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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
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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
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Description
Introduction. Evidence shows that the United States' healthcare system is inefficient and lacks the quality and cost-effectiveness of other systems. The Institute for Healthcare Improvement outlined the Triple Aim to improve the healthcare system through 1) improvement of population health for a defined population, 2) enhance the patient care experience,

Introduction. Evidence shows that the United States' healthcare system is inefficient and lacks the quality and cost-effectiveness of other systems. The Institute for Healthcare Improvement outlined the Triple Aim to improve the healthcare system through 1) improvement of population health for a defined population, 2) enhance the patient care experience, and 3) reduce per capita cost of care. The World Health Organization has identified interprofessional practice (IPP) and interprofessional education (IPE) as a possible approach to achieve the Triple Aim. The Student Health Outreach for Wellness (SHOW) initiative is an interprofessional free clinic and outreach initiative for individuals experiencing homelessness. The goal of the current study was to evaluate whether interprofessional care delivery through SHOW moved SHOW's practice towards the Triple Aim for SHOW's defined population. Methods and Results. Data assessing adherence to Triple Aim goals of population health and costs of care were collected from voluntary post-visit patient satisfaction surveys, while data assessing patient experience were collected from shift rosters of SHOW versus a similar non-interprofessional clinic. SHOW, on average, provided access to more disciplines than a similar non-interprofessional clinic. Access to care cost savings was assessed by surveying patients on where they would have sought care elsewhere SHOW had not been available ; of the 53 patients surveyed, 14 indicated they would have gone to the emergency department (ED); in all, SHOW diverted a little over $30,000 in patient ED visits. Improved health outcomes were measured by each patient's self-perception of his/her health. 91% of patients agreed or strongly agreed that their health had been improved by coming to the clinic. Conclusion. Preliminary data suggest that SHOW's IPP care delivery results in high patient satisfaction rates and positive self-perception of health outcomes, thus may improve the patient experience and minimize costs of care by deterring ED visits within the population. Further studies are needed to determine how specific aspects of interprofessional care can further move towards Triple Aim objectives.
ContributorsSingh, Sukhdeep (Co-author) / Paode, Pooja (Co-author) / Harrell, Liz (Thesis director) / Wermers, Rita (Committee member) / Department of Finance (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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
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
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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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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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Description
Water is a scarce resource that is recycled through wastewater treatment plants (WWTPs) to help fulfill the demand for water. Agriculture is a large consumer of water, indicating that WWTP-treated water is proportionally applied to crops at a high rate. Recycled water is highly regulated but is capable of containing

Water is a scarce resource that is recycled through wastewater treatment plants (WWTPs) to help fulfill the demand for water. Agriculture is a large consumer of water, indicating that WWTP-treated water is proportionally applied to crops at a high rate. Recycled water is highly regulated but is capable of containing high-risk pathogens and contaminants despite the efforts of physical and microbial treatments throughout the WWTP process. WWTPs are also producers of biosolids, treated sewage sludge regulated by the EPA that can be applied in agricultural settings to act as a fertilizer. Biosolids are a useful fertilizer as they are rich in nitrogen and contain many beneficial nutrients for soil and crops. Due to biosolids being a by-product of recycled water, they are susceptible to containing the same pathogens and contaminants that can be transferred in the WWTP systems. Antibiotic resistance (AR) is an ever-growing threat on a global scale and is one of the areas of concern for consideration of pathogen spread from WWTPs. Antibiotic resistance bacteria, created through mutation of bacterial plasmids producing antibiotic resistance genes (ARGs), have been quantified and studied to help mitigate the risk posed by continued AR spread in the environment. This study aims to produce a comprehensive collection of quantified ARG concentration data in biosolids, as well as producing a QMRA model integrating Monte Carlo distributions to provide groundwork for understanding of the direct dosage and consumption of ARGs to the standard U.S. citizen. The study determined that sul1, sul2, tetM, and tetO are ARGs of high concern in biosolid samples based on current concentration data of biosolid samples. The resulting dose models and gene concentration distributions provide data to support the need to mitigate AR risk presented by agricultural biosolid application.
ContributorsMorgan, Grace (Author) / Hamilton, Kerry (Thesis director) / Muenich, Rebecca (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)
Created2022-05