Medicine and Health Sciences Commons^™

Suicide Risk Assessment In A Psychiatric Medical Unit, Olga D'Argenio

Master's Projects

Suicide is a major health concern in the United States. In a scholarly article, Hutton (2015) found that annually, 2.2 million adults plan suicide, 8.3 million have thoughts of suicide, and 1 million adults attempt suicide. A 2013 Center for Disease Control (CDC) analysis found that suicide rates among persons age 35 to 64 years have increased during the years of 1999-2010 by 28.4%. Bolton, Gunnell, and Turecki (2015) found that suicide is a major international public health problem claiming one life every 40 seconds. The study also states suicide is a second leading cause of death in people age …

Re-Optimization Of Radiation Therapy Dose To The Prostate Using Cbct: Reducing Dose To Organs At Risk, R. Charles Keider Jr.

Masters Theses

Cancer of the prostate is the second most common cancer among American males. The prostate is small gland, located in the pelvis, posterior to the bladder and anterior/inferior to the rectum. Due to this location when irradiating the prostate the normal tissue organs at risk are the bladder and rectum. Negative effects seen when these structures are irradiated can include; bladder stricture, dysuria, hematuria, diarrhea, rectal bleeding, and proctitis.

In order to eliminate or reduce these negative effects more precise and accurate treatment techniques have been employed. Intensity Modulated Radiation Therapy (IMRT) has been successful in achieving greater precision when …

Evaluation Of The Nutritional Options For Wellness (Now) Program: Mitigating Cardiovascular Disease And Type 2 Diabetes Through Food Pantries, Sarah L. Henning

Masters Theses

Individuals with a lower socioeconomic status are at higher risk for chronic disease diagnosis and complications (Gerteis et al., 2014). The NOW Program is a social service program that was created in order to relieve some of the burden placed on these individuals utilizing the charitable food system. The purpose of the study was to perform a quantitative program evaluation on the NOW Program which is administered by pantry coordinating organization. The NOW Program connects chronically ill, low income members of Kent County with local food pantries that offer diet specific food and health education about their specific chronic disease …

Juvenile Idiopathic Arthritis: A Systematic Review Of Occupational Therapy Interventions, Meredith L. Aja, Katie L. Cole, Trenton S. Warning

Pediatrics

Background: The purpose of this systematic review is to describe the current role of occupational therapy (OT) in the treatment of Juvenile Idiopathic Arthritis (JIA). JIA is an umbrella term that encompasses six subtypes of the disease. JIA is one of the most common childhood chronic diseases and can be accompanied by symptoms such as pain, stiffness, and loss of function, as well as psychosocial impacts. JIA participants generally receive pharmacological treatment, but less commonly receive therapeutic interventions to help reduce symptoms. Individualized treatment plans are necessary for clients with JIA due to the diverse nature of the disease. …

Evidence Based Protocol: Improving Depression Assessments In Primary Care, Katherine E. Hoffhines

Master's Projects

Depression is a destructive condition that can have a profoundly negative impact on quality of life, wellbeing, and health (Thase, Stowell, Berry, Mencia & Blum, 2014). Worldwide, depression is the leading cause of medical disability costing the health care system over $210 billion annually (World Health Organization, 2014; Greenberg, Fournier, Sisitsky, Pike & Kessler, 2015). The World Health Organization (2016) estimates depression affects 350 million people of all ages globally. One and three adults in the U.S. will experience a major depressive episode during their lifetime (Kessler, Petukhova, Sampson, Zaslavsky & Wittchen, 2012; Rubin, Ciechanowski, Egede, Lin & Lustman, 2004). …

Patient Falls: Reducing Patient Falls With Injury, Frederick Comer

Master's Projects

The occurrence of patient falls is a very important health concern facing the healthcare industry. Many patients not only experience falls, but have falls with an injury. This is a patient safety concern that can have serious effects on patient outcomes, is a leading cause of patient injuries in hospitals, and are costly adverse events (Trepanier & Hilsenbeck, 2014). It is important that healthcare professionals determine ways to prevent what has been deemed a preventable event (Bemis-Dougherty & Delaune, 2008). In 2005 The Joint Commission (TJC) included patient falls with injury as part of their National Patient Safety Goals (Bemis-Dougherty …

Postdischarge Calls In The Ed: Improving Quality And Efficiency, Megan E. Pashnik

Master's Projects

No abstract provided.

Evidence Based Protocol: Discharge Delays In The Acute Care Setting, Kylie C. Schaberg

Master's Projects

According to Batalden, Nelson, Godfrey and Lazar (2011, p, 25), the clinical microsystem is a “place where patients, families and health caregivers meet” and encompasses all interactions from the moment a patient enters the system up to and including when the patient leaves the system. In order to understand the complex and dynamic changes that occur at the microsystem level, a thorough assessment must be completed. The purpose of this chapter is to gain a greater understanding of the mechanism of the microsystem and the effects that this microsystem has on the process for discharging patients from the hospital setting …

Lgbt Client Satisfaction At A University-Associated Primary Care Center, Christopher M. Bouma

Doctoral Projects

Sexual minority individuals are a vulnerable population. Historically this has led to worse access to care and worse health outcomes compared to heterosexual individuals; this can be addressed through changes to practice. Patient satisfaction has also been a health care focus in recent years for all patients. This project examined patient satisfaction in a small university-associated primary care center and compared patient satisfaction scores for sexual minorities to heterosexual respondents. This was conducted after a series of lesbian, gay, bisexual, and transgender (LGBT) educational initiatives with center staff. A total of 73 individuals chose to participate. Most individuals were highly …

Conquering The Kitchen: Cooking And Older Adult Male Caregivers, Miranda Jenkins, George Kukich

Older Adult

Older adult men who have taken on an unfamiliar role as a caregiver find themselves at a loss with how to conduct meal preparation and cooking (Russell, 2007). The purpose of this study was to explore the effects of a specialized cooking class on the perceptions of older adult male caregivers. Method: This mixed method, retrospective study analyzed surveys from subjects who attended a cooking class designed specifically for male caregivers. Participants were 60 years of age or older and were required to be living in one of nine participating local counties. Results: The participants reported that the course expanded …

A Retrospective Study Of Handwriting Skills Of Kindergarten Students, Danielle Benter, Dawn Fields, Catherine Nichols

Pediatrics

OBJECTIVE: The purpose of this study was to guide teachers and occupational therapist in recognizing handwriting needs in order to provide appropriate early intervention support for handwriting.

METHOD: 218 kindergarten students in a public school district were screened for handwriting ability using the Handwriting Without Tears and the Public School’s copy screeners. Students were assessed three times during the 2014 to 2015 school year on letter memory, line placement, letter orientation, copy legibility, and copy placement skills.

RESULTS: The results indicated that winter scores were a better predictor of spring scores. Significant effects in four out of five variables were …

Integrating Interprofessional Experience Throughout A First-Year Physician Assistant Curriculum Improves Perceptions Of Health Care Providers, Martina Reinhold, Sango Otieno, Theresa Ann Bacon-Baguley

Funded Articles

Purpose: Interprofessional collaboration is essential in Physician Assistant (PA) practice. Therefore, a three-semester sequence of Hospital Community Experience (HCE) was implemented during the didactic phase of the PA program providing students with weekly opportunities to shadow/observe health care professions.

Methods: This longitudinal, cohort study evaluated the effect of the HCE on PA students' perceptions of other health care professions prior to HCE, immediately after HCE, and one year later, after the clinical clerkships. The Interprofessional Perception Scale (IPS) survey was used to assess perceptions.

Results: Comparison of the IPS between the Pre-HCE and subsequent time points revealed statistically significant positive …

Replicable Interprofessional Competency Outcomes From High-Volume, Inter-Institutional, Interprofessional Simulation, Deborah Bambini, Matthew Emery, Margaret De Voest, Lisa Meny, Michael J. Shoemaker

Peer Reviewed Articles

There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE) experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students’ perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students …

Driving In Early-Stage Alzheimer’S Disease An Integrative Review Of The Literature, Rebecca Davis, Jennifer M. Ohman

Funded Articles

One of the most difficult decisions for individuals with Alzheimer’s disease (AD) is when to stop driving. Because driving is a fundamental activity linked to socialization, independent functioning, and wellbeing, making the decision to stop driving is not easy. Cognitive decline in older adults can lead to getting lost while driving, difficulty detecting and avoiding hazards, as well as increased errors while driving due to compromised judgment and difficulty in making decisions. The purpose of the current literature review was to synthesize evidence regarding how individuals with early-stage AD, their families, and providers make determinations about driving safety, interventions to …

Identification Of Nonalcoholic Fatty Liver Disease In Patients With Hepatitis C: Using Evidence Based Guidelines To Improve Diagnosis And Transition Of Care From Specialty Care Provider To Primary Care Provider, Debra B. Bayus

Doctoral Projects

Chronic liver disease is a process that involves progressive destruction and regeneration of the liver causing fibrosis, cirrhosis and hepatocellular carcinoma, and early death. Persons with chronic liver disease treated for hepatitis C with abnormal radiological imaging consistent with increased fat content in the liver (hepatic steatosis) should be evaluated for nonalcoholic fatty liver disease (NAFLD). However, individuals treated at a community hepatitis C treatment clinic are currently not being evaluated for NAFLD. In addition, if NAFLD is diagnosed, management of these co-occurring conditions is required to delay disease progression. Factors contributing to gaps in NAFLD care include: poor communication, …

Helping Others To Keep Hope, Take Action, And Gain Control Of Generalized Anxiety Disorder, Stephanie Hamilton

Honors Projects

No abstract provided.

Genetic Amplification: Quantitative Polymerase Chain Reaction And Its Problems And Uses, Drew Mcwilliams

Honors Projects

Quantitative polymerase chain reaction (qPCR), also called real-time PCR, has become a cornerstone of DNA analysis, enabling detection of minute amounts of nucleic acids (Whittwer et. al, 1997). In 1983, Kary Mullis developed a new method of genetic amplification—the polymerase chain reaction [PCR] (Bartlett & Stirling, 2003). A little over 20 years later, PCR now is a common and often crucial technique used in medical and biological research laboratories for a variety of applications. Some of these applications include DNA cloning for sequencing, DNA-based phylogeny, the diagnosis of hereditary diseases, the identification of genetic fingerprints (used in forensic sciences and …

Sexual Health Education Among The Intellectually And Developmentally Delayed Populations: An Examination Of Medical Providers Perspective, Sarah E. Nota

Masters Theses

Sexuality is a recognized human right as it influences mental, social and emotional wellbeing. Despite this, individuals with intellectual or developmentally delays (ID/DD) rarely receive the necessary sexual education. ID/DD persons are also at an increased risk for sexual abuse, further demonstrating the strong need for education. A natural setting in which to receive unbiased and informative sexual health information is through their medical provider. The purpose of this research was to examine current clinic standards, education, and perceptions of medical providers in regards to sexual education for ID/DD adolescents. Medical providers and students within West Michigan were surveyed with …

Population Health Management Risk Assessment Tool Validation: Directing Resource Utilization, Sonya L. Christensen

Doctoral Projects

The Affordable Care Act (ACA) of 2010 is transforming health care across the nation into a value-based system that emphasizes quality and continuity with reimbursement tied to patient outcomes. The shift in emphasis is best realized through the strategy of Population Health Management, a change from traditional episodic treatment of illness to management of the health needs of populations throughout the continuum of health. The goal of care is to ensure that patients, especially the chronically ill, receive effective attention to their health needs in order to improve outcomes, decrease costs, and provide a positive patient experience. An important component …

Implementing Spirometry-Driven Evidence-Based Asthma Care In A Primary Care Practice, Douglas C. Rau

Doctoral Projects

This project was a quality improvement initiative employing an educational intervention to increase the awareness and stress the importance of utilizing spirometry in the diagnosis, treatment, and management of asthma. Clinical support staff received training on how to perform spirometry and providers received education on the interpretation and utility of spirometry results to drive care to improve outcomes for clients with asthma. Project outcomes examined the self-rated confidence to perform and interpret spirometry before and after the intervention and the subsequent utilization pattern of office-based spirometry at the primary care clinic. For clinical support staff, the self-comfort level at performing …

Implementation Of A Smart Goal Intervention For Diabetic Patients: A Practice Change In Primary Care, Mackenzie Swanson

Doctoral Projects

Self-management techniques have been shown to be useful practice tools for providers managing patients with chronic disease. One valuable aspect of self-management is goal setting, whereby the patient is directed to create highly attainable personal goals to modify a selected behavior. Through the attainment of these goals, the patient begins to experience confidence and improved self-efficacy in managing chronic diseases such as diabetes. This paper provides background on the use of SMART goals for diabetic patients, how this practice change supports Meaningful Use objectives and helps meet the requirements for future reimbursement opportunities. A thorough organizational assessment of a Midwest …

Physical Activity Assessment And Intervention Among Adult Patients At A Community Health Center, Michelle L. Vandentoorn

Doctoral Dissertations

Low levels of physical activity are associated with a number of serious health conditions in adults. These conditions include hypertension, diabetes, certain types of cancers, cardiovascular disease, and an increased risk of mortality. In spite of these serious health risks, few adults in the United States are achieving the recommended levels of physical activity. The diseases associated with low physical activity levels contribute to high healthcare costs.

Healthcare providers claim that they are not aware of available interventions and resources to increase physical activity levels in their patients. Through screening patients for physical activity levels during office visits, providers can …

Health Literacy Assessment And The Meaningful Use Incentive Of Providing Clinical Summaries In An Underserved, Hypertensive Population, Tami Pettenger

Doctoral Projects

Hypertension is a common diagnosis in the United States and can lead to health complications if not well managed. However, this condition often has few to no symptoms which may lead patients to modify, disregard, or otherwise be non-adherent to treatment plans. Also a patient’s health literacy level may directly affect his or her ability to understand and act on health information. This may be especially true in vulnerable populations such as older adults and underserved communities. In addition, the education material provided to patients, such as clinical summaries following a health visit, may not be consistent or understandable or …

Proof Of Concept Of A Mobile Health Short Message Service Text Message Intervention That Promotes Adherence To Oral Anticancer Agent Medications: A Randomized Controlled Trial, Sandra L. Spoelstra, Charles W. Given, Alla Sikorskii, Constantinos K. Coursaris, Atreyee Majumder, Tracy Dekoekkoek, Monica Schueller, Barbara A. Given

Peer Reviewed Articles

Introduction: This multisite, randomized controlled trial assigned 75 adult cancer patients prescribed an oral anticancer agent to either an experimental group that received daily text messages for adherence for 21 days plus usual care or a control group that received usual care.

Materials and Methods: Measures were administered at baseline, weekly (Weeks 1–8), and at exit (Week 9). A satisfaction survey was conducted following the intervention. Acceptability, feasibility, and satisfaction were examined. Primary outcomes were adherence and symptoms. Secondary outcomes were depressive symptoms, self-efficacy, cognition, physical function, and social support. Mixed or general linear models were used for the analyses …

Quality Improvement Initiative In Transplant Diabetes Care: Needs Assessment And Protocol Development, Dawn Korson

Doctoral Projects

Over 30,000 people receive a solid organ transplant each year, with 5-30% developing post-transplant diabetes mellitus (PTDM) (United Networking for Organ Sharing, 2015). At a Midwestern transplantation center, over 22% of patients with a history of diabetes were not consulted to endocrinology after kidney and liver transplantation. With poor glycemic control, there is an increased risk of developing PTDM leading to poor outcomes. Utilizing the Donabedian model and the Six Sigma’s Define, Measure, Analyze, Improve, and Control (DMAIC) as guides for implementation, the purpose of this project was to address the process measures of increasing appropriate consultations for evaluation and …

Screening Initiative For Non-Stroke Geriatric Inpatients, Kimberly Harper

Doctoral Projects

Current literature reveals a need for improved depression screening efforts among inpatient geriatrics. This population is at higher risk for severe depression, suicidal ideations, poorer health outcomes related to decreased compliance to healthcare regimens, and increased healthcare costs. Current best practice involves the utilization of the Geriatric Depression Scale-Short Form (GDS-SF), a 15-question yes or no answer screening tool. While not diagnostic, the tool has established validity and reliability testing. The GDS-SF should not be used on subsets of the population diagnosed with stroke, dementia or delirium.

The purpose of this project was to develop a protocol for implementation of …

Evaluating The Effectiveness Of An Exercise Program For Persons With Multiple Sclerosis, Tiffany Kuipers

Doctoral Projects

Multiple sclerosis (MS) is a chronic, degenerative condition of the central nervous system that leaves patients with a wide variety of symptoms and disability. Symptoms include decreases in energy levels, muscle strength, bone strength, vision, sensation, coordination, cognition, hearing, balance, and quality of life. Exercise has been well supported as a way to reduce symptoms and slow the disease progression of MS. Outpatient exercise programs have also been shown effective in providing patients with the necessary tools to perform appropriate exercises at home. Yet, few programs are available that are appropriate for patients with MS. This project aimed to, first, …

Importance And Implementation Of Exercise Programs In The Geriatric Population, Denise Grezeszak

Honors Projects

No abstract provided.

Nursing’S Role In Physician Aid In Dying: Assisting Suicide Or Providing Death With Dignity, Elizabeth Miklos

Honors Projects

No abstract provided.

Use Of Culturally Tailored Media To Increase Hiv Screening Among African Americans, Leda Evans

Doctoral Projects

Over one million people in the United States have HIV with a substantial portion of these individuals being African American. Innovative approaches to improving the HIV disparity among African Americans have been encouraged by the federal government. Culturally tailored HIV risk reduction interventions have been noted as effective in several studies in reducing risk behavior. The purpose of the intervention was to determine if the use of culturally tailored HIV risk reduction media would result in an increase in HIV screening among African Americans. A one-time community based-intervention with no control group was utilized to determine impact of media. Screening …