Medicine and Health Sciences Commons^™

Caffeine And Human Perception Of Time, Trevor Fry

EWU Masters Thesis Collection

The purpose of this study was to investigate the effect of caffeine on several components of time perception in an attention-demanding task. Review of the current literature shows that the rhythm of the brain's internal clock, controlled by the suprachiasmatic nucleus (SCN), which is believed to mediate the perception of short durations, is sensitive to a variety of stimuli including stimulants. This study expands on previous research on the effect of caffeine on prospective time estimation by having participants estimate multiple short durations while completing a cognitively complex time estimation task involving math. The study included a moderate dose caffeine …

Redefining Medical Necessity: A Consumer-Driven Solution To The U.S. Health Care Crisis, Ryan Abbott, Carl Stevens

Loyola of Los Angeles Law Review

The American health care system is plagued by high costs and poor public health outcomes, due in part to the overuse of costly diagnostic tests and treatments. In 2009, the Institute of Medicine estimated that unnecessary care wastes $750 billion, equivalent to about 30 percent of health care spending. Moreover, overtreatment can directly harm patients as a result of surgical complications, drug toxicity, and hospital-acquired infections. Yet while the problem of medical waste has long been recognized, solving the problem has proven elusive. In part, this difficulty is due to perverse economic incentives for physicians and hospitals, which still primarily …

Measuring Capability For Healthy Diet And Physical Activity, Robert L. Ferrer, Inez Cruz, Sandra Burge, Bryan Bayles, Martha Castilla

Public Health (Archived)

PURPOSE Patterns of diet and physical activity, major drivers of morbidity and mortality, are contingent on people’s feasible opportunities to pursue healthy behaviors. Our objective for this mixed methods study was to develop measures of feasible opportunities for diet and activity.

METHODS The Capability Approach framework for evaluating people’s real freedoms to pursue their values guided the research. A community-based participatory model was applied to conduct focus groups of adults with obesity or diabetes mellitus from an economically disadvantaged Latino community. Focus group themes were developed into survey items that assess how individual circumstances and neighborhood contexts influence opportunities for …

Paramedic Students' Perceived Self-Efficacy At Airway Management, Holly Herron

Doctor of Nursing Practice Scholarly Projects

The out of hospital (OOH) environment is chaotic, unpredictable and unforgiving. Paramedics are the primary providers of life-saving, OOH airway management, which includes respiratory assessment, bag-valve-mask ventilation (BVM), and endotracheal intubation (ETI). OOH ETI is the most difficult skill for which to obtain and retain clinical competence. Preventable patient care errors and deaths related to OOH ETI are a healthcare concern. Clinical experience remains limited for paramedic students in the acquisition of adequate ETI experience.

The purpose of this study was to assess the perceived self-efficacy (PSE) of paramedic students in ETI. Bandura's self-efficacy theory was the theoretical framework for …

Injuries Among Miners In Kentucky During 2010-2012 From Workers Compensation Data, Evelyn Thomas

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: Coal miners in Kentucky have higher rates of injury morbidity and mortality than national rates. In order to understand better what is happening in this area, we not only analyzed the injuries and deaths, but also identified common characteristics between these nonfatal and fatal injuries. The objectives of this study were to 1) Identify injuries among coal miners in Kentucky; 2) Determine if there are any other risk factors for injuries other than working in a mine; and 3) Determine the different health effects on coal mine workers. Methods: Data from Kentucky Workers’ Compensation First Reports of Injuries and …

Influence Of Marianismo On Colorectal Cancer Screening Behavior Among Hispanic Women In The United States, Robin Thompson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer death in the United States (U.S).1 Although early detection and treatment can reduce CRC-related morbidity and mortality, almost twothirds of patients are diagnosed with advanced stage disease indicating non-adherence to recommended screening guidelines.1 Indeed, less than half of individuals over 50 years of age get screened at recommended intervals.2 More specifically, lower rates of CRC screening exist among these groups: those identifying as being of Hispanic origin, the uninsured, disabled individuals, and women.3 In a 2011 report from the National Center on Health …

An Exploration Of Empowerment, Sexual Violence, And Hiv Among Indian Women, Brigid Kyung-Hwa Cecil

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Empowerment plays a major role in sexual violence and HIV among women worldwide. Findings on empowerment in relation to domestic violence or HIV are scarce and are conflicting. The purpose of this study was to examine the relationship between empowerment and HIV status by means of sexual violence, and to compare this relationship between previously married women (N = 2,658) and currently married women (N = 37,539) living in India. The Baron and Kenny mediated regression model was used, involving simple logistic and multiple logistic regression, drawing from the National Family Health Survey 2005-2006 (NFHS-3). Sexual violence was not found …

Association Of Hiv Testing, Educational Attainment, And Age Among Black And Non-Black Men, Ashley N. Martell

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Human Immunodeficiency Virus (HIV) infection can lead to a chronic condition, Acquired Immunodeficiency Syndrome (AIDS), but can be well managed with a combination of medications, treatments, and remedies.1 The emergence of HIV in the United States in 1981 created an atmosphere unlike any other at that time. Overtime, the science community has worked diligently to combat this disease through research, practice, and intervention. Although many efforts have been put forth over the past thirty years, millions of Americans still remain infected with HIV.2 Among those who are infected with HIV/AIDS we see disproportionate rates among specific races and gender. Research …

Patterns Of Pneumoconiosis Mortality In Kentucky: Analysis Of Death Certificate Data, Jake Beggs

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

ABSTRACT

Background: Despite ongoing surveillance efforts, mortality rates associated with total pneumoconiosis, and particularly coal worker’s pneumoconiosis, have remained elevated. Methods: Kentucky death certificate data from 2003-2011 was statistically compared to other coal mining states and descriptively analyzed from 2011-2013 to determine the mortality burden and public health implications of pneumoconiosis and coal worker pneumoconiosis (CWP) on Kentucky residents from 2003-2013. Results: Kentucky’s total pneumoconiosis and coal workers’ pneumoconiosis mortality rates decreased from 2003-2009, then increased in following years, showing a significant quadratic trend from 2003-2013 (p<.05) compared to West Virginia, Pennsylvania, and the overall United States rates that had significant negative linear trends from 2003-2011(p<.05). Deaths from pneumoconiosis primarily occurred in white males from CWP in the Appalachian region. Individuals diagnosed with pneumoconiosis died from respiratory illness 50% of the time, heart-related problems (23%) and cancer (12%). Autopsies were only performed on 12% of decedents over the three year study period and the primary locations of death were in hospital (47%) and at home (36%). Conclusions: Increased coal mining industry worker environmental exposure protection should be enhanced in Kentucky. Additionally, healthcare efforts should focus on increasing patient education to ensure early detection and treatment for individuals suffering from pneumoconiosis as well as for comorbid conditions such as Chronic Obstructive Pulmonary Disease. To further target healthcare and treatment of pneumoconiosis patients, increased autopsies of individuals with pneumoconiosis should be performed to identify involvement of other conditions such as silicosis and optimize pneumoconiosis fatality surveillance.

Prevention, Recognition, And Treatment Of Pediatric Obesity In The Ambulatory Care Setting, Susan Farrus-Brown

Doctor of Nursing Practice Scholarly Projects

The World Health Organization (WHO) in 1995 described obesity as a chronic disease and one of the most important public health threats and in 2000 reported obesity as a “global epidemic.” The numbers of obese children are increasing in society; moreover, the onset of obesity is occurring at even a younger age than in the past. The prevalence of pediatric obesity is staggering and interventions need to be developed to decrease the risk for chronic and related psychological diseases.

The objective of this project was to provide education on utilization of a tool kit to increase the nurse practitioner (NP) …

Post-Laminectomy Back Pain: Understanding The Progress From Acute To Chronic Pain State, James Derek Calhoun

DNP Projects

In the United States, 74.6% of patients who have lumbar laminectomy surgery have residual low back pain (Hussain & Erdek, 2014) and overall costs of low back pain may reach up to $200 billion per year (Carey & Frebuger 2013). To further address this problem, a study was conducted to determine if treatment in a chronic pain clinic could result in a reduction in the development of a chronic pain state for adult patients who have had lumbar laminectomy surgeries. A convenience sample of 50 patients was selected from the Interventional Pain Associates clinic at the University of Kentucky. Records …

Examining The Identity Of The Art Therapist: The Voice Of Practice And Relational Care, Denise Malis

Expressive Therapies Dissertations

The purpose of this study was to investigate the impact of personal art making on the identity and practice of the professional art therapist. This qualitative study explored the subjective experience of six female professional art therapists. Interviews were conducted and participants were asked about their personal art-making, art therapy practice, and the meaning of their professional identity. A narrative methodology, the Listening Guide, was applied to the interview data and emphasized each participant’s voice and use of expressive language. Data from this study established a three-fold identity for the professional art therapist: counselor, artist, and art therapist. Confidence in …

The Bridge Drawing With Path Art-Based Assessment: Measuring Meaningful Life Pathways In Higher Education Students, Olena Darewych

Expressive Therapies Dissertations

This cross-sectional study investigated the relationships among the Bridge Drawing with Path (BDP) art-based assessment and two positive psychology instruments: the Meaning in Life Questionnaire (MLQ; Steger et al., 2006) and the Adult State Hope Scale (ASHS; Snyder et al., 1996). All three assessments (BDP, MLQ and ASHS) are intended to test for an individual’s goal-related pursuits. Forty-four higher education students studying in Britain and Canada participated in the study. Results indicated that an association exists between BDP written associations and MLQ-presence of meaning sub-scores. Participants who scored high on MLQ – presence of meaning generated more sources of life …

Music Therapy As An Intermodal Practice: Clients And Therapists Perspectives, Daniel Hyams

Expressive Therapies Dissertations

This qualitative study used a phenomenological approach to investigate the lived experiences of clients and music therapists working with an integrated arts approach in music therapy. Seventeen client participants (aged 11-19 years old) underwent five consecutive therapy sessions with one of three qualified music therapists. The guiding questions pertained to the participants’ experience of having various arts materials in addition to the standard musical instruments available during the music therapy sessions. The results showed a positive response from the clients’ perspectives, and a negative response from the therapists. The clients unanimously preferred having choice in the sessions. The therapists, however, …

Simulated Patients' Experiences With Verbal Feedback For First Year Medical Students And Residents: A Grounded Theory Study, Carol Fleishman

Educational Studies Dissertations

The purpose of this study was to explore the experiences of simulated patients (SPs) with the process of providing verbal feedback for first-year medical students and residents during formative simulation activities. Feedback to medical trainees provides a valuable learning context, effecting communication and interpersonal skills which impact healthcare outcomes and patient safety. This qualitative research study used a grounded theory approach based on data from semi-structured interviews with 17 SPs who were casual employees of a standardized patient program for a large academic medical center in the mid-Atlantic region of the USA. The study analyzed what participants said about their …

Calibration Of Built-In Accelerometer Using A Commercially Available Smartphone, Jung-Min Lee, Youngwon Kim, Yi-Suk Kwon, Timothy R. Derrick, Gregory J. Welk

Research Presentations

Wearable trackers that detect sleep offer users a way to track their sleep quality and patterns without the use of expensive equipment. Few studies have tested the validity of these trackers on sleep measure. PURPOSE: To examine the validity of the Actigraph GT9X (AG), SenseWear Mini Armband (SW), Basis Peak (BP), Fitbit Charge HR (FB), Jawbone UP3 (JU), and Garmin Vivosmart (GV) for estimating sleep variables as compared with a sleep diary. METHODS: 78 healthy individuals participated in the study. Group 1 (n= 38) and wore the AG, SW, BP, and FB or Group 2 (n = 40) …

Recognizing Patient Safety Importance Through Instrument Validation On Physicians' Assessment Of An Ehr, Cherie Notebloom, Kathryn Dempsey Cooper

Interdisciplinary Informatics Faculty Proceedings & Presentations

Patient safety and high quality patient care are critical concerns for healthcare providers. The Institute of Medicine report suggests medical errors account for up to 98,000 patient deaths each year. Therefore, the US healthcare system is looking to information technology applications as one means of making patient care safer. This paper compares the psychometric properties of the Electronic Health Record Nurse Satisfaction instrument (based on the Health Information Technology Research-based Evaluation Framework) to our study that employed the same instrument but measured clinical physicians' opinions of an EHR to determine if the instrument could be used across domains of users. …

Effects Of Yoga On Arm Volume Among Women With Breast Cancer Related Lymphedema: A Pilot Study, Mary I. Fisher, Betsy Donahoe-Fillmore, Laura Leach, Colleen O'Malley, Cheryl Paeplow, Tess Prescott

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Early detection efforts and aggressive treatment have resulted in female breast cancer survival rates approaching 90%. Treatments for breast cancer often result in upper extremity morbidities including the development of lymphedema. Impairments may result from the development of lymphedema, including decreased arm function, range of motion and strength along with increased arm swelling and heaviness. This arm swelling can be accompanied by a general decline in the quality of life (QOL). Therefore, it is important to determine effective methods to manage lymphedema. Exercise is one aspect of lymphedema management that has been supported by research to improve physiologic function of …

The Immediate Effects Of Carbon Composite Ankle Foot Orthoses On Balance And Gait In Individuals With Peripheral Neuropathy: A Pilot Study, Holly Combs, Tristen Glesey, Renee Laux, Lucas Petkewitz, Gina Santoianni

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Peripheral neuropathy (PN) is a neurological disorder that involves damage or disease of the peripheral nervous system. Diabetes is one of the most common causes on PN, while another large percentage of cases are idiopathic in nature. Individuals with PN often experience a distal to proximal progression of motor and sensory deficits such as loss of proprioception, muscle weakness, and loss of ankle reflexes. Since lower extremity proprioception plays a primary role in postural control, individuals with PN demonstrate difficulty maintaining balance, especially under conditions in which vision or vestibular input are also compromised. Because of these deficits, individuals with …

The Utility Of Functional Movement Assessment On Nba Players, Philip A. Anloague, Donald S. Strack, Joshua Corbeil, Carl Eaton, Shawn Windle, Branden Bubnick, Philip Firkins, Alex Gehle, Krystal Heile, Timothy Lynn, Steven Short

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Professional basketball related injuries have not declined over the last decade despite improvements in training and conditioning or medical advancements in diagnostics, surgery, or rehabilitation. A descriptive epidemiological study of 80% of the National Basketball Association (NBA) teams over 17 years reported an injury incidence of 19.1 per 1000 athlete exposures, and 59,179 games missed due to injury. Starkey found that the there has been a 12.4% increase in game-related injuries in the NBA in a 10-year period from the 1988 - 1997 seasons. It is suspected that increased contact within the NBA along with improved player athleticism, size, power, …

Heart Valve Surgery: Euroscore Vs. Euroscore Ii Vs. Society Of Thoracic Surgeons Score, Muhammad Sharoz Rabbani, Irfan Qadir, Yasir Ahmed, Marrium Gul, Hasanat Sharif

Section of Cardiothoracic Surgery

Background: This is a validation study comparing the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II with the previous additive (AES) and logistic EuroSCORE (LES) and the Society of Thoracic Surgeons' (STS) risk prediction algorithm, for patients undergoing valve replacement with or without bypass in Pakistan.PATIENTS AND Methods: Clinical data of 576 patients undergoing valve replacement surgery between 2006 and 2013 were retrospectively collected and individual expected risks of death were calculated by all four risk prediction algorithms. Performance of these risk algorithms was evaluated in terms of discrimination and calibration.Results: There were 28 deaths (4.8%) among 576 patients, …

Neurosurgery Literature Highlights & Psychiatry Literature Highlights, Muhammad Waqas Shaiq, Muhammad Shahzad Shamim

Pakistan Journal of Neurological Sciences (PJNS)

Today, a great challenge of our profession is to envision how we will deliver exemplary neurosurgical care in the future. To accomplish this requires anticipating how economic, political, and societal influences will affect our ability to provide the highest quality of patient care in an arena that will look increasingly different from today's world of medicine. Already, our profession is battling a relentless assault as numerous sectors implement change that impacts us and our community every day. Surviving this requires an effective strategy that will involve significant cultural change.

A Risk Prediction Model For The Assessment And Triage Of Women With Hypertensive Disorders Of Pregnancy In Low-Resourced Settings: The Minipiers (Pre-Eclampsia Integrated Estimate Of Risk) Multi-Country Prospective Cohort Study, Beth A. Payne, Jennifer A. Hutcheon, J. Mark Ansermino, David R. Hall, Zulfiqar Ahmed Bhutta, Shereen Z. Bhutta, Christine Biryabarema, William A. Grobman, Henk Groen, Farizah Haniff, Jing Li, Laura A. Magee, Mario Merialdi, Annettee Nakimuli, Ziguang Qu, Rozina Sikandar Sultanali, Nelson Sass, Diane Sawchuck, D. Wilhelm Steyn, Mariana Widmer, Jian Zhou, Peter Von Dadelszen

Department of Obstetrics & Gynaecology

Background: Pre-eclampsia/eclampsia are leading causes of maternal mortality and morbidity, particularly in low- and middle- income countries (LMICs). We developed the miniPIERS risk prediction model to provide a simple, evidence-based tool to identify pregnant women in LMICs at increased risk of death or major hypertensive-related complications.

Methods and Findings: From 1 July 2008 to 31 March 2012, in five LMICs, data were collected prospectively on 2,081 women with any hypertensive disorder of pregnancy admitted to a participating centre. Candidate predictors collected within 24 hours of admission were entered into a step-wise backward elimination logistic regression model to predict a composite …

An Introduction: Quantification Of The Hippocampal Bdnf Content Of Maternally Separated Rats Using A Western Blot Protocol, Bernajane M. Palisoc, Laurel M. Pritchard, Emily Hensleigh

McNair Poster Presentations

Among industrialized nations, the United States has the worst incidence of child maltreatment with 3 million cases per year (U.S. Department of Health and Human Services, 2012). Studies have shown that individuals who were maltreated when they were young are more susceptible to drug abuse such as alcohol, cocaine, and nicotine (Maddahian, Newcomb, & Bentle, 1988). Early life stress (ELS) causes hyperactivation of the Hypothalamic-Pituitary- Adrenal (HPA) Axis (Heim et al., 2000; Plotsky et al., 2005). The dysregulation of the HPA axis causes the secretion of glucocorticoid stress hormones by large amounts, which in return attenuates hippocampal Brain-derived neurotrophic factor …

Commercial Sexual Exploitation Of Teens, Tamieka Meadows, Alexis Kennedy

McNair Poster Presentations

This research explores whether commercially sexually exploited children (CSEC) abuse drugs or face greater histories of abuse than their delinquent peers. This research will evaluate whether girls who are CSEC victims experience more abuse of drugs or experience more physical, emotional, or sexual abuse. The study also explores whether CSEC victims witnessed more abuse than non-CSEC victims. A survey of needs and issues facing delinquent girls was given to 130 girls between the ages of 13 to 18. Questions asked about their drug use, abuse history, and whether they witnessed abuse. This research found that many girls who are CSEC …

Serum Procalcitonin Levels On Antibiotic Duration & Patient Outcomes In Copd Exacerbations, Monee Carter

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

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Reduction Of Unplanned Extubations In The Neonatal Intensive Care Unit, Sharon Fassino

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Unplanned extubations (UE) are a preventable adverse event which occurs when intubated patients have their endotracheal tubes (ETT) accidentally dislodged from their airway. The method of securing the ETT has been identified as the most common reason for unplanned extubations (Veldman et al. , 2006). The purpose of this project was to decrease the rate of UEs in the neonatal intensive care unit from 4.9 UEs per 100 ventilator days to less than two UEs per 100 ventilator days by implementing a standard method of securing the endotracheal tube with a securement device. Methods This was a prospective, controlled research …

Hpv Vaccine Decision-Making In Hispanic And African American Parents: A Secondary Data Analysis, Lavonda Mclennan

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The human papillomavirus (HPV) is the most common sexually transmitted infection (STI) and a highly preventable cause of morbidity and mortality in the United States (U.S.). There are more than 79 million Americans infected with HPV and approximately 14 million newly diagnosed cases ofHPV annually (United States Department of Health & Human Services [DHHS], n.d.). More than 40 strains of HPV can lead to genital warts and various types of cancers, mostly cervical cancer (Centers for Disease Control and Prevention [CDC], 2013a). Although the HPV vaccine can prevent approximately 21,000 HPV related cancers, uptake of the HPV vaccine remains suboptimal. …

What Are The Therapeutic Strategies Used By Mental Health Providers To Create A Therapeutic Alliance And Effective Patient- Provider Relationship For Psychotropic Medication Adherence?, Agnes Okoro

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The annual cost of medication non - adherence problems in United States (U.S.) is approximately $100 billion dollars (Heesch, 2013; Julius, Novitsky, & Dublin, 2009). Mental health providers often encounter psychotropic medication non adherence among incarcerated persons with schizophrenia despite their alliance- enhancing efforts, resulting in increased violence, hospitalization, and an impact on economy. Therapeutic alliance, an effective and collaborative relationship between the health care provider and the patient has a positive association with treatment adherence as supported by the result of many studies (Julius et al., 2009; Kvrgic, Cavelli, Beck, Rusch, & Vaulth, 2013 ; McCabe et al., 2012). …

Policy Analysis: Impact Of Legislative Policy On Infant Mortality, Aimee T. Dunnam

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

This study examined the impact of health policy on infant mortality. Public Use Data Files were used to assess differences in groups before and after the initiation of health policy as law. House Bill 1983 restricted the delivery of infants before 39 weeks gestation when born by elective induction or elective cesarean section. Infants born prematurely are at higher risk for adverse outcomes. A total of 3,078 identified infants were included in the sample. Infants were categorized according to their gestational age of 33-34 weeks, 35-36 weeks, and greater than 37 weeks. Data analyzed showed no statistical significance in the …