Medicine and Health Sciences Commons^™

Effects Of A Patient Progression Coordinator On Hospitalized Patient Progression Times, Amy C. Wright Msn, Rn

Doctor of Nursing Practice Projects

Background: Since 2005, the Joint Commission required moving patients through the hospital quickly. Previous efforts at our hospital improved Emergency Department throughput but hospital-wide congestion of patients remained.

Objectives: To examine the effects of implementing a patient progression coordinator (PPC) on hospital length of stay (LOS) for patients with ST-elevated myocardial infarction (STEMI), ischemic stroke, knee replacement, and hip replacement.

Methods: We used a separate sample, pre- post- intervention design conducted in a southern California community hospital. The intervention was implementation of a PPC to facilitate movement of patients through the hospital. LOS, from time of admission to discharge, was …

Nsu Sharks Rx_Spring 2019, Nova Southeastern University

NSU Sharks Rx

Volume 5, Number 1

Nsu Sharks Rx_Spring 2019, Nova Southeastern University

NSU Sharks Rx

Newsletter

Elastic Resistance Effectiveness On Increasing Strength Of Shoulders And Hips, Kelsey J. Picha, Muataz R. Almaddah, Jordan Barker, Tavis Ciochetty, W. Scott Black, Timothy L. Uhl

Physical Therapy Faculty Publications

Elastic resistance is a common training method used to gain strength. Currently, progression with elastic resistance is based on the perceived exertion of the exercise or completion of targeted repetitions; exact resistance is typically unknown. This study's objective is to determine if knowledge of load during elastic resistance exercise will increase strength gains during exercises. Participants were randomized into two strength training groups, elastic resistance only and elastic resistance using a load cell (LC) that displays force during exercise. The LC group used a Smart Handle (Patterson Medical Supply, Chicago, IL) to complete all exercises. Each participant completed the same …

Development Of A Unique Student Pharmacist Internship In A Primary Care Provider System, Norman E. Fenn Iii, Natalie R. Gadbois, Gwen J. Seamon, Shannon L. Castek, Kimberly S. Plake

Pharmacy Faculty Publications and Presentations

Purpose: To describe a unique pharmacy intern program in a group of federally qualified health center (FQHC) outpatient primary care provider clinics. Summary: A pharmacy intern program was created at the North Central Nursing Clinics in Indiana, a group of four FQHC outpatient primary care provider facilities. Intern-performed tasks included: Prior authorization (PA) requests, medication assistance program (MAP) applications, sample procurement and inventory, and contraceptive devices for implantation inventory management. Interns interacted with clinic administration, nurse practitioners, and medical staff to complete their assigned responsibilities. Over a one-year period, the interns completed documentation on more than 2000 charts during a …

The Relationship Between Social Anxiety And Alcohol And Marijuana Use Outcomes Among Concurrent Users: A Motivational Model Of Substance Use, Margo C. Villarosa-Hurlocker, Adrian J. Bravo, Matthew R. Pearson, Protective Strategies Study Team

Faculty Publications

Background: College students with more social anxiety symptoms are particularly vulnerable to problematic alcohol and marijuana use given their susceptibility for elevated anxiety symptoms in social settings combined with the normative nature of substance use. Existing research has established substance use as coping motivated for these students when examining alcohol and marijuana use problems separately. The next step is to determine whether students with more social anxiety who use both substances do so for similar or different reasons. The current study tested a comprehensive (i.e., all variables in the same model) motivational model of alcohol/marijuana use in a sample …

The Pharmabiotic For Phenylketonuria: Development Of A Novel Therapeutic, Chloé Elizabeth Lebegue

Senior Theses

Phenylketonuria, now known as phenylalanine hydroxylase (PAH) deficiency, is a genetic disorder of metabolism affecting approximately one in every 15,000 infants born in the United States. Patients have nonfunctional PAH enzyme secondary to one or more genetic mutations. The enzyme deficit results in destructive supraphysiologic blood phenylalanine levels upon consumption of the essential dietary amino acid phenylalanine. Current standards of care mitigate signs and symptoms of the disorder, but do not approach a cure. The methods for creating a prototype pharmabiotic as an innovative treatment strategy for PAH deficiency are described herein.

DNA molecular cloning techniques were utilized to engineer …

Stoichiometry Of Hud To Khsrp: A Key Determinant For “Go And Stop” Signaling In Axon Growth, Devon Elizabeth Cassidy

Senior Theses

Development of the nervous system follows a sequential pattern of gene expression in a precise spatiotemporal manner. There are a number of transcriptional and post-transcriptional mechanisms that control these gene networks. Of particular importance is the mechanisms that modulates mRNA stability, since expression of many neuronal genes is controlled by changes in rates of mRNA decay. HuD and KHSRP, two AU-rich elements (ARE) RNA binding proteins, exert opposite effects on mRNA stability, with HuD stabilizing and KHSRP destabilizing bound mRNA. Ongoing work from our lab has implicated interactions of HuD and KHSRP with target mRNAs in regulating rates of axon …

Be Your Best S.E.L.F., Rachel Wood, Casey Hasenbein

Senior Theses

The goal of our thesis was to use our knowledge as Exercise Science students and personal trainers to improve the health of an underserved population in South Carolina. We created a voluntary exercise and self-defense program for the girls residing at Epworth Children’s Home. The program began on October 1, 2018 and concluded on April 29, 2019 with data collecting taking place between October 8th and March 18th. Every other week SASS Defense taught their self-defense program, and on the alternating weeks we facilitated an exercise class. The program also included a mentorship aspect to create a supportive social environment …

A Comparison Of The United States And Costa Rican Health Care Systems And Their Influence On Immigrant Women's Maternal And Child Health Outcomes, Tamera R. Sullivan

Senior Theses

Health is a fundamental right for all humans, and every nation has a unique system for health care delivery. While the United States and Costa Rica follow two different welfare state models, there is still value in comparing the two countries. This project was inspired by my public health-based study abroad experience in Costa Rica in May 2018, which sparked a desire to learn more about the structures that form the health care system of each country. The United States has a more privatized and fragmented health care system, while Costa Rica has a public, universal health care system. Although …

Examining The Role Of Socioeconomic Status In Concussion Recovery In A Pediatric Population, Chandler Melton

Senior Theses

The purpose of this thesis was to assess the role of socioeconomic factors in concussion recovery in a pediatric population. We sought to use a composite index (including maternal education, paternal education, household income) and individual factors of maternal education, paternal education, and household income as socioeconomic measures that could be significant components in recovery. We hypothesized that those with lower socioeconomic standing (composite or individual factor) would have greater deficits as evidenced by clinical symptoms, mood disturbances, and cognitive function. 45 subjects who presented to a local concussion clinic are included in this study. For each subject, clinical symptoms, …

The Write Stuff - Spring 2019 (Vol.16, No.2), Research Medical Library

Write Stuff 2019

• Setting up a writing critique group
• NIH clarifies terminology regarding rigor of the prior research
• Scientific Publications’ grant proposal editing service
• European Plan S aims to mandate open access by 2020
• NIH tip: Check your funding opportunity announcement 30 days before submitting your grant application
• Unusual terms used in scientific writing and publishing: “Blinded” peer review and clinical trials

Does The Use Of An On-Q Pump Improve Postsurgical Outcomes In Patients With Secondary Chronic Shoulder Pain?: A Retrospective Study, Deborah Thompson-Spencer

Doctoral Projects

Orthopedic shoulder surgery is a common therapy for many medical conditions, but the healing process for orthopedic shoulder surgery can be adversely impacted by chronic shoulder pain. Frequently, chronic pain is not adequately controlled by opioid analgesics provided to patients during the surgical healing process, resulting in greater pain and diminished postsurgical mobility. The focus of this Doctor of Nursing Practice project was to examine the question of whether, among male and female adult patients (40-64 years of age) with a history of secondary chronic shoulder pain lasting three or more months who have undergone orthopedic shoulder surgery, the use …

Providing Preventive Health Education And Developing A Referral Policy And Toolkit To Increase Access To Primary Care For Individuals With Mental Illness, Phaedra Mclin, Stephanie Myers

Doctoral Projects

Treatment rates in primary care for the mental health population is traditionally low. Individuals with mental illnesses were at a higher risk for the development of chronic health problems (Ross et al., 2015). Substance Abuse and Mental Health Services Administration (SAMHSA) indicated that many people with serious mental illness die from preventable diseases. People with serious mental illness also have a higher mortality rate than those in the general population (SAMHSA, 2017b).

The purpose of this Doctor of Nursing Practice (DNP) project was to determine if educational training regarding specific chronic disease conditions influenced the attitude and knowledge of the …

Actualizing Best Care Practices At A Psychiatric Treatment Center To Validate The Asset Of An On-Site Electrocardiogram, Pamela Metts

Doctoral Projects

Considerations to be contemplated in daily health delivery systems are complex and require varied approaches to deliver best-care processes that produce optimal patient outcomes. Specialty practice sites not only require the capability but also necessitate proficiency and dedication in meeting and exceeding essential healthcare competencies. A psychiatric treatment center specialty practice was the setting for this DNP project. The focus of this project included: (1) care resourcefulness, (2) safety initiatives, (3) increased privacy and confidentiality compliance, and (4) cost-efficiency measures.

Technology use beyond the security of the safety available within the treatment complex is a current policy at the psychiatric …

Comparison Of The Depth Of Cure Of Flowable Composites Polymerized At Variable Increment Thicknesses And Voltages: An In Vitro Study, Sadia Tabassum, Muhammad Hasan Hameed, Farhan Raza Khan

Section of Dental-Oral Maxillofacial Surgery

Objectives: The aim of this study is to compare the depth of cure of two composite materials (SDR and Filtek bulk-fill) cured at variable increment depths (2, 4, and 6 mm) and voltages (180 and 220 volts).
Materials and Methods: Each sample of the composite material was packed in a mold of 2 mm, 4 mm, and 6 mm and curing light (quartz tungsten halogen) of optimal intensity was exposed for 20 s at 2 different voltages on each specimen. After curing, the specimens were removed and the composite on the nonexposed end was scraped with a plastic instrument. The …

The Effect Of Remote Ischemic Preconditioning On Exercise Hyperemia In Multiple Sclerosis, Jane E. Rosmarin

Honors Theses

Remote ischemic preconditioning (RIPC) is a non-invasive technique in which blood flow is cut off to a limb for a short period of time which produces a protective effect throughout the whole body to subsequent low oxygen conditions. One of the prominent cardiovascular limitations to exercise in individuals with multiple sclerosis (MS) is fatigue, which may stem from the decreased delivery of oxygen to muscle tissue during exercise. The purpose of this study was to test the hypothesis that RIPC would increase forearm blood flow (FBF) and utilization of oxygen at the level of the muscle tissue in individuals with …

Leaving A Legacy: Empowering Students To Give Back, Eric Schutter

Honors Theses

Most college universities struggle to convince alumni to give back to their former institutions. Currently, only 19.9% of college alumni give back to their former colleges (Alumni Factor, 2018). Despite the amount of time and energy that schools invest in their students, many of the students are not making any sort of commitment in return. However, there is a solution. If college programs found ways to create avenues for students, both current and former, to give back outside of just university general funds, they could see an increase in student giving from both parties. While there is a notion that …

Complete Care Model Impact On Glycemic Control In California State Prisons, Diane M. O’Laughlin

Doctoral Projects

The Complete Care Model (CCM) is a health care delivery model based on the well-studied and internationally validated chronic care theory. Since the integration of the chronic care theory into California Department of Corrections and Rehabilitation (CDCR) patient care in 2008, steady improvement in health care related mortality has been seen, and there have been no unavoidable health care related deaths in CDCR since 2012 (Gransee, 2018). However glycemic control in CDCR diabetic patients has made no statistically significant change since the implementation of the CCM in 2015 when comparing the two years before and the two years after implementation …

Losing Weight And Improving A1c Level By Adding A 30-Minute Walk To Individuals' Daily Activities, Lobat Danehvar-Jahromi

Doctoral Projects

Overweight/obesity is a global health concern, as is the growing prevalence of type 2 diabetes mellitus. Health complications related to these two problems negatively affect individuals’ quality of life and the healthcare system. In the literature on controlling these two health issues and preventing their related health complications, few studies examine use of a simple and affordable method. This research investigated the possibility of improving BMI (body mass index) and lowering blood sugar level, as measured by A1c, by adding a 30-minute daily walk to individuals’ activities. Thirty patients classified as overweight or obese (BMI of 25-35) with type 2 …

Does Preoperative Ostomy Education Decrease Anxiety In The New Ostomy Patient?, Michelle Suzann Harris

Doctoral Projects

Background: There are approximately 100,000 patients with new ileostomies and colostomies created in the United States each year. These patients have specialized needs that include acceptance of altered body image, psychological stress, learning of difficult tasks, and occasionally an ominous diagnosis leading to the need for surgery. In addition to pre-surgical stoma site marking on the abdomen, ostomy nurses have identified early education to be an important factor in long-term success and management of the patient . Early education and stoma site marking may assist with a better-situated stoma leading to fewer complications related to appliance adherence and leakage. …

Is There A Relationship Between Limited English Proficiency (Lep), Medication Adherence Behaviors, And Adverse Asthma Outcomes In Hispanic Adults With Moderate To Severe Persistent Asthma?, Archana Kartik Chandra

Doctoral Projects

The effects of LEP are well documented in the literature. LEP decreases medication adherence, causes ineffective communication between patients and providers, and reduces health outcomes. Asthma is known to be misdiagnosed and under-treated in Hispanic adults. There are discrepancies in the literature about the effects of LEP in Hispanic adults with persistent asthma.

The purpose of this study was to determine if the presence of LEP is associated with medication adherence behaviors and adverse asthma outcomes in Hispanic adults with moderate to severe persistent asthma. Hispanic adults with LEP were assessed for asthma outcomes and medication adherence behaviors.

The results …

Nurse Managers: An Association Between Empowerment And Burnout, Sonja Lynn Avery

Doctoral Projects

The purpose of the study is to ascertain the presence of an inverse relationship between nurse managers’ feelings of structural empowerment and self-perception of burnout. Although research is available studying the effects of staff nurse empowerment and burnout, literature is sparse relative to evaluation of nurse manager empowerment and burnout. Of the studies available, there is supportive evidence pertaining to the negative implications associated with nurse manager burnout such as reduced staff nurse retention and morale, decrease in quality of patient care, and financial impact on organizational success. With such negative implications associated with a lack of empowerment and burnout, …

Addressing Disparities In Nurses’ Understanding Of Congestive Heart Failure, David Tomas Palecek

Doctoral Projects

Congestive heart failure (CHF) continues to affect millions of people a year and remains one of the leading causes of re-hospitalization in the US. Within the Central San Joaquin Valley (CSJV) the incidence of CHF remains significantly higher than the rest of California. In order to ensure appropriate patient care and outcomes registered nurses (RNs) must have a thorough and full understanding of the disease process and its associated symptomatology. This study aimed to find if the implementation of an interactive multimedia educational program focusing on all aspects of CHF could improve RNs education and understanding of CHF. It is …

Subsequent Event Risk In Individuals With Established Coronary Heart Disease, Riyaz S. Patel, Vinicius Tragante, Amand F. Schmidt, Raymond O. Mccubrey, Michael V. Holmes, Laurence J. Howe, Kenan Direk, Axel Åkerblom, Karin Leander, Salim S. Virani

Office of the Provost

Background: The Genetics of Subsequent Coronary Heart Disease (GENIUS-CHD) consortium was established to facilitate discovery and validation of genetic variants and biomarkers for risk of subsequent CHD events, in individuals with established CHD.
Methods: The consortium currently includes 57 studies from 18 countries, recruiting 185 614 participants with either acute coronary syndrome, stable CHD, or a mixture of both at baseline. All studies collected biological samples and followed-up study participants prospectively for subsequent events.
Results: Enrollment into the individual studies took place between 1985 to present day with a duration of follow-up ranging from 9 months to 15 years. Within …

Patient Willingness To Undergo Robotic Surgery: Identification And Validation Of A Predictive Model, Emily C. Anania

Doctoral Dissertations and Master's Theses

INTRODUCTION: The purpose of the current dissertation is to better understand the factors which make an individual willing (or unwilling) to undergo robotic surgery. Though surgical feasibility and provider perceptions are often studied, little research has investigated how patients perceive robotic surgical systems.

METHOD: A two-stage approach was taken in order to build and validate a regression equation in order to predict an individual’s willingness to undergo robotic surgery based on several factors. Stage 1 employed a sample size of 1324 participants in order to build the model. Participants responded to a survey indicating their willingness to undergo robotic surgery, …

Law Library Blog (April 2019): Legal Beagle's Blog Archive, Roger Williams University School Of Law

Law Library Newsletters/Blog

No abstract provided.

Inotuzumab Ozogamicin In Pediatric Patients With Relapsed/Refractory Acute Lymphoblastic Leukemia., Deepa Bhojwani, Richard Sposto, Nirali N. Shah, Vilmarie Rodriguez, Constance Yuan, Maryalice Stetler-Stevenson, Maureen M. O'Brien, Jennifer L. Mcneer, Amrana Quereshi, Aurelie Cabannes, Paul Schlegel, Claudia Rossig, Luciano Dalla-Pozza, Keith August, Sarah Alexander, Jean-Pierre Bourquin, Michel Zwaan, Elizabeth A. Raetz, Mignon L. Loh, Susan R. Rheingold

Manuscripts, Articles, Book Chapters and Other Papers

Although inotuzumab ozogamicin (InO) is recognized as an effective agent in relapsed acute lymphoblastic leukemia (ALL) in adults, data on safety and efficacy in pediatric patients are scarce. We report the use of InO in 51 children with relapsed/refractory ALL treated in the compassionate use program. In this heavily pretreated cohort, complete remission was achieved in 67% of patients with overt marrow disease. The majority (71%) of responders were negative for minimal residual disease. Responses were observed irrespective of cytogenetic subtype or number or type of prior treatment regimens. InO was well-tolerated; grade 3 hepatic transaminitis or hyperbilirubinemia were noted …

A New Paediatric Diabetes Knowledge Test - M-Wikad Development And Factor Analysis., Sarah Tsai, Susana Patton, Stephen Delurgio, David D. Williams, Kavitha Dileepan, Alexander Karmazin, Melinda Storm, Mark A. Clements

Manuscripts, Articles, Book Chapters and Other Papers

Purpose: The purpose of this study was to develop a measure of type 1 diabetes mellitus (T1DM) knowledge that is aimed at youth and is based on contemporary management standards. Methods: An 88-item test was derived from the American Association of Diabetes Educators 7 Self-Care Behaviors. Results: A multidisciplinary team selected the best 49 items which were piloted in a sample of 119 youths (59 males, aged 12-18, having a mean ± standard deviation glycated haemoglobin (A1C) of 9.9%±1.80 (84.7±19.7 mmol/mol). A minimum absolute point-biserial correlation coefficient of 0.250 was used to choose 49 items from the original 88 questions. …

Identification Of Inadvertent Azygous Vein Cannulation Using Transthoracic Echocardiography During Venoarterial Extracorporeal Membrane Oxygenation Initiation., Bethany Runkel, Jason D. Fraser, John Daniel, Karina M. Carlson

Manuscripts, Articles, Book Chapters and Other Papers

It is well known that optimal cannula positioning during initiation of venoarterial (VA) extracorporeal membrane oxygenation (ECMO) is directly related to ECMO circuit function. Malpositioned cannulae can have deleterious effects on clinical outcomes, and inadvertent cannulation of the azygous vein during initiation of ECMO is a rare but potentially devastating complication that has been reported only a few times in the literature. Here we report a case of azygous vein cannulation in a neonate that was not identified on chest radiography but was recognized and corrected expeditiously with the use of transthoracic echocardiography.