Medicine and Health Sciences Commons^™

Novel Strategies To Overcome Carboplatin Resistance In Triple Negative Breast Cancer Using Patient Derived Xenografts, Mohammad A. Al Zubi

Theses and Dissertations

Triple-negative breast cancer (TNBC) patients have a poor prognosis and rely on chemotherapeutic treatment as standard of care. Often, they develop chemotherapy resistance, which leaves them without more therapeutic options, like targeted therapy. New models have been developed to test targeted inhibitors in human tumors, and they are known as patient-derived xenografts (PDX). These tumors are obtained from patients, then established and maintained in mice where they areused for tumor studies. In this work, we characterized 14 PDXs for their primary tumor growth rate and investigated metastatic propensity using spontaneous and experiment metastasis models. We utilized RNA-sequencing to characterize contributions …

Quality Of Medical Care For Adults With Intellectual/Developmental Disabilities, Priya Chandan

Theses and Dissertations

QUALITY OF MEDICAL CARE FOR ADULTS WITH INTELLECTUAL/DEVELOPMENTAL DISABILITIES

By Priya Chandan, M.D., M.P.H.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of

Philosophy at Virginia Commonwealth University.

Virginia Commonwealth University, 2020.

Director: Director: Gloria J. Bazzoli, Ph.D.

Bon Secours Professor, Department of Health Administration

People with intellectual/developmental disabilities (IDD) are difficult to identify in administrative data, limiting the ability to study the quality of health care provided to this population. This study utilized clinical diagnoses to define a sample of hospitalized patients with IDD in the largest publicly available all-payer inpatient care database—the …

The Role Of Interleukin-18 In Myocardial Ischemia/Reperfusion, Yogesh Dhakal

Theses and Dissertations

Acute Myocardial Infarction (AMI) is one of the leading causes of morbidity for cardiovascular diseases (CVDs) in the western world. While mortality rates for AMI has reduced in the last 20 years due to advancements in clinical interventions, patients who have an AMI are significantly more likely to develop heart failure (HF) in the following years. Reperfusion of the ischemic tissue is a necessary procedure to restore blood delivery to cardiomyocytes, minimize myocardial dysfunction, and reduce infarct size. Still, the step of reperfusion itself induces myocardial damage in a phenomenon known as reperfusion injury. Considering that the degree of myocardial …

Can School Be A Source Of Trauma? Assessing Academic Traumatic Stress As A Mechanism Underlying The Health Outcomes Of Black Undergraduate Students, Ebony A. Lambert

Theses and Dissertations

Research examining Black students’ school experiences demonstrates that exposure to oppressive power dynamics in schools may lead to adverse physiological and psychological consequences. Recent conceptualizations in public discourse further posit that traumatic educational experiences, operationalized here as academic trauma or the cumulative toll of adverse and oppressive experiences in academic settings, may influence Black students’ wellbeing even after they have graduated. However, academic trauma has yet to be investigated empirically, and the health contributions of such educational harm remain unstudied. Moreover, little is known about how culturally-relevant personal characteristics (e.g., emotion regulation strategies) influence Black students’ reactivity to academic trauma. …

Impact Of Performance-Based Budgeting On Quality Outcomes In U.S. Military Healthcare Facilities, Kimberly L. Decker Virginia Commonwealth University

Theses and Dissertations

Performance-based budgeting (PBB) is a variation of pay for performance that is applicable to government programs. It works by increasing or decreasing funding based on pre-established performance thresholds, which incentivizes organizations to improve performance. In late 2006, the U.S. Army implemented a PBB program in all of its healthcare facilities due to rising concerns over costs and quality in its facilities. The U.S. Army’s PBB program tied hospital-level funding decisions to performance on key cost and quality-related metrics. This study examined the impact of this program and a subsequent PBB program on quality improvement in U.S. Army healthcare facilities. Drawing …

Hospital Investment In Urgent Care: Impacts On Emergent, Outpatient, And Ambulatory Surgery Volumes, Hillary A. Linhart

Theses and Dissertations

As the popularity of urgent care centers (UCCs) has grown, hospitals have increasingly chosen to invest in this care model. Hospital interest in UCCs is largely driven by two key factors. First, hospitals aim to use UCCs to generate referrals, which generate additional patient volume for downstream hospital services. Secondly, hospital UCC investment presents an opportunity to ease the demand for non-urgent care in the emergency department (ED) by diverting low-acuity ED patients to the more appropriate UCC setting. No study to date has evaluated the impact of hospital UCC investment on referrals or downstream service volumes. A few studies …

An Exploration In Accountable Care Organization Structure, Contingency And Performance, 2015-2017, Siriporn P. Satjapot

Theses and Dissertations

The Patient Protection and Affordable Care Act of 2010 enacted one of the most significant reforms seen in the United States healthcare landscape. The Center for Medicare and Medicaid (CMS) led transformation efforts in regulatory reform and coverage expansion across the U.S. population. Since 2010, care delivery systems have been shifting from episodic, decentralized and fee-for-service models to value-based population health models, like accountable care organizations (ACO). ACOs have been specifically primed for local response to improve the health of their communities. ACO research has traditionally focused on performance measures like mortality, readmissions, quality outcomes and savings. ACO organizational characteristics …

Spag17 Is Important For Protein Trafficking In Mammalian Spermiogenesis, Virali Bhagat

Theses and Dissertations

Spermiogenesis is the process through which undifferentiated germ cells develop into mature spermatozoa. While spermiogenesis is a very well-regulated process, the protein-protein interactions regulating it remain poorly understood. A knockout (KO) mouse for the ciliary protein SPAG17 was generated by our lab. Loss of SPAG17 has been shown to disrupt the transport of proteins important for acrosome biogenesis and manchette functions. With this information, we hypothesized that SPAG17 plays an essential role in protein trafficking during mammalian spermiogenesis. To further investigate this, immunofluorescence (IF) studies were performed in germ cells collected from both WT and SPAG17 KO mice to visualize …

Prediction Of The Vaginal Microbiome Using Urine Samples, Christopher R. Diachok

Theses and Dissertations

The vaginal microbiome is associated with women’s health, including but not limited to the pathogenesis of bacterial vaginosis, adverse pregnancy outcomes including preterm birth and sexually transmitted infections. However, there has been very limited research on the urinary microbiome and its relationship to the vaginal microbiome. We sought to predict the vaginal microbiome profile using clean catch urine samples from the same person. Here, paired vaginal and urine samples were collected and sequenced by 16S ribosomal RNA sequencing. Alpha and beta diversity analysis showed that there was no significant difference between the paired vaginal and urine microbiomes. In fact, a …

Anticholinergic Burden And Risk Of Cognitive Impairment In Older Adults, Syeda Hashimi

Theses and Dissertations

Studies reveal that 10-27% of older adults chronically use anticholinergic medications. Increased cumulative anticholinergic burden scores are associated with increased risks of dementia. The mechanisms by which anticholinergic drugs negatively impact cognition remain elusive. However, researchers speculate that the drug’s impairment of cholinergic neurons promotes neuroinflammation.

We hypothesize that drugs with anticholinergic properties will induce inflammation in the brain. MCP1 and IL 6 are chemokines that contribute to neuroinflammation. We investigated the influence of diphenhydramine (Benadryl) on the production of MCP1 and IL-6 in Normal Human Astrocytes and Paroxetine on the production of MCP1 in Normal Human Astrocytes and Normal …

Diagnostic Accuracy Of Chest Computed Tomography Scans For Suspected Patients With Covid-19: Receiver Operating Characteristic Curve Analysis, Lianpin Wu, Qike Jin, Jie Chen, Jiawei He, David Brett-Major, Jianghu James Dong

Journal Articles: Epidemiology

BACKGROUND: Computed tomography (CT) scans are increasingly available in clinical care globally. They enable a rapid and detailed assessment of tissue and organ involvement in disease processes that are relevant to diagnosis and management, particularly in the context of the COVID-19 pandemic.

OBJECTIVE: The aim of this paper is to identify differences in the CT scan findings of patients who were COVID-19 positive (confirmed via nucleic acid testing) to patients who were confirmed COVID-19 negative.

METHODS: A retrospective cohort study was proposed to compare patient clinical characteristics and CT scan findings in suspected COVID-19 cases. A multivariable logistic model with …

Colorectal Cancer Screening Uptake: Differences Between Rural And Urban Privately-Insured Population, Mesnad Alyabsi, Jane L. Meza, K. M. Monirul Islam, Amr Soliman, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

Earlier studies investigated rural-urban colorectal cancer (CRC) screening disparities among older adults or used surveys. The objective was to compare screening uptake between rural and urban individuals 50-64 years of age using private health insurance. Data were analyzed from 58,774 Blue Cross Blue Shield of Nebraska beneficiaries. Logistic regression was used to assess the association between rural-urban and CRC screening use. Results indicate that rural individuals were 56% more likely to use the Fecal Occult Blood Test (FOBT) compared with urban residents, but rural females were 68% less likely to use FOBT. Individuals with few Primary Care Physician (PCP) visits …

การพัฒนาวิธี Real-Time Quantitative Rt-Pcrสำหรับตรวจหาลีดเดอร์อาร์เอ็นเอซับจีโนมิกของเชื้อไวรัส Sars-Cov-2, สินินาถ เพชราช

Chulalongkorn University Theses and Dissertations (Chula ETD)

โรคอุบัติใหม่ไวรัสโคโรนา 2019 (COVID-19) เกิดจากการติดเชื้อ Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) โรคนี้ติดต่อกันได้ง่ายจากคนสู่คน ทำให้ไวรัสแพร่ระบาดอย่างต่อเนื่องไปทั่วโลก การตรวจติดตามและการประเมินไวรัสที่ปลดปล่อยเชื้อ (viral shedding) เป็นระยะเวลานานหลายสัปดาห์ จึงมีความสำคัญต่อการป้องกันและควบคุมการแพร่กระจายของเชื้อ ซึ่งเป็นอุปสรรคต่อการบริหารจัดการทางการแพทย์ รวมถึงมีค่าใช้จ่ายในการรักษาสูง ดังนั้นการตรวจพบ SARS-CoV-2 subgenomic RNA leader (sgRNA) เป็นตัวบ่งบอกสถานะของไวรัสในระยะ active มีความสามารถเพิ่มจำนวนได้ ในงานวิจัยนี้ได้ตรวจติดตามระยะเวลาการปลดปล่อย SARS-CoV-2 sgRNA leader และ genomic RNA (gRNA) จากตัวอย่างระบบทางเดินหายใจ 111 ตัวอย่าง (ของผู้ป่วย COVID-19 จำนวน 10 ราย) ด้วยวิธี real-time quantitative RT-PCR (qRT-PCR) ผลการทดลองพบว่า E-sgRNA leader สามารถตรวจพบได้นานถึง 15 วัน และตรวจพบในตัวอย่างที่มีปริมาณไวรัส (viral load) มากกว่า 100,000 copies/ml (≥1E+05 virus E gene copies/ml) ในขณะที่ gRNA ยังตรวจพบได้นานถึง 24 วัน นอกจากนี้ยังค้นพบว่ามีผู้ป่วย COVID-19 จำนวน 2 ใน 10 ราย ที่ E-sgRNA leader ปรากฏตัวอีกครั้งหลังจากที่ตรวจไม่พบแล้วเป็นเวลา 2 วัน ถึง 8 วัน ด้วยเหตุนี้เพื่อความปลอดภัย จึงแนะนำให้ผู้ป่วยกักตัวหรือแยกตัวอย่างน้อย 14 วันหลังจากได้รับอนุญาตให้กลับบ้าน ดังนั้นการประเมิน E-sgRNA leader เป็นประโยชน์ต่อการวางแผนการรักษาผู้ป่วยโรคติดเชื้อไวรัส COVID-19

ผลของการฝึกการรับรู้และตอบสนองที่ข้อต่อร่วมกับการออกกำลังกายแบบสั่นสะเทือนทั้งร่างกายต่อการทรงตัวและการทำงานของระบบประสาทกล้ามเนื้อในนักกีฬาที่มีภาวะข้อเท้าไม่มั่นคง, ณภัทร เครือทิวา

Chulalongkorn University Theses and Dissertations (Chula ETD)

เพื่อศึกษาและเปรียบเทียบผลของการฝึกการรับรู้และตอบสนองที่ข้อต่อร่วมกับการออกกำลังกายแบบสั่นสะเทือนทั้งร่างกายที่มีต่อความสามารถในการทรงตัวและการทำงานของระบบประสาทกล้ามเนื้อในนักกีฬาที่มีภาวะข้อเท้าไม่มั่นคง ผู้เข้าร่วมงานวิจัยเป็นนักกีฬาระดับมหาวิทยาลัย ทั้งเพศชายและหญิงที่มีภาวะข้อเท้าไม่มั่นคง จำนวน 52 คน มีอายุระหว่าง 18-27 ปี โดยผ่านการตรวจร่างกายและเกณฑ์การคัดเข้าก่อนเข้าร่วมงานวิจัย จากการตอบแบบสอบถามประเมินตนเอง CAIT ได้คะแนนน้อยกว่าหรือเท่ากับ 24 คะแนน โดยแบ่งผู้เข้าร่วมวิจัยออกเป็น 4 กลุ่มๆ ละ 13 คน ได้แก่ กลุ่มควบคุมที่ไม่ได้รับการฝึกการรับรู้และตอบสนองที่ข้อต่อร่วมกับการออกกำลังกายแบบสั่นสะเทือนทั้งร่างกาย (Control) กลุ่มทดลอง 1 ที่ได้รับการฝึกการรับรู้และตอบสนองที่ข้อต่อเพียงอย่างเดียว (PPT) กลุ่มทดลอง 2 ที่ได้รับการออกกำลังกายแบบสั่นสะเทือนทั้งร่างกายเพียงอย่างเดียว (WBV) และกลุ่มทดลอง 3 ที่ได้รับการฝึกการรับรู้และตอบสนองที่ข้อต่อร่วมกับการออกกำลังกายแบบสั่นสะเทือนทั้งร่างกายต่อเนื่องกัน (PPT+WBV) โดยกลุ่มทดลองทั้ง 3 กลุ่มได้รับโปรแกรมการฝึกที่กำหนด 3 ครั้งต่อสัปดาห์ เป็นระยะเวลา 6 สัปดาห์ ในช่วงการทดลองทุกกลุ่มจะได้รับการฝึกซ้อมทักษะตามปกติภายใต้การควบคุมดูแลของผู้ฝึกสอน ทำการเก็บรวบรวมข้อมูลก่อนและหลังการฝึก ได้แก่ ข้อมูลคุณลักษณะทั่วไป การทดสอบความสามารถในการทรงตัวขณะอยู่นิ่งโดยเครื่องไบโอเด็กซ์ (Biodex stability system) และการทรงตัวขณะเคลื่อนไหวโดยการทดสอบการทรงตัวตามแนวเส้นรูปดาว (Star excursion balance test) วัดการรับรู้ความรู้สึกที่ข้อต่อ (Joint position senses, JPS) วัดความแข็งแรงของกล้ามเนื้อข้อเท้า ทดสอบการทำงานของข้อเท้าโดยการกระโดดลงสู่พื้น (Time to stability, TTS) และฮอฟแมนรีเฟล็กซ์ (H-reflex) ที่กล้ามเนื้อน่องด้านใน (Soleus muscle) ผลการวิจัยพบว่า ในกลุ่มควบคุม ไม่พบความแตกต่างของทุกตัวแปรก่อนและหลังการทดสอบอย่างมีนัยสำคัญทางสถิติ (p>0.05) ขณะที่ทั้ง 3 กลุ่มทดลอง มีค่าเฉลี่ยความสามารถในการทรงตัวทั้งขณะอยู่นิ่ง เวลาที่ผู้ทดสอบอยู่นิ่งหลังจากที่กระโดดลงมาสู้พื้นด้วยขาข้างเดียว และค่าเฉลี่ยความสูงของ H-reflex ที่กล้ามเนื้อ Soleus ดีขึ้นอย่างมีนัยสำคัญทางสถิติ (p<0.05) ยกเว้นบางตัวแปรในกลุ่ม WBV ที่มีค่าความสามารถในการการรับรู้ตำแหน่งของข้อต่อที่ไม่เปลี่ยนแปลง (p>0.05) ส่วนกลุ่ม PPT ไม่พบความแตกต่างก่อนและหลังการฝึกอย่างมีนัยสำคัญทางสถิติ (p>0.05) ของค่าความแข็งแรงของกล้ามเนื้อข้อเท้าและความสามารถในการทรงตัวขณะเคลื่อนไหว และกลุ่ม PPT+WBV ไม่พบความแตกต่างของความแข็งแรงของกล้ามเนื้อข้อเท้าที่ก่อนและหลังการฝึกอย่างมีนัยสำคัญทางสถิติ (p …

Demonstration Of Reciprocal Diurnal Variation In Human Serum T3 And Rt3 Concentration Demonstrated By Mass Spectrometric Analysis And Establishment Of Thyroid Hormone Reference Intervals., Qian Sun, Lívia Avallone, Brian Stolze, Katherine A Araque, Yesim Özarda, Jacqueline Jonklaas, Toral Parikh, Kerry Welsh, Likhona Masika, Steven J Soldin

Articles, Abstracts, and Reports

Background: There has been a wide range of reference intervals proposed in previous literature for thyroid hormones due to large between-assay variability of immunoassays, as well as lack of correction for collection time. We provided the diurnal reference intervals for five thyroid hormones, namely total thyroxine (TT4), total triiodothyronine (TT3), free thyroxine (FT4), free triiodothyronine (FT3), and reverse T3 (rT3), measured in serum samples of healthy participants using a liquid chromatography/tandem mass spectrometry (LC-MS/MS) method.

Methods: Couplet serum samples (a.m. and p.m.) were collected from 110 healthy females and 49 healthy males. Healthy volunteers were recruited from four participating centers …

Intravascular Lymphoma With Progressive Cns Hemorrhage And Multiple Dissections., Ricky Chen, Gurjeet Singh, J Scott Mcnally, Cheryl A Palmer, Adam De Havenon

Articles, Abstracts, and Reports

Introduction: Intravascular lymphoma (IVL) is an uncommon and often fatal disease characterized by intraluminal proliferation of lymphomatous cells within blood vessels. Because of a heterogeneous clinical presentation and lack of sensitive diagnostic protocols, diagnosis of IVL is most often made at autopsy. However, with early diagnosis and appropriate chemotherapy, the prognosis is greatly improved and complete remission is possible. In order to broaden the possible presentations of IVL, we present a patient with an atypical manifestation of biopsy-proven intravascular large B-cell lymphoma who suffered dissections of both intracranial and extracranial arteries in addition to progressive intracranial hemorrhages.

Conclusion: IVL is …

Innovative Framework For Academic And Public Health Departments' Partnership On Preparing Future Practitioners- Preliminary Data, Michele Kekeh, Muge Akpinar-Elci, Myngoc Nguyen, Nancy Welch

Community & Environmental Health Faculty Publications

This article presents a model to respond to current public health challenges and transform knowledge into preventive strategies. It also presents an innovative way for academic institutes and public health departments to focus on public health workforce development. Academic institutes partnership with public health departments have started fostering service-learning opportunities to engage students in public health with an emphasis on the specific public health outcomes. However, the benefit of service–learning projects on the health departments and the populations served is largely unknown. Recently, these service-learning opportunities are becoming less sustainable due to the inability of preceptors to provide the necessary …

Anemia And It's Associated Factors Among Adolescents In Kuwait, Lemia Shaban, Abdullah Al-Taiar, Abdur Rahman, Reem Al-Sabah, Olusegun Mojiminiyi

Community & Environmental Health Faculty Publications

We estimated the prevalence of anemia among school children and investigated factors associated with this problem in Kuwait. A cross-sectional study was conducted on 1415 adolescents randomly selected from middle schools in Kuwait. Hemoglobin, iron, ferritin, folate and vitamin B-12, in addition to many other laboratory indicators, were measured in a venous blood sample. Data on risk factors for anemia were collected from parents and adolescents. Multiple logistic regression was used to investigate factors associated with anemia. The prevalence of anemia was 8.06% (95% CI: 6.69-9.60%), which was significantly higher among females compared to males (10.96% vs. 5.04%; p < 0.001). Mean (SD) Hb level was 133.7 (9.89) g/L and 130.00 (10.48) g/L among males and females, respectively (p < 0.001). The prevalence of mild, moderate and severe anemia was 5.94%, 1.91% and 0.21%, respectively. Gender, age, iron concentration and ferritin were associated with anemia in multivariable analysis. These data indicate that anemia among school children in Kuwait is of mild public health significance. Further reduction in anemia in school girls should focus on correcting iron deficiency. Surveillance systems for anemia may consider using a cut-off point that is specific for the method of blood sampling and the method of Hb measurement.

Risk Factors For Workplace Encounters With Weapons By Hospital Employees, James Blando, Chalsie Paul, Mariana Szklo-Coxe

Community & Environmental Health Faculty Publications

Objective:The specific aim of this study was to determine which risk factors were associated with frequent weapons confiscation in a healthcare facility. This study investigated the hypothesis that hospital-related factors impact the frequency of weapons confiscation.

Study design:Cross-sectional.

Methods:A cross-sectional survey was administered on-line to hospital security directors and assessed the associations of organizational factors with the frequency of weapons confiscation.

Results:It was found that hospitals with metal detectors were more than 5 times as likely to frequently confiscate weapons, suggesting this intervention is effective. It was also found that hospitals with psychiatric units were more likely to have frequent …

An Analysis Of Inclusion Resources, As A Pathway To Retention Of Minority Students In The Medical Profession, Beverly K. Andre

PCOM Capstone Projects

What is Diversity? Retention? Often, these terms are used interchangeably without true understanding of their individual meanings. Diversity is offering a variety or having multiple ethnicities amongst a cohort in proportions seen within society. However, retention refers to the continuous possession or maintenance of the variation seen in said cohort. With regards to medical institutions, it seems that there is no separation. Many medical institutions seek to be diverse and create a picture of multiethnic cohorts but regrettably, effective retention techniques aren’t always adopted to make these visions a reality. The damage caused by the lack of adequate retention techniques …

A Systematic Review Of The Of Factors Contributing To Sustained Homelessness And Those Influencing The Deterioration Of Homeless Health And Healthcare, Mojisola Delano

PCOM Capstone Projects

Homelessness is a perpetual problem occurring in society. With a lack of competency of either government institutions or private establishments to provide the required intervention to provide shelter and aid for the existing homeless population or to prevent further homelessness; the next best objective would be to keep this population healthy, by employing hygiene interventions. However, there is a serve lack in hygiene interventions as well. A few US cities and many counties abroad have begun to research and implement strategies for sanitary intervention in homeless hygiene in hopes that if they are unable to “cure” homelessness, then they can …

A Discrete Age Structured Model Of Hantavirus In A Rodent Reservoir In Paraguay, Megan A. Rúa

Biological Sciences Faculty Publications

Many rodent-borne hantaviruses are zoonotic pathogens that can cause disease in humans through inhalation of aerosolized rodent excreta. To evaluate the prevalence of Jaborâ virus (JABV) over time within its rodent reservoir, Akodon montensis, we formulated a mathematical model with multiple rodent age classes and unique infection class progression features. We then parameterized the model with data collected from a survey of JABV harbored by Akodon montensis in the Mbaracayú Reserve in Paraguay. Our model incorporates three types of infection over the lifetime of the rodent as well as a recovered class. A new feature of the model allows transition …

Defining Current Gaps In Quality Measures For Cancer Immunotherapy: Consensus Report From The Society For Immunotherapy Of Cancer (Sitc) 2019 Quality Summit, Sara Pai, David Blaisdell, Rachel Brodie, Robert G. Carlson, Heidi Finnes, Michele Galioto, Roxanne E. Jensen, Tom Valuck, Antonia R. Sepulveda, Howard L. Kaufman

Population and Public Health Sciences Faculty Publications

Background Quality measures are important because they can help improve and standardize the delivery of cancer care among healthcare providers and across tumor types. In an environment characterized by a rapidly shifting immunotherapeutic landscape and lack of associated long-term outcome data, defining quality measures for cancer immunotherapy is a high priority yet fraught with many challenges. Methods Thus, the Society for Immunotherapy of Cancer convened a multistakeholder expert panel to, first, identify the current gaps in measures of quality cancer care delivery as it relates to immunotherapy and to, second, advance priority concepts surrounding quality measures that could be developed …

The Va Mission Act Of 2018: A Potential Game Changer For Rural Gme Expansion And Veteran Health Care, Anne Victoria Neale, Phil Lupo, Marjorie A. Bowman, Dean A. Seehusen

Population and Public Health Sciences Faculty Publications

The Veterans Healthcare Administration (VHA) is the largest health care delivery system in the United States. It includes 172 medical centers (VAMCs), with over 1,100 Community Based Outpatient Centers (CBOCs) and various other sites of care. In addition to training physicians to care for veterans and active duty service members, the VHA is also directed to assist in supplying health care personnel to the nation.Through its Office of Academic Affiliations (OAA), VHA develops partnerships with Accreditation Council for Graduate Medical Education (ACGME)/American Osteopathic Association (AOA) accredited residency program sponsoring institutions. These collaborations include 144 out of 152 allopathic medical schools …

Individual Ems Disposition In The Prehospital Setting To Predict Future Opioid Overdose And Mortality, Lillie Valliere

Global Public Health | Senior Theses

Introduction

There have been over 400,000 deaths related to prescription opioids in the US since 1999, with the highest prevalence among individuals aged 45-54 years old. However, adults between the ages of 18 and 34 have the highest prevalence of misuse of prescription opioids. With accidental overdoses as a leading cause of death, Marin County is just one community that is heavily impacted by this ongoing epidemic. Statistics related to non-fatal and fatal opioid overdoses are difficult to accurately count due to the differing ways counties may categorize cause of death, diagnoses, and other contributing factors. However, looking at 911 …

Effects Of Latinx Parental English Proficiency On Stress, Maria Alvarez Pineda

Global Public Health | Senior Theses

Background

In the United States, patients who have Limited English Proficiency (LEP) report having more problems communicating with their children’s doctor which leads to these children having worse health care access than those who have parents with a High English Proficiency (HEP). Parents with LEP also experience discrimination in this setting which can lead to increased psychological distress. The goal of this study was to determine if the level of English Proficiency is associated to stress levels and discrimination among Latinx parents when they take their chidlren to the doctor.

Methods

Participants consisted of 22 Latinx parents (86.4% Mexican and …

Communication Of Professional Readiness In Dietetics And Human Nutrition Undergraduates: A Pilot Study, Heather Norman-Burgdolf, Emily M. Dewitt, Nathan L. Vanderford, Julie Plasencia

Dietetics and Human Nutrition Faculty Publications

Learning experiences within the dietetics and human nutrition undergraduate curricula develop knowledge and skills pertinent to student career goals. Core competency requirements are extensively assessed in these programs, yet the communication of transferable skills gained and student professional readiness are rarely examined. The purpose of this study was to evaluate undergraduate students' perceived professional readiness following six professional development workshops on transferable skills and career preparedness communicated through resumes and personal statements. In this pilot study, twelve upper-level dietetics and human nutrition students self-assessed their resumes and personal statements with rubrics and completed surveys before and after the intervention. Following …

The Role Mentoring Plays In The Transition Of Practice Of Newly Credentialed Athletic Trainers, Stacy E. Walker, Stephanie Mazerolle Singe, Julie M. Cavallario

Ellmer School of Nursing Faculty Publications

Context: Mentoring has been identified as an important method to support newly credentialed athletic trainers during their transition to practice. Gaining a better understanding of this relationship could provide valuable insights that may assist employers and professional programs to develop a plan, which could better facilitate the transition.

Objective: To examine what aspects of the mentoring relationship provided the most benefit during transition to practice.

Design: Grounded theory.

Setting: Individual phone interviews.

Patients or Other Participants: 13 athletic trainers who graduated from a professional master's program, were certified between February and July of 2016, and obtained employment between July to …

The Journal Of Undergraduate Research: 2019

The Journal of Undergraduate Research

This is the complete issue of the South Dakota State University Journal of Undergraduate Research, Volume 17.

Improving The Patient Experience With Communication, Pauline Adora Salmon

Walden Dissertations and Doctoral Studies

A quality patient experience is one of the highest priorities for hospitals as patients and families are looking to healthcare providers to meet their demands for quality service. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures the extent to which providers effectively communicate pertinent information such as communication about medications. On a 20-bed intermediate care unit, the HCAHPS item scores relating to nurse communication and communication about medicine were inconsistent and, on most occasions, were below the comparison benchmark of the 50th percentile when compared to other like hospitals. The purpose of this quality improvement project …