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- All Subjects: medicine
- Creators: Brian, Jennifer
Description
This paper sought to answer the question of how to improve the American healthcare system. The Affordable Care Act aimed to do this by increasing access to insurance. What this has done, however, is exacerbate the already rising rate of physician shortages. As a way to fix this problem, it is suggested that state legislatures and the federal government adopt the rising trend of expanding scope of practice to the extent of the care providers' certification. This is a movement has garnered support throughout the country and 20 states already allow for nearly autonomous practice by advanced practice nurses (APNs). This paper looked at systematic review, peer-reviewed papers, state/federal legislation and labor statistics to demonstrate how this move could increase access to healthcare providers as well as decrease cost by nearly 25%. This paper also evaluated how to formalization of nursing education has had positive impacts on the French healthcare system. Additionally, it evaluated a more specific look at Arizona and used data provided by the Arizona Board of Nursing and The Arizona Medical Board to make a compelling argument as to why this is a viable option for solving the disparity between rural and urban healthcare. The conclusion of the paper was to push policy makers to make the statutory constraints of the profession closer to the certification the people receive in their education as opposed to relying on case law. Additionally, it would be helpful to use technological innovations, like project echo, to help these professionals practice in rural areas. This will ultimately lead to a healthcare system that better serves the needs of all populations, as well as decreasing the overall cost of care.
ContributorsKingsbury, Andrew (Author) / Brian, Jennifer (Thesis director) / McGregor, Joan (Committee member) / Reddy, Swapna (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
While the transition from sectarian to allopathic medicine was almost entirely beneficial due to our perceived value in the type of evidence and transparency that science provides, key values within sectarian practice were lost in this transition. Attention to these values helps us better understand the role and treatment of patients in modern medicine. Modern scientific physicians have proven the inefficacy of sectarian treatments by scientific practices, but the efficacy of exact sectarian remedies may not have bearing on the importance of sectarian values. These values were: medical simplicity, harmlessness in treatment, independence from physicians and accessibility of treatment. A more in-depth analysis of sectarian values allows us to understand that while the values of allopathic medicine have become ubiquitous, it has not always been that way. It is time to consider the validity in the sectarian values we have abandoned; this analysis was one of many on medicine's imminent developmental horizon. This realization allows us to call into question the importance of our current practicing values, and the necessity that they continue to stand alone.
ContributorsAyala, Erik Richard (Author) / Brian, Jennifer (Thesis director) / Ross, Christian (Committee member) / Department of Psychology (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental disorder that is becoming increasingly common. Autism does not yet have a known etiology, nor a definitive diagnostic test, thus making diagnosis a difficult and rarely uniform task. Currently, ASD is behaviorally diagnosed based on criteria defined by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Recently, a change was made in the criteria from more lenient criteria in DSM-IV-TR, to more narrow criteria laid out by the DSM-V, which supersedes the DSM-IV-TR. This drastic change raised many questions and debates about which set of criteria are better. The more lenient criteria offers a more inclusive diagnosis giving greater access to therapies; while the narrow diagnostic criteria excludes some individuals, creating a more uniform diagnosis that's easier to use in research. This thesis analyzes the change in diagnostic criteria from the DSM-IV-TR to the DSM-V and the effects of these changes on the practices of diagnosis. In addition, it explores the implications of this change for the families of children with autism and for those involved in autism research, examining their respective opinions and interests pertaining to narrow verses broad diagnostic criteria. Building on this analysis, the thesis offers recommendations about diagnostic criteria should be set. It argues that the wellbeing of patients takes priority over the interests of researchers, and thus diagnosis should be done in a way that offers the best prognosis for all children who suffer from autistic symptoms.
ContributorsBremer, Michelle Nichole (Author) / Hurlbut, Ben (Thesis director) / Robert, Jason (Committee member) / Brian, Jennifer (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
This study was conducted as part of an underlying initiative to elucidate the mechanism of action of natural antibacterial clay minerals for application as therapeutic agents for difficult-to-treat infections such as methicillin-resistant Staphylococcus aureus (MRSA)-derived skin lesions and Buruli ulcer. The goal of this investigation was to determine whether exposure to the leachate of an antibacterial clay mineral, designated as CB, produced DNA double-strand breaks (DSBs) in Escherichia coli. A neutral comet assay for bacterial cells was adapted to assess DSB levels upon exposure to soluble antimicrobial compounds. Challenges involved with the adaptation process included comet visualization and data collection. To appropriately account for antimicrobial-mediated strand fragmentation, suitable control reactions comprised of exposures to water, ethanol, kanamycin, and bleomycin were developed and optimized for the assay. Bacterial exposure to CB resulted in significantly longer comet lengths compared to negative control exposures, suggesting that CB killing activity involves the induction of DNA DSBs. The results of this investigation further characterize the antimicrobial mechanisms associated with a particular clay mineral mixture. The adapted comet assay protocol described herein functions as an effective tool to assess double-strand fragmentation resulting from exposure to soluble antimicrobial compounds and to visually compare results from experimental and control reactions.
ContributorsSolanky, Dipesh (Author) / Haydel, Shelley (Thesis director) / Stout, Valerie (Committee member) / Adusumilli, Sarojini (Committee member) / Barrett, The Honors College (Contributor) / College of Liberal Arts and Sciences (Contributor)
Created2012-12
Description
Glioblastoma multiforme (GBMs) is the most prevalent brain tumor type and causes approximately 40% of all non-metastic primary tumors in adult patients [1]. GBMs are malignant, grade-4 brain tumors, the most aggressive classication as established by the World Health Organization and are marked by their low survival rate; the median survival time is only twelve months from initial diagnosis: Patients who live more than three years are considered long-term survivors [2]. GBMs are highly invasive and their diffusive growth pattern makes it impossible to remove the tumors by surgery alone [3]. The purpose of this paper is to use individual patient data to parameterize a model of GBMs that allows for data on tumor growth and development to be captured on a clinically relevant time scale. Such an endeavor is the rst step to a clinically applicable predictions of GBMs. Previous research has yielded models that adequately represent the development of GBMs, but they have not attempted to follow specic patient cases through the entire tumor process. Using the model utilized by Kostelich et al. [4], I will attempt to redress this deciency. In doing so, I will improve upon a family of models that can be used to approximate the time of development and/or structure evolution in GBMs. The eventual goal is to incorporate Magnetic Resonance Imaging (MRI) data into a parameterized model of GBMs in such a way that it can be used clinically to predict tumor growth and behavior. Furthermore, I hope to come to a denitive conclusion as to the accuracy of the Koteslich et al. model throughout the development of GBMs tumors.
ContributorsManning, Miles (Author) / Kostelich, Eric (Thesis director) / Kuang, Yang (Committee member) / Preul, Mark (Committee member) / Barrett, The Honors College (Contributor) / College of Liberal Arts and Sciences (Contributor)
Created2012-12
Description
Though schizophrenia was categorized as a mental illness over 100 years ago, there is a plethora of knowledge that continues to perplex the scientific and medical community alike. This tragic mental disorder affects approximately 1% of the general population, and many of these individuals are homeless if left untreated. Each schizophrenia patient has a different set of symptoms, so all of these patients experience a variety of positive and negative symptoms. Negative symptoms are called so as they are in absence, and some examples include apathy, anhedonia, lack of motivation, reduced social drive, and reduced cognitive functioning. Positive behavior, on the other hand, is a change in behavior or thoughts such as visual or auditory hallucinations, delusions, confused thoughts, disorganized speech, and trouble concentrating. Because schizophrenia patients do not share the exact same set of symptoms, research in schizophrenia requires a tremendous amount of medical resources. Over the last few years, new studies have started in the field of schizophrenia involving proteomics, or the study of proteins and their function. This new frontier gives doctors and scientists alike a new opportunity to improve the quality of life of schizophrenia patients by providing a potential method through which patients would receive individualized treatment based on their specific symptoms.
ContributorsPeterson, Rozabel (Author) / Brian, Jennifer (Thesis director) / School of Molecular Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05