Medicine and Health Sciences Commons^™

Nutrition And Health Status Of Hemodialysis Patients In Dhaka, Bangladesh, Tanjina Rahman

Wayne State University Dissertations

Methods to identify patients at risk for End stage renal disease (ESRD) are a high priority in Bangladesh, where kidney transplants/dialysis options are limited and costly. Every year, 35,000 to 40,000 people reach ESRD in Bangladesh, but currently available facilities can hardly accommodate only 9000 to 10,000 new patients with twice weekly dialysis and the remaining 66% have no access to any kind of renal replacement therapy (RRT) in the form of dialysis or transplantation. Nutrition is an important factor in maintaining good health of hemodialysis patients. However, data on nutritional status of Bangladeshi dialysis patients is limited and is …

The Effects Of Postpartum Depression, Acculturative Stress, And Social Support On Mother-Infant Bonding Among U.S. Immigrant Women Of Arabic Descent, Darin Mansor Mathkor

Wayne State University Dissertations

Purpose and Background/Significance: The transition from “woman” to “mother” is a significant life event and can be extremely stressful when merged with the transition from ‘local’ to ‘immigrant’. The development of mother-infant bonding is considered a critical process in the postpartum period. Immigrant women have higher rates of PPD compared with women in their native countries. Among the general population, PPD is strongly associated with lower quality mother-infant bonding. Social support can play a central role in lowering the levels of PPD, and may contribute to higher quality of mother-infant bonding. Moreover, limited data suggests that acculturative stress is found …

An Occupational Hygiene And Safety Primer, Volume 2, Tim Ryan

OHIO Open Faculty Textbooks

Intended to teach the basic tenets of occupational hygiene and safety to a wide variety of undergraduate college students with quite diverse backgrounds, the information in these volumes is open-sourced from a variety of experts on the subject.

An Occupational Hygiene And Safety Primer, Volume 1, Tim Ryan

OHIO Open Faculty Textbooks

Intended to teach the basic tenets of occupational hygiene and safety to a wide variety of undergraduate college students with quite diverse backgrounds, the information in these volumes is open-sourced from a variety of experts on the subject.

First Pass Effect In Patients Treated With The Trevo Stent-Retriever: A Track Registry Study Analysis., Maxim Mokin, Christopher T Primiani, Alicia C Castonguay, Raul G Nogueira, Diogo C Haussen, Joey D English, Sudhakar R Satti, Jennifer Chen, Hamed Farid, Candace Borders, Erol Veznedaroglu, Mandy J Binning, Ajit Puri, Nirav A Vora, Ron F Budzik, Guilherme Dabus, Italo Linfante, Vallabh Janardhan, Amer Alshekhlee, Michael G Abraham, Randall Edgell, Muhammad Asif Taqi, Ramy El Khoury, Aniel Q Majjhoo, Mouhammed R Kabbani, Michael T Froehler, Ira Finch, Sameer A Ansari, Roberta Novakovic, Thanh N Nguyen, Osama O Zaidat

Articles, Abstracts, and Reports

Background and Objective: The first pass effect (FPE; achieving complete recanalization with a single thrombectomy device pass) has been shown to be associated with higher rates of good clinical outcomes in patients with acute ischemic stroke. Here, we investigate clinical and radiographic factors associated with FPE in a large U.S. post-marketing registry (TRACK, Trevo Stent-Retriever Acute Stroke). Methods: We analyzed the TRACK database (multicenter registry of 634 patients from 23 centers from March 2013 through August 2015), which 609 patients were included in the final analysis. FPE was defined as a single pass/use of device, TICI 2c/3 recanalization, and no …

Sando Pea: Between Tradition And Health Challenge Among Kaluppini Indigenous People, Nurbaya -, Wahyu Chandra

Antropologi Indonesia

Sando pea was a name for traditional birth attendants among Kaluppini people of South Sulawesi, Indonesia. The presence of traditional birth attendants was considered one of the factors that cause delays in accessing health facilities for mothers. It resulted in high maternal mortality rate, especially in developing countries, including Indonesia. The study aimed to explore and describe the role of traditional birth attendants among Kaluppini people and the health challenges faced by this community in accessing health facilities. Using qualitative approach, data were collected through indepth interviews and focus group discussions. A total of 6 sando peas and 67 mothers …

Characterization And Representation Of Patient Use Of Virtual Health Technology In Primary Care, Wen-Jan Tuan

MUSC Theses and Dissertations

Purpose. Advances in virtual care technology have made healthcare more convenient and accessible. The goal of this study was to elucidate current patient portal behaviors by examining the pattern of time and service type use of patients, via data provided by access logs within electronic health records, to increase communication and care coordination through online healthcare portals. Methods. We conducted a retrospective study of patients in an academic healthcare center over a 5-year period using access log records in electronic health records (EHR). Dimensionality reduction analysis was applied to group portal functionalities into more interpretable and meaningful feature domains, followed …

A Descriptive Case Study On Patient Flow At A Medical Center In A Resource-Limited Setting, Salman Moti

MUSC Theses and Dissertations

Medical centers operating in resource-limited settings face unique challenges associated with a scarcity of resources, expertise, and infrastructure. While inefficiencies can be identified in any organization, they can be particularly problematic for health care facilities that seek to expand the scope of their operations in resource-limited areas as resources that are already in short supply are utilized to fuel non-value-added activities. In this descriptive case study of a newly built medical center in Khorog, Tajikistan, we consider a medical center’s patient flow and the underlying systemic factors that contribute to the current state of affairs as well as interventions that …

A Mixed Methods Study To Investigate Barriers And Enablers To Nurses’ Implementation Of Nonpharmacological Interventions For Infants With Neonatal Abstinence Syndrome (Nas), Allison Suber Adrian

MUSC Theses and Dissertations

The national burden of Neonatal Abstinence Syndrome on individuals, families, and the healthcare system has reached epidemic proportion. The rising incidence of Neonatal Abstinence Syndrome significantly impacts healthcare utilization and costs due to increases in Neonatal Intensive Care Unit admissions and length of hospitalization, to the possible detriment of maternal-infant bonding. Because nonpharmacologic nursing care is not complicated by the potentially harmful side effects of pharmacological treatment, it should be considered the standard of care for opioid-exposed infants; therefore, a comprehensive understanding of the barriers and enablers to nurses’ implementation of nonpharmacological interventions for infants with Neonatal Abstinence Syndrome is …

The Interleukin-12 Family Of Cytokines And Receptor Signaling In Graft-Versus-Host Disease, David Bastian

MUSC Theses and Dissertations

Allogeneic hematopoietic stem cell transplantation (allo-HCT) is an effective means by which to treat a wide variety of diseases resulting from dysfunctional hematopoiesis due to a potent anti-tumor response known as the graft-versus-tumor (GVT) effect after chemotherapy and/or irradiation. The necessity of donor T cells to mediate GVT is offset by the consequential development of graft-versus-host disease (GVHD); a leading cause of mortality among allo- HCT recipients. The IL-12 family of cytokines signals through Janus Kinase 2 (JAK2) and is comprised of IL-12, IL-23, IL-27, IL-35 and IL-39. IL-12 (p35+p40) and IL-23 (p19+p40) have well documented proinflammatory functions responsible for …

Neuromodulation Of Spinal Pathways Involved In Chronic Pain: Implications For Motor Rehabilitation, Taylor Ray Mayberry

MUSC Theses and Dissertations

No abstract provided.

Unintended Consequences Of Population Health In Medical Home Contracts With Mcos To Improve Quality Of Care, Mildred Scott

MUSC Theses and Dissertations

Public policy efforts to improve population health are important. However, any public policy may have unintended consequences, and the risk of these side-effects may be substantial if they include payment incentives to providers or economic incentives for patients. A recent policy initiative The Population Health Medical Home Contracts with MCOs to Improve Quality of Care is the focus of this study. The Center for Medicare and Medicaid Services (CMS) implemented a quality initiative to improve the quality of healthcare and services for patients with Medicare and Medicaid benefits to improve Healthcare Effectiveness Data and Information Set (HEDIS) Measures. As a …

Obesity In The Geriatric Population, Candace Glaze

MUSC Theses and Dissertations

This retrospective cross-sectional study focused on patients who were 65 years and older who have Medicare and an ICD10 code of obesity. The study uses archival billing data from the 2017 Medicare 5% Limited Data Set to examine use of bariatric surgery. This study examined the different characteristics (geographic region, age, sex, co-morbidities) for all patients with a BMI greater than 40 who had bariatric surgery in 2017 compared to patients with a BMI greater than 40 who did not receive a surgical intervention. Results found that patients who are female are associated with higher odds of receiving bariatric surgery. …

Cost And Variations In Trauma Types For Pediatric Er Visits By South Carolina County, Cokeitha James Gaddist

MUSC Theses and Dissertations

Children between the ages of 0 to 19 are treated in South Carolina emergency rooms (ER) and hospitals for unintentional injuries at an alarming rate which contributes to high medical cost and high mortality and morbidity rate. The objective of the study is to examine ER visits and hospital discharge data for pediatric patients in South Carolina by county to identify trauma types for unintentional injuries, cost, distribution by high-risk populations and by rural or urban classification to determine appropriate interventions. This is a quantitative study using retrospective analysis of archival data from ER visits and hospital discharge data for …

Determination Of N-Linked Glycosylation Changes In Hepatocellular Carcinoma And The Associated Glycoproteins For Enhanced Biomarker Discovery And Therapeutic Targets, Connor Allen West

MUSC Theses and Dissertations

With hepatocellular carcinoma (HCC) remaining as the fifth most common cancer in the world, causing more than 700,000 deaths annually, the need for reliable, early stage diagnoses and preventive treatments is crucial. While serum glycoproteins are hepatic in origin, making them excellent targets for HCC biomarkers, they can originate from both cancerous and non-cancerous regions and direct analysis of cancerous tissue itself is lacking. To counteract this, I hypothesized that direct tissue analysis combined with proteomic analysis could be utilized to identify more potential targets specific to HCC for early detection. This was done with a primary focus on glycosylation—as …

Mitigating The Risk Of Financial Distress And Closure In Rural Hospitals: A Multiple Case Study, Christopher Brian Wiggs

MUSC Theses and Dissertations

Few studies have explored strategies rural hospitals have implemented to lower the risk of financial distress and closure. The objective of this doctoral project is to explore factors rural hospital stakeholders consider when determining the most appropriate business model for their organization. A multiple case study design was utilized to explore key factors considered in the decision-making processes at three rural hospitals in the southeastern Unites States with varying business models and characteristics. Nine rural hospital stakeholders including administrators, clinician, and community leaders participated in semi-structured interviews. Interviews were recorded, transcribed, and analyzed using an inductive coding process. Seven themes …

Inhibition Of Penicillin-Binding Protein 2: Toward New Therapeutics For Antimicrobial-Resistant Gonorrhea, Jonathan M. Turner

MUSC Theses and Dissertations

Gonorrhea is the second most common sexually transmitted bacterial infection in the United States, with nearly 600,000 cases reported in 2018 by the Centers for Disease Control. Alarmingly, the causative agent Neisseria gonorrhoeae has developed resistance to a number of antimicrobials over the last century. With limited options remaining, the CDC now recommends dual therapy with ceftriaxone and azithromycin to decrease the likelihood of resistance development. However, strains with combined cephalosporin and macrolide resistance have now emerged, raising concerns of a post-antibiotic future in which untreatable gonorrhea would impose enormous human and economic cost. The discovery and development of novel …

Relationship Between Nurse Job Satisfaction Variables And Voluntary Turnover Intention, Mmayen Monday Nnah

Walden Dissertations and Doctoral Studies

Increased turnover among hospital nurses has adverse business outcomes. Hospital nurse managers are concerned with minimizing turnover to reduce hospital costs, lower risk to patients, and positively impact hospital performance. Grounded in motivation-hygiene theory, the purpose of this quantitative correlational study was to examine the relationship among nurses' views of the quality of work environments, level of management support, opportunities for promotion, and nurses' voluntary turnover intentions. Data were collected from nurses with registered nurse status or a bachelor of science in nursing degrees working in hospital settings in the United States (N = 82), who completed the Job Satisfaction …

Type 2 Diabetes Prevention And Management Educational Toolkit, Theresa O. Orjiakor

Walden Dissertations and Doctoral Studies

AbstractDiabetes is one of the chronic diseases that are challenging to prevent and manage. Approximately 8.3% of the United States' population has type 2 diabetes. One of the primary challenges in managing the disease entails reducing the associated financial and human costs by preventing new cases and enacting social change. Prevention and management education programs using enhanced toolkit may have positive effects on type 2 diabetes patients, who start enjoying a good quality of life, as well as positive social change in their communities and families. The purpose of this project was to develop and evaluate a type 2 diabetes …

Nursing Clinical Practice Guideline Development For The Care Of Sexual Assault Survivors, Elssy J. Bingham

Walden Dissertations and Doctoral Studies

Sexual assault, a form of sexual violence, is an egregious crime that continues to be a serious and significant public health problem which affects millions of people each year in the United States and globally. Sexual assault may have lasting and devastating negative physical and emotional consequences. Knowledgeable nurses can have a positive impact on a survivor’s safety and recovery. The purpose of this project was to develop a Clinical Practice Guideline (CPG) for nurses who provide the initial care when patients present in the emergency room following sexual assault. The conceptual framework used for this project included Knowle’s Theory …

Program Evaluation Of A Home-Based Primary Care Practice And Patients With Heart Failure, Anne Rose Walsh

Walden Dissertations and Doctoral Studies

Heart failure (HF) affects over 5.5 million adults in the United States with a prevalence of 10%'€“20% in older adults and accounts for 3% of all hospital admissions with a readmission rate as high as 25% within 1 month of discharge. Patients with HF account for approximately 42% of the doctor of nursing practice project site's patient population, and the health system has a 30-day readmission rate of 35% for patients with HF in 2 large hospitals. Thus, the health system loses almost $13 million per year in Medicare penalties. This retrospective quality improvement project reviewed the effectiveness of care …

Pressure Injury Prevention In An Urban Surgical Intensive Care Unit, Kayma P. Ricks

Walden Dissertations and Doctoral Studies

Hospital-acquired pressure injuries (HAPIs) affect approximately 2.5 million patients in the

United States, annually. Prevention requires surgical intensive care unit (SICU) nursing staff to

effectively use evidence-based risk assessment measures to appropriately identify patients at risk

for developing HAPIs and to prevent poor patient outcomes. The Braden Scale risk assessment

tool has demonstrated reliability and validity in the prediction and assessment of patients at risk

for the development of HAPIs. The purpose of this Doctor of Nursing Practice (DNP) project

was to improve nurses’ knowledge of the appropriate use of the Braden Scale risk assessment

tool in the SICU of …

Strategies To Retain Mental Health Workers In Community Mental Health Clinics, Debbie L. Young

Walden Dissertations and Doctoral Studies

In 2017, the United States employee turnover rate for mental health workers with 2 or more years of experience was more than 50%. High turnover rates among these mental health workers are associated with inadequate quality of care for patients with mental health issues in community mental health clinics. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative multiple case study was to explore retention strategies used by health care administrators to retain their mental health workers with more than 2 years of experience. The participants consisted of 6 health care administrators who successfully implemented strategies to minimize high …

Managing Disruptive Patient Behaviors In A Mental Health Clinic: A Staff Education Program, Mary Odusanya

Walden Dissertations and Doctoral Studies

Disruptive patient behavior is a significant issue in healthcare. Staff education programs are beneficial in managing disruptive patient behaviors. There has been an increase in the occurrence of disruptive patient behaviors at the clinical site, which is an outpatient mental health clinic, and staff members are not well equipped to deal with these situations. The purpose of this project was to develop, implement, and evaluate a staff education program on how to manage disruptive patient behaviors in an outpatient mental health clinic. Using a pre- and posttest design, the project aimed to answer the question of whether a staff education …

Rural Practical Nursing Students' And Faculty Members' Perceptions Of Supports And Barriers To Success, Amy J. Randall-Mcsorley

Walden Dissertations and Doctoral Studies

Practical nursing program students at a rural vocational school (RCC) in the midwestern United States were graduating at a low rate that was putting the school at risk to not meet accreditation standards set by the Council on Occupational Education. The purpose of this study was to explore the perceptions of practical nursing program students and faculty at RCC about institutional, situational, and dispositional supports and barriers students faced toward graduation. The conceptual framework, Cross’s model of barriers to adult learning, was used to identify institutional, situational, and dispositional supports and barriers. A bounded case study design was employed to …

Addressing Cardiovascular Disease Among Populations Disproportionately Impacted In The United States, Michael Leron Sells

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) causes the most deaths in the United States and is disproportionately impacting certain groups more than others. A gap in the research exists when focusing on national data for those who bear the highest burden of CVD amongst people with hypertension when cardiovascular morbidity and mortality are examined. There is also a need to investigate the relationships between key indicators for CVD health disparities in people with hypertension. The purpose of this quantitative study is to investigate the cumulative effect of key health disparities indicators such as race, age, gender, education, and income using national-level surveillance data …

Effectiveness Of Education On Modified Early Warning System For Nurses, Shanmugavalli Janakaraj

Walden Dissertations and Doctoral Studies

The research problem at the practicum site was a delay in recognizing patient’s deterioration due to lack of nurses’ knowledge with early warning signs. It is important to address the problem as the Quality Department noted the delay in identification of patient decline and treatment from mortality case reviews, rapid response team and Code Blue debriefing analysis and missed sepsis identification. A further gap analysis revealed an inadequacy of staff knowledge with warning signs. The purpose of this project was to educate nurses on the Modified Early Warning System (MEWS), a patient assessment scoring system based on six physiological parameters. …

An Interpretive Qualitative Study Of Idaho Head Start Families Facing Food Insecurity, Sherry Deiter

Walden Dissertations and Doctoral Studies

The purpose of this basic interpretive qualitative study was to examine food insecurity among Idaho Head Start enrolled families, focusing on barriers and deterrents to accessing available nutrition assistance programs. The social-ecological model (SEM) was used as the theoretical foundation for this study. Based on this model, the research questions were designed to explore experiences of participants related to individual, interpersonal, community, organizational, policy, and educational factors that influenced food insecurity. Parents who had children enrolled in Idaho Head Start programs that met purposeful sampling criteria were recruited for the study. A total of 11 parents, all who had experiences …

Perceptions Of Health Care Professionals Providing Smoking Cessation In Health Care Settings, Dr. Tenishia Tamika Edwards

Walden Dissertations and Doctoral Studies

Tobacco use affects many individuals in the United States and around the world, particularly those who have existing health disparities. Smoking cessation therapy is a process used by health care professionals (HCPs) to help aid in the reduction or elimination of tobacco use. HCPs providing this service in health care settings can reach patients directly while helping to decrease the mortality rate in those who use tobacco. The purpose of this phenomenological qualitative study was to identify HCPs’ perceptions of patient barriers to adherence to smoking cessation services and what can be done to improve smoking cessation in health care …

Accelerated Baccalaureate Nursing Student And Faculty Perceptions Of Blended Learning, Emily Elliott

Walden Dissertations and Doctoral Studies

In response to the demand for baccalaureate-educated nurses, nursing schools offer an accelerated baccalaureate of science in nursing (BSN). The problem is nursing programs have used blended learning approaches, but it is unclear whether and in what ways accelerated BSN students benefit from this learning design. The purpose of this qualitative case study was to explore how faculty and students perceived the benefits and challenges of an accelerated BSN program utilizing a blended learning format. Knowles’s adult learning theory served as the conceptual framework through which interview data were analyzed. Participants included 6 faculty and 7 students from 1 school …