Medicine and Health Sciences Commons^™

Patient-Reported Outcomes Screening For Improved Patient Wellness: A Cancer Center Initiative, Alison Morris

Doctor of Nursing Practice (DNP) Projects

Background: People experiencing serious illness have significant unmet physical, emotional, social and spiritual needs. The Quality Oncology Practice Initiative (QOPI) requires patients to be screened for emotional wellbeing and pain by their second oncology visit. This project details one cancer center’s quality improvement initiative to (a) implement electronic screening of every cancer patient by their second oncology visit, (b) design processes for ongoing assessment and intervention of need(s), and (c) develop measurable and sustainable evaluation metrics to ensure that palliative care needs are met. Methods: In June 2015, we launched electronic collection of patient-reported outcomes (PROs) using the Patient Reported …

Sleep Disordered Breathing And Pregnancy: Prevalence And Outcomes At Delivery, Ryan Lyle Nations

Dissertations

Introduction
Sleep Disordered Breathing (SDB) during pregnancy is associated with maternal and neonatal morbidity, and in-hospital mortality. A recent prevalence study using the Nationwide Inpatient Sample reported an obstructive sleep apnea (OSA) prevalence of 7.3 per 10,000 in 2013, a rate of 24% per year over the last decade. The rise in prevalence mirrors the rise in obesity. Military Treatment Facilities (MTF) have seen an increase in obesity and related co-morbidities with an unknown prevalence of SDB. Most studies have been conducted in high-risk populations; the general prevalence of SDB and its association with adverse pregnancy outcomes in a military …

Velamentous Cord: A Dangerous Case Complicated By A Rural Population#11;#11;, Adam M. Franks, Carolyn Curtis, Shawndra Barker

Shawndra Barker MD

A velamentous cord insertion occurs when the umbilical cord’s Wharton jelly fails to reach the placenta, due to early placental atrophy around the insertion site, leaving a segment of unprotected vessels running through the thin membranes of the amniotic sac. Figure 1 depicts the velamentous cord insertion.

Velamentous Cord: A Dangerous Case Complicated By A Rural Population, Adam Franks, Md, Carolyn Curtis, Md, Shawndra Barker, Md

Shawndra Barker MD

A velamentous cord insertion occurs when the umbilical cord’s Wharton jelly fails to reach the placenta, due to early placental atrophy around the insertion site, leaving a segment of unprotected vessels running through the thin membranes of the amniotic sac. This area of weakness exposes a threat to the well-being of the fetus through acute hemorrhage and both acute and chronic restriction of nutrition. With advances in technology, resolution capabilities of ultrasounds allow for antenatal diagnosis, when previously this was impossible. With this knowledge, considerations for screening and management of this pathology are essential when dealing with a rural population …

Velamentous Cord: A Dangerous Case Complicated By A Rural Population#11;#11;, Adam M. Franks, Carolyn Curtis, Shawndra Barker

Adam M. Franks, MD

A velamentous cord insertion occurs when the umbilical cord’s Wharton jelly fails to reach the placenta, due to early placental atrophy around the insertion site, leaving a segment of unprotected vessels running through the thin membranes of the amniotic sac. Figure 1 depicts the velamentous cord insertion.

Velamentous Cord: A Dangerous Case Complicated By A Rural Population, Adam Franks, Md, Carolyn Curtis, Md, Shawndra Barker, Md

Adam M. Franks, MD

A velamentous cord insertion occurs when the umbilical cord’s Wharton jelly fails to reach the placenta, due to early placental atrophy around the insertion site, leaving a segment of unprotected vessels running through the thin membranes of the amniotic sac. This area of weakness exposes a threat to the well-being of the fetus through acute hemorrhage and both acute and chronic restriction of nutrition. With advances in technology, resolution capabilities of ultrasounds allow for antenatal diagnosis, when previously this was impossible. With this knowledge, considerations for screening and management of this pathology are essential when dealing with a rural population …

Velamentous Cord: A Dangerous Case Complicated By A Rural Population, Adam Franks, Md, Carolyn Curtis, Md, Shawndra Barker, Md

Marshall Journal of Medicine

A velamentous cord insertion occurs when the umbilical cord’s Wharton jelly fails to reach the placenta, due to early placental atrophy around the insertion site, leaving a segment of unprotected vessels running through the thin membranes of the amniotic sac. This area of weakness exposes a threat to the well-being of the fetus through acute hemorrhage and both acute and chronic restriction of nutrition. With advances in technology, resolution capabilities of ultrasounds allow for antenatal diagnosis, when previously this was impossible. With this knowledge, considerations for screening and management of this pathology are essential when dealing with a rural population …

Practice Matters: Screening And Referring Congregants With Major Depression, Kim Link, Dawn M. Garrett Wright, Mary Branstetter Dnp

International Journal of Faith Community Nursing

The purpose of this article is to provide Faith Community Nurses with current recommendations regarding screening and caring for individuals with major depression. Epidemiological data on major depression will be presented, along with recommended screening tools to assist in detecting major depression. Recommendations for the management of major depression will be presented, including the role that the Faith Community Nurse can play when providing care and education to individuals with major depression.

Promoting Colorectal Cancer Screening Among Haitian Americans, Steven S. Coughlin, Erica I. Lubetkin, Jennifer L. Hay, Renald Raphael, Selina A. Smith

Journal of the Georgia Public Health Association

Background: Few studies have examined colorectal cancer screening among Haitian Americans, although striking disparities in colorectal cancer screening and mortality are well-documented among U.S. Blacks. Race, socioeconomic status, and place of birth are factors associated with colorectal cancer incidence and mortality patterns.

Methods: In this article, we summarize published studies on colorectal cancer screening among Haitian Americans, identified through bibliographic searches in PubMed and CINAHL through August 2015, and offer recommendations for further research.

Results: Only one qualitative study and three quantitative surveys have examined colorectal cancer screening among Haitian Americans. A qualitative study found important differences in perceptions of …

Certain Actions From The Functional Movement Screen Do Not Provide An Indication Of Dynamic Stability, Robert G. Lockie, Samuel J. Callaghan, Corrin A. Jordan, Tawni M. Luczo, Matthwe D. Jeffriess, Farzad Jalilvand, Adrian B. Schultz

Research outputs 2014 to 2021

Dynamic stability is an essential physical component for team sport athletes. Certain Functional Movement Screen (FMS) exercises (deep squat; left- and right-leg hurdle step; left- and right-leg in-line lunge [ILL]; left- and right-leg active straight-leg raise; and trunk stability push-up [TSPU]) have been suggested as providing an indication of dynamic stability. No research has investigated relationships between these screens and an established test of dynamic stability such as the modified Star Excursion Balance Test (mSEBT), which measures lower-limb reach distance in posteromedial, medial, and anteromedial directions, in team sport athletes. Forty-one male and female team sport athletes completed the screens …

Measurement Of Illness Perception And Behaviour Along A Continuum Of Symptomatic Knee Osteoarthritis: A Transdisciplinary Approach, Clayon B. Hamilton

Electronic Thesis and Dissertation Repository

Objectives: A multifactorial approach is recommended for the identification/diagnosis, prognosis, and treatment of pain in knee osteoarthritis (OA). One aspect of this approach includes illness perception and behaviour. The purpose of this thesis was to investigate the measurement of illness perception and behaviour along a continuum of symptomatic knee OA, starting from the early symptoms of knee OA.

Methods: Three studies were conducted to fulfill this purpose. The first study was a scoping review that applied an interpretative analysis to validated measures that had been used to assess people with knee pain and/or knee OA. Second was the construct validation …

Examining Factors Influencing Colorectal Cancer Screening Of Rural Nebraskans Using Data From Clinics Participating In An Accountable Care Organization: A Study Protocol., Lufei Young, Jungyoon Kim, Hongmei Wang, Li-Wu Chen

Journal Articles: College of Nursing

BACKGROUND: Although mortality rates of colorectal cancer (CRC) can be significantly reduced through increased screening, rural communities are still experiencing lower rates of screening compared to urban counterparts. Understanding and eliminating barriers to cancer screening will decrease cancer burden and lead to substantial gains in quality and quantity of life for rural populations. However, existing studies have shown inconsistent findings and fail to address how contextual and provider-level factors impact CRC screening in addition to individual-level factors.

PURPOSE: The purpose of the study is to examine multi-level factors related to CRC screening, and providers' perception of barriers and facilitators of …

Faster Title And Abstract Screening? Evaluating Abstrackr, A Semi-Automated Online Screening Program For Systematic Reviewers, John Rathbone, Tammy Hoffmann, Paul Glasziou

Paul Glasziou

Background: Citation screening is time consuming and inefficient. We sought to evaluate the performance of Abstrackr, a semi-automated online tool for predictive title and abstract screening. Methods: Four systematic reviews (aHUS, dietary fibre, ECHO, rituximab) were used to evaluate Abstrackr. Citations from electronic searches of biomedical databases were imported into Abstrackr, and titles and abstracts were screened and included or excluded according to the entry criteria. This process was continued until Abstrackr predicted and classified the remaining unscreened citations as relevant or irrelevant. These classification predictions were checked for accuracy against the original review decisions. Sensitivity analyses were performed to …

Re-Issuing The Screening Mammography Challenge, Daniel Passerman

Clinical Research in Practice: The Journal of Team Hippocrates

The author reissues the challenge to monitor the to monitor the discussion related to screening mammography in the reader's own clinical setting.

Alcohol Consumption, Depression, Insomnia And Colorectal Cancer Screening: Racial Differences, Daniel Owusu, Megan Quinn, Ke Sheng Wang

ETSU Faculty Works

Background: Mortality from colorectal cancer (CRC) can be reduced drastically by early detection and early treatment. However, uptake of CRC screening is relatively low, about 50% for those whom the test is highly recommended.

Objectives: We examined the influence of and racial differences in depression, insomnia, alcohol use, and tobacco use on CRC screening uptake in the US.

Patients and Methods: Analysis of the 2012 National Health Information Survey data was conducted. Both weighted univariate and multiple logistic regression analyses were performed in SAS to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs). A total …

The Effect Of An Educational Intervention On Knowledge And Intent To Participate In Cervical Cancer Screening, Ann Marie Trapp

Evidence-Based Practice Project Reports

Globally, cervical cancer ranks third among cancers affecting women (Arbyn et al., 2013). In the United States, approximately 12,000 women are diagnosed with cervical cancer and approximately 4,000 women die yearly (Centers for Disease Control and Prevention, 2014). Papanicolaou (Pap) screening is an effective means of detecting precancerous cell changes of the cervix with early cervical cancer diagnosis carrying a 91% five-year survival rate (Gonzalez et al., 2012). The purpose of this evidence-based practice project was to identify interventions that increase adherence to cervical cancer screening and to implement best practices to reduce unnecessary deaths related to late diagnoses of …

Commercial Sexual Exploitation: The Role Of The Advanced Practice Nurse In Screening Patient At-Risk, Sheri Rickman Patrick

Doctoral Projects

Problem: Human trafficking or commercial sexual exploitation (CSE) is a global problem effecting every country including the United States. The impact of human trafficking while it is devastating to individuals, the impact goes well beyond individual victims and undermines the health, safety and security of all nations (U.S. Department of State Publication, 2007, p. 5).This research is an attempt to assess the knowledge of advance practice nurses or nurse practitioners (NP) in the subject of commercial sexual exploitation and their willingness to screen their patients who may be at-risk.

Methods: The design was web-based with advanced practice nurses who are …

Prevalence Of Incidental Prostate Cancer: A Systematic Review Of Autopsy Studies, Katy J. L. Bell, Chris Del Mar, Gordon Wright, James Dickinson, Paul Glasziou

Christopher Del Mar

Prostate cancer screening may detect non-progressive cancers, leading to over-diagnosis and over-treatment. The potential for over-diagnosis can be assessed from the reservoir of prostate cancer in autopsy studies that report incidental prostate cancer rates in men who died of other causes. We aimed to estimate the age-specific incidental cancer prevalence from all published autopsy studies. We identified eligible studies by: searches of Medline and Embase, forward and backward citation searches, and contacting authors. We screened the titles and abstracts of all articles; checked the full text articles for eligibility; and extracted clinical and pathology data using standardized forms. We extracted: …

Practice Matters: Screening And Caring For Those With Hypertension, Dawn M. Garrett Wright, Maria E. Main, Mary L. Branstetter

International Journal of Faith Community Nursing

The purpose of this article is to review best practices for screening and monitoring hypertension for Faith Community Nurses (FCNs). Epidemiological data regarding hypertension will be presented, along with current guidelines for blood pressure monitoring. Information on lifestyle modification and patient education resources is included to assist the FCN to improve service to patients at risk for and with current hypertension.

Breast Cancer Screening: Early Detection Is Not Enough, Judy A. Tjoe

Journal of Patient-Centered Research and Reviews

N/A

Experiences With Weight Loss Triggers In Women Prescribed To Lose Weight By Their Physician, Mark D. Faries, Elizabeth Espie, Erik Gnagy, Kyle P. Mcmorries

Faculty Publications

Background: With the global rise of individuals classified as overweight and obese, weight-related screenings have been promoted to combat their high prevalence and associated health problems. Hopefully, such screenings can act as a ‘trigger’ for health behavior change, however little is known about the experience of weight loss triggers.
Objectives: The aim of this study was to elaborate on the experiences and meanings of weight-control triggers in a sample of overweight women prescribed by their physician to lose weight.
Patients and Methods: We conducted exploratory qualitative interviews, grounded in phenomenological practices, to elaborate on the experience and meaning of weight …

Osteoporosis: Prevention, Screening, And Treatment In The Primary Care Setting, Jeanne T. Gosselin

Family Medicine Clerkship Student Projects

Osteoporosis, with its related fragility fractures, is largely a preventable disorder, not an inevitable part of aging. Through effective education, screening, and treatement in the primary care setting, it may be possible to curb the impending rise of osteoporosis and costly fractures as the population ages. A time-conserving patient education pamphlet on osteoporosis was developed for a family medicine practice in central Vermont. The educational intervention is sensitive to the time constraints of a busy practice and may provide a much needed foundation for osteoporosis education in the primary care setting.

Screening, Brief Intervention And Referral To Treatment For Substance Abuse In Waitsfield, Vt, Chi An Liu

Family Medicine Clerkship Student Projects

Substance abuse is an issue in Waitsfield, VT and currently there is no formal program or intervention at Mad River Family Practice to help patients overcome their addictions. Screening, brief intervention and referral to treatment (SBIRT) is a program to identify at risk patients, raise awareness of their abuse, and help them find support and treatment they need.

Assessing The Perceptions And Knowledge Of Breast Cancer And Mammography In The Refugee Population, Patrick Silveira

Family Medicine Clerkship Student Projects

No abstract provided.

Bridging The Gap, Amy Wei-Hsin Yu

Family Medicine Clerkship Student Projects

Many elders must choose between paying bills, buying medication or buying food. Some elders are unaware that they qualify for food assistance, or would feel stigmatized using it. Only 1 in 3 eligible seniors (60+) participate in 3SquaresVT (SNAP), a federal nutrition program of the USDA administered by the Vermont Department for Children and Families. Over 14,000 (11%) of Vermont seniors face the threat of hunger and almost 7,000 (5%) are at-risk for hunger (food-insecure). Food insecurity can be screened for by using Hunger Free Vermont’s Two Question Screen.

A Comparison Of The Predictive Accuracy Of Three Screening Models For Pulmonary Arterial Hypertension In Systemic Sclerosis, Yanjie Hao, Vivek Thakkar, Wendy Stevens, Kathleen Morrisroe, David Prior, Candice Rabusa, Peter Youssef, Eli Gabbay, Janet Roddy, Jennifer Walker, Jane Zochling, Joanne Sahhar, Peter Nash, Susan Lester, Maureen Rischmueller, Susanna M. Proudman, Mandana Nikpour

Medical Papers and Journal Articles

Introduction: There is evidence that early screening for pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc) improves outcomes. We compared the predictive accuracy of two recently published screening algorithms (DETECT 2013 and Australian Scleroderma Interest Group (ASIG) 2012) for SSc-associated PAH (SSc-PAH) with the commonly used European Society of Cardiology/European Respiratory Society (ESC/ERS 2009) guidelines.

Methods: We included 73 consecutive SSc patients with suspected PAH undergoing right heart catheterization (RHC). The three screening models were applied to each patient. For each model, contingency table analysis was used to determine sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values for …

Screening For Peripheral Artery Disease, Cheryl Gordon

Walden Dissertations and Doctoral Studies

Peripheral artery disease (PAD) affects 8 to 10 million Americans, and the incidence of PAD is expected to increase as the population ages. A high percentage of the PAD is undiagnosed prior to the onset of a serious cardiovascular event; therefore, the inability to screen and diagnose for PAD in the early stages could hinder efforts to decrease adverse consequences of cardiovascular disease. Individuals with PAD have a 3 to 5 times increased risk of cardiovascular disease (CVD) mortality when compared to people without PAD. Guided by the Stetler model, the purpose of this project was to evaluate the relationship …

Conducting A Needs Assessment At Outpatient Medical Clinic, Fidelia Ijeuru Ukah

Walden Dissertations and Doctoral Studies

Colorectal cancer is one of the most common cancers in the United States and confronting its challenges has remained a problem to the United States health sector, especially among outpatient clinics. Guided by health belief model, the purpose of this needs assessment was to identify patients age 50 and older in outpatient clinic located in a large metropolitan city in Texas who should receive information on the need for colorectal cancer screening based on their risk for developing colorectal cancer as outlined by American Cancer Society. A sample of 70 charts of patients age 50-75 years was randomly selected and …

Mri As An Adjunct To Conventional Mammography Screening For Cancer In Dense Breast Tissue, Rachel Sunmattie Connett

Walden Dissertations and Doctoral Studies

Diagnostic methods to effectively image dense breast tissue (DBT) can pose challenges for breast cancer screening. While conventional mammography is the gold standard for breast cancer screening, this technique has a low sensitivity to DBT and can miss about 78% of cancers in DBT, but magnetic resonance imaging (MRI) has a high sensitivity for imaging DBT, and produces a smaller number of false positives. The purpose of this study was to determine the extent to which conventional mammograms can miss breast cancer in women with DBT and to determine if an adjunct method of imaging DBT might detect breast cancers …

Women's Perspectives On Adequacy Of Screening And Treatment For Postpartum Depression, Gloria Marcia Watson

Walden Dissertations and Doctoral Studies

Postpartum depression affects some 10% to 20% of mothers. Its impact on the health and well-being of mothers and their infants is well documented. If not identified and addressed early, it can result in emotional burden, costly hospitalization and treatment, and, at worst, suicide and or infanticide. Empowerment theory was the conceptual framework for this hermeneutic phenomenological study. The purpose was to understand the lived experiences of the screening and treatment processes of 10 women from New York City experiencing postpartum depression and their perceived adequacy of the treatment received. In-depth interviews were used to investigate participants' lived experiences of …