Public Health Commons^™

Advanced Practice Nursing Initiatives In Africa, Moving Towards The Nurse Practitioner Role: Experiences From The Field, Deborah C. Gray, Melanie Rogers, Minna K. Miller

Ellmer School of Nursing Faculty Publications

AIM: This paper discusses the development and progression of the advanced practice nurse practitioner role in Africa.

BACKGROUND: Providing adequate primary health care is problematic in Africa. The World Health Organization and International Council of Nurses proposed that nurses, specifically advanced practice nurse practitioners with the requisite skills in disease prevention, diagnosis and management, can be key to solving the primary care issue.

SOURCES OF EVIDENCE: This paper utilized publications from PUBMED, CINAHL, policy papers, websites, workgroups, conferences, and the experiences and knowledge of authors involved in leading and moving forward key events and projects.

DISCUSSION: Four African countries have …

A Qualitative Exploration Of Well-Being In Cancer Survivorship: Implications For Counselors, Hallie M. Sylvestro, Lindsey K. Umstead, Heather Delgado, Christopher Lawrence, Keith Mobley, Kelly L. Wester, Andrew Wood

Adultspan Journal

Adult cancer survivors represent an important–and growing–population that could benefit from counseling services. This study employed consensual qualitative research to examine the well-being experiences of eight cancer survivors. Findings suggest a broad range of changes to individual well-being following cancer diagnosis and treatment, and indicate counseling can provide an ideal setting for processing such changes. Recommendations for counseling practice and future research are provided.

Improved Pediatric Icu Mortality Prediction For Respiratory Diseases: Machine Learning And Data Subdivision Insights, Johayra Prithula, Muhammad E H Chowdhury, Muhammad Salman Khan, Khalid Al-Ansari, Susu M Zughaier, Khandaker Reajul Islam, Abdulrahman Alqahtani

Faculty, Staff and Student Publications

The growing concern of pediatric mortality demands heightened preparedness in clinical settings, especially within intensive care units (ICUs). As respiratory-related admissions account for a substantial portion of pediatric illnesses, there is a pressing need to predict ICU mortality in these cases. This study based on data from 1188 patients, addresses this imperative using machine learning techniques and investigating different class balancing methods for pediatric ICU mortality prediction. This study employs the publicly accessible "Paediatric Intensive Care database" to train, validate, and test a machine learning model for predicting pediatric patient mortality. Features were ranked using three machine learning feature selection …

Creating Capacity To Accommodate Additional Cardiac Catheterization Procedures, Kristin Anthony

Operations Transformation

Patient access to diagnostic outpatient (OP) cardiac catheterization is limited by a perceived lack of capacity. Outpatient cardiac cath pts flow through the ACU for pre/post procedure care. Current schedule limits pts that may be scheduled through the ACU to two OP procedures/day. Cardiologists request the ability to schedule beyond the two procedures/day allowed. Significant variation in pre/postoperative care orders exist amongst cardiologists resulting in variability in length of stay. Cardiac procedures are booked either as 60/90/120 minutes – Epic case averaging technology is not active in the cath lab. As a result, the case minutes in the cath lab …

Transition To Adult Care For Bleeding Disorders: Building A Multidisciplinary Tool, Leslie Larson, Ekaterina Funk, Dana Grass, Felicia Munster, Eric Larsen, Louise Baca, Glen Roy, Sara Artinyan

Operations Transformation

Youth with chronic illnesses often have poorer health outcomes after transitioning to adult care. Maine Health Bleeding Disorders is a Health Resources and Services Administration (HRSA) grant funded Hemophilia Treatment Center (HTC) that serves patients with congenital bleeding disorders. We provide multidisciplinary specialty care throughout the lifespan which includes pediatric and adult hematologists, family nurse practitioners, nurses, physical therapists, social worker, dietitian, genetic counselor, and research coordinator. In 2022, HRSA mandated all federally funded HTCs increase by 25 percent from baseline the number of individuals ages 12 to 26 years seen in a comprehensive clinic that have a health care …

Development Of An Endometriosis Toolkit To Support Clinicians In Providing Quality Care For Women, Rachel Hasbun

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Endometriosis is the abnormal growth of endometrium-like tissue outside the uterine cavity, affecting approximately 11% of women in the United States during their reproductive years. Diagnostic challenges stem from its varied clinical presentations, reliance on laparoscopy for definitive diagnosis, and limited awareness among practitioners and patients, potentially leading to diagnostic delays of up to 13 years.

Problem: The complexities of diagnosing endometriosis in primary care and specialty settings, combined with limited provider awareness and a lack of comprehensive resources, hinder timely and accurate identification. This leads to suboptimal treatment and care for women affected by the condition.

Methods: …

Teaching Medical Procedural Skills For Performance, Kersi Taraporewalla, Paul Barach, André Van Zundert

College of Population Health Faculty Papers

Procedures are a core element of medical professional practice. Today's training approach was formulated in the mid-twentieth century based on a computer analogue of the brain. Despite minor modifications, the system has remained relatively unchanged for the past 70 years. It delivers competence. However, competence is not reliable performance. The inability to adapt to the variety of patients and variations in the performance environments, such as the operating room, results in patient morbidity and mortality. There is a need for changes in the development and training of medical procedural skills based on current theories of skill acquisition, movement theory, and …

Desvenlafaxine Induced Acute Angle-Closure Glaucoma - Case Report, Venkatesh Babu Dr, Priyankha Kothandaraman Dr, Megha Sadashiv Dr., Kishor M

Digital Journal of Clinical Medicine

The World Health Organization (WHO) estimates that Depressive disorder affects more than 264 million people worldwide. The global prevalence of depression among those who are aged 18 years and older was approximately 4.4%. According to a 2017 study by India's National Institute of Mental Health and Neuroscience s (NIMHANS), 7.5% of the population in the nation suffers from depression affecting one in 20 Indians_[1].

SSRIs ( Selective Serotonin Re uptake Inhibitors) and SNRIs ( serotonin-nor epinephrine re uptake inhibitors) are increasingly the first-line choices of anti-depressant because of their tolerable side-effect profile and low rate of lethality if …

Casar Auc Community Only Lecture: Men, Women’S Body Autonomy & Gbv Crimes In Egypt, Us & Canada: Why Men Need To Step Up For The Education Of Women's Body Autonomy, The Prince Alwaleed Center For American Studies And Research Casar

Performances, Events, and Presentations

This was a hybrid CASAR AUC community only lecture titled: ‘Men, Women’s Body Autonomy & GBV crimes in Egypt, US & Canada’: Why men need to step up for the education of women’s body autonomy.

This lecture featured Tadwein from Egypt, Women’s Advocates from the US & London Abused Women's Counseling Center from Canada (via Zoom). This lecture was part of course AMST 1091 ‘Exploring Feminist Perspectives in Egypt & the US’ (core curriculum pathways two- American studies) taught by Yasmeen El-Ghazaly, CASAR Assistant to Director & Adjunct Faculty - Wednesday May 15th, 2024

The lecture pondered on the following …

Automate Isolation Infection-Prevention Precautions (Aid-Ip): Improving The Efficiency Of Hospital Isolation With Viral Respiratory Infections, Timothy Burchard, Michael Platt, La'sonya Buford

Research Days

The AID-IP project is a QI study working to improve the process of isolation and de-isolation regarding respiratory viruses at Children's Mercy Hospital. Specifically, we aim to improve adherence to proper isolation precautions, minimize cognitive workload regarding the maintenance of isolation for staff, and improve family satisfaction with isolation practice.

Improving Healthcare Workers’ Biohazardous Spill Safe Handling Skills, Zeina Mhanna, Ahmad Tassi

BAU Journal - Health and Wellbeing

All healthcare workers (HCWs) are exposed to biohazardous material. Biohazardous material may come in the form of spills, posing a risk of infection to (HCWs) who are not trained on how to safely handle them. While international guidelines recommend training HCWs on how to safely handle biohazardous spills in order to improve their skills, there are no studies that tackled this recommendation. The aim of this study is to improve HCWs’ biohazardous spill safe handling skills through training, and to evaluate the association between the HCWs’ improvement level and demographical characteristics. The study was conducted in a Southern Lebanese hospital …

Characterization Of Nationally Reported Pediatric Deaths Involving Fentanyl Ingestions In Missouri, Margaret Campbell, Mary Moffatt, Emily Killough, Terra Frazier

Research Days

There has been a dramatic rise in pediatric deaths associated with synthetic opioid use, with the most prominent being Fentanyl. This is a retrospective cohort study using data from the National Center for Fatality Review and Prevention with the goal of identifying risk factors that increase the vulnerability of children to Fentanyl ingestion. Ultimately this research may help lead to improved identification of at risk children with the goal of implementation of targeted prevention programming.

Exploring Social Workers Potential Role In Mitigating Maternal Mortality Through Coordinated Care, Jena Brown-Talib

Honors Theses

Maternal health disparities persist as a significant challenge in Mississippi, particularly for African American women. This thesis explores the intersection of coordinated care models and social work interventions in addressing maternal mortality. Coordinated care involves collaboration among physicians, nurses, practitioners, social workers, community health workers, and other support services, aiming to maximize pregnant patients' overall health outcomes.

Analyzing strategies of social workers within coordinated care models is important for improving maternal health outcomes within this study. A qualitative approach was chosen to delve beyond statistics and illuminate the reality of maternal health disparities and the efforts to resolve them. Data …

An Analysis Of Professional Education For Future Physicians To Address Implicit Racial Bias In Black Maternal Health, Jasmine Butler

Honors Theses

The history of medicine in the United States is littered with incidences of racism and exploitation of Black Americans. The extensive history of medical racism has continued to be perpetuated in healthcare today. Within the field of maternal health, the dark history of medicine shows its face with the treatment of black mothers. Black maternal health is a current public health crisis currently being exacerbated through discrimination in the form of implicit bias. Implicit bias is a current issue in our healthcare system that needs to be addressed through adequate training of both medical students and physicians. This qualitative research …

Methods And Variability In Physician Associate Student Advocacy Education, Jason P. Prevelige, Lindsay Gietzen

Pacific Journal of Health

Objective: To assess the current practices of PA programs pertaining to how advocacy education is taught to their students and to determine differences among the programs.

Methods: PA program directors were interviewed about advocacy education including time allotted, when it is provided, learning objectives, source materials, teaching methods, determination of competency, and tracking of student advocacy participation after graduation.

Results: All noted that advocacy education is important, however meaningful, in-depth, instruction can be limited for a variety of reasons. Such reasons include limited educational time to ensure that a sizeable set of standards is met, limited access …

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

The Tensegrity Curriculum: A Comprehensive Curricular Structure Supporting Cultural Humility In Undergraduate Medical Education., Anne C Jones, Kristin N Bertsch, Deborah Williams, Millicent King Channell

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Due to growing health disparities in underserved communities, a comprehensive approach is needed to train physicians to work effectively with patients who have cultures and belief systems different from their own. To address these complex healthcare inequities, Rowan-Virtua SOM implemented a new curriculum, The Tensegrity Curriculum, designed to expand beyond just teaching skills of cultural competence to include trainees' exploration of cultural humility. The hypothesis is that this component of the curriculum will mitigate health inequity by training physicians to recognize and interrupt the bias within themselves and within systems. Early outcomes of this curricular renewal process reveal increased student …

Addressing Gaps In Care Through A Medical Student-Led Cancer Screening Project, Matthew Green, Hannah Ngo, Dakota B. Pastore, Jenna Zappetti, Olivia Siciliano, Meghan Mcquade, John Sauer, Anne Jones

Rowan-Virtua Research Day

Background: Colorectal cancer (CRC), breast cancer (BrCa), and cervical cancer are three of the most preventable cancers. Despite the known significance for early detection and treatment, barriers to screening remain. We developed a medical student-led project to improve adherence to national cancer screening guidelines in patients across Rowan-Virtua Family Medicine (FM) practices. This study assesses the initiative’s efficacy in improving adherence to CRC, BrCa, and cervical cancer screenings.

Methods: Rowan-Virtua FM patients between the ages of 21-75 (n=735) were identified as due or up-to-date on cancer screenings based on chart review. Student volunteers were trained to contact patients to discuss …

A Problem-Based Approach To Racial And Ethnic Inequities In The German Health System, Thomas C. Lane

German Studies Undergraduate Senior Theses

This work is the first comprehensive book-length survey of racial and ethnic inequities in Germany’s health system. It takes a novel approach to understanding health inequities by focusing on the overarching structures which shape them in the German context, using examples from various areas of the health system to clarify their nuances. The Introduction grounds the need for understanding and combating health inequities in Germany’s unique postwar constitutional commitment to human dignity. Next, Chapter 1 outlines the current methods by which inequities are measured in Germany and why they are problematic. Chapter 2 covers current inequities in the provision of …

Stopping The Bleed At Uri, Emily Lefebre

Senior Honors Projects

The number one cause of preventable death is uncontrolled bleeding from traumatic injury. From the unlikely scenario of a school shooting, to a campus car accident or an injury during a sports or club event, possessing skills to effectively stop a life-threatening bleed becomes a matter of life or death. The American College of Surgeons Committee on Trauma (ACS COT) STOP THE BLEED® program is a campaign to teach communities how to respond effectively and efficiently to life-threatening bleeding in emergencies. STOP THE BLEED® aims to empower individuals with the knowledge and skills to stop severe bleeding by tourniquet application, …

Pcos: Comparing Inositol Supplementation To Metformin Treatment, Caitlin Liechti-Hawkins

University Honors College

The purpose of this literature review is to compare the viability of inositol versus metformin for the treatment of polycystic ovarian syndrome (PCOS). The research outlines the criteria for diagnosis and the many symptoms associated with the condition. The aim is to discover if inositol should be recommended for PCOS symptoms as a replacement for metformin. It was found that safety and popularity of the two options were important factors for physicians and patients to consider before choosing a treatment. Within these scopes, adverse effects, costs, regulation, and belief of treatment were compared. Findings indicated that inositol supplementation may possibly …

Evaluating The Association Of Influenza Vaccination On Long-Term Covid-19 Symptoms In U.S. Adults, Ratnakar Pingili

Capstone Experience: Master of Public Health

Objective. To evaluate the association of influenza vaccination in the past 12 months with Long COVID effects and clinical and sociodemographic factors.

Methods. Cross-sectional study with data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), covering 415,132 non-institutionalized U.S. adults with a confirmed COVID-19 diagnosis and influenza vaccination reported within the last 12 months. Logistic regression was conducted between influenza vaccination (exposure) and Long COVID (outcome), controlling for demographic variables, pre-existing health conditions, and socioeconomic status.

Results. Of 120,603 participants, 21.89% reported Long COVID symptoms and 42.04% had received an influenza vaccine. Findings indicate a statistically significant 13% reduction …

Covid-19 Vaccine Perception And Hesitancy Among Uninsured Free Clinic Patients, Samin Panahi, Brenda Spearman, Justine Sundrud, Mason Lunceford, Akiko Kamimura

Patient Experience Journal

There are many complexities regarding the acceptance of COVID-19 vaccines, mainly because the COVID-19 vaccine had a fast track of development compared to vaccines developed in the past years. The purpose of this study is to understand COVID-19 vaccine perception and hesitancy among uninsured free clinic patients using the theory of planned behavior. This study had seven focus groups with 37 total participants, including 19 Spanish speakers. Free clinic adult patients (over the age of 18) participated in four focus groups during Summer of 2021. The average age of the participants was 44.7, and the majority of the participants self-identified …

“Not Your Father’S Heart”: How Healthcare Discrimination For Neurodivergent Patients Taught Me About The Human Experience, Cate Murphy

Patient Experience Journal

It is easy to assume all patients who come into a hospital for acute crisis care have a clear understanding of how their experience will be facilitated. When a patient is neurodivergent, they cannot always agree to needed intervention. This is exacerbated by the “poor timing” of questions portrayed to impact the critical care received, sometimes irreparably. This is my story of watching my young, active partner suffer two massive heart attacks and refuse intervention because he was ashamed to admit he had not seen a doctor in over thirty years. Due to his neurodivergence, he could not process questions …

Investing In The Bottom Line: The Value Case For Improving Human Experience In Healthcare, Jason A. Wolf, Vishal Bhalla, Brian Carlson, Jennifer Carron, Lanie Dixon, Julie K. Oehlert, Brant J. Oliver

Patient Experience Journal

Investment in human experience is imperative for healthcare organizations. It is a strategic focus that can lead to great benefits. Those that overlook experience, seeing it as “simply” about satisfaction or survey data, do so at great cost to their organization, team members, and most importantly those we serve – patients. A commitment to human experience – integrating the patient, workforce, and community experience – is essential for all healthcare organizations in realizing the goals they strive for and the impact they aspire to achieve. It leads to high-quality outcomes for those they care for. It creates a positive environment …

The Evolution Of Patient Experience: From Holistic Care To Human Experience, Corey Adams, Reema Harrison, Jason A. Wolf

Patient Experience Journal

Patient experience has evolved as a critical concept and outcome in health systems internationally. Evolving from consumer-led movements, coupled with shifts in the positioning of patients among clinical professions, the global focus on patient experience is now evident in nationally mandated measurement tools, the creation of dedicated institutional leadership roles, and outlets such as the Patient Experience Journal. By critically analysing the pivotal factors and milestones that have shaped its evolution throughout healthcare history, this review provides an in-depth exploration of the evolution of patient experience. In doing so, the review provides a critical analysis of the application of patient …

Looking Back To Move Forward: The Next Decade And Beyond For Human Experience, Jason A. Wolf

Patient Experience Journal

This issue comes out at an important moment for the experience conversation. It was ten years ago from the publication date of this issue on April 30, 2014, that the first issue of Patient Experience Journal (PXJ) was released. PXJ was intended to be a gathering place. A virtual town square for the experience movement where people could and would come together to share ideas and proven practice. This value of collaboration is at the foundation of our very efforts as a global community through The Beryl Institute. Experience is not some secret competitive ingredient in the world of healthcare. …

Preventive Strategies For Elder Abuse Within Hospice Care By Healthcare Professionals, Joshua Eason

Nursing | Student Research Posters

Background: Healthcare professionals providing hospice care need to have particular specialized abilities, empathy, and trust. Unfortunately, some of these medical professionals are unable to provide their patients the care they need, so they will instead abuse and ignore them. Elder abuse must be identified and addressed in hospice care settings if older patients are to have their rights and dignity upheld and a standardized, compassionate end-of-life care program is to be provided for each patient.

Purpose: The purpose of this study is to examine the effectiveness and preventative strategies for elder abuse, implemented by healthcare providers within the hospice care …

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

Assessment Of Condylar Morphology In Various Facial Types-Cbct Study, Dr.Shruti Patil

Annual Research Symposium

Mandibular condyle being part of the TMJ complex, its volume and shape play a pivotal role in treatment stability and outcomes in orthodontic and orthognathic patients over long term periods. Different loading patterns would result in different morphology of the TMJ. The association with different facial types and understanding the relationship between condylar position, morphology and jaw base divergence is limited. This study’s objective is to assess the condylar structure which includes condylar height, width and height of the fossa in different jaw base divergences.

A cross-sectional study was conducted in which 90 patients undergoing Orthodontic treatment were selected and …