Medicine and Health Sciences Commons^™

Preventing Obesity And Cardiovascular Disease In At-Risk Youth, Allison Patricia Woolf, Nicole Ashley Bauernfeind, Rachel Katharine Civale, Elizabeth Rose Spellman

Senior Honors Projects, 2010-2019

The literature review that was conducted focuses on exploring the most effective way to prevent development of Cardiovascular Disease (CVD) as a late effect of childhood obesity or risk thereof. Our research focused on the 8-10 year old at-risk and obese pediatric populations and whether the use of interactive educational interventions in the community setting can be of use to reduce CVD development and improve overall health status. Our findings determined that interactive educational interventions early in childhood can improve health outcomes for these populations and prevent subsequent development of CVD. We minimized the inclusion of all research whose evidence …

Mental Hell, Jesenia De Moya, Hanaa' Tameez, Maritza Villela

Capstones

Mental Hell explores how difficult it is for low-income Latinos in New York City to access mental health care. Through explanations from experts and the personal stories of three Latinas New Yorkers who have gone through the process of trying to get the care they need, the story guides the reader through the many roadblocks this demographic encounters specifically under the insurance of Medicaid.

This is an extremely important topic that affects many New Yorkers, and we believe something needs to be done to make this type of healthcare more accessible for Latinos. New York City has a very high …

Implementation Of A Fruit And Vegetable Voucher Program In San Francisco, Alexandra Kambur

Master's Projects and Capstones

Chronic disease has emerged as the predominant public health challenge of the 21st century. Chronic diseases like cardiovascular disease, cancer, type 2 diabetes and obesity have maintained their top positions as the leading causes of poor health, disability, death, and high health-care expenditures for over a decade. Health and hunger go hand-in-hand. Today over 15 million households in the United States struggle with food insecurity, meaning they do not have sufficient access to food that meets their dietary needs for an active and healthy life. The issue of food insecurity in cities like San Francisco, California is exacerbated by the …

Community Development Projects In Moldova, Berkend Pura

Capstone Collection

This Independent Practitioner Inquiry Capstone (IPIC) aims to provide relevant information, from a Peace Corps (PC) Volunteer (PCV) standpoint, on a renovation project that was implemented in the village of Vorniceni, Republic of Moldova. At its core, this was a community development project that involved the active participation of the community of Vorniceni, providing local resources and knowledge towards the goal of building a healthier sanitation facility on the second floor of the local kindergarten.

The results of this effort indicate that the involvement of the client (people) is crucial to sucess in implementing projects, and it also shows that …

Increasing The Adherence To Updated Clinical Practice Guidelines For Tb Screening Among Hiv Patients Entering A Congregate Setting Utilizing A Clinical Reminder, Domingo Lopez

Doctor of Nursing Practice

Purpose: The purpose of this Doctor of Nursing Practice project was to update an existing tuberculosis policy for screening HIV-positive individuals entering a south Texas jail to meet current evidence-based guidelines and increase the adherence of jail staff to the updated screening process.

Background and Significance: In 2015, over 700,000 people were jailed in the United States with over 20,000 being HIV-positive. Tuberculosis is highly contagious and spreads through the air. HIV is a virus that targets the immune system. HIV-positive people are 17-22 times more likely to contract tuberculosis. The current screening process at the jail showed a low …

Contributors To Wisconsin’S Persistent Black-White Gap In Life Expectancy, Max T. Roberts

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

For decades, blacks have faced shorter life expectancy than their white counterparts. This persistent disparity has led to a gap in life expectancy between the two groups. Nationally, this gap has decreased over the last 40 years. However, this is not the case at the state-level as some states have experienced little or no improvement in the life expectancy gap. Such is the case in Wisconsin, where the life expectancy gap is the largest in the nation for males, and the gap actually has grown for females over the last two decades. This study seeks to examine this persistent gap …

Social-Ecological Factors Affecting Patient Shield Use Among Radiologic And Computed Tomography Technologists, Megan Housenick-Lee

Electronic Theses and Dissertations

Medical radiation is estimated to contribute to over 200,000 deaths annually. Recent increases in the use of radiation-producing medical imaging examinations have led to increasing cumulative radiation dose to the general public. Multiple measures have been taken to address this alarming trend, including physician education, technologist education on dose reduction, and equipment-facilitated dose reduction techniques. Shield use can reduce the primary beam by up to 95%. Medical imaging technologists are the primary individuals responsible for applying shielding during an examination. Currently, literature shows that technologists are not shielding individuals as often as they should.

After pilot testing, medical imaging technologists …

Acculturation And Causes Of Death Among Filipinos In The Us: Focus On Cancer, Abegail Terso Reyes

UNLV Theses, Dissertations, Professional Papers, and Capstones

Filipinos in the US are 3.4 million, yet the main causes of death among this primarily immigrant population have not been well characterized nor compared with the mortality experience of their counterparts in the Philippines. Age-adjusted mortality rates were computed for the main causes of death for three populations: Filipinos living in the Philippines (FPHs), Filipinos living in California (FCAs), and non-Hispanic whites in California (WCAs). Regression-derived mortality rate ratios stratified by sex were used to compare the populations, using WCA as the referent population. Included causes of death were ischemic heart disease, stroke, cancer and chronic lower respiratory disease, …

Youth Focus Groups: Design And Analysis Plan For The Bears Project, M. Renee Beacom Claborn

Capstone Experience

This capstone project produced a qualitative research design and analysis plan for youth focus groups as part of a Quality Improvement project at OneWorld Community Health Center (OWCHC) School-Based Health Center (SBHC) located at Bryan High School (BHS) in a program called BEARS. The intended use of this project is to serve as a reference guide for BEARS program planners to utilize as part of the data collection and analysis processes. The purpose for collecting qualitative data for this project is three-fold. 1. To explore adolescents’ perspectives of risk behaviors and associated health determinants common to their age group 2. …

Primary Care Provider’S Perspectives Of Integrating Public Health Into The Prevention And Management Of Type Ii Diabetes Mellitus In Rural Nebraska, Emma Frost-Briley

Capstone Experience

Through the 2011 Community Health Needs Assessment, the Four Corners Health Department has identified type II diabetes mellitus as one of the communities top concerns within their communities. The goals of this project were: to develop a survey to assess the state of current practices of primary care providers on type II diabetes mellitus in the health department district, to identify primary care providers views on prevention, treatment, and management of type II diabetes mellitus in the health department district, and to examine primary care providers and local health department’s views on how primary care and public health can be …

The Relationship Between Bmi & Mandated Physical Education Requirements Of Elementary Schools, Kathryn Fairlamb

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The physical activity policies of elementary schools in Arkansas and correlations between physical activity requirements and body mass index have been studied. Examination of the policies at the individual school, district, or state level were noted. The statewide BMI database was consulted. Interviews with physical education teachers was conducted to assess policy implementation. Results may provide schools and policy makers with insight on future physical activity policies.

Interns Matter: Maximizing Integration Of Interns Into Community Agencies, Valerie Garcia

Capstone Projects and Master's Theses

Hope Services is a non-profit agency serving individuals with developmental disabilities in six counties. Over the years, there have been many agencies that have formed connections with Hope Services. One of these collaborative partnerships has been with CSU Monterey Bay’s (CSUMB) integration of interns through their field placement program. However, recently former Hope Services South District Manager, Greg Dinsmore, witnessed a lack of utilization and integration of interns across all Hope Services agencies. Through firsthand experience as a mentor, he witnessed the benefits of utilizing interns and saw the need for further advocacy and support for the integration of interns …

Santa Clara County Senior Nutrition Program Evaluation Report, Tae Hwan Ihm

Master's Projects

Santa Clara County conducts a Senior Nutrition Program (SNP) in conjunction with the City of San Jose, the Outreach Paratransit Program and local community-based organizations (CBOs) like Sourcewise (Lam, 2015). These programs combined represent a significant investment of public funds, with more than 45% of the SNP program’s funding coming from the county General Fund (Lam, 2015). Such a large financial commitment needs to demonstrate some benefit to the participants, and some positive outcomes from the current program design. This study evaluated the SNP’s effectiveness in achieving its primary goals. Primary goals of the SNP are to promote senior citizens’ …

Effect Of Intimate Partner Violence Education On Nurses Readiness To Screen, Felisha Dixon-Brazier

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

This quality improvement translational project was intended to increase the confidence of nurses screening for intimate partner violence, through education. The project utilized a focus group and the Physicians Readiness to Manage Intimate Partner Violence Survey to gather needs, knowledge gaps, and prior education to develop IPV education for a group of nurses at a public health department. Nurses were found to have a low level of IPV knowledge, with a mean score of 42.44 (SD= 15.13), on a 100-point scale. Six of the nurses also reported less than one hour of previous IPV training in the past. Nurses reported …

Patient-Centered Medical Home Adoption In School-Based Health Centers, Abbey Gregg

Theses & Dissertations

The patient-centered medical home (PCMH) is promoted as a primary care delivery design that can improve health care quality and patient outcomes while controlling health care costs. To achieve PCMH recognition, primary care providers must implement practice-level changes in order to deliver care that is comprehensive, coordinated, accessible, high quality, and whole-person oriented. This practice transformation requires advanced use of health information technology, staff investment in quality improvement and care coordination, and significant investments of both financial and human resources to support these activities. As a safety-net provider, school-based health centers (SBHCs) serve vulnerable children that typically experience barriers to …

Community-Based Asthma Intervention Programs And Their Impact On Childhood Health Outcomes And Burdens On The Healthcare System, Danika Ng

Master's Projects and Capstones

Since 1997, asthma prevalence rates have increased by 3% annually, leading to a current rate of 18.4 million adults and 6.2 million children with asthma, high hospitalization and emergency department visit rates, and an overall healthcare spending of 50 billion dollars. However, this increase in prevalence is disproportionately impacting children. Asthma is the third leading cause for hospitalization in children, have higher proportions of children being hospitalized with asthma symptoms, and have higher rates of asthma attacks. Recent literature shows that perceived lack of adequate education in areas such as medication adherence, medical device usage, asthma trigger avoidance, lack of …

Evaluation Of Increased Targeted Enforcement And Community-Based Outreach And Education Programs To Increase Nighttime Seatbelt Use In East Tennessee, Kwaku Frimpong Boakye

Doctoral Dissertations

According to the National Highway Traffic Safety Administration (NHTSA), motor vehicle crashes are the leading cause of death among people aged 1-54 in the United Sates. In 2015, the number of motor-vehicle deaths on U.S. roadways totaled 35,092, a 7% increase from 2014 (32,744). Though lower gas prices and increased vehicle mileage combined with risky driving behaviors (e.g. speeding, driving while texting) account for the increased fatality rate, seatbelt non-use has been a significant contributory factor. It is estimated that nearly half (48%) of passenger vehicle occupants involved in fatal crashes each year are unrestrained.

In a recent 2014 report …

Rna Sequencing In The Development Of Cancer-Cachexia, Thomas Allen Blackwell

Graduate Theses and Dissertations

Introduction: Cancer is a major public health problem in the U.S. and the world. In 2013 there were an estimated 1,660,290 new cases of cancer in the U.S. Cancer-Cachexia (CC) is a common effect of many cancers, and is directly responsible for 20-40% of cancer-related deaths. The mechanisms that control the development of CC are not well understood. Most investigations of CC focus on the post-cachectic state and do not examine the progression of the condition. The purpose of this study was to utilize RNA sequencing to analyze transcriptomic alterations throughout the progression of CC. Methods: Lewis Lung Carcinoma cells …

Assessing Patient Perceptions Of Self-Care: Examining Chronic Disease In An Underserved Rural Area, Somer Leigh Overshon

Graduate Theses and Dissertations

The Affordable Care Act of 2010 mandated healthcare reform in the United States by requiring insurance coverage for more Americans. Further, the law deemed healthcare providers, communities and individuals throughout the nation were responsible for fighting chronic disease and escalating healthcare costs. Preventive care and self-care have been cited as low-cost options for initiating change in the American population by helping individuals have access, information and resources to make better healthcare choices and manage their chronic diseases. The purpose of this ethnographic study was to identify the perceptions of self-care from patients living with chronic disease in an underserved, rural …

Testing An Integrated Model Of Help Seeking With Ethnically Diverse Primary Care Patients, Bianca Teresa Villalobos

Graduate Theses and Dissertations

Structural and attitudinal barriers prevent many individuals from accessing professional mental health services and often times lead to the premature termination of treatment. Although research findings suggest that the integration of mental health services in primary care can increase access to services and reduce stigma for typically underserved populations, dropout occurs at high rates. The current study aims to: (1) identify correlates of attitudinal and structural barriers in a primary care setting, and (2) test the ability of the Integrated Model of Seeking Help (IMoSH) to predict follow-up for behavioral health visits. In particular, it was hypothesized that attitudinal barriers …

How To Effectively Improve Nurse-Physician Communication, Savannah R. Lacoste

Honors Theses

A study of the issue of Nurse-Physician communication, its causes, effects, importance, and possible improvements through research. The results suggest both physicians and nurses agree that nurse-physician communication is an important problem, and can be effectively improved in many ways including: a required nurse-physician communication class for pre-medical and pre-nursing students at an undergraduate level, improved and structured communication tools, and inter-professional education (IPE) between nurses and physicians. The research provides the outlooks of twenty-five nurses and twenty-five physicians independently, as well as demonstrating the nurse-physician disconnect through data comparison and analysis.

A Mixed-Methods Study Of Sexual Assault In Lesbian, Gay, And Bisexual Adults In The U.S., Sasha Nichole Canan

Graduate Theses and Dissertations

Background. Previous research finds that (1) lesbian and bisexual (LB) women as well as gay and bisexual (GB) men have higher rates of rape victimization compared to their heterosexual (H) peers and (2) perceived familial support reduces the impact of some of rape’s negative health outcomes in heterosexual victims. However, specific contextual factors regarding rape and assessment of familial support for LGB victims are severely lacking. Also, measurements of sexual assault victimization have yet to be validated in this population.

Methodology. The current study used a mixed-methods design that included two phases of data collection. Phase 1 was a national …

Predictors Of Anemia Among Hiv Patients In Uganda, Catherine Nagawa

Masters Theses

HIV-related anemia is associated with increased risk of death. Prior studies suggest an inverse relationship between CD4 cell count and anemia, and a positive relationship between HIV-clinical stage and anemia. However, none have assessed the role of antiretroviral therapy (ART) treatment combinations in these relationships. Therefore, we conducted a cross-sectional study to evaluate the relationship between CD4 cell count, HIV clinical stage and anemia among 4803 Ugandan HIV-patients, and assessed the role of ART treatment combinations. We included HIV patients (> 15 years) receiving ART therapy combinations between 2010- 2015. We evaluated CD4 cell count and anemia using blood tests, …

Exploring The Health Effects Of Precarious Employment By Sex/Gender Using Mixed Methods, Kathleen Flandrick

Dissertations and Theses

Employment in the United States has changed dramatically since the mid-1970s. Labor market forces like globalization and diversification of the American workforce have led to a heavily segmented labor market where new types of flexible employment such as temporary, contingent, and nonstandard work arrangements are increasingly common. These newer types of work are often on the lower end of the precarious employment continuum, categorizing jobs by their degree of: 1) temporariness, 2) disempowerment, 3) vulnerability, 4) compensation (wages), 5) rights, and 6) ability to exercise worker rights. The increase in precarious employment likely disproportionately affects women when compared to men, …

Ethical Issues Of Parental Vaccine Hesitancy And Resistance To The Mmr Vaccine, Harlie Silver

Honors Theses

In this thesis I present a brief history of vaccination, the anti-­vaccine movement, the measles virus, and the associated risks to children and adults. I then discuss the factors contributing to parental vaccine hesitancy and resistance, consider issues of under-vaccination, herd immunity, and the underlying ethical issues. Finally, I address exemptions to school-­required immunizations and argue for the elimination of both philosophical and religious exemptions, while examining parental moral responsibility when it comes to the health and safety of one’s own children and those with whom they may come in contact.

From Food To Food Justice: Pathways And Narratives Of Young Food Activists In New York City, Amy Kwan

Dissertations and Theses

With a rise in obesity and other non-communicable, diet-related health problems and the persistence of food insecurity among many vulnerable populations, the involvement of young people in the current, burgeoning food-justice movement has the potential to bring forth transformative changes to our food system and thus improve population health. While much is known about the outcomes of providing opportunities for young people to be actively and civically engaged in their communities, there is a lack of research on the pathways, narratives, and experiences that bring young people into food justice activism.

Through semi-structured, in-depth interviews with 25 young food activists …

Incorporating Place And Space: A Hierarchical Spatial Approach To Exploring Preventable Congestive Heart Failure Hospitalizations In New York City, Rachael Weiss Riley

Dissertations and Theses

Background: Faced with rising medical care costs, increasing prevalence, and widening health disparities, preventing congestive heart failure (CHF) hospitalizations is a central public health concern. Despite evidence of geographical clustering in preventable CHF admissions, there is a lack of research designed to examine spatial patterning of CHF and the local area neighborhood determinants that contribute to this variability. This study sought to assess and evaluate the importance of both space and place in analyzing preventable CHF hospitalizations and readmissions by applying appropriate statistical techniques, clarifying the assumption inherent in each method, and interpreting the findings within the context of existing …

The Role Of Socioeconomic Context In The Association Between Educational Attainment And Morbidity And Mortality, Jennifer Brite

Dissertations and Theses

Although the association between educational attainment and health is one of the most studied in the social science, little is known about the role of social and economic context. Fundamental Cause Theory suggests that the education-health gradient will be weakest in contexts where the better educated are unable to leverage their resources to achieve better health. This dissertation tests several different factors that may moderate the association between educational attainment and morbidity and mortality: 1. Demographic characteristics, including race, immigration status, and gender, 2. Status consistency (defined as education equivalent to that required for current occupation), 3. Unemployment rates at …

Community Living Integration Club For Women In Recovery From Sex Trafficking, Toni Thompson

Occupational Therapy Program Student Theses, Dissertations and Capstones

Sex trafficking is one form of human trafficking, a heinous human rights violation that transcends international borders. People who have been trafficked often present with complex neurobehavioral, psychological, emotional, physiological, sensory, and developmental difficulties. The United Nations developed the international 3 p protocol to guide governmental agencies, non-governmental groups, and individuals in developing programs and legal actions of trafficking prevention, protection, and prosecution. Protection encompasses the recovery of trafficking survivors and community integration has been identified as an essential foundation for successful recovery. Measurable components of community integration include safe housing, stable employment, and vocation-focused education. This Capstone describes the …

Who's Hungry In San Diego, Alison M. Schurman, Kathy S. James

Doctor of Nursing Practice Final Manuscripts

Objective: Food insecurity (FI) is a lack of access to nutritious food. FI has been linked to multiple preventable diseases from behavioral disorders to asthma to obesity and its sequelae. In San Diego County, 14 percent of families are food insecure. The AAP recommends screening for FI at all well appointments using the two-question FI screening tool. The aim of this project was to implement this tool at a multi-clinic, low income population community health center where ninety-five percent of patients meet qualification for SNAP benefits.

Methods: Stakeholders chose one week to screen all patients presenting to clinic for FI …