Medicine and Health Sciences Commons^™

Determining The Potential Scalability Of Transport Interventions For Improving Maternal, Child, And Newborn Health In Pakistan, Naeem Uddin Mian, Mariam Zahid Malik, Sarosh Iqbal, Muhammad Adeel Alvi, Zahid Memon, Muhammad Ashraf Chaudhry, Ashraf Majrooh, Shehzad Hussain Awan

Centre of Excellence in Women and Child Health

Background: Pakistan is far behind in achieving the Millennium Development Goals regarding the reduction of child and maternal mortality. Amongst other factors, transport barriers make the requisite obstetric care inaccessible for women during pregnancy and at birth, when complications may become life threatening for mother and child. The significance of efficient transport in maternal and neonatal health calls for identifying which currently implemented transport interventions have potential for scalability.
Methods: A qualitative appraisal of data and information about selected transport interventions generated primarily by beneficiaries, coordinators, and heads of organizations working with maternal, child, and newborn health programs …

Adolescent Oral Health In Kentucky, 2007 National Survey Of Childhood Health Analysis, Kory Brinker

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

Research indicates that children raised by their grandparents can have poorer health outcomes than their peers living in mother or father based households. There is, however, little research that indicates how childhood oral health is affected by grandparents raising grandchildren. This study investigated grandparent based family structures, and how this family structure affects oral health of Kentucky children. Using data from the 2007 National Survey of Children’s Health, 113 Kentucky children were identified as living with a grandparent as a primary caregiver. Chi-Square analyses were utilized to assess the oral health status of these children, as well as what role …

Needle Stick Injuries And Blood Born Pathogen Exposures Among Health Care Workers In University Of Kentucky Health Care Facilities, Haider Sahmsulddin

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

Objectives:

The number of cases of needle stick and sharps-related injuries among healthcare workers are difficult to estimate due to underreporting. Multiple research studies have been done in this area but the scale of the problem is substantial and requires further attention. This study focuses on the cases of needle stick injuries and blood born pathogen exposure among health care workers at the University of Kentucky. The purpose of this study is to examine the rates of needle stick vs splash related injuries among the University of Kentucky health care workers from 2009 to 2014, and stratify the frequencies of …

Panel 1: Legal And Neuroscientific Perspectives On Chronic Pain, David Seminowicz, Amanda Pustilnik, Stephen Rigg, Andre Davis, Karen D. Davis, Hank Greely

Journal of Health Care Law and Policy

No abstract provided.

Panel 2: “Excess” Pain, Hyperalgesia, And The Variability Of Subjective Experience, Amanda Pustilnik, David Seminowicz, Stephen Rigg, Joel Greenspan, Morris Hoffman, Adam Kolber, Michael Pardo

Journal of Health Care Law and Policy

No abstract provided.

Panel 3: Chronic Pain, “Psychogenic” Pain, And Emotion, David Seminowicz, Amanda Pustilnik, M. Kaylie Gioioso, Jennifer Chandler, Robert Dinerstein, Jennifer A. Haythornthwaite, Tor D. Wager

Journal of Health Care Law and Policy

No abstract provided.

Panel 4: Translational Expectations And Issues: Making It Work In Practice, Amanda Pustilnik, David Seminowicz, M. Kaylie Gioioso, Martha Farah, Nancy Gertner, Stacey Tovino

Journal of Health Care Law and Policy

No abstract provided.

Breastfeeding Initiatives In Rural Kentucky: An Action Research Approach To Improving Public Health, Mallory D. Ratliff

Occupational Therapy Doctorate Capstone Projects

Breastfeeding offers numerous benefits for mother and baby and should be considered a priority for the health of communities as opposed to a parenting choice (American Academy of Pediatrics, 2012). Occupational therapists have a place in breastfeeding support, public health promotion, and guiding performance patterns (Pitonyak, 2014).

This study sought to identify what occupational therapists within the medical and community systems could offer stakeholders involved in breastfeeding support and neonatal care. Action research methods were utilized to allow stakeholders in a rural community in Kentucky to decide what objectives could benefit their area. A series of three focus groups were …

Community Based Programming Promoting Physical Activity, Jennifer Hight M.S. Otr/L

Occupational Therapy Doctorate Capstone Projects

Background: Childhood obesity is a growing health concern, negatively impacting a child’s quality of life, and ability to engage in daily occupations; while contributing to rising healthcare costs. This Capstone Project is a community based program encouraging the development of gross motor skills in the four year old population of a local childcare center to promote engagement in physical activity for less engagement in sedentary daily activities.

Purpose: Although many causal factors have been linked to childhood obesity, current review of the literature demonstrating effective interventions to decrease obesity in the pediatric population is limited, and there is a scarcity …

A Descriptive Study Of Menopausal Woman's Life Experiences, Stressors And Their Occupational Meanings, Melanie Ford Dr.

Occupational Therapy Doctorate Capstone Projects

This study describes some of the major physical and emotional occupational needs of menopausal women, and the direct impact this has on their relationships and overall well-being. The primary objective of this research project was to describe the life experiences of menopausal women and how various stressors affected their emotional, physical, and relational occupations. A descriptive grounded theory method was used to explore the stressors, their meanings, and the women’s unique perspectives of their menopausal experiences. Data were collected through semi-structured interviews and then coded and analyzed into key categories. From this information, specific themes were formulated, resulting in an …

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …

Enriching Occupational Therapy In Early Intervention: Using And Documenting The Evidence, Shelli Dry, Christine Myers

Occupational Therapy Doctorate Capstone Projects

Occupational therapists working in Kentucky’s Early Intervention System (First Steps) are required to use evidence-based practice within their treatment sessions. Evidence-based practice incorporates information from scientific research, the clinician’s expertise and the family’s values in an all-encompassing treatment approach. Implementing evidence-based practice into treatment sessions promotes efficiency in treatment by improving clinical outcomes in a shorter period of time. This capstone project was developed as a first step in identifying methods to promote the implementation and documentation of evidence-based practice into early intervention services. This project included developing an online continuing education course and exploring changes in occupational therapists perceptions …

The Behavioral Impact Of Knowledge On Breast Cancer Risk Reduction, Mia Hung

Walden Dissertations and Doctoral Studies

The purpose of this study was to investigate the behavioral impact of knowledge regarding the relationship between breast cancer, vitamin D supplementation, and sunlight exposure considering levels of self-efficacy and response-efficacy. The study was based on protection motivation theory, which attributes behavior change to cognitive processes related to perceived threats and has demonstrated efficacy in promoting breast cancer risk-reducing behaviors. The study employed a quasi-experimental research design based on a survey using SurveyMonkey. Participants were New York City-residing women ranging in age from 25 to 74 who were recruited via an invitation from SurveyMonkey. Correlation analysis and linear regression analysis …

The Association Between Rheumatoid Arthritis And Type 2 Diabetes Mellitus, Magaly Perez Nieves

Walden Dissertations and Doctoral Studies

A research report from the Centers for Disease Control and Prevention (CDC) indicated that more than 50% of people with diabetes mellitus (DM) in the United States (U.S.) also have arthritis. The diabetes population is disproportionately affected by arthritis, but there has been limited and inconsistent research to confirm the association between type 2 diabetes mellitus (T2DM) and rheumatoid arthritis (RA). The current study aimed to identify an association between T2DM and RA for noninstitutionalized U.S. adults between 1999 and 2012 using a nationally representative sample from the National Health and Nutrition Examination Survey (NHANES) database (n =31,488 ). A …

Retrospective Study Of Trauma Programming And, Domonique La'toya Rice

Walden Dissertations and Doctoral Studies

In state psychiatric hospitals in the United States, many patients are admitted with a history of trauma. Although trauma-focused interventions are offered within these psychiatric facilities, there remain issues with the higher-than-average length of treatment and rehospitalization rates for patients with a diagnosis of posttraumatic stress disorder or for those who are suffering with a history of trauma. This study investigated between group differences for measured levels of attendance and type of group intervention (which included the men's trauma recovery empowerment model, dialectical behavior therapy, and art and healing) on the risk for violence as measured by scores on the …

Improving The Experiences Of Informal And Formal Alzheimer's Disease And Dementias Caregivers, Roxroy Anthony Reid

Walden Dissertations and Doctoral Studies

Informal and formal caregivers of persons with Alzheimer's disease and related dementias (ADRD) encounter a more difficult and unique set of challenges than do caregivers of individuals with general disabilities. If adequate caregiver supports are not provided, caregivers may experience increased strain as the disease progresses, increasing the likelihood of unnecessary institutionalization of their care recipients and increasing the cost to the public. Using rational choice theory and political systems theory, the purpose of this study was to differentiate between the phenomenological experiences of formal and informal caregivers of ADRD patients. The overall research was a qualitative design that used …

A Pilot Study To Develop A Projective Method To Understand And Measure Resilience, Tina Chen

Walden Dissertations and Doctoral Studies

Many factors affect resilience, such as personality traits and environmental support. A projective assessment has many advantages to understand a person as a whole. Up to present, there is no projective assessment for resilience. This dissertation was a pilot study to develop a projective method. Sixty-five college students participated in this study. Participants used words to describe their feelings after hearing an open-ended story with a traumatic event; they also completed the story. In this study, the resilience ratio, defined as the ratio of the number of positive responses divided by the number of total responses, reflected the resilience level …

Reducing The Surgical Patient's Family Member's Anxiety Using An Electronic Patient Tracking Board, Pamela M. Barberi

Walden Dissertations and Doctoral Studies

Family members of surgical patients experience anxiety due to lack of consistent communication during the surgical process. Attending to the needs of the surgical patient's family members is an important factor easily forgotten in a busy clinical arena. The purpose of this project was to decrease the surgical patient's family member's anxiety by providing family members with timely and consistent information regarding the patient's progress through surgery. The theoretical foundation used was general systems theory showing that a change in one part of a system leads to change in the whole system with the use of improved communication and feedback. …

Icd-10-Cm Implementation Strategies: An Application Of The Technology Acceptance Model, Judith Monestime

Walden Dissertations and Doctoral Studies

The United States is one of the last countries to transition to the 10th edition of the International Classification of Diseases (ICD-10) coding system. The move from the 35-year-old system, ICD-9, to ICD-10, represents a milestone in the transformation of the 21st century healthcare industry. All covered healthcare entities were mandated to use the ICD-10 system on October 1, 2015, to justify medical necessity, an essential component in determining whether a service is payable or not. Despite the promising outcomes of this shift, more than 70% of healthcare organizations identified concerns related to education efforts, including lack of best practices …

Social Network Correlates Of Hcv And Hiv Transmission Risk Behaviors Among Injecting Drug Users, Victor Emanuel Reyes-Ortiz

Walden Dissertations and Doctoral Studies

Drug injection is an increasingly important risk factor in the transmission of blood-borne pathogens, including the hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The purpose of the study was to examine the influence of social network factors on HCV and HIV. The study was grounded in social network theory and sought to determine whether social network characteristics affect high-risk sexual and drug injection behavior as well as self-reported HIV and HCV status. The study design was a quantitative cross-sectional survey. A total of 181 participants in a needle exchange program completed a survey in Spanish assessing individual drug …

Awareness Of Diabetes Risk Associated With Individuals 18 And Older, Rebecca Jane Boone

Walden Dissertations and Doctoral Studies

The risk of developing Type 2 diabetes is increasing at epidemic proportions, and is 12-17% higher in Marion County Florida than it is across the state, based on Florida Department of Health statistics. The purpose of this DNP project was to determine if awareness of individual risk of developing Type 2 diabetes through a questionnaire would result in high-risk participants agreeing to attend a diabetes prevention program (DPP) at a local medical clinic. The health belief model and Rosswurm and Larrabee's model for change were used as frameworks. The review of the literature showed that prevention programs were highly effective …

Cultural Beliefs And Experiences Of Formal Caregivers Providing Dementia Care To American Indians, Damon Grew Syphers

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is a significant public health concern for all elders in the United States. It is a particular concern for the American Indian (AI) population, which is one of the fastest-aging populations in the United States and the smallest, most underrecognized, and most culturally-diverse group in the country. A formal caregiver understanding of AD in the AI population is scarce. This phenomenological study was designed to discern what is known about AD in the AI population by exploring the cultural beliefs and experiences of formal caregivers who provide care for AI dementia patients. Specifically, this study sought to …

Reimportation Of Prescription Drugs As Contributing Component To Patient Drug Adherence: A Qualitative-Grounded Theory Study, Jeffrey Tubbs

Walden Dissertations and Doctoral Studies

Pharmaceutical drugs are one of the most socially important heath care products. They are part of many individuals' everyday lives, from the eradicating of diseases at birth to treating patients at the end of life. However, for many patients access is prevented due to expensive cost. This study explored cost-related non-adherence (CRN) and researched if reimportation of pharmaceutical drugs from other countries could increase patient drug adherence. The perceptions of 10 patients and 10 providers in Maine were assessed. Maine is the only state that allowed its citizens to purchase prescription drugs from abroad. The research questions addressed (a) how …

The Effect Of A Culture Of Safety On Patient Throughput, Laurie Lee Dawn Dillon

Walden Dissertations and Doctoral Studies

There is a national movement to create improvements in patient safety and outcomes due to evolutionary changes in the healthcare. Many health care organizations are using the framework of a culture of safety in order to create a reliable and stable work environment that emphasizes safety and improves patient outcomes. Patient throughput, defined as the active management of the supply of patient beds (rooms for occupation) to the demand of patients to beds and the length of time it takes for this action to occur, has been identified as one of the areas in need of improvement. This study considered …

Health Care Seeking Behavior And Provider Responses For Hcv-Positive African Americans, Kathleen Susanna Bailey

Walden Dissertations and Doctoral Studies

Of the 3.5 million persons infected with chronic HCV in the United States, the African American population is the largest racial group with chronic HCV. Disparities in access to care and treatment involve a complex set of individual, interpersonal, socioeconomic, and environmental factors that influence the course of HCV infection in the African American population, resulting in poorer outcomes and survival. Drawing upon both the theory of reasoned action and the theory of planned behavior, this study was conducted to determine whether the seeking of health care by HCV-positive African Americans and the responses of health care providers to HCV-positive …

Promotion Of The Hospital's Patient Portal, Courtnie Jones Burrell

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services wanted to ensure that electronic health records were used in a meaningful manner to improve coordination and quality of patient care. In 2011, the federal government began offering monetary incentives to help healthcare facilities and providers adopt technology that supported patient access and increased their ability to manage their own health. The hospital where this project took place encouraged patients’ involvement in their health by providing a patient portal, yet the public has underutilized it. The purpose of this project was to develop an evidence-based strategy for future implementation at the hospital that …

Factors Influencing The Adoption Of Learning Management Systems By Medical Faculty, Kristy Burrough

Walden Dissertations and Doctoral Studies

Despite recommendations by the Association of American Medical Colleges regarding

the adoption of technology in medical universities, faculty are still reluctant to adopt new

learning technologies. The purpose of this qualitative interview study was to determine

the factors existing in the adoption of learning management technology among late

adopters within the faculty of colleges labeled as comprehensive academic medical

centers. Using the Everett Rogers diffusion of innovations theory as its framework, this

study sought to ascertain the factors late adopters identify as preventing them from

adopting technology and to determine what measures they suggest to increase technology

adoption among their …

Financing School-Based Health Centers: Sustaining Business Operational Services, Ingrid Monique Hayes-Burrell

Walden Dissertations and Doctoral Studies

School-based health centers (SBHCs) have faced challenges in securing adequate funding for operations and developing sound business systems for billing and reimbursement. Specifically, administrators often lack strategies to develop and sustain funding levels to support appropriate resources for business operations. The focus of this descriptive study was to explore best practice strategies to develop and sustain funding through the experiences of SBHC administrators. The conceptual framework included Elkington's sustainability theory, which posits that corporate social responsibility, stakeholder involvement, and citizenship improve manager's effect on the business system. Twenty full-time SBHC administrators working in separate locations throughout the state of Maryland …

The Effects Of The Night Shift On Nursing Staff Of An Inpatient Hospice Facility, Carolyn Dopson Horton

Walden Dissertations and Doctoral Studies

The night shift environment in an inpatient hospice facility is unique in care and relegates challenging situations for the nursing staff. Using the Parse methodology, the purpose of this project was to explore the challenges faced by inpatient hospice facility night shift nursing staff in providing a continuum of care for dying patients and their families. Nine night shift hospice nurses participated in 45-60 minute interviews. The interviews were conducted in a hospice quiet room or a designated place of comfort for the participant, which allowed for dialogical engagement. The interviews were unstructured with open-ended questions about lived experiences. The …

Providers' Knowledge Of The U.S. Health Care System And Their Medical Practice Choices: A Study Of Physicians, Residents, And Non-Physician Practitioners, Cora Case

Walden Dissertations and Doctoral Studies

The expansion of health insurance through health care reform has reduced the number of uninsured. but access to providers has not been addressed. Understanding the relationship between practice choices and aptitude of health policy and delivery is essential to determine other factors or motivators that contribute to the development of health care access policies. This descriptive study explored the value-laden elements of health care reform, such as social constructions, to learn whether there are implicit ways to address the issue of access to health care in the United States. Schneider and Ingrams's conceptualization of policy making through social construction was …