Medicine and Health Sciences Commons^™

The Consequences Of Failing: A Memoir, Olivia M. Zajac

All College Thesis Program, 2016-2019

Failing is part of our human nature. I have never met a person who has never failed at something. Sometimes when I look back at my failures I feel like crying, and other times I laugh at the mistakes that I have made. But no matter the type of failure I have suffered, I have learned one thing. Failures, along with successes, have shaped me into the person I am today. When I fail, I often fall. But each fall is a chance for me to get back up. I don’t plan to stop failing any time soon.

Just like …

Challenges In Mathematical Cognition: A Collaboratively-Derived Research Agenda, Lara Alcock, Daniel Ansari, Sophie Batchelor, Marie-Josee Bisson, Bert De Smedt, Camilla Gilmore, Silke M. Gobel, Minna Hannula-Sormunen, Jeremy Hodgen, Matthew Inglis, Ian Jones, Michele Mazzocco, Nicole Mcneil, Michael Schneider, Victoria Simms, Keith Weber

Brain and Mind Institute Researchers' Publications

This paper reports on a collaborative exercise designed to generate a coherent agenda for research on mathematical cognition. Following an established method, the exercise brought together 16 mathematical cognition researchers from across the fields of mathematics education, psychology and neuroscience. These participants engaged in a process in which they generated an initial list of research questions with the potential to significantly advance understanding of mathematical cognition, winnowed this list to a smaller set of priority questions, and refined the eventual questions to meet criteria related to clarity, specificity and practicability. The resulting list comprises 26 questions divided into six broad …

Characterization And Target Identification Of Ak301: A Novel Mitotic Arrest Agent, Michael J. Bond, Avijeet S. Chopra, Marina Bleiler, Michelle Yeagley, Eric Scocchera

University Scholar Projects

The Giardina Laboratory has recently identified AK301 as a novel mitotic arrest agent. This work aimed to characterize the arrest state induced by AK301 (EC₅₀ ~ 150nM) and identify the cellar targets responsible for the arrest. It was found that AK301 arrest is readily reversible upon withdrawal of AK301. Cells that slip from mitosis after removal of AK301 are sensitized to apoptosis. This was found to be unique for AK301 when compared to other mitotic arrest agents like colchicine, vincristine, and BI2536. Arrested cells were found to have increased ATM activity as well as an upregulation of p53 and …

Honoring Others By Accompaniment, Merrilee Brown

Theses and Graduate Projects

Nurses recognize that access to healthcare for marginalized individuals prevents some from utilizing western medicine basic health services. People living in the margins can experience difficult encounters to healthcare as a system and a culture. Providers in Scott County that offer access to the marginalized are referred to as safety net services, lack individual choice, resource coordination, or a health partnership with individuals struggling in their daily lives. public Health Nurses recognize the need for intentional collaboration among providers. This project began with a Hispanic individual who had accessed all safety net providers in Scott County and still was not …

Essential Nursing Care For The Sole, Teresa A. Miller

Theses and Graduate Projects

This paper illuminates the transformational journey experienced while exploring nursing practice involvement in essential holistic foot care as a Doctor of Nursing-Transcultural Nursing (DNP-TCN) practice project. The underlying theoretical framework is based on the relational caring complexity theory by Marilyn A. Ray and Marian C. Turkel, depicting model complexity concepts essential to holistic health and wellness nursing foot cares. As an advanced practice nurse, this practice shift is an assertion of health and wellness essentials in the model of holistic nursing, as foot health is tied to the health of the physical body and spiritual soul of the living. Individual …

Bleeding And Thromboembolic Events In Patients With Heartmate Ii Mechanical Circulatory Support, Salman Allana, Carrie Chapman, Nancy Sweitzer, Maryl Johnson, Takushi Kohmoto, Margaret Murray, David Murray, Zhanhai Li, Peter S. Rahko

The VAD Journal

Background: Bleeding and thromboembolic events (TE) are common complications following HeartMate II (HMII) implantation. The aim of the study was to review our experience related to bleeding and TE events in patients with a HMII and identify factors associated with increased risk of these events.

Methods: We retrospectively reviewed 70 consecutive patients who received a HMII between May 2006 and December 2011. The patients were followed for 12 months or until cardiac transplantation, device explantation or death. Major bleeding was defined by INTERMACS criteria with intracranial bleeding events added.

Results: There were 48 bleeding events in 28 (40%) patients with …

Structural Dynamics Of A Methionine Γ-Lyase For Calicheamicin Biosynthesis: Rotation Of The Conserved Tyrosine Stacking With Pyridoxal Phosphate, Hongnan Cao, Kemin Tan, Fengbin Wang, Lance Bigelow, Ragothaman M. Yennamalli, Robert Jedrzejczak, Gyorgy Babnigg, Craig A. Bingman, Andrzej Joachimiak, Madan K. Kharel, Shanteri Singh, Jon S. Thorson, George N. Phillips Jr.

Pharmaceutical Sciences Faculty Publications

CalE6 from Micromonospora echinospora is a (pyridoxal 5′ phosphate) PLP-dependent methionine γ-lyase involved in the biosynthesis of calicheamicins. We report the crystal structure of a CalE6 2-(N-morpholino)ethanesulfonic acidcomplex showing ligand-induced rotation of Tyr100, which stacks with PLP, resembling the corresponding tyrosine rotation of true catalytic intermediates of CalE6 homologs. Elastic network modeling and crystallographic ensemble refinement reveal mobility of the N-terminal loop, which involves both tetrameric assembly and PLP binding. Modeling and comparative structuralanalysis of PLP-dependent enzymes involved in Cys/Met metabolism shine light on the functional implications of the intrinsic dynamic properties of CalE6 in catalysis and holoenzyme maturation.

Use Of Insulin Pumps In The Perioperative Patient, Judith Raboy

Nursing Capstones

No abstract provided.

Juvenile Justice—Translational Research On Interventions For Adolescents In The Legal System (Jj-Trials): A Cluster Randomized Trial Targeting System-Wide Improvement In Substance Use Services, Danica K. Knight, Steven Belenko, Tisha Wiley, Angela A. Robertson, Nancy Arrigona, Michael Dennis, John P. Bartkowski, Larkin S. Mcreynolds, Jennifer E. Becan, Hannah K. Knudsen, Gail A. Wasserman, Eve Rose, Ralph Diclemente, Carl G. Leukefeld, Jj-Trials Cooperative

Behavioral Science Faculty Publications

Background: The purpose of this paper is to describe the Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, a cooperative implementation science initiative involving the National Institute on Drug Abuse, six research centers, a coordinating center, and Juvenile Justice Partners representing seven US states. While the pooling of resources across centers enables a robust implementation study design involving 36 juvenile justice agencies and their behavioral health partner agencies, co-producing a study protocol that has potential to advance implementation science, meets the needs of all constituencies (funding agency, researchers, partners, study sites), and can be implemented …

Blood Glucose Management In The Surgical Patient, Alison Lynch

Nursing Capstones

No abstract provided.

Effect Of Dietary Starch Source And Concentration On Equine Fecal Microbiota, Brittany E. Harlow, Laurie M. Lawrence, Susan H. Hayes, Andrea Crum, Michael D. Flythe

Animal and Food Sciences Faculty Publications

Starch from corn is less susceptible to equine small intestinal digestion than starch from oats, and starch that reaches the hindgut can be utilized by the microbiota. The objective of the current study was to examine the effects of starch source on equine fecal microbiota. Thirty horses were assigned to treatments: control (hay only), HC (high corn), HO (high oats), LC (low corn), LO (low oats), and LW (low pelleted wheat middlings). Horses received an all-forage diet (2 wk; d -14 to d -1) before the treatment diets (2 wk; d 1 to 14). Starch was introduced gradually so that …

Pulmonary Primary Blast Injuries, Moe Uddin

Honors Scholar Theses

Primary underwater explosions are particularly dangerous because of the water properties relative to air, and the resulting pathologies presents difficulty in determining their etiologies. The whole body is affected by the blast wave and the survivor is considered a trauma patient. The exact mechanism of injury is not well understood. In the literature, there are inconsistencies between the explosive and the resulting outcome of the experimental animals. Primary lung blast injuries is the leading cause of mortality in underwater explosions and this explores the different pathologies, symptoms, and treatments that are currently available.

Implementation Of Teamstepps In The Operating Room A Quality Improvement Project, Teresa D. Vincent

Graduate Theses, Dissertations, and Capstones

Abstract

This project aimed to determine if implementing Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) at Norton Women’s Kosair Children’s Hospital (NWKCH) main operating room would decrease the occurrence of adverse events leading to patient harm. The TeamSTEPPS’ goal is to create high-reliability teams (HRT) and thus limit the potential for patient harm, including but not limited to wrong site surgery and unintentionally retained foreign objects. In the last decade, the healthcare industry has increased focus on patient safety; however, even with the implementation of evidence-based practice and new technical advances, patient safety within the operating …

Implementation Of Teamstepps In Acute Care Settings, Teresa D. Vincent

Graduate Theses, Dissertations, and Capstones

Abstract

Patient safety in a hospital is the concern of all healthcare team members, whether the patient is in the facility for a few hours or a few days. Even though policies and procedures are in place to reduce the occurrence of errors during the course of a patient’s admission to the hospital, adverse outcomes may still occur. Errors and omissions in communication between team members have been identified as one of the leading reasons for injury to patients and organizations are searching for processes that can assist them in improving team communication. Team Strategies and Tools to Enhance Performance …

Descriptive Epidemiology Of Somatising Tendency: Findings From The Cupid Study., Sergio Vargas-Prada, David Coggon, Georgia Ntani, Georgia Ntani, Karen Walker-Bone, Keith T. Palmer, Vanda E. Felli, Raul Harari, Lope H. Barrero, Sarah A. Felknor, David Gimeno, Anna Cattrell, Matteo Bonzini, Eleni Solidaki, Eda Merisalu, Rima R. Habib, Farideh Sadeghian, Muhammad Masood Kadir, Sudath S. P. Warnakulasuriya, Ko Matsudaira, Busisiwe Nyantumbu, Malcolm R. Sim, Helen Harcombe, Ken Cox, Leila M. M. Sarquis, Maria H. Marziale, Florencia Harari, Rocio Freire, Natalia Harari, Magda V. Monroy, Leonardo A. Quintana, Marianela Rojas, E. Clare Harris, Consol Serra, J. Miguel Martinez, George Delclos, Fernando G. Benavides, Michele Carugno, Marco M. Ferrario, Angela C. Pesatori, Leda Chatzi, Panos Bitsios, Manolis Kogevinas, Kristel Oha, Tiina Freimann, Ali Sadeghian, Roshini J. Peiris-John, Nalini Sathiakumar, A. Rajitha Wickremasinghe, Noriko Yoshimura, Helen L. Kelsall, Victor C. W. Hoe, Donna M. Urquhart, Sarah Derrett, David Mcbride, Peter Herbison, Andrew Gray, Eduardo J. Salazar Vega

Community Health Sciences

Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed …

The Story Of Emily, Lori L. Jennings Ms, Barb O'Neil, Kim Bossy, Denise Dodman, Jill Campbell

Patient Experience Journal

This case study describes Bluewater Health’s quest to weave the philosophy and practice of patient and family-centered care from the boardroom to the bedside by introducing Emily. Emily’s image is a composite of photographs of staff, physicians, volunteers, patients and families exemplifying that each has a role in Emily’s care. Emily represents every patient and family of the past, present, and future. Emily’s journey started with the launch of Bluewater Health‘s 2013-2015 strategic plan and moved throughout the organization as patient councils were established and the organization embedded three foundational patient and family-centered RNAO Best Practice Guidelines into daily practice …

Relationship-Centred Care In Health: A 20-Year Scoping Review, Sophie Soklaridis Phd, Paula Ravitz Md Frcpc, Gili Adler Nevo Md Frcpc, Susan Lieff Md Prcpc

Patient Experience Journal

Relationship-centred care (RCC) is a framework for conceptualizing health care which recognizes that the nature and quality of relationships in health care influence the process and outcomes of health care. Our goal was to undertake a scoping review of the peer-reviewed and grey literature on RCC in health. Using Arksey and O’Malley’s scoping review methodology we identified literature about RCC in teaching, learning and clinical practice. Electronic databases were searched, and targeted searches were also conducted for grey literature to capture unpublished material. Subsequently, data abstraction tools were used with eligible studies for analysis. Sixty-nine publications originated mainly from the …

Applying Experience-Based Co-Design With Vulnerable Populations: Lessons From A Systematic Review Of Methods To Involve Patients, Families And Service Providers In Child And Youth Mental Health Service Improvement, Alison Mulvale, Ashleigh Miatello, Christina Hackett, Gillian Mulvale

Patient Experience Journal

The objective was to identify methods used to involve patients, family and service providers in child and youth mental health service improvement research. We analyzed the alignment of methods used with Experience-Based Co-Design (EBCD) methodology, and how power imbalances among participants were addressed. A systematic review of the English-language peer review literature since 2004 was carried out. The EMBASE, Scholar’s Portal, PubMed, Web of Science databases and the Ontario College of Art and Design University libraries were searched electronically for variations of ‘child’, ‘mental health’, ‘experience-based co-design’, ‘participatory research’ and ‘health care services’. Textual data was systematically extracted and analyzed. …

Impact Of Logo Wear On Provider Perception Of Patient, Bill R. Gombeski Jr

Patient Experience Journal

Patient’s appearance affects provider perception of patients and subsequent provider behavior. Based on anecdotal information, it was hypothesized that wearing a health organization’s brand would result in a more positive perception of a patient by providers and subsequently a better patient experience. A study of 121 individuals with patient contact was conducted. Using photos of patients with and without a health care brand on their shirts, study subjects rated the attractiveness and willingness to engage with photos of patients. Patients with a Mayo brand and UK HealthCare brand showed some significant positive attractiveness over the same patient without the brand. …

Patient Evaluations Of The Interpersonal Care Experience (Ice) In U.S. Hospitals: A Factor Analysis Of The Hcahps Survey, Geoffrey A. Silvera, Jonathan R. Clark

Patient Experience Journal

The Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) is widely used to evaluate patients’ perceptions of their inpatient healthcare experiences. The HCAHPS is organized into 10 measures: six composite measures, two individual measures, and two global measures.¹ In prior research on the link between patients’ care experiences and hospital’s quality and cost outcomes, scholars have grouped these measures in a variety of ways. The evident lack of consistency in these groupings along with the persistent lack of empirical justification for these groupings suggests a need to empirically examine the relational structure of HCAHPS measures. …

Developing Approaches To The Collection And Use Of Evidence Of Patient Experience Below The Level Of National Surveys, Elizabeth J. Gibbons, Chris Graham, Jenny King, Kelsey Flott, Crispin Jenkinson Professor, Raymond Fitzpatrick Professor

Patient Experience Journal

National approaches to collecting patient feedback provide trust level information which although can provide a benchmark for trusts often doesn’t provide information about specific services or patients experiences of pathways of care. This more granular level of data could be more informative for local service development and improvement. This research explored the feasibility and usefulness of such approaches. A conceptual model and standard questionnaire of patient experience was developed that might work across a range of services and pathways of care. Seven trusts were recruited as collaborating sites in which the model and survey instrument was tested. These were from …

Impact Of Hospital Diagnosis-Specific Quality Measures On Patients’ Experience Of Hospital Care: Evidence From 14 States, 2009-2011, Emily M. Johnston, Kenton J. Johnston, Jaeyong Bae, Jason M. Hockenberry, Arnold Milstein, Edmund Becker

Patient Experience Journal

In order to assess consistency across quality measures for Untied States hospitals, this paper uses patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey for three years (2009-2011) from 1,333 acute-care hospitals in fourteen states to analyze patterns in hospital-reported patient experience-of-care scores by diagnosis-specific process and outcome measures for acute myocardial infarction, heart failure, and pneumonia. We also evaluate how scores have changed over the three-year period. We find significant differences in patient experience-of-care scores for 195 out of 230 relationships between HCAHPS patient experience-of-care scores and 23 diagnosis-specific process and outcomes measures. We …

Please Tick The Appropriate Box: Perspectives On Patient Reported Experience, Mette Sandager, Morten Freil, Janne Lehmann Knudsen

Patient Experience Journal

Patient experience surveys are increasingly used as a method for evaluating important aspects of quality of care and the results are used politically to support general decision-making. However, there have been limited attempts to summarize the newest and most essential knowledge on how to measure and interpret patient experience data. This paper aims to summarize knowledge on the association between delivered care and patient reported experience and the factors influencing this association, and to outline a conceptual model illustrating the association. The method employed is integrative literature review. Quantitative and qualitative studies as well as theoretical and discussion papers that …

Exploring Patient Satisfaction With Interdisciplinary Care Of Complex Feeding Problems, Claire K. Miller Phd, Scott Pentiuk Md

Patient Experience Journal

Measures of patient satisfaction with health care experiences are recognized as essential in the healthcare market environment. To our knowledge, there are no specific patient experience measures that assess patient and caregiver satisfaction with a multidisciplinary approach to management of complex feeding and swallowing issues in pediatric patients. In order to explore patient experience and to identify opportunities for improvement, a pilot patient satisfaction survey was developed in an interdisciplinary feeding team clinic. Patients and families were surveyed following clinic encounters between July of 2014 and January of 2015. Likert style questions were used to assess experience with ease of …

Preference-Sensitive Decisions Of Patients With Metastatic Breast Cancer: The Need For Decision Support, Julie Van De Haterd, Helene Voogdt-Pruis, Ilse Raats, Rianne Van Den Brink, Haske Van Veenendaal

Patient Experience Journal

Because of disease progression and the increasing number of treatment options, patients with metastatic breast cancer face multiple decisions over time. Our aim was to identify the multiple decisions patients with metastatic breast cancer face in order to decide which decision aids will be developed. First, we analyzed the clinical practice guidelines to identify decisions encountered by patients with metastatic breast cancer and healthcare professionals. Furthermore, an online questionnaire for patients, a focus group interview with patients and interviews with healthcare professionals were performed. In addition, we performed a systematic literature research and internet search to identify relevant decision support …

Patient Perceptions Of An Aidet And Hourly Rounding Program In A Community Hospital: Results Of A Qualitative Study, Tosha Allen, Tyne Rieck, Stacie Salsbury

Patient Experience Journal

Quantitative evidence links patient satisfaction scores to the use of communication strategies such as AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you) and Hourly Rounding. However, little is known about patient perceptions of these tools in regards to their hospital experience. Qualitative interviews were conducted with a convenience sample of 14 adult medical/surgical inpatients in one mid-sized, community hospital, following hospital discharge. The interview data was transcribed and opened coded, utilizing constant comparison to identify common themes. Themes emerged in four topical areas: (a) patient experience of hospitalization, (b) AIDET, (c) Hourly Rounding, and (d) unexpected findings. Patients placed significant …

Can Social Media Reduce Discrimination And Ignorance Towards Patients With Long Term Conditions? A Chronic Kidney Disease Example In The Uk And More Widely, Shahid N. Muhammad, Amy J. Zahra, Howard J. Leicester, Heather Davis, Stephen Davis

Patient Experience Journal

Long Term Conditions (LTCs) are increasing in prevalence and cost in Western healthcare. Patients with such conditions are often classed as “disabled”, because of impacts of self-care on “activities of daily life” or secondary consequences of conditions (impairments) affecting factors such as mobility, concentration and communications. Disability needs are often ignored in the design of services and treatment of individuals. It manifests as services which some find difficult to use and lack of personal respect (discrimination) often based on lack of understanding by the healthcare profession itself (ignorance). This paper explores how Social Media (SM), an example “Assistive Technology” in …

Evaluating Recall Of Key Safety Messages, And Attitudes And Perceptions Of A Patient Safety Initiative At A Pediatric Hospital, Deepika Sriram, Carol Cooke, Régis Vaillancourt, Gilda Villarreal, Annie Pouliot, Nanette Labelle, Tracy Wrong

Patient Experience Journal

Involving inpatients in their safety and well-being is becoming increasingly common. Interventions have been developed to encourage patients to be active in their own safety, but published evaluations are scarce. The Patient Safety Ambassador (PSA) program was developed to increase patient and parent/guardian engagement and knowledge in patient safety. This study aimed to determine recall ability of key safety messages and explore attitudes and perceptions towards the PSA program, hence obtaining feedback for program improvements. Participants were pediatric inpatients and parents of inpatients. Face-to-face semi-structured interviews were conducted. Cued and non-cued recall ability was determined using questions with and without …

Does She Think She’S Supported? Maternal Perceptions Of Their Experiences In The Neonatal Intensive Care Unit, Emily A. Lilo, Richard J. Shaw, Julia Corcoran, Amy Storfer-Isser, Sarah M. Horwitz

Patient Experience Journal

Parents’ involvement in the care of their infants in the neonatal intensive care unit (NICU) is critically important, leading many NICUs to implement policies and practices of family-centered care (FCC). Analyzing narrative interviews, we examined whether mothers of premature infants who participated in an intervention to help reduce anxiety, stress, and depression felt that their NICU experience reflected four key nursing behaviors previously identified as being necessary to achieving FCC. Fifty-six narratives derived from semi-structured interviews with the mothers were analyzed qualitatively and quantitatively to examine whether the women experienced emotional support, parent empowerment, welcoming environment, and parent education, as …

Female And Male Patients’ Perceptions Of Primary Care Doctors’ Communication Skills In Hong Kong, Vivienne Leung Dr., Kimmy Cheng Dr.

Patient Experience Journal

This study examined how female and male patients perceive primary doctors’ communication skills in the Chinese context. To do so, this study specifically investigates female and male patients’ general perceptions toward primary care doctors’ communication skills in medical consultations. Specifically, this study focused on (a) female and male patients’ satisfaction level toward primary care doctors’ communication skills in medical consultations (b) female and male patients’ perception of the types of verbal and nonverbal communication skills applied by primary care doctors in medical consultations (c) as well as which gender of doctors with whom patients prefer to communicate during primary care …