Preventive Medicine Commons^™

Factors Associated With Parental Decision Making And Childhood Vaccination, Zuwen Qiu-Shultz

UNLV Theses, Dissertations, Professional Papers, and Capstones

In order to better understand factors affecting immunization status, logistic regression was used to assess the association of various socio-demographic factors and whether parents would have their child immunized if not a state mandate. Factors included in the study were race, household income, number of children in the household, number of adults in the household, if the child had a primary provider, if the child had a health check-up in the last twelve months, and medical insurance status of the child. The combined Nevada Kindergarten Health Survey Result of 2009-2010 (Year Two) and 2010-2011 (Year Three) conducted by the Nevada …

Schistosomiasis (Bilharzia) In Madagascar: A Case Study Of A Neglected Tropical Disease, Sarah Grace Sawyer

Independent Study Project (ISP) Collection

Over 50% of Madagascar’s population is infected with intestinal or urinary schistosomiasis (Rollinson et al., 2012). The disease slowly debilitates infected persons, who are frequently children, resulting in lower productivity and reduced learning in school-age children. The disease involves a vicious cycle perpetuated by a number of environmental, psychological, and social factors. A multifaceted approach, involving mass treatment, biological control, environmental control, education, and disease surveillance, can lead to schistosomiasis control and elimination in Madagascar. This would yield many socio-economic benefits such as increased productivity, increased school attendance rates, and generally better welfare. Schistosomiasis is the most burdensome and deadly …

Patient Safety In The Cardiac Operating Room: Human Factors And Teamwork: A Scientific Study From The American Heart Association, Joyce A. Wahr, Richard L. Prager, J. H. Abernathy Iii, Elizabeth A. Martinez, Eduardo Salas, Patricia C. Seifert, Robert C. Groom, Bruce D. Spiess, Bruce E. Searles, Thoralf M. Sundt Iii, Juan A. Sanchez, Scott A. Shappell, Michael H. Culig, Elizabeth H. Lazzara, David C. Fitzgerald, Vinod H. Thourani, Pirooz Eghtesady, John S. Ikonomidis, Michael R. England, Frank W. Selke, Nancy A. Nussmeier

Publications

The cardiac surgical operating room (OR) is a complex environment in which highly trained subspecialists interact with each other using sophisticated equipment to care for patients with severe cardiac disease and significant comorbidities. Thousands of patient lives have been saved or significantly improved with the advent of modern cardiac surgery. Indeed, both mortality and morbidity for coronary artery bypass surgery have decreased during the past decade. Nonetheless, the highly skilled and dedicated personnel in cardiac ORs are human and will make errors. Refined techniques, advanced technologies, and enhanced coordination of care have led to significant improvements in cardiac surgery outcomes.

First Steps Phase Ii Initiative: Improving Developmental, Autism, And Lead Screening For Children, Kimberley S. Fox Mpa, Carolyn E. Gray Mph, Martha Elbaum Williamson Mpa

Population Health & Health Policy

First STEPS (Strengthening Together Early Preventive Services) is a learning initiative supported by Maine's CHIPRA quality demonstration grant to support measure-driven practice improvement in pediatric and family practices across the state on improving developmental, autism, and lead screening for children. This report, authored by research staff at the USM Muskie School, evaluates the impact of Phase II of Maine's First STEPS initiative, which was implemented from May to December 2012 and included 12 practices serving more than 20,000 children on MaineCare (Maine's Medicaid system). The authors assess changes in developmental, autism, and lead screening rates and evidence-based office processes in …

The Effect Of Heart Failure Education On Reducing Readmissions, Mayola Lara Villarruel

Evidence-Based Practice Project Reports

Management of heart failure is a significant financial challenge for the health care industry, costing approximately $33.2 billion annually. Common reasons for preventable heart failure readmissions include inadequate discharge education and lack of self-care and health management activities. Education at discharge is a vital component of improving heart failure outcomes. Following a review of the literature, high quality evidence supports that heart failure education should focus on medication adherence, sodium and fluid restriction, daily weights, activity tolerance, identification of deteriorating signs and symptoms of heart failure, and smoking cessation. The purpose of this EBP project was to reduce heart failure …

Nutri One-On-One: The Assessment And Evaluation Of A Single One-On-One Nutritional Coaching In Patients Affected By Metabolic Syndrome, Jennifer L. King

PCOM Biomedical Studies Student Scholarship

The Nutri One-on-One Program's aim was to positively modify participants' nutritional habits and lifestyles through a brief one-on-one health coaching session, which was conducted within a primary healthcare setting at the Philadelphia College of Osteopathic Medicine's Clinics. It is documented that 70% of deaths in the U.S. result from complications secondary to chronic diseases of metabolic syndrome. The participants were selected by physicians and classified as suffering from one or more of the five indicators of metabolic syndrome: abdominal obesity, elevated serum triglycerides, low HDL-cholesterol, elevated blood pressure, and insulin resistance. Evidence shows that health coaching positively assists individuals in …

Successful Aging And Creativity : An Investigation On Functional Status And Psychological Wellbeing In Older Adults, Mirie E. Levy

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: While the literature supports the maintenance of functional status as integral to successful aging, the relationship of creativity on functional status has received little attention. Creativity has been associated with health and aging in the research but only a small number of studies have examined creativity interventions to enhance functional status and boost psychological wellbeing.

Methods: A pretest-posttest quasi-experimental design was used to investigate an 8-week creativity intervention on functional status and psychological wellbeing in older adults. Sample subjects were 92 men and women all over age 60. A series of two-way mixed ANOVAs measured differences between treatment and …

Examining Universal Primary Healthcare Through Community-Based Initiatives, Donald E. Warden

Oglethorpe Journal of Undergraduate Research

This paper examines enacting community-based primary healthcare programs and initiatives. It looks at the weaknesses of past attempts, the successes of current attempts, and gives insight into ways everyday citizens can change the way the world does healthcare. There are social, economic, and political barriers as to why these programs are not enacted. Since 1978, Member states of the United Nations strive towards healthcare for all. The original 1978 Declaration of Alma-Ata sets the bar at achieving this goal by the year 2000. Now in the 21^st century, the world still battles inadequate healthcare. Nations continue to strive towards …

Self-Management And Self-Management Support On Chronic Low Back Patients In Primary Care, Jennifer Kawi

Interdisciplinary Research Scholarship Day

• Chronic low back pain (CLBP) afflicts 28.5% of adults costing $100-200 billion dollars.
• In response, the Institute of Medicine (2011) strongly recommended self-management (SM) to engage patients to care for themselves adequately.
• Healthcare professionals are also urged to provide effective self-management support (SMS) to empower patient’s ability to self-manage.
• SM and SMS have shown success in improving other chronic disease outcomes; current knowledge base are insufficient in non-malignant CLBP

The Young And Suicide, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

No abstract provided.

Carrots, Sticks And False Carrots: How High Should Weight Control Wellness Incentives Be? Findings From A Population-Level Experiment, Harald Schmidt

Frontiers in Public Health Services and Systems Research

Employers are increasingly using wellness incentives, including penalties for unhealthy behavior. Survey data suggests that people are willing to accept the principle of penalizing those perceived to take health risks, but the equally relevant question of the magnitude of acceptable penalties is unclear.

While the principle of penalizing overweight and obese people has some support, findings from a population-level experiment (n=1,000) suggest that the acceptable size of penalties is comparatively small, around $50: more than 10-fold below levels favored by advocates. Reward-based incentives are favored over penalty-based ones by a factor of 4. Of two different ways of framing penalty …

Breath And Urine Alcohol Level Analysis To Increase Student Awareness Of Road Safety., Kim Daly

Students Learning with Communities

The aim of this project was to increase student’s awareness of road safety and the relationship between alcohol and driving. This was carried out in conjunction with the Garda Road Safety Unit and the DIT interdisciplinary project known as CARS, College Awareness of Road Safety. This project was carried out last year by another student therefore the aim this year was to build and expand on the work that had been done so far. Increasing the student’s awareness was achieved by speaking to class groups to explain the project and asking them to take part by supplying samples of breath …

Do Mechanical Pressure-Equalizing Devices Such As Otovent® And Prep Relieve Or Reduce Ear Pain And Pressure In Aircraft Passengers During Flight?, Michael Ferentino

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not mechanical pressure-equalizing devices relieve or reduce ear pain and pressure in aircraft passengers during flight.

STUDY DESIGN: A review of two double-blind control trials and one case control study published between 1988 and 2010 in the English language.

DATA RESOURCES: Double-blind control trials focused on the use of pressure-equalizing ear plugs (PREP) and a case control study on the Otovent® auto-inflation device for the prevention of barotrauma in aircraft passengers were found using Cochraine Library, Medline, and PubMed.

OUTCOMES MEASURED: Outcomes measured …

Is Probiotic Supplementation Effective In Reducing The Incidence Of Atopic Dermatitis In Children Age 3 And Under?, Kristen M. Mclaughlin

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not probiotic supplementation is effective in reducing the incidence of atopic dermatitis in children age 3 and younger.

STUDY DESIGN: Systematic review of three Engligh language primary studies one published in 2009 and the other two in 2010.

DATA SOURCES: Three double blind randomized controlled trials comparing the efficacy of probiotic supplementation for reducing the incidence of atopic dermatitis in children ages 3 and under were found using Cochrane Library EBM and PubMed databases.

OUTCOMES MEASURED: Diagnosis of atopic dermatitis, via a positive …

Does Immersion In Water During Labor Decrease The Likelihood Of Perineal Tears?, Julie Rikkers

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this review is to determine whether or not “Does water immersion in the course of labor decrease the risk of perineal injury during vaginal delivery?”

STUDY DESIGN: Review of three English Language primary studies published in 1996, 2001 and 2002.

DATA SOURCES: Two Randomized, Double-Blind, Controlled trials as well as One Case Control Study which evaluated Maternal and Neonatal Outcomes during labor and delivery were found using PubMed and Cochrane Databases.

OUTCOME MEASURED: Each study looked at women who used water immersion during labor and those that did not. The outcomes measured were those regarding …

Are Triptan Drugs Safe And Effective For Use In The Prevention Of Menstrually Related Migraines (Mrms)?, Christina Ponzio

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Triptan drugs are safe and effective for use in the prevention of menstrually related migraines (MRMs).

STUDY DESIGN: Review of two English language randomized controlled trials and one pilot randomized control trial.

DATA SOURCES: Randomized controlled trials comparing Triptan drugs to a placebo group were found using Medline, PubMed, and OVID.

OUTCOMES MEASURED: Incidence of MRM based on patient self-report; number of relapses; patients’ subjective evaluations of effectiveness based on questionnaire; adverse effects of Triptan treatment.

RESULTS: Two randomized controlled trials …

Does Daily Intake Of Glucosamine Supplements Prevent The Need For Knee Replacements Later In Life For Adult Patients Predisposed To Osteoarthritis?, Nancy Helmy

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not daily intake of glucosamine supplements prevents the need for knee replacements later in life for adults predisposed to osteoarthritis.

STUDY DESIGN: Review of three English language primary randomized controlled trial studies published between 2001 and 2008

DATA SOURCES: Three double blind randomized control trials comparing glucosamine supplements to placebo were found using PubMed.

OUTCOMES MEASURED: Outcomes were measured using radiographic studies of the knees, joint space measurements, and symptoms were evaluated using Lequesne and WOMAC indexes.

RESULTS: The Reginster (2001) and Pavelka (2002) studies demonstrated no …

What Is The Effectiveness Of Onabotulinumtoxina (Botox®) In Reducing The Number Of Chronic Migraines (Cm) In Patients 18-65 Years Old?, Kristin A. Beddingfield

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not onabotulinumtoxinA (Botox®) is effective in reducing the number of chronic migraines (CM) in patients 18-65 years old? Study Design: Review of three published, double blind randomized controlled trials were used for this review, which were found on PubMed; were selected based on their relevance to the clinical question and if they included patient oriented outcomes.

OUTCOMES MEASURED: The outcomes measured were headache/migraine free days measured by >50% responder rate analysis, the Treatment Responder Rate based on Physician Global Assessment, and total adverse events reported by …

Does Parent And Therapist Delivered Qigong Massage Therapy Decrease Sensory And Self-Regulation Impairments In Children Ages 3-6 Years Old With Autism?, Lisa A. White

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not parent and therapist delivered Qigong massage therapy decreases sensory and self-regulation impairments in children ages 3-6 years old with autism.

STUDY DESIGN: Reviewed three English primary studies published in 2005, 2009 and 2011.

DATA SOURCES: All studies were randomized controlled trials that compared a group of children with autism who received Qigong massage treatments to a controlled group of children with autism who did not receive the treatments. All studies were found using PubMED and Cochrane research databases.

OUTCOMES MEASURED: Overall reduction …

Does Neonatal Massage Lead To Reduced Stress Behavior In Medically Stable Preterm Infants In The Nicu?, Sarah E. Werner

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not neonatal massage leads to reduced stress behavior in medically stable preterm infants in the NICU.

STUDY DESIGN: Review of three English language primary studies published in 1996, 2005 and 2007.

DATA SOURCES: Three randomized control trials comparing stress behavior in preterm infants receiving massage to a control group that did not receive massage were found using PubMed and Medline databases.

OUTCOMES MEASURED: Researcher recorded stress behavior as behavioral distress activity and motor activity via direct observations and a time sampling method. Motor …

Military Tobacco Dependence Treatment: Implications Of Treatment Type On Abstinence And Weight Management Ability, Bradley A. Briscoe

DNP Projects

Military readiness, employer productivity and individual health are all significantly impacted by high rates of tobacco use. Current research, to date, suggests that use of brief, individually tailored behavioral modification strategies through group therapy may be most effective in smoking cessation. The objective of this Practice Inquiry Project was to explore aspects of tobacco use the U.S. military population and examine potential relationships between type of treatment, smoking abstinence, and maintenance of body weight (e.g. avoid weight gain) among those seeking tobacco use cessation. The findings of this project can provide guidance on enhancing current tobacco cessation efforts to enable …

Analysis Of Vitamin D Status At Two Academic Medical Centers And A National Reference Laboratory: Result Patterns Vary By Age, Gender, Season, And Patient Location, Jonathan R. Genzen, Jennifer T. Gosselin, Thomas C. Wilson, Emilian Racila, Matthew D. Krasowski

Psychology Faculty Publications

Background: Testing for 25-hydroxyvitamin D [25(OH)D] has increased dramatically in recent years. The present report compares overall utilization and results for 25(OH)D orders at two academic medical centers - one in New York and one in Iowa – in order to characterize the vitamin D status of our inpatient and outpatient populations. Results are also compared to those from a national reference laboratory to determine whether patterns at these two institutions reflect those observed nationally.

Methods: Retrospective data queries of 25(OH)D orders and results were conducted using the laboratory information systems at Weill Cornell Medical College / New York Presbyterian …

Preventing Sudden Cardiac Death In Athletes: In Search Of Evidence-Based, Cost-Effective Screening, Paolo Angelini, Mladen I Vidovich, Christine E Lawless, Macarthur A Elayda, J Alberto Lopez, Dwayne Wolf, James T Willerson

The Texas Heart Institute Journal

Sudden cardiac death in athletes is a recurrent phenomenon at sporting events and during training. Recent studies have associated sudden cardiac death with such cardiovascular conditions as coronary artery anomalies, cardiomyopathies, and electrocardiographic abnormalities, most of which are screenable with modern imaging techniques. We recently inaugurated the Center for Coronary Artery Anomalies at the Texas Heart Institute, which is dedicated to preventing sudden cardiac death in the young and investigating coronary artery anomalies. There, we are conducting 2 cross-sectional studies intended to firmly establish and quantify, in a large group of individuals from a general population, risk factors for sudden …