Medicine and Health Sciences Commons^™

Creating Buy-In From Nurse Leaders To Implement Inpatient Education And Screening For Human Trafficking: A Quality Improvement Initiative, Andrea Macdonald

DNP Scholarly Projects

BACKGROUND: Human trafficking is an under-recognized healthcare issue affecting an

estimated 20 to 40 million individuals globally. Professional nursing organizations, healthcare

regulatory bodies and legislators have declared the need for education and screening practices. A

quality improvement initiative designed to create buy-in from nurse leaders to create and

implement education, screening and a protocol to guide care of human trafficking victims who

may present to inpatient and clinic settings at the organization was developed to bridge gaps in

knowledge and inform evidence-based practice.

METHODS: Literature review informed the development of an education intervention presented

to nurse leaders using multi-modal learning …

Integrating Yoga Into A Medication Assisted Treatment Program To Improve Retention, Linda Davidson

DNP Scholarly Projects

Background: In 2017, Health and Human Services declared the opioid epidemic a public health emergency (US Department of Health & Human Services, 2017). As a response, access to medication assisted treatment (MAT) programs was encouraged. In 2016, a community health center in Western North Carolina started a MAT program integrating buprenorphine treatment with behavioral health (BH) services. Data from May 2018 through May 2019 demonstrated retention in the MAT program ranged from 65-75% at a given time with behavioral health attendance under 50%.

Aims: The aim of this quality improvement project was to examine if integrating yoga, an …

Moving A Licensed Practical Nurse To A Registered Nurse In New Hampshire: A Health Policy Initiative, Vicki Gamez

DNP Scholarly Projects

Background: The United States is expected to experience a shortage of Registered Nurses (RN) due to a demand for more nurses to care for an aging population. Not only is there a current deficit in the number of RNs, but there is also a lack of ethnic and racial diversity among RNs. Licensed Practical Nurse (LPN) transition programs increase workforce mobility and allow LPNs to build upon their education and clinical experience as they transition to the RN roles. Therefore, the aim of this DNP project was to implement a health policy change initiative that addresses the barriers of workforce …

Improving Transitions In Care: Focus On The Revocation Of Conditional Discharge Process In New Hampshire, Stacy A. Sorrell

DNP Scholarly Projects

Background: At this time there is no standardized education for providers of New Hampshire Hospital addressing the Revocation of Conditional Discharge Process. Psychiatric patients in New Hampshire most at risk for harm to self or others are managed through Involuntary Commitment Orders. These orders are intended to support those most at risk of destabilization and treatment non-compliance. The Revocation of Conditional Discharge Process is one of the procedures used to re-hospitalize a patient whose care is managed through an Involuntary Commitment Order when needed. The psychiatric providers at New Hampshire Hospital must complete this last step in the revocation process, …

The Impact Of Income On Nutrition: A Case Study Of Northern Mozambique, Hunter Swanigan, Lawton Lanier Nalley

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

In 2017, Mozambique ranked as one of the least developed countries in the world by measures of health, education, and income. With a minimal annual income, purchasing adequate food to meet recommended levels of nutrients for a healthy diet is difficult, leaving 40% of the country undernourished. This study analyzed what foods are available during the dry months (hungry season) of May through October in the Nampula province of Mozambique to determine if it is possible to meet recommended levels of nutrients from purchasing and growing food. Three different levels of income were used to determine what percentage of the …

Patient-Specific Factors Associated With Surgical Delay In A Large Academic Hospital, Natalie Meyers

Dissertations

The high cost of healthcare is driving the search for more efficient practice, especially in high-stakes locations like the operating room. In addition to financial losses, patients suffer physical and emotional distress, including an increased risk of morbidity or mortality when surgical cases are delayed due to inefficiency. While patient-related causes of delay have been implicated, it is unclear which specific factors are most significant. This study aimed to identify specific patient factors correlated with surgical delay and develop a predictive risk algorithm that describes the relationship between patient-specific factors and surgical delay.

A retrospective review of 36,543 patients’ charts …

Nsu Sharks Rx_Winter 2020, Nova Southeastern University

NSU Sharks Rx

Newsletter

The Impact Of The Nursing Shortage On The Quality Of Care Of Veterans, Brian Alexander Fainguersch

Honors College Theses

No abstract provided.

Primary Causes And Risk Factors Leading To Nurse Burnout In The Healthcare Field, Alexa D'Angelo

Honors College Theses

Nurse burnout has become a growing issue among hospitals throughout the world. It is a subject that greatly effects both the mental and physical health of current and future nurses going into the field. This study explored the most popular and well-known causes and risk factors of nurse burnout throughout hospitals. Through the use of structured interviews, three participants were chosen with backgrounds in varying specialties. The interviews consisted of ten predetermined questions, with room for the participants to elaborate. Along with the interviews, data was gathered from current, up to date literature on the research topic of nurse burnout. …

Overlapping Vulnerabilities In Workers Of The Electronics Recycling Industry Formal Sector: A Commentary, Diana M. Ceballos, Daniel Côté, Bouchra Bakhiyi, Michael A. Flynn, Joseph Zayed, Sabrina Gravel, Robert F. Herrick, France Labrèche

Éditoriaux, lettres à l'éditeur

No abstract provided.

Context Of Injury Among Abusive And Accidental Injuries In Children, Lindsay Eysenbach

Yale Medicine Thesis Digital Library

Child physical abuse is a significant public health challenge with an incidence of approximately 6.4 hospitalized cases per 100,000 children. Many abused children, however, will go undiagnosed by physicians evaluating these injuries. Assessing whether a child has been abused is a high-stakes decision: a missed case leaves a child vulnerable to future injury, but an inaccurate diagnosis of abuse may be greatly disruptive and stigmatizing to children and their families. Previous research has established key physical examination and radiographic findings that are associated with abusive injury. A gap in the literature, however, is the role of additional injury circumstances and …

Genetic Investigation Reveals Novel Pathways For Disease Pathogenesis In Inherited And Mosaic Skin Disorders, Shayan Cheraghlou

Yale Medicine Thesis Digital Library

Introduction

Genetic mosaicism underlies many inherited and acquired cutaneous disorders. Despite the barriers to genetic analysis of mosaic disorders, next generation sequencing has led to substantial progress in understanding their pathogenesis, which has significant implications for clinical management and genetic counselling. Advances in paired and deep sequencing technologies in particular have made study of mosaic disorders more feasible. In this study, we aim to utilize next generation sequencing technologies in order to evaluate the genetic cause of three mosaic cutaneous disorders: epidermolytic acanthoma (EA), progressive symmetric erythrokeratodermia (PSEK), and mosaic childhood acantholytic dyskeratosis.

Methods

Using genomic DNA extracted from paraffin-embedded …

The Cost-Effectiveness Of Culture Vs Naat Based Screening Of Pregnant Women For Group B Streptococcus To Reduce Early-Onset Sepsis Of The Newborn, Bertie Geng

Yale Medicine Thesis Digital Library

While great progress has been made to reduce its incidence, group B streptococcus (GBS) is still a leading cause of neonatal disease. Current standard of care recommends antepartum rectovaginal GBS culture of all pregnant women at 36 weeks of gestation in order to identify candidates for intrapartum prophylaxis to reduce vertical transmission. The purpose of the study is to assess three alternative nucleic acid amplification (NAAT) screening strategies for GBS: antepartum NAAT at 36 weeks, intrapartum NAAT, or a combined intrapartum and antepartum approach in which patients with penicillin allergies undergo antepartum culture screening and all other patients undergo intrapartum …

Obstructive Sleep Apnea And Pain Intensity In Young Patients, Wardah Athar

Yale Medicine Thesis Digital Library

Obstructive sleep apnea and pain intensity in young patients

Wardah Athar; Mary E. Card; Antonios Charokopos; Kathleen Akgün; Eric C. DeRycke; Sally G Haskell; Henry K. Yaggi; Lori A. Bastian. Yale University School of Medicine, New Haven, CT.

Objective: This study aims to examine whether young patients who are diagnosed with obstructive sleep apnea (OSA) are more likely to report higher pain intensity when compared to young patients without OSA.

Design/Participants: To do so, we conducted a cross-sectional analysis of a cohort study of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) Veterans who had at least one clinical encounter …

A Systematic Review Of Cost-Effectiveness Analyses On Endovascular Thrombectomy In Ischemic Stroke Patients, Xiao Wu

Yale Medicine Thesis Digital Library

The purpose of this study was to examine the practice of recent cost-effectiveness analyses (CEA) on endovascular treatment (EVT) in ischemic stroke patients, with a particularly focus on methodological conduct of accounting for costs and utilities.

We performed a literature search in Ovid Embase, Ovid MEDLINE, and Web of Science for CEAs published in the last 10 years on EVT. Cost or comparative effectiveness analyses were excluded.

Twenty-two studies were included in the final analysis, from the United States, Canada, Europe, Asia, and Australia. They all concluded EVT to be cost-effective, but with significant variations in methodology. Fifteen studies employed …

Establishing A Myocardial Ischemia-Reperfusion Injury Model In Mice And Rats Using Left Anterior Descending Artery Ligation And Isolated Heart Experiments, Alexander Papa

PCOM Biomedical Studies Student Scholarship

Myocardial infarction (MI) is a leading cause of death globally, with over 730,000 cases each year in the United States alone. Factors involved in the prognosis of an MI include identification of the artery occluded, the time to reperfusion, the size of the infarct, and the degree of cardiomyocyte death. Thus, the treatment of MI typically involves targeting one or more of these factors. Timely opening of an occluded artery to reperfuse the ischemic tissue remains the mainstay treatment through either thrombolytic therapy, arterial stenting, or percutaneous coronary intervention. However, reperfusion itself may cause further damage through the generation of …

The Role Of Autophagy In Hydrogen Peroxide- Or Methylglyoxal- Induced Cardiac Myocyte Damage, Amogh Sehgal

PCOM Biomedical Studies Student Scholarship

Oxidative stress (e.g., increased hydrogen peroxide [H₂O₂] levels) and dicarbonyl stress (e.g. increased methylglyoxal [MG]) serve as initiators for the pathogenesis of cardiovascular diseases and diabetic complications. Increased H₂O₂-derived free radicals and MG can be highly reactive and attack cellular components resulting in cell damage and even cell death. Normally, endogenous antioxidants and glyoxalase degrade H₂O₂ and MG, respectively. Additionally, autophagy facilitates the break-down of damaged cellular components allowing the components to be recycled by the cells. Researchers are still unclear about whether autophagy exacerbates cell damage or protects …

Safety, Feasibility, And Efficacy Of Early Rehabilitation In Patients Requiring Continuous Renal Replacement: A Quality Improvement Study, Kirby P. Mayer, Amanda R. Hornsby, Victor Ortiz Soriano, Timothy C. Lin, Jennifer T. Cunningham, Hanwen Yuan, Caroline E. Hauschild, Peter E. Morris, Javier A. Neyra

Physical Therapy Faculty Publications

Introduction: Early rehabilitation in critically ill patients is associated with improved outcomes. Recent research demonstrates that patients requiring continuous renal replacement therapy (CRRT) can safely engage in mobility. The purpose of this study was to assess safety and feasibility of early rehabilitation with focus on mobility in patients requiring CRRT.

Methods: Study design was a mixed methods analysis of a quality improvement protocol. The setting was an intensive care unit (ICU) at a tertiary medical center. Safety was prospectively recorded by incidence of major adverse events including dislodgement of CRRT catheter, accidental extubation, bleeding, and hemodynamic emergency; and minor adverse …

Challenges Of Diagnosis And Management Of Postpartum Choriocarcinoma In Resource Limited Settings: A Case Report From A Tertiary Hospital Of Western Kenya, Amubuomombe Philippe, Benjamin Elly, Andrew Cheruiyot, Sahara Shurie, Elkanah Omenge

Obstetrics and Gynaecology, East Africa

Choriocarcinoma is a rare occurrence in pregnancy. It is a highly curable malignant tumour that arises from trophoblastic cells within the uterus. However, the timely diagnosis of choriocarcinoma following birth is challenging, especially in low resource settings because most clinicians are not aware about the existence of the disease following uneventful pregnancy and birth. This report discusses the case of a 28 years old patient, para 2, diagnosed with choriocarcinoma two months after uneventful vaginal delivery at term. She underwent a total abdominal hysterectomy, followed by chemotherapy treatment; and succumbed to her disease. It highlights difficulties encountered on diagnosis and …

Low Sensitivity Of The Carehpv™ Assay For Detection Of Oncogenic Human Papillomavirus In Cervical Samples From Hiv-Infected And Hiv-Uninfected Kenyan Women, Titus Maina, Aaron Ermel, A. Moormann, Susan Cu-Uvin, Elkanah Omenge, Philip Tonui, K Chelimo, B Rosen, Peter Itsura, K. Muthoka

Obstetrics and Gynaecology, East Africa

Background: Human papillomavirus (HPV) infection causes cervical cancer (CC), a common malignancy among Kenyan women. New CC screening methods rely on oncogenic HPV (“highrisk”, or HR-HPV) detection, but most have not been evaluated in swabs from Kenyan women.

Methods: HPV typing was performed on 155 cervical swabs from Kenyan women using the Roche Linear Array® (LA) and careHPV™ (careHPV) assays. Detection of 14 oncogenic HPV types in careHPV assay was compared to LA results.

Results: Compared to LA, sensitivity and specifi city of careHPV assay was 53.0% and 80.9%, respectively. The sensitivity and specifi city of careHPV …

Breast Cancer Recurrence Rate In Patients Treated For Early Breast Cancer, Cecilia Munguti

Master of Medicine in General Surgery

Background: Breast cancer, the leading cause of cancer in Kenya among women, has a prevalence of 57.1 per 100,000 women and an annual mortality of 3.7 per 100,000. Early breast cancer is curable, but has a residual risk of recurrence of 10.4% in the first 5 years. Fifty percent of the recurrences occur after the first 5 years after diagnosis. Recurrent breast cancer is associated with poorer prognosis and higher mortality rates. Objectives: The primary objective was to determine the breast cancer recurrence rates for women managed for DCIS and early breast cancer at Aga Khan University Hospital. Secondary objectives …

The Quality Of Life Of Patients With Early Breast Cancer And Their Partners One Year After Breast Conserving Surgery Versus Modified Radical Mastectomy: A Single Centre Five Year Review, Senoga Andrew

Master of Medicine in General Surgery

Background: Breast cancer accounts for the highest incidence rate (40.3/100000) and fourth highest mortality rate (17.8/100000) among cancers in Kenya. Forty percent of breast cancer cases in Kenya are early breast cancer and this is will increase with scaled up awareness campaigns and screening. Breast conserving surgery (BCS) followed by radiotherapy (BCT) and modified radical mastectomy (MRM) are the commonest forms of surgical techniques utilized in treatment of early breast cancer with similar overall survival and recurrence rates. These treatments impact variably on the quality of life of the patients and their spouses who are their immediate emotional and social …

Prevalence And Factors Associated To Incidental Prostate Carcinoma Among Patients Undergoing Turp For Benign Prostatic Enlargement., Isaac Herman Mawalla

Master of Medicine in General Surgery

Background: Prostate carcinoma carries higher morbidity and mortality when diagnosed late. Prostate cancer screening is paramount, however, there are no specific clinical signs for early-stage prostate cancer. As an independent variable, prostate-specific antigen is an established predictor of cancer. Incidental prostate cancer is detected by histological examination of resected biopsy tissue that had been previously diagnosed as benign. In the current PSA-use era the prevalence of incidental prostate cancer ranges from 1.4 to 13%. The prevalence in Tanzania as published by Gunda et al was 21.71%. This is alarmingly high. However, in his study, patients with high prostate-specific antigens were …

Perceptions Of Surgeons On Surgical Antibiotic Prophylaxis Use At Aga Khan Hospital, Dar Es Salaam., Elizabeth Elibariki Mmari

Master of Medicine in General Surgery

Introduction: Surgical site infections are a major cause of morbidity and mortality among operated patients. The use of antibiotic prophylaxis in prevention and reduction of incidence of surgical site infection is widespread. In spite of the accessibility of universal and national guidelines for surgical prophylaxis, recent studies surveying the present routine of prophylaxis have demonstrated overutilization of a wide range antibacterial medications for a single patient. Few studies have shown qualitatively factors influencing this, and perceptions of surgeons on surgical antibiotic prophylaxis use. Unfortunately, none of these studies have been done in Tanzania. Objective: To describe the perceptions of surgeons …

Referral Patterns Affecting Age At Orchidopexy For Undescended Testis At A Tertiary Hospital In Nairobi., Muthua Ken Njoroge

Master of Medicine in General Surgery

BACKGROUND: Undescended Testis is the most common urological congenital anomaly with significant burden of disease especially in our local context. Management relies on early diagnosis, in the perinatal period, and prompt referral to an appropriate surgical unit. Spontaneous descent, while possible, doesn’t occur beyond 6 months and thus surveillance should not proceed beyond this age. Current guidelines recommend surveillance up to 6 months, referral by 9 months and, most importantly, orchidopexy by 1 year of age. Despite these clear guidelines, achieving them has proven difficult globally with low rates of orchidopexy by 1 year. The most common cited cause has …

The Status Of Smokeless Tobacco Use And Its Associated Factors Among The Business Guilds Population Of Chabahar, Seyed Saeed Mazloomy Mahmoodabad, Mohammad Saeed Jadgal, Iraj Zareban, Hossein Fallahzadeh

Internet Journal of Allied Health Sciences and Practice

Purpose: Use of smokeless tobacco is a major preventable cause of premature death and diseases. It leads to over 5 million deaths annually worldwide. This study aimed to investigate the status of smokeless tobacco use and its associated factors among the business guilds population of Chabahar City, Iran. Method: The present descriptive cross-sectional study was conducted on 320 users of various types of smokeless tobacco selected by simple random sampling method. Data were collected using a researcher-made demographic questionnaire, smokeless tobacco inventory, attitude questionnaire, and behavior questionnaire. The validity and reliability of these tools were confirmed in the previous studies. …

Can The Forward-Step-Down Test Be Used Reliably In The Clinical Setting To Assess Movement Changes Resulting From Maximal Exertion? A Pilot Study, Erin Mccallister, Daniel W. Flowers

Internet Journal of Allied Health Sciences and Practice

Introduction: Visual assessment of lower extremity mechanics is used frequently in clinical practice, and objective scoring of the visual assessment is beneficial to improve objectivity of patient evaluation. In addition, lower extremity mechanics change with fatigue and these changes may increase the risk of lower extremity injury. The Forward-Step-Down Test (FSDT) is one such objective tool, but its ability to detect changes in movement quality in response to exertion are not known. Methods: This study utilized a repeated-measures design, where the participants were scored on the FSDT before performing the Bruce protocol for an exertion stimulus. The participants were re-scored …

Adoption Of The Health Information Exchange (Hie) System And The Role Of The Healthcare Leadership, Muhammad Faisal Ashfaque

Theses and Dissertations

The advancement in technology calls for improvement in service delivery in healthcare systems, especially in the present health pandemic of the COVID-19. At present, healthcare systems utilize several electronic health techniques. However, there is a need for the creation of interoperability that can assist healthcare organizations in exchanging data more effectively through the global adoption of healthcare information exchange (HIE). The current research examines the adoption of HIEs and healthcare leadership roles to realize a fully functional interoperable patient HIE. This study utilized the systematic document analysis method to review qualitative data on the different aspects of healthcare leadership, implementation …

Antidiabetic Activities Of An Lc/Ms Fingerprinted Aqueous Extract Of Fagonia Cretica L. In Preclinical Models, Imran Nazir, Nisar Ur Rahman, Zunaira Alvi, M. Hafizur Rahman, Jandirk Jandirk Sendker, Tao Zhang, Neil Frankish, Helen Sheridan

Articles

Diabetes mellitus is a chronic disease and one of the most important public health challenges facing mankind. Fagonia cretica is a medicinal plant used widely in the Punjab in Pakistan. A recent survey has demonstrated that traditional healers and herbalists frequently use this plant to treat diabetes. In the current study, the traditional medicine was prepared as a tea, and the profile of the main metabolites present in the traditional medicine was analysed via LC/MS/MS. The extract was shown to contain a number of phenolic glycosides including quercetin-3-O-rutinoside, kaempferol-3-O-rutinoside, kaempferol-3-O-glycoside, kaempferol-3(6′-malonylglucoside), isorhamnetin-3-O-rutinoside, and isorhamnetin 3-(6″-malonylglucoside) in addition to two unidentified …

Dietary Fat Intakes In Irish Children: Changes Between 2005 And 2019, Aileen O’Connor, Maria Buffini, Anne Nugent, Laura Kehoe, Albert Flynn, Janette Walton, John Kearney, Breige Mcnulty

Articles

Objective:To examine current dietary fat intakes and compliance in Irish childrenand to examine changes in intakes from 2005 to 2019.Design:Analyses were based on data from the Irish National Children’s FoodSurvey (NCFS) and the NSFS II, two cross-sectional studies that collected detailedfood and beverage intake data through 7-day and 4-day weighed food diaries,respectively.Setting:NCFS and NCFS II, Republic of Ireland.Participants:A nationally representative sample of 594 (NCFS) and 600 (NCFS II)children aged 5–12 years. Current intakes from the NCFS II were compared withthose previously reported in the NCFS (www.iuna.net).Results:Current intakes of total fat, SFA, MUFA, PUFA andtransfat as a percentageof total energy are …