Medicine and Health Sciences Commons^™

Managing Operational Efficiency And Health Outcomes At Outpatient Clinics Through Effective Scheduling, Samira Fazel Anvaryazdi

Wayne State University Dissertations

A variety of studies have documented the substantial deficiencies in the quality of health care

delivered across the United States. Attempts to reform the United States health care system in the 1980s and 1990s were inspired by the system's inability to adequately provide access, ensure quality, and restrain costs, but these efforts had limited success. In the era of managed care, access, quality, and costs are still challenges, and medical professionals are increasingly dissatisfied.

In recent years, appointment scheduling in outpatient clinics has attracted much attention in

health care delivery systems. Increase in demand for health care services as well …

Integrated Analysis Of The Value Of Wetland Services In Coastal Adaptation; Methodology And Case Study Of Hampton-Seabrook Estuary, New Hampshire, Paul Kirshen, Semra Aytur, David M. Burdick, Diane Foster, Tom Lippmann, Ellen Douglas, Sydney Nick, Chris Watson

Jackson Estuarine Laboratory

The present impacts from coastal storms and high tides grow significantly over time due to SLR even over the relatively short period to 2060. Hydrodynamic model simulations of storm surge with and without sea level rise scenarios show that although flooding and inundation increases with increasing subtidal forcing and higher sea level, dissipation of the tide and storm surge in the estuary channel somewhat limits the maximum inundation that might otherwise be expected in the back marsh areas. The estuary is dominated by high marsh, which lies high in the intertidal zone and by 2060 it will convert to mostly …

Vcu Health Nursing Inquiry Process Diagram (Version 2), Roy E. Brown

VCU Libraries Faculty and Staff Publications

This diagram outlines the nursing inquiry process to help answer questions that arise in the clinical setting. The diagram further helps a nurse understand how to distinguish whether a situation calls for evidence-based practice, performance improvement or research. It also guides a nurse through clarifying the initial question, gathering the evidence, and through each step in the subsequent process.

Speech Language Pathology Graduate Handbook - 2017-2018, Department Of Audiology And Speech-Language Pathology, East Tennessee State University

Speech-Language Pathology Handbooks

No abstract provided.

Using Art Observation In Museum Education To Broach Topics Of Bias And Power Among Health Professional Trainees, Robert Michel Rock

Yale Medicine Thesis Digital Library

The Liaison Committee on Medical Education has identified training on cross cultural interaction and bias as high-priority topics. There has been little published on the use of fine art, specifically painting or sculpture, as a means of entry into discussion on issues of bias in medicine relating to race, gender, and other identities. Making the Invisible Visible (MIV) is a 3-hour, guided museum tour that uses art observation to facilitate dialogue about biases embedded in Western culture as well as their influence on personal and professional interaction. The tour uses intersectionality and critical pedagogy as theoretical frameworks to approach multiple …

Long-Term Survival Of De Novo Stage Iv Human Epidermal Growth Factor Receptor 2 (Her2)-Positive Breast Cancers Treated With Her2 Targeted Therapy, Yao Wong

Yale Medicine Thesis Digital Library

Background: An increasing number of metastatic HER2 positive cancers are diagnosed as de novo stage IV disease. We hypothesize that a subset of these patients, who achieve complete clinical response or no evidence of disease (NED) status after multi-agent HER2-targeted treatments may have long progression free (PFS) and overall survival (OS).

Methods: 483 patients with de novo stage IV HER2 positive breast cancer diagnosed between 1998-2015 were identified through the medical records at Yale and MD Anderson Cancer Centers. Treatment, clinical variables and survival were extracted and compared between those who achieved NED status and those who did not.

Results: …

Investigation Of Wavenumber Calibration For Raman Spectroscopy Using A Polymer Reference, Dongyue Liu, Hugh Byrne, Luke O'Neill, Bryan M. Hennelly

Conference papers

Raman spectroscopy is an optical technique that can be used to evaluate the biomolecular composition of tissue and cell samples in a real-time and non-invasive manner. Subtle differences between datasets of spectra obtained from related cell groups can be identified using multivariate statistical algorithms. Such techniques are highly sensitive to small errors, however, and, therefore, the classification sensitivity of Raman spectroscopy can be significantly impacted by miscalibration of the optical system due to small misalignments of the optical elements and/or variation in ambient temperature. Wavenumber calibration is often achieved by recording the spectrum from a wavenumber reference standard, such as …

Curricula And Methods For Physician Compassion Training: Protocol For A Systematic Review, Sundip Patel, Alexis Pelletier-Bui, Stephanie Smith, Michael Roberts, Hope Kilgannon, Stephen Trzeciak, Brian Roberts

College of Science & Mathematics Departmental Research

Introduction: Compassionate patient care has been associated with improved clinical outcomes for patients. However, current evidence suggests that healthcare is experiencing a compassion crisis, with physicians frequently overlooking opportunities to treat patients with compassion. Although there is evidence that compassionate care can be enhanced through training interventions, it is currently unclear what specific skills and behaviours ought to be taught and how best to transfer this information to the learner. The objectives of this systematic review are to collate the world’s literature on compassion training to determine (1) the specific skills and behaviours that should be taught (curriculum), and (2) …

Gender Disparities In The Association Between Socio-Demographics And Non-Communicable Disease Risk Factors Among Adults With Disabilities In Shanghai, China, Youran Zhang, Gang Chen, Qi Zhang, Jun Lu, Huijiong Yu

Community & Environmental Health Faculty Publications

BACKGROUND. Non-communicable disease (NCD) risk factors can co-exist with disability and cause a greater burden on the health status of adults with disabilities. A lack of egalitarian social policies in China may result in gender disparities in the NCD risk factors of adults with disabilities. However, little is known about the gender disparities in the association between socio-demographics and NCD risk factors among adults with disabilities in China; consequently, we examined this association among adults with disabilities in Shanghai, China.

METHODS. We used the health examination data of 44,896 adults with disabilities in Shanghai in 2014. Descriptive analyses and …

Health Professions Students' Attitudes Toward Teamwork Before And After An Interprofessional Education Co-Curricular Experience, Shelley C. Mishoe, Kimberly Adams Tufts, Leigh Ann Diggs, James D. Blando, Denise Claiborne, Johanna M. Hoch, Martha L. Walker

Community & Environmental Health Faculty Publications

Background: Effective interprofessional collaboration may positively impact clinical outcomes, patient satisfaction, and cost effectiveness. However, educational silos and discipline-specific socialization have reinforced each health profession’s independent values, attitudes, and problem-solving approaches.

Methods and Findings: Students’ (N = 376) attitudes about teamwork were measured with the Interprofessional Attitudes Scale, Teamwork, Roles, and Responsibilities subscale using a pretest-posttest design. Experiential learning strategies and a case study approach were used to introduce students to the roles and responsibilities of the students’ disciplines. There was a positive mean difference in pretest-posttest measures (p < .001) with a moderate effect size (r = .27).

Conclusions: Providing opportunities for pre-licensure health sciences …

Preparedness Of School Psychologists To Provide Services For Students Diagnosed With Cancer, Lauren Mckenzie Blevins

Theses, Dissertations and Capstones

Children who survive cancer face many challenges when reintegrating into the school system. School psychologists are among the school support professionals who may aid in providing support and identifying appropriate interventions and accommodations for the academic and mental health needs of these students. This study identifies whether school psychologists in West Virginia perceive themselves to be adequately prepared to assist students who have survived cancer upon returning to school. A survey containing fourteen questions regarding the individual’s experience, training, and knowledge was distributed to school psychologists in attendance at the Fall 2016 West Virginia School Psychologists’ Association conference. Of the …

Prenatal Opioid Maintenance In The U.S. And Its Effect On Neonatal Abstinence Sysndrome: The Case Of West Virginia's Opioid Epidemic, Morgan Ruley

Theses, Dissertations and Capstones

Introduction: West Virginia’s opioid epidemic has been the cause of about 1,000 deaths each year. Opioid abuse has become an issue among pregnant mothers and has increased the effects of NAS in infants. The purpose of this research study was to evaluate the participation of prenatal opioid maintenance to determine if it has decreased the amount of treatment needed for NAS in infants in WV.

Methodology: The methodology for this study utilized a literature review and a semi-structured interview. It consisted of academic sources, five electronic databases, academic journals, and government websites. Thirty-seven sources were referenced for this literature …

Cephalometric Analysis Of Growth And Treatment With The Structural Technique: A Review Of Its Background And Clinical Application, Ib Leth Nielsen

Taiwanese Journal of Orthodontics

The aim of this review is to provide the fundamental basis and scientific evidence for the so-called “structural technique.” In this article we will discuss the benefits and challenges of this technique as well as present and compare it to the so-called “best fit” technique. Furthermore, we will introduce the three parts of the analysis, most commonly used for evaluation of growth and treatment changes. The “structural technique” developed by Professor Arne Björk and his associate Dr. Vibeke Skieller is the result of their longitudinal studies using metallic implants as biological markers. These studies showed that most of the information …

Education And Enhanced Support To Improve Breastfeeding Success: A Quality Improvement Project In A Rural Community, Amberlyn Kay Gentry

Doctor of Nursing Practice Projects

Abstract

Problem Description: Breastfeeding continuation rates fall below the Healthy People 2020 goal of 60.6% for any breastfeeding at six months postpartum. In Navajo County, Arizona the breastfeeding rate for WIC participants was 36.9%. Breastfeeding provides health benefits to babies and women and decreased health care costs. A quality improvement project was developed and implemented with a pilot group of participants in a rural Northeastern Arizona community.

Interventions: After a thorough literature review, four interventions were selected. These included: development of a community health coalition, prenatal breastfeeding education, administration of a new baby tea event, and extended support …

Implementation Of A Nurse Visit Model For Patients With Congestive Heart Failure In A Federally Qualified Health Center, Heather Brantley

Doctor of Nursing Practice Projects

Background: Chronic congestive heart failure is the primary cause for hospitalizations among people 65 and over in the United States, resulting in two-thirds of all heart failure costs .Congestive heart failure (CHF) continues to be one of the most prevalent and expensive chronic illnesses to treat throughout the world in a time when cost-effectiveness, improved quality, and care based on outcomes is a requirement . Chronic heart failure is the primary cause for hospitalizations among people 65 and over in the United States, resulting in two-thirds of all heart failure costs (Lambrinou, Kalogirou, Lamnisos, & Sourtzi, 2012). Traditional approaches …

Deaf In Her Own Way: The Role Of Identity In Social Justice Leadership, Judy Drescher

Student Coursework: Ed.D. program

The following fieldwork chronicles the personal and professional trajectory of Cindy Greenspun, a social justice leader at Yale University Library. At the age of eighteen months, Greenspun suffered an illness that resulted in the loss of her hearing and spent nearly the first half of her life fully immersed in the hearing world. Through significant self-reflection and perseverance, Greenspun evolved beyond the binary paradigm of oralism–the exclusive use of speech and lip reading–to ultimately embrace the essence of being both bilingual (speech and sign) and bicultural (hearing and non-hearing). These attributes not only enabled Greenspun to navigate between two distinctly …

Proactive Coordination In Healthcare Service Systems Through Near Real-Time Analytics, Seung Yup Lee

Wayne State University Dissertations

The United States (U.S.) healthcare system is the most expensive in the world. To improve the quality and safety of care, health information technology (HIT) is broadly adopted in hospitals. While EHR systems form a critical data backbone for the facility, we need improved 'work-flow' coordination tools and platforms that can enhance real-time situational awareness and facilitate effective management of resources for enhanced and efficient care. Especially, these IT systems are mostly applied for reactive management of care services and are lacking when they come to improving the real-time "operational intelligence" of service networks that promote efficiency and quality of …

Chk1 Target Validation In Recurrent Mutant P53 Pediatric Tumors, Jeremiah D. Shultz, Barbara J. Bailey, Pankita H. Pandya, Jixin Ding, Kevin Van Der Jeught, M. Reza Saadatzadeh, Xiongbin Lu, Karen E. Pollok

Summer Research

Based on genomic data from the Pediatric Precision Genomics Program at Riley Hospital as well as published studies, many recurrent pediatric solid tumors express mutant forms of the tumor suppressor protein p53. p53’s central role in cell cycle arrest and apoptotic pathways has been well studied. Glioblastoma multiforme (GBM) and Ewing’s sarcoma are two cancers with low 5-year survival rates in recurrent pediatric populations. GBM is the most aggressive type of brain tumor, with survival rates that range from 15-30% in pediatrics. Ewing’s is a rare cancer of the bone and the soft tissue around the bones with a 70% …

Sex Differences In Bone Marrow Mast Cell St2 Expression In Response To Il-33 Stimulation, Madison Tissue, Rachel Gensamer, Melissa Brown, Margaret Caulfield

Summer Research

Multiple sclerosis (MS) is an autoimmune disease of the CNS that leads to physical disability, cognitive impairment, and other symptoms associated with neurological damage. MS is a T-cell mediated demyelinating disease with a male to female ratio of 1:3. The molecular mechanisms of sex differences in MS are not well understood. This sexual dimorphism is reflected in experimental autoimmune encephalomyelitis (EAE), a murine model of MS in SJL/J mice. Previous studies show sex-specific differences in immune production and response to IL-33 which promotes a protective Th2 response to EAE in male mice. We set out to understand how sexspecific cell …

Evidence-Based Guidelines And Protocol Implementation In A Primary Care Clinic To Improve Chronic Asthma Care, Jo E. Cote

Doctor of Nursing Practice Projects

The aim of this project was to pilot the implementation of evidence-based guidelines and protocols for chronic asthma care in a rural primary care clinic system. Asthma is under-diagnosed and under-treated, resulting in significant burden of disease. Achieving asthma control requires collaborative care between the patient and healthcare clinicians. Education on evidence-based guidelines was provided to healthcare clinicians. Effectiveness of education and integration of altered workflow was measured. Integration of evidence-based guidelines and protocols was demonstrated by clinicians. The results support expanding the project to the remaining five clinics in the clinic system.

Making The Grade: Mentors’ Perspectives Of A Course-Based, Smart, Healthy Campus Pilot Project For Building Mental Health Resiliency Through Mentorship And Physical Activity, Rebecca Fried, Shazya Karmali, Jennifer Irwin, Francesca Gable, Alan Salmoni

Health Studies Publications

The purpose of this academic-year-long pilot study was to explore senior Kinesiology students’ (i.e., ‘mentors’; N = 30) experiences in an undergraduate course focused on building resilience among first- years via physical activity (PA) and mentorship. The psychosocial experiences of mentors were also tracked via qualitative interviews and validated questionnaires at pre-, mid-, and post-intervention. Inductive content analysis revealed mentors’ perspectives of the program’s positive influence on their PA, resilience, and mental health; and some added stressors. One-way, repeated-measures ANOVAs indicated few statistically significant findings over time regarding participants’ levels of: resilience [F(2, 54) = 8.82 , p < .05]; behavioural control [F(2, 54) = 25.44, p < .05 ]; and positive affect [F(2, 54) = 52.97, p < .05 ]. This pilot program demonstrates promise for future university-based interventions.

Nephrocutaneous Fistula Due To Xanthogranulomatous Pyelonephritis, Simcha Weissman, Madeeha Ghaffar, Dana Safavian, Sharma Rubal, Anthony Khabut, Mohammad G. Maruf, Michael Krzyzak

Touro College of Osteopathic Medicine (New York) Publications and Research

While the development of a fistulous tract from the kidney to the proximal adjacent organs is relatively common, a tract leading to the skin is a rare occurrence. The primary cause of a fistula is prior surgical intervention or malignancy leading to abscess formation. Our case involves Xanthogranulomatous pyelonephritis (XGP) causing a longstanding lobulated abscess, ultimately leading to the formation of a fistulous tract.

Non-Insidious Large Joint Manifestation Of Severe Cachectic Rheumatoid Arthritis., Simcha Weissman, Mira Alsheikh, Khalil Kamar, Joshua Breslin, Anthony Khabut, Mohammad G Maruf

Touro College of Osteopathic Medicine (New York) Publications and Research

Rheumatoid arthritis (RA) is an autoimmune disorder in which constitutional symptoms typically occur before joint swelling becomes a true clinical phenomenon. Weight loss, although common, is generally mild in nature and occurs after long standing inflammation. While large joints do become inflamed, RA has a much stronger predilection for the small joints. Our case is a rarity in the fact that there was initial large joint swelling without long standing inflammation. Additionally, the weight loss was cachectic in nature and extreme. Furthermore, while extra-articular manifestations do commonly occur, spontaneous pneumothorax is certainly atypical. The content of this manuscript serves to …

Imaging-Based Clusters In Current Smokers Of The Copd Cohort Associate With Clinical Characteristics: The Subpopulations And Intermediate Outcome Measures In Copd Study (Spiromics), Babak Haghighi, Sanghun Choi, Jiwoong Choi, Eric A. Hoffman, Alejandro P. Comellas, John D. Newell, R. Graham Barr, Eugene Bleecker, Christopher B. Cooper, David Couper, Mei Lan Han, Nadia N. Hansel, Richard E. Kanner, Ella A. Kazerooni, Eric A.C. Kleerup, Fernando J. Martinez, Wanda O'Neal, Stephen I. Rennard, Prescott G. Woodruff, Ching-Long Lin

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Classification of COPD is usually based on the severity of airflow, which may not sensitively differentiate subpopulations. Using a multiscale imaging-based cluster analysis (MICA), we aim to identify subpopulations for current smokers with COPD.

METHODS: Among the SPIROMICS subjects, we analyzed computed tomography images at total lung capacity (TLC) and residual volume (RV) of 284 current smokers. Functional variables were derived from registration of TLC and RV images, e.g. functional small airways disease (fSAD%). Structural variables were assessed at TLC images, e.g. emphysema and airway wall thickness and diameter. We employed an unsupervised method for clustering.

RESULTS: Four clusters …

Use Of A 4-Week Up-Titration Regimen Of Roflumilast In Patients With Severe Copd, Henrik Watz, Nitin Bagul, Klaus F. Rabe, Stephen I. Rennard, Vijay Kt Alagappan, Jonas Román, Axel Facius, Peter Ma Calverley

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: The oral selective phosphodiesterase-4 inhibitor roflumilast (ROF) reduces exacerbations in patients with severe COPD. Adverse events (AEs) can cause early ROF discontinuation. Alternative dosing strategies may help patients continue their therapy.

METHODS: In this multicenter, double-blind trial, 1,321 patients with severe COPD were randomized 1:1:1 to 4 weeks' treatment with ROF 250 µg once daily (OD), 500 µg every other day (EOD), or 500 µg OD, each followed by ROF 500 µg OD for 8 weeks, plus standard therapy. The primary end point was the percentage of patients prematurely discontinuing study treatment.

RESULTS: Patients in the 250 µg OD/500 …

The Visualizations Behind The Genetics Of Athletic Injury And Performance, Dylan Pinckert

Art Honors Papers

No abstract provided.

Virginia Dental Journal (Vol. 95, No. 1, 2018)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 95, No. 3, 2018)

Virginia Dental Journal

No abstract provided.

2018 Apothecary, Southwestern Oklahoma State University

Apothecary

This publication is dedicated to the Southwestern College of Pharmacy faculty, staff, alumni, and students. We congratulate this year's graduating seniors and wish you success in your professional careers.

It is with great honor we present the 2018 Apothecary issue. This year’s Apothecary was made possible by the provision of generous financial contributions from many stores, businesses, and Southwestern College of Pharmacy alumni. We greatly appreciate and thank you for your continued support.

Assessing Health Beliefs Associated With Chronic Obstructive Pulmonary Disease Among Nepalese College Students, Tyler Cutrer

Merge

Chronic Obstructive Pulmonary Disease (COPD) is a rising global health issue in developing countries, such as Nepal, due to several preventable risk factors such as smoking. In this study, the researcher will assess the perceived risks and susceptibility associated with COPD among the Nepali student population at Mississippi University for Women (MUW). The researcher utilized the Health and Belief Model as an analysis framework and conducted qualitative research in the form of a focus group. As the study population, Nepali students were invited to complete a semi-structured interview in order to explore their health beliefs related to COPD. The interview …