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Supplies Needed for Devices to Aid in Health Care in Developing Countries

Description

Many developing countries do not have health care systems that can afford technological biomedical devices or supplies to make such devices operational. To fill this void, nonprofit organizations, like Project C.U.R.E., recondition retired biomedical instrumentation so they can send medical supplies to help these developing countries. One of the issues…

Many developing countries do not have health care systems that can afford technological biomedical devices or supplies to make such devices operational. To fill this void, nonprofit organizations, like Project C.U.R.E., recondition retired biomedical instrumentation so they can send medical supplies to help these developing countries. One of the issues with this is that sometimes the devices are unusable because components or expendable supplies are not available (Bhadelia). This issue has also been shown in the Impact Evaluations that Project C.U.R.E. receives from the clinics that explain the reasons why certain devices are no longer in use. That need underlies the idea on which this honors thesis has come into being. The purpose of this honors project was to create packing lists for biomedical instruments that Project C.U.R.E. recycles. This packing list would decrease the likelihood of important items being forgotten when sending devices. If an extra fuse, battery, light bulb, cuff or transducer is the difference between a functional or a nonfunctional medical device, such a list would be of benefit to Project C.U.R.E and these developing countries. In order to make this packing list, manuals for each device were used to determine what supplies were required, what was necessary for cleaning, and what supplies were desirable but functionally optional. This list was then added into a database that could be easily navigated and could help when packing up boxes for a shipment. The database also makes adding and editing the packing list simple and easy so that as Project C.U.R.E. gets more donated devices the packing list can grow.

ContributorsGraft, Kelsey Anne (Author) / Coursen, Jerry (Thesis director) / Walters, Danielle (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)

Created2018-05

Delivering Advancing Healthcare

Description

In the medical industry, there have been promising advances in the increase of new types of healthcare to the public. As of 2015, there was a 98% Premarket Approval rate, a 38% increase since 2010. In addition, there were 41 new novel drugs approved for clinical usage in 2014 where…

In the medical industry, there have been promising advances in the increase of new types of healthcare to the public. As of 2015, there was a 98% Premarket Approval rate, a 38% increase since 2010. In addition, there were 41 new novel drugs approved for clinical usage in 2014 where the average in the previous years from 2005-2013 was 25. However, the research process towards creating and delivering new healthcare to the public remains remarkably inefficient. It takes on average 15 years, over $900 million by one estimate, for a less than 12% success rate of discovering a novel drug for clinical usage. Medical devices do not fare much better. Between 2005-2009, there were over 700 recalls per year. In addition, it takes at minimum 3.25 years for a 510(k) exempt premarket approval. Plus, a time lag exists where it takes 17 years for only 14% of medical discoveries to be implemented clinically. Coupled with these inefficiencies, government funding for medical research has been decreasing since 2002 (2.5% of Gross Domestic Product) and is predicted to be 1.5% of Gross Domestic Product by 2019. Translational research, the conversion of bench-side discoveries to clinical usage for a simplistic definition, has been on the rise since the 1990s. This may be driving the increased premarket approvals and new novel drug approvals. At the very least, it is worth considering as translational research is directly related towards healthcare practices. In this paper, I propose to improve the outcomes of translational research in order to better deliver advancing healthcare to the public. I suggest Best Value Performance Information Procurement System (BV PIPS) should be adapted in the selection process of translational research projects to fund. BV PIPS has been shown to increase the efficiency and success rate of delivering projects and services. There has been over 17 years of research with $6.3 billion of projects and services delivered showing that BV PIPS has a 98% customer satisfaction, 90% minimized management effort, and utilizes 50% less manpower and effort. Using University of Michigan \u2014 Coulter Foundation Program's funding process as a baseline and standard in the current selection of translational research projects to fund, I offer changes to this process based on BV PIPS that may ameliorate it. As concepts implemented in this process are congruent with literature on successful translational research, it may suggest that this new model for selecting translational research projects to fund will reduce costs, increase efficiency, and increase success. This may then lead to more Premarket Approvals, more new novel drug approvals, quicker delivery time to the market, and lower recalls.

ContributorsDel Rosario, Joseph Paul (Author) / Kashiwagi, Dean (Thesis director) / Kashiwagi, Jacob (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)

Created2016-05

Comparative Analysis of Interprofessional Clinic Models: Recommendations for Best Practice Implementation

Description

As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional practice and education to improve patient outcomes, reduce costs, and…

As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional practice and education to improve patient outcomes, reduce costs, and enhance the patient experience of care (Triple Aim). Interprofessional collaboration among diverse disciplines is evident on the Phoenix Biomedical Campus, integrating a wide variety of institutions and multiple health profession programs; and at the Student Health Outreach for Wellness (SHOW) free clinic, -- a successful tri-university, student-led, faculty mentored, and community-based model of interprofessional learning and care -- based in downtown Phoenix. This project conducted a comparative analysis of interprofessional components of 6 different clinical models in order to provide recommendations for best practice implementation. These models were chosen based on availability of research on interprofessionalism with their clinics. As a result, three recommendations were offered to the SHOW clinic for consideration in their efforts to improve both patient and educational outcomes. Each recommendation was intentionally formulated for its capacity to increase: interprofessionalism and collaboration between multiple disciplines pertaining to healthcare, among healthcare professionals to promote positive patient and educational outcomes. These recommendations include implementing an interprofessional education (IPE) course as a core component in an academic program's curriculum, offering faculty and professional development opportunities for faculty and mentors immersed in the interprofessional clinics, and utilization of simulation centers. Further studies will be needed to evaluate the impact these specific interventions, if adopted, on patient and educational outcomes.

ContributorsMousa, Mohammad (Co-author) / Mousa, Bakir (Co-author) / Johnson, Ross (Co-author) / Harrell, Liz (Thesis director) / Saewert, Karen (Committee member) / Harrington Bioengineering Program (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)

Created2017-05

Effect of splinting techniques on the correction of hand deformities: a scoping review

Description

The purpose of this paper was to systematically review current literature regarding the effect of hand splints on aesthetic outcomes for individuals with acquired hand deformities. Hand splints vary in form and function, and are used to maintain or ameliorate hand function and aesthetics. A literature search was performed on…

The purpose of this paper was to systematically review current literature regarding the effect of hand splints on aesthetic outcomes for individuals with acquired hand deformities. Hand splints vary in form and function, and are used to maintain or ameliorate hand function and aesthetics. A literature search was performed on peer-reviewed publications that used splinting as an intervention for conservative hand improvement. Evidence from ten randomized clinical trials (published from 2003 to 2015) was evaluated for aesthetic improvement among a total of 659 subjects. Cosmetic outcomes were analyzed by a change in angle measurements, such as extensor lag, ulnar deviation, and passive and active range of motion. Of these ten studies, five focused on hand deformities caused by neurological impairment, while the other five measured those with musculoskeletal complications. Only two of the ten studies concluded that splinting could aesthetically improve the hands, and only one of these reporting statistical significance in its data. The data was not only limited in quantity, but was presented in heterogeneous formats. There was an extensive variation in measured outcomes, intervention protocols, follow-up times, and many other aspects of the studies; this dissimilarity led to difficulty in performing a systematic assessment. The majority of evidence concludes that splinting does not improve the appearance of deformities, however none directly investigated this measure. Therefore, further RCTs that include measurements of cosmetic traits are necessary to better quantify the effect of splinting for management of hand deformities. This review was the first of its kind to evaluate the correction of hand deformities using splints as an intervention.

ContributorsVale, Nicholas Marshall (Author) / Santello, Marco (Thesis director) / Skiba, Jeffry (Committee member) / Harrington Bioengineering Program (Contributor, Contributor) / Barrett, The Honors College (Contributor, Contributor) / School of Biological and Health Systems Engineering (Contributor)

Created2017-05

Somatosensory Modulation during Speech Planning

Description

Previous studies have found that the detection of near-threshold stimuli is decreased immediately before movement and throughout movement production. This has been suggested to occur through the use of the internal forward model processing an efferent copy of the motor command and creating a prediction that is used to cancel…

Previous studies have found that the detection of near-threshold stimuli is decreased immediately before movement and throughout movement production. This has been suggested to occur through the use of the internal forward model processing an efferent copy of the motor command and creating a prediction that is used to cancel out the resulting sensory feedback. Currently, there are no published accounts of the perception of tactile signals for motor tasks and contexts related to the lips during both speech planning and production. In this study, we measured the responsiveness of the somatosensory system during speech planning using light electrical stimulation below the lower lip by comparing perception during mixed speaking and silent reading conditions. Participants were asked to judge whether a constant near-threshold electrical stimulation (subject-specific intensity, 85% detected at rest) was present during different time points relative to an initial visual cue. In the speaking condition, participants overtly produced target words shown on a computer monitor. In the reading condition, participants read the same target words silently to themselves without any movement or sound. We found that detection of the stimulus was attenuated during speaking conditions while remaining at a constant level close to the perceptual threshold throughout the silent reading condition. Perceptual modulation was most intense during speech production and showed some attenuation just prior to speech production during the planning period of speech. This demonstrates that there is a significant decrease in the responsiveness of the somatosensory system during speech production as well as milliseconds before speech is even produced which has implications for speech disorders such as stuttering and schizophrenia with pronounced deficits in the somatosensory system.

ContributorsMcguffin, Brianna Jean (Author) / Daliri, Ayoub (Thesis director) / Liss, Julie (Committee member) / Department of Psychology (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)

Created2019-05

Transitions of Privatized Healthcare in the United States

Description

This thesis project discusses the transitions of the physician profession and their struggle to maintain autonomy throughout American History until approximately the 1980's. Included in the historical account of the physician profession, is the development of the American Hospital System and its origins working under the physician profession. As history…

This thesis project discusses the transitions of the physician profession and their struggle to maintain autonomy throughout American History until approximately the 1980's. Included in the historical account of the physician profession, is the development of the American Hospital System and its origins working under the physician profession. As history progresses from 1760 on, what comes to light is a cyclical struggle for physicians to remain independent from the corporations, while using them to gain social and economic prestige. This work focuses on how the establishment of private practice in the United States has lead to the current system in place today, illustrating a long fight for control of the medical field that still rages on today. As physicians gained power and autonomy in the medical field during the 20th century, constant attempts of government intervention can be seen within the convoluted history of this professional field. The rise of corporate healthcare, that works in tandem with private physicians, was a critical period in forgotten American History that subsequently allowed physicians to increase their stranglehold on the medical service industry. The goal of this research was to establish a better understanding of American Medicine's history to better tackle the new problems we face today. As America transitions to a period of public health outcry, it is important to establish a somewhat linear rendition of a mostly untold history that directly impacts the lives of every citizen in this country. This work attempts to mend the broken pieces of that history to give light to how healthcare evolved into what it is today.

ContributorsParkhurst, Erik Lewis (Author) / Tyler, William (Thesis director) / Coursen, Jerry (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)

Created2018-12

Startle-evoked movement in multi-jointed, two-dimensional reaching tasks

Description

Previous research has shown that a loud acoustic stimulus can trigger an individual's prepared movement plan. This movement response is referred to as a startle-evoked movement (SEM). SEM has been observed in the stroke survivor population where results have shown that SEM enhances single joint movements that are usually performed…

Previous research has shown that a loud acoustic stimulus can trigger an individual's prepared movement plan. This movement response is referred to as a startle-evoked movement (SEM). SEM has been observed in the stroke survivor population where results have shown that SEM enhances single joint movements that are usually performed with difficulty. While the presence of SEM in the stroke survivor population advances scientific understanding of movement capabilities following a stroke, published studies using the SEM phenomenon only examined one joint. The ability of SEM to generate multi-jointed movements is understudied and consequently limits SEM as a potential therapy tool. In order to apply SEM as a therapy tool however, the biomechanics of the arm in multi-jointed movement planning and execution must be better understood. Thus, the objective of our study was to evaluate if SEM could elicit multi-joint reaching movements that were accurate in an unrestrained, two-dimensional workspace. Data was collected from ten subjects with no previous neck, arm, or brain injury. Each subject performed a reaching task to five Targets that were equally spaced in a semi-circle to create a two-dimensional workspace. The subject reached to each Target following a sequence of two non-startling acoustic stimuli cues: "Get Ready" and "Go". A loud acoustic stimuli was randomly substituted for the "Go" cue. We hypothesized that SEM is accessible and accurate for unrestricted multi-jointed reaching tasks in a functional workspace and is therefore independent of movement direction. Our results found that SEM is possible in all five Target directions. The probability of evoking SEM and the movement kinematics (i.e. total movement time, linear deviation, average velocity) to each Target are not statistically different. Thus, we conclude that SEM is possible in a functional workspace and is not dependent on where arm stability is maximized. Moreover, coordinated preparation and storage of a multi-jointed movement is indeed possible.

ContributorsOssanna, Meilin Ryan (Author) / Honeycutt, Claire (Thesis director) / Schaefer, Sydney (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)

Created2016-12

A Systematic Review of Racial Inclusivity in Stroke Rehabilitation Research

Description

SUMMARY: A failed attempt to conduct a systematic review of disparities in racial inclusivity in stroke rehabilitation research: A call to action Group Members: Adeline Beeler & Mikayla McNally Faculty Mentor(s): Dr. Sydney Schaefer & Dr. Keith Lohse Topic Overview: Stroke is responsible for the death of an individual every…

SUMMARY: A failed attempt to conduct a systematic review of disparities in racial inclusivity in stroke rehabilitation research: A call to action Group Members: Adeline Beeler & Mikayla McNally Faculty Mentor(s): Dr. Sydney Schaefer & Dr. Keith Lohse Topic Overview: Stroke is responsible for the death of an individual every four minutes in the United States. While all Americans are gravely affected by this statistic, Black Americans are at a significantly increased risk of first stroke incidence when compared to their white counterparts, majorly due to heightened prevalence of stroke risk factors. Not only does race contribute as a factor in stroke incidence, but it also has a considerable impact in the physical impairment of Black Americans following stroke occurrence. While it still remains unclear as to whether or not stroke plays a significant role in stroke rehabilitation efforts, there is a clearly demonstrated need for increased reporting or participation of Black Americans in stroke rehabilitation clinical trials to have the ability to conduct a systematic review of these racial disparities in the near future. In the analysis of 36 stroke rehabilitation-related clinical research studies, 80% of selected trials failed to report any participant racial demographics, with 77.3% of the NIH-funded trials not reporting, as well. Out of the 7 trials that did provide some sort of participant racial information, only 5 successfully provided statistically significant racial data compared to the remainder that simply categorized participants’ race as “white” or “other.” In order to fully investigate the effects of race on stroke rehabilitation, it is imperative that researchers collect and report equally distributed and diverse participant racial data when publishing clinical research. Potential methods of improvement for researchers to include more racially diverse subject populations include more comprehensive and in-depth advertising and recruitment strategies for their studies. Research Methods: In order to produce accurate analyses of the current state of the relationship between race and stroke rehabilitation efforts, 36 stroke rehabilitation clinical research trials from various locations across the United States were identified using the Centralized Open-Access Rehabilitation Database for Stroke (SCOAR). These trials were evaluated in order to extract relevant data, such as number of trial participants, average age of participants, if the research trial was funded by the National Institute of Health (NIH) or not, and any reported participant racial demographic details. Trends across these categories were compared between all trials to determine if any disparities existed in providing data sufficient to support the relationship between varying racial populations and stroke rehabilitation efforts. Future Project Efforts: Future efforts will include the completion of submitting a Point of View/Directions for Research article for publication to offer an opportunity for clinical and basic researchers to examine the discrepancies surrounding racial inclusivity in stroke rehabilitation clinical research. The aim is to improve the ability of clinicians to interpret the literature, translate research studies into practices, and better direct future experiments. Further identification of stroke rehabilitation clinical research trials will be necessary, as well as modifications to current written work content.

ContributorsBeeler, Adeline (Author) / McNally, Mikayla (Co-author) / Schaefer, Sydney (Thesis director) / Lohse, Keith (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)

Created2021-12

A Systematic Review of Racial Inclusivity in Stroke Rehabilitation Research

Description

SUMMARY: A failed attempt to conduct a systematic review of disparities in racial inclusivity in stroke rehabilitation research: A call to action Group Members: Adeline Beeler & Mikayla McNally Faculty Mentor(s): Dr. Sydney Schaefer & Dr. Keith Lohse Topic Overview: Stroke is responsible for the death of an individual every…

SUMMARY: A failed attempt to conduct a systematic review of disparities in racial inclusivity in stroke rehabilitation research: A call to action Group Members: Adeline Beeler & Mikayla McNally Faculty Mentor(s): Dr. Sydney Schaefer & Dr. Keith Lohse Topic Overview: Stroke is responsible for the death of an individual every four minutes in the United States. While all Americans are gravely affected by this statistic, Black Americans are at a significantly increased risk of first stroke incidence when compared to their white counterparts, majorly due to heightened prevalence of stroke risk factors. Not only does race contribute as a factor in stroke incidence, but it also has a considerable impact in the physical impairment of Black Americans following stroke occurrence. While it still remains unclear as to whether or not stroke plays a significant role in stroke rehabilitation efforts, there is a clearly demonstrated need for increased reporting or participation of Black Americans in stroke rehabilitation clinical trials to have the ability to conduct a systematic review of these racial disparities in the near future. In the analysis of 36 stroke rehabilitation-related clinical research studies, 80% of selected trials failed to report any participant racial demographics, with 77.3% of the NIH-funded trials not reporting, as well. Out of the 7 trials that did provide some sort of participant racial information, only 5 successfully provided statistically significant racial data compared to the remainder that simply categorized participants’ race as “white” or “other.” In order to fully investigate the effects of race on stroke rehabilitation, it is imperative that researchers collect and report equally distributed and diverse participant racial data when publishing clinical research. Potential methods of improvement for researchers to include more racially diverse subject populations include more comprehensive and in-depth advertising and recruitment strategies for their studies. Research Methods: In order to produce accurate analyses of the current state of the relationship between race and stroke rehabilitation efforts, 36 stroke rehabilitation clinical research trials from various locations across the United States were identified using the Centralized Open-Access Rehabilitation Database for Stroke (SCOAR). These trials were evaluated in order to extract relevant data, such as number of trial participants, average age of participants, if the research trial was funded by the National Institute of Health (NIH) or not, and any reported participant racial demographic details. Trends across these categories were compared between all trials to determine if any disparities existed in providing data sufficient to support the relationship between varying racial populations and stroke rehabilitation efforts. Future Project Efforts: Future efforts will include the completion of submitting a Point of View/Directions for Research article for publication to offer an opportunity for clinical and basic researchers to examine the discrepancies surrounding racial inclusivity in stroke rehabilitation clinical research. The aim is to improve the ability of clinicians to interpret the literature, translate research studies into practices, and better direct future experiments. Further identification of stroke rehabilitation clinical research trials will be necessary, as well as modifications to current written work content.

ContributorsMcNally, Mikayla (Author) / Beeler, Adeline (Co-author) / Schaefer, Sydney (Thesis director) / Lohse, Keith (Committee member) / Barrett, The Honors College (Contributor) / Watts College of Public Service & Community Solut (Contributor) / Harrington Bioengineering Program (Contributor)

Created2021-12

beeler_fall_2021.pdf

ContributorsBeeler, Adeline (Author) / McNally, Mikayla (Co-author) / Schaefer, Sydney (Thesis director) / Lohse, Keith (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)

Created2021-12

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