Medicine and Health Sciences Commons^™

Recidivism Among Previously Incarcerated People Enrolled In Riverside County Whole Person Care, Ndifreke Emmanuel Etim

CGU Theses & Dissertations

The United States continues to policy shift towards reducing the number of incarcerated people; however, many people released from incarceration will be rearrested due to re-entry challenges. Several re-entry programs, such as the Whole Person Care pilot, have been developed to address these challenges and ensure that formerly incarcerated people successfully transition into the community. The primary aim of this project is to explore the determinants of recidivism among previously incarcerated people enrolled in the Whole Person Care pilot in Riverside County. This study suggests early linkage to services, such as mental health and substance use treatment services, will reduce …

Access To Medication-Assisted Treatment For Opioid Dependence In The United States – Identifying Implications For Policy And Practice, Mofoluwake Adeniyi

CGU Theses & Dissertations

Americans make and use the most opioids in the world. Although comprising somewhat less than 5% of the world’s population, the United States (US) produces approximately 90% of the global supply of Hydrocodone and consumes an estimated 80% of the total international supply. It is not surprising, therefore, that the American opioid epidemic, particularly as it involves adults (those 18 years and older), is worsening—Indeed, President Trump declared it a national public health emergency. Many therefore anticipate that the US Congress will enact evidence-informed policies to address the opioid crisis. Opioid Use Disorder (OUD) is a pattern of opioid use …

Systemic Risk Management Plan For Electronic Medical Records (Emr): Why And How?, Ziniya Zahedi, Faisal Mahmud, Cesar Pinto

Engineering Management & Systems Engineering Faculty Publications

Electronic patient data use and handling are critical issues in terms of privacy, confidentiality, security, and the Health Insurance Portability and Accountability Act (HIPAA) regulations. The risks associated with electronic patient data are not limited to identity theft but rather include a person’s social, economic, and psychological well-being. However, there have not been many studies that have focused on the associated risk factors that could lead to these situations. This paper identifies those risks related to electronic patient data breaches by means of a grounded theory approach and develops a systemic risk management plan that enables engineering managers and risk …

Just Because (Most) Hospitals Are Publishing Charges Does Not Mean Prices Are More Transparent, Cody L. Mullens, J Andres Hernandez, Evan D. Anderson, Lindsay Allen

Faculty & Staff Scholarship

Background: The Centers for Medicare and Medicaid Services (CMS) recently mandated that all hospitals publish their charge description masters (CDMs) online, in a machine-readable format, by January 1, 2019. In addition, CMS recommended that CDM data be made available in a manner that was consumer friendly and accessible to patients.

Objective: This study aimed to (1) examine all hospitals across the state of Pennsylvania to understand policy compliance and (2) use established metrics to measure accessibility and consumer friendliness of posted CDM data.

Methods: A cross-sectional analysis was conducted to quantify hospital website compliance with the recent CMS policies requiring …

Differentiating Peripherally-Located Small Cell Lung Cancer From Non-Small Cell Lung Cancer Using A Ct Radiomic Approach, Bihong T. Chen, Zikuan Chen, Ningrong Ye, Isa Mambetsariev, Jeremy Fricke, Ebenezer Daniel, George Wang, Chi Wah Wong, Russell C. Rockne, Rivka R. Colen, Mohd W. Nasser, Surinder K. Batra, Andrei I. Holodny, Sagus Sampath, Ravi Salgia

Journal Articles: Biochemistry & Molecular Biology

Lung cancer can be classified into two main categories: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), which are different in treatment strategy and survival probability. The lung CT images of SCLC and NSCLC are similar such that their subtle differences are hardly visually discernible by the human eye through conventional imaging evaluation. We hypothesize that SCLC/NSCLC differentiation could be achieved via computerized image feature analysis and classification in feature space, as termed a radiomic model. The purpose of this study was to use CT radiomics to differentiate SCLC from NSCLC adenocarcinoma. Patients with primary lung cancer, …

Profile Of Cardiac Arrhythmia In Acute Stroke Patients, Julius Stephen Nkhondeya Msukuya

Master of Medicine in Internal Medicine

Introduction: Cardiac arrhythmias are common and can be fatal in acute strokes, but they are often under-recognized. The presence of cardiac arrhythmia in acute stroke doubles the mortality. Objectives: This study aimed to determine the types of cardiac arrhythmia in acute stroke patients admitted in two urban hospitals in Dar es Salaam, The Aga Khan Hospital, Dar es Salaam and Muhimbili National Hospital. The secondary objectives were to determine the associations between the characteristic of stroke and cardiac arrhythmias as well as to determine the impact of cardiac arrhythmia on 30- days stroke outcomes. Methods: This was a prospective longitudinal …

The Clinicodemographic Profile Of Multiple Sclerosis At Aga Khan University Hospital (Nairobi), Imran Jamal

Master of Medicine in Internal Medicine

Background: Multiple sclerosis (MS) is the leading cause of nontraumatic disability in young adults and is the most common immune-mediated inflammatory demyelinating disease of the CNS. MS was initially considered to be rare in sub-Saharan Africa (SSA). However, there have been reports of rising trends of MS in regions with previously low prevalence. Objective: The primary objective of this study was to describe the demographic and clinical characteristics of MS patients at AKUHN. Methods: Medical records of patients with MS at the AKUHN were obtained using the ICD 10 code search at the medical records section of the hospital between …

Validation Of Kiswahili Version Of World Health Organization Quality Of Life-Hiv Bref Questionnaire Among People Living With Hiv/Aids In Tanzania., Nuru Abdallah Kondo

Master of Medicine in Family Medicine

Background: WHO has developed an HIV specific quality of life tool (WHOQOLHIV-BREF) for assessing Quality of life of HIV positive individuals. This tool takes to account the different cultural variations that exist worldwide and hence enable assessment of the quality of life across different cultures/context. This tool has been validated in different cultures and is cross-culturally a promising tool. It is simple to use in routine clinics as it is self-administered. Despite its sound validity and reliability from several studies, the developers recommend it to be validated in different cultures to fully assess its psychometric properties before its adaptation. Objectives: …

Implementation Of A Novel Return-To-Ride Concussion Management Policy For Collegiate Hunter/Jumper Equestrian Athletes, Devon Serrano, Velyn Wu

Clinical Practice in Athletic Training

A concussion return-to-participation protocol specific to equestrian is critical in the safe return of athletes to their respective discipline. When the care of the hunter/jumper equestrian teams became the responsibility of the Sports Medicine staff at Sweet Briar College, a return-to-participation concussion management policy was needed to ensure the safety of the equestrian student-athletes. A quality-improvement project focusing on the development of a “Return-to-Ride” protocol was started in the fall semester of 2016. The Sports Medicine staff collaborated with the Sweet Briar College riding center to create and ensure compliance of the protocol. The intended aim of developing this protocol …

Quality Improvement In Athletic Training Education On Female Athlete Triad, Kristen A. Paloncy-Patel, Melissa R. Penkalski, Shannon M. Hauschildt, Natalie B. Allen

Clinical Practice in Athletic Training

There are significant health risks associated with the female athlete triad (Triad), therefore early detection and prevention is key. Athletic trainers often serve as the frontline defense and can have a crucial role in identifying the Triad. Yet knowledge, confidence, and practice standards in the recognition, referral and treatment is lacking. The purpose of the following Quality Improvement document is to provide athletic trainers with a framework for improving Triad-specific knowledge, confidence, and practice standards. The 2014 Female Athletic Triad Coalition consensus statement provides an evidence-based risk stratification system for detection and referral of the Triad. The Coalition suggests including …

Point-Of-Care Research: Retrospective Analysis Of The Evaluation And Classification Of Tendon Pathology In Athletic Training, Ashley J. Reeves, Russell T. Baker, Scott W. Cheatham, Alan Nasypany

Clinical Practice in Athletic Training

Tendon pathology has been studied across healthcare professions but remains poorly understood. Imaging and clinical findings have been used to diagnose tendon pathology, but these findings are discrepant. It is vital that clinicians use sound clinical judgment to determine the most accurate clinical diagnosis and treatment options given documented clinical findings. The purposes of this study were to assess athletic trainers’: 1) documented clinical findings for patients presenting with tendon pain, 2) use of documented findings to inform clinical diagnosis of tendon pathology, and 3) change in tendon pathology classification when presented with a novel diagnostic term. A total of …

Functional Balance Assessment Of Firefighters During Mass-Screening Examinations, Rachel M. Eiler, Zachary K. Winkelmann, Kenneth E. Games

Clinical Practice in Athletic Training

Firefighters are tactical athletes who are required to complete rigorous tasks as part of their job functions. The focus of this clinical outcomes assessment was to assess functional balance assessment through the use of the anterior reach test with and without personal protective equipment (PPE) during a mass-screening examination. The screening was completed with 61 active firefighters in a local fire department with access to athletic training services. The results of the anterior reach assessment identified a significant difference of a firefighter’s anterior reach when donning and doffing PPE. Anterior reach distances were significantly reduced (P < 0.001) on the right leg with (mean = 55.78 cm ± 7.53 cm) and without PPE (mean = 58.92 cm ± 6.47 cm). Similarly, significant decrements (P = 0.003) in left leg anterior reach distance in firefighters donning (mean = 57.67 cm ± 8.25 cm) and doffing (mean = 59.82 cm ± 6.31 cm) PPE. Clinical application of these findings suggests that healthcare providers working with tactical athletes, specifically firefighters, should consider the risks associated with donning PPE such as functional balance deficits.

Deep Vein Thrombosis In Lower Extremity Of A Female Collegiate Volleyball Athlete: A Case Study, Lucas D. Dargo, Kendra Borton, Rachel Roths, Zachary Dougal

Clinical Practice in Athletic Training

Deep vein thrombosis (DVT) occurs when a blood clot forms in deep veins in the body, usually in the lower extremity. DVT is commonly seen in older or hospitalized patients. This case is unique because the patient is a 20-year-old female division III collegiate volleyball athlete, which is not the typical age or population affected by DVT or clotting disorders. The patient presented with swelling, pain, and decreased knee flexion (3/5) and plantarflexion (4/5) strength in her left lower extremity. These impairments reduced her ability to walk or run. The patient’s athletic trainer (AT) initially diagnosed her with a left …

Posterior Glenoid Dysplasia As A Secondary Finding To Labrum Tear And Subscapularis Strain: A Case Study, S. Andrew Cage, Brandon J. Warner, Diana M. Gallegos

Clinical Practice in Athletic Training

The purpose of this disablement model case study was to describe the case of a collegiate baseball pitcher suffering from a labral lesion and supraspinatus strain that may have been the result of posterior glenoid dysplasia. Despite gross instability and glenohumeral external rotation weakness, the patient was initially able to continue to pitch. While posterior glenoid dysplasia has been described in literature, there have not been studies that have evaluated soft tissue changes that may be associated with this bony morphology abnormality. In this case, the patient reported to the athletic training staff complaining of pain, tightness, and a “clunking” …

Assessment Of Stress Effects On Cognitive Flexibility Using An Operant Strategy Shifting Paradigm, Andrew T. Gargiulo, Xinyue Li, Laura A. Grafe

Psychology Faculty Research and Scholarship

Stress affects cognitive function. Whether stress enhances or impairs cognitive function depends on several factors, including the 1) type, intensity, and duration of the stressor; 2) type of cognitive function under study; and 3) timing of the stressor in relation to learning or executing the cognitive task. Furthermore, sex differences among the effects of stress on cognitive function have been widely documented. Described here is an adaptation of an automated operant strategy shifting paradigm to assess how variations in stress affect cognitive flexibility in male and female Sprague Dawley rats. Specifically, restraint stress is used before or after training in …

Killing Them To Save Us’: Lessons From Politicide For Preventing And Countering Terrorism, Clark R. Mccauley

Psychology Faculty Research and Scholarship

This chapter reviews and extends the analysis of mass political murder advanced by Chirot and McCauley, then applies this analysis to understanding and countering terrorism. The justification for this application is that both politicide and terrorism target civilians in the context of asymmetric conflict. Three generalizations emerge. Politicide and terrorism cannot be understood or countered without (i) studying both sides in the conflict, (ii) separate studies of leaders, perpetrators, and mass sympathizers, and (iii) acknowledgment of the threats and grievances perceived by both sides. The chapter concludes with implications for fighting the war of ideas against jihadist and right-wing terrorists.

Obstetric Training In The Southeast Us: A 2019 Cera Study, Julia Fashner, Christy Cavanagh, Aimee Eden

OB-GYN

Purpose: To describe obstetric training in Southeast family medicine residencies in 2019. To determine factors that contribute to continuity deliveries, vaginal deliveries and residents who continue OB after graduation.

Methods: A survey of family medicine program directors was conducted in 2019. We took the answers from the 32 South Atlantic program directors that completed the survey questions of interest. We used chi-square tests and Kruskal-Wallis rank test to compare variables. STATA 14 was used for analysis.

Results: Half of the programs had graduates with10% of graduates continue OB after graduation. The following factors were significant for graduates who continue OB: …

Indigenous Healing In New Zealand: An Anthropological Analysis Of "Traditional" And "Modern" Approaches To Well-Being, Lillian T. Brice

Honors Theses

Drawing on contemporary anthropological approaches used by scholars of well-being and medical anthropology (i.e. Michael Jackson and Lisa Stevenson), I explore how indigenous healers in New Zealand blend “traditional” and “modern” elements to establish a creative and inclusive system. Specifically, I explore the use of herbal treatments, ritual chanting, and ceremonies that encapsulate Māori cultural values. I also explore the impact of biomedicine and New-Age wellness approaches on indigenous healing. I argue that Māori healing moves beyond the binary of “tradition” and “modern” as healers merge the past and present and combine the foreign and native. My research is based …

Tolerance Intervals For Time Series Models And Specifying Trimming/Winsorizing Cutoffs, Kedai Cheng

Theses and Dissertations--Statistics

Confidence intervals are used to capture a parameter of interest, usually a mean or a quantile, at a specified confidence level. Prediction intervals are another practical interval that aim at making sound predictions of future values with some confidence. Although these are useful inference tools, neither of them gives people a plausible range of the sampled population. Tolerance intervals are such an inference tool that captures a specified proportion of the sampled population at a predetermined confidence level. In this dissertation, tolerance intervals for an autoregressive process with order p are constructed. In addition, a method of utilizing tolerance interval …

Clinical Measurements Of The Posterior Shoulder Endurance Test (Pset), Neil A. Evans

Theses and Dissertations--Rehabilitation Sciences

Of the intrinsic factors responsible for non-traumatic shoulder pain, muscular endurance is often not measured by rehabilitation professionals due to the lack of available shoulder endurance measures. Measurement properties of the PSET have not been adequately assessed in previous studies. The purpose of this dissertation was to develop the clinical measurement properties of the Posterior Shoulder Endurance Test (PSET) so that it might be used as a clinical measure of shoulder muscular endurance.

Electromyography (EMG) offers the ability to identify which muscles in the posterior shoulder girdle are fatiguing during the PSET. Surface EMG of upper trapezius (UT), middle trapezius …

Psychosocial Predictors Of Chronic Pain And Pain-Related Disability 12 Months After Lower Extremity Fracture, Joshua Judson Van Wyngaarden

Theses and Dissertations--Rehabilitation Sciences

Over 700,000 lower extremity fractures occur each year with a large portion of these patients developing adverse long-term pain and disability outcomes. Current literature indicates that 39% to 62.7% of all patients report continued pain long after traumatic lower extremity fracture. Concurrent physical limitations and reduced quality of life are common, with nearly one-third of all patients reporting pain-related disability seven years after limb threatening trauma, and approximately 50% of these patients having limitations in functional mobility and activities of daily living at long-term follow-up. These poor long-term injury-related pain and disability outcomes are alarming and require further action to …

Simulation Impact On Medication Administration Safety: A Simulation Quality Improvement Project, Stacy Simpson

Doctor of Nursing Practice Projects

Background: Two medication simulations increasing in rigor, patient acuity, and distractions were implemented among undergraduate nursing students.

Objectives: To increase nursing student confidence, knowledge, and competence when administering medications.

Design: Two medication administration simulations were implemented and data was collected from students via a pre-simulation quiz, observation during the simulation via a Clinical Simulation Evaluation Tool, and student evaluation of the simulation with a modified version of the Simulation Evaluation Tool Likert scale.

Settings: Gaston Community College nursing simulation lab.

Participants: 53 undergraduate nursing students enrolled in NUR 101 and 42 students in NUR 102 …

Enhancing Teamwork In Nursing Students, Heather Rawson

Doctor of Nursing Practice Projects

Abstract

The purpose of this project was to equip senior practical nursing students (n = 11) with the skills needed to increase their feelings of preparedness to join an intradisciplinary team in the workplace after graduation. This project utilized a pre-test/post-test design using TeamSTEPPS^® Teamwork Attitudes Questionnaire (T-TAQ) to determine if participation in TeamSTEPPS^® training and a simulation exercise enhanced perception of teamwork in senior practical nursing students. A paired t-test was performed to analyze the data collected from the questionnaires acquired before and after the TeamSTEPPS^® training. The results showed a t-value of 8.49, greater than …

Civility Promotion: How It Affects Workplace Incivility, Shawanda Lang

Doctor of Nursing Practice Projects

Incivility is also known as uncivil behavior, horizontal violence, or bullying. These terms are often used to describe the conduct an individual may display toward another that are deemed undesirable in healthcare organizations. Uncivil behavior has been an increasing topic in healthcare and has consequently gained the attention of organizations such as the American Nurses Association and regulatory agencies such as The Joint Commission. Incivility has the opportunity to affect teamwork, individual well-being, and patient safety. The aim of this project was to promote civility by bringing knowledge and awareness of the participants through an educational series. Although the pre …

Evaluation For Association Between Maternal Microbiota And Development Of Necrotizing Enterocolitis Or Gram-Negative Bacteremia In Preterm Infants, Mei Chi Quek

Master of Medicine in Paediatrics and Child Health

Background: Preterm birth is the leading cause of perinatal morbidity and mortality worldwide. There is a need for a better understanding of the correlation of vaginal microbiota with adverse preterm outcomes. Our study aimed to explore how the vaginal microbiota influences the outcome of the preterm infants, determine whether fecal microbiota in premature infants differs from that in term infants, and explore the microbiota pattern in preterm neonates who received multiple antibiotics. Method: A prospective cohort design was used to enroll 33 women admitted in spontaneous labor between 25 to 36 weeks, and 33 controls matched for age and parity …

First-Time Characterization Of Viable But Non-Culturable Proteus Mirabilis: Induction And Resuscitation, Reham Wasfi, G. R. Abdellatif, H. M. Elshishtawy, Hossam M. Ashour

USF St. Petersburg Campus Faculty Publications

Pathogenic bacteria can enter into a viable but non-culturable (VBNC) state under unfavourable conditions. Proteus mirabilis is responsible for dire clinical consequences including septicaemia, urinary tract infections and pneumonia, but is not a species previously known to enter VBNC state. We suggested that stress-induced P. mirabilis can enter a VBNC state in which it retains virulence. P. mirabilis isolates were incubated in extreme osmotic pressure, starvation, low temperature and low pH to induce a VBNC state. Resuscitation was induced by temperature upshift and inoculation in tryptone soy broth with Tween 20 and brain heart infusion broth. Cellular ultrastructure and gene …

Examining The Design And Usability Of Telemedicine Communications: A Mixed-Methods Study, Jessica Campbell

Electronic Theses and Dissertations, 2020-2023

This dissertation describes a mixed-methods study that examines the usability of telemedicine provider interfaces. This study consisted of content analysis, survey, and think aloud methodologies, which afford a multifaceted corpus of data for which to draw inferences and identify design features and functions that negatively impact usability. Usability is a critical component of the user experience with a telemedicine provider interface and can suede or impede the acceptance and adoption of telemedicine. Telemedicine has the potential to increase quality healthcare access and positive health outcomes for individuals who use it, and usability is a key component of technology acceptance and …

Mobile Health Technology To Enhance Healthcare Service Delivery In Developing Nations (Saudi Arabia), Nawaf Khan

Electronic Theses and Dissertations, 2020-2023

Saudi Arabia is among the countries that have very high prevalence rates of diabetes and hypertension, with prevalence rates of almost 18% and 25%, respectively. The majority of patients with diabetes and hypertension fail to manage their diseases and to show up for their follow up appointments. Mhealth technology is among the interventions that have been recently adopted to overcome these issues and improve the quality of healthcare services. This study aims to evaluate the effectiveness of a mobile phone application named diabetes and hypertension application (DHA Tracking) to promote adherence for patients with diabetes and hypertension in Mecca, Saudi …

A Computational Biomechanical Model-Based Optimization Of Fulcrum Support In Orthosis Enabled Closed Reduction Of Developmental Dysplasia Of The Hip, Christopher Rose

Electronic Theses and Dissertations, 2020-2023

Hip abduction orthosis devices (HAOD) are used to reduce the hip joint of infants affected by developmental dysplasia of the hip (DDH). HAOD have been successful for mild cases of DDH and ineffective for severe cases. Efforts in understanding the biomechanics of lower limbs have been made to improve the success rate of current treatment methods, especially for Grade IV dislocations (G4). The aim of this dissertation is twofold: first, it proposes the use of a varying fulcrum point (FP) located below the leg to improve DDH treatment; and secondly, it defines the optimal FP (OP) location for a broad …

Gelsolin-Mediated Actin Filament Severing In Crowded Environments, James Heidings

Electronic Theses and Dissertations, 2020-2023

Actin is an essential cytoskeletal protein that plays key roles in several cellular functions such as phagocytosis and cell motility with the help of actin binding proteins (ABPs). Gelsolin is a calcium regulated ABP that severs and caps actin filaments. Gelsolin helps control actin filament assembly dynamics that are required for cell survival. Cleavage products of gelsolin lead to Familial Amyloidosis, Finnish type, and conformational changes to gelsolin are implicated in disease progression. The majority of in vitro studies of gelsolin and actin have been performed in dilute buffer conditions which do not simulate the molecular interactions occurring in the …