Medicine and Health Sciences Commons^™

A Rapid Review Of Physician Burden Secondary To Electronic Health Records Use In The United States From 2015 To 2020, Lori Wong

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: After the passing of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, there has been a tremendous increase in the number of hospitals and providers adopting and using Electronic Health Records (EHRs). While EHRs were a way of improving efficiency, quality, and safety of healthcare, there is emerging evidence that they are contributing to physician burden, which can take the form of increased workload, decreased satisfaction, negative attitudes, and burnout. For instance, Arndt et al. found that physicians spent half of their workday on the EHR during and after work, and Robertson et al. …

Hospital-Based Safe To Sleep Intervention To Decrease Sleep-Related Infant Deaths In St. Louis, Missouri, Olivia M. Pokoski

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The city of St. Louis in Missouri has an elevated infant mortality rate compared to St. Louis County, Missouri, and the United States. When controlling for race, black or African American infants are over twice as likely to die before their first birthday compared to their white counterparts. Two of the leading causes of infant death are sleep-related causes and sudden infant death syndrome (SIDS) which occur if the infant is placed in an unsafe sleeping environment. To address this burden Affinia Healthcare, Barnes Jewish Hospital, and St. Mary’s Hospital have decided to implement a hospital-based Safe to Sleep campaign. …

Growing Green Minds: Implementation Of A School Garden & Nutrition Program For The Freedom Area School District In Rural Wisconsin, Marissa Schuh

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Most children in the U.S. consume too few fruits and vegetables which is putting them at risk to develop obesity and other lifestyle diseases. The 2015-2020 Dietary Guidelines for Americans recommends that individuals should increase the amount and variety of fruits and vegetables consumed in order to prevent weight gain and other chronic diseases. Research shows that garden-based educational programs can increase children’s fruit and vegetable intake as well as change their preferences and attitudes towards eating and trying new fruits and vegetables. Incorporating a garden and nutrition curriculum into a school setting is an ideal opportunity to improve children’s …

Implementing The Fit And Strong! Program To Reduce Osteoarthritis In The Older Adult Population Of Carmel, Indiana, Lauren Alexis Bergstrom Roach

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Osteoarthritis is a health outcome most commonly experienced by older adults. As the “baby boomer” population continues to age, the demand for services for older adults also increases. Fit and Strong! is an evidence-based program that works to reduce symptoms of osteoarthritis in this population through an 8-week course of physical activity classes, taught by Fit and Strong! certified instructors. Carmel, Indiana, a city in Hamilton County, has a high percentage of older adults within its population, and community health needs assessments have indicated that Hamilton County citizens have repeatedly expressed a need for resources for older members of the …

Associations Between Occupational Therapy Students’ Approaches To Studying And Their Academic Grade Results: A Cross-Sectional And Cross-Cultural Study, Tore Bonsaksen, Ted Brown, Hua B. Lim, Kenneth Fong, Milada C. Småstuen

Journal of Occupational Therapy Education

Students’ approaches to studying are generally viewed as essential for their learning outcomes and are often described as being either deep, strategic or surface. However, research on associations between study approaches and academic outcomes among occupational therapy students are rare, as are studies that include cross-cultural comparisons. The objective of this study was to assess the degree to which the deep, strategic, and surface approaches to studying were associated with occupational therapy students’ grade point average, in the total sample and when stratified by country, while controlling for age, gender and time spent on independent study. Seven hundred and twelve …

The Subject-Centered Integrative Learning Model: A New Model For Teaching Occupational Therapy’S Distinct Value, Barb Hooper, Matthew Molineux, Wendy Wood

Journal of Occupational Therapy Education

The concept of occupation-centered education has been used to describe what programs do when they infuse occupation throughout an occupational therapy curriculum. In describing occupation-centered education, educators often describe the strategies they use to help students learn occupation, including courses about occupation, direct experience with occupation, cases and questions that connect biomedical sciences and health conditions to occupation, assignments that require students to infuse occupation into therapy, curriculum threads related to occupation, and many others. While each of these strategies is important, no conceptual model exists that defines occupation-centered education, elaborates its concepts and principles, and guides the development of …

Domestic Military Operations And The Coronavirus Pandemic, Mark P. Nevitt

Faculty Articles

In response to the novel coronavirus crisis, we are witnessing one of the largest domestic military operations in American history. This article proceeds in three parts. Part I considers the emergency authorities invoked to address the coronavirus, including the Public Health Service Act (PHSA), National Emergencies Act (NEA), and Stafford Act. Part II deals with the laws, regulations, and policies governing the military’s role as a law enforcer— including restrictions on the military’s role to quell civilian disturbances. I also briefly discuss martial law, a rarely invoked but powerful authority held at the federal, state, and local levels. Part III …

Against The "Safety Net", Matthew B. Lawrence

Faculty Articles

Then-Representative Jack Kemp and President Ronald Reagan originated the “safety net” conception of U.S. health and welfare laws in the late 1970s and early 1980s, defending proposed cuts to New Deal and Great Society programs by asserting that such cuts would not take away the “social safety net of programs” for those with “true need.” Legal scholars have adopted their metaphor widely and uncritically. This Article deconstructs the safety net metaphor and counsels against its use in understanding health and welfare laws. The metaphor is descriptively confusing because it means different things to different audiences. Some understand the safety net …

Reflections On The Effects Of Federalism On Opioid Policy, Matthew B. Lawrence

Faculty Articles

One thing we have seen today that we talk about in health law all the time is how the policy, the laws and institutions up at the 10,000 foot level, can so dramatically influence the personal, people’s lived experiences. Our speakers today have done a really great job of drawing out abstract institutional questions and also showing us how those questions have influenced the lives of real people in often tragic ways. Another thing we have seen that we talk about in administrative law all the time is the importance of expertise, especially given how hard it is to trace …

Changing The Subject Of Sati, Deepa Das Acevedo

Faculty Articles

Charan Shah's 1999 death was widely considered to be the first sati, or widow immolation, to have occurred in India in over twenty years. Media coverage of the event focused on procedural minutiae-her sari, her demeanor-and ultimately, several progressive commentators came to the counterintuitive conclusion that the ritually anomalous nature of Charan's death confirmed its voluntary, secular, and noncriminal nature. This article argues that the "unlabeling" of Charan's death, like those of other women between 1999 and 2006, reflects a tension between the nonindividuated, impervious model of personhood exemplified by sati and the particularized citizen-subject of liberal-democratic politics in India.

Essentializing Labor Before, During, And After The Coronavirus Pandemic, Deepa Das Acevedo

Faculty Articles

In the era of COVID-19, the term essential labor has become part of our daily lexicon. Between March and May 2020, essential labor was not just the only kind of paid labor occurring across most of the United States; it was also, many argued, the only thing preventing utter economic and humanitarian collapse. As a result of this sudden significance, legal scholars, workers’ advocates, and politicians have scrambled to articulate exactly what makes essential labor “essential.” Some commentators have also argued that the rise of essential labor as a conceptual category disrupts—or should disrupt—longstanding patterns in the way the nation …

Examining The Relationship Between Adverse Childhood Experiences (Aces) And Health-Risk Behaviors Among Adolescents In New Hampshire, Riana S. Malik

Honors Theses and Capstones

Adverse Childhood Experiences (ACEs) are traumatic instances in the first 18 years of life including abuse, neglect, and household dysfunction. The Centers for Disease Control and Prevention (CDC) has outlined priority health-risk behaviors among adolescents as substance use, violent behaviors, unhealthy diet, physical inactivity, and unsafe sexual behaviors. Previous research has linked both ACEs and health-risk behaviors to negative health outcomes including disability, chronic disease, and substance use. That said, understanding and preventing risky behaviors among adolescents and working to reduce the lasting harm caused by ACEs can lead to healthier adults and communities going forward.

This research defines ACEs …

Effect Of Bubaline Blood-Derived Platelet Rich Fibrin (Prf) In Canine Periodontitis, Poranee Banyatworakul

Chulalongkorn University Theses and Dissertations (Chula ETD)

Periodontal disease is one of the most common oral disease in elderly dogs. The effect of periodontal disease is generalized contribute to several systemic conditions. Bioactive surgical additives have been introduced in small animal treatment to reduce inflammation and to enhance periodontal healing. Platelet-rich fibrin (PRF), a clumping of platelets, leucocyte, growth factors and cytokines trapping in a dense fibrin meshworks, is considered as a novel healing biomaterial. Autologous PRF have been demonstrated an excellent response in canine periodontal regeneration. However, a complicated health status should be concerned to obtain a high volume. Xenogenic blood donor is now focusing to …

Genetic And Pathological Investigations Of Viruses In Rabies-Negative Brain Of Cats And Dogs, Sabrina Wahyu Wardhani

Chulalongkorn University Theses and Dissertations (Chula ETD)

All year round, The Thai Red Cross Society received more than 100 animal samples that were suspected for rabies to be tested. Most of these animals were suspected for rabies due to the clinical signs of neurological disorder they developed before they die. Interestingly, in greater number of cases, rabies infection was ruled out as the cause of neurological disorder by direct fluorescent antibody test (dFAT). In respect to the importance of virus in the outcome of neurological disorder, this study was initiated to investigate the underlying cause of viral infection in the brain of rabies-negative cats and dogs that …

Effect Of Foam Pad Balance Exercise In Individual With Cancer Undergoing Chemotherapy, Chanatsupang Saraboon

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: People with cancer undergoing chemotherapy usually report a decline in balance and physical function. Foam pad balance exercises improve balance and physical function in older adults. This study aimed to examine the effect of foam pad balance exercise on balance, physical function, peripheral neuropathy, and quality of life in people with cancer undergoing chemotherapy. Methods: Thirty participants were divided randomly into 2 groups: control group (CG) and balance exercise group (BG). The BG were asked to perform foam pad balance exercises 60 minutes/day, twice a week for 6 weeks, and conventional therapy. The CG was given conventional therapy only. …

Clinical Outcomes Of Implantoplasty In The Treatment Of Peri-Implantitis: A Systematic Review, Jonghann Chai

Chulalongkorn University Theses and Dissertations (Chula ETD)

Peri-implantitis is a biological complication that possibly occur following the placement of titanium dental implants. Treatments include both non-surgical and surgical modalities. During surgical procedure, several techniques have been introduced to decontaminate the infected implant surface. The aim of this systematic review was to assess the effectiveness of the implantoplasty technique in the treatment of peri-implantitis, by investigating the changes in the clinical and radiographic parameters of peri-implant tissues after treatment and assessing both the short and long-term implant survival following the implantoplasty. A systematic review was conducted by searching electronic online (PubMed, Scopus, EMBASE) databases, published between January 2000 …

ฤทธิ์การต้านมะเร็งของสารไบแซนโทนจากไลเคน Usnea Aciculifera ต่อเซลล์มะเร็งลำไส้ใหญ่และทวารหนักของมนุษย์, ณัฏธิดา เมฆสุกใส

Chulalongkorn University Theses and Dissertations (Chula ETD)

ไบแซนโทน (Bixanthones) เป็นกลุ่มสารชีวสังเคราะห์ที่มีโครงสร้างทางเคมีหลักเป็น xanthone ซึ่งเกิดจาก xanthone monomer สองโมเลกุลมาเชื่อมต่อกันด้วยพันธะแบบต่างๆแล้วเกิดเป็นสารไบแซนโทนขึ้นหลากหลายชนิดและสามารถพบได้ในแหล่งธรรมชาติ ได้แก่ พืช เชื้อรา และไลเคน ฤทธิ์ทางเภสัชวิทยาหลักของสารกลุ่มนี้ที่พบ ได้แก่ ฤทธิ์ต้านจุลชีพ ฤทธิ์ต้านอนุมูลอิสระ และฤทธิ์ต้านมะเร็ง จากการศึกษาที่ผ่านมาพบว่า สารไบแซนโทนที่สกัดได้จากพืชและเชื้อราหลายชนิดมีฤทธิ์ในการต้านเซลล์มะเร็งต่างๆ ได้ เช่น เซลล์มะเร็งเม็ดเลือดขาว (P388) เซลล์มะเร็งปอด (LL2 และ H520) เซลล์มะเร็งเต้านม (MCF-7) เซลล์มะเร็งหลอดอาหาร (TE1 และ KYSE-150) และเซลล์มะเร็งต่อมลูกหมาก (DU-145) เป็นต้น แต่อย่างไรก็ตามยังไม่เคยมีรายงานการศึกษาฤทธิ์ต้านมะเร็งและกลไกการออกฤทธิ์ของสารไบแซนโทนที่สกัดได้จากไลเคนในเซลล์มะเร็งลำไส้ใหญ่และทวารหนักมาก่อน ในงานวิจัยนี้จึงสนใจที่จะศึกษาฤทธิ์ต้านมะเร็งของสารไบแซนโทนทั้ง 8 ชนิดที่สกัดได้จากไลเคน Usnea aciculifera ในเซลล์มะเร็งลำไส้ใหญ่และทวารหนัก ได้แก่ เซลล์ HT-29 ผลการศึกษาพบว่า สารไบแซนโทนสองชนิด ได้แก่ TT-03 และ TT-08 สามารถยับยั้งการรอดชีวิตและมีความเป็นพิษต่อเซลล์มะเร็ง HT-29 มากที่สุด โดยพบว่า สารไบแซนโทน TT-08 มีความเป็นพิษต่อเซลล์ปกติ PCS201-010 น้อยกว่าสารไบแซนโทน TT-03 และมีค่าดัชนีความจำเพาะ (selectivity index) ของเซลล์ลำไส้ปกติ CRL-1790 ต่อเซลล์มะเร็ง HT-29 เท่ากับ 1.95 ดังนั้นผู้วิจัยจึงเลือกสารไบแซนโทน TT-08 มาทำการศึกษาต่อไป จากการศึกษาต่อในระดับเซลล์และโมเลกุล พบว่า สารไบแซนโทน TT-08 มีความเป็นพิษต่อเซลล์มะเร็ง HT-29 แปรผันตามความเข้มข้นและระยะเวลาที่ใช้ทดสอบโดยมีค่าความเข้มข้นที่ทำให้เซลล์ตายร้อยละ 50 เท่ากับ 3.87± 0.13, 2.05 ± 0.06 และ 1.51± 0.11 ไมโครโมลาร์ หลังจากได้รับสารนาน 24, 48 และ 72 ชั่วโมง และสามารถยับยั้งการเจริญเติบโตของเซลล์มะเร็งผ่านการชักนำให้เกิดการหยุดของวัฏจักรเซลล์ที่ระยะ S …

The Relationship Between Oral Health Literacy And Periodontal Health Status Among The Elderly In Panare, Pattani, Thailand, Panat Piyakhunakorn

Chulalongkorn University Theses and Dissertations (Chula ETD)

This study aimed to determine the association between oral health literacy (OHL) and periodontal status among Thailand's older population. This cross-sectional study was conducted between 1 July and 30 September 2020 at HPHs in, Panare, Pattani, Thailand. A total of 216 independent living older adults, participated in the study. OHL data were obtained using the Thai version of Health Literacy in Dentistry (HeLD‐Th). Trained interviewers performed face-to-face interviews for oral health-related behaviours information. The periodontal status was collected through intra-oral examination by a calibrated examiner. Data were analyzed using the SPSS version 22. Mann–Whitney U tests, Chi-Square tests, and Binary …

Effects Of Correction Of Scapular Alignment On Pain And Cervical Range Of Motion In Patients With Neck Pain And Depressed Scapula, Siwaluk Srikrajang

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: A depressed scapular position has been proposed to be associated with cervical disorders. Active scapular correction is suggested as a potential intervention that may improve symptoms for patients with neck pain. The purpose of this research was to examine the effects of active scapular correction on cervical range of motion (ROM), pain, and pressure pain threshold (PPT) in chronic neck pain with the depressed scapula. Methods: This research consists of two studies. Study I: A randomized control trial was conducted in 46 participants with chronic neck pain and depressed scapula. Participants were randomly assigned into either the intervention (n …

Modification Of Cognitive Impairment Screening Tool On Smart Device For Thai Elderly, Pipuchana Phowwiboon

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: At present, the number of elderly people is constantly increasing all over the world. Therefore, we need to prepare for this change. Technology is now a vital part of every aspect of life, including health. For this reason, the researchers have developed an application used in the field of health as a tool to assist in assessing dementia in the elders. It is quick to combine the scores and record the elders' information, which is likely to benefit healthcare workers. Objective: To determine the construct validity of modification of cognitive impairment screening tool on smart devices compared with the …

Factors Related To Physical Therapy Management In Patients With Knee Osteoarthritis, Patsakon Saisuri

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Most physical therapists in developed countries use evidence-based physical therapy for patients with knee osteoarthritis (OA). Conversely, little is known concerning treatment used by Thai physical therapists (PTs) in such patients. Objective: To study the relationship among characteristics of PTs, patients with knee OA, and type of physical therapy treatments. Methods: This survey applied three sets of questionnaires to collect data. Questionnaire Set-A collected PTs’ information and experience in treating knee OA. Questionnaires Set-B collected patients’ information regarding history of knee OA, pain, disability, and function (using pain scale and the modified Thai version of the Western Ontario and …

Immediate Effect Of Pain Relief By Ultrasound In Individuals With Sub-Acute Ankle Sprain: A Randomized-Controlled Trial, Thongchai Suksri

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Ultrasound therapy (US) is commonly used to treat ankle sprain. However, there is a lack of evidence concerning the analgesic effect of US on subacute ankle sprain. Objective: To investigate the immediate effect of US on pain, ankle range of motion (ROM), and plantar pressure in individuals with unilateral subacute ankle sprains. Methods: Fifty-four participants with unilateral subacute ankle sprains (aged 16-55 years) were recruited and randomly allocated into 2 groups: treatment group (n = 27) and control group (n = 27). A single intervention session was applied in both groups. The treatment group was treated with US, whereas …

Optimising Subjective Anterior Eye Grading Precision, Marta Vianya-Estopa, Manbir Nagra, Arnold Cochrane Arnold Cochrane, Neil Retallic Neil Retallic, Dean Dunning, Louise Terry Louise Terry, Aoife Lloyd, James Wolffsohn

Articles

To establish the optimum grading increment which ensured parity between practitioners while maximising clinical precision.

Clinical And Neurophysiological Effects Of Dry Needling On Individuals With Chronic Ankle Instability, Jennifer Mullins

Theses and Dissertations--Rehabilitation Sciences

Ankle sprains are generally considered innocuous injuries; however, as many as 74% of patients will develop chronic symptoms. 1-3 Chronic ankle instability (CAI) is defined by a history of ankle sprain accompanied by ongoing bouts of giving way, residual ankle sprain symptoms, and a decrease in patient-perceived function. As understanding of sensorimotor deficits in individuals with CAI have advanced, treatment strategies have evolved to include a robust focus on balance training to mitigate dynamic and static postural control impairments exhibited in individuals with CAI. A problem arises as these improvements have not been conclusively linked to a decrease in CAI. …

The Effects Of Three Service Delivery Models On Vocabulary Learning By Second-Grade Children, Laura Stone

Theses and Dissertations--Rehabilitation Sciences

Speech-Language Pathologists (SLPs) provide services to children in schools across the United States primarily in a direct small group service delivery model outside of the regular education classroom. To date little research exists to indicate that direct pull-out service delivery is an effective model in elementary schools for students requiring speech and language therapy. One area that has been studied is the effectiveness of vocabulary intervention among service delivery models. Preliminary findings suggest that students with language and literacy deficits learn vocabulary well within a regular education environment with SLP support. However, there is little consensus on how service delivery …

Effects Of Load Carriage On Shoulder Neuromuscular Functions And Recovery, Muataz R. Almaddah

Theses and Dissertations--Rehabilitation Sciences

Load carriage is a primary source for injury occurrence among military personnel and recreational hikers affecting all body areas. The shoulder ranks as the second or third most common site of injuries among military personnel. Many studies report that elevations in self-reported fatigue, soreness, and discomfort in the shoulders accompany the load carriage. Almost 50% of military personnel experienced a load carriage injury during the first episode of training, and 75% of those injured suffered a second injury during their career. The goal of this research project is to investigate the components associated with load carriage shoulder symptoms to determine …

Biopsychological Predictors Of Pain And Function In Patients With Rotator Cuff Conditions, Nicole Cascia

Theses and Dissertations--Rehabilitation Sciences

Predicting worse patient-reported outcomes in those with Rotator Cuff (RC) conditions is dependent on examining both biological and psychological impairments. In order to help determine which biopsychological factors are associated with pain and function in patients with RC related conditions and to determine who may be at an increased risk for worse outcomes after Reverse Shoulder Arthroplasty (RSA), biopsychological associations between patient demographics, scapular motion, humeral motion, RC tear size, pain associated psychological distress, and function were clinically evaluated to investigate prediction models for pain and function. The central hypothesis is that in a group of patients with symptomatic Cuff …

Vestibular Function And Sports-Related Concussion: An Exploratory Investigation Of The Consequences Of Sports Related Concussion On Vestibular Function And Outcomes, Carolina Quintana

Theses and Dissertations--Rehabilitation Sciences

Sports-related concussions (SRC), or mild traumatic brain injuries that occur as a result of sports or athletic participation, are said to affect approximately 300,000 young adults and 1.4 million youth athletes in the United States on an annual basis. SRC create a significant burden on the health care system by generating an estimated $60 billion dollars in direct and indirect costs in 2000. In addition to the financial burden these injuries create, they additionally impose both short- and long-term effects for those effected and their overall health. Among the many effects of concussions are physical signs as symptoms such as …

Physical And Occupational Therapy For Young Children With Delayed Motor Development: Exploring Current Practices, Challenges, And Families’ Implementation Of Home Activities In Early Intervention, Afnan Gmmash

Theses and Dissertations--Rehabilitation Sciences

The literature supports the use of family-centered early intervention(EI) for young children with or at risk for cerebral palsy (CP) to promote the children’s motor development. Young children with or at risk for delayed motor development in their first three years of life are entitled to EI under Part C of The Individuals with Disabilities Education Improvement Act. Identifying current EI provided for young children with delayed motor development is essential to detect possible gaps and factors that could prevent therapists from providing the best EI. Understanding the parent’s perspective on the implementation of activities outside therapy to maximize the …

Anterior Cruciate Ligament Injury-Induced Alterations In Inflammation And Muscle Physiology, Emily R. Hunt

Theses and Dissertations--Rehabilitation Sciences

Long term weakness and atrophy of the quadriceps muscle are a direct result of anterior cruciate ligament (ACL) injuries and persist for up to 10 years post injury. Muscle atrophy ensues regardless of ligamentous reconstruction surgery, indicating that muscle atrophy following injury is a function of the ligament rupture and not reconstruction surgery. Elucidating the mechanisms underlying quadriceps atrophy following ACL rupture is crucial for developing interventions to restore proper quadriceps size and mitigate weakness thereby allowing for improved patient function. In addition to understanding the specific mechanisms that contribute to quadriceps atrophy following ACL rupture, the timing of atrophic …