ADVANCING INTERPROFESSIONAL PRIMARY HEALTH CARE SERVICES IN RURAL SETTINGS FOR PEOPLE WITH CHRONIC LOW BACK DISORDERS: A TEAM AND TECHNOLOGY APPROACH

Background Rural Canadians are more likely to have chronic back disorders than their urban counterparts. Their barriers to accessing providers with expertise in chronic back disorder management include: reduced availability of local practitioners and lengthy travel requirements. Joining an urban Physical Therapist (PT) with expertise in chronic back disorders with a rural primary team and patient using telehealth may be an option for this disparity in access. Methods This dissertation includes three studies presented in the following manuscripts: 1) A systematic review examining the use of videoconferencing by PTs for the management of musculoskeletal conditions; 2) A comparison of three different intervention groups: PTalone, Nurse Practitioner alone (NPalone), and NP/PTteam to determine the agreement of the models of care on diagnosis and management decisions; and 3) an examination of the experiences of patients and practitioners involved in a teamand technology model of care for chronic back disorders. Results Gaps in the literature included: few large RCTs and comparative studies, an absence of studies examining interprofessional models of care, no examination of combined telehealth and in-person types of care, and the need for more rigorous study designs to facilitate meta-analysis. The NP/PTteam made similar decisions regarding diagnosis and management for chronic back disorders compared to an in-person PT. This demonstrated that the contribution of PT to the team resulted in the same findings as a PT who examined a patient independently. It is a feasible method of managing chronic back disorders in rural areas, and is met with satisfaction by patients and practitioners. Analysis of semi-structured interviews of patients and practitioners who experienced the team and technology model of care identified the following themes: access to care for chronic back disorders, effective interprofessional practice (team), enhanced clinical care for CBD, and technology. Conclusions A team and technology approach to care is comparable to in-person PT for diagnosis and management decisions in chronic back disorders. This approach can enhance access to care for chronic back disorders in rural areas and result in improved clinical care for rural residents with chronic back disorders

Developing Electrochemical Biosensors for Point-of-care Diagnostics of Cardiovascular Biomarkers

Troponin is known as a type of reliable biomarker for the detection of cardiac disorders. Cardiac troponin I (cTnI), as a subunit of troponin, is highly sensitive to cardiac injury; therefore, the cTnI level is used as an index to diagnose myocardial damage, particularly acute myocardial infarction. It can be also used in cardiospecific diagnosis, risk stratification therapeutic treatment and post risk management. In this research, an amperometric immunosensor was developed based on planar electrode and sandwich ELISA format. The electrical response corresponding to biological information was obtained via four main procedures, including electrode modification, immunoreaction, signal amplifications and amperometric detection. Enzyme labels such as horseradish peroxide (HRP) and alkaline phosphatase (ALP) were used for signals amplification. Since alkaline phosphatase works better in low background current levels and has great reproducibility, it was used for nanomaterials, chitosan, gold nanoparticle, carbon nanotube as electrode modification investigation. The anti-cTnI antibody is detectable by electrochemical technology. Necessary conditions and interferences of the experiment were examined. Detection range was from 0.001 ng ml-1 to 300 ng ml-1 on PDDA-MWCNT sensor, and from 0.02 ng ml-1 to 200 ng ml-1 on chitosan-AuNPs sensor. The detection range was investigated using cyclic voltammetry. The signal behavior recorded was linear to cTnI concentration. This behavior makes the developed biosensor be able to widely use in clinical practice. Likewise, two liquid substrates were catalyzed by hydroquinone and 3, 3’, 5, 5’-teteramethylbenzidine respectively. Hydrogen peroxide (H2O2) is a product of glucose oxidizes catalyzing the oxidation of β-D-glucose by oxygen. It is also used as an oxidizing agent in catalyzing HRP. Hence, an HRP-based immunosensor is important in integrating an immunosensor and an enzyme sensor for the purpose of achieving multianalyte detection compacted on one chip. The cTnI immunosensor developed here is rapid, easy-to-use, cost-efficient and robust

Early Information Access to Alleviate Emergency Department Congestion

Alleviating Emergency Department (ED) congestion results in shorter hospital stay which not only reduces the cost of medical procedure but also increase the hospital performance. Length of patient stay is used to determine the hospital performance. Organization Information Processing (OIPT) Theory is used to explain the impact of information access and availability on the information processing need and ability of a hospital. Technical devices such as RFID that works as “Auto Identification tags” is suggested to increase the information availability as well as the information processing capability of the hospitals. This study suggests that the OIPT needs to be further broken down into its entity form and then the impact of these entities is measured separately. On the other hand, institutional factors such as employee behavior towards the new technology is studied to analyze the impact of human factors in the implementation of these technical devices in the ED procedures. It can be implied from this study that early information access does increase the use of supporting EMR implementation. However, the importance of the use of EMR decreases with time on hospital performance. Moreover, other factors such as management policies related to IT positively moderates the relationship between information availability and the processing capability of a hospital ED

18th Annual Symposium of the School of Science, Engineering and Health

Message from the Dean We in the School of Science, Engineering and Health welcome you to this 18th Annual Symposium, and our first as Messiah University. Here you will see our students, faculty and staff showcase innovation, creativity, teamwork and professionalism in our academic departments. Basic and applied research in science and health fields stem from curiosity, acquired skill, and a desire to test and improve processes from foundational principles. The outcomes of scientific research expand intellectual understanding and have tremendous impact on quality of life, environmental health, and human flourishing. We miss having you as guests on our campus but warmly welcome you to enjoy this day virtually. Angela Hare Dean School of Science, Engineering and Health, Messiah Universit

Holistic System Design for Distributed National eHealth Services

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14th Annual Symposium of the School of Science, Engineering and Health

Welcome to the 14th Annual Symposium of the School of Science, Engineering and Health. This event continues a strong tradition showcasing student and faculty innovation, creativity and productivity in academic departments largely from within the School of Science, Engineering and Health