Medicine and Health Sciences Commons^™

Setting Up Triage Services In The Emergency Department: Experience From A Tertiary Care Institute Of Pakistan. A Journey Toward Excellence., Munawar Khursheed, Jabeen Fayyaz, Ahsan Jamil

Department of Emergency Medicine

The history of triage started from the French battle field for prioritizing patients. Emergency triage was started in early 1950's in USA in order to treat the sickest first. It has now become an integral component of all emergency departments (ED). The basic aim of triage is not only to sort out patients according to the criticality of their illness, but it also serves to streamline the patient flow. This will ultimately enable the ED physician to provide right management at the right time to the right patient in the available resources. In turn has a positive impact in reducing …

Review And Analysis Of Quality Healthcare System Enhancement In Developing Countries., Zohra Kurji, Zahra Zahra Shaheen Premani Shaheen, Yasmin Mithani

School of Nursing & Midwifery

Quality has multidimensional perspectives. It is a continuous and dynamic process. A systematic search of national and international literature was conducted from peer-reviewed databases MEDLINE, CINAHL and PubMed during January to July 2012. There are many frameworks to assess and measure quality. All frameworks give some levels in which quality could be assessed. Therefore, multiple frameworks should be used for measuring quality based on the situation and environment. Measuring quality is very important for primary healthcare programme, especially for developing countries because if we will not do quality assessment, our resources will not be utilised effectively and people may divert …

‘What About The Mother?’ Women׳S And Caregivers׳ Perspectives On Caesarean Birth In A Low-Resource Setting With Rising Caesarean Section Rates, Helena Litorp, Andrew Mgaya, Hussein Kidanto, Sara Johnsdotter, Birgitta Essén

Faculty of Health Sciences, East Africa

Objective in light of the rising caesarean section rates in many developing countries, we sought to explore women׳s and caregivers׳ experiences, perceptions, attitudes, and beliefs in relation to caesarean section.

Design qualitative study using semi-structured individual in-depth interviews, focus group discussions, and participant observations. The study relied on a framework of naturalistic inquiry and data were analysed using thematic analysis.

Setting a public university hospital in Dar es Salaam, Tanzania.

Participants we conducted a total of 29 individual interviews, 13 with women and 16 with caregivers, and two focus group discussions comprising five to six caregivers each. Women had undergone …

Radiobiological Evaluation Of Intensity Modulated Radiation Therapy Treatments Of Patients With Head And Neck Cancer: A Dual-Institutional Study, G. Narayanasamy, A. P. Pyakuryal, S. Pandit, J. Vincent, C. Lee, P. Mavroidis, N. Papanikolaou, Mahesh Kudrimoti, T. T. Sio

Radiation Medicine Faculty Publications

In clinical practice, evaluation of clinical efficacy of treatment planning stems from the radiation oncologist's experience in accurately targeting tumors, while keeping minimal toxicity to various organs at risk (OAR) involved. A more objective, quantitative method may be raised by using radiobiological models. The purpose of this work is to evaluate the potential correlation of OAR-related toxicities to its radiobiologically estimated parameters in simultaneously integrated boost (SIB) intensity modulated radiation therapy (IMRT) plans of patients with head and neck tumors at two institutions. Lyman model for normal tissue complication probability (NTCP) and the Poisson model for tumor control probability (TCP) …

The Role Of Community Pharmacy-Based Vaccination In The Usa: Current Practice And Future Directions, Albert Bach, Jeffery A. Goad

Pharmacy Faculty Articles and Research

Community pharmacy-based provision of immunizations in the USA has become commonplace in the last few decades, with success in increasing rates of immunizations. Community pharmacy-based vaccination services are provided by pharmacists educated in the practice of immunization delivery and provide a convenient and accessible option for receiving immunizations. The pharmacist's role in immunization practice has been described as serving in the roles of educator, facilitator, and immunizer. With a majority of pharmacist-provided vaccinations occurring in the community pharmacy setting, there are many examples of community pharmacists serving in these immunization roles with successful outcomes. Different community pharmacies employ a number …

Can Dentistry Have Two Contracts With The Public?, David A. Nash

Oral Health Science Faculty Publications

The social contract is an implicit agreement between parts of society and society as a whole. Since the Middle Ages, the learned professions, recently including dentistry, have had a covenantal relationship with the public based on trust, exchanging monopoly privileges for benefiting the public good. Unlike commercial trade in commodities, professional relationships are grounded in ensuring an adequate level of oral health to all. A second contract is emerging where dentists relate to society as business operators, exchanging commodity services for a price. Recent actions by the Federal Trade Commission and the U.S. Supreme Court make it unlikely that dentistry …

School Of Nursing Newsletter July 2015, Southern Adventist University School Of Nursing

Southern Nursing - School of Nursing Newsletter

The July 2015 issue of the newsletter features articles on faculty sabbaticals, the new summer session, spring break mission trips, and the President's Award to office manager Conni Cash.

The Challenges Of Afghanistan And Iraq Veterans’ Transition From Military To Civilian Life And Approaches To Reconnection, Jennifer Ahern, Miranda Worthen, Jackson Masters, Sherri Lippman, Emily Ozer, Rudolf Moos

Faculty Publications

Afghanistan and Iraq veterans experienced traumas during deployment, and disrupted connections with friends and family. In this context, it is critical to understand the nature of veterans’ transition to civilian life, the challenges navigated, and approaches to reconnection. We investigated these issues in a qualitative study, framed by homecoming theory, that comprised in-depth interviews with 24 veterans. Using an inductive thematic analysis approach, we developed three overarching themes. Military as family explored how many veterans experienced the military environment as a “family” that took care of them and provided structure. Normal is alien encompassed many veterans experiences of disconnection from …

Statement Of The Third International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015, Tamara Hew-Butler, Mitchell H. Rosner, Sandra Fowkes-Godek, Jonathan P. Dugas, Martin D. Hoffman, Douglas P. Lewis, Ronald J. Maughan, Kevin C. Miller, Scott J. Montain, Nancy J. Rehrer, William O. Roberts, Ian R. Rogers, Arthur J. Siegel, Kristin J. Stuempfle, James Winger, Joseph G. Verbalis

Health Sciences Faculty Publications

The third International Exercise-Associated Hyponatremia (EAH) Consensus Development Conference convened in Carlsbad, California in February 2015 with a panel of 17 international experts. The delegates represented 4 countries and 9 medical and scientific sub-specialties pertaining to athletic training, exercise physiology, sports medicine, water/sodium metabolism, and body fluid homeostasis. The primary goal of the panel was to review the existing data on EAH and update the 2008 Consensus Statement.¹ This document serves to replace the second International EAH Consensus Development Conference Statement and launch an educational campaign designed to address the morbidity and mortality associated with a preventable and treatable …

Know Your Value: Negotiation Skill Development For Junior Investigators In The Academic Environment—A Report From The American Society Of Preventive Oncology's Junior Members Interest Group, Allison B. Burton-Chase, Maria C. Swartz, Stephanie A. Navarro Silvera, Karen Basen-Engquist, Faith E. Fletcher, Peter G. Shields

Department of Public Health Scholarship and Creative Works

The American Society of Preventive Oncology (ASPO) is a professional society for multidisciplinary investigators in cancer prevention and control. One of the aims of ASPO is to enable investigators at all levels to create new opportunities and maximize their success. One strategy adopted by ASPO was to develop the Junior Members Interest Group in 1999. The Interest Group membership includes predoctoral fellows, postdoctoral fellows, and junior faculty members who are provided career development and training opportunities (1). Responsibilities of the members of the Junior Members Interest Group include serving on the ASPO Executive Committee and the Program Planning …

What Matters Most For Children: Influencing Inequality At The Start Of Life, Eboni C. Howard

Mickey Leland Center Information Portal

This paper provides an overview of the science of early childhood and summarizes the disparities and the opportunity gaps stemming from inequalities. It also describes categories of programs, services and policies for children birth to age 3 that might affect the extent of inequality and provide supportive early life experiences.

Easing The Transition From Clinician To Nurse Educator: An Integrative Literature Review, Jane S. Grassley, Andrea Lambe

Nursing Faculty Publications and Presentations

Background: Experienced clinicians who choose to become academic nurse educators bring to their new faculty role strong clinical skills and a desire to influence the next generation of nurses. However, many find themselves unprepared for the challenges they encounter. Intentional mentoring is needed to ease their transition from clinician to nurse educator. Method: An integrative literature review was conducted to identify the essential components of a comprehensive mentoring program to facilitate a positive transition experience from expert clinician to novice nursing faculty. Searches were conducted of the ProQuest Central and CINAHL databases for peer-reviewed articles. Results: A review of 17 …

Nanoformulation For Anticancer Drug Delivery: Enhanced Pharmacokinetics And Circulation, Gaurav Parekh

Doctoral Dissertations

In this study, we have explored the application of the Layer-by-Layer (LbL) assembly technique for improving injectable drug delivery systems of low soluble anticancer drugs (e.g. Camptothecin (CPT), Paclitaxel (PTX) or Doxorubicin (DOX)). For this study, a polyelectrolyte shell encapsulates different types of drug nanocores (e.g. soft core, nanomicelle or solid lipid nanocores).The low soluble drugs tend to crystallize and precipitate in an aqueous medium. This is the reason they cannot be injected and may have low concentrations and low circulation time in the blood. Even though these drugs when present in the cancer microenvironment have high anti-tumor inhibition, the …

Assessing Idaho Rural Family Physician Scope Of Practice Over Time, David Schmitz, Ed Baker, Lisa Mackenzie, Logan Kinney, Ted Epperly

Public and Population Health Faculty Publications and Presentations

Context: An important consideration determining health outcomes is to have an adequate supply of physicians to address the health needs of the community. Purpose: The purpose of this investigation was to assess scope of practice factors for Idaho rural family physicians in 2012 and to compare these results to findings from a 2007 study. Methods: The target population in this study was rural family physicians in Idaho counties with populations of fewer than 50,000. Identical surveys and methods were utilized in both 2007 and 2012. Results: The physician survey was mailed to 252 rural physicians and was returned by 89 …

Pregnancy Apps: A Closer Look At The Implications For Childbirth Educators, Christine Frazer, Leslie Hussey, Emily Bosch, Michelle Squire

Walden Faculty and Staff Publications

Most pregnant women download an average of three pregnancy apps during their gestational period. There are no set standards in place for what needs to be included in an app’s description leaving consumers to decide for themselves when it comes to selecting the right app to download. The childbirth educator must be knowledgeable about pregnancy apps, in-tune as to what apps their clientele download, and how to analyze them for credibility. This article presents characteristics associated with women of childbearing age (i.e. Millennial/Net generation); the reasons why pregnant women are turning to apps; the limitations of apps, and the childbirth …

Assessing The Health And Safety Aspects Of Reboiler Maintenance Activities, William Svendsen

Graduate Theses & Non-Theses

Maintenance on equipment at an oil and gas facility is an everyday occurrence in Alberta, Canada. Due to their inherent hazards, especially from explosion, fire and chemicals, these facilities (refineries and upgraders) are tightly regulated places in which to work. In these plants, hazards can come in many different shapes and forms; all of which must be mitigated to ensure the safety of both the equipment and the workers. Examples of such hazards include hydrogen sulphide (H2S), naturally occurring radioactive material (NORM), ergonomics and noise.

The intent of this survey was to determine if there were any gaps in Client …

Exposure Assessment To Respirable Crystalline Silica Particles During Airfield Maintnenance Concrete Operations, Kenneth Pratt

Graduate Theses & Non-Theses

Crystalline silica is found in naturally occurring and manmade materials. According to OSHA, approximately 2.2 million people are exposed to silica each year (OSHA, 2002). These individuals are at an increased risk of silicosis, an incurable disease that is often fatal. The objective of this project was to determine if airport maintenance workers are exposed to crystalline silica over the current permissible exposure limit. Two days of sampling was conducted and it was determined that there was some exposure to the Airfield Paint Crew exceeding the action level. The highest employee exposure was at 0.362 mg/m3 with a corresponding PEL …

Heat Stress Prevention Program For Workers In Demilitarization Protective Ensemble At Pueblo Chemical Agent-Destruction Pilot Plant Training Facility, Joseph Padayhag

Graduate Theses & Non-Theses

The Pueblo Chemical Agent-Destruction Pilot Plant (PCAPP) is being constructed to dispose of the entire stockpile of sulfur mustard contained in munitions stored at Pueblo Chemical Depot, Colorado. The PCAPP Training Facility provides courses on protective measures necessary for making entries into areas with hazardous concentrations of chemical warfare agents in air. Students are trained to work in Demilitarization Protective Ensemble (DPE), an encapsulating, impermeable, and positive pressure suit. The course includes wearing the suit and performing tasks to simulate work in PCAPP toxic areas.

Wearing DPE will increase the heat stress load for workers making entries. The PCAPP heatstress …

Occupational Silica Exposure For The Fuel Distributing Company On Hydraulic Fracturing Locations, Caleb Moore

Graduate Theses & Non-Theses

This report investigates the potential exposure to respirable crystalline silica experienced by fuel distributing employees on hydraulic fracturing locations. Hydraulic fracturing is an oil and gas technique used to develop shale formations all across the United States of America. This is done by injecting large volumes of water, sand, and treatment chemicals under high pressure into oil wells within the shale formation. This well stimulation is possible due to the high pressure of the fluid, which creates and opens cracks and fissures in the formation. The sand contained inside the fluid flows into these opened fissures and becomes wedged, holding …

A Pilot Study To Assess The Impact Of The Proposed Crystalline Silica Standard In The Construction Industry, Kendra Lyons

Graduate Theses & Non-Theses

No worker should have to suffer a life altering or fatal illness for the sake of a job, yet thousands of workers have died or developed a disabling illness from occupational exposure to silica. The Occupational Safety and Health Administration (OSHA) has not updated the permissible exposure limit (PEL) for silica since 1971. The current PEL for respirable crystalline silica in the construction industry is 250 mppcf/ (%SiO₂ + 5) TWA which is adjusted per the amount of silica in the sample. This exposure limit is known to cause silicosis, a disease developed from silica exposure. The construction industry …

Health And Safety Considerations Associated With Sodium Debris Bed Experimental Nuclear Assembly Dismantlement, Alan Carvo

Graduate Theses & Non-Theses

As the end of World War II approached, scientists who developed the processes to generate nuclear material for war-time use grew interested in applying those technologies to the generation of power for cities across the United States. Concerns about the availability of natural uranium led to the development of self-fueling fast neutron breeder reactors. In order to produce plutonium at a rate greater than the consumption of uranium during a nuclear chain reaction, high-energy “fast” neutrons are required. Fast neutron reactors utilize low melting-point metals, like sodium, to provide cooling.

After the earliest reactors experienced trouble providing adequate cooling during …

Literature Review Of Studies Linking Benzene And Leukemia, Kylene Owens

Graduate Theses & Non-Theses

The purpose of this review was to discover how the by-products of oil production, such as benzene played a significant role in health issues, particularly leukemia. The objective is to evaluate the association of benzene exposure and leukemia through laboratory toxicity studies and public and occupational epidemiology studies. Multiple articles were researched to find a link between benzene exposure and the development of leukemia. Several articles were viewed and some eliminated due to their irrelevant to this paper or their duplicated information with other articles. A total of six articles were selected for this paper. Research has shown that benzene …

Takotsubo Cardiomyopathy, Angela J. Occidental

Nursing Student Class Projects (Formerly MSN)

Takotsubo cardiomyopathy is a rare, reversible form of cardiomyopathy. First cases of takotsubo cardiomyopathy were described in Japan, twenty years ago (Milinis, & Fisher, 2012). takotsubo cardiomyopathy is a transient left ventricular dysfunction, typically triggered by severe emotional or physical distress. Left ventricular ballooning is characteristic of Takotsubo syndrome. Images of this ballooning resemble a takotsubo vessel used in Japan for collecting octopus, thus the reason for the syndrome name (Pelliccia, et. al, 2014). In recent years, this cardiomyopathy has been described as “Broken heart syndrome” because severe emotional stress has been implicated as the cause of this cardiomyopathy in …

Investigating Duchenne’S Muscular Dystrophy, Ashley Beaujon

Nursing Student Class Projects (Formerly MSN)

Young boys usually present with disordered or delayed motor development, muscle weakness, and possible speech delays in early childhood (Ruiten et al, 2014). The first symptoms almost always show up prior to the age of six years. Parents may notice their young child with DMD having a hard time standing up, walking, or climbing stairs, and many will eventually need a wheelchair to get around (Brennan, 2014). Initial blood tests obtained are remarkable for an elevated creatine kinase (CK) and then diagnosis is typically confirmed with a genetic test showing a mutation in the dystrophin gene (Ruiten et al, 2014). …

Acute Pancreatitis, Laura Skidmore

Nursing Student Class Projects (Formerly MSN)

Acute pancreatitis (AP) can be a singular incidence, a relapsing process or exacerbations of chronic pancreatitis. AP is a rapidly developing inflammatory disorder of the pancreas and can affect other organ systems. The process begins when pancreatic enzymes are activated prematurely and leak into surrounding tissue. The digestive process begins before reaching the intestines. AP is characterized clinically by abdominal pain and elevated levels of pancreatic enzymes in the blood. The pathogenesis is not fully understood however, a number of conditions are known to induce the disorder such as gallstones and chronic alcohol abuse (Schub & Kornusky, 2014)

Cardiac Tamponade, Ashley Miner

Nursing Student Class Projects (Formerly MSN)

The topic the author chose to research is cardiac tamponade. Cardiac tamponade occurs when fluid builds up in the pericardial cavity, which is the cavity that surrounds the heart. Cardiac tamponade can occur due to various reasons, including myocardial infarctions, pericarditis, traumas, and placement of pacer wires. Palpitations, chest pain, and shortness of breath are common symptoms that occur with cardiac tamponade. Pericardiocentesis and a pericardial window are two interventions that are commonly used to treat cardiac tamponade. Cardiac tamponade is a medical emergency and without any intervention, may lead to cardiac arrest and possible death. The author chose cardiac …

Myasthenia Gravis And Implications For The Certified Registered Nurse Anesthetist, Matthew Predick

Nursing Student Class Projects (Formerly MSN)

In healthcare and, specifically anesthesia, there are many conditions that require various considerations by the prudent provider. An example of a condition requiring special attention is myasthenia gravis. Myasthenia gravis is an autoimmune disease in which skeletal muscle weakness and rapid fatigue result from destruction of nicotinic acetylcholine receptors [7]. Although the prevalence is not overwhelmingly high with most recent estimates of prevalence around 14 to 20 per 100,000 people in the United States [5] and 20 per 100,000 worldwide [9], inappropriate perioperative management of those with this ailment can result in serious consequences. Understanding the pathophysiology, various treatments (both …

Idiopathic Pulmonary Fibrosis: Understanding Has Led To Exciting Treatments, William Metz

Nursing Student Class Projects (Formerly MSN)

Pulmonary fibrosis can be described as an excessive amounts of fibrous connective lung tissue in the lung. Idiopathic pulmonary fibrosis(IPF) is the most common form of interstitial lung disease(ILD). When an obvious cause cannot be determined, a diagnosis of Idiopathic pulmonary fibrosis is made. The mean survival for patients is approximately 3-5 years from time of diagnosis. IPF is found primarily in men over 50 years of age, with a history of cigarette smoking with concurrent environmental and occupational inhalation exposures(Leslie, 2011, p. 592). Pulmonary fibrosis has been identified by early pathologists at the beginning of the last century. During …

Cervical Spinal Cord Injury, Melissa Schimmel

Nursing Student Class Projects (Formerly MSN)

A spinal cord injury (SCI) can occur at any level of the spinal cord. A SCI involves an interruption between the brain and the body due to an injury or damage to the spinal cord (Sheppard Center, 2011, p1.). The location and extent of the injury is important because it will determine the severity and extent of dysfunction. The higher the injury is to the spinal cord, the more severe the loss of motor function (Sheppard Center, 2011, p.4). The spinal cord injuries are classified by based on the extent of injury, motor and sensory losses. The injury is considered …

Abdominal Aortic Aneurysm: A Silent Killer, Kristen Springer

Nursing Student Class Projects (Formerly MSN)

Rupture of an abdominal aortic aneurysm (AAA) is a significant cause of mortality in the United States. “Often asymptomatic, AAA is considered a silent killer because it frequently remains undiagnosed until the time of rupture or the patient’s death” (Gordon & Toursarkinssian, p. 242). As healthcare professionals, being aware of the pathophysiology, risk factors and symptoms influencing this disease is important in aiding early diagnosis and treatment, helping to reduce complications and mortality rates of those affected.