Adult Postoperative Open-Heart Patients: Anemia and 30-Day Hospital Readmission

Background. In 2013 alone, more than 4% (3.9 million) of patients discharged from a hospital were readmitted. Anemia following a surgical procedure is associated with early hospital readmission. Purpose/Aims. The following were specific aims of this dissertation: Aim 1. To develop an operational definition of the term condition-based maintenance as applied to health care and discuss the applicability and effectiveness of condition-based maintenance within health care. Aim 2. To identify the number of adult patients undergoing elective open-heart surgery with preoperative anemia. Aim 3. To examine the relationship between preoperative anemia, sociodemographics, and 30-day hospital readmission rates among postoperative open-heart adult patients. Aim 4. To explain the development and impact of the Hospital Readmissions Reduction Program (HRRP) and discuss the political, social, and economic implications of CABG as a newly targeted condition within the HRRP. Approach. To address aim 1, the Walker and Avant model for concept analysis was used to review and analyze relevant literature, create a basic operational definition, and clarify related concepts. To address aims 2 and 3, a retrospective cross‐sectional study was conducted using the STS Database to identify 1,353 surgical cases between August 2014 and July 2018. Cross-tabs and multivariable logistic regression analysis were used to assess the prevalence of preoperative anemia and association with 30-day hospital readmission. To address aim 4, a policy analysis was performed in accordance with Bardach and Patashnik’s procedure. Findings. From the concept analysis process, the notion of condition-based maintenance emerged, holding promise in advancing symptom science through development of personalized strategies to treat and prevent adverse symptoms of illness. The prevalence of preoperative anemia was 43.7% (n = 591), and 177 (13%) had a 30-day hospital readmission. Patients with preoperative anemia had 1.88 (95% CI 1.36, 2.58) times higher odds of being readmitted. Through policy analysis, a correlation between insurance and 30-day hospital readmission following a CABG procedure was identified. Currently, penalty programs may be adjusted to better capture sociodemographic differences. Implications. The findings from this study suggest preoperative anemia is associated with increased risk for 30-day hospital readmission. These results provide a basis for further risk reduction strategies and preoperative optimization

Education and Employment Outcomes in Persons with Pediatric-Onset Spinal Cord Injury vs. Adult-Onset Spinal Cord Injury

Employment is considered to be an important predictor of life satisfaction and success. Statistics on unemployment rates are of concern among our society, especially when the statistics involve individuals with disabilities. In an era where the American with Disabilities Act and Rehabilitation Act have pushed for the community and workforce to become more accessible, unemployment rates among individuals with disabilities still remain high. Spinal cord injury (SCI) is an interesting population in that individuals, who want to work, can work with the appropriate technology and accommodations. Yet, over half of the individuals with SCI who worked prior to their injury remain unemployed years later. Many of the past and current studies investigating employment recruit subjects who are at least 18 years of age, with some recruiting individuals who are 16 years of age. Children with disabilities have a plethora of resources and services offered to them within the school district. From Individualized Education Programs (IEP) to transition services, many individuals work with the child to help them become an active participant in society. This study looks specifically at SCI of pediatric-onset. Examining already existing data collected by the NSCID, we investigated: a) employment and education rates among individuals with pediatric-onset SCI (PO-SCI) compared with adult-onset SCI (AO-SCI); b) variables that may contribute to vocational outcomes among this population; and c) if acquiring an SCI at a young age is positively correlated with higher rates of employment and levels of education. Statistical results yielded no difference between PO-SCI and AO-SCI with respect to employment rates (working vs. not working). Differences were noted in level of education achieved between PO-SCI and AO-SCI, with individuals who had PO-SCI more likely to pursue additional education and higher levels of education post-injury. Results do indicate that post-injury level of education does correlate with post-injury employment status; higher levels of education yielded higher employment levels at follow-up. Results from the study also indicate that individuals with spinal cord injury, regardless of age at injury, still remain unemployed years after their injury. Rehabilitation counselors can play a crucial role in helping individuals with SCI overcome employment barriers

Unwed Mothers‘ Private Safety Nets and Children‘s Socioemotional Wellbeing

Using longitudinal data from the Fragile Families and Child Wellbeing Study (N = 1,162) and the National Evaluation of Welfare-to-Work Strategies (N = 1,308), we estimate associations between material and instrumental support available to unwed, low-income mothers and young children‘s socioemotional wellbeing. In multivariate OLS models, we find mothers‘ available support is negatively associated with children‘s behavior problems and positively associated with prosocial behavior in both datasets; associations between available support and children‘s internalizing and prosocial behaviors attenuate but remain robust in residualized change models. Overall, results support the hypothesis that the availability of a private safety net is positively associated with children‘s socioemotional adjustment.

Wind Symphony and Wind Ensemble

This KSU School of Music performance features KSU Wind Ensemble, led by Director of Bands Dr. David Kehler, and KSU Wind Symphony, led by Associate Director of Bands Dr. Debra Traficante, with KSU faculty soloists Doug Lindsey, cornet, and Ryan Moser, trumpet. Program features works by Arnold Schoenberg, James Stephenson, George Gershwin, and more.https://digitalcommons.kennesaw.edu/musicprograms/2109/thumbnail.jp

Duo Trompiano!

Judy Cole and Doug Lindsey met in the Fall of 2012 and have since performed dozens of concerts all over Georgia and the Southeast. From their very first collaboration, Duo Trompiano! have been committed to making great music accessible to audiences of all ages that spans genres from jazz standards to modern trumpet repertoire.https://digitalcommons.kennesaw.edu/musicprograms/1959/thumbnail.jp

The playing experiences of esport participants: An analysis of treatment discrimination and hostility in esport environments

The eSport industry has seen rapid growth over the previous decade with additional opportunities for participants to compete in competitive and casual environments. As such, the sport industry has taken notice of this increase in popularity and exposure for eSport. A recent call to arms by sport management scholars suggests that the field of sport management needs to broaden research endeavors to include analyses of eSport and eSport spaces. To that end, this investigation serves as one of the first that investigates the playing experiences of eSport participants with a particular focus on the presence of discrimination and hostility in playing environments for men and women competitors. Previous events within the eSport industry, such as the now infamous harassment of female gamers known as Gamergate, suggests that female eSport players may experience discrimination and hostility at higher rates than their male counterparts. Guided by the frameworks of hegemonic masculinity and treatment discrimination, this investigation gauged the experiences of men and women eSport participants with discrimination and hostility in eSport playing environments. Results indicated that female eSport participants reported experiencing instances of treatment discrimination more frequently than their male counterparts, while male participants reported experiencing hostility more frequently. Results aim to assist the eSport industry as well as sport management scholars in guiding new policy to create inclusive spaces for eSport enthusiasts and career hopefuls