynda C. Koech

Master of Medicine in Family Medicine

Objective: To determine the modifiable and non-modifiable risk factors for childhood asthma in children aged between two and 15years in a tropical urban East-African setting. Methods: Hospital based case-control study matched for age + two months and sex. Data were obtained from parents of cases and controls using a structured interviewer-administered questionnaire. The study sample consisted of 226 cases of two to 15years old, with physician-confirmed asthma, who met a set of defined clinical criteria and 226 controls with no previous diagnosis or symptoms of asthma matched by sex and age (+two months). The Risk Factors included in this study …

Perception Of Final Year Undergraduate Medical Students Towards Family Medicine In Dar Es Salaam, Tanzania, Eric Luggar Aghan

Master of Medicine in Family Medicine

Primary health care was identified as the ideal model of health care delivery during the Alma Atta conference in USSR in 1978. The World Health Organization urged member countries to adopt it as a model of health care service delivery to their people. Since then many countries have adopted a primary health care model including Tanzania. In countries such as Cuba and Costa Rica where primary health care has successfully been implemented, access to affordable and quality health care service to all has resulted in lowered morbidity, mortality, improved quality and longevity of life. The success story behind primary health …

Generalized Anxiety Disorder: Can We Rest Now?, Aamir Abbas, Haider A. Naqvi

Pakistan Journal of Neurological Sciences (PJNS)

Generalized anxiety disorder is a complex psychiatric syndrome. Current understanding on the epidemiological risk factors, genetic vulnerability and neurobiology of the GAD is beginning to unfold the complexities behind this disorder. This narrative review has attempted to put together the recent advances in the area of GAD research with intent to identify the gaps requiring further research.

Novel Use Of An Ultrasonic Bone-Cutting Device For Endoscopic-Assisted Craniosynostosis Surgery, Chaichana Kl, Jallo Gi, Dorafshar Ah, Ahn Es

Pakistan Journal of Neurological Sciences (PJNS)

Endoscopic-assisted craniosynostosis surgery is associated with less blood loss and shorter operative times as compared to open surgery. However, in infants who have low circulating blood volumes, the endoscopic approach is still associated with significant blood loss. A major source of blood loss is the bone that is cut during surgery. We discuss the novel use of an ultrasonic bone-cutting device for craniosynostosis surgery, which decreases bone bleeding. This device, which has primarily only been used for spine and skull base surgery, may help reduce blood loss in these infants.

20th Annual Meeting Of Pakistan Society Of Neurology Bhurban, Islamabad April 2013, Aftab Leghari, Hazim Brohi

Pakistan Journal of Neurological Sciences (PJNS)

: Stroke is a major preventable public health challenge. Diabetic patients constitute a fair percentage of patients with stroke. Numerous epidemiological studies in the United States and Europe suggest that one fifth of stroke patients have diabetes.We evaluate the risk factors leading to stroke in Diabetic patients

Studies On Bronchodilator And Cardiac Stimulant Activities Of Urginea Indica, Samra Bashir, Saima Abbas, Aslam Khan, Anwar H. Gilani

Department of Biological & Biomedical Sciences

This study was designed to evaluate bronchodilator and cardio-tonic effects of Urginea indica to provide rational for these medicinal uses. U. indica bulb extract was studied on rabbit tracheal and guinea-pig atrial preparations mounted in tissue baths under simulated physiological conditions. U. indica inhibited carbachol (1 µM) and K⁺ (80 mM)-induced contractions in rabbit trachea, similar to dicyclomine, suggesting the presence of anticholinergic and calcium channel blocking (CCB) mechanisms in U. indica. Anticholinergic and CCB effects of U. indica were respectively confirmed when it shifted the carbachol and Ca²⁺ concentration-response curves rightwards, similar to dicyclomine. U. indica (0.01-1 …

Gut Modulator Effects Of Conyza Bonariensis Explain Its Traditional Use In Constipation And Diarrhea, I A. Bukhari, A J. Shah, R A. Khan, S A. Meo, A Khan, A H. Gilani

Department of Biological & Biomedical Sciences

BACKGROUND AND OBJECTIVES:

The current investigation was carried out to explore the pharmacological basis of the crude extract of Conyza bonariensis (Cb.Cr) for its use in constipation and diarrhea.

MATERIALS AND METHODS:

The plant extract of Conyza bonariensis (C. bonariensis) was prepared, isolated guinea-pig ileum and rabbit jejunum preparations were used to evaluate its gut modulator effects.

RESULTS:

The Cb.Cr (0.3-10 mg/mL) exhibited spasmogenic effect in isolated guinea-pig ileum preparation, which was about 19-84% of the acetylcholine maximum. Pretreatment of the tissues with atropine (0.1 µM) abolished the contractile effect, similar to acetylcholine. Among the fractions, only the butanol fraction …

Implementing Incentive-Based Hiv Interventions In Zambia: The Compact Model, Sam Kalibala, Waimar Tun, Chabu Kangale, Jill Keesbury, Ray Handema, Mwaka Monze

HIV and AIDS

The Population Council received a cooperative agreement from USAID to implement the Community Mobilization for Preventive Action (COMPACT) project, to develop and determine the feasibility of “community compacts” as an innovative approach to prevent HIV in Zambian communities. The aim is to mobilize the communities through a capacity-building process that enables them to identify HIV prevention targets, develop interventions to achieve those targets, and measure the results. This study determined baseline levels of key indicators related to HIV, sexual behaviors, gender-based violence, alcohol abuse, and reproductive health. These baseline measures will be compared with midline and endline levels to assess …