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Title: EXPLORING DIET, PHYSICAL ACTIVITY, AND SELF-REPORTED HEALTH STATUS AMONG INDIVIDUALS IN THE MEDICALLY UNDERSERVED POPULATION.
Creator: Devoe, Kelley R, Valdes, Anna, University of Central Florida
Abstract / Description: The primary purpose of this study is to determine if certain lifestyle and health behaviors (e.g. smoking, physical activity, diet) in the medically underserved population have any influence on particular health statuses. This study also looked to determine if these health behaviors resulted in particular medical aliments being more prevalent or specific to this community. The secondary purpose of this study aims to gain information that may help health care providers practicing in this...
Show moreThe primary purpose of this study is to determine if certain lifestyle and health behaviors (e.g. smoking, physical activity, diet) in the medically underserved population have any influence on particular health statuses. This study also looked to determine if these health behaviors resulted in particular medical aliments being more prevalent or specific to this community. The secondary purpose of this study aims to gain information that may help health care providers practicing in this community to earlier identify risk factors in patients before a medical problem becomes more severe, difficult and expensive to treat. A survey, adapted from the CDC's Behavioral Risk Factor Surveillance System (BRFSS), was created to allow for the collection of descriptive statistical data. The survey contains questions on the various topics of diet, physical activity, chronic diseases, and self-perception of overall health status. The survey was distributed to 20 older adult participants at Hebni Nutrition, LLC, all from disadvantaged backgrounds. Descriptive statistics were used to analyze the data. Of the 20 surveys collected, about half of the respondents reported consuming close to the recommended fruit and vegetable servings and participating in regular physical activity. Furthermore, the participants reported rates of diabetes and hypertension well above average. This study's results were inconclusive as to whether any specific health behaviors among medically underserved individuals influence the prevalence of chronic diseases in this population; more likely a combination of many factors and overall poorer health habits that persist over a lifetime are contributors to chronic diseases among the medically underserved population.
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Date Issued: 2018
Identifier: CFH2000292, ucf:45892
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000292

Title: A COMPARATIVE STUDY OF MEDICAL AND LITERARY REPRESENTATIONS OF SHELL SHOCK, 1914-50.
Creator: Das, Madison, Kane, Louise, University of Central Florida
Abstract / Description: This thesis explores shell shock--a common but misunderstood disorder seen in soldiers of World War One--through a Medical Humanities framework. Chapter 1 conducts a traditional medical review of scientific articles published on the pathology, symptoms, and treatment of shell shock between 1914-50. Chapter 2 builds upon this by offering a literary reading of Rebecca West's novel, The Return of the Soldier, which was published as the war drew to a close in 1918. The reading of West draws upon...
Show moreThis thesis explores shell shock--a common but misunderstood disorder seen in soldiers of World War One--through a Medical Humanities framework. Chapter 1 conducts a traditional medical review of scientific articles published on the pathology, symptoms, and treatment of shell shock between 1914-50. Chapter 2 builds upon this by offering a literary reading of Rebecca West's novel, The Return of the Soldier, which was published as the war drew to a close in 1918. The reading of West draws upon the medical research detailed in Chapter 1 to offer new conclusions about Chris's shell shock. The thesis shows how taking an interdisciplinary approach to shell shock enables the development of new perspectives of and approaches to shell shock, its history and significance, and its links to present-day mental health conditions such as post-traumatic stress disorder (PTSD).
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Date Issued: 2019
Identifier: CFH2000543, ucf:45655
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000543

Title: IS THE DOCTOR IN? THE EFFECTS OF EMIGRATION ON THE HEALTH CARE SYSTEMS IN POLAND AND ROMANIA.
Creator: Wolk, Gabriela B, Turcu, Anca, University of Central Florida
Abstract / Description: The �brain drain� phenomenon encompasses the mass movement of highly educated individuals. Highly-skilled and well-educated migrants are moving to more developed and urban settings, often in search of a higher standard of living and better wages. Since joining the European Union and the Schengen Agreement, Poland and Romania have experienced significant emigration which has subsequently affected their health care systems. Motivations for emigrating from these two countries and the effects...
Show moreThe �brain drain� phenomenon encompasses the mass movement of highly educated individuals. Highly-skilled and well-educated migrants are moving to more developed and urban settings, often in search of a higher standard of living and better wages. Since joining the European Union and the Schengen Agreement, Poland and Romania have experienced significant emigration which has subsequently affected their health care systems. Motivations for emigrating from these two countries and the effects emigration has had on patients and other doctors will be considered. The paper also seeks to compare policy responses to the mass medical emigration phenomenon in both countries, as well as the outcomes of such policies. The main methodology of study throughout this project entails a comparative assessment of the governmental policy responses to brain drain. An analysis of Poland�s and Romania�s health care systems will be performed initially. The analysis includes details on the causes and factors that bring about migration, the impact that emigration has had on patients, how doctors remaining in the sending country are affected, and what social upheavals and unrest result from such emigration. Following, the levels and flows of migration are considered for each country, looking at the type of people leaving, whether educated or not, and the range of professions, with a focus on health professionals that are migrating from both countries. After an analysis has been performed for both countries, the results will be compared to one another, paying special attention to any differences and potential reasons for these differences.
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Date Issued: 2016
Identifier: CFH2000062, ucf:52903
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000062

Title: The Role of Resilience on Second-Victim Outcomes: Examining Individual and External Factors of Medical Professionals.
Creator: Hernandez, Claudia, Burke, Shawn, Bowers, Clint, Porter, Marissa, University of Central Florida
Abstract / Description: The present work is intended to bring awareness to medical professionals impacted by the occurrence of errors they have committed or witnessed (i.e., second-victims) and highlight the negative effects that may result from such errors. The purpose of this research is to test whether resilience and negative affect that is experienced after a medical error are related. Additionally, four variables are tested as moderators of this relationship, two of which are considered individual variables (i...
Show moreThe present work is intended to bring awareness to medical professionals impacted by the occurrence of errors they have committed or witnessed (i.e., second-victims) and highlight the negative effects that may result from such errors. The purpose of this research is to test whether resilience and negative affect that is experienced after a medical error are related. Additionally, four variables are tested as moderators of this relationship, two of which are considered individual variables (i.e., self-efficacy and work meaningfulness), and two of which are characterized as external variables (i.e., co-worker support and organizational support). Twenty-two healthcare professionals from a hospital's Cardio-Vascular Intensive Care Unit participated in a short survey. Results showed a relationship exists between resilience and negative affect experienced by second victims, post-error. The limitations of the current work, practical implications, and ideas for future research will be expanded upon herein.
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Date Issued: 2019
Identifier: CFE0007651, ucf:52475
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007651

Title: The Effectiveness of Virtual Humans vs Pre-Recorded Humans in a Standardized Patient Performance Assessment.
Creator: Palathinkal, Joel, Kincaid, John, Shumaker, Randall, Allred, Kelly, Smith, Roger, University of Central Florida
Abstract / Description: A Standardized Patient (SP) is a trained actor who portrays a particular illness to provide training to medical students and professionals. SPs primarily use written scripts and additional paper-based training for preparation of practical and board exams. Many institutions use various methods for training such as hiring preceptors for reenactment of scenarios, viewing archived videos, and computer based training. Currently, the training that is available can be enhanced to improve the level...
Show moreA Standardized Patient (SP) is a trained actor who portrays a particular illness to provide training to medical students and professionals. SPs primarily use written scripts and additional paper-based training for preparation of practical and board exams. Many institutions use various methods for training such as hiring preceptors for reenactment of scenarios, viewing archived videos, and computer based training. Currently, the training that is available can be enhanced to improve the level of quality of standardized patients. The following research is examining current processes in standardized patient training and investigating new methods for clinical skills education in SPs. The modality that is selected for training can possibly affect the performance of the actual SP case.This paper explains the results of a study that investigates if there is a difference in the results of an SP performance assessment. This difference can be seen when comparing a virtual human modality to that of a pre-recorded human modality for standardized patient training. The sample population navigates through an interactive computer based training module which provides informational content on what the roles of an SP are, training objectives, a practice session, and an interactive performance assessment with a simulated Virtual Human medical student. Half of the subjects interact with an animated virtual human medical student while the other half interacts with a pre-recorded human. The interactions from this assessment are audio-recorded, transcribed, and then graded to see how the two modalities compare. If the performance when using virtual humans for standardized patients is equal to or superior to pre-recorded humans, this can be utilized as a part task trainer that brings standardized patients to a higher level of effectiveness and standardization. In addition, if executed properly, this tool could potentially be used as a part task trainer which could provide savings in training time, resources, budget, and staff to military and civilian healthcare facilities.
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Date Issued: 2011
Identifier: CFE0004149, ucf:49037
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004149

Title: Bleeding Control Using Multiple Amputee Trauma Trainer in Medical Simulation: Comparison of Movement Versus Non-Movement in Training.
Creator: Allen, Christine, Kincaid, John, Schatz, Sarah, Allred, Kelly, Talbert, Steven, Sotomayor, Teresita, University of Central Florida
Abstract / Description: Army first responders, specifically Combat Medics and Combat Lifesavers, provide medical intervention while in the field. Didactic as well as hands-on training helps to prepare these first responders, and one module they receive involves bleeding control. First responders are taught to use the Combat Application Tourniquet(&)#174; (CAT(&)#174;) to stop bleeding from limbs subjected to severe injury such as amputation, gunshot, or severe lacerations. A training aid like the Multiple Amputee...
Show moreArmy first responders, specifically Combat Medics and Combat Lifesavers, provide medical intervention while in the field. Didactic as well as hands-on training helps to prepare these first responders, and one module they receive involves bleeding control. First responders are taught to use the Combat Application Tourniquet(&)#174; (CAT(&)#174;) to stop bleeding from limbs subjected to severe injury such as amputation, gunshot, or severe lacerations. A training aid like the Multiple Amputee Trauma Trainer(TM) (MATT(TM)) simulator provides tourniquet training using a lifelike bilateral lower limb amputee. In addition, MATT(TM) combines movement and resistance while the first responder applies the tourniquet, mimicking conditions one would see in a real situation. This research describes tourniquet history, appropriate usage, field tourniquet review, surgical tourniquet, CAT(&)#174; bleeding intervention procedures, bleeding physiology and complications, prehospital tourniquet use in recent conflicts, medical simulation fidelity, and a review of the value of animatronic movement during tourniquet simulation-based training. I then evaluate the effectiveness of animatronic movement during tourniquet training using the Advanced MATT in an experiment using Army first responders. The control group experienced no movement while the experimental group experienced movement when applying a tourniquet during the lab-training. Each group then alternately experienced Advanced MATT movement during an immersive scenario along with fog, strobe lights, and battle sounds. It was hypothesized that 1) In the immersive scenario, the experimental groups (i.e., those who were trained on a moving simulator) would have a faster reaction time as compared to those participants who did not receive training on the moving Advanced MATT simulator; 2) In the lab-based training, the experimental groups would have a slower reaction time; 3) In the immersive scenario, the experimental groups would have a faster tourniquet application time when subjected to movement while in the lab-based training, but the experimental groups would also have a slower tourniquet application time when initially subjected to movement in the laboratory-based training; finally, 4, 5, and 6) Participants who completed lab-based tourniquet training on the Advanced MATT simulation with animatronic movement would report higher perceived realism scores than participants who complete the training on a static version of the Advanced MATT and participants who completed a tourniquet training immersive scenario on the Advanced MATT simulation with movement would report higher perceived realism, presence, and self-efficacy scores than participants who complete the training on a static version of the Advanced MATT. The empirical results show a significant overall training effect of the Advanced MATT simulator (with or without movement). For reaction time and tourniquet application time, involving simulator movement was significant over varying scenarios. A small reduction in reaction and tourniquet application time on the battlefield may be extremely beneficial on the battlefield. Participants who received movement generally gave more positive reactions than those who did not received movement, although these results failed to reach statistical significance. Participants who received movement, followed by a scenario without movement rated the subjective ratings the lowest, suggestive of the lack of movement. Furthermore, despite the order movement was received, no large drops in performance occurred in any condition, indicating that negative training was avoided.
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Date Issued: 2011
Identifier: CFE0004468, ucf:49316
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004468

Title: Utilization of Ambulatory Services by the Health Maintenance Organization of Florida.
Creator: Hansen, Thomas Harold, Mendenhall, Thomas S., Health
Abstract / Description: University of Central Florida College of Health Thesis; The utilization of ambulatory services by the health maintenance organization of Florida (HMO), independent practice association (IPA) model, was compared to a fee-for-service population. Each randomly selected group consisted of 250 patients being cared for by the same providers, at the same clinic, during the calendar year 1986. Demographic and clinical data was gathered from the office charts. Frequencies were evaluated by the...
Show moreUniversity of Central Florida College of Health Thesis; The utilization of ambulatory services by the health maintenance organization of Florida (HMO), independent practice association (IPA) model, was compared to a fee-for-service population. Each randomly selected group consisted of 250 patients being cared for by the same providers, at the same clinic, during the calendar year 1986. Demographic and clinical data was gathered from the office charts. Frequencies were evaluated by the Statistical Package for the Social Sciences and t-tests were run to substantiate variance at the 0.05 level of confidence. The HMO group is a younger population (t=0.017), and the males are responsible for the increased utilization of ambulatory services (t-0.001). Trends of increased utilization are noted across the age groups and the variables. The rate of hospitalization is insignificantly higher for the HMO population and covers a broader range of age groups. Consequently, this HMO IPA model increases the rate of ambulatory service utilization in a younger population without reducing the rate of hospitalization. Cost effectiveness studies and organizational management evaluations are needed.
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Date Issued: 1988
Identifier: CFR0008167, ucf:53069
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFR0008167

Title: Synergistic Visualization And Quantitative Analysis Of Volumetric Medical Images.
Creator: Torosdagli, Neslisah, Bagci, Ulas, Hughes, Charles, Jha, Sumit Kumar, Lisle, Curtis, University of Central Florida
Abstract / Description: The medical diagnosis process starts with an interview with the patient, and continues with the physical exam. In practice, the medical professional may require additional screenings to precisely diagnose. Medical imaging is one of the most frequently used non-invasive screening methods to acquire insight of human body. Medical imaging is not only essential for accurate diagnosis, but also it can enable early prevention. Medical data visualization refers to projecting the medical data into a...
Show moreThe medical diagnosis process starts with an interview with the patient, and continues with the physical exam. In practice, the medical professional may require additional screenings to precisely diagnose. Medical imaging is one of the most frequently used non-invasive screening methods to acquire insight of human body. Medical imaging is not only essential for accurate diagnosis, but also it can enable early prevention. Medical data visualization refers to projecting the medical data into a human understandable format at mediums such as 2D or head-mounted displays without causing any interpretation which may lead to clinical intervention. In contrast to the medical visualization, quantification refers to extracting the information in the medical scan to enable the clinicians to make fast and accurate decisions.Despite the extraordinary process both in medical visualization and quantitative radiology, efforts to improve these two complementary fields are often performed independently and synergistic combination is under-studied. Existing image-based software platforms mostly fail to be used in routine clinics due to lack of a unified strategy that guides clinicians both visually and quan- titatively. Hence, there is an urgent need for a bridge connecting the medical visualization and automatic quantification algorithms in the same software platform. In this thesis, we aim to fill this research gap by visualizing medical images interactively from anywhere, and performing a fast, accurate and fully-automatic quantification of the medical imaging data. To end this, we propose several innovative and novel methods. Specifically, we solve the following sub-problems of the ul- timate goal: (1) direct web-based out-of-core volume rendering, (2) robust, accurate, and efficient learning based algorithms to segment highly pathological medical data, (3) automatic landmark- ing for aiding diagnosis and surgical planning and (4) novel artificial intelligence algorithms to determine the sufficient and necessary data to derive large-scale problems.
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Date Issued: 2019
Identifier: CFE0007541, ucf:52593
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007541

Title: Learning Algorithms for Fat Quantification and Tumor Characterization.
Creator: Hussein, Sarfaraz, Bagci, Ulas, Shah, Mubarak, Heinrich, Mark, Pensky, Marianna, University of Central Florida
Abstract / Description: Obesity is one of the most prevalent health conditions. About 30% of the world's and over 70% of the United States' adult populations are either overweight or obese, causing an increased risk for cardiovascular diseases, diabetes, and certain types of cancer. Among all cancers, lung cancer is the leading cause of death, whereas pancreatic cancer has the poorest prognosis among all major cancers. Early diagnosis of these cancers can save lives. This dissertation contributes towards the...
Show moreObesity is one of the most prevalent health conditions. About 30% of the world's and over 70% of the United States' adult populations are either overweight or obese, causing an increased risk for cardiovascular diseases, diabetes, and certain types of cancer. Among all cancers, lung cancer is the leading cause of death, whereas pancreatic cancer has the poorest prognosis among all major cancers. Early diagnosis of these cancers can save lives. This dissertation contributes towards the development of computer-aided diagnosis tools in order to aid clinicians in establishing the quantitative relationship between obesity and cancers. With respect to obesity and metabolism, in the first part of the dissertation, we specifically focus on the segmentation and quantification of white and brown adipose tissue. For cancer diagnosis, we perform analysis on two important cases: lung cancer and Intraductal Papillary Mucinous Neoplasm (IPMN), a precursor to pancreatic cancer. This dissertation proposes an automatic body region detection method trained with only a single example. Then a new fat quantification approach is proposed which is based on geometric and appearance characteristics. For the segmentation of brown fat, a PET-guided CT co-segmentation method is presented. With different variants of Convolutional Neural Networks (CNN), supervised learning strategies are proposed for the automatic diagnosis of lung nodules and IPMN. In order to address the unavailability of a large number of labeled examples required for training, unsupervised learning approaches for cancer diagnosis without explicit labeling are proposed. We evaluate our proposed approaches (both supervised and unsupervised) on two different tumor diagnosis challenges: lung and pancreas with 1018 CT and 171 MRI scans respectively. The proposed segmentation, quantification and diagnosis approaches explore the important adiposity-cancer association and help pave the way towards improved diagnostic decision making in routine clinical practice.
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Date Issued: 2018
Identifier: CFE0007196, ucf:52288
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007196

Title: HOW SYMPTOMS OF ANXIETY, DEPRESSION, ATTENTION DEFICIT DISORDER (ADD) OR ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) CONTRIBUTE TO STUDENTS SELF-MEDICATING VIA MARIJUANA AND NON-MEDICAL PRESCRIPTION DRUGS.
Creator: Thomas, Maria, Donley, Dr. Amy, University of Central Florida
Abstract / Description: This study examines student's nonmedical prescription drug (NMPD) and marijuana use and whether anxiety, depression, ADD or ADHD symptoms are associated with their use and if students are self-medicating to alleviate symptoms. The method of obtaining this information was provided by a total of 278 college students who voluntarily and anonymously completed a Web-based survey. This study fills in the gaps of previous research and reveals the most frequent NMPD's used by students and their...
Show moreThis study examines student's nonmedical prescription drug (NMPD) and marijuana use and whether anxiety, depression, ADD or ADHD symptoms are associated with their use and if students are self-medicating to alleviate symptoms. The method of obtaining this information was provided by a total of 278 college students who voluntarily and anonymously completed a Web-based survey. This study fills in the gaps of previous research and reveals the most frequent NMPD's used by students and their overall perceptions of their intended effects of the drug and answers why students do not seek professional help for their anxiety, depression and impulsivity symptoms. Results from the survey indicate that students who report NMPD use self- reported higher symptoms of anxiety, depression and impulsivity. NMPD users reported higher percentages of other substance abuse compared to nonusers. The most prominent NMPD's used by students are Adderall and Vicoden or Codeine. Data also indicates student's primary reasons for their NMPD use are related to academic purposes; as opposed to nonacademic. This analysis is further supported by the fact that the majority of NMPD users did not use before they began college and do not use while classes are not is session. Furthermore, students perceive their overall intended effects of their NMPD use to be beneficial, despite the known risks associated with their drug use. By examining college student's current NMPD use we can provide alternative solutions to students who are self-medicating as a coping mechanism for underlying issues or mental health disorders. Also, we can provide them with the necessary services in order to address their problems professionally.
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Date Issued: 2013
Identifier: CFH0004445, ucf:45114
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004445

Title: SYSTEM DESIGN AND OPTIMIZATION OF OPTICAL COHERENCE TOMOGRAPHY.
Creator: Akcay, Avni, Rolland, Jannick, University of Central Florida
Abstract / Description: Optical coherence imaging, including tomography (OCT) and microscopy (OCM), has been a growing research field in biomedical optical imaging in the last decade. In this imaging modality, a broadband light source, thus of short temporal coherence length, is used to perform imaging via interferometry. A challenge in optical coherence imaging, as in any imaging system towards biomedical diagnosis, is the quantification of image quality and optimization of the system components, both a primary...
Show moreOptical coherence imaging, including tomography (OCT) and microscopy (OCM), has been a growing research field in biomedical optical imaging in the last decade. In this imaging modality, a broadband light source, thus of short temporal coherence length, is used to perform imaging via interferometry. A challenge in optical coherence imaging, as in any imaging system towards biomedical diagnosis, is the quantification of image quality and optimization of the system components, both a primary focus of this research. We concentrated our efforts on the optimization of the imaging system from two main standpoints: axial point spread function (PSF) and practical steps towards compact low-cost solutions. Up to recently, the criteria for the quality of a system was based on speed of imaging, sensitivity, and particularly axial resolution estimated solely from the full-width at half-maximum (FWHM) of the axial PSF with the common practice of assuming a Gaussian source power spectrum. As part of our work to quantify axial resolution we first brought forth two more metrics unlike FWHM, which accounted for side lobes in the axial PSF caused by irregularities in the shape of the source power spectrum, such as spectral dips. Subsequently, we presented a method where the axial PSF was significantly optimized by suppressing the side lobes occurring because of the irregular shape of the source power spectrum. The optimization was performed through optically shaping the source power spectrum via a programmable spectral shaper, which consequentially led to suppression of spurious structures in the images of a layered specimen. The superiority of the demonstrated approach was in performing reshaping before imaging, thus eliminating the need for post-data acquisition digital signal processing. Importantly, towards the optimization and objective image quality assessment in optical coherence imaging, the impact of source spectral shaping was further analyzed in a task-based assessment method based on statistical decision theory. Two classification tasks, a signal-detection task and a resolution task, were investigated. Results showed that reshaping the source power spectrum was a benefit essentially to the resolution task, as opposed to both the detection and resolution tasks, and the importance of the specimen local variations in index of refraction on the resolution task was demonstrated. Finally, towards the optimization of OCT and OCM for use in clinical settings, we analyzed the detection electronics stage, which is a crucial component of the system that is designed to capture extremely weak interferometric signals in biomedical and biological imaging applications. We designed and tested detection electronics to achieve a compact and low-cost solution for portable imaging units and demonstrated that the design provided an equivalent performance to the commercial lock-in amplifier considering the system sensitivity obtained with both detection schemes.
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Date Issued: 2005
Identifier: CFE0000651, ucf:46527
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0000651

Title: REIMAGINING DRUGS: AN ANTHROPOLOGICAL ANALYSIS OF U.S. DRUG POLICY FRAMEWORKS AND STUDENT ACTIVISM.
Creator: Sarmento, Megan A, Harris, Shana, University of Central Florida
Abstract / Description: As the repercussions of the nearly 50-year U.S. War on Drugs are revealing themselves to be harmful and life-threatening, especially to lower-class and minority populations, social movements aimed at drug policy reform have been on the rise. While today's generation of college students were raised on abstinence-based discourses, which constantly warned and threatened them about the dangers of drug use, these same students often change their perspective, some as early as high school, when they...
Show moreAs the repercussions of the nearly 50-year U.S. War on Drugs are revealing themselves to be harmful and life-threatening, especially to lower-class and minority populations, social movements aimed at drug policy reform have been on the rise. While today's generation of college students were raised on abstinence-based discourses, which constantly warned and threatened them about the dangers of drug use, these same students often change their perspective, some as early as high school, when they begin having their own experiences with drugs and engage in more drug-related conversations. As a result, many students become motivated to change drug policy and education and address the stigma associated with drug use in order to reduce drug-related harm to individuals. This thesis examines the ideas and efforts of students at a university in the southeastern United States who are actively engaged in making these changes. Based on interviews with students involved with two drug policy reform groups in 2018, this thesis highlights the role of student activism in the larger drug policy reform movement. Student activists raise awareness of the need for a critical examination of U.S. drug policy frameworks and their place in this endeavor. I argue that student activists' involvement in the drug policy reform movement is motivated by the numerous disparities they experience and observe in the dominant abstinence-based drug approach. Based on these students' perspectives, I argue for a shift towards a more holistic harm reduction education that aims to increase the quality of care and livelihood for drug users, an accomplishment they believe is inextricable from U.S. policy.
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Date Issued: 2018
Identifier: CFH2000439, ucf:45742
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000439

Title: HEALTH INSURANCE STATUS AND DIABETES MANAGEMENT PRACTICES AMONG BLACK ADULTS IN THE U.S.
Creator: Rosier, Luderve, Wells, Brittny, University of Central Florida
Abstract / Description: The purpose of this study was to investigate the relationship between health insurance status and diabetes management (in terms of medication adherence and physical activity levels) in Black adults based on socioeconomic factors. Data were harvested from the Sample Adult Questionnaires of the National Health Interview Survey (NHIS) between the years of 2010 and 2016. The survey questions that were collected included information about the participants' income, education level, insurance status...
Show moreThe purpose of this study was to investigate the relationship between health insurance status and diabetes management (in terms of medication adherence and physical activity levels) in Black adults based on socioeconomic factors. Data were harvested from the Sample Adult Questionnaires of the National Health Interview Survey (NHIS) between the years of 2010 and 2016. The survey questions that were collected included information about the participants' income, education level, insurance status, diabetes diagnosis, medication therapy and physical activity levels. This study employed the most recent version of the Statistical Package for Social Sciences (SPSS) software. The association between diabetes management and socioeconomic factors were analyzed using chi-square analysis. It was hypothesized that Black adults who were uninsured, lower income, and less-educated would report lower adherence to medication and lower physical activity participation when compared to their insured, higher income, and higher-educated counterparts. However, there was no statistically significant relationship between health insurance status and diabetes management in people of different socioeconomic status. Too few people met the weekly recommendations for moderate exercise thus chi-square outcomes for physical activity were invalid. This study will be beneficial for future research as it has provided more generalizable information on this topic due to the use of a national dataset. This study also highlighted the importance of adequate physical activity interventions for this population and can be used for further research on Black adults with diabetes.
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Date Issued: 2018
Identifier: CFH2000303, ucf:45751
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000303

Title: SUPERVISOR EXPECTATIONS, EVENT REPORTING, AND PATIENT SAFETY PERCEPTIONS: EXPLORING POTENTIAL MODERATORS AND MEDIATORS.
Creator: Hernandez, Claudia, Burke, Shawn, University of Central Florida
Abstract / Description: Given the high number of errors and negative events committed within medical settings, the emphasis on patient safety culture is becoming more prevalent. Despite this effort, underreporting has been and continues to be an issue in this area. Some research has shown a link between underreporting and lack of management responsiveness, but more work is necessary to identify reasons for underreporting and potential mitigating solutions. The objective of the present research is to answer questions...
Show moreGiven the high number of errors and negative events committed within medical settings, the emphasis on patient safety culture is becoming more prevalent. Despite this effort, underreporting has been and continues to be an issue in this area. Some research has shown a link between underreporting and lack of management responsiveness, but more work is necessary to identify reasons for underreporting and potential mitigating solutions. The objective of the present research is to answer questions regarding the impact supervisors have on staff's patient safety perceptions and event reporting, through the use of archival survey data collected with the AHRQ Hospital Safety Culture Survey (2004). Probable moderators and mediators of key relationships were explored as well. Results are presented and their implications are discussed herein.
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Date Issued: 2016
Identifier: CFH2000084, ucf:45551
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000084

Title: THE RISKS AND BENEFITS OF SELECTIVE SEROTONIN REUPTAKE INHIBITORS AND THE EFFECT OF PARENT-CHILD COMPLIANCE ON MEDICATION TEACHING IN PEDIATRIC ANXIETY DISORDERS.
Creator: Nizam, Sabiha, Dever, Kimberly, University of Central Florida
Abstract / Description: Pediatric anxiety disorders characterized as Generalized, Separation, and Social Anxiety Disorders, are chronic debilitating conditions that leave children feeling tense and isolated, both physically and emotionally. Selective serotonin reuptake inhibitors (SSRIs) are a classification of antidepressants that can be prescribed to children diagnosed with these disorders. SSRIs have been shown to be effective in treating anxiety disorders in children. The purpose of this literature review was to...
Show morePediatric anxiety disorders characterized as Generalized, Separation, and Social Anxiety Disorders, are chronic debilitating conditions that leave children feeling tense and isolated, both physically and emotionally. Selective serotonin reuptake inhibitors (SSRIs) are a classification of antidepressants that can be prescribed to children diagnosed with these disorders. SSRIs have been shown to be effective in treating anxiety disorders in children. The purpose of this literature review was to examine and determine if there are more risks or benefits associated with SSRIs, as well as evaluate teaching and education regarding anxiety disorder medication compliance in both children and parents. A secondary purpose of this research was to provide recommendations in nursing practice to allow children to feel more involved in their medical regimen. The following databases were used for the search: CINAHL, Academic Search Premier, and Web of Science. Key terms used in the search include but are not limited to: child* and anxiety, not autism, and selective serotonin reuptake inhibitors, OR SSRI*, OR adolsecen*, not med*, pediatric*, OR side effects. The results suggest that the benefits of SSRI therapy in children with anxiety disorder, when taken on a regularly scheduled basis, outweigh the risks, however more research aimed at compliance with SSRI therapy in children and parents is necessary. Further research analyzing children with anxiety disorders is needed to assess SSRI usage based specifically on their developmental age, and the inclusion of appropriate teaching and explanation related to their diagnoses to identifying stressors that can include behavioral therapy as well.
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Date Issued: 2016
Identifier: CFH2000020, ucf:45574
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000020

Title: THE IMPACT OF A NURSE-DRIVEN EVIDENCE-BASED DISCHARGE PLANNING PROTOCOL ON ORGANIZATIONAL EFFICIENCY AND PATIENT SATISFACTION IN PATIENTS WITH CARDIAC IMPLANTS.
Creator: King, Tracey, Sole, Mary Lou, University of Central Florida
Abstract / Description: Purpose: Healthcare organizations are mandated to improve quality and safety for patients while stressed with shorter lengths of stay, communication lapses between disciplines, and patient throughput issues that impede timely delivery of patient care. Nurses play a prominent role in the safe transition of patients from admission to discharge. Although nurses participate in discharge planning, limited research has addressed the role and outcomes of the registered nurse as a leader in the...
Show morePurpose: Healthcare organizations are mandated to improve quality and safety for patients while stressed with shorter lengths of stay, communication lapses between disciplines, and patient throughput issues that impede timely delivery of patient care. Nurses play a prominent role in the safe transition of patients from admission to discharge. Although nurses participate in discharge planning, limited research has addressed the role and outcomes of the registered nurse as a leader in the process. The aim of this study was determine if implementation of a nurse-driven discharge planning protocol for patients undergoing cardiac implant would result in improved organizational efficiencies, higher medication reconciliation rates, and higher patient satisfaction scores. Methods: A two-group posttest experimental design was used to conduct the study. Informed consent was obtained from 53 individuals scheduled for a cardiac implant procedure. Subjects were randomly assigned to either a nurse-driven discharge planning intervention group or a control group. Post procedure, 46 subjects met inclusion criteria with half (n=23) assigned to each group. All subjects received traditional discharge planning services. The morning after the cardiac implant procedure, a specially trained registered nurse assessed subjects in the intervention for discharge readiness. Subjects in the intervention groups were then discharged under protocol orders by the intervention nurse after targeted physical assessment, review of the post procedure chest radiograph, and examination of the cardiac implant device function. The intervention nurse also provided patient education, discharge instructions, and conducted medication reconciliation. The day after discharge the principal investigator conducted a scripted follow-up phone call to answer questions and monitor for post procedure complications. A Hospital Discharge Survey was administered during the subject's follow-up appointment. Results: The majority of subjects were men, Caucasian, insured, and educated at the high school level or higher. Their average age was 73.5+ 9.8 years. No significant differences between groups were noted for gender, type of insurance, education, or type of cardiac implant (chi-square); or age (t-test). A Mann-Whitney U test (one-tailed) found no significant difference in variable cost per case (p=.437) and actual charges (p=.403) between the intervention and control groups. Significant differences were found between groups for discharge satisfaction (p=.05) and the discharge perception of overall health (p=.02), with those in the intervention group reporting higher scores. Chi square analysis found no significant difference in 30-day readmission rates (p=.520). Using an independent samples t-test, those in the intervention group were discharged earlier (p=.000), had a lower length of stay (p=.005), and had higher rates of reconciled medications (p=.000). The odds of having all medications reconciled were significantly higher in the intervention group (odds ratio, 50.27; 95% CI, 5.62-450.2; p=.000). Discussion/Implications: This is the first study to evaluate the role of the nurse as a clinical leader in patient throughput, discharge planning, and patient safety initiatives. A nurse driven discharge planning protocol resulted in earlier discharge times which can have a dramatic impact on patient throughput. The nurse driven protocol significantly reduced the likelihood of unreconciled medications at discharge and significantly increased patient satisfaction. Follow-up research is needed to determine if a registered nurse can impact organizational efficiency and discharge safety in other patient populations.
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Date Issued: 2008
Identifier: CFE0002188, ucf:47915
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002188

Title: Factors Influencing unmet Medical Need among U.S. Adults: Disparities in Access to Health Services.
Creator: Khanijahani, Ahmad, Wan, Thomas, Malvey, Donna, Liu, Albert Xinliang, Anderson, Kim, University of Central Florida
Abstract / Description: Inequities in access to health services has negative consequences on individual well-being, and imposes financial and emotional burden on patients, families, health care systems, and the public. Inequities engendered from differences in socioeconomic status, health insurance coverage, race, and other characteristics can engender disparities. This study aimed to identify the potential predictors of unmet medical need among the civilian noninstitutionalized U.S. adults. Inability to receive...
Show moreInequities in access to health services has negative consequences on individual well-being, and imposes financial and emotional burden on patients, families, health care systems, and the public. Inequities engendered from differences in socioeconomic status, health insurance coverage, race, and other characteristics can engender disparities. This study aimed to identify the potential predictors of unmet medical need among the civilian noninstitutionalized U.S. adults. Inability to receive needed medical care or receiving medical care after a delay, due to the associated costs, constructed unmet medical need. This study used a four-year (2014-2017) National Health Interview Survey (NHIS) data (sample size: 296,301 adults) and implemented a conceptual framework to study disparities in access to health services and estimate the relative importance of predisposing, enabling, and need factors as the predictors of unmet medical need. Findings from machine learning and logistics regression models highlight the importance of health insurance coverage as a key contributing factor of health disparities. About 60% of variation in unmet medical need was predictable, with over 90% accuracy, solely with health insurance coverage status. Self-rated health status, family structure, and family income to poverty ratio were other statistically significant predictors. Even after controlling for a wide variety of sociodemographic and health status variables such as age, gender, perceived health status, education, income, etc., health insurance remains significantly associated with unmet medical need (OR: 5.03, 95%CI: 4.67-5.42). To ensure precise national estimates, proper survey data analysis methods were incorporated to account for the complex sampling method used by NHIS. Furthermore, the enabling factors (health insurance and income) exert much more weight on unmet medical need than predisposing factors and need factors. The findings raise the concerns about the existence and magnitude of disparities in health care access and provide a comprehensive framework to a target population for understanding the sources of health inequities with data-driven evidence. Results can be utilized to address potential areas for designing public policy and program interventions by identifying the relative vulnerability of different population groups for lacking access to affordable health services. Future studies using longitudinal panel data are necessary to establish a causal relationship between the predictors and unmet medical need.
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Date Issued: 2019
Identifier: CFE0007477, ucf:52686
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007477

Title: Development of S-nitroso-N-acetylpenicillamine (SNAP) Impregnated Medical Grade Polyvinyl Chloride for Antimicrobial Medical Device Interfaces.
Creator: Feit, Corbin, Brisbois, Elizabeth, Vaidyanathan, Raj, Kuebler, Stephen, University of Central Florida
Abstract / Description: In the clinical setting, polyvinyl chloride (PVC) accounts for 25% of all polymers used in medical device applications. However, medical devices fabricated with PVC, such as endotracheal tubes, extracorporeal circuits (ECCs), or intravenous catheters suffer from thrombosis and infection. Mortality associated with hospital associated infections (HAIs) exceed 100,000 deaths each year. One method to overcome these challenges is to develop bioactive polymers with nitric oxide (NO) release. Nitric...
Show moreIn the clinical setting, polyvinyl chloride (PVC) accounts for 25% of all polymers used in medical device applications. However, medical devices fabricated with PVC, such as endotracheal tubes, extracorporeal circuits (ECCs), or intravenous catheters suffer from thrombosis and infection. Mortality associated with hospital associated infections (HAIs) exceed 100,000 deaths each year. One method to overcome these challenges is to develop bioactive polymers with nitric oxide (NO) release. Nitric oxide exhibits many physiological roles including, antibacterial, antithrombic, anti-inflammatory activity. In this study, Tygon(&)#174; PVC tubing was impregnated with a NO donor molecule, S-nitroso-N-acetylpenicillamine (SNAP), via a simple solvent-swelling-impregnation method, where polymer samples were submerged in a SNAP impregnation-solvent (methanol, acetone, plasticizer). An additional topcoat of a biocompatible CarboSil 2080A (CB) was applied to reduce SNAP leaching. The SNAP-PVC-CB were characterized for NO release using chemiluminescence, leaching with UV-Vis spectroscopy, surface characterization with scanning electron microscopy, tensile strength analysis, stability during storage and sterilization, and antimicrobial properties in vitro. The SNAP-PVC-CB exhibited NO flux of 4.29 (&)#177; 0.80 x 10-10 mol cm-2 min-1 over the initial 24 h under physiological conditions and continued to release physiological levels of NO for up 14 d (incubated in PBS at 37 (&)deg;C). The addition of CB-topcoat reduced the total SNAP leaching by 86% during incubation. Mechanical properties and surface topography remained similar to original PVC after SNAP-impregnation and application of CB-topcoat. After ethylene oxide sterilization and 1-month storage, SNAP-PVC-CB demonstrated excellent SNAP stability (ca. 90% SNAP remaining). In a 24 h antibacterial assay, SNAP-PVC reduce viable bacteria colonization (ca. 1 log reduction) of S. aureus and E. coli compared to PVC controls. This novel method for SNAP-impregnation of medical grade plasticized PVC holds great potential for improving the biocompatibility of post-fabricated PVC medical devices.
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Date Issued: 2019
Identifier: CFE0007887, ucf:52782
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007887

Title: Medical School Prerequisite Courses Completed at Two-Year Colleges by Medical School Matriculants: An Analysis at the University of Central Florida.
Creator: Myszkowski, Erin, Cintron Delgado, Rosa, Boyd, Tammy, Owens, James, Dorman, Teresa, Szentmiklosi, Jillian, University of Central Florida
Abstract / Description: Many medical school admissions personnel and pre-health advisors advise premedical students not to take the medical school prerequisite courses at two-year colleges because they believe the courses are less academically rigorous than the same courses at four-year institutions (Losada, 2009; Marie, 2009; Thurlow, 2008, 2009a, 2009b). According to this belief, premedical students who complete the medical school prerequisite courses at a two-year college could be at a disadvantage in regard to...
Show moreMany medical school admissions personnel and pre-health advisors advise premedical students not to take the medical school prerequisite courses at two-year colleges because they believe the courses are less academically rigorous than the same courses at four-year institutions (Losada, 2009; Marie, 2009; Thurlow, 2008, 2009a, 2009b). According to this belief, premedical students who complete the medical school prerequisite courses at a two-year college could be at a disadvantage in regard to medical school admission compared to those students who complete the medical school prerequisite courses at a four-year institution. In an effort to analyze these perceptions, this study examined factors pertaining to the enrollment of premedical students in the medical school prerequisite courses at two-year colleges. This research study examined the enrollment statuses and grades of matriculants to medical school from the University of Central Florida between 2007 and 2011. Specifically, the type of student enrollment of the matriculants who completed any of the medical school prerequisite courses at a two-year college was examined, and both their type of institutional enrollment and grades in the organic chemistry courses were also examined. The results indicated that there were significant differences in types of student enrollment in most medical school prerequisite courses at two-year colleges, and based on these differences, the researcher identified whether completing certain prerequisite courses as certain types of enrollment were either (")more acceptable(") or (")less acceptable(") for premedical students. In addition, the results indicated that there were not significant differences in organic chemistry grades based on the type of institution where the courses were taken. Based on these results, the researcher could not categorize the courses at either type of institution as (")more rigorous(") or (")less rigorous(") than the other, but the researcher also recommends that these results should be perceived cautiously until additional, more in-depth research can be conducted on this topic. Finally, recommendations and implications for premedical students, pre-health advisors, medical school admissions personnel, two-year colleges, and four-year institutions were discussed.
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Date Issued: 2012
Identifier: CFE0004579, ucf:49211
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004579

Title: HAVE YOU HEARD? PREDICTORS OF HPV AWARENESS AMONG A RANDOM SAMPLE OF COLLEGE STUDENTS.
Creator: Arrastia, Meagan, Rivera, Fernando, University of Central Florida
Abstract / Description: College students have been identified as at high risk for contracting Human Papillomavirus (HPV) due to engaging in risky behaviors, such as binge drinking and unprotected sex. Before preventative measures like vaccination and condom usage can be promoted, awareness must be evaluated. A random sample of 438 college students was surveyed on their awareness of HPV using both paper and online surveying methods. Using binary logistic regression, HPV awareness was predicted using demographic...
Show moreCollege students have been identified as at high risk for contracting Human Papillomavirus (HPV) due to engaging in risky behaviors, such as binge drinking and unprotected sex. Before preventative measures like vaccination and condom usage can be promoted, awareness must be evaluated. A random sample of 438 college students was surveyed on their awareness of HPV using both paper and online surveying methods. Using binary logistic regression, HPV awareness was predicted using demographic measures. The majority of the sample reported having heard of HPV before. Sexually active respondents and females were significantly more likely to report awareness. Non-whites and first-generation college students were also more likely to report awareness. These demographic predictors will help identify groups needing educational and HPV intervention programs. Implications and further research is discussed.
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Date Issued: 2009
Identifier: CFE0002640, ucf:48208
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002640

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