Medicine and Health Sciences Commons^™

Integrative Review On The Initiation Of A Systematic Oral Care Education Program, Toni Rochelle Thomas

Doctoral Dissertations and Projects

Hospital-acquired infections, such as non-ventilated hospital-acquired pneumonia (NVHAP), are significant patient safety concerns. The lack of oral care in the non-ventilated acute care patient population is a significant contributor to NVHAP. The nursing staff is on the front line in providing oral care to hospitalized patients but often lacks knowledge and understanding regarding the relationship between oral care and NVHAP. Searching MEDLINE, PubMed, CINAHL, and EBSCO databases for current, peer-reviewed, scholarly articles for English language articles between 2010-2020 led to supporting findings. These findings revealed missed oral care as the most common modifiable risk factor contributing to increased hospital-acquired pneumonia …

Employee Wellness Program Participation: Exploring Participation Of Registered Nurses In East Tennessee, Jacquelyn Turner

Doctoral Dissertations and Projects

Many organizations are faced with the challenge of managing employee retention and absenteeism. While retention strategies are focal to organizational leaders across the board, the growing shortage of nurses nationwide creates a critical concern for healthcare leaders. The purpose of this qualitative case study was to delve into the existing body of research pertaining to the impact of employee wellness programs on employee retention and absenteeism and further explore the reasons why employees choose to/ not to participate in wellness programs offered by employers. The intent of this study was to add to the existing body of knowledge on employee …

Mentor Programs As A Strategic Approach To Nurse Retention: Integrative Review, Nancy Jo Thompson

Doctoral Dissertations and Projects

The purpose of this integrative review is to identify commonalties of mentor program success demonstrated by registered nurse retention to support DNP leaders seeking to address the nursing shortage by retaining newly licensed and experienced registered nurses. Mentor programs offer nurse leaders a low-cost solution with a high return on investment to address nurse retention. The United States is facing a tremendous nursing shortage compounded by multiple factors, including an unprecedented global pandemic. An aging population is leaving the profession while the new generation of nurses struggle to find their niche. Registered nurses make up the largest sector of health …

An Integrative Review: Best Practices In Advanced Practice Registered Nurse (Aprn) Telehealth Services To Improve Outcomes For Children With Chronic Health Conditions, Tamara Sue Moyer

Doctoral Dissertations and Projects

Telehealth is a rapidly growing field that affords individuals the opportunity to receive access to specialty providers, reduce expenses and travel, break down geographic barriers, deliver equality of care, and improve patient outcomes. Equality of healthcare for pediatric patients with chronic health conditions in rural areas face geographic barriers to delivery of care, resulting in poor patient outcomes, and increased costs. An integrative review was completed to identify and describe research findings in an attempt to answer the clinical questions proposed and identify areas in research that can lead to improved patient outcomes. The need to receive access to specialty …

The Basic Rules Of Doing A Good Search And Search Tips - Revised, Roy E. Brown

VCU Libraries Faculty and Staff Publications

This is a handout that is used as a reference for those who are learning to more effectively search databases for assignments and evidence-based practice projects. The revised handout contains information related to the databases that may be searched as well as about Google Scholar.

Please contact the author for a version that can be reused and rebranded.

The Evidence Based Practice Question Development & Search Tips Checklist (Revised), Roy E. Brown

VCU Libraries Faculty and Staff Publications

The Evidence Based Practice Question Development and Search Tips Checklist is a tool that is used in instructional sessions with nurses in reference to evidence-based practice and literature searching. It is intended as a reference handout. The revised handout contains information related to the databases that may be searched as well as about Google Scholar.

It is under a creative commons license. If you would like a version that can be rebranded for your organization to use, please contact the author for an editable version.

Respecting Autonomy And Enabling Diversity: The Effect Of Eligibility And Enrollment On Research Data Demographics, Kayte Spector-Bagdady, Shengpu Tang, Sarah Jabbour, Nicholson Price, Ana Bracic, Melissa S. Creary, Sachin Kheterpal, Chad M. Brummett, Jenna Wiens

Articles

Many promising advances in precision health and other Big Data research rely on large data sets to analyze correlations among genetic variants, behavior, environment, and outcomes to improve population health. But these data sets are generally populated with demographically homogeneous cohorts. We conducted a retrospective cohort study of patients at a major academic medical center during 2012–19 to explore how recruitment and enrollment approaches affected the demographic diversity of participants in its research biospecimen and data bank. We found that compared with the overall clinical population, patients who consented to enroll in the research data bank were significantly less diverse …

Opioid Settlement Funds: Do Not Neglect Patients With Pain, Mark C. Bicket, Barbara Mcquade, Chad M. Brummett

Articles

The opioid crisis has escalated in the setting of the COVID-19 pandemic to new extremes and has claimed more than half a million lives in the US since 2000. Lawsuits to address the civil and criminal liability of drug companies and other groups have originated from federal, state, local, and tribal jurisdictions. When successful, there will likely be billions of dollars and significant discretion as to how these funds are spent. Several groups have produced reports with principles to address the toll of addiction using settlement funds. However, they lack actionable strategies to address the needs of patients with pain, …

Grouping Algorithms For Informative Array Testing In Disease Surveillance, David Sokolov

Graduate Theses, Dissertations, and Problem Reports (ETD)

In order to maintain normal operations and prevent unnecessary morbidity and mortality during times of disease outbreak, institutions find a need to conduct frequent and widespread testing of their constituents, often under significantly limited testing resource constraints. Faced with the challenge of how best to allo- cate these limited resources to maximum effect, institutions are increasingly turning to group (or “pooled”) testing, which involves testing strategically-chosen groups of patient samples rather than individual samples, producing significant testing resource savings under certain regimes of disease prevalence. While group test- ing can be conducted without any a priori knowledge of individual disease …

Biocompatible And Multifunctional Trityl Spin Probes For Electron Paramagnetic Resonance Spectroscopy, Teresa D. Gluth

Graduate Theses, Dissertations, and Problem Reports (ETD)

The primary objective of my thesis was to develop and utilize a biocompatible multifunctional trityl spin probe for concurrent measurement of pO₂, pH_e, and [P_i] in vivo by electron paramagnetic resonance (EPR) spectroscopy (Chapter 2). My first goal was to synthesize the proposed probe we are terming HOPE71. Secondly, HOPE71 was characterized by X-band and L-band EPR spectroscopy. Next, the biocompatibility of HOPE71 was assessed through an albumin binding test, cytotoxicity assays, and in vivo intravenous tolerance. Then, the use of HOPE71 to measure the target parameters was demonstrated in a breast cancer …

2021 Annual Report, Evidence To Practice, Cep Annual Reports, Stephen Phillippi, Sonita Singh, S. Hoffpauir, Denise Danos, Lisa Staples, Brooke Dupre, Willandra Whiting, L. Simpson, K. Beiter, C.L. Thomas, Ronnie Rubin, Brian Bumbarger

Policy & Position Papers

No abstract provided.

Janus Kinase 1 Drives Endoplasmic Reticulum Stress-Induced Transcriptional Reprogramming In Astrocytes, Savannah Graham Sims

Graduate Theses, Dissertations, and Problem Reports (ETD)

Neurological and neurodegenerative diseases are heterogenous and devastating diseases with limited therapeutic options and no cures. The broad, long-term goal of this project was to elucidate therapeutic targets for neurodegenerative conditions that attenuate damaging inflammation while leaving the beneficial immune response intact and avoiding broad immunosuppression. Inflammation and the accumulation of misfolded proteins are associated with a wide variety of neurological diseases. Here, we have examined how the accumulation of misfolded proteins shapes inflammatory signaling in the glial cell population astrocytes. Astrocytes are the most populous cell in the central nervous system (CNS) and provide physical and trophic support to …

Examining Social Vulnerability And The Association With Covid-19 Incidence In Harris County, Texas, Guillermo A Tortolero, Marcia De Oliveira Otto, Ryan Ramphul, Jose-Miguel Yamal, Alison Rector, Michael Brown, Melissa F Peskin, Dania Mofleh, Eric Boerwinkle

Faculty, Staff and Student Publications

Studies have investigated the association between social vulnerability and SARS-CoV-2 incidence. However, few studies have examined small geographic units such as census tracts, examined geographic regions with large numbers of Hispanic and Black populations, controlled for testing rates, and incorporated stay-at-home measures into their analyses. Understanding the relationship between social vulnerability and SARS-CoV-2 incidence is critical to understanding the interplay between social determinants and implementing risk mitigation guidelines to curtail the spread of infectious diseases. The objective of this study was to examine the relationship between CDC's Social Vulnerability Index (SVI) and SARS-CoV-2 incidence while controlling for testing rates and …

Gender Differences In Fear And Risk Perception During The Covid-19 Pandemic, Abdelaziz Alsharawy, Ross Spoon, Alec Smith, Sheryl Ball

Faculty, Staff and Student Publications

The COVID-19 pandemic has led many people to suffer from emotional distress. Previous studies suggest that women process and express affective experiences, such as fear, with a greater intensity compared to men. We administered an online survey to a sample of participants in the United States that measures fear of COVID-19, perceptions about health and financial risks, and preventative measures taken. Despite the empirical fact that men are more likely to experience adverse health consequences from COVID-19, women report greater fear and more negative expectations about health-related consequences of COVID-19 than men. However, women are more optimistic than men regarding …

Reframing: A Grounded Theory Study Of Postmenopausal Women Following Osteoporotic Fracture, Ashley D. Barber

Graduate Theses, Dissertations, and Problem Reports (ETD)

BACKGROUND: Osteoporosis is a chronic disease resulting in low bone mass and increased bone fragility. Most often seen in women age 65 and older, osteoporosis is usually diagnosed following osteoporotic fracture. Despite numerous treatment options many women continue to remain untreated for osteoporosis and are at increased risk for subsequent fractures and complications. PURPOSE: The initial purpose of this classic grounded theory study was to explore the decision-making process women aged 65 and older experience when considering osteoporosis treatment following osteoporotic fracture. Following the tenth participant interview the researcher discovered a new main concern that emerged from participant interviews. Participants …

Understanding The Variable Drivers Of Toxicity For The Broad Class Of Carbon Nanotubes And Nanofibers From U.S. Facilities, Kelly E. Fraser

Graduate Theses, Dissertations, and Problem Reports (ETD)

Pulmonary exposure to carbon nanotubes or nanofibers (CNT/F) is known to induce inflammation, toxicity, or tumorigenesis, and is a concern in the occupational setting. U. S. facility employees are at risk of inhalation exposure of multi-walled carbon nanotubes and carbon nanofibers during primary and secondary manufacturing. To date, only one MWCNT, Mitsui-7 has been classified as possibly carcinogenic to humans (Group 2B), while all other materials were subsequently categorized as unclassifiable (Group 3). This class of material has recently been listed as a high priority to the International Agency for Research on Cancer due to this significant knowledge gap. Furthermore, …

Developing And Evaluating A Quality Improvement Intervention To Facilitate Patient Navigation In The Accountable Health Communities Model, Jennifer L Holcomb, Gretchen H Walton, Itunu O Sokale, Gayla M Ferguson, Vanessa R Schick, Linda Highfield

Faculty, Staff and Student Publications

Introduction: The Accountable Health Communities (AHC) Model was designed to address the health-related social needs of Centers for Medicare & Medicaid Services beneficiaries. Bridge organizations across the AHC Model have identified lack of technical assistance and peer planning as potential barriers to Model success, particularly around patient navigation. The technical assistance and peer planning literature lacks an organizing, conceptual framework, but implementation science frameworks could serve as useful guides. The Strengthening Peer AHC Navigation (SPAN) research protocol seeks to fill this gap and will apply three implementation science frameworks, Consolidated Framework for Implementation Research, Intervention Mapping, and the Expert Recommendations …

Patterns And Risk Factors Of Opioid-Suspected Ems Overdose In Houston Metropolitan Area, 2015-2019: A Bayesian Spatiotemporal Analysis, Cici Bauer, Tiffany Champagne-Langabeer, Christine Bakos-Block, Kehe Zhang, David Persse, James R Langabeer

Faculty, Staff and Student Publications

BACKGROUND: Opioid-related overdose deaths are the top accidental cause of death in the United States, and development of regional strategies to address this epidemic should begin with a better understanding of where and when overdoses are occurring.

METHODS AND FINDINGS: In this study, we relied on emergency medical services data to investigate the geographical and temporal patterns in opioid-suspected overdose incidents in one of the largest and most ethnically diverse metropolitan areas (Houston Texas). Using a cross sectional design and Bayesian spatiotemporal models, we identified zip code areas with excessive opioid-suspected incidents, and assessed how the incidence risks were associated …

Determination Of Optimal Deployment Strategy For Reboa In Patients With Non-Compressible Hemorrhage Below The Diaphragm, Nicholas L Johnson, Charles E Wade, Erin E Fox, David E Meyer, Charles J Fox, Ernest E Moore, Jonathan Morrison, Thomas Scalea, Eileen M Bulger, Kenji Inaba, Bryan C Morse, Laura J Moore

Faculty, Staff and Student Publications

BACKGROUND: Non-compressible truncal hemorrhage (NCTH) is the leading cause of preventable death after trauma. Resuscitative endovascular balloon occlusion of the aorta (REBOA) achieves temporary hemorrhage control, supporting cardiac and cerebral perfusion prior to definitive hemostasis. Aortic zone selection algorithms vary among institutions. We evaluated the efficacy of an algorithm for REBOA use.

METHODS: A multicenter prospective, observational study conducted at six level 1 trauma centers over 12 months. Inclusion criteria were age >15 years with evidence of infradiaphragmatic NCTH needing emergent hemorrhage control within 60 min of ED arrival. An algorithm characterized by the results of focused assessment with sonography …

Biomechanically Inspired Assistive Technology To Restore Movement Of The Upper Limbs After Stroke, Ariel Thomas

Graduate Theses, Dissertations, and Problem Reports (ETD)

A stroke often damages the neural structures responsible for movement. Stroke is a heterogeneous disease, affecting each survivor differently. There are common motor features of a stroke, but even these features vary across time as an individual proceeds through different stages of recovery. The different ways in which stroke motor impairment can present itself are often overlooked, but these differences are fundamental to the understanding of the disease and its recovery. When motor assessments are capable of acquiring information necessary to parse out a detailed profile of each stroke case, this will lead to an improved neuromechanical understanding of the …

Feasibility And Acceptability Of A Technology-Based, Rural Weight Management Int Ervention In Older Adults With Obesity, John A. Batsis, Curtis L. Petersen, Matthew M. Clark, Summer B. Cook, David Kotz, Tyler L. Gooding, Meredith N. Roderka, Rima I. Al-Nimer, Dawna M. Pidgeon, Ann Haedrich, K. C. Wright, Christina Aquila, Todd A. Mackenzie

Dartmouth Scholarship

Background

Older adults with obesity residing in rural areas have reduced access to weight management programs. We determined the feasibility, acceptability and preliminary outcomes of an integrated technology-based health promotion intervention in rural-living, older adults using remote monitoring and synchronous video-based technology.

Methods

A 6-month, non-randomized, non-blinded, single-arm study was conducted from October 2018 to May 2020 at a community-based aging center of adults aged ≥65 years with a body mass index (BMI) ≥30 kg/m2. Weekly dietitian visits focusing on behavior therapy and caloric restriction and twice-weekly physical therapist-led group strength, flexibility and balance training classes were delivered using video-conferencing …

Effectively Communicating Comprehensive Tumor Genomic Profiling Results: Mitigating Uncertainty For Advanced Cancer Patients, Nicci Bartley, Megan C. Best, Barbara B. Biesecker, Alana Fisher, David Goldstein, Bettina Meiser, David M. Thomas, Mandy L. Ballinger, Phyllis Butow

IES Papers and Journal Articles

Objective: To understand advanced cancer patients’ experience of uncertainty when receiving comprehensive tumor genomic profiling (CTGP) results, and their perceptions of how healthcare provider (HCP) communication impacts uncertainty.

Methods: Thirty-seven semi-structured interviews with advanced cancer patients were conducted within two weeks of patients receiving CTGP results. Transcripts were thematically analyzed, using an inductive approach.

Results: We identified three themes that illustrate patient experience of uncertainties when receiving CTGP results: 1. Type and degree of uncertainty fluctuates along with changing illness circumstances and the nature of the CTGP results; 2. HCPs’ co-ordination of care and communication shapes uncertainty, with immediate, clearer …

The Content, Teaching Methods And Effectiveness Of Spiritual Care Training For Healthcare Professionals: A Mixed-Methods Systematic Review, Kate Fiona Jones, Piret Paal, Xavier Symons, Megan C. Best

IES Papers and Journal Articles

Context: Spirituality has been demonstrated to play an important role in healthcare, yet many staff feel ill-equipped to deliver spiritual care. Spiritual care training programs have been developed to address this need.

Objective: The aim of this mixed-methods systematic review was to identify spiritual care training programs for healthcare professionals or students, and to investigate program content, teaching methods, key outcomes, and identified challenges and facilitators.

Methods: A mixed-methods systematic review was conducted. The search terms (‘religio*’ OR ‘spiritual*’ OR ‘existenti*’) were combined with (‘educat*’ OR ‘train*’ OR ‘curricul*’ OR ‘program*’), AND (‘care’ OR ‘therap*’ OR ‘treatment’ OR ‘competenc*’). Search …

Australian Perspectives On Spiritual Care Training In Healthcare: A Delphi Study, Kate F. Jones, Jennifer Washington, Matthew Kearney, David Kissane, Megan C. Best

IES Papers and Journal Articles

Objective: The aim was to establish core components of spiritual care training for healthcare professionals in Australia.

Methods: This study used the Delphi technique to undertake a consensus exercise with spiritual care experts in the field of healthcare. Participant opinion was sought on (i) the most important components of spiritual care training; (ii) preferred teaching methods; (iii) clinical scenarios to address in spiritual care training; and (iv) current spiritual assessment and referral procedures.

Results: Of the 107 participants who responded in the first round, 67 (62.6%) were female, 55 (51.4%) worked in pastoral care, and 84 (78.5%) selected Christian as …

Cancer Patient Knowledge About And Behavioral Intentions After Germline Genome Sequencing, Christine E. Napier, Grace Davies, Phyllis N. Butow, Timothy E. Schlub, Megan C. Best, Nicci Bartley, Ilona Juraskova, Bettina Meiser, Katherine M. Tucker, Barbara B. Biesecker, David M. Thomas, Mandy L. Ballinger, Members Of The Pigeon Project

IES Papers and Journal Articles

Objectives: Germline genome sequencing (GS) is becoming mainstream in cancer diagnosis and risk management. Identifying knowledge gaps and determinants of health behavior change intentions will enable effective targeting of educational and management strategies to translate genomic findings into improved cancer outcomes.

Methods: Probands diagnosed with cancer of likely genetic origin that consented to but not yet undergone GS, and their biological relatives, completed a cross-sectional questionnaire assessing GS knowledge and hypothetical intention to change behaviors.

Results: Probands (n = 348; 57% university educated) and relatives (n = 213; 38% university educated) had moderate GS knowledge levels, with greater knowledge associated …

Heeding The Call Of Covid-19, David Wiebers, Valery Feigin

Animal Sentience

We are grateful to all of our commentators. They have provided a wide range of valuable perspectives and insights from many fields, revealing a broad interest in the subject matter. Nearly all the commentaries have helped to affirm, refine, expand, amplify, deepen, interpret, elaborate, or apply the messages in the target article. Some have offered critiques and suggestions that help us address certain issues in greater detail, including several points concerning industrialized farming and the wildlife trade. Overall, there is great awareness and strong consensus among commentators that any solution for preventing future pandemics and other related health crises must …

Tacit To Explicit Knowledge Transfer In A University Health Care Program: Use Of Student-Professor And Professor-Professor Collaboration, Geela Spira, Allen S. Keener

Pedagogicon Conference Proceedings

Student feedback indicated difficulty applying Occupational Therapy values such as “participation in meaningful occupations” into clinical interventions. Two instructors of a components-based course and a theory course collaborated to link practical OT interventions to conceptual OT models. Use of a model for transfer of tacit knowledge was utilized. Each instructor kept a reflective diary. An iterative process for a semester attempted to transfer learned explicit knowledge into an integrated intuitive ‘art of the therapy’ which incorporated Occupational Science core concepts. Worksheets were developed to make the pathway more explicit. By semester’s end, students completed a comprehensive plan for client care.

Worker Health Inequities In Central America, Carlos Eduardo Siqueira

Gastón Institute Publications

No abstract provided.

Analysis Of Covid 19 Mortality And Case Fatality In A Low Income Region Of Brazil, Carlos Eduardo Siqueira, Luiz C De Abreu

Gastón Institute Publications

Introduction: Inserted in the vulnerable context of the Brazilian Amazon, the state of Tocantins has suffered damages with the dissemination of COVID-19 in its territory; however, little evidence is published from this state. Objective: This study aims to analyze the case-fatality, mortality, and incidence of COVID-19 in Tocantins. Methods: This is an ecological study, population-based, time- series analysis of COVID-19 cases and deaths in the state of Tocantins from March 2020 to August 2021. Results: During the examined period, 219,031 COVID-19 cases, and 3,594 deaths were registered due to disease. Two possible occurrence peaks were characterized in this time- series …

A Time-Series Ecological Study Protocol To Analyze Trends Of Incidence, Mortality, Lethality Of Covid-19 In Brazil, Luiz C De Abreu, Khalifa Elmusharaf, Carlos Eduardo Siqueira

Gastón Institute Publications

Introduction: since the first case of COVID-19 was confirmed in February 2020, Brazil has reported more than 20 million cases and more than 600,000 deaths on October 31, 2021. The behavior of the pandemic was also different in the various states, from the less developed to the more developed, such as the state of São Paulo. Objective: to describe step-by-step time series for analyzing trends in mortality, lethality and incidence of COVID-19 in Brazil. Methods: a protocol for an ecological study of time series, covering the 26 states and the federal district (Brasilia). Results: the descriptions have the potential to …