Medicine and Health Sciences Commons^™

Evaluation, Validation & Implementation Of A Computerized Diagnostic Decision Support System In Primary Practice, Joe Bridges

Translational Projects (Open Access)

Background: Medical diagnosis may be the most complex task attempted by humans. Studies estimate that 95% of diagnoses in outpatient care are accurate, implying that the annual rate of inaccurate diagnoses is 12 million in the US alone, with the potential for patient harm in about half. A well-researched differential might reduce inaccurate diagnoses by offering alternatives matching the patient’s symptoms. This study searched the literature for articles evaluating the diagnostic performance of commercially available computerized diagnostic decision support systems. This search led to selecting Isabel Pro, developed by Isabel Healthcare, Ltd. of Haslemere, UK.

Evaluation and Validation: …

Anxiety And Related Factors Among Mothers Of Postoperative Pediatric Patients At King Chulalongkorn Memorial Hospital, Yadaporn Yordsawat, Chutima Roomruangwong, Prapapan Rajatapiti

Chulalongkorn Medical Journal

Background: According to previous studies, mothers caring for children with various diseases had anxiety. However, few studies were conducted on anxiety and related factors among mothers of postoperative pediatric patients in Thailand. Objectives: To study the prevalence of anxiety and related factors among mothers of postoperative pediatric patients at King Chulalongkorn Memorial Hospital. Methods: Data were collected from 105 mothers of pediatric patients receiving corrective surgery as in-patients and out-patients by using questionnaires including: 1) The mothers’ demographic questionnaire; 2) The children’s background questionnaire; 3) The STAI Form-Y1, Y2 anxiety measuring form; and, 4) The Parental Stress Scale: Pediatric Intensive …

Intention To Have No Children And Its Relation To Mental Health: A Case Study Of Personality And Coping Traits Of Married Couples, Registering At Bangrak District Office, Pichaya Wattanavitukul, Chutima Roomruangwong

Chulalongkorn Medical Journal

Background: Modern families tend to have fewer children, planning to have no children has seen more and more. There are pieces of evidence that many families planned to have no children even the family’s economic status has improved. Objectives: To examine the prevalence of intention to have no children among those who come to get marriage registration at Bangrak District Office, Bangkok Metropolis, and association between intention to have no children and personality and coping. Methods: The cross-sectional descriptive study was conducted in males and females who come to get marriage registration at Bangrak District Office, Bangkok Metropolis. The data …

Effects Of Transcranial Direct-Current Stimulation Combined With Physical Therapy In Chronic Low Back Pain Treatments: A Randomized Controlled Pilot Study, Mai Loan Pham Thi, Wanida Donpunha, Saowanee Nakmareong, Paradee Auvichayapat, Kittisak Sawanyawisuth, Taweesak Janyacharoen

Chulalongkorn Medical Journal

Background: Chronic low back pain (CLBP) affects 80.0% of the population and reduces their quality of life (QOL). Searching for its most effective treatment has being a challenge in the health-care system. Although studies using transcranial direct current stimulation (tDCS) plus physical therapy (PT) that aim to relieve pain, an optimal intervention method and clinical effectiveness evaluations related to CLBP patient aspects have not been completely investigated. Objectives: The purpose of this study was to compare treatment effects between a combination of tDCS and PT (combined group) and PT alone (PT group) in pain intensity, gait speed, lumbar range of …

Incidence Of Delirium In Hip Fracture Surgery At King Chulalongkorn Memorial Hospital, Siree Sukhanonsawat, Yanin Thipakorn, Paul Thisayakorn

Chulalongkorn Medical Journal

Background: Postoperative delirium in hip fracture patients is a significant public health problem that affects the quality of patients’ lives and increases morbidity and mortality rate. Objective: To investigate the incidence of delirium and associated factors in elderly patients who underwent hip fracture surgery. Methods: This is a cross-sectional descriptive study. Data were collected from the patients aged  65 years who underwent hip fracture surgery at King Chulalongkorn Memorial Hospital. The Thai Mental State Examination (TMSE) was used to investigate cognitive function preoperatively and on the 4th postoperative day. Postoperative delirium was assessed for 4 consecutive days using the …

Kundalini, Cerebrospinal Fluid, Multidimensional Health, Theresia Portoghese

LMU Theses and Dissertations

The focus of this thesis is to explore “the inner spiritual architecture” (prāṇa, nāḍī, cakra) through the lens of the pañcamayakośa model concerning raising kuṇḍalinī. We will discuss how the components of the “spiritual architecture” are directly influenced by four select techniques (mula bandhā uḍḍīyāna bandhā, jālandhara bandhā, and mahabandā). These are known as bandhās/mudras, which are specific to The Medieval Transformation for raising kuṇḍalinī. Our focus will explore the mechanics of the bandhās and the recorded, effects.

The thesis’s secondary focus is cerebrospinal fluid (CSF). Under the traditional lens of the pañcamayakośa model, a comparison will be made between …

Mountains Of Evidence, Mary I. Fisher

Physical Therapy Faculty Publications

No abstract provided.

How Pornography Consumption Affects The Consumer And A Biblical Response To The Temptations Of Modern Sexuality, Peyton Mayes

Senior Honors Theses

It has been shown that 93% of boys and 62% girls prior to age 13 have been exposed to pornography (Sabina et al., 2008). Only in the last decade has the ability to view sexual content been made available to almost all groups of society, regardless of wealth or social status. This paper will address this issue by reviewing literature on the neuropathology, sexual dysfunctions, and violent content associated with pornography consumption. Although a significant amount of research has been done on the impacts of pornography, there is relatively little discussion on possible interventional methods. This gap in knowledge will …

A Literature Review Of The Prevalence, Metabolism, And Usage Guidelines Of Non-Nutritive Sweeteners, Rebecca Ide

Senior Honors Theses

Due to their reputation for being a healthier option to traditional table sugar, non-nutritive sweeteners have garnered popularity, particularly with those affected by type II diabetes mellitus (DM2) or obesity. A literature review on the characteristics, metabolism, and optimal cooking guidelines of non-nutritive sweeteners was performed to establish more knowledge about these trending food additives. The literature review indicates that the presence of non-nutritive sweeteners (NNS) may influence glucose metabolism by binding T1R2/T1R3 sweetness receptors present throughout the gastrointestinal tract. However, not all studies showed positive correlations. Though inconclusive, the studies suggest a possible connection between excessive NNS consumption and …

The Acorn Squash Problem: A Digestible Conceptualisation Of Barriers To Emergency Food Assistance, John C. Jones, Joanne Christaldi, Diana Cuy Castellanos

Nutrition Faculty Publications

Background: In common narratives of emergency food assistance, donors likely believe their efforts directly manifest as people consuming their donated food. For example, a person donating canned lima beans during a canned food drive may visualise someone eventually eating those lima beans. However, cultural and socio-economic barriers often exist that prevent people from accessing and consuming the donated food. These barriers are often complex and otherwise well-intentioned donors, volunteers and organisations may not initially consider them.

Method: This commentary article, which draws from existing US emergency food systems literature, uses the imagery of an acorn squash one might find at …

Vaccine Hesitancy In The Post-Covid-19 Era: An Interdisciplinary Approach For A Trust-And-Risk Paradigm With Governmental And Intergovernmental Implications, Laurent Cleenewerck De Kiev, Danny A. Schieffler

Healthcare Informatics Faculty Publications

Vaccine hesitancy was described as a major global health challenge by the World Health Organization before the outset of the COVID-19 pandemic (Ten Health Issues WHO Will Tackle This Year, 2019).

During the COVID-19 pandemic, the introduction of several new vaccines (notably Pfizer, Moderna, J&J) and with them new vaccine technologies (mRNA) under emergency use authorization (EUA), combined with the political context of these vaccines’ accelerated development, triggered a heightened level of vaccine hesitancy and refusal in the United States and around the world (FDA, 2021).

This paper study undertakes to investigate the foundations and recent evolution of this phenomenon …

An Analysis Of The Psychological And Physical Effects Of A Physical Activity Program During In-Patient Pediatric Cancer Treatment, Zoë Winters

Undergraduate Theses

There is limited published research regarding the use of physical activity in cancer treatment programs, and even fewer in pediatric treatment plans; however, there is a common consensus that following the conclusion of cancer treatment an individual’s physical fitness has been majorly impacted. The inactivity that commonly coexists with cancer treatment often results in extended periods of time in rehabilitation programs and decreased independence. Along with the physical detriments caused by inactivity, increased dependence on others often brings about feelings of helplessness that can further cause emotional detriments. It has however been demonstrated in previous research that adding physical activity …

Standardizing Naturalistic Teaching Opportunities For Problem-Based Learning In Diabetes Education: A Quality Improvement Project, Austin Mccaslin

DNP Projects

Significance and Background:

Poor diabetes management is linked to serious long and short-term health complications. Despite this, medication adherence is a significant problem in adolescents with type 1 diabetes. Management is further complicated by low socioeconomic status, even when mitigated by free healthcare, highlighting health literacy as a culprit of disparities. Evidence shows that a common barrier for adolescents is proficiency in dose determination. Carbohydrate counting is an integral skill, necessary for attaining glycemic control. At a homecare agency serving adolescents with poorly controlled diabetes by providing oversight of medication administration and education, it was noted that patients continued to …

Psychological Factors That Interfere With Provider Use Of Medication Assisted Treatment For Opioid Use Disorder, Courtney Spencer

Doctor of Psychology (PsyD)

Since the implementation of Medication Assisted Treatment (MAT) for treatment of Opioid Use Disorder (OUD), providers have struggled to obtain the necessary waiver (X-waiver) due to required federal applications, training, and guidelines around prescribing. Nevertheless, prescribers have gone through this arduous process to gain their X-waiver, but a unique phenomenon has occurred where some providers with an X-waiver are not utilizing their ability to prescribe MAT. The current study sought to uncover trends in providers prescribing practices while assessing possible factors involved including personality, compassion, compassion fatigue, personal connection, and confidence factors that may be associated with a willingness to …

Determining The Role Of Gata3 In A Sub-Population Of Vestibular Hair Cells, Sydney Sheltz-Kempf

Dissertations

The inner ear can be divided based on two functions: hearing and balance. The hearing organ is called the cochlea, while the organs responsible for balance are called the vestibular system. One of these vestibular organs, the utricle, is positioned horizontally in the body and relatively parallel to the ground, resulting in sensitive detection of both sideways, and forward and backward acceleration. One major question in the field of otolaryngology focuses on the unique differences between these organs and the evolutionary importance of their similarities. One particular gene of interest called Gata3 is initially expressed highly in the cochlea and …

The Influence Of Integrated Behavioral Health Primary Care Setting On The Utilization Of Mental Health Services And Depression Treatment Response Among Men, Tendai Masiriri

Dissertations

The 2010-2013 National Health Interview Survey showed that nearly 9% of men had daily feelings of anxiety or depression, yet less than 41% sought help for their symptoms (Blumberg et al., 2016). Men are more reluctant than women to seek help (Angst et al., 2002; Brownhill et al., 2005). The failure to seek help among men is associated with multiple factors related to stigma and gender, yet male suicide rates are approximately 3-5 times higher than their female counterparts. However, they have a higher likelihood of seeking help from a medical provider rather than a mental health provider. If men …

Symmetry Is Associated With Interlimb Coordination During Walking And Pedaling After Stroke, Brice T. Cleland, Sheila M. Schindler-Ivens

Physical Therapy Faculty Research and Publications

Background and Purpose:

Asymmetry during walking may be explained by impaired interlimb coordination. We examined these associations: (1) propulsive symmetry with interlimb coordination during walking, (2) work symmetry with interlimb coordination during pedaling, and (3) work symmetry and interlimb coordination with clinical impairment.

Methods:

Nineteen individuals with chronic stroke and 15 controls performed bilateral, lower limb pedaling with a conventional device and a device with a bisected crank and upstroke assistance. Individuals with stroke walked on a split-belt treadmill. Measures of symmetry (%Propulsion_walk, %Work_ped) and interlimb phase coordination index (PCI_walk, PCI_ped) were …

A Community Educational Intervention To Improve Firearm Safety Behavior In Families, Elizabeth G. Choma Msn, Rn, Cpnp-Pc

Doctor of Nursing Practice Projects

Background: Every day in America children, are injured or killed from the accidental shooting of firearms. Additionally, few households with children report storing all guns unloaded and locked up. Recent evidence supports education on safe firearm storage as an effective intervention in promoting firearm safety in families with children. However, Pediatric healthcare providers often do not have enough time for firearm education during well visits.

Objective: This Quality Improvement (QI) project aimed to use an educational intervention with statistics on firearms in children and implemented the Asking Saves Kids (ASK) campaign to assess and improve firearm safety behaviors in families …

A Certified Nurse Program: Mitigating Barriers To Certification, Kymberlee Cox Msn, Rn, Npd-Bc, Pccn-K

Doctor of Nursing Practice Projects

Background: Certification recognizes a nurse's specialized knowledge, skill, and expertise. It has been linked to positive patient, nurse, and organizational outcomes. Recognizing these advantages, the nursing department set a goal to increase certification rates. However, perceived barriers to certification existed, and rates remained unchanged. A program was needed to overcome these obstacles.

Aims/Objectives: To develop and evaluate a Certified Nurse Program that addresses the perceived barriers to certification by proactively supporting, preparing, and recognizing nurses who pursue and maintain a specialty certification.

Methodology: A 200-bed Maryland suburban hospital adopted the program. Initiatives for certification support, preparation, and recognition were implemented. …

A Telehealth Blood Pressure Education Program On Hypertension Knowledge, Selfcare, And Behavior, Cheynnie N. Burnett Msn, Aprn, Fnp-C

Doctor of Nursing Practice Projects

Background: Hypertension poses a significant risk for morbidity and mortality. Regular blood pressure monitoring, medication compliance, and/or lifestyle modifications have shown to improve control. Digital communication in healthcare, such as telemedicine provides patients and primary care offices an opportunity to improve access to care and education.

Objectives: This Quality Improvement (QI) Project aimed to answer the question: In adult patients with a diagnosis of hypertension, what is the effectiveness of implementing an evidence- based telehealth blood pressure management program in a primary health care setting, when compared to baseline, on blood pressure knowledge, management, and self-care over a nine- week …

The Impact Of Mentorship On Nurses’ Level Of Self-Efficacy And Motivation To Pursue Board Leadership Positions, Amy K. Mccarthy Msn, Rnc-Mnn, Ne-Bc

Doctor of Nursing Practice Projects

Background: Nurses comprise the largest component of the healthcare workforce and possess a unique understanding of healthcare operations and patient care. On average, the proportion of nurses serving on hospital boards range from 2 to 6%, with the proportion of physicians averaging 20%. Over the last decade, much attention has been placed on emphasizing the importance of a nurse’s presence on boards. Despite these initiatives, nurses continue to display an overall hesitancy towards board service.

Objectives: The aim of this project was to implement an evidence-based mentorship program to address barriers to board leadership and increase overall self-efficacy and motivation …

Improving Screening For Sleep Disturbance In Patients With Parkinson’S Disease, Jenny Nguyen Msn, Fnp-C

Doctor of Nursing Practice Projects

Background: Sleep disturbance (SD) is one of the most common and debilitating non-motor manifestations of Parkinson’s disease (PD). SD intensifies the disease-related disabilities of motor and non-motor symptoms. In spite of this, it is often under-recognized and underaddressed by healthcare professionals. The Movement Disorder Society recommends the Parkinson’s disease Sleep Scale (PDSS – 2) be used to screen and measure severity of overall sleep problems in this patient population.

Objectives: The purpose of this quality improvement (QI) project is to increase the utilization of the PDSS-2, a standardized approach to assessment of sleep difficulties. This can facilitate identification of individual …

Implementation Of A Standardized Handoff Tool For The Transition Of Care Of Adult Liver Transplant Patients, Suzanne Robertazzi Msn, Anp-Bc

Doctor of Nursing Practice Projects

Background: The transfer of care of the adult liver transplant patient from the inpatient to the outpatient setting has increased in complexity and has the potential to lead to errors and adverse events.

Objective: This pre-post design quality improvement project implemented a hand-off communication tool to improve adult liver transplant patient outcomes when transitioning from the inpatient to outpatient setting.

Methods: The hand-off tool was based on Illness severity, Patient summary, Action list, Situation awareness, and Synthesis (I-PASS). An EMR chart review was completed on discharged liver transplant patients 3 months (N=28) prior and 4 months (N=36) after I-PASS implementation. …

The Impact Of The Covid-19 Pandemic On Medical School Pathway Programs, Nick Jennings, Charmi Trivedi, Julie Orban, Sonal Batra

GW Research Showcase 2021-2026

No abstract provided.

Challenges In The Management Of Pulmonary Atresia And Intact Ventricular Septum (Pa Ivs), Danielle Healey, Zainab Awan, Alyssia Venna, Priya Misra, Yves D’Udekem

GW Research Showcase 2021-2026

No abstract provided.

Costs And Outcomes Of Ed Patients With Uncomplicated Biliary Colic, Michael Makutonin, Ali Moghtaderi, Sophia Newton, Yan Ma, Andrew Meltzer

GW Research Showcase 2021-2026

No abstract provided.

Association Between Clinical Seizures And Eeg Factors With Neurologic And Neurocognitive Outcomes In Pediatric Cerebral Malaria, Daniel Muller, Angela Sarkisian, Alexander Andrews, Daniel James Clark, Douglas G. Postels

GW Research Showcase 2021-2026

No abstract provided.

Assessment Of Eye Pain Symptoms Among Pediatric Students During The Covid-19 Pandemic, Jason Dossantos, Julie Thomasian, Monica Manrique, Isabelle Dortonne, Sohel Rana, Richard Birdsong

GW Research Showcase 2021-2026

No abstract provided.

Effect Of Alcohol Use Disorder On Revision Rates And Perioperative Outcomes In Total Shoulder Arthroplasty, Anthony K. Chiu, Kendrick Cuero, Samuel I. Fuller, Amil R. Agarwal, Tim Kreulen, Umasuthan Srikumaran

GW Research Showcase 2021-2026

No abstract provided.

Effect Of Cannabis Use Disorder On Total Shoulder Arthroplasty Outcomes, Anthony K. Chiu, Samuel I. Fuller, Amil R. Agarwal, Kendrick Cuero, Tim Kreulen, Umasuthan Srikumaran

GW Research Showcase 2021-2026

No abstract provided.