Medicine and Health Sciences Commons^™

Penalized Mixed-Effects Ordinal Response Models For High-Dimensional Genomic Data In Twins And Families, Amanda E. Gentry

Theses and Dissertations

The Brisbane Longitudinal Twin Study (BLTS) was being conducted in Australia and was funded by the US National Institute on Drug Abuse (NIDA). Adolescent twins were sampled as a part of this study and surveyed about their substance use as part of the Pathways to Cannabis Use, Abuse and Dependence project. The methods developed in this dissertation were designed for the purpose of analyzing a subset of the Pathways data that includes demographics, cannabis use metrics, personality measures, and imputed genotypes (SNPs) for 493 complete twin pairs (986 subjects.) The primary goal was to determine what combination of SNPs and …

Aerosolized Surfactants: Formulation Development And Evaluation Of Aerosol Drug Delivery To The Lungs Of Infants, Susan Boc

Theses and Dissertations

The overall aim of this research project was to develop surfactant dry powder formulations and devices for efficient delivery of aerosol formulations to infants using the excipient enhanced growth (EEG) approach. Use of novel formulations and inline delivery devices would allow for more efficient treatment of infants suffering from neonatal respiratory distress syndrome and bronchiolitis.

A dry powder aerosol formulation has been developed using the commercial product, Survanta ® (beractant) and EEG technology to produce micrometer-sized hygroscopic particles. Spray drying and formulation parameters were initially determined with dipalmitoylphosphatidylcholine (DPPC, the dominant phospholipid in pulmonary surfactant), which produced primary particles 1 …

Predictive Relationships Between Electronic Health Records Attributes And Meaningful Use Objectives, Solomon Nii Koppoe

Walden Dissertations and Doctoral Studies

The use of electronic health records (EHR) has the potential to improve relationships between physicians and patients and significantly improve care delivery. The purpose of this study was to analyze the relationships between hospital attributes and EHR implementation. The research design for this study was the cross-sectional approach. Secondary data from the Health Information and Management Systems Society (HIMSS) Analytics Database was utilized (n = 169) in a correlational crosssectional research design. Normalization Process Theory (NPT) and implementation theory were the theoretical underpinnings used in this study. Multiple linear regressions results showed statistically significant relationships between the 4 independent variables …

Emergency Department Use For Nontraumatic Dental Conditions And Adult Oral Health, Cheryl Anne Lassiter-Edwards

Walden Dissertations and Doctoral Studies

Nontraumatic dental-related emergency department visits has resulted in a financial burden to hospitals across the United States. This study investigated whether there is a relationship between adult preventive dental care and emergency department visits for nontraumatic dental conditions by comparing specific states. Guided by Andersen's behavioral model of health services utilization, this retrospective quantitative study also investigated associations between state-specific community water fluoridation and dental-related emergency department visits. The population of interest was adult Medicaid enrollees who visited the emergency department for non-trauma-related dental conditions in the top 5 most populous states as identified in the 2012 NHAMCS survey. These …

Exploring Burnout And Perceived Stress In Emergency Managers During Deployments, Angelika Phillips

Walden Dissertations and Doctoral Studies

The stressful nature of deploying to a disaster makes it necessary for a good emergency manager to be capable of coping in high-pressure situations. When intensified by extended work hours, deployments can often lead to burnout, job strain, and emotional stress, which can have a significant impact on an employee's well-being. The purpose of this study was to examine the effects of burnout and perceived stress amongst emergency managers working for FEMA and to determine if social support was an effective intervention. The theoretical foundation used for this study was the job demands-resources theory, which aided in understanding, explaining, and …

Use Of Simulation For Tracheostomy Care, A Low Volume, High Risk Nursing Procedure, Vijaya Ramakrishnan

Walden Dissertations and Doctoral Studies

Often, education regarding low volume and high-risk procedures, like tracheostomy, are ignored. Lack of experience, skills, and human resources can lead to decreases in confidence levels, diminished quality of care, and potentially an adverse event. The purpose of this DNP project was to prepare simulation-based education on the tracheostomy procedure and provide hands-on education to bedside nurses. The project answered the question: To what extent will a simulation-based teaching method adequately prepare staff nurses in a post-acute surgical unit to perform this high risk low volume procedure? The Johns Hopkins evidence-based model method was used to assist in translation of …

Oral Care And The Connection To Adverse Events In Dentistry, Melissa A. Rhoney

Walden Dissertations and Doctoral Studies

As the healthcare industry continues to change, dental providers are concerned about the different types of adverse events that can occur if systemic diseases are not well understood when treating patients. The purpose of this study was to explore the level of understanding among dental care providers of the relationship between oral care and systemic diseases and how these are linked to adverse events. The theoretical foundation that was used for this study was the Swiss cheese model. The research questions were designed to address the level of understanding among dental care providers of the link between oral care and …

Educational Training Of Staff Nurses For Evidence-Based Practice, Tina June Theriaque

Walden Dissertations and Doctoral Studies

Translating research into practice takes 10 to 20 years or more. Evidence-based practice (EBP) integration remains at 10% to 20%, despite recommendations requiring EBP-guided decisions. Up to 30% decreases in health care system spending, improved quality outcomes, and increased staff satisfaction result from EBP integration. Nurse leaders, who rate quality and safety as the highest priority but EBP as the lowest, are accountable for EBP enculturation; a desire to support bedside registered nurses in EBP exists, yet this EBP use knowledge gap supersedes this goal. The purpose of this project was to provide an EBP education program introducing the use …

The Effects Of Hourly Rounding On Patient Safety And Satisfaction, Renee Allatzas

Walden Dissertations and Doctoral Studies

The clinical practice problems addressed by the DNP project were the low patient satisfaction scores and the high number of falls on a hospital neurological step-down unit. The purpose of this project was to improve the Hospital Consumer Assessment of Healthcare Providers and Systems score on one patient satisfaction question and decrease the number of patient falls by implementing hourly rounding, using a script related to patient comfort and toileting needs. The scripted questions were expected to increase the satisfaction of patients and decrease unassisted falls due to increased attention to patient pain and positioning and timely help with toileting …

Levels Of Income And Quality Of Care For Adults With Type 2 Diabetes, Lorna Bowen

Walden Dissertations and Doctoral Studies

Type 2 diabetes impacts the lives of adults in the low-income, middle-income, and high-income brackets in the United States and globally. More research was needed on how adults 45 years and older in Marion County managed their diabetes and the care they received based on their income. This case study involved investigating how adults 45 years and older in Marion County self-managed their diabetes and the quality of care they received based on their income. The health belief model supported the conceptual framework for the study. Data were collected through face-to-face and telephone interviews with 15 purposefully selected participants. Data …

Quality Of Life Among Entrepreneurs With Chronic Fatigue Syndrome, Brittany Kesler

Walden Dissertations and Doctoral Studies

The impacts of chronic fatigue syndrome (CFS) are far reaching, resulting in many burdens in the individual lives of CFS patients. One notable challenge lies in the inability to participate in the workforce due to associated physical, mental, and emotional symptoms. Previous research indicates that alternative employment options may help to overcome work related barriers presented with various types of chronic illness. Entrepreneurship is one path to working that offers many benefits, including autonomy, flexibility of work schedule, choice of work environment, and control. Questions though remain as to whether entrepreneurship enhances QOL or exacerbates symptoms among individuals with CFS. …

The Predictability Of Facebook Memorial Page Participation On Grief, Colleen Grote

Walden Dissertations and Doctoral Studies

As the world's largest social networking site, Facebook, continues to grow in popularity, it is imperative for counselors and counselor educators to better understand how online environments impact all facets of life, including death. Grief behaviors on Facebook have been a focus of scholars since the launch of the social networking site in 2004. Researchers have demonstrated that Facebook memorial pages have a significant impact on the social and cultural practices related to death and memorialization for Facebook users. However, despite a rapid rise in research related to online mourning, researchers have yet been able to establish the potential risk …

A Comparative Analysis Of Family Therapies On Youth With A Co-Occurring Disorder, Rochelle Henderson-Clark

Walden Dissertations and Doctoral Studies

There are approximately 1.3 million youth who have been diagnosed with a co-occurring disorder. The purpose of this study was to analyze the relationship between the type of therapy (brief strategic family therapy or family functional therapy), demographic factors (age, race, type of drug used), and therapy discharge status (successful or unsuccessful) in male youth with a co-occurring disorder of attention-deficit hyperactivity disorder and substance use disorder. A correlational research design of a cross-sectional nature was used for this study and secondary data were obtained from a mental health agency located in Hampton Roads Virginia. The theoretical basis for this …

Improved Rehabilitation By Improving Discharge Processes To Decrease Readmissions, Deborah A. Walton

Walden Dissertations and Doctoral Studies

Inadequate discharge planning for individuals with chronic illnesses or injuries is associated with increased readmissions to the hospital or rehabilitation facility where the original treatments were administered. To help ensure the recovery of discharged patients and avoid readmissions, discharge planners guide medication and care processes. The rate of readmissions was high in a stand-alone rehabilitation center due to ineffective discharge plans. Patients, family members, and caregivers lacked knowledge about medications, treatments, and self-care guidelines after the patient left the facility. The purpose of this project was to ascertain the impact of improved discharge processes using the (a) IDEAL Discharge Planning …

Motivation And Sociodemographic Factors In Organized Physical Activity Events, Katy Gozalka

Walden Dissertations and Doctoral Studies

Adult physical activity is important for prevention of chronic diseases and to minimize health issues; therefore, the motivational influences of sociodemographic variables on participation in organized physical activity events warrant an investigation. The purpose of this quantitative study was to investigate differences in motivational influences between various sociodemographic variables as related to physical activity events in organized settings. The theoretical framework that guided this research study consisted of the theory of reasoned action (TRA), and the health belief model (HBM). The TRA was applied to study the intention of health behavior, while the HBM was used to investigate individuals' motivation …

Predictors Of Readmission To Youth Counseling Services Among Adolescents In Saskatoon Canada, Felicia Lawal

Walden Dissertations and Doctoral Studies

Anxiety, depression, and substance use disorders are some of the frequently occurring mental illnesses among Canadian children and adolescents that can result in debilitating short and long terms outcomes. The rise in readmission rates for recipients of mental illness in Saskatchewan, coupled with the high incidences of suicide-related deaths, necessitates a patient outcome evaluation for predictors of readmission to youth counseling services among adolescents. The purpose of this secondary data analysis study was to explore the associations between anxiety, depression, substance use disorder, individual counseling, family counseling, group counseling, and the outcome of readmission within 1 year following discharge from …

Coping With Sickle Cell Disease Using Cognitive Behavior Therapy, Helen Alexander

Walden Dissertations and Doctoral Studies

This project focused on identifying the best evidence available on the use of cognitive behavior therapy (CBT) for pediatric patients and families with sickle cell disease (SCD) to improve their coping skills with pain management. This resulted from an identified gap in nursing practice regarding psychosocial support for this subset of hospitalized pediatric patients. The practice-focused question was whether there was evidence in the literature on the use of CBT techniques to improve parental coping skills with children who have chronic and life-threatening illness that could be utilized with sickle cell disease. The theory of stress and coping guided the …

The Influence Of Static Stretching Of Knee Flexors On Knee Biomechanics, Joshua David Perrin

Browse all Theses and Dissertations

There is a greater incidence of non-contact anterior cruciate ligament (ACL) injury in female athletes compared to males. The higher rate of ACL injury in female athletes is most likely multifactorial and is influenced by intrinsic and extrinsic risk factors. This study examines the effects of an extrinsic factor — static stretching of the hamstrings on knee biomechanics. Twelve female athletes performed drop vertical jump (DVJ) tasks before and after a hamstrings static stretching protocol. Knee kinematics and kinetics were recorded during the contact phase of the DVJ. The results of this study revealed stretching had no significant effect on …

The Effect Of Soleus Fatigue During Sidestep Cutting Maneuvers: Implications For The Acl, Michael William Ciesa

Browse all Theses and Dissertations

The soleus muscle is a monoarticular plantarflexor composed slow-twitch fatigue-resistant muscle fibers. Through its attachment to the proximal tibia, contraction of the soleus muscle in a closed kinetic chain (when the foot is planted) produces a posterior pulling force on the posterior proximal tibia. The anterior cruciate ligament (ACL) is responsible for preventing anterior displacement of the tibia relative to the femur. Through the production of a posterior pulling force on the tibia, soleus muscle contraction in a closed kinetic chain could help reduce strain on the ACL. Fatigue is a neuromuscular phenomenon that can alter biomechanical strategies during athletics …

The Scoop, Vol. 4 Issue 10, January 2018, Health Sciences Library

Volume 4

Latest news and events from the Health Sciences Library in our monthly newsletter for January 2018.

Accuracy Of A Smartphone-Based Orthodontic Treatment Monitoring Application, Heather Moylan

Theses and Dissertations

Objectives: Dental Monitoring® (“DM,” Dental Monitoring, Paris, France), is a cloud-based software that allows orthodontists to track patients’ treatment remotely. The purpose of this study was to investigate the accuracy of the software in making linear measurements.

Methods: Patients took intraoral photographs using the DM application, immediately followed by impressions for plaster models. Intercanine and intermolar width and arch depth measurements were made by DM and compared to measurements made on the plaster models. Data was analyzed using two one-sided t-tests for equivalence with equivalence bounds of

+/-0.5mm. Significance level was set at 0.05.

Results: Thirty sets of measurements were …

Expressway To Cancer Clinical Trials: Reducing Administrative Barriers To Enrollment, Audra Putt, Mph, Cph

Michigan Journal of Public Health

This "Notes from the Field" piece provides information on the work of MCC's cancer control priorities and the results of collaborative efforts to address them. The MCC's Clinical Trials Workgroup was tasked with developing a project to support the Cancer Plan for Michigan’s Diagnosis and Treatment Goal in 2016.

Fragile X Syndrome And Family Occupations: Sertraline Treatment, Tracy Ye, Decerie Mendoza, Elena A. Javier, Martina C. Dualan

Student Research Posters

Current research on children with Fragile X Syndrome (FXS) lacks inclusion of qualitative outcomes on the child’s daily occupational performance. Standardized measurements are frequently utilized and provide useful information, however, can be less sensitive to change (Berry Kravis et al., 2013) and miss capturing family perspectives and improvements within meaningful occupations. This research incorporates family perspectives via semi-structured interviews to promote an in-depth understanding about FXS and its impact on child and family occupations in addition to standardized assessment scores through in-depth case study analysis. This study used a mixed method research design examining four male participants who were given …

A Sensory-Based Program To Enhance Occupational Performance For Dementia, Naomi Grace Wong, Jacob Joseph Gantan, Ivy Annahi Torres-Flores, Heather Anne August

Student Research Posters

Dementia is a neurological disease, causing behavioral and cognitive symptoms, that progressively impairs an individual’s ability to engage in meaningful activities. Progressive deterioration associated with dementia impacts occupational performance and independence and quality of life. Sensory based interventions, such as drumming groups, have been hypothesized to be a non-pharmacological intervention for individuals with dementia. The purpose of this study was to analyze the effects of a sensory based intervention program, in this case participation in a drumming group, on functional engagement during self-feeding for individuals with dementia. Researchers gathered data over the course of two days using the Functional Behavior …

Exploratory Application Of A Sensory Activity Schedule In Head Start Preschool, Marian Perez, Elaine Wong, Michelle Perryman

Student Research Posters

Objective: The objective of this research is to determine whether the implementation of sensory activity schedule in a preschool classroom can increase the on-task behaviors of the students.

Methods: Three students were recruited to participate in a quantitative multiple single subject design with qualitative follow-up study. The participants performed sensorimotor activities before circle time and were monitored for frequency of their off-task behavior using a time sampling frequency data collection. Afterwards, the head teacher was interviewed to discuss the experience.

Results: Off-task behavior decreased from baseline on all three children, which supports the efficacy of sensory activity schedule in reducing …

The Impact Of Fall Efficacy On Occupational Performance In Community-Dwelling Older Adults, Michelle Fong, Araya Moua, Erin Denola, Merit Franklin

Student Research Posters

Falls are a major health concern in the older adult (OA) population. While there is research on falls and their prevention, research on how low fall efficacy (FE) impacts the occupational engagement of the OA population is limited. FE is defined as the confidence a person has in his/her ability to complete a task without falling (Tinetti & Powell, 1993). A qualitative study was conducted using a phenomenological approach to explore the lived experiences of OAs with low FE and the impact on occupational performance. Participants who scored ≤ 6 on the Modified Fall Efficacy Scale (MFES) engaged in a …

Assistive Technology And The Impact Of Occupations, Chelsea Golding, Chantelle Bond, Vhernna Fernandez, Eizelle Barrientos

Student Research Posters

Objective: The purpose of this research was to empirically examine the occupational impact of assistive technology - AT (with a specific focus on word prediction, text to speech and speech recognition) from the perspectives of the end user, family and school personnel (e.g. teachers, therapists & specialists) across various contexts (e.g. home, school, community).

Method: Qualitative data included semi-structured interviews, audio and video recordings, and records reviews. The data was coded and analyzed using a constant comparison method to identify themes pertaining to the occupational use of AT and thusly the impact to overall occupational performance.

Findings: Six themes were …

Occupational Responses Of Older Adults Following Partner Loss, Carol Huang, Jane Song, Peter Behr, Stephanie Sterner

Student Research Posters

Spousal loss has been frequently identified as a life stressor that can greatly impede one’s ability to age at home. The purpose of this study is to identify the occupational changes that commonly result after this event and their impacts on one’s ability to age in place. This study utilized a qualitative phenomenological research design. Eight participants were recruited from an educational program for older adults and were interviewed using a semi-structured interview format. Researchers transcribed and coded all interviews to determine emergent themes. Two major categories of themes were found: occupational and intrinsic responses. The areas of occupation that …

Fulminant Hemolysis In Glucose-6-Phosphate Dehydrogenase Deficiency, Bushra Moiz, Sidra Asad Ali

Department of Pathology and Laboratory Medicine

Key Clinical Message
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked disorder affecting some 400 million people worldwide. Though clinically silent, it may result in hemolysis on oxidative stress induced by drugs or infections. Viral hepatitis A with coexisting G6PD deficiencycan be devastating associated with severe hemolysis, anemia, renal failure, and hepatic encephalopathy.

Ectopic Enterobius Vermicularis Iinfestation; An Extremely Rare Cause Of Mesenteric Lymphadenopathy Mimicking Tuberculous Lymphadenitis, Summaya Zafar, Muhammad Usman, Zubair Ahmad

Department of Pathology and Laboratory Medicine

Enterobius vermicularis (EV) is a pinworm which commonly resides in the lumen of the intestinal tract and lays eggs on the perianal skin. However, rarely the worm can infest various other sites in the body and cases with infestation of such ectopic sites have been reported in literature. Rare cases of mesenteric lymph node involvement have also been reported. We report a case in a young male who presented with signs and symptoms of acute appendicitis. During surgery, enlarged mesenteric lymph nodes were identified. Histological examination revealed adult worm in the appendiceal lumen. Histological examination of mesenteric lymph node revealed …