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- Creators: College of Health Solutions
- Member of: Barrett, The Honors College Thesis/Creative Project Collection
Research Objective Social determinants of health (SDOH) are the conditions in one’s living environment that affect health, functioning, and quality of life. Total joint arthroplasty (TJA) is a surgical procedure to replace a damaged joint with an artificial joint. TJA complications include acute myocardial infarction, pneumonia, sepsis, surgical site bleeding, pulmonary embolism, or periprosthetic joint infection. Previous research demonstrates that Black race, Hispanic ethnicity and poverty were negatively associated with TJA outcomes in veterans. The goal of this mixed methods quality improvement study is to determine if SDOHs affect TJA complications at a health system in the Phoenix metropolitan area. Methodology For this study, records from patients who underwent hip or knee TJAs at any of the four system facilities between 2/2019-2/2020 were included. Demographics and clinical data were extracted from the electronic health record (EHR) via Midas+ Care Management with SDOH variables from case manager notes corresponding to food, utilities, housing and transportation insecurities, and interpersonal safety. Complications were identified using ICD-10 codes. SDOH for individuals with and without complications were compared. A multinomial logistic regression was performed in SPSS to identify significant variables. Semi-structured interviews with case managers (n=2), orthopedic surgeons(n=5), and primary care physicians (n=4) were performed to explore care team interactions with SDOH. Interview notes were coded and analyzed based on response frequency and themes. Results Of 2,520 patients who underwent TJA, 50 (1.98%) experienced a TJA complication. Of those, 38% screened positive for an SDOH. For those without a TJA complication, 27% screened positive for an SDOH (p=0.093). Most interview participants identified a correlation between socioeconomic status and surgical outcomes. They also recognized that language barriers for Spanish-speaking individuals and family involvement post-discharge are significant factors in TJA outcomes. Conclusions This single system mixed methods retrospective quality improvement study demonstrates that patients who screen positive for an SDOH are more likely to experience a TJA complication. We recommend that SDOH assessments be obtained for all patients undergoing TJA, be available to care teams, and be incorporated into care plans to improve outcomes.
Physical therapy modalities are passive tools that are used in physical therapy clinics, beside the exercise program and manual therapy, that promote blood flow, decrease inflammation, and improve range of motion and function. Electrical stimulation, ultrasound, ice, and heat were analyzed in this review. The purpose of this quantitative review is to use the research that has been conducted over the past 30 years to determine if physical therapy modalities are effective at decreasing inflammation, increasing range of motion and function, decreasing pain, and to draw a conclusion about whether or not they should still be used on patients today. Systematic reviews and meta analysis were analyzed and compared to qualitative surveys and patient/therapist surveys conducted in this study to determine if ultrasound, electrical stimulation, ice, and heat were effective. The results showed that both electrical stimulation and ultrasound were effective for decreasing pain, increasing functionality, and decreasing inflammation (Ashrafi, 2017; Bistolfi, 2018; Ferronato, 2017; Fuentes, 2010; Haile, 2021; Yu, 2015). However, the types of injuries, frequency, and duration of the modalities used still need to be further researched to understand how to maximize the effectiveness of these modalities. Ice therapy was significantly effective at decreasing inflammation, while heat therapy was significantly effective at decreasing pain, both in the short term (Wang et al., 2021).
For most women, pregnancy is the period in which they will have more interaction with the healthcare field than any other period in their lives. The quality and accessibility of obstetric care varies greatly throughout the United States, and health disparities in this field have the largest impact on African American women. Black mothers in the U.S. are three to four times more likely than white mothers to die as a result of pregnancy related complications. The increased risk of maternal morbidity and mortality seen in the African American population is largely due to preventable causes. This thesis project includes three case studies which analyze the most prevalent and preventable sources of health disparity affecting Black mothers: preeclampsia, hemorrhage, and cesarean section. Possible solutions to each of these disparities are explored on an individual, institutional, and societal scale.
Methods: This study was a randomized, wait-list, control trial with assessments at baseline and post-intervention (week 4). Participants were asked to meditate using Calm for 10 minutes per day. A p value ≤0.05 was considered statistically significant.
Results: The majority of participants (n=19) stated using Calm helped them cope with the stress of PA school. The intervention group participated in meditation for an average of 76 minutes/week. There were significant differences in all outcomes for the intervention group (all p ≤0.06). There was a significant interaction between group and time factors in emotional exhaustion (p=.016) and depersonalization (p=.025).
Conclusions: Calm is a feasible way to reduce burnout in PA students. Our findings provide information that can be applied to the design of future studies.
The mission of EZ-Sit is to alleviate pain and increase comfort by creating a product that allows users to put their feet up when sitting for long periods of time. This product will connect to any single stem office chair with ease and will provide users with the ability to put their feet up whenever and wherever they work. Our goal is to empower individuals to pursue their goals without the hindrance of discomfort that comes with sitting for extended periods of time. At EZ-Sit we believe that no one’s productivity should be impeded due to the pain caused by a sedentary work life. We hope that this product will bring about physical well being in the workplace so individuals can focus on the day ahead of them. At EZ-Sit, our values include personal health, affordability, and productivity. Personal health is one of our core principles because we believe that people should not have to endure pain while sitting in order to get their work done. We value the integrity of the hard work that many people show while trying to pursue their dreams. We believe this strong drive for personal or professional growth should not have the consequences of pain. We also believe that our solution should be accessible to all regardless of financial situations. Our Vision at EZ-Sit is to create awareness around healthy sitting practices in addition to how these practices can boost productivity and can prevent burnout. We want to encourage people to take a stand about their sitting habits. Our analysis of the foot rest industry shows that this is not the first product of its kind, but the EZ-Sit is certainly the most accessible. Footrests exist all over the internet and in stores, but all of them are independent of the actual chair. These foot rests are one size-fits all and provide no physiological benefits to users who are either too short or too tall. In addition there are chairs on the market that have a built-in footrest. These chairs, however, are very expensive. This effectively excludes a whole portion of the market who do not have the means to invest in the product. We plan on marketing to young professionals who fall into the age range of eighteen to twenty-eight years old. We want to emphasize that taking care of your body while pursuing your goals is not something to be taken lightly. When we have a working model we plan on using social media platforms such as Instagram and TikTok to show how the product works as well as educate individuals around the health benefits of this product. Because this product is new to the market it is important for users to understand why it is different from other footrests in the market. Social media will also help to differentiate our product from the others by showing comparisons. We also plan on utilizing slogans that resonate without demographics such as “EZ-Sit, That’s It!” in order to grab the attention of our target audience.