Medicine and Health Sciences Commons^™

Electronic Health Record Implementation Strategies For Decreasing Healthcare Costs, Christopher A. Foster

Walden Dissertations and Doctoral Studies

Some managers of primary care provider (PCP) facilities lack the strategies to implement electronic health records (EHRs), which could decrease healthcare costs and enhance the efficiency and quality of healthcare that patients receive. The purpose of this single-case study was to explore the strategies PCP managers used to implement EHRs to decrease healthcare costs. The population consisted of 5 primary care managers with responsibility for the administration, oversight, and direct working knowledge of EHRs in Central Florida. The conceptual framework was the technology acceptance model. Data were collected from semistructured face-to-face interviews and the review of company documents, including training …

Advisory Committee On Immunization Practices Recommendations, Socioeconomics, Demographics, And Influenza Vaccine Uptake, Jennifer Gadarowski

Walden Dissertations and Doctoral Studies

Seasonal influenza outbreaks are associated with morbidity and mortality in the United States. Though children are the most susceptible to influenza infection and are most likely to transmit the illness to others, many children are not vaccinated. The purpose of this study was to examine the relationship between seasonal influenza vaccination Advisory Committee on Immunization Practices (ACIP) recommendations, demographic characteristics, socioeconomic factors, and vaccine type among children over 3 consecutive flu seasons. This quantitative cross-sectional study was guided by the social ecology of health model. Secondary data from 3 consecutive flu seasons (2014-2015, 2015-2016, and 2016-2017) provided by the National …

Evaluating An Educational Initiative For Postsurgical Vascular Patients, Cynthia Ann Gillespie

Walden Dissertations and Doctoral Studies

The educational medium GetWellNetWork (GWNW) in a large magnet teaching facility offered few educational videos specific to vascular patients with a focus on leg elevation after lower extremity bypass surgery. Supplying patient-specific education has the potential for providing cost-effective nursing care to vascular patients and improving hospital reimbursement. Guided by the interactive care model, a storyboard was developed using best-practice evidence for vascular postoperative patients that could lead to the development of a video to address the educational needs of vascular patients upon discharge. The practice focused question asked if a video addressing the importance of leg elevation would improve …

Public Health Implications Of Retailer Resale Of Returned Textile Clothing Merchandise, Antonette M. A. Francis-Shearer

Walden Dissertations and Doctoral Studies

Historically, 18th century anecdotal accounts of the decimation of several tribes of U.S. of the Native American population by trading of infected textile blankets alludes to the role of retail in the transmission of infectious disease. This study explores implications of the modern day retail organization practice of reselling returned clothing textiles from a public health infectious disease perspective. A qualitative multi-case study, utilized responses from 20 open-ended, unstructured interviews of retail employees assigned to the returns process. Additionally, several informal observations of select U.S.based, top-ranked clothing retail organizations, identified by the National Retail Federation were completed. Select federal, state, …

Exploring Education Needs For Heart Failure Patients' Transition Of Care To Home, Michelle D. Williams

Walden Dissertations and Doctoral Studies

Transitions of care is a model designed to ensure that patients have resources needed to assist them to care for themselves at home after hospital discharge, which helps to decrease preventable adverse events. For people with heart failure (HF) to transition home from the hospital successfully, specific education is needed that is individualized to the disease process, but most patients' educational needs after discharge are unmet. The purpose of this qualitative study, guided by the Meleis middle range theory of transition, was to explore the perspectives of people with HF about their educational needs in order to gather data that …

Hiv Testing And Black Men Who Have Sex With Men, Stephaun Elite Wallace

Walden Dissertations and Doctoral Studies

HIV incidence among Black men who have sex with men (BMSM) is extremely high in contrast to their estimated population size and compared to other racial groups. Researchers have established that a significant proportion of these new cases annually originate from HIV transmission by BMSM who are unaware of their HIV status. The purpose of the study was to assess the relationship between age, sexual behavior, social support, substance use, internalized homophobia, depression, and HIV test history in BMSM. Guided by the social ecological model (SEM) as the conceptual framework, a quantitative cross-sectional study was designed to analyze secondary data …

Obesity Epidemic In The Military: Implications For Veterans, Tracy Lewis

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine the impact of overweight and obesity on veterans' careers. Obesity, once thought unproblematic for the military, is being recognized as a health concern that has expansive implications for the health and readiness of service men and women, as well as for veterans. There is an abundance of information on obesity within the general population, but research on the impact of obesity on military careers is limited. This quantitative, cross-sectional research study investigated how obesity is a challenge throughout a veteran's career, from enlistment to retirement, using an online survey to gather data …

An Educational Program For Primary Nursing, Marsha-Gail Mcdonald

Walden Dissertations and Doctoral Studies

To increase continuity of care and reduce clinical errors, management in an inpatient rehabilitation unit of a private, nonprofit hospital chose to change the care delivery model to primary nursing; unit nurses had inadequate understanding of primary nursing, creating a gap in practice. The purpose of this project was to develop an educational program on primary nursing to address the question of how education on primary nursing would impact the understanding of the model among the nurses in the patient rehabilitation unit of the project site. Rogers's diffusion of innovation model provided a framework for developing the educational program. The …

Nursing Staff Education For Heart Failure Disease Management, Kerri Murphy

Walden Dissertations and Doctoral Studies

Heart failure (HF) has a global significance for the older population and is the most common reason for hospitalization. Patients with HF can reduce their risk for hospital readmissions and adverse outcomes through self-management of their disease. Nurses are responsible for educating patients about HF self-management; however, nurses at the project site lacked sufficient understanding and confidence to perform adequate HF patient education, creating a gap in practice. This project was guided by Pender's health promotion model and adult learning theory with the goal to increase nurses' knowledge and confidence with the self-management principles of HF. The purpose of this …

Afatinib And Temozolomide Combination Inhibits Tumorigenesis By Targeting Egfrviii-Cmet Signaling In Glioblastoma Cells, Raghupathy Vengoji, Muzafar A. Macha, Rama Krishna Nimmakayala, Satyanarayana Rachagani, Jawed A. Siddiqui, Kavita Mallya, Santhi Gorantla, Maneesh Jain, Moorthy P. Ponnusamy, Surinder K. Batra, Nicole Shonka

Journal Articles: Biochemistry & Molecular Biology

BACKGROUND: Glioblastoma (GBM) is an aggressive brain tumor with universal recurrence and poor prognosis. The recurrence is largely driven by chemoradiation resistant cancer stem cells (CSCs). Epidermal growth factor receptor (EGFR) and its mutant EGFRvIII are amplified in ~ 60% and ~ 30% of GBM patients, respectively; however, therapies targeting EGFR have failed to improve disease outcome. EGFRvIII-mediated cross-activation of tyrosine kinase receptor, cMET, regulates GBM CSC maintenance and promote tumor recurrence. Here, we evaluated the efficacy of pan-EGFR inhibitor afatinib and Temozolomide (TMZ) combination on GBM in vitro and in vivo.

METHODS: We analyzed the effect of afatinib and …

Trefoil Factor(S) And Ca19.9: A Promising Panel For Early Detection Of Pancreatic Cancer, Rahat Jahan, Koelina Ganguly, Lynette M. Smith, Pranita Atri, Joseph Carmicheal, Yuri Sheinin, Satyanarayana Rachagani, Gopalakrishnan Natarajan, Randall E. Brand, Muzafar A. Macha, Paul M. Grandgenett, Sukhwinder Kaur, Surinder K. Batra

Journal Articles: Biochemistry & Molecular Biology

BACKGROUND: Trefoil factors (TFF1, TFF2, and TFF3) are small secretory molecules that recently have gained significant attention in multiple studies as an integral component of pancreatic cancer (PC) subtype-specific gene signature. Here, we comprehensively investigated the diagnostic potential of all the member of trefoil family, i.e., TFF1, TFF2, and TFF3 in combination with CA19.9 for detection of PC.

METHODS: Trefoil factors (TFFs) gene expression was analyzed in publicly available cancer genome datasets, followed by assessment of their expression in genetically engineered spontaneous mouse model (GEM) of PC (KrasG12D; Pdx1-Cre (KC)) and in human tissue microarray consisting of normal pancreas adjacent …

Pr55Α Regulatory Subunit Of Pp2a Inhibits The Mob1/Lats Cascade And Activates Yap In Pancreatic Cancer Cells, Ashley L. Hein, Nichole D. Brandquist, Caroline Y. Ouellette, Parthasarathy Seshacharyulu, Charles A. Enke, Michel M. Ouellette, Surinder K. Batra, Ying Yan

Journal Articles: Biochemistry & Molecular Biology

PP2A holoenzyme complexes are responsible for the majority of Ser/Thr phosphatase activities in human cells. Each PP2A consists of a catalytic subunit (C), a scaffold subunit (A), and a regulatory subunit (B). While the A and C subunits each exists only in two highly conserved isoforms, a large number of B subunits share no homology, which determines PP2A substrate specificity and cellular localization. It is anticipated that different PP2A holoenzymes play distinct roles in cellular signaling networks, whereas PP2A has only generally been defined as a putative tumor suppressor, which is mostly based on the loss-of-function studies using pharmacological or …

Animal Assisted Therapy In Pediatric Speech-Language Therapy With A Preschool Child With Severe Language Delay: A Single-Subject Design, Heather K. Anderson, Sandra L. Hayes, Julie P. Smith

Internet Journal of Allied Health Sciences and Practice

Background: The application of animal assisted therapy (AAT) in provision of services is an emerging area of research in the allied health literature. Prior investigators have called for additional research concerning applications of animal assisted therapy in specific settings and patient populations.

Objectives: to (a) investigate the effect of animal assisted therapy on the quantity of vocalizations in a single child participant with severe speech delay, and (b) identify optimal animal assisted therapy practices in pediatric group speech-language therapy.

Design: A case study was conducted using ABA single-case design. The number of vocalizations produced by the participant was measured …

Preventing Interpersonal Violence At The University Of Kentucky: A Community-Level Expansion Of The Green Dot Program, Chelsey Reid

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

College students in the United States are at risk for being impacted by interpersonal violence (IPV), a spectrum of violence that includes sexual assault, dating violence, domestic violence, and stalking, with 1 in 5 women and 1 in 16 men being impacted by victimization during their collegiate careers. Through enhanced approaches to primary prevention, including through active bystander training, research has identified evidence-based strategies for reducing IPV prevalence. In Kentucky, 10.1% of all women impacted by IPV are first victimized prior to 18-years-old and 12.4% of all completed rapes are either alcohol or drug-facilitated. In light of these cumulative data, …

Brief Intervention And Buprenorphine Initiation For Opioid Use Disorder In Northern Kentucky Emergency Departments, Cady Cornell

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The opioid epidemic has had sweeping, devastating effects on the United States. Kentucky has the fifth highest overdose mortality rate in the nation and the Northern Kentucky counties, specifically Kenton and Campbell, have been especially affected. Their opioid overdose mortality rates are the third and fourth highest in the state, respectively. In order to contribute to ongoing Northern Kentucky community efforts to combat the opioid epidemic, St. Elizabeth Healthcare is proposing to implement The Brief Negotiation Interview (BNI) in our emergency departments in order to provide more comprehensive care. The BNI is a motivational interviewing strategy that has been combined …

Methods For Multiple Imputation By Chained Equations Accounting For Missingness: A Simulation Study, Nathaniel Wilson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Improper treatment of missing data can lead to biased or invalid results. If the data are missing at random (MAR), multiple imputation by chained equations (MICE) is one method utilized to reduce bias. When implementing MICE, the imputation model must be compatible with the final analysis model. We aim to show how to include interaction terms in the imputation model to ensure valid results are obtained. Data were simulated for one continuous outcome originating from two binary predictor variables and their interaction. Missingness was imposed via a MAR mechanism. To handle the missing data, four methods were performed: complete records …

Thyroid Function Screening & Dysfunction In Patients With Heart Failure: An Examination Of Practice At The University Of Kentucky Albert B. Chandler Hospital From 2007-2017, Alexandra Paige Hall

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: Heart failure constitutes a global pandemic affecting at least 26 million globally (an estimated 5.7 million of which are Americans), and its burden on our healthcare system is projected to increase.[1] As a result, it is imperative that diagnostics and treatment among that population be evidence based in order to contain costs and optimize patient outcomes. Over the last 20 years, thyroid function screening has been recommended for patients upon initial diagnosis of heart failure by the American College of Cardiology and other professional organizations. However, it remains unclear whether this recommendation is followed by practitioners and how much …

A Comparison Of Pediatric Prevention Policies To Pediatric Health Supervision Codes, Rania Burke

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The number of policy statements from the AAP presents pediatricians with an increasing amount of advice related to prevention, yet the definition of prevention and well-child visits has not changed for outpatient office visits. Outpatient office visits are the primary means by which preventive care is administered. The objective of this study is to quantify and characterize the prevention policy recommendations that pediatricians are expected to provide patients/guardians beyond the well-child visit. Secondarily, an analysis was completed to demonstrate which prevention policies make recommendations that can be coded for reimbursement as part of a well-child prevention visit.

METHODS The author …

Effectiveness Of Thailand National Quitline Services: A Gender Analysis(ผลของบริการเลิกบุหรี่ของศูนย์บริทารเลิกบุหรี่ทางโทรศัพท์แห่งชาติ : การวิเคราะห์แยกเพศ), Suwimon Rojnawee, Jintana Yunibhand, Orrawan Khongtor

Journal of Nursing Research, Innovation, and Health

Purpose: To study demographic characteristics, smoking behaviors, differentiation between gender and smoking behaviors and quit rate among smokers calling Thailand National Quitline (TNQ)Design: Quasi-experimental studyMethods: The 650 smokers who called TNQ during September 2016 to February 2017 were voluntary assigned into three interventions; 1) text to quit (n=143), 2) telephone counseling (n=121), and 3) text to quit and telephone counseling (n=386), and set quit date within next 30 days. Data collection was done by telephone interviewing. Descriptive analysis for the demographic data indicated that most of subjects were male (85.85%), 25-44 years old (43.38%), smoked 11-20 cigarettes per day (55.69%). …

The Effect Of Health Teaching On Self-Practice Among Persons With Colorectal Cancer Risk(ผลของการให้ความรู้ต่อการปฏิบัติตนก่อนการส่องกล้องลําไส้ใหญ่ ในบุคคลกลุ่มเสี่ยงโรคมะเร็งลําไส้ใหญ่), Nirin Chomali, Rungrawee Navicharern

Journal of Nursing Research, Innovation, and Health

Purpose: 1) To study of the self-practice before undergoing to colonoscopy among persons with colorectal cancer risk who received the health teaching program and 2) compare the self-practice before undergoing to colonoscopy among persons with colorectal cancer risk who received the health teaching program and those who received conventional nursing care.Design: Quasi-experimental research, posttest only design.Method: The samples group is persons with colorectal cancer risk in the range of age between 18-59 years old who was undergoing colonoscopy at Surin provincial hospital, Thailand. The sample were consisted of 44 patients and assigned to the experimental and control group (22 persons …

Predictors Of Academic Performance Among Baccalaureate Students Thammasat University(ปัจจัยทํานายสมรรถนะทํางด้านการเรียนของนักศึกษาระดับปริญญาตรี มหาวิทยาลัยธรรมศาสตร์), Nutchanart Bunthumporn, Sararud Vuthiarpa, Sukan Vattanaamorn

Journal of Nursing Research, Innovation, and Health

Purpose: To examine the factors predicting academic performance in baccalaureate students Thammasat University.Design: Descriptive predictive researchMethod: Data were collected from 250 baccalaureate students Thammasat University; using a personal data, the Coopersmith Self-esteem Inventory School Form, the Center for Epidemiologic Studies Depression scale (CES-D), and the Resourcefulness Scale (RS). The reliabilities of these questionnaires were 0.71, 0.83 and 0.81 respectively. The data were analyzed using descriptive statistics and multiple regression analysis.Finding: The study found that self-esteem was significantly positively correlated with academic performance. Only self-esteem could accounted for 2.70% of the variance explained in academic performance in baccalaureate students. The findings …

Self-Management Experiences Of Asthma In School-Age Children(ประสบการณ์การจัดการตนเองเกี่ยวกับโรคหืดของเด็กวัยเรียน), Boonjai Srisatidnarakul, Wipada Sangnimitchaikul

Journal of Nursing Research, Innovation, and Health

Objective: To explore the experiences of self-management in school-age children with asthma.Research design: Descriptive qualitative research.Methods: The informants were 26 school-age children with asthma who came to the Asthma and Allergy Clinic in the Out-Patient Department at Thammasat University Hospital who were selected by purposive sampling. Data was collected by conducting in-depth interviews, transcribed verbatim and analyzed by content analysis.Findings: The informants were composed of nineteen boys and seven girls with asthma with ages ranging from 9-12 years and an average age of 10.5 years, standard deviation was 1.1 years. According to the data analysis, the experiences of the school-age …

Su Guia Para La Inmunoterapia, Lehigh Valley Health Network, Accc Association Of Community Cancer Centers

Lehigh Valley Topper Cancer Institute

No abstract provided.

Effect Of Calcium Supplementation On Maternal Hypertensive Disorders And Neonatal Outcomes Among Pregnant Thai Women: A 2-Year Interim Analysis Report, Shina Oranratanaphan, Surang Triratanachat, Sukanya Chaikittisilpa, Patou Tantbirojn, Noppadol Chaiyasit, Unnop Jaisamrarn, Dhiraphongs Charoenvidhya

Chulalongkorn Medical Journal

Background: Calcium intake is inversely correlated with hypertensive disorder in pregnancy. The amount ofdaily calcium intake varies by country. Therefore, the effect of calcium supplementation may be different.Objectives: The primary outcome was to evaluate the effect of calcium supplementation in hypertensivedisorder in pregnant Thai women. Secondary outcomes were to evaluate the side effects of calcium supplementation and the effects on delivering small for gestational age infants.Methods: One hundred and sixty-two Thai women who visited the antenatal care (ANC) Clinic, King Chulalongkorn Memorial Hospital were enrolled. Patients were randomly allocated to Group A received ferrous sulfate (200 mg) and calcium carbonate …

Adjuvant Effect Of Hydrochlorothiazide On Radioiodine Treatment In Low-Iodine Uptake Graves’ Disease Patients, Maythinee Chantadisai, Supatporn Tepmongkol

Chulalongkorn Medical Journal

Background: The outcome of radioiodine (RAI) treatment in Graves’ disease patients depends mostly onthe percentage of RAI uptake in the thyroid gland. Most Graves’ disease patients have a high percentage of RAI uptake while some have low uptake even after continuation of a low-iodine diet before RAI treatment.Hydrochlorothiazide has been proven to increase the percentage of uptake in low-iodine diet low-uptake Graves’ disease patients. However, the effect on the patient’s outcome has never been demonstrated.Objective: The aim of this study was to investigate the outcome of RAI treatment in low-iodine uptake Graves’disease patients who were pre-treated with hydrochlorothiazide (HCTZ). The …

To Feel Better: A Personal Account Of My Eating Disorder, Savannah Kate Woods

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Eating disorders are complex mental health disorders. The following stories and moments apply psychological skills, knowledge, and perspective to my personal struggles with bulimia. The personal narratives vary greatly in word count. Please be aware some scenes may be disturbing or uncomfortable.

Workplace Incivility And Employee Sleep: The Role Of Rumination And Recovery Experiences, Caitlin A. Demsky, Charlotte Fritz, Leslie B. Hammer, Anne E. Black

Psychology Faculty Publications and Presentations

This study examines the role of negative work rumination and recovery experiences in explaining the association between workplace incivility and employee insomnia symptoms. Drawing on the perseverative cognition model of stress and the effort–recovery model, we hypothesize a moderated mediation model in which workplace incivility is associated with insomnia symptoms via negative work rumination. This indirect effect is proposed to be conditional on employees’ reported level of recovery experiences (i.e., psychological detachment from work and relaxation during nonwork time). In examining this model, we further establish a link between workplace incivility and sleep and identify one pathway to explain this …

Blood Pressure Screening Practices Among Dental Hygienists, Mariah Sullinger

All Graduate Theses, Dissertations, and Other Capstone Projects

“There is consensus on the importance of early detection and treatment of hypertension and dental care is one of the few medical services which involves a considerable proportion of the population returning for routine check-ups” (Berne, Engstrom, Gahnberg, & Svardsudd, 2011, p 194). Little is known about the frequency and consistency of blood pressure screening practices or barriers affecting these procedures. Research findings may support efforts to increase or routinize scope and frequency of this preventive procedure among dental healthcare providers or make it a standard of care. Data from the survey was used to assess what type of setting …

Sugar-Sweetened Beverages: A Survey To Assess Adults Knowledge, Attitudes, And Consumption Patterns Of Sugar-Sweetened Beverages, Jeff Schafer

All Graduate Theses, Dissertations, and Other Capstone Projects

Sugar-sweetened beverages (SSBs) have a direct impact on the general health of the country when looking at the rising obesity levels (CDC, 2017a). The USDA’s dietary guidelines suggest that the daily intake of added sugar should be limited to 6 teaspoons for women and 9 teaspoons for men (Hughes, 2017). However, the average American consumes 20 teaspoons of sugar daily (Hughes, 2017). These extra calories are converted into fat and stored in the body. Data collected throughout the years indicates a rise in the number of Americans living with a weight above healthy recommendations, which is termed, obese. Obesity is …

The Relationship Of Blood Pressure Self-Monitoring And Hypertension Control, Durga Mishra

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this structured literature analysis is to review the relationship of blood pressure self-monitoring and hypertension control. Blood pressure self-monitoring can help reduce the high blood pressure burden among people with hypertension, minimize the risk of heart disease and related complications. Self-care is an important component in managing chronic illness. Self- monitoring of blood pressure may allow people with hypertension to be concerned about their long-term health. Furthermore, blood pressure self-monitoring may lead to lifestyle modification behaviors and adherence to treatment. The positive relationship of blood pressure self- monitoring and hypertension control may help people to understand the …