Medicine and Health Sciences Commons^™

The Mental Effect Of Obesity On Active-Duty Service Members In The United States: A Phenomenological Approach, Tegan M. Quigley

Doctoral Dissertations and Projects

This phenomenological research was intended to explore the impact that obesity has on the mental health of soldiers in the U.S. military. The U.S. military has stringent physical fitness standards that must be met by each soldier regardless of sex. These standards can be challenging to maintain. Obesity is an increasing issue in the United States, and soldiers are not immune. Research regarding the physical issues that occur from obesity has been performed, but this study aimed to explore the behavioral or mental health effects that obesity can have within the military community. This study explored the following questions: In …

Agnotology Of The E-Cigarette Industry: How The E-Cigarette Industry Continues The Tobacco Industry's Legacy Of Creating Controversy And Confusion Within The Scientific Community And The General Population, Calvin Lewis

University Honors Theses

The purpose of this paper is to determine the extent to which the e-cigarette industry follows in the footsteps of the tobacco industry's attempts to disrupt science and cause controversy. Four tactics are described that the tobacco industry uses to disrupt science: funding research that is designed to show results that support their position, criticizing and suppressing research that goes against their position, changing risk assessment and scientific research standards to fit their aims, and spreading data created by their interest groups to politicians and the nonacademic press. Evidence is found to show that both the tobacco industry and e-cigarette …

Standardizing Critical Skills And Competency Validation To Promote Self-Efficacy Among Rapid Response Nurses, Kelli Dail Baker

Doctoral Dissertations and Projects

Competency validation is a key component of supporting nurses with necessary skills to provide care for their patients. However, many healthcare organizations do not have a standardized process for determining which skills are evaluated and the method by which evaluation occurs. To address competency validation among rapid response nurses (RRNs), this evidence-based practice project was proposed to increase self-efficacy. This project involved a thorough data review of all rapid response skills, categorizing all interventions based on quantity and acuity, and holding a hands-on educational fair for a set of standardized skills. A quasi-experimental design was used to collect data pre- …

The Transition From In Person Sessions To Telemental Health Sessions For College Counseling Center Counselors, Katherine L. Karimian

Doctoral Dissertations

This study was conducted by applying Interpretative Phenomenological Analysis (IPA) to explore the lived experiences of college counseling center (CCC) counselors during their rapid switch from in person to online services as a result of university and colleges moving to remote education during the peak of the COVID-19 pandemic (~March 2020 - August 2021). Six participants from different regions of the United States were interviewed via Zoom and analyzed through IPA. There were five themes that emerged:Blurred work/home boundaries, interpersonal relationships within work setting, adapting to teletherapy, impact of teletherapy on services, and preferring remote work. Emergent subthemes were parenting, …

Proximity Analysis Of Native Proteomes Reveals Phenotypic Modifiers In A Mouse Model Of Autism And Related Neurodevelopmental Conditions, Yudong Gao, Daichi Shonai, Matthew Trn, Jieqing Zhao, Erik J Soderblom, S Alexandra Garcia-Moreno, Charles A Gersbach, William C Wetsel, Geraldine Dawson, Dmitry Velmeshev, Yong-Hui Jiang, Laura G Sloofman, Joseph D Buxbaum, Scott H Soderling

Faculty, Staff and Students Publications

One of the main drivers of autism spectrum disorder is risk alleles within hundreds of genes, which may interact within shared but unknown protein complexes. Here we develop a scalable genome-editing-mediated approach to target 14 high-confidence autism risk genes within the mouse brain for proximity-based endogenous proteomics, achieving the identification of high-specificity spatial proteomes. The resulting native proximity proteomes are enriched for human genes dysregulated in the brain of autistic individuals, and reveal proximity interactions between proteins from high-confidence risk genes with those of lower-confidence that may provide new avenues to prioritize genetic risk. Importantly, the datasets are enriched for …

Single Cell Dual-Omic Atlas Of The Human Developing Retina, Zhen Zuo, Xuesen Cheng, Salma Ferdous, Jianming Shao, Jin Li, Yourong Bao, Jean Li, Jiaxiong Lu, Antonio Jacobo Lopez, Juliette Wohlschlegel, Aric Prieve, Mervyn G Thomas, Thomas A Reh, Yumei Li, Ala Moshiri, Rui Chen

Faculty, Staff and Students Publications

The development of the retina is under tight temporal and spatial control. To gain insights into the molecular basis of this process, we generate a single-nuclei dual-omic atlas of the human developing retina with approximately 220,000 nuclei from 14 human embryos and fetuses aged between 8 and 23-weeks post-conception with matched macular and peripheral tissues. This atlas captures all major cell classes in the retina, along with a large proportion of progenitors and cell-type-specific precursors. Cell trajectory analysis reveals a transition from continuous progression in early progenitors to a hierarchical development during the later stages of cell type specification. Both …

Untargeted Lipidomics Reveals Racial Differences In Lipid Species Among Women, Ghazaleh Pourali, Liang Li, Kayla R Getz, Myung Sik Jeon, Jingqin Luo, Chongliang Luo, Adetunji T Toriola

2020-Current year OA Pubs

Understanding the biological mechanisms underlying racial differences in diseases is crucial to developing targeted prevention and treatment. There is, however, limited knowledge of the impact of race on lipids. To address this, we performed comprehensive lipidomics analyses to evaluate racial differences in lipid species among 506 non-Hispanic White (NHW) and 163 non-Hispanic Black (NHB) women. Plasma lipidomic profiling quantified 982 lipid species. We used multivariable linear regression models, adjusted for confounders, to identify racial differences in lipid species and corrected for multiple testing using a Bonferroni-adjusted p-value <  10

Feedback In Emergency Medical Services: A Missing Cornerstone, Stephen E. Taylor

Doctoral Dissertations and Projects

The purpose of this mixed methods constructivist grounded theory (CGT) study is to explore how paramedics and medical directors (MD)s in the United States perceive outcomes feedback regarding its type, quality, and quantity. This type of feedback, which can influence their critical thinking skills, knowledge base, and job satisfaction, is crucial to their professional development. In this study, patient outcomes feedback refers to general patient information, including emergency department assessment, treatment, diagnosis, admission or discharge decisions, and the overall outcome of the patient's hospital experience. The conceptual framework, focusing on the perspectives of paramedics and medical directors, is based on …

An Integrative Review: Improving Copd Patient Outcomes Using The Teach-Back Method, Bichundo Lambert

Doctoral Dissertations and Projects

Chronic obstructive pulmonary disease (COPD) is a common clinical health concern that causes airflow resistance to the lungs and persistent respiratory symptoms, which can impact quality of life for the COPD patient. The condition is common to adults over 40 years of age. It is estimated that 210 million people worldwide suffer from the disease, and its incidence is on the rise. In United States, COPD affects 16 million people and costs the government $24 billion annually. The researchers predicts that COPD will be the third-leading course of mortality by 2030 worldwide. The objective of this integrative review was to …

The Impact Of Social Media Use On Maternal Vaccination Decisions, Natalie Raquel Flynn

Doctoral Dissertations and Projects

This quantitative study aimed to explore the impact of social networking sites (SNS) on maternal vaccination decisions. Utilizing purposive sampling, the study ensured a representative sample of mothers or expectant mothers over 18 years old, with at least one child under 18, residing in the United States. Participants completed a composite survey consisting of three individual surveys assessing social media usage, vaccination decisions, and information-seeking behaviors. Descriptive statistics were employed for comprehensive analysis, investigating the influence of accessing social media platforms on maternal COVID-19 vaccination decisions. The Shapiro-Wilk test assessed the normality of age, while frequencies, percentages, median, and interquartile …

Exploring Student Perceptions Of Problem-Based Learning And Clinical Field Experiences: A Phenomenological Study, Ashley Michelle Boles

Doctoral Dissertations and Projects

The purpose of this phenomenological study is to understand the experiences of participating in a physical therapy course primarily taught using problem-based learning teaching methods for Doctor of Physical Therapy students at a university in the mid-western United States. This study aimed to understand student perception of PBL and its effects on clinical field experiences (CFEs), specifically related to higher-order processing skills. The theory guiding this study was the social constructivism theory as it explains how knowledge acquisition and learning occurs through social interactions during problem-based learning activities. The central research question this study attempted to answer was: What were …

Pediatric Respiratory Assessment Measurement Tool And The Benefits Of Utilizing It: An Integrated Review, Amy Michelle Randolph

Doctoral Dissertations and Projects

Asthma is a leading cause of hospitalizations of pediatric patients. The absence of comprehensive screening in the emergency department setting can impact the care of the patient who presents in respiratory distress. This integrated review focused on the benefits of the utilization of the Pediatric Respiratory Assessment Measurement tool. The methods utilized to collect evidence included a web-based search that led to a review of multiple articles. The results were analyzed using MeInky’s Hierarchical Levels of Evidence and organized into a literature matrix. The review ultimately supported the hypothesis that the PRAM tool is an effective instrument compared to other …

Exploring Prelicensure Bsn Students' Knowledge Of Mindfulness Meditation Using A Smartphone App To Manage Stress And Promote Resilience: A Qualitative Single Case Study, Beth A. Kelley

Doctoral Dissertations and Projects

The purpose of this qualitative single case study was to explore pre-licensure Bachelor of Science in Nursing (BSN) students' knowledge of mindfulness meditation (MM) using a smartphone app (SMA) to manage stress and promote resilience. Guiding this study was the transactional model of stress, adaptation, and coping by Lazarus and Folkman (1984) and the zone of proximal development (ZPD) educational theory by Vygotsky. The study asked the following questions: What was pre-licensure Bachelor of Science of Nursing (BSN) students’ knowledge of mindfulness meditation (MM) using a smartphone app (SMA) to manage stress and promote resilience? What had the prelicensure BSN …

Optimizing Care Delivery: Determining The Impact Of A Mobile Interpreter App On Patient Satisfaction, Leslie M. Bright

Doctoral Dissertations and Projects

Introduction: Patients with limited English proficiency (LEP) experience increased health disparities including poorer health outcomes, lack of access to quality healthcare services, and decreased patient satisfaction related to cultural and language barriers.

Purpose/Significance: The purpose of this project was to determine the impact of a technology-based mobile app used for medical interpreter services on patient satisfaction in patients with LEP during urgent care visits.

Methods: The project design consisted of a mobile interpreter app used for medical translation services during urgent care visits. Pretest and posttest patient satisfaction questionnaires were administered before and after the mobile app use to determine …

The Impact Of Bariatric Surgery On Glutathione Synthesis In Individuals With Severe Obesity, Hong Chang Tan, Jean W Hsu, E Shyong Tai, Shaji Chacko, Jean-Paul Kovalik, Farook Jahoor

Faculty, Staff and Students Publications

Glycine is deficient in individuals with obesity but improves following bariatric surgery. Glycine deficiency could impair glutathione (GSH) synthesis and worsen oxidative stress. We examined the impact of obesity-associated glycine deficiency and bariatric surgery on GSH synthesis. Twenty-one participants with severe obesity and twenty-one healthy weight controls were recruited. [1,2-13C2] glycine was infused to measure the erythrocyte (RBC) GSH synthesis rate. Participants with obesity underwent bariatric surgery, and 19 were restudied six months post-surgery. Compared to healthy weight controls, individuals with obesity had significantly lower concentrations of RBC GSH (2.43 ± 0.23 vs. 2.63 ± 0.26 mmol/L, p < 0.01). However, there were no differences in GSH fractional synthesis rate [78.0 (51.4–123.7) vs. 76.9 (49.3–110.1) % pool/day, p = …

Left Atrial Venoarterial Extracorporeal Membrane Oxygenation Strategy In Postcardiotomy Cardiogenic Shock: A Case Series, Daniel Manzur-Sandoval Md, Gian Manuel Jiménez-Rodríguez Md, José Luis Elizalde-Silva Md, Meredith Fernanda Sánchez-Torres Md, Uriel Encarnación-Martínez Md, Cristhian Josué Gaytán-García Md, José Octavio Salazar-Delgado Md, Guadalupe Lisseth Hernández-González Md, Gustavo Rojas-Velasco Md

The VAD Journal

Postcardiotomy cardiogenic shock is a rare complication with high mortality. When patients do not respond to the placement of an intra-aortic balloon pump or pharmacological treatment, therapy with peripheral venoarterial extracorporeal membrane is a viable option that allows active resuscitation. The adjunct use of Impella® (Abiomed, Danvers, MA, USA) allows active unloading of the dysfunctional left ventricle. However, left atrial venoarterial extracorporeal membrane oxygenation (LAVA-ECMO) is an appealing and effective strategy in cases of aortic dissection, aortic valve replacement, or bioprosthesis of the aorta. Insertion of an extraction cannula that can discharge both atria or only the left atrium allows …

Improving Patient Care: Expansion Of Access To Free Clinics, Anahis H. Davidian, Gail M. Bloom

Patient Experience Journal

Free clinics provide free or reduced-fee healthcare services for uninsured, underserved, and marginalized populations. Free clinics may be the only source of primary care for socioeconomically disadvantaged individuals lacking health insurance. However, consistently understaffed and underfunded free clinics are struggling to meet growing needs. The demand for services results in long waitlists with long wait times. Most free clinics rely on volunteer providers and staff due to limited financial resources. This case study proposes recommendations that can address the challenges of funding limitations while improving free clinics' ability to offer more accessible and equitable care to serve a greater proportion …

Foundational Patient Experience: Analyzing 10 Years Of Patient Experience Research, Geoffrey A. Silvera Phd, Mha, Courtney Haun Phd, Mph, Varun Natarajan

Patient Experience Journal

In this study, we seek to provide a critical examination of the field of Patient Experience (PX) by using citation analysis to determine the foundational keystones of the PX knowledge base. This study will employ a systematic citation analysis to evaluate the articles published in the Patient Experience Journal (PXJ), focusing on citation frequency as evidence of impact on the field. To achieve this, we examine the entire corpus of article citations published in the PXJ from 2014–2023 (Volumes 1–10). By examining a corpus consisting of 515 independent articles (N=515) that include over 12,000 references (n=12,712) over the course of …

Patient Experiences With An Mhealth App For Complex Chronic Disease Care: Connections Despite Lack Of Traditional Clinical Interactions, Jenney Lee, Melissa Cheyney, Michael A. May, Marit L. Bovbjerg

Patient Experience Journal

Chronic diseases are costly to treat and burdensome for patients. Mobile health (mHealth) technologies might reduce costs of care and increase patient self-efficacy in chronic disease management, but the patient experience of mHealth is poorly understood. Our objective, therefore, was to evaluate patient experiences with using an mHealth app for complex chronic disease management, within a U.S. population of low-income patients. We used nurse/patient text messages from an mHealth complex chronic disease management tool, and exit interviews from patients, to assess qualitatively Medicaid patients' experiences with a remote monitoring mHealth app. Salient themes about the patient experience included: (1) Visibility …

Patient Experience And Virtual Reality: The Use Of An Mri Exam Simulator, Jaqueline Maria Da Silva Jms, Marcus Antonio Medeiros De Souza Mams, Mônica Augusta Reis Dos Santos Mars, Milena Loureiro De Melo Mlm, Lorena De Fátima Lucena Almeida Lfla, Alayde Ricardo Da Silva Ars, Êmilly Vitória Dos Santos Vieira Evsv, Alessandra Nascimento Pontes Anp, Jandson De Oliveira Soares Jos

Patient Experience Journal

Magnetic resonance (MR) imaging is a safe diagnostic method of high accuracy detection and characterization of various pathological conditions. However, due to the very closed aspect of the apparatus, the high sound amplitude emitted and the need to remain motionless for a significant time, some patients experience discomfort and high levels of anxiety, compromising time and image quality management that can impair the clinical outcome of the patient or even give up the performance of this procedure. Therefore, this study aimed to validate, with patients, the use of Virtual Reality (VR) as a humanized practice of exposure to magnetic resonance …

Examining The Impact Of Telehealth Visits On Patient And Family Experience In A Pediatric Emergency And Urgent Care Center, Abigail Gauthier Md, Callie Krentz Md, Shiran Chan Ms, Michelle Widecan Dnp, Aprn, Cpnp, Ac/Pc, Adam A. Vukovic Md, Med

Patient Experience Journal

Providers and healthcare organizations have created novel ways of evaluating patients using telehealth. Patient volumes in urgent cares (UCs) and emergency departments (EDs) continue to climb, contributing to longer wait times and suboptimal patient and family experiences (PFEs). Optimizing use of telehealth may not only impact PFE of those evaluated virtually, but also reduce crowding in EDs and UCs, indirectly impacting PFE in those spaces as well. The purpose of this study is to identify any association between telehealth encounters and PFE scores. This is a retrospective review of patients seen via telehealth in virtual urgent care, UC, or the …

Accompanying People Affected By Cancer In Their Return To Life After Treatment: A Report On An Experiment Conducted In Canada, Christine Arsenault, Saskia Hazout, John Calogerinis, Françoise Poirier, Louise Normandin, Cécile Vialaron, Monica Iliescu Nelea, Marie-Pascale Pomey

Patient Experience Journal

This study aims to assess family doctors' perceived needs for improved patient follow-up post-acute treatment in oncology departments, specifically focusing on the Patient Oriented Discharge Summary (PODS) for individuals living with cancer. A cross-sectional quantitative survey targeted family doctors, and a before/after exploratory study was conducted with patients to measure their needs pre- and post-PODS implementation. Twenty-one out of 42 family doctors participated in the survey (50%). Patient data was collected at three points in time: prior to PODS implementation (T1, n = 20/30; 77%), one month later (T2, n = 20/26; 77%), and six months later (T3, n = …

We Did Our Best!: The Experience Of Frontline Workers In Long-Term Care During Covid-19 Outbreaks, Jillian M. Gratton, Lenora Duhn, Rosemary Wilson, Pilar Camargo-Plazas

Patient Experience Journal

In Canada, the COVID-19 pandemic had devastating effects for those living in long-term care (LTC) homes, yet little is known about the experiences of the frontline workers who endured in those settings with COVID-19 outbreaks. Specialized knowledge will improve our understanding of the effects of the pandemic on frontline workers (FW), enabling the development of stronger practices. The purpose of this research was to gain a deeper understanding of the experiences of FW caring for residents in LTC homes during a COVID-19 outbreak, using narrative inquiry. The methods used for data collection include interviews, field notes, and photovoice. Participants were …

Investigating The Perceived Impact Of Surgeons' Burnout On Surgical Physician Associates' Wellness In United States Ambulatory Surgery Centers, Rhionna J. Smith, Lihua Dishman, John W. Fick, Kathleen M. Thomas

Patient Experience Journal

Surgeons are the de facto leaders of surgical teams with surgical physician associates (SPAs) as integral members who function in all areas of the peri-operative environment. Surgeons often supervise SPAs. Ambulatory surgery centers (ASCs) provide patients with same-day diagnostic and preventive procedures as more convenient alternatives to hospital-based outpatient procedures. This qualitative, national, and cross-sectional study explored the perceived impact of surgeons' burnout on SPAs' wellness in U.S. ASCs during global health crises. Primary demographic and qualitative data were collected using a self-developed, three-section survey instrument: (1) information regarding informed consent; (2) 10 short demographic questions; and (3) two open-ended …

Is Timing Everything?: The Role Of Time On The Relationship Between Patient-Centered Communication And Provider Empathy, Shanequa S. Roscoe-Nelson, Geoffrey A. Silvera Phd, Mha

Patient Experience Journal

Several studies have indicated that providers that successfully implement patient-centered communication (PCC) practices related to health literacy and exemplify higher levels of empathy improve patient health outcomes. Time is frequently noted as a barrier when implementing PCC practices. The purpose of this study was to examine the role of time on the relationship between PCC and provider empathy. A cross-sectional study design was employed utilizing data from the 2019 Medical Expenditure Panel Survey-Household Component (MEPS-HC) and a supplemental survey, Self-Administered Questionnaire (SAQ), including a total of 6,459 patient respondents (N = 6,459). Structural Equation Modeling (SEM) was utilized for the …

Primary Care Productivity And Patient Satisfaction Community Practice: What Is The Relationship?, Thomas G. Howell Jr.

Patient Experience Journal

Research has shown a consistent positive association between patient and provider experience and improved patient outcomes and safety. There is a belief that patient satisfaction and physician productivity are competing interests. The relationship for primary care physicians, in a Midwest Health system was evaluated as part of this project. Data from Press Ganey patient satisfaction surveys on likelihood of recommending the practice and the physician were compared between primary care physicians in the top quartile of average monthly patient visits and those that were in the three lower quartiles. A secondary analysis of patient satisfaction scores related to continuous years …

The Perceived Usefulness Of Patient Narrative Feedback In Primary Care Settings, Sasmira Matta, Yuna S.H. Lee, Rachel Grob, Mark Schlesinger, Ingrid Nembhard

Patient Experience Journal

Research suggests that insights from patient narratives – stories about care experiences in patients' own words – contain information that can be used to improve care. However, assessments of narratives reported by clinical personnel have been mixed. This is the first study, to our knowledge, to systematically measure how useful personnel in primary care perceive patient narratives to be. We surveyed 276 clinical and administrative personnel in nine primary care clinics in a large health system in the United States. We found that perceived usefulness of patient narratives is generally high, but varies by individual characteristics such as level of …

Listening To The Unsaid: Utilizing Patient-Reported Outcome Measures (Proms) To Manage The Dental Anxiety Of A Special Child, Asiya Attar, Kasturi Shukla

Patient Experience Journal

This article is the journey of a dentist who adopted the additional role of a healthcare manager and embarked on a transformative journey to enhance the realm of pedodontics. The story describes how the care process and related experiences were improved for a special child who came anxious and worried to a dental office for treatment and returned with better outcomes. Dental anxiety is a known barrier to smooth dental care which is further amplified in children and more so for the special children. In addition to providing the best treatment, we ensured a worry-free environment to release the anxiety …

Research Imitates Life: Researching Within Your Lived Experience, Bethany Donaghy, Delane Linkiewich

Patient Experience Journal

This personal narrative article seeks to bring awareness to and provide an overview of the various aspects that come with being a lived experience researcher including the host of benefits and challenges that come with conducting research within one's own area of lived experience. Throughout this narrative, we (Bethany Donaghy, an autistic person, and Delane Linkiewich a person living with chronic pain) share our perspectives on what it is like to be lived experience researchers. Our narratives discuss how the many identities we hold both improve the impact and relevance of our research while also posing challenges for us like …

A Commitment To Experience Must Reach Across The Continuum Of Care, Jason A. Wolf Phd

Patient Experience Journal

A conversation on patient experience is not restricted to one care setting, nor should it be. People's healthcare journeys are not singular instances, but most often a series of encounters that while perhaps separate operationally from the delivery side of care, all weave together to frame one experience for a patient, their family members and care partners. This special issue purposefully takes us outside the traditional conversation space for experience, looking at segments of the care continuum including primary care, ambulatory care, free clinics and even dental care and the use of non-traditional care methods such as telehealth and app-based …