Digital Commons Network^™

The Question Of Opium: Money, Morality And Japan’S Transimperial Participation In Opium Regulation, 1868 – 1925, Brian F. Gibb

Electronic Thesis and Dissertation Repository

‘The Opium Question’ was not a question, but rather it framed the issue of the under-regulated production, trade and consumption of opium in Asia throughout the nineteenth century. How did opium contribute to Japan’s imperial expansion? Furthermore, how did Japan learn from other imperial powers and use non-state epistemic knowledge to learn to expand its empire? Historians of drugs often use the term prohibition in relation to illicit drugs, when I argue that we should be discussing their regulation. Meiji Japan was faced with the issue of Chinese imperial subjects who were also dependent on opium. As part of the …

Implementation Of Menstrual Cycle And Fertility Awareness Education For Community Healthcare Providers Serving Guatemalan Women, Alissa Struble

Doctor of Nursing Practice Projects

Research indicates that lack of reproductive knowledge, literacy & academic attrition, lack of educator support, poverty, religion, gender inequality, and decreased access to electronic devices contribute to high numbers of teenage pregnancies in Guatemala. Educating United States (U.S.) healthcare providers and Guatemalan volunteers/workers about fertility awareness using Standard Days Method® (SDM) and CycleBeads® has the potential to empower young Guatemalan women and encourage them to make independent, informed reproductive decisions. In December 2023, a quality improvement project was implemented in a Guatemalan rural health clinic. Likert scale questionnaires were utilized to assess knowledge and comfort levels regarding fertility awareness. Analysis …

Globalizing Occupational Therapy: Bridging Gaps In Community-Based Care Of The Dominican Republic Through Digital Education In Therapeutic Interventions, Laura Hildreth

Occupational Therapy Capstone Projects

Title: Globalizing Occupational Therapy: Bridging Gaps in Community-Based Care of the Dominican Republic Through Digital Education in Therapeutic Interventions

Author: Laura Hildreth

Background: Stroke is the second leading cause of death and third leading cause of disability worldwide. Disability from stroke is especially found in low-resource settings where access to rehabilitation therapy services is limited. This paper presents the development of the Stroke Stride Rehab Program which is an evidence-based program aimed to improve stroke rehabilitation outcomes in rural and remote communities, specifically in Puerto Plata, Dominican Republic.

Methods: The development of Stroke Stride Rehab included a detailed and comprehensive …

Establishing Routine Multiple Micronutrient Supplementation During Pregnancy In An Impoverished Guatemalan Community, Marissa Schuette, Erin Brueggemann

Doctor of Nursing Practice Projects

Pregnant and breastfeeding women in impoverished settings face heightened nutritional demands, placing them and their children at increased risk of inadequate nutrition's detrimental effects. Existing literature suggests that supplementing with multiple micronutrients (MMS) may offer superior protection against morbidity and mortality compared to traditional iron and folic acid (IFA) formulations. This research is set in the Land of Hope (LOH) clinic, located in Escuintla, Guatemala, a community served by the non-profit organization ER Abroad. The study aims to assess the feasibility of standardizing MMS provision to pregnant women at LOH, coupled with supplementary education on pregnancy and nutrition. The team …

Identifying And Improving Developmental Delays In Children Within Central America, Alyssa Blake

Doctor of Nursing Practice Projects

Roughly 40% of children living in low-income countries worldwide are at an increased risk of not reaching developmental milestones. Many of these children are at risk due to lack of resources, quality healthcare, and proper developmental screenings. Short-term medical mission trips (STMMs) aim to improve the health of those residing in developing countries. However, although the U.S. does carry out many STMMs to developing countries within Central America to help improve health outcomes, pediatric developmental screenings are often not a part of routine health visits during these STMMs. This may be due to providers having a general lack of experience …

Impact Of Supervisors’ Person-Centered Listening On Sense Of Belonging Among Occupationally Minoritized Healthcare Professionals, Nelu Nedelea

Theses and Dissertations

Significant gender and racial disparities are evident when comparing the composition of the U.S. healthcare workforce to the general U.S. population. Latinx individuals are underrepresented across all professions, while non-White individuals and women are occupational minorities in executive roles and in physician, surgeon, and advanced practitioner roles. Lack of diversity poses problems for underrepresented healthcare professionals, their organizations, and their patients. While diverse professionals experience various forms of microaggression, discrimination, prejudice, and diminished sense of belonging in their fields, these conditions can compromise communication among the various healthcare professionals involved with a patient, in turn, potentially threatening patient safety and …

An Overview Of Sino-Indian Relations In The Last 15 Years, Suchi Patel

Undergraduate Theses and Capstone Projects

India and China are emerging as two of the most powerful countries in the world, threatening the dominance that Western nations have known for so long in recent history. With a rich and dynamic history behind both of these nations, there are many geopolitical factors at play when analyzing the nature of their relationship. Previous media that is widespread in news and magazines have often painted one as a villain and the other as heroic, depending on its political stances. Through analysis of peer-reviewed journals, economic data from the respective governments and the Observatory of Economic Complexity, along with cross-sectional …

Medical Practitioners Perceived Benefits And Costs Of Volunteering For A Multi-Sport Major Games, Kelsie Stunden

Electronic Thesis and Dissertation Repository

Volunteering as a medical practitioner at a multi-sport major games (MSMG) is a career highlight for many, but its benefits and costs have not been thoroughly explored. Framed by Social Exchange Theory, this study aims to address this gap by examining the experiences of medical volunteers at a recent MSMG. An online anonymous survey, based on Doherty’s (2009) study of Jeux du Canada Games volunteers, was completed by 78 Canadian medical practitioners who had volunteered at a MSMG in the previous six years. The study revealed that professional identification and networking were the greatest benefits experienced by medical volunteers, while …

Short Term Medical Mission Gerd And Ulcer Treatment Guideline, Robin Risky

Doctor of Nursing Practice Projects

The United States conducts over 6,000 international medical mission trips each year. The short-term nature of these trips, unfamiliarity with the patient population, language barriers, limited resources, and inadequate staff training are just some of the factors that make it challenging to provide quality care. One way to avoid doing harm is to follow evidence-based guidelines when treating common conditions. This quality improvement project sought to provide an evidence-based protocol for short-term medical missions (STMMs), guiding providers and pharmacy staff on the treatment of GERD and peptic ulcer. This project was implemented in a rural health clinic at the Land …

Compassion Fatigue And Burnout In Mission Trip Providers, Camille Roland

Doctor of Nursing Practice Projects

Compassion fatigue (CF), burnout (BO), lack of compassion satisfaction, and impaired mental health have had catastrophic effects on nurses, providers, and support staff in the past few years due to COVID-19, labor shortage, an influx of critically ill patients, and long hours. Compassion fatigue was coined by Figley as a state of exhaustion and dysfunction biologically, psychologically, and socially because of prolonged exposure to compassion stress. Related concepts identified as burnout and secondary traumatic stress (STS) play an inclusive role in one’s ability to cope with daily environmental stressors causing physical, emotional, and mental breakdown. The link between …

Importance Of Eye Exams As A Secondary Preventative Measure For Diabetic Retinopathy: Winning The War On Blindness, Alondra S. Arredondo, Olivia Demeyer, Rachel Louise Pfenning-Wendt, Samuel Wolfe

All Electronic Theses and Dissertations

Despite current efforts by medical professionals to reduce the prevalence of diabetic retinopathy (DR), a microvascular complication of uncontrolled diabetes, this noncommunicable disease remains the leading cause of preventable vision loss worldwide (Cheloni et al., 2019). Research estimates 90% of DR cases could be prevented if detected early through routine eye exams, yet certain social determinants of health still remain a significant barrier for many individuals to receive this care. According to Wong & Sabanayagam (2020), only 25% of DM patients in developing countries receive routine care with adequate eye screenings. The goal of this community service project was to …

International Academic Partnerships In Orthopaedic Surgery, Michael Jesse Flores

Yale Medicine Thesis Digital Library

Abstract: INTERNATIONAL ACADEMIC PARTNERSHIPS IN ORTHOPAEDIC SURGERY. Michael J. Flores. Department of Orthopaedics & Rehabilitation, Yale University, School of Medicine, New Haven, CT.

Introduction: Orthopaedic-related disease (ORD) is one of the leading health challenges faced worldwide and is a significant cause of global morbidity and mortality, especially in low- and middle-income countries (LMICs). In recent years, international orthopaedic outreach to address the global burden of ORD has received greater attention due to initiatives such as the Lancet Commission on Global Surgery (LCGS). Many strategies have been considered to address the global burden of ORD, most commonly though volunteer trips by …

Clinical Vaccination Education Guideline For The African American Community, Margaret Chinedum Nwoji

Walden Dissertations and Doctoral Studies

AbstractVaccination hesitancy is high among African Americans and other people of color. The practice gap addressed in this project was the lack of a culturally sensitive clinical guideline for vaccination education relevant to the African American community. The practice-focused question was answered by developing an evidence-based Clinical Vaccination Education Guideline for the African American Community (CVEGAAC) that was validated by a group of four content experts using the Appraisal of Guidelines, Research, and Evaluation tool. The content experts scored each of the domains above 90%, implying that the CVEGAAC is of high quality and ready for implementation. The end users …

What Impact Does The Ability To Access Healthcare Have On Maternal Outcomes In Africa?, Helena Harris

Nursing | Senior Theses

Background: Maternal mortality rates reflect health inequities in access to obstetric care in some parts of the world including many African countries. Geographical barriers and limited number of skilled human resources have put women in rural areas at a significantly higher risk of maternal mortality.

Research Question: What impact does the ability to access healthcare have on maternal outcomes in African rural areas compared to urban cities?

Methods: A literature review was performed of credible databases. Six articles were reviewed extensively highlighting the purpose, strengths, and limitations of each study. Refer to Appendix A for the literature review table.

Findings: …

Construyendo Puentes De Salud: Un Análisis De Las Percepciones Sobre El Uso De Promotores De Salud Comunitarios (Psc) Como Estrategia Para Superar Las Barreras En El Acceso A La Salud En 16 Comunidades Rurales De Nicaragua. El Caso De Fundación Amos – Salud Y Esperanza, Ximena Valeria Medrano Gutiérrez

Maestría en Estudios y Gestión del Desarrollo – MEGD

La presente investigación analizó las perspectivas de los promotores de salud y los colaboradores de Fundación AMOS-Salud y Esperanza con respecto al uso de PSC como estrategia para la reducción de las inequidades en el acceso a la salud en comunidades rurales. Se exploraron las experiencias personales de los Promotores de Salud Comunitarios (PSC) y los colaboradores de la fundación a la hora de implementar los programas de Atención Primaria en Salud (APS) en veintiún comunidades rurales de cuatro departamentos de Nicaragua. De igual los participantes realizaron una evaluación reflexiva cualitativa de las fortalezas y áreas de mejora de la …

The Successful Characteristics That Contribute To Black Male Students Matriculating Into Medical School, Cedric Brown

Electronic Theses and Dissertations, 2020-2023

In 2019, individuals that identified as Black represented 13.4% of the U.S. population, 12.5% of the undergraduate student enrollment population and 7.1% of the medical school population. Subsequently, this has yielded a 5% Black physician population and workforce consisting of just 2.3% Black male physicians (AAMC, 2018). The disproportionately low Black physician representation contributes to greater healthcare disparity outcomes within the U.S. Black population. This study is centered on the post-positive characteristics of Black male medical students that have successfully overcome barriers to entry and matriculated into medical school. The phenomenological post-positive study was conducted through the lens of Self-Efficacy …

Voices From Below: The Politics Of Leprosy Control In Southeastern Nigeria, 1926-1960, Odinakachukwu Kingsley Eze

Electronic Theses and Dissertations

Leprosy was an endemic disease in colonial Southeastern Nigeria but became an epidemic between the 1920s and 1940s. Unlike malaria and sleeping sickness, its endemicity did not impede European penetration at the dawn of the twentieth century. However, its spread across Nigeria intensified during colonial rule, with acute prevalence in regions hitherto prone to the disease. Therefore, from the 1920s to 1960, Southeastern Nigeria became the epicenter of British policies tailored towards preventing, curing, and eradicating leprosy disease in Nigeria. Existing research has established the involvement of different actors in this course–including Christian missionaries, colonial officials, specialized agencies, and international …

Christian Mass Movements In South India And Some Of The Critical Factors That Changed The Face Of Christianity In India, Philip Joseph Mathew

Electronic Thesis and Dissertation Repository

The main reason for Christian growth in India was not individual conversions but rather Christian mass movements (CMMs). Since the late 1700s, a series of independent CMMs among non-Christians and a mass reformation movement within the Suriani community have occurred in the southern end of India. These MMs culminated in a mass emancipation movement against caste-imposed segregation of Dalits in the late 1800s, an event of national significance. In the early 1900s, Pentecostalism evolved from these CMMs and transformed the religious landscape of Christianity in South India and later in India as a whole. The Thoma Christians were the early …

Improving The Delivery Of Discharge Instructions On The Postpartum Unit By Increasing The Nurses' Knowledge, Judy Anne Settles

Master's Projects and Capstones

Abstract

The field of nursing prides itself on two critical functions: safety and patient education. One of the mechanisms for both education and safety is the discharge process. Improvements in the discharge process have been shown to increase patient comprehension and safety. This study is grounded in the (Barach & Johnson, 2006) healthcare organizational framework called the 5 Ps microsystems assessment to explore the impacts and improvements in the discharge instruction process on a postpartum unit in a large organization. It was found that HCAHPS scores regarding discharge instructions were 55-60%, which is below what is considered satisfactory. Utilizing the …

Cultural Safety And The Provision Of Humanitarian Nursing In Haiti, Jennifer Weitzel

Theses and Dissertations

Nurses comprise the largest segment of the global health workforce including in humanitarian settings. Guided by strict ethical to address issues of global health inequities, nurses are currently limited in their ability to address root causes of inequities as the most commonly used nursing concepts and theories are informed by racist and colonist ideologies. To address this gap, this study was guided by critical race theory and cultural safety to explore how nurses’ worldviews, with explicit attention to race, influence care in the humanitarian setting. The study focused on care delivered in Haiti taking into account its history with the …

The Introduction Of A Global Medical Education Strategy, Amy L. Outschoorn

The Dissertation in Practice at Western University

Significant effort has been made in improving global health care over the last several decades, however, there had been a lack of consistency in the delivery of care. This includes a lack of access to safe and affordable surgery and comprehensive care in low- and middle-income countries. Health care organizations require that medical providers are equipped with the highest quality of medical education programs to enhance the provision of patient care. This Organizational Improvement Plan (OIP) examines a global, medical mission-based, Non-Governmental Organization (NGO), that provides highly specialized surgery and comprehensive care locally and internationally through medical volunteers. The Problem …

Healthcare Profession Students Of Color Participating In International Service-Learning, Ellyn Katherine Couillard

USF Tampa Graduate Theses and Dissertations

This qualitative exploratory case study investigated the healthcare profession students’ of color experience and the perceived impact of completing international service-learning (ISL). Before this study, most of the research about healthcare profession students in ISL reported had mainly White participants or reported data and findings in the aggregate. To complete this research, I performed two semi-structured interviews with each of the five participants incorporating photo-elicitation techniques. Then I performed constant comparative methods and communicated with a peer debriefer about my findings. Five participants were selected using max maximum variation based on racial, ethnic, and cultural backgrounds, programs of study, and …

Promise And Problems Of Short-Term Mission Trips Through The Eyes Of Christian Young Adults, Hayley Culver

Capstone Collection

Short-term mission trips are a popular form of international travel among Christian youth. Though many who attend these trips see them as a way to gain international experience and help others, there are also those who question the value of such trips and describe them as merely “voluntourism.” This research study investigated the experiences of 11 people who did a mission trip as a young adult, guided by the following research questions: What motivates young people to do short-term mission trips? What lasting impact do these trips have on their participants’ worldviews? The findings reveal that while most trip-goers were …

Cultural Barriers To Orthopedic Follow-Up Care In Pucallpa, Peru, Jona Bakke, Alyssa Braun, Laura Luttio

All Electronic Theses and Dissertations

Scalpel at the Cross (SATC) is a nonprofit Christian organization that serves the Pucallpa, Peru community through short-term medical mission trips. Teams travel to Pucallpa each year to perform orthopedic surgeries, educate providers in local clinics, and build relationships within the community (Lezak et al., 2020). One aspect of this organization’s mission is to provide adequate follow-up care after surgery (Larson, 2014). However, SATC representatives have identified a general lack of understanding among patients regarding the need for follow-up care after surgical procedures (K. Rodriguez & E. Cardona, personal communication, September 25, 2020). In order to address this problem, the …

Nurses’ Perceptions Of Culturally Competent Care At The Bedside, Judith Cox

Walden Dissertations and Doctoral Studies

The population served by health care systems in the United States is widely diversified, which requires nurses to be culturally competent in their care practices. However, studies have shown that nurses do not consistently deliver culturally competent care. This basic qualitative study was designed to explore nurses’ perceptions of cultural competence at the bedside to understand what is needed to improve cultural competency practices. Campinha-Bacote’s conceptual framework for cultural competency was used to guide this study that included face-to-face, videoconference interviews using semi structured and open-ended questions from 13 voluntary, acute care bedside nurses. Interviews were audio recorded and uploaded …

Preparing For Professional Programs: Strategies And Practices For Pre-Medical Education, April Elayne Curry

Theses and Dissertations

This study examines the preparation process for students in professional programs and highlights strategies and practices for pre-medical education. The COVID-19 pandemic has highlighted elements of the healthcare system that explore how critical physicians are that can lead with both a global perspective and with compassionate patient care. In order to understand the competencies required for this leadership process, it is critical to consider the medical school lifecycle from the undergraduate education to residency. Working from the admissions process, we consider what competencies are required for medical school success and physician preparedness and we use that to shape a solid …

The Efficacy Of A Service-Learning Experience In The New Orleans Area In Improving Intercultural Competence Of Nutrition And Dietetics Students, Michel D. Harris

UNF Graduate Theses and Dissertations

There is a large gap between minority representation in the field of dietetics and the United States population, and nutrition students need advanced cultural competence training in preparation for future work with diverse populations. Universal recommendations for delivering and evaluating cultural competence training in nutrition programs are non-existent, and students tend to lack understanding of how to develop this skill. Service-learning in underserved communities with reflective assignments have been used to develop cultural competence skills, but most reported results are anecdotal. This non-randomized mixed methods study sought to find out if a service-learning experience improves intercultural competence of nutrition students …

Family Relationships And Academic Performance Via Belongingness Among Cuban Medical Students: Examining Family Legacy And Sex As Moderators, Maria J. Cisneros-Elias

Theses and Dissertations

Medical diplomacy is a foundational part of Cuban domestic and foreign policy (Feinsilver, 2010). Cuba has an abundance of doctors, encouraged by the country’s free medical education program (Hand et al., 2020), and has made a significant impact with its well-established healthcare system, provision of healthcare for all of its citizens, and healthcare support internationally. The current study aims to focus on processes underlying Cuban medical students’ academic performance, as they are a critical component of this successful system, and a population that has received limited empirical attention. Thus, the current study used path analyses to examine the relations between …

Short Term Medical Mission Antibiotic Protocol, Greg Jennings

Doctor of Nursing Practice Projects

Background/Introduction: Short term medical mission trips are growing in popularity and with this growth the level of care provided must remain evidenced based. Mission groups traveling to developing countries consist primarily of volunteers. And while many of those serving on mission trips are medically trained, some have minimal healthcare knowledge. Pharmacists are not always available to dispense medications on mission trips and therefore it is common for registered nurses in the pharmacy to dispense the medications prescribed by the providers. Because the medications available on mission trips are limited, often times substitutions must be made, especially when it comes …

Program Development And Evaluation Of A Diabetes Self-Management Education And Support Toolkit On An E-Learning Platform For Young Adults Living With Type 2 Diabetes, Marlene Eicher

Doctor of Nursing Practice Scholarly Project

The purpose of this project was to develop and evaluate the effectiveness of a diabetes education toolkit on an e-learning platform for improving individual self-management and medication knowledge to promote healthy lifestyle behaviors for young adults living with type 2 diabetes mellitus (T2DM).

A descriptive, quasi-experimental design with one-group pretest-posttest was used. Participants were recruited from an independently owned medical clinic. The participants were English-speaking young adults, between ages 18 to 39 with a diagnosis of prediabetes or T2DM. The intervention was a DSMES toolkit with twelve e-learning modules that participants completed over a three-month period. Data collected was age …