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- All Subjects: healthcare
- Creators: Harrington Bioengineering Program
- Creators: Reddy, Swapna
- Member of: Barrett, The Honors College Thesis/Creative Project Collection
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 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
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 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
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 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
Description
This paper describes Social Determinants of Health and the implementation of a screener. Social Determinants are structural drivers in an individual's life that affect their status of health. A screener's potential effectiveness at a student-run interdisciplinary clinic was also explored in the paper through the analysis of Student Health Outreach for Wellness (SHOW). SHOW's framework allows for a unique implementation of the screener because of the vulnerable population it serves, and the flexibility of the organization's structure. Its interdisciplinary nature allows for the SDOH screener to be integrated into its process more easily, especially with the presence of disciplines such as social work. A Social Determinants of Health questionnaire can be an important instrument to increase effectiveness in patient care by acknowledging each patient's situation more comprehensively, and moving forward with the most appropriate care plan. Among a vulnerable population such as those experiencing homelessness, an SDOH screener can identify key areas of focus that patients need addressed in order to improve their health status. A literature review was conducted to observe previous screener structures and questions. A model screener and best practices are provided as a guide for other clinics to use and adapt in their own settings. The domains of the sample screener questionnaire are tailored to serve populations with housing insecurity. The hope is to move forward with this screener after further modification of the questions, resources associated to each, and its prospective connection to the EHR system. The screener is planned to be executed at the SHOW clinic in Fall of 2018. In conclusion, a social determinants of health screener should be implemented in interdisciplinary clinics in a similar manner to SHOW's approach, to shift the focus of healthcare toward patient-centered care.
ContributorsThomas, Christy Maria (Author) / Reddy, Swapna (Thesis director) / Essary, Alison (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
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 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
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 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
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
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
Description
Introduction: Health disparities for the Native American population in the United States have been well documented for years. Native Americans face many barriers to healthcare access, including low socioeconomic status, historical trauma, and lack of access to healthcare facilities. Barriers to healthcare and challenges associated with achieving optimal health among Native Americans contribute to health disparities within these populations. If these barriers are to be overcome, they must be understood and addressed. Purpose: The purpose of this review was to identify barriers to healthcare access for Native American populations as well as strategies to address barriers. Method: A preliminary scan of several online databases was conducted. Key terms used in the search included American Indians, Native American, healthcare, healthcare access, health disparities, barriers, and intervention. Articles were selected based on relevance, and data from each chosen article were extracted and categorized. Results: The initial search resulted in 272 articles of potential interest. Based on the abstract review, 32 were deemed relevant, and full text reviews were completed. Based on the full text review, an additional 10 articles were excluded, resulting in a final review of 22 articles. The articles addressed barriers related to various health conditions: cancer treatment, drug or alcohol use, maternal and child health, historical trauma, diabetes and chronic illnesses, and oral health. Conclusion: Native Americans face several barriers to healthcare access that are associated with social, physical, and mental health disparities. Successful efforts to address these barriers include patient-centered, culturally-competent interventions. Others include interventions which focus on community involvement.
ContributorsMohamed, Hebah (Co-author) / Mohamed, Hitham (Co-author) / Coplan, Bettie (Thesis director) / Reddy, Swapna (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
Description
This thesis uses the Foucauldian model of the biopolitical state to explain the regulation of refugee women’s bodies who have undergone female genital cutting/mutilation (FGC/M). The main theoretical framework for this thesis is inspired by Dr. Khiara Bridges’ work: Reproducing Race: An Ethnography of Pregnancy as a Site of Racialization (2011). Her book explains how “material and societal conditions appear to affirm the veracity of race” (Bridges, 2011, 10). She describes pregnancy as a “racially salient event” that inevitably engages racial politics. In her book, she illustrates how the material body is the primary sign of racial difference (Bridges, 2011, 47). I argue that race and culture are inscribed in the body, and FGC/M is a physical representation of that inscription. As a result, a physical representation of racialization opens women with FGC/M to far more scrutiny and regulation. I define the United States and France as biopolitical states whose values and agendas regulate and police bodies to behave according to their norms. The value set that underlies the United States is predicated on principles of sovereignty, federalism, and an emphasis on a Puritanical work ethic where an individual must earn their benefits from the state. In France, however, there is less stigma surrounding social welfare but there is forced cultural assimilation that results in a singular, secular French identity. These value systems then inform the tools to police behavior. The tools, or systems, I have identified for this thesis are the adoption of human rights instruments into domestic law, refugee policy, healthcare systems, and regulation of women’s reproductive health. All of these macro-level systems then inform individual patient-provider relationships since those interactions are not independent of these systems. I argue that refugee women who have undergone FGC/M deviate from these prescribed norms and thus are subjugated to overwhelming biopolitical regulation.
ContributorsRamakumar, Asha Anjali (Author) / Reddy, Swapna (Thesis director) / Switzer, Heather (Committee member) / College of Health Solutions (Contributor) / Dean, W.P. Carey School of Business (Contributor) / School of Social Transformation (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05