Medicine and Health Sciences Commons^™

Evaluating The Effectiveness Of Diabetes Class: A Project To Improve Quality Metric Measures, Miriam O. Russell

Doctoral Projects

Background: Diabetes is a significant health issue worldwide. Its increasing prevalence globally and regionally has been documented. Consequently, complications have resulted in higher morbidity and mortality in patients with diabetes (Martin & Lipman, 2013). The lack of education on self-managing diabetes can lead to serious complications. An effective approach, including evaluating and enhancing diabetes education, is necessary to improve diabetes self-management (Johnson & Raterink, 2009).

Objectives: To provide evaluation of a diabetes education class through quality measures and create a toolkit that will enhance the impact on the current diabetes education class.

Methods: A retrospective chart review that analyzes five …

Interprofessional Collaboration During Discharge Planning For A Large Midwestern Hospital, Sarah Shepler

Doctoral Projects

Introduction: Interprofessional collaboration (IPC) improves the quality of healthcare delivery. IPC enhances communication during discharge planning, through use of structured daily rounds to reduce readmissions, length of stay (LOS), cost, and mortality. A $240 billion reduction in cost could be achieved with IPC. The Joint Commission, Institute of Medicine, and World Health Organization emphasize use of IPC to reduce errors, improve patient outcomes, and refine transitions of care for patients.

Objectives: The goal of this project was to determine how IPC within structured daily rounds during discharge planning impacts patient LOS and staff satisfaction.

Methods: This quality improvement project was …

Evaluation Of A Simulation-Based Nurse Residency Program, Cheri A. Van Wyngarden

Doctoral Projects

Upon completion of nursing school, new graduate nurses sit for licensure examination to demonstrate the minimal knowledge necessary to practice safely as an entry level nurse. Despite satisfactory completion of this examination, many new graduate nurses lack the competency and confidence to safely practice (Jung, Lee, Kang, & Kim, 2016 & Liaw, Palham, Chan, Wong & Lim, 2014). Traditional models of preceptorship with orientation are not adequately preparing new graduate nurses for practice. Nurse residency programs narrow the gap between demonstrated knowledge and competent practice. Varying types of nurse residency programs have successfully replaced traditional nursing orientation methods across the …

An Integrated Model Of Palliative Care In The Emergency Department To Improve Referrals, Jennifer L. Schlatter

Doctoral Projects

Introduction: The emergency department plays a critical role in the trajectory of in-hospital patient care. The Center to Advance Palliative Care (CAPC) along with the American College of Emergency Physicians (AECP) recommend early referral to palliative care for patients with life limiting illnesses that present to the emergency department. Research demonstrates that early palliative care consultations result in patient directed goals of care, improved symptom management, decreased length of stay, and reduced direct costs for inpatient hospitalizations.

Objectives: The goal of this project was to implement evidence-based recommendations for early palliative care referrals in an adult emergency department to improve …

More Than Growth? A Study Of The Additional Functions Of Growth Hormone In The Human Body, Damien Chance Hutchins

Undergraduate Honors Theses

Growth Hormone (GH) may have many more effects on the human body than those commonly known by the public. A study was conducted to determine what these additional functions may be, if these functions could necessitate the continued use of GH treatment for adults with Growth Hormone Deficiency (GHD), and how these effects might invite the additional usage of GH as a treatment for normal individuals. Research consisted of a literature review and a statistical analysis of 86 adult GHD reports regarding how GH treatment had affected various symptoms. Reports were analyzed for significance using one-way ANOVAs. Observed results support …

The Effects Of Intermittent Fasting On Chronic Disease In Adults: A Systematic Review, Brendan Teeters

Undergraduate Honors Theses

This systematic review investigated thirteen primary and secondary research studies from the past 20 years to determine the effects of intermittent fasting on chronic disease in adults through evaluation of biological markers pertaining to inflammation, oxidative stress, and the cardiovascular system. The dependent variables examined included heart rate, blood pressure, and cholesterol levels for cardiovascular risk; leptin and TNF-a for inflammatory risk; and F₂-Isoprostanes and free radicals for oxidative stress biomarkers. The reviewed studies found that there was a decrease in resting heart rate, systolic and diastolic blood pressure, blood LDL and total cholesterol levels, inflammatory cells, like …

Risk Benefit Analysis Of Treatments For Cystic Acne, Callie Elliott

Undergraduate Honors Theses

Acne is a prevalent skin disorder and is displayed through various different incidences. Cystic acne, a severe form of acne that is difficult to treat, reaches deep into the skin underneath the epidermis layer and produces painful, inflamed cysts that contain sebum, dead skin cells, and Propionobacterium acnes, the acne causing bacteria. Because this is an uncomfortable type of acne and is tough to treat, researchers have developed and tested a number of treatments to determine the best course of treatment for reducing and potentially eradicating cystic acne. These treatments are most commonly in the form of systemic or topical …

Do Patient Reported Outcome Measurement Information System (Promis) Scales Demonstrate Responsiveness As Well As Disease-Specific Scales In Patients Undergoing Knee Arthroscopy?, Raymond J. Kenney, Jeff Houck, Brian D. Giordano, Judith F. Baumhauer, Meghan Herbert, Michael D. Maloney

Faculty Publications - College of Physical Therapy

Background: The Patient Reported Outcomes Information System (PROMIS) is an efficient metric able to detect changes in global health. Purpose: To assess the responsiveness, convergent validity, and clinically important difference (CID) of PROMIS compared with disease-specific scales after knee arthroscopy. Study Design: Cohort study (Diagnosis); Level of evidence, 2.

Methods: A prospective institutional review board–approved study collected PROMIS Physical Function (PF), PROMIS Pain Interference (PI), International Knee Documentation Committee (IKDC), and Knee injury and Osteoarthritis Outcome Score (KOOS) results in patients undergoing knee arthroscopy. The change from preoperative to longest follow-up was used in analyses performed to determine responsiveness, convergent …

Designing Ethakul: A Mobile Just-In-Time Learning Environment For Bioethics In Pakistan, Azra Naseem, Kulsoom Ghias, Sohail Bawani, Mohammad Ali Shahab, Sameer Nizamuddin, Waqar Kashif, Kausar S. Khan, Tashfeen Ahmad, Murad Khan

Institute for Educational Development, Karachi

In developing countries such as Pakistan, bioethics has not been included in mainstream thinking in medical education. The authors’ experiences suggest that current methods of teaching bioethics are problematic as students are unable to translate theory to practice. Alternative pedagogies, such as just-in-time learning (JiTL) using mobile devices, may be able to foster the development and implementation of ethical reasoning among nurses, doctors, and medical and nursing students. This research was conceived to determine the effectiveness of mobile JiTL – anytime, anyplace learning through mobile devices – for teaching bioethics. After obtaining ethical clearance, a participatory design (PD) approach was …

Beyond The Employment Dichotomy: An Examination Of Recidivism And Days Remaining In The Community By Post-Release Employment Status, Amanda Marie Bunting, Michele Staton, Erin Winston, Kevin Pangburn

Behavioral Science Faculty Publications

Criminological research has tended to consider employment in a dichotomy of employed versus unemployed. The current research examines a sample of individuals 1-year post-release to assess the extent to which four distinct employment categories (full-time, part-time, disabled, and unemployed) are associated with reincarceration and days remaining in the community. Findings indicate disabled individuals remain in the community longer and at a higher proportion compared with other employment categories. Furthermore, unique protective and risk factors are found to be associated with each employment category while some risk factors (e.g., homelessness) highlight the importance of addressing reentry barriers regardless as to employment …

Venoarterial Extracorporeal Membrane Oxygenation And Implantable Cardioverter-Defibrillator Implantation In A Hemodynamically Unstable Infant With Ventricular Tachycardia From Multiple Cardiac Rhabdomyomas, Victor Kieu, Richard J. Czosek, Timothy K. Knilans, James A. Quintessenza, Roosevelt Bryant Iii, Shaun Mohan

Pediatrics Faculty Publications

Tuberous sclerosis complex (TSC) is a neurocutaneous disorder characterized by benign tissue hamartomas in multiple organ systems, including cardiac rhabdomyomas. Though prevalent in TSC, cardiac tumors are rare in children, occurring in about 0.03%–0.17%. Rhabdomyomas are the most common, accounting for 45%. When present, they are multiple and in the ventricular myocardium. Frequently, they regress and surveillance is all that is required until spontaneous regression. Intervention is necessary when life-threatening obstruction or hemodynamically significant refractory arrhythmias occur. This case highlights the course of a 6-month-old infant with TSC and cardiac rhabdomyomas who presented in refractory ventricular tachycardia (VT) with decompensation …

Neuroprotective Activity Of Leukemia Inhibitory Factor Is Relayed Through Myeloid Zinc Finger-1 In A Rat Model Of Stroke, Stephanie M. Davis, Lisa A. Collier, Elspeth A. Foran, Christopher C. Leonardo, Craig T. Ajmo Jr., Keith R. Pennypacker

Neurology Faculty Publications

The aim of this study was to determine whether leukemia inhibitory factor (LIF) exerts its neuroprotective effects through signal transduction of the transcription factor myeloid zinc finger-1 (MZF-1). According to the hypothesis of this study, MZF-1 mediates LIF-induced neuroprotective signaling during ELVO through increased expression and transcriptional activity. To determine the in vivo role of MZF-1 in LIF-induced neuroprotection, we used Genomatix software was used to MZF-1 sites in the promoter region of the rat superoxide dismutase 3 (SOD3) gene. Stroke was induced via middle cerebral artery occlusion, and animals were administered PBS or 125 μg/kg LIF at …

Utilization Of Rectangular Collimation In Dental And Dental Hygiene Programs, Elizabeth Ann Wagner

Dental Hygiene ETDs

Rectangular collimation has proven to reduce the radiation dose to the patient as well as increase image quality. Studies have been conducted in the past to determine whether utilization of rectangular collimation results in a greater retake rate, however, there is a lack of data regarding the amount of rectangular collimation devices that are currently in use. The purpose of this study was to determine to what extent, if any, rectangular collimators are being utilized in dental and dental hygiene programs. A survey was created and sent via email to the program directors of Accredited dental and dental hygiene programs. …

Antimicrobial Resistance Patterns Of Bacterial Colonization In Urine Of Patients With Spinal Cord Lesion Admitted At Thai Red Cross Rehabilitation Center, Sutunchalee Sikanjananun, Sirikwan Panyasriwanit, Wasuwat Kitisomprayoonkul, Chusana Suankrata, Natthiya Tantisiriwat

Chulalongkorn Medical Journal

Background: The emergence of extended spectrum beta-lactamase (ESBL)-producing Escherichia coli andKlebsiella pneumoniae at the stand-alone Rehabilitation Center of the Thai Red Cross Society has become aconcern for treatment of patients with neurogenic bladder.Objective: To identify commonly observed bacterial colonization in urine of patients with spinal cord lesions.Methods: Medical records of all 135 patients with spinal cord lesions and who were admitted to the Thai Red Cross Rehabilitation Center were retrospectively reviewed for demographic data, type of neurogenic bladder and bladder management, and common bacterial colonization in urine specimens with antimicrobial susceptibility reports.Results: Of the 135 spinal cord lesion patients, 100 …

Cognitive Impairment And Associated Factors In The Elderly At Pracha Niwet Village In Thailand, Chotiman Chinvararak, Natsara Dumrongpiwat, Puangsoi Worakul, Sookjaroen Tangwongchai

Chulalongkorn Medical Journal

Background: Thailand has already become an aging society. Previous studies showed that cognitive impairment is one of the most common problems in the elderly. The prevalence of major neurocognitive disorder globally is between 5 - 7%. Currently, there are still limited data of cognitive impairment in Thailand.Objectives: To determine the prevalence of cognitive impairment and to explore factors associated with it.Methods: A descriptive study was conducted in the elderly aged above 60 years at Pracha Niwet Village fromSeptember to October 2017. The research instruments consisted of four questionnaires:1) the demographic data form,2) the mini – mental state examination: Thai version …

Impact Of Self-Contact Lens Fitting With Uncorrected Refractive Error On Visual Acuity And Lens Movement In Contact Lens Wearers, Pussadee Paensuwan, Pavasut Leedasawat, Wanachat Chaiyasan, Darawan Pejchang

Chulalongkorn Medical Journal

Background: Contact lenses are increasingly popular for refractive error correction. An eye examination andcontact lens fitting for individual wearers are very important for best visual acuity and fitting accomplishment.Most Thai contact lens users buy their lenses from local shops and fitted the lens themselves withoutprofessional eye care services. This article reports on the impact of self-contact lens fitting on visual acuity andlens movement to establishes the requirement of contact lens access control.Objectives: To investigate the impact of self-contact lens fitting focusing on the uncorrected refractive error via visual acuity measurement and to determine the effect of lens base curve on …

Preparation And Characterization Of Demineralized Bone Matrix/Chitosan Composite Scaffolds For Bone Tissue Engineering, Panudda Dechwongya, Korbtham Sathirakul, Baldur Kristjánsson, Suwabun Chirachanchai, Sittisak Honsawek

Chulalongkorn Medical Journal

Background: A propitious alternative to supply bone substitutes is to develop living tissue substitutes basedon biodegradable materials. Demineralized bone matrix (DBM) can support and promote osteogenesis; scaffold is also attractive for use in bone tissue engineering. Chitosan scaffold has been shown to possess biological and mechanical properties suitable for tissue engineering and clinical applications.Objectives: This study aimed to develop a novel DBM/chitosan composite scaffold and to investigate whetheror not it has the ability to support the attachment and proliferation of human periosteal cells in vitro for bonetissue engineering.Methods: Chitosan and DBM/chitosan scaffolds (ratios 1:1 and 1:2) were fabricated with a …

Critical Embodied Praxis For Social Justice And Peace Educators: A Story Of Personal Transformation Through Analysis Of My Jewish And Settler Identities, Cara Michelle Silverberg

Capstone Collection

In this paper, I examine definitions of and relationships between violence, oppression, peace, liberation, and embodiment in the context of critical pedagogy in order to construct a theory of critical embodied praxis for social justice and peace educators. Considering the body to be a tangible vessel through which narratives and mechanisms of violence are expressed and maintained, I explore the potential of the body to be a vessel through which liberatory narratives may be generated and shared. After constructing a theory of critical embodied praxis, I illustrate this framework in action through a personal narrative that explores the intersections …

Spatial Analysis Of Exposure To Soil Heavy Metals, Oral Bioaccessibility And Risk Assessment In Houston, Texas, Tsai Shu Chu

Dissertations and Theses (Open Access)

Chronic exposure to heavy metals could lead to adverse health effects such as cancer, neurological development diseases and immunological diseases. The ingestion pathway has been considered the major exposure route for heavy metal contaminated soils. Heavy metals may be proportionally bioaccessible for the human body to absorb. There are no risk assessment studies done in Houston to evaluate health risks from exposure to heavy metals and no spatial analysis done yet. The aims of this dissertation are (1) to characterize 13 heavy metals: magnesium (Mg), vanadium (V), chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), nickel (Ni), copper (Cu), zinc …

Stochastic Search Variable Selection Applied To A Bayesian Hierarchical Generalized Linear Model For Dyads, Adriana Lopez Ordonez

Dissertations and Theses (Open Access)

In behavioral science research, many outcomes of interest can be influenced by interpersonal relationships (Gyarmathy & Neaigus, 2007). To assess such outcomes, data can be collected using dyads. Each dyad has two elements, an actor, who responds to a stimulus and a partner, who can potentially influence the actor (Kenny, Kashy, & Cook, 2006). One popular model for analyzing dyadic data is the Actor Partner Interdependence model (APIM). In this study, we proposed a variable selection method applied to a probit Bayesian Hierarchical Generalized Linear Model (Bayesian HGLM) to fit the APIM to dyadic data. The proposed method used stochastic …

Kolmogorov-Smirnov Type Tests Under Spatial Correlations, Wenjun Zheng

Dissertations and Theses (Open Access)

Kolmogorov-Smirnov test is a non-parametric hypothesis test that measures the probability of deviations, that the interested univariate random variable is drawn from a pre-specified distribution (one-sample KS) or has the same distribution as a second random variable (twosample KS). The test is based on the measure of the supremum (greatest) distance between an empirical distribution function (EDF) and a pre-specified cumulative distribution function (CDF) or the largest distance between two EDFs. KS test has been widely adopted in statistical analysis due to its virtue of more general assumptions compared to parametric test like t-test. In addition, the p-value derived from …

Rapid Assessment Of Problem Solving For Kids (Raps-K), Hannah Perdew

Mahurin Honors College Capstone Experience/Thesis Projects

The Rapid Assessment of Problem Solving (RAPS) is a clinical assessment of verbal problem solving skills created by Dr. Robert Marshall and colleagues (Marshall, 2003). The assessment, originally developed for adults, is based on the well-known twenty questions game. The clinician administering the assessment chooses a target picture and the participant asks yes or no questions to eliminate incorrect answers and, eventually, identify the target picture. Question asking efficiency, indicated by the number of choices eliminated, is considered to reflect levels of cognitive functioning, specifically problem solving. Recently, the RAPS has been utilized with typically developing children and children with …

Sometimes A Crucible: Mindfulness Art Therapy Experientials In A Dbt-Oriented Residential Partial Hospitalization Program For Dually-Diagnosed Adults, Joan Mancuso

Expressive Therapies Capstone Theses

My thesis concerns observations made while incorporating mindfulness-oriented art therapy experientials into hour-long, didactic DBT skills-training groups at a residential partial program serving dually-diagnosed adults. For the thesis, I adapted two exercises from Clark’s DBT-Informed Art Therapy. My research method was arts-based grounded theory, referencing Corbin’s grounded theory and Wadeson and Allen’s thinking on the use of art for professional processing. My data took the form of a journal, word clouds, poems, and small artworks I iteratively created to deepen my learnings. My experientials highlighted areas of confusion regarding mindfulness that I attempted to address. Through the process, I …

Rethinking Pulmonary Toxicity In Advanced Non-Small Cell Lung Cancer In The Era Of Combining Anti-Pd-1/Pd-L1 Therapy With Thoracic Radiotherapy., Mengqian Li, Lu Gan, Andrew Song, Jianxin Xue, You Lu

Department of Radiation Oncology Faculty Papers

The combination of programmed cell death 1/programmed cell death ligand 1 blockade and thoracic radiotherapy has become the new standard of care in the treatment of locally advanced non-small-cell lung cancer. The information regarding the pulmonary safety of such therapy remains limited to mostly retrospective studies and case reports with a small portion of data from prospective clinical trials. By analyzing the underlying mechanisms of interactions between radiation and immunotherapy from preclinical data and summarizing safety data from relevant clinical studies with pulmonary toxicity, we believe that longer and rigorous follow-up is warranted, to determine if the combination of such …

Premedical Programs Newsletter, April-May 2019, University Of Dayton

Pre-Health Resource Center Campus Communications

Newsletter for students, staff, and faculty in the premedical and predental programs. This issue contains information about the University of Dayton & Miami Valley Hospital Healthcare Symposium; senior award nominees; service opportunities; medical and dental school application workshops; service opportunities; and acceptance to graduate school.

The Effect Of A Portable Electrical Muscle Stimulation Device At Home On Muscle Strength And Activation Patterns In Locomotive Syndrome Patients: A Randomized Control Trial, Yuichi Nishikawa, Kohei Watanabe, Shuhei Kawade, Tetsuya Takahashi, Hiroaki Kimura, Hirofumi Maruyama, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

The aim of the present study was to quantify the effect of electrical muscle stimulation (EMS) intervention using a portable device on muscle strength and activation patterns in locomotive syndrome. Nineteen women were randomly assigned to the intervention group (n = 10; age = 71–82 years) and control group (n = 9; age = 70–84 years). Participants in the intervention group used a portable EMS device to stimulate the bilateral quadriceps muscles for 8 weeks (23 min/5 days/week). To understand the effects of EMS, the following measurements were made at baseline, 8 weeks, and 12 weeks: locomotive syndrome assessment score, …

Improving Nursing Students’ Attitudes And Beliefs About Transgender Clients Through The Use Of A Simulated Clinical Experience, J. Alex Thompson Msn, M.Ed., Rn, Cne

Doctor of Nursing Practice Projects

Background: Negative healthcare experiences may lead to poor health outcomes for transgender individuals, but nursing curricula give little attention to transgender healthcare. This study engaged nursing students in a simulated clinical experience (SCE) which featured a young adult transgender male in an acute care setting to determine whether participation would have a significant impact on student nurses’ attitudes and beliefs about transgender individuals.

Methods: The convergent parallel mixed-methods design used a one group pretest-posttest and a post-case debriefing interview to examine undergraduate nursing student attitudes and beliefs toward transgender individuals. Participants (N=27) reported their feelings via the Transgender Attitudes and …

Online Sexual Health Education With Rural Independent Study Charter School Students, Crystal L. Gardner Msn, Phn, Rn

Doctor of Nursing Practice Projects

Background: Sexually transmitted infections (STIs) and unwanted pregnancies continue to be public health problems in the United States. Each year there are about 20 million new STIs in the United States with about half of the infections occurring in people 15 to 24 years old (The Centers for Disease Control and Prevention, 2016).

Objectives: The purpose of this descriptive pre- and post-test study was to determine if an online STI prevention program increased knowledge about STIs, STI related resources, and lowered STI risk-taking behaviors in rural northern California students attending an alternative high school.

Methodology: “Positive Prevention PLUS” curriculum and …

Self-Efficacy In Emerging Nurse Leaders: The Effects Of A Virtual Community Of Practice On Nurse Educators In A New Practice Role, Kevin Daugherty Hook Msn, Ma, Ms, Agpcnp-Bc, Crnp

Doctor of Nursing Practice Projects

Background: Clinical nurse educators in long-term and skilled nursing facilities have an opportunity to exercise new leadership skills in bridging the gap between education and practice.

Objective: To assess the effects of a virtual Community of Practice (CoP) on the self-efficacy of clinical nurse educators who work in newly developing leadership roles in a large long-term and skilled nursing organization operating in multiple sites across the United States.

Methodology: The exploratory pilot study used a one group pre-test/posttest method. A convenience sample was used to enroll participants with newly created roles in clinical education. The Leader Efficacy Questionnaire (LEQ) was …

A Pre/Post Intervention Study To Assess Social Capital Through Bonding And Bridging Among Federal Nurse Teleworkers, Carrie Jeffries Mph, Ms, Rn, Anp-Bc, Aacrn, Aahivs, Nea-Bc, Fache

Doctor of Nursing Practice Projects

Background: The social capital components of bonding (within groups) and bridging (between external groups) are essential to building healthy and effective teleworking relationships that are required to retain staff.

Objectives: To identify if delivering a relationship building educational intervention to federal nurse teleworkers who used the internet daily would improve their total Internet Social Capital Scale (ISCS) scores and bonding and bridging subscale scores.

Methods: Our study employed a pre/post intervention design, aiming for a convenience sample of 75% (n=41/55) of federal nurse teleworkers. We delivered, via webinar, a 45-minute educational session on telework and techniques to increase bonding and …