Medicine and Health Sciences Commons^™

Physician Hospital Arrangement Influence On Nonprofit Hospital Quality,Financial Performance And Community Benefit Expenditures, Andrea Cervin

Dissertations and Theses (Open Access)

Federal policy has encouraged hospitals to provide certain quality outcomes and cost containment. Hospitals have responded by forming physician hospital organizations in attempts to achieve quality outcomes and capture reimbursements. At the same time, federal policy has awarded hospitals with nonprofit status with the requirement to provide community benefits in exchange for the tax exemption they receive. With the formation of physician hospital organizations, there remains the question of whether hospitals are achieving desired quality metrics and whether hospitals are financially viable. There is also public and media interest recently regarding whether nonprofit hospitals fulfill their obligations for community benefit …

T​He​ E​Ffect​ ​Of​ U​Nconventional​ G​As​ ​And​ O​Il​ D​Rilling​ E​Missions​ ​On​ A​Sthma​ ​And​ R​Espiratory D​Iseases​ ​In​ ​The​ B​Arnett​ S​Hale​ ​Of​ T​Exas, Stella A. Okoroafor

Dissertations and Theses (Open Access)

Unconventional gas and oil drilling (UGOD) has increased substantially in the United States for more than a decade. The resultant environmental unsafe air pollution effects of UGOD both locally and regionally have been well documented in the literature. Despite the dramatic increase in unconventional well drilling and the toxicant exposure, the health consequences of UGOD remain largely uncertain. This study assesses the relationship between active wells and healthcare use for respiratory diseases by zip code from 2004 to 2008 in the Barnett shale area of Texas. The first modern shale gas well was drilled in the Barnett shale area of …

A Geospatial Examination Of The Association Between Geographic Food Access And Food Insecurity In Central Texas: The Role Of Race/Ethnicity And Urbanicity, Kathryn Janda

Dissertations and Theses (Open Access)

Food insecurity is a public health issue that affects one in ten Americans, one in seven Central Texans, and is associated with malnutrition, chronic disease, and obesity. Geographic food access is the most intervened upon aspect of food insecurity and is often measured objectively through mapping software, such as ArcGIS. Yet when geographic food access is only measured in terms of distance to food retail, analyses do not full capture the nuances of community context. Thus, other sources of data, like survey data, and demographic indicators, such as race/ethnicity and urbanicity, should be incorporated into the research exploring the association …

Determining The Drivers Of Quality Of Life In Hiv Patints Treated With Antiretroviral Therapy In Subsaharan Africa, Oubote Sangbana

Dissertations and Theses (Open Access)

During the last decade, HIV in sub-Saharan Africa has shifted from a fatal disease to a chronic condition thanks to the expansion of antiretroviral therapy (ART). As a result, the focus of care has transitioned from survival to quality of life (QoL), and the latter has become a significant outcome measure during patient follow up. Yet, the determinants of QoL among HIV patients in western and central Africa are not well known. The objective of this dissertation was to determine the main factors associated with QoL among ART-treated HIV adult patients in western and central Africa to ensure healthcare providers …

Utility Of Plasma Biomarkers In The Validation Of Reported Loc & Pta For Gcs 13-15 Patients: A Track-Tbi Pilot Study, Jeffrey Brennan

Dissertations and Theses (Open Access)

Depending on a brain injury patient to accurately report their duration of unconsciousness and amnesia is clearly flawed. We constructed biomarker-based models to validate these self-reported measurements using a GCS 13-15 subset of participants from TRACK-TBI, a multi-institutional study on traumatic brain injury. Potential covariates were assessed for significant interactions with biomarker level. We report that the predictions of LOC and PTA failed. GFAP exhibited the most consistent serum level increase between categories of both LOC and PTA. Given a number of issues with the study sample, we recommend continued investigation on the prediction of LOC and PTA using a …

Disability Rights As A Necessary Framework For Crisis Standards Of Care And The Future Of Health Care, Laura Guidry-Grimes, Katie Savin, Joseph A. Stramondo, Joel Michael Reynolds, Marina Tsaplina, Teresa Blankmeyer Burke, Angela Ballantyne, Eva Feder Kittay, Devan Stahl, Jackie Leach Scully, Rosemarie Garland-Thomson, Anita Tarzian, Doron Dorfman, Joseph J. Fins

All Faculty Scholarship

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled …

The Course Of Acute Stress Disorder And Post Traumatic Stress Disorder In Parents With Infants In The Neonatal Intensive Care Unit, Caroline Bertsch

Dissertations and Theses (Open Access)

NICU parents have up to a 60% chance to develop acute stress disorder (ASD) and/or post-traumatic stress disorder (PTSD) during or after their baby’s NICU stay. Emotional and demographic factors contributing to ASD/PTSD have been previously identified. Although support factors desired by NICU parents have been described, it has not yet been determined how the presence or absence of these desired support factors may impact the development of ASD/PTSD. English and Spanish speaking parents over the age of 18 were eligible to participate in a survey that assessed stress, coping and support in the NICU. Participants also completed a validated …

Refuge For The Refugee, Chelsia Sooksengdao

Architecture Undergraduate Honors Theses

This capstone investigates the overlap of psychology and architecture as a tool to address the issue of mental wellness in refugees. It focuses on the way refugee camp conditions perpetuate the trauma that is experienced, and how the inhabited spaces foster unhealthy interactions that add to the emotional stress refugees endure. Most of these unhealthy interactions are caused by overcrowded living conditions that prevail in most refugee camps, leading to violations of privacy and personal space. By investigating aspects of social psychology and proxemics, this capstone connects these concepts to spatial solutions, with the goal of reducing emotional stress and …

Are "Replicants" The Spine Surgeons Of The Future?, Jens R Chapman, Jeffrey C Wang, Karsten Wiechert

Articles, Abstracts, and Reports

No abstract provided.

The Lived Experiences Of Breathlessness In Adults With Chronic Heart Failure, Cecilia Cipriano Lijauco

Nursing Dissertations - Archive

Heart failure (HF) is a significant disease condition affecting 6.5 million Americans. Breathlessness is the hallmark symptom of HF impacting affected individual’s functional capacity and quality of life. It is a subjective symptom best described by individuals experiencing it, yet there are very few qualitative studies to understand this phenomenon in HF. The purpose of this study was to explore how adults with HF describe their experiences of breathlessness, determine characteristics, types and patterns, explore the impact of breathlessness on their daily life, and explore how affected individuals manage their breathlessness. Fourteen participants with diagnosis of HF and self-report of …

2020-05-01_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …

Kujdesi Në Zbatimin E Dhënies Së Injeksioneve, Infuzioneve Dhe Përcjellja E Tyre. Roli I Infermieres, Adelina Pllana

Theses and Dissertations

Hyrje: Infermieria përkufizohet si mbrojtja, promovimi dhe optimizimi i shëndetit dhe aftësive, për parandalimin e sëmundjeve dhe lëndimeve, nëpërmjet diagnozës dhe trajtimit të pacientëve. Injeksioni është akti i vendosjes së një lëngu, veçanërisht një ilaç, në trupin e një personi.

Qëllimi i këtij punimi është të hulumtojë mbi zbatimin e drejtë /jo të drejtë të dhënies së terapisë përmes injeksioneve, infuzioneve periferike dhe rolin e infermierës në këtë proces.

Metodologjia: Ky studim ndërsektorial u realizua midis muajit Janar 2020 dhe Shkurt 2020 në Klinikën e Kirurgjisë Torakale në Qendrën Klinike Universitare të Kosovës, si dhe në Klinikën e Kirurgjisë në …

Kujdesi Infermieror Dhe Diabeti Mellitus, Biondina Veliu

Theses and Dissertations

Arsyeja pse e mora këtë temë për studim është fakti se rastet me diabetin mellitus në vendin tonë janë të shumta. Është e rëndësishme që të mësojmë dhe të marrim sa më shumë informacione rreth Diabetit Mellitus qe t’i vijmë në ndihmë pacientëve dhe t’i sigurojmë një kujdes të veçant për ta. Qëllimi i studimit është që të mësojmë sa më shumë rreth komplikacioneve të kësaj diagnoze qëti sigurojme pacienteve një mënyrë të jetesës sa më të mirë. Duhet të bëjmë që këta pacintë të mos izolohen nga shoqëria por të përshtaten në mënyren e re të jetesës dhe të …

Female Degus Show High Sociality But No Preference For Familiar Peers, Nathan Insel, Katharine L. Shambaugh, Annaliese K. Beery

Neuroscience: Faculty Publications

Group-living animals vary in social behavior across multiple dimensions, including in the selectivity of social interactions with familiar versus unfamiliar peers. Standardized behavioral tests can be used to tease apart different dimensions of behavior. These serve a dual function—on one hand, helping to isolate behavioral factors that may support collective behavior in natural habitats, and, on another, providing a basis for comparative approaches to understanding physiological mechanisms of behavior. Degus (Octodon degus) are South American caviomorph rodents that nest and forage in groups with relatively low genetic relatedness. Flexibility in group membership is likely supported by gregariousness toward strangers, but …

2020-2021 Summer Bulletin, University Of Mississippi Medical Center

Bulletins/Catalogs

2020-2021 Summer Bulletin

Surgical Management And Outcome Of Newly Diagnosed Glioblastoma Without Contrast Enhancement (Low-Grade Appearance): A Report Of The Rano Resect Group, Ameya A Jategaonkar, Vivian F Kaul, Eric Lee, Eric M Genden

Faculty, Staff and Student Publications

The palatomaxillary structure plays critical roles in both form and function of the midface. Surgical defects of the palate and maxilla can be associated with significant morbidity and deformity. Various defect classification systems have been used to assist in reconstruction and rehabilitation. Reconstructive options include prosthetic rehabilitation, local flaps, and free tissue transfer. Here, we review the functional and surgical anatomy of the palatomaxillary complex, defect classification systems, and provide an overview of reconstructive options.

Effects Of Shift Length On Nursing Staff’S Productivity, Safety, And Well-Being, Victoria Sivesind

Nursing | Senior Theses

In this thesis the relationship between normal shift length for nurses and fatigue, burnout, intention to leave job, and patient outcomes and satisfaction. A review of literature has been done and conclusions have been made about the previous research reviewed in the thesis. A proposal for further research has been included and details how the author plans to provide further clarification to the questions at hand in order to better clinical nursing practice for the future. The proposed study includes sending out a survey to members of the Sigma Theta Tau Honors Nursing Society. It will inquire about shift length, …

The Relationship Between Low Socioeconomic Status And Mortality Rates Of School Age Children Related To Motor Vehicle Accidents, Rubi Calderon-Rodriguez

Nursing | Senior Theses

The purpose of this study is to assess nurses’ perceptions on the relationship between low socioeconomic status and high mortality rates of children due to motor vehicle accidents(MVAs). MVAs are the leading cause of death among children four years and older. Studies reviewed in this paper support that low socioeconomic status is associated with high child mortality rates caused by motor vehicle accidents. Factors contributing to these high mortality rates include: the lack of or improper use of restraints, low parental education attainment levels, black or Hispanic race, and environmental risks of low socioeconomic areas. A mixed methods study is …

Nurses’ Reported Use Of Therapeutic Interventions Surrounding A Stillbirth Event, Sonya Woo

Nursing | Senior Theses

Psychological alterations and therapeutic interventions utilized for mothers who have suffered a stillbirth have been assessed and addressed in prior literature. This researcher reviewed ten articles highlighting the depression, grief, guilt, stress and concerns that can arise and interventions that were initiated within weeks immediately following stillbirth, during the time of a subsequent pregnancy, and a few years after having a subsequent child. An increased utilization of healthcare and health care provider presence have shown to positively influence the psychological effects of stillbirth. This researcher looked into the frequency and variety of which these interventions are being implemented in a …

Enhanced B7-H4 Expression In Gliomas With Low Pd-L1 Expression Identifies Super-Cold Tumors., Di Chen, Gaopeng Li, Chunxia Ji, Qiqi Lu, Ying Qi, Chao Tang, Ji Xiong, Jian Hu, Fatma Betul Aksoy Yasar, Yan Zhang, Dave S B Hoon, Yu Yao, Liangfu Zhou

Articles, Abstracts, and Reports

BACKGROUND: Characterizing expression profiles of different immune checkpoint molecules are promising for personalized checkpoint inhibitory immunotherapy. Gliomas have been shown as potential targets for immune checkpoint inhibitors recently. Our study was performed to determine coexpression levels of two major B7 immune regulatory molecules programmed death ligand 1 (PD-L1) and B7-H4, both of which have been demonstrated to inhibit antitumor host immunity in gliomas.

METHODS: We assessed tumor tissues from stage II-IV primary gliomas (n=505) by immunohistochemistry (IHC) for protein levels of both PD-L1 and B7-H4. Gene coexpression analysis assessing clusters based on extent of PD-L1/B7-H4 classifier genes expression were investigated …

Randomized Phase Ii Study Of Stereotactic Body Radiotherapy And Interleukin-2 Versus Interleukin-2 In Patients With Metastatic Melanoma., Brendan Curti, Marka R Crittenden, Steven K Seung, Christopher B Fountain, Roxanne Payne, Shuching Chang, Jessica Fleser, Kimberly Phillips, Ian Malkasian, Lyn B Dobrunick, Walter Urba

Articles, Abstracts, and Reports

BACKGROUND: A pilot study of stereotactic body radiation therapy (SBRT) followed by high-dose interleukin-2 (IL-2) showed a higher than anticipated objective response rate (ORR) among patients with metastatic melanoma (MM). We performed a prospective randomized study to determine if the ORR of SBRT + IL-2 was greater than IL-2 monotherapy in patients with advanced melanoma.

METHODS: Patients with MM who had adequate physiological reserve for IL-2 and at least one site suitable for SBRT were eligible. There was a 1:1 randomization to SBRT + IL-2 or IL-2 monotherapy. Patients received one or two doses of SBRT (20 Gy per fraction) …

Results Of Lung Cancer Screening In The Community., John R Handy, Michael Skokan, Erika Rauch, Steven Zinck, Rachel E Sanborn, Svetlana Kotova, Mansen Wang

Articles, Abstracts, and Reports

PURPOSE: To address doubts regarding National Lung Screening Trial (NLST) generalizability, we analyzed over 6,000 lung cancer screenings (LCSs) within a community health system.

METHODS: Our LCS program included 10 sites, 7 hospitals (2 non-university tertiary care, 5 community) and 3 free-standing imaging centers. Primary care clinicians referred patients. Standard criteria determined eligibility. Dedicated radiologists interpreted all LCSs, assigning Lung Imaging Reporting and Data System (Lung-RADS) categories. All category 4 Lung-RADS scans underwent multidisciplinary review and management recommendations. Data was prospectively collected from November 2013 through December 2018 and retrospectively analyzed.

RESULTS: Of 4,666 referrals, 1,264 individuals were excluded or …

Characterization Of Adnexal Masses Using Contrast-Enhanced Subharmonic Imaging: A Pilot Study., Lauren J. Delaney, Priscilla Machado, Mehnoosh Torkzaban, Andrej Lyshchik, Corinne Wessner, Christine H. Kim, Md, Norman G Rosenblum, Scott D. Richard, Kirk Wallace, Flemming Forsberg

Department of Radiology Faculty Papers

OBJECTIVES: This pilot study evaluated whether contrast-enhanced subharmonic imaging (SHI) could be used to characterize adnexal masses before surgical intervention.

METHODS: Ten women (with 12 lesions) scheduled for surgery of an ovarian mass underwent an SHI examination of their adnexal region using a modified LOGIQ E9 scanner (GE Healthcare, Waukesha, WI) with an endocavitary transducer, in which digital clips were acquired by pulse destruction-replenishment SHI across the lesions. Time-intensity curves were created offline to quantitatively evaluate SHI parameters (fractional tumor perfusion, peak contrast intensity, time to peak contrast enhancement, and area under the time-intensity curve), which were compared to pathologic …

Patient-Centered Emr Communication, Christi Lynn Camarena

Doctoral Projects

The electronic medical record (EMR) has become the standard in health care documentation. The EMR has been shown to improve the availability of medical records, provide tools to facilitate communication, and improve patient safety. Because of the absence of standardized training and EMR research, there is a gap in understanding the relationship between the EMR and the provider-patient relationship. The EMR requires the provider to use purposeful and deliberate patient-centered EMR communications behaviors to facilitate a meaningful, engaging, and educational dialogue with patients. These behaviors have been studied in physician populations and standardized tools have been developed to assist in …

Ntchs© Health Literacy Intervention Pilot Study, Genevieve Evenhouse

Doctoral Projects

This pilot study explored the effectiveness of a validated curriculum called, “Navigating the Health Care System” (NTHCSÓ) in improving the health literacy of high school-aged adolescents in response to the national call to promote knowledge and skills in all ages, and socio-economic and cultural groups to achieve healthier lives. Low health literacy has been shown to greatly affect the quality of lives, health outcomes, and health spending of individuals with and without health conditions across social demographics. High school-aged adolescents are the population of interest of this study due to their developmental milestones which allows for knowledge and skill building …

The Collaborative Health Objectives In Combatting The Effects Of Diabetic Peripheral Neuropathy (Choice): A Second Chance To Change Diabetic Destiny, Alishia A. Claibourn

Doctoral Projects

The Collaborative Health Objective in Combatting the Effects of Diabetic Peripheral Neuropathy (CHOICE); A Second Chance to Change Diabetic Destiny, is a research pilot study that will test the validity of The Diabetic Foot Book. Diabetic peripheral neuropathy (DPN) affects 60-70% of the diabetic population. The CHOICE project will use The Diabetic Foot Book, a patient education booklet, created explicitly for the DPN population. The goal of the pilot study is to evaluate the effectiveness of The Diabetic Foot Book to increase health literacy and affect behavior change in the DPN population.

Respiratory Distress Observation Scale Implementation For Comfort Care Patients In The Acute Care Setting, Marianne Wachalovsky

Doctoral Projects

One of the most common symptoms at the end of life is respiratory distress. Respiratory distress or dyspnea is a subjective symptom and therefore challenging to assess, especially when the patient is unable to communicate. Controlling symptoms depend on the knowledge and assessment skills of the clinicians and their willingness to administer the necessary pharmacological intervention. Assessment and treatment of this symptom presented a gap in the quality of care for the patients in the hospital of the author. An exhaustive literature review established that this existed also in other clinical settings and led to the Respiratory Distress Observation Scale …

Inspire : Vol 3, Issue 5, Department Of Medicine

INSPIRE – Department of Medicine Archives

Content

• Message From The Chair
• Medicine at National and International Forums
• Featured Faculty: Dr Aamir Hameed “Success is a fight between you and yourself”
• What Are Academics Around the World Reading This Month?
• Publications

Pattern Of Recovery And Outcomes Of Patient Reported Physical Function And Pain Interference After Ankle Fusion: A Retrospective Cohort Study, Jessica M. Kohring, Jeff Houck, Irvin Oh, Adolf S. Flemister, John P. Keptz, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Background: Research on outcomes after ankle fusion focuses on basic activities of daily living, fusion rates, and gait parameters. Little has been reported on the patient’s perspective after surgery. The purpose of this study was to determine the change in patient reported physical function and pain interference after ankle fusion surgery to guide patient expectations and improve provider communication.

Methods: This was a retrospective review of prospectively collected patient reported outcome measurement information system (PROMIS) data in 88 ankle arthrodesis procedures performed from May 2015 to March 2018. The PROMIS Physical function (PF) and pain interference (PI) measures were collected …

Medical-Legal Partnerships: Assessment Of Mental Health & Substance Abuse Patients And Social/Legal Needs, Fung J. Liu

Capstone Experience: Master of Public Health

A medical-legal partnership (MLP) is a model which brings together health and legal services in the form of a multidisciplinary team that works to address medical and legal issues. Currently, Legal Aid of Nebraska is partnering with Bluestem Health, a local federally qualified health center (FQHC) located in Lincoln, Nebraska, to identify legal issues and provide civil legal aid services through a screening and referral process. The purpose of this capstone project was to assess the characteristics and determine the types of social/legal needs of FQHC patients referred to Legal Aid of Nebraska. Data collected was utilized to assess whether …