Medicine and Health Sciences Commons^™

Accountable Care Organizations And Transaction Cost Economics, Stephen S. Farnsworth Mick, Patrick D. Shay

Health Administration Publications

Using a Transaction Cost Economics (TCE) approach, this paper explores which organizational forms Accountable Care Organizations (ACOs) may take. A critical question about form is the amount of vertical integration that an ACO may have, a topic central to TCE. We posit that contextual factors outside and inside an ACO will produce variable transaction costs (the non-production costs of care) such that the decision to integrate vertically will derive from a comparison of these external versus internal costs, assuming reasonably rational management abilities. External costs include those arising from environmental uncertainty and complexity, small numbers bargaining, asset specificity, frequency of …

Baseline Results Of The Neuronext Spinal Muscular Atrophy Infant Biomarker Study, Stephen J. Kolb, Christopher S. Coffey, Jon W. Yankey, Kristin Krosschell, David Arnold, Mathula Thangarajh, +20 Additoinal Authors, Neuronext Clinical Trial Network

Neurology Faculty Publications

Objective

This study prospectively assessed putative promising biomarkers for use in assessing infants with spinal muscular atrophy (SMA).

Methods

This prospective, multi-center natural history study targeted the enrollment of SMA infants and healthy control infants less than 6 months of age. Recruitment occurred at 14 centers within the NINDS National Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT) Network. Infant motor function scales and putative electrophysiological, protein and molecular biomarkers were assessed at baseline and subsequent visits.

Results

Enrollment began November, 2012 and ended September, 2014 with 26 SMA infants and 27 healthy infants enrolled. Baseline demographic characteristics of the …

Starting Your Own Primary Care Np Pratice--Lessons Learned, Laura Markwick

Nursing Faculty/Staff Publications

The recently passed Modernization Act in New York (NY) eliminates the mandatory collaborative physician requirement for nurse practitioners (NPs) with 3600 hours of experience. Although NPs must provide referral sources upon request, the new law eliminates the barrier of filing written signed agreements. These changes could facilitate the process for NPs to start their own practice. This article provides some insight into this process from the lens on one who started a primary care FNP practice in Western New York (WNY), including barriers encountered and lessons learned.

Noise-Induced Hearing Loss In Young Adults, Maeve Derrig

Communication Sciences and Disorders: Student Scholarship & Creative Works

No abstract provided.

Teaching Strategies To Prepare Prelicensure Nursing Students To Teach-Back, Mariann Kerr

Student Theses, Dissertations and Capstones

Background: Prelicensure nursing programs prepare generalists with essential knowledge, skills, and attitudes to practice in complex health care environments. Nurse educators determine which teaching strategies will best prepare the nurse generalist. Purpose: The purpose of this study was to determine the effectiveness of a teaching plan that combined the strategies of pretest/posttest, classroom activities, and a problem-based learning activity: a clinical immersion experience. The skill of "teach-back" was taught and evaluated. Theoretical framework: Two theories guided the teaching plan for this research. Adult learning theory (Knowles, 1975, 1980, 2012) addressed how and why adults learn, and social cognitive theory (Bandura, …

Qualitative Descriptive Study Of The Experiences Of Nurse Educators In Developing And Implementing Concurrent Enrollment Adn-Bsn Programs, Janice Evans Hawkins

Student Theses, Dissertations and Capstones

Nursing leaders have called for more bachelor-of-science-in-nursing-(BSN)-prepared nurses to meet workforce demands. There is limited capacity in BSN programs to meet the projected demand. Currently, associate degree in nursing (ADN) programs produce the majority of registered nurses. To increase the number of BSN graduates, nurse educators recommend innovative educational models for seamless progression from the ADN to the BSN. Concurrent enrollment ADN-BSN programs offer one potential model to produce more BSN graduates. The purpose of this study was to describe the process of developing and implementing concurrent enrollment ADN-BSN programs. The research question was as follows: What is the experience …

Predictive Factors Impacting Intent To Stay Teaching For Associate Degree Adjunct Clinical Nurse Faculty, Julie Ann Woodworth

Student Theses, Dissertations and Capstones

Background: The full-time nurse faculty shortage has resulted in nursing programs employing adjunct nursing faculty heavily into the clinical teaching component to fill the gap. Many adjunct faculty members continue to teach semester after semester; however, there is a lack of evidence to support the predictive factors that facilitate intent to stay teaching. Purpose: The purpose of this study was to better understand predictors of intent to stay teaching for associate degree (AD) adjunct clinical nurse faculty. Theoretical Framework: Frederick Herzberg’s two-factor motivator-hygiene theory (1959) was utilized as a foundation to explore the factors that impact intent to stay teaching. …

Emotional Intelligence And Empathy Of Nursing Students In An Immersive Capstone Clinical Course, Michelle L. Finch

Student Theses, Dissertations and Capstones

Background. Today’s baccalaureate nursing students need to be prepared to care for patients in an ever-changing, high acuity environment. Many programs offer a capstone immersive clinical experience. However, the benefits of this experience have not been fully explored, and the effect on patient care is unknown. Purpose. The purpose of the study was to determine if there was a change in levels of Emotional Intelligence (EI) and empathy in senior students who completed a capstone immersive clinical experience in the final semester of a baccalaureate nursing program. Theoretical Framework. The theoretical framework for this study was the Mayer and Salovey’s …

Influence Of Academic Self-Efficacy On The Early Academic Success Of Underrepresented Minority Nursing Students Enrolled In The First Semester Of A Baccalaureate Nursing Program, Connie Hataway

Student Theses, Dissertations and Capstones

The identification of reliable predictors of early academic achievement is imperative for the retention and graduation of all nursing students, and particularly underrepresented minority (URM) students. Students with a high sense of academic self-efficacy exhibit greater persistence and interest in their academic performance, a premise that led to this investigation of self-efficacy as a variable affecting early academic success among baccalaureate nursing students. The purpose of this study was to (a) to determine if a significant relationship existed between academic self-efficacy and successful progression for first semester baccalaureate nursing students in general and URM students specifically, (b) determine the predictive …

Initiating A Perinatal Depression Screening Protocol In A Community-Based Hospital, Mari Seidu

Student Theses, Dissertations and Capstones

Background: According to the World Health Organization (WHO), perinatal depression (PD) is the most common childbirth complication. About 10% of pregnant women and about 13% of postpartum women experience a mental health disorder, primarily depression (WHO, 2016). One of the WHO (2015 a) goals for maternal mental health includes providing strategies for the promotion of psychosocial well-being and prevention of mental disorders of mothers during and after delivery. Purpose: The purpose of this performance improvement project was to establish a perinatal depression risk screening protocol and improve nursing knowledge on PD at a community-based hospital in Miami. Theoretical Framework: Beck’s …

A Comparative Evaluation Of Endodontic Irrigation Methods For Removal Of The Smear Layer, Ramzi Walid Alhashimi

Student Theses, Dissertations and Capstones

The purpose of this in vitro study is to compare the effect of various irrigation systems on smear layer removal in curved root canals. Root canal irrigation plays an important role in the debridement and disinfection of the root canal system. It has been well documented that the flushing component of the irrigants is as important as the tissue dissolving capability. Therefore, the efficacy of the irrigant might also be influenced by the method by which it is introduced. Fifty-one recently extracted molar teeth with root curvatures of more than 30° were selected according to Schneider's method. The teeth were …

Comparison Of Resistance To Sliding Between Brackets And Archwires Utilizing Various Ligature Materials, Jagdesh Dudani

Student Theses, Dissertations and Capstones

Objectives: The purpose of this study was to investigate the association between ligature material and frictional force created during orthodontic cuspid retraction. Maximum static and mean kinetic frictional resistance between conventional metallic orthodontic appliances and esthetic orthodontic appliances will be compared as well. Background: The use of ceramic brackets in conjunction with coated archwires and ligatures as an alternative to conventional stainless steel appliances has increased in response to the demand for more esthetic orthodontic appliances. Esthetic appliances are associated with increased frictional forces and therefore thought to slow the orthodontic treatment. Knowledge of frictional forces generated within various orthodontic …

Accuracy And Consistency Of Preformed Orthodontic Arch Wires And The Effect Of Energy Drinks, Caroline Albea

Student Theses, Dissertations and Capstones

Introduction: Selection of the proper arch wire requires a thorough knowledge and understanding of the mechanical properties of wires as well as the system being used. Even with careful selection, orthodontists may experience different results due to the inaccuracy of the stated wire dimensions. Previous studies by Melling et al. have shown nickel titanium, stainless steel, and chrome-cobalt arch wires to be thinner than their marketed values.1 However, the literature is lacking information regarding (1) accuracy of the currently available orthodontic arch wires and (2) the consistency of the arch wire size. Orthodontic wires are also exposed to various chemical …

Evaluating Conventional And Digital Impressions Of Single Unit Restorations, And Conventional Vs. Digital Impressions From The Laboratory Technicians’ Perspective, Tagreed Alohali

Student Theses, Dissertations and Capstones

Objectives: To Evaluate the quality of Digital Impressions and Conventional Impressions sent to commercial dental labs and to compare Conventional impressions vs. Digital impressions from the Laboratory Technicians’ Perspective. Background: The literature lacks studies that evaluate the quality of final impressions of indirect restorations, particularly in the USA, additionally there is a direct relation between impressions accuracy and produced restoration quality, which makes it impossible to produce high quality restoration from poor impression. Methods: 259 PVS impressions were evaluated for their quality by a calibrated examiner using a specific evaluation form. Type of tray, arch and required restoration were recorded. …

Perspectives Volume 4: Number 1, Winter-Spring 2016, College Of Health Care Sciences

Perspectives

No abstract provided.

Effect Of Stance Symmetry On Perturbation-Induced Protective Stepping In Persons Poststroke And Controls, Katherine M. Martinez

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem Statement: Stepping is a common strategy after a perturbation. Stroke survivors display a predilection for stepping with non-paretic leg. Insight into induced stepping between stroke survivors and age-matched control may guide our understanding for reactive postural control training post stroke. Purpose: To investigate the difference in perturbation-induced stepping between chronic stroke survivors and age-matched controls at three phases of the stepping response: preparation, execution, and landing and association with clinical outcome measures. Procedure: Twenty-one community-dwelling chronic stroke survivors (mean age 59y/o ±13yrs) and 17 age- and gender-matched controls (mean age 54.4y/o ±17yrs) completed this study. Clinical measures of gait, …

Doctorate In Family Therapy Curriculum, Nova Southeastern University

College of Arts, Humanities, and Social Sciences Course Catalogs

No abstract provided.

Evaluating The Validity Of Texas 2 Steps, Tracy Hallak, Luis E. Aguerrevere

Faculty Publications

The Texas 2 STEPS Evaluation Tool was assessed for face validity. Thirty Certified Orientation and Mobility Specialists (COMS) piloted the tool while evaluating children under the age of five years. Each participant was asked to evaluate their comfort level working with this population and report the number of years’ experience they have working as a COMS. The majority of participants found the tool useful for assessing orientation and mobility (O&M) skills in children. The Texas 2 STEPS was also found to be user friendly regardless of the COMS years of experience. Together these findings indicate that the Texas 2 STEPS …

Inhibition Of Enterobacter Cloacae And Klebsiella Oxytoca By Garlic (Allium Sativum L.) And Garlic Pills, Lucinda Choules, Dennis A. Gravatt, Stephen M. Kosovich, Wei Yuan, Ping Wang, Ron Havner

Faculty Publications

Multidrug resistant infections and superinfections are increasing globally. Intrinsic and acquired resistance to multiple antibiotics by bacteria from the Enterobacteriaceae family exasperate treatment efforts by clinicians. Carbapenem antibiotics were once relied upon to treat multidrug resistant infections. However, Carbapenem Resistant Enterobacteriaceae (CRE) infections are becoming more common, requiring that an alternative treatment be found. This study trialed an ancient cure, Fresh Garlic Extract (FGE) created from garlic (Allium sativum L.) and commercially prepared garlic pills against two opportunistic Enterobacteriaceae in vitro utilizing: disc diffusion, well diffusion (introducing DIFF-bolts), and HPLC. FGE and four brands of garlic pills inhibited the growth …

Review Of Adhd: What Everyone Needs To Know, Lisa N. Mccleary

Faculty Publications

No abstract provided.

A Technique Of Improved Medial Meniscus Visualization By Anterior Cruciate Ligament Graft Placement In Chronic Anterior Cruciate Deficient Knees, Christopher J. Vertullo, Lahann Wijenayake, Jane E. Grayson

Faculty Publications

It is customary to perform medial meniscus repair before anterior cruciate ligament (ACL) graft placement when undertaken as a combined procedure. However, in chronic ACL-deficient knees, intraoperative anterior tibiofemoral translation can cause the medial meniscus repair to be more technically challenging. Intraoperative anterior tibiofemoral translation can both reduce the visualization of the medial meniscus and make its reduction unstable. An operative sequence alteration of ACL graft placement and tensioning before medial meniscal repair improves medial meniscus visualization in chronically ACL-deficient knees by using the ACL graft’s ability to prevent anterior tibiofemoral translation. The technique sequence is as follows: (a) the …

Time-Course Analysis Of Brain Regional Expression Network Responses To Chronic Intermittent Ethanol And Withdrawal: Implications For Mechanisms Underlying Excessive Ethanol Consumption, Maren L. Smith, Marcelo F. Lopez, Kellie Archer, Aaron R. Wolen, Howard C. Becker, Michael F. Miles

Pharmacology and Toxicology Publications

Long lasting abusive consumption, dependence, and withdrawal are characteristic features of alcohol use disorders (AUD). Mechanistically, persistent changes in gene expression are hypothesized to contribute to brain adaptations leading to ethanol toxicity and AUD. We employed repeated chronic intermittent ethanol (CIE) exposure by vapor chamber as a mouse model to simulate the cycles of ethanol exposure and withdrawal commonly seen with AUD. This model has been shown to induce progressive ethanol consumption in rodents. Brain CIE-responsive expression networks were identified by microarray analysis across five regions of the mesolimbic dopamine system and extended amygdala with tissue harvested from 0-hours to …

An Efficient Basket Trial Design, Kristen Cunanan, Alexia Iasonos, Ronglai Shen, Colin B. Begg, Mithat Gonen

Memorial Sloan-Kettering Cancer Center, Dept. of Epidemiology & Biostatistics Working Paper Series

The landscape for early phase cancer clinical trials is changing dramatically due to the advent of targeted therapy. Increasingly, new drugs are designed to work against a target such as the presence of a specific tumor mutation. Since typically only a small proportion of cancer patients will possess the mutational target, but the mutation is present in many different cancers, a new class of basket trials is emerging, whereby the drug is tested simultaneously in different baskets, i.e., sub-groups of different tumor types. Investigators not only desire to test whether the drug works, but also to determine which types of …

Drinking From The Data Well: Response To Gamete Donor Anonymity And Limits On Numbers Of Offspring: The Views Of Three Stakeholders, Martha M. Ertman

Faculty Scholarship

No abstract provided.

Access To Essential Medicines In African Countries: An Introduction, Peter G. Danchin, Diane Hoffmann

Faculty Scholarship

No abstract provided.

Crhbp Polymorphisms Predict Chronic Pain Development Following Motor Vehicle Collision, S. D. Linnstaedt, A. V. Bortsov, A. C. Soward, R. Swor, D. A. Peak, J. Jones, N. Rathlev, D. C. Lee, R. Domeier, P. L. Hendry, S. A. Mclean

Journal Articles

Musculoskeletal pain (MSP) is a common sequela of traumatic stress exposure. While biologic factors contributing to chronic MSP after motor vehicle collision (MVC) have traditionally focused on tissue injury, increasing evidence suggests that neuro/stress/immune processes mediated by stress system activation may play a more dominant role. In a previous study we found that genetic variants in the hypothalamic-pituitary-adrenal (HPA) axis-related gene FKBP5 influence vulnerability to persistent MSP 6 weeks after MVC. In the present cohort study (n = 855) we evaluated whether genetic variants in several other important HPA axis-related genes, including the glucocorticoid receptor (NR3C1), corticotropin-releasing hormone receptor R1 …

Relationship Between Obesity And Clinical Outcome In Adults With Acute Myeloid Leukemia: A Pooled Analysis From Four Calgb (Alliance) Clinical Trials, J. J. Castillo, F. Mulkey, S. Geyer, J. E. Kolitz, W. Blum, B. L. Powell, S. L. George, R. A. Larson, R. M. Stone

Journal Articles

Obesity has been previously suggested as an adverse prognostic marker in patients with acute leukemia. To evaluate the relationship between obesity and clinical outcome, disease-free survival (DFS) and overall survival (OS), in patients with acute myelogenous leukemia (AML), including acute promyelocytic leukemia (APL), we performed a pooled analysis of four CALGB (Alliance) clinical trials. Our study included 446 patients with APL from CALGB 9710, and 1,648 patients between 18 and 60 years of age with non-APL AML from CALGB 9621, 10503, and 19808. Obesity was defined as BMI >/=30 kg/m(2) . Multivariate Cox proportional-hazard regression models were fitted for DFS …

Sotatercept (Ace-011) For The Treatment Of Chemotherapy-Induced Anemia In Patients With Metastatic Breast Cancer Or Advanced Or Metastatic Solid Tumors Treated With Platinum-Based Chemotherapeutic Regimens: Results From Two Phase 2 Studies, H. Raftopoulos, A. Laadem, P. J. Hesketh, J. Goldschmidt, N. Gabrail, C. Osborne, M. Ali, M. L. Sherman, D. Wang, J. Crawford, +3 Additional Authors

Journal Articles

PURPOSE: Sotatercept may represent a novel approach to the treatment of chemotherapy-induced anemia (CIA). We report the results from two phase 2 randomized studies examining the use of sotatercept for the treatment of CIA in patients with metastatic cancer. METHODS: In study A011-08, patients with metastatic breast cancer were randomized to 2:2:2:1 to receive sotatercept 0.1, 0.3, or 0.5 mg/kg, or placebo, respectively, every 28 days. In study ACE-011-NSCL-001, patients with solid tumors treated with platinum-based chemotherapy received sotatercept 15 or 30 mg every 42 days. The primary endpoint for both studies was hematopoietic response, defined as a hemoglobin (Hb) …

Nephrologists As Educators: Clarifying Roles, Seizing Opportunities, K. D. Jhaveri, M. A. Perazella

Journal Articles

Nephrologists play an important role in providing medical education in a variety of settings, including the medical school classroom, nephrology consult service, outpatient clinic, and dialysis unit. Therefore, nephrologists interact with a variety of learners. In this article the current state of published literature in medical education in nephrology is reviewed. Eight attending roles are identified of the nephrologist as a medical educator in the academic settings: inpatient internal medicine service, nephrology inpatient consult service, inpatient ESRD service, outpatient nephrology clinic, kidney transplantation, dialysis unit, classroom teacher, and research mentor. Defining each of these distinct settings could help to promote …

A Phase Ii Randomized Trial Comparing Standard And Low Dose Rituximab Combined With Alemtuzumab As Initial Treatment Of Progressive Chronic Lymphocytic Leukemia In Older Patients: A Trial Of The Ecog-Acrin Cancer Research Group (E1908), C. S. Zent, X. V. Wang, R. P. Ketterling, C. A. Hanson, E. N. Libby, J. C. Barrientos, T. G. Call, J. E. Chang, J. J. Liu, M. S. Tallman, +5 Additional Authors

Journal Articles

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) patients requiring initial therapy are often older and frailer and unsuitable candidates for standard chemoimmunotherapy regimens. Shorter duration combination monoclonal antibody (mAb) therapy using alemtuzumab and rituximab has been shown to be effective and tolerable treatment for CLL. Standard dose anti-CD20 mAb therapy causes loss of CD20 expression by surviving CLL cells, which can be minimized by decreasing the mAb dose. We report a randomized phase II clinical trial enrolling older (>/= 65 years) patients (median age 76 years, n=31) with treatment naive progressive CLL. Patients received 8-12 weeks of standard subcutaneous alemtuzumab …