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 …

A Preliminary Examination Of Elevated Blood Lead Levels In A Rural Georgia County, R. Christopher Rustin, Yu Sun, Chris Calhoun, Christy Kuriatnyk

Environmental Health Sciences Faculty Publications

Background: Rural areas are often viewed as lower risk for lead poisoning and toxic exposures seriously impacting development of the brain and central nervous system; this report examines the prevalence of elevated blood lead levels for children <6 years of age in rural Ben Hill County, GA.

Methods: Lead surveillance data from the Georgia Department of Public Health (DPH) were analyzed using SAS®v-9.3 to calculate the prevalence of elevated blood lead levels (≥5ug/dL) among those children in Ben Hill County who had been tested for lead; the results were compared to Georgia and national data.

Results: A preliminary analysis of 2010-2015 screening data for Ben Hill County indicates that 8.73% …

Identifying The Complexity Of Bipolar Disorder, Brandie Marie Stiles

Dissertations

Bipolar disorder is a complex illness that is difficult to correctly diagnosis and treat. Experts estimate that a correct diagnosis and treatment for bipolar disorder may be delayed for up to 7-10 years after symptoms become problematic. The primary purpose of this study was to identify the complexity of diagnosing bipolar disorder, including diagnostic patterns, recommended treatment, and patient response. A focused ethnography, including in-depth interviews and a retrospective chart review, were completed to answer the research questions: 1) What is the nature of the experience of receiving a diagnosis of bipolar disorder? 2) What are the diagnostic and treatment …

Cost Effectiveness Of Potential Art Adherence Monitoring Interventions In Sub-Saharan Africa, Andrew N. Phillips, Valentina Cambiano, Fumiyo Nakagawa, Loveleen Bansi-Matharu, Papa Salif Sow, Peter Ehrenkranz, Deborah Ford, Owen Mugurungi, Tsitsi Apollo, Joseph Murungu, David R. Bangsberg, Paul Revill

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background -Interventions based around objective measurement of adherence to antiretroviral drugs for HIV have potential to improve adherence and to enable differentiation of care such that clinical visits are reduced in those with high adherence. It would be useful to understand the approximate upper limit of cost that could be considered for such interventions of a given effectiveness in order to be cost effective. Such information can guide whether to implement an intervention in the light of a trial showing a certain effectiveness and cost.

Methods - An individual-based model, calibrated to Zimbabwe, which incorporates effects of adherence and resistance …

Kinder Ready: Exploring The Role Of Technology In Promoting School Readiness Among Low-Income Parents In A Clinic-Based Setting, Brenda Lu

Master's Projects and Capstones

The Stanford Pediatric Advocacy Program advocates to improve the health status of children in Silicon Valley and the surrounding community. This summer, I worked on a project called Kinder Ready, with the goal of evaluating the feasibility of technology use in promoting school readiness in children ages zero to five. We used a variety of qualitative research methods, including focus groups, one-on-one interviews, and surveys to collect feedback from the community on what their children need to transition into schools. Our local participatory research approach has paved the way for many new partnerships with local organizations, while strengthening existing ones. …

Superdoctors: A Consideration Of Virtue Ethics And Human Enhancement, Rosa Dale-Moore

Sound Decisions: An Undergraduate Bioethics Journal

Much of the technology used in today’s society could be considered enhancements under some framework. Human uses of substances and practices such as caffeine, meditation, brain training apps and creativity courses, plus countless other extracurricular activities and products all force the human body to be its best, or even past its best. The need for ethical consideration arises when deciding the uses for technology and enhancements. This paper will consider the ethics of human enhancement with regards to the specific profession of physician under the framework of virtue ethics.

Reconciling Eugenics For The Sake Of Human Survival, Conor O'Keefe

Sound Decisions: An Undergraduate Bioethics Journal

This paper will attempt to argue for the moral permissibility of genetic enhancement through the ethical lens of principlism, which necessitates the consolidation of positive and negative eugenics as therefore equally permissible. I will argue that through modern medicine and technology we have a moral obligation to establish a more fair baseline of human functioning, and that giving consent to such enhancement is morally justifiable.

Longevity Extension From A Socioeconomic Perspective: Plausibility, Misconceptions, And Potential Outcomes, Eric Ralph

Sound Decisions: An Undergraduate Bioethics Journal

In the last several decades, a significant amount of progress has been made in pursuits to better understand the process of aging and subsequently gain some level of control over it. Wide-ranging successes with gene therapy and increased comprehension of the genetic components of aging have also recently culminated in numerous successes in extending the longevity of animals and the first human trial of a gene therapy to extend life through telomerase manipulation is already underway, albeit on a small scale (Mendell et al. 2015; Bernardes de Jesus et al. 2012; Konovalenko 2014). In light of these recent accomplishments, bioethicists, …

Advocation For The Universal Legalization Of Physician-Assisted Suicide As A Last Resort Measure, Mckinley Nevins

Sound Decisions: An Undergraduate Bioethics Journal

Considerations of physician-assisted suicide are pressing, emotionally charged, and urgently needed. Current safeguards that exist to protect the patients from coercion and abuses of power are crucial, but incomplete. Additional safeguards must be implemented to protect the role of physicians in cases of PAS as well. Also, improved palliative care measures should be advocated for and considered as the best option in cases of individuals suffering horrendously in the last month of a terminal illness. The universal legalization of physician-assisted suicide in all 50 states should be advocated for, so that once all palliative care measures available have been exhaustively …

The Ethics Of Using Animal Stem Cells, Katelyn Rosen

Sound Decisions: An Undergraduate Bioethics Journal

Stem cell research is highly debated in fields of bioethics. This project examines the often-overlooked issue of using animal versus human stem cells. Stem cells can either be cultivated from embryonic cells, which are undifferentiated and pluripotent, or they are cultivated from adult stem cells, which normally replace worn out or damaged cells. Regenerative medicine uses stem cells to create new therapies to produce new cells, organs, and tissues with the intention to improve someone’s functioning, being healthier. Most research on stem cells aims to use embryonic stem cells to help create therapies to treat diseases and injuries or use …

Moral Distress, Leadership Integrity, Ethical Climate And Turnover Intent In Critical-Care Nurses, Desha L. Johnson Makiya

Nursing Theses and Dissertations

Objectives: To determine what relationships exist between moral distress, perceived leadership integrity, ethical climate, and turnover intent among adult critical care nurses and the moderating effect of leadership integrity and ethical climate on moral distress and subsequent turnover intent; to obtain a richer and fuller understanding of how critical care nurses experience moral distress within the context of critical care work.

Participants: Adult critical care nurse members of AACN (n=254), 22-70 years old, recruited February – March 2016.

Methods: A Qualtrics survey posted on the AACN eNewsline included the moral distress scale-revised, perceived leadership integrity scale, hospital ethical …

Falls Program On An Acute Psychiatric Unit, Joseph Hunter Rose

Master's Projects and Capstones

In the metropolitan hospital’s acute psychiatric unit there has been an increase in falls incidence as well as need for evaluation of the effectiveness of Schmid Fall Risk Assessment tool in its ability to properly identify those at risk. In the last fiscal year there were 45 falls among 28 patients on the acute psychiatric unit.Falls are harmful to the patients and can cause prolonged hospital stays with non-reimbursable costs to the hospital. Falls amongst psychiatric patients is an even greater challenge to address due to the nature of the mental health disease process. This project addresses general costs of …

Producing A Subunit Vaccine For Porcine Epidemic Diarrhea Virus, Zayn Khamis

Electronic Thesis and Dissertation Repository

Porcine epidemic diarrhea virus (PEDv) causes disease and mortality to piglets worldwide. Most vaccines used to combat the disease have been ineffective live attenuated virus vaccines. The goal of this project was to produce a plant-made subunit vaccine based off the membrane protein of the virus. This is the first time this protein has been produced in plants. An elastin-like polypeptide fusion membrane protein accumulated up to 0.8 mg/g of fresh leaf weight when transiently expressed in Nicotiana benthamiana. Virus-like particles were also produced for the first time for PEDv, and were able to form with just the membrane …

Examining The Impacts Of Wife Abuse And Child Abuse On Saudi Women’S Mental And Physical Health, Eman Alhalal

Electronic Thesis and Dissertation Repository

Research has not extensively examined the contextual mechanisms by which Intimate Partner Violence (IPV) and child abuse lead to chronic pain. Post-traumatic Stress Disorder (PTSD) and depressive symptoms overlap, yet, it is not clear whether they function in unique ways as mediators of the relationships of abuse with chronic pain. Thus, the purposes of this study were to: a) test a causal model that explains the mechanisms by which severity of child abuse and wife abuse affect chronic pain among Saudi women, and the mediating role of symptoms of depression and PTSD and perceived family support and, b) advance the …

Physiological And Psychological Responses Of Surgeons And Trainees, Sarantis Abatzoglou

Electronic Thesis and Dissertation Repository

Performing surgical procedures can increase the physiological stress and mental strain experienced by practicing surgeons and their trainees. This may negatively affect work and learning capacity and quality of patient care by increasing the incidence of burnout, sleep disorders, fatigue and other negative behaviours such as substance abuse. This study aimed to compare the physiological and psychological responses of similar clinical situations between orthopaedic surgeons and their clinical fellows. An observational prospective cohort study was performed in that matter. Our results showed overall increased physiological responses of the fellows during surgery days compared to the clinic days. On the contrary, …

An Interdisciplinary Process Change: Conversion Of Picc Line Capping Solution From Heparin To Normal Saline, Angela Colella, Brandon Bodager, Frank Spexarth, Natalie Mcdonough, Deb Kastenholz, Paul Grebe

Angela Colella, PharmD, BCPS

Background: Heparin-induced thrombocytopenia (HIT) and HIT with thrombosis syndrome (HITTS) are serious conditions. Patients are at increased risk for developing HIT/HITTS with any exposure to heparin, even intravenous line flushes. Patients may be exposed to heparin multiple times each day when they have a peripherally inserted central catheter (PICC) that is flushed and capped with heparin. At Aurora Health Care, heparin is the standard capping solution for PICCs, but with a recent switch to positive pressurized caps, normal saline may be a capping option that reduces patient exposure to heparin. Purpose: To reduce heparin exposure at a single hospital by …

Quality Improvement Of Procedural Services In Family Medicine Residency Clinics, Keisha Rogers, Nora Guschwan, Lisa Sullivan Vedder

Aurora Family Medicine Residents

Background: Performing common procedures in our family medicine residency clinics is often a difficult and inefficient process. A 2008 Society of Teachers of Family Medicine consensus statement on procedural training found higher job satisfaction and better financial compensation for family practitioners who performed procedures. Patient satisfaction is likely increased when minor procedures are able to be performed by their primary clinician. This would suggest a disconnect between the known benefits of providing procedural services and the ability of our residency clinics to provide those services in an efficient manner. Purpose: To assess clinician and staff comfort with performance of common …

Identifying Disparities In Colorectal Cancer Screening Rates In Milwaukee-Based Academic And Nonacademic Clinics, Jasmine Wiley, Jonathan J. Blaza, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns, Shelby L. Pischke, Tracy L. Greiten

Aurora Family Medicine Residents

Background: The Institute for Healthcare Improvement’s Triple Aim focuses on improving the patient’s experience of care, improving population health and reducing the per capita cost of health care. Health care systems and providers continuously seek to improve quality of care through understanding what percentage of their patients are achieving quality-of-care standards for various indicators, including immunizations, tobacco cessation, asthma and cancer screening. As health care moves toward reimbursing for value-based care, deepening our understanding of patient population characteristics within each of these conditions is vital to continuous quality improvement.

Purpose: To determine if there are race/ethnicity/age/preferred language (REAL) disparities in …

Aligning Asthma Education Across The Continuum Of Physician Education: Impact On Clinical Metrics, Lisa Sullivan Vedder, Deborah Simpson, Jacob L. Bidwell, John R. Brill, Theresa Frederick

Aurora Family Medicine Residents

Background: All trainees entering family medicine residency training programs after June 1, 2012, must complete the same American Board of Family Medicine (ABFM) Maintenance of Certification (MOC) requirements as practicing physicians. These shared requirements provide an opportunity to align physician education initiatives across the continuum focused around a clinical care topic to improve health care system metrics. Purpose: To assess the initial effectiveness of an ABFM Asthma Part IV approved MOC module, aligned to meet residency and medical student program accreditation requirements, on health care system metrics. Methods: An ABFM Asthma Part IV MOC module was implemented for family medicine …

Impact Of A Family Medicine Resident Wellness Curriculum: A Feasibility Study, Christine Runyan, Judith A. Savageau, Stacy E. Potts, Linda F. Weinreb

Judith A. Savageau

BACKGROUND: Up to 60% of practicing physicians report symptoms of burnout, which often peak during residency. Residency is also a relevant time for habits of self-care and resiliency to be emphasized. A growing literature underscores the importance of this; however, evidence about effective burnout prevention curriculum during residency remains limited.

OBJECTIVES: The purpose of this project is to evaluate the impact of a new, 1-month wellness curriculum for 12 second-year family medicine residents on burnout, empathy, stress, and self-compassion.

METHODS: The pilot program, introduced during a new rotation emphasizing competencies around leadership, focused on teaching skills to cultivate mindfulness and …

Decade-Long Trends In The Timeliness Of Receipt Of A Primary Percutaneous Coronary Intervention, Han-Yang Chen, Joel M. Gore, Kate L. Lapane, Jorge L. Yarzebski, Sharina D. Person, Catarina I. Kiefe, Robert J. Goldberg

Catarina I. Kiefe

OBJECTIVES: The purpose of this study was to examine decade-long trends (2001-2011) in, and factors associated with, door-to-balloon time within 90 minutes of hospital presentation among patients hospitalized with ST-segment elevation myocardial infarction (STEMI) who received a primary percutaneous coronary intervention (PCI).

METHODS: Residents of central Massachusetts hospitalized with STEMI who received a primary PCI at two major PCI-capable medical centers in central Massachusetts on a biennial basis between 2001 and 2011 comprised the study population (n=629). Multivariable regression analyses were used to examine factors associated with failing to receive a primary PCI within 90 minutes after emergency department (ED) …

Decade-Long Trends In The Timeliness Of Receipt Of A Primary Percutaneous Coronary Intervention, Han-Yang Chen, Joel M. Gore, Kate L. Lapane, Jorge L. Yarzebski, Sharina D. Person, Catarina I. Kiefe, Robert J. Goldberg

Jorge L. Yarzebski

OBJECTIVES: The purpose of this study was to examine decade-long trends (2001-2011) in, and factors associated with, door-to-balloon time within 90 minutes of hospital presentation among patients hospitalized with ST-segment elevation myocardial infarction (STEMI) who received a primary percutaneous coronary intervention (PCI). METHODS: Residents of central Massachusetts hospitalized with STEMI who received a primary PCI at two major PCI-capable medical centers in central Massachusetts on a biennial basis between 2001 and 2011 comprised the study population (n=629). Multivariable regression analyses were used to examine factors associated with failing to receive a primary PCI within 90 minutes after emergency department (ED) …

A Delphi Process To Address Medication Appropriateness For Older Persons With Multiple Chronic Conditions, Terri R. Fried, Kristina Niehoff, Jennifer Tjia, Nancy Redeker, Mary K. Goldstein

Jennifer Tjia

BACKGROUND: Frameworks exist to evaluate the appropriateness of medication regimens for older patients with multiple medical conditions (MCCs). Less is known about how to translate the concepts of the frameworks into specific strategies to identify and remediate inappropriate regimens.

METHODS: Modified Delphi method involving iterative rounds of input from panel members. Panelists (n = 9) represented the disciplines of nursing, medicine and pharmacy. Included among the physicians were two geriatricians, one general internist, one family practitioner, one cardiologist and two nephrologists. They participated in 3 rounds of web-based anonymous surveys.

RESULTS: The panel reached consensus on a set of markers …

Human Organ Transplantation: Legal Aspects, Thomas J. Ford

The Catholic Lawyer

No abstract provided.

Amendment Of The Abortion Law: Relevant Data And Judicial Opinion, John T. Noonan, Jr.

The Catholic Lawyer

No abstract provided.

The Lowdown Of Out-Of-Competition Testing: What The Rmtc Isn't Telling Us About Its Proposed Regulations, Clara Fenger, Tanya Boulmetis, Kim Brewer, Thomas Tobin

Maxwell H. Gluck Equine Research Center Faculty Publications

No abstract provided.

Physical Therapy Management Of A Patient After Hemorrhagic Stroke Using A Task-Oriented Approach In A Skilled Nursing Facility: A Case Report, Kaela Fischer

Case Report Posters

Stroke is the leading cause of long term disability in the U.S.; nearly 800,000 Americans have a stroke each year. Subarachnoid hemorrhagic stroke occurs when one of the blood vessels in the brain bursts causing a release of blood which increases intracranial pressure. There is a lack of rehabilitation research in the skilled nursing setting for hemorrhagic stroke. The purpose of this case report is to describe the PT management, using a task-oriented approach, of a patient with a subarachnoid hemorrhagic stroke being treated in a skilled nursing setting.

Physical Therapy Management Of A Patient With Chronic Brainstem Stroke Syndrome To Improve Functional Mobility: A Case Report, Kelley Flahaven

Case Report Papers

Background and Purpose: Brainstem strokes are much less common and have a higher mortality rate than cortical strokes. Brainstem strokes can lead to several physical impairments, including gaze palsies, quadriplegia, ataxia, or cranial nerve deficits, leading to decreased balance and safety as well as decreased independence with functional activities. The purpose of this case report is to provide an overview of the physical therapy care plan created for a patient with chronic brainstem strokes. Case Description: The patient is a middle-aged man who had two brainstem strokes over two years ago. He initially received physical, occupational, and speech therapies, then …

Functional Training In A Patient With Middle Cerebral Artery Stroke With Multiple Comorbidities: A Case Report, Darien Lewis

Case Report Papers

Background and Purpose: Strokes affecting the middle cerebral artery (MCA) cause impairments of recovery affected by the patient’s premorbid status. Although there is a significant amount of research detailing physical therapy (PT) interventions for patients with hemiplegia, there is a lack of evidence supporting interventions for patients with hemiplegia following stroke that have multiple comorbidities. The purpose of this case report is to describe a progressive PT plan of care (POC) for a patient following MCA stroke with multiple comorbidities in the skilled nursing setting. Case Description: The patient was a 71-year-old male admitted to the skilled nursing facility (SNF) …

December 2016, Randy Curry, Cindy Brooks

RURAL ROCKS

Rural Rocks, the Rural Health Network newsletter by the SWOSU College of Pharmacy