Medicine and Health Sciences Commons^™

Evaluating The Association Of Influenza Vaccination On Long-Term Covid-19 Symptoms In U.S. Adults, Ratnakar Pingili

Capstone Experience

Objective. To evaluate the association of influenza vaccination in the past 12 months with Long COVID effects and clinical and sociodemographic factors.

Methods. Cross-sectional study with data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), covering 415,132 non-institutionalized U.S. adults with a confirmed COVID-19 diagnosis and influenza vaccination reported within the last 12 months. Logistic regression was conducted between influenza vaccination (exposure) and Long COVID (outcome), controlling for demographic variables, pre-existing health conditions, and socioeconomic status.

Results. Of 120,603 participants, 21.89% reported Long COVID symptoms and 42.04% had received an influenza vaccine. Findings indicate a statistically significant 13% reduction …

Standardizing The Discharge Process To Reduce Copd Readmission Rates, Kristine Doligosa

Doctor of Nursing Practice Scholarly Projects

Background: Frequent acute exacerbations of chronic obstructive pulmonary disease (AECOPD) can lead to unfavorable patient outcomes and costly readmissions. Inadequate patient support during discharge and an inconsistent discharge process are factors contributing to high readmissions in this population.

Purpose: This quality improvement project aimed to reduce COPD-related hospital readmissions by standardizing the discharge process for patients admitted with AECOPD and identify patient risk factors for readmission.

Methods: Following a quantitative and quasi-experimental design, this project standardized the discharge process for patients admitted with AECOPD using the Re-Engineered Discharge Toolkit components and a discharge care bundle. The project was …

Using Simulation To Assess Knowledge And Attitude Amongst Healthcare Provider Regarding Cardiopulmonary Resuscitation At A Tertiary Care Hospital In Karachi, Pakistan- A Pre And Post Test Qausi Experimental Study, Nausheen Barkat Ali Noorani

Theses & Dissertations

No abstract provided.

Icu Liberation Bundle: A Multidisciplinary Approach, Julie Anne Snyder Amoroso

Student Scholarly Projects

Practice Problem: Patients with increased ventilator days see dramatic increases in their chances of developing healthcare-related conditions (HAC). Extended ICU stays increase the potential for problematic issues in patients' physical, mental and spiritual health with short-and-long-term consequences.

PICOT: The PICOT question that guided this project was looking at adult ventilated patients in a medical ICU (P) and what is the effect of initiating interdisciplinary ABCDEF-ICU liberation bundle rounding as (I) compared to no ICU liberation bundle rounding (C) has on the length of ventilator days (O) over eight weeks (T).

Evidence: Evidence from quality studies and backing from the …

Discharge Care Bundle To Reduce Copd 30-Day Readmission Rates In A Hospital Acute Care Unit, Dao Vang

Student Scholarly Projects

Practice Problem: Chronic obstructive pulmonary disease (COPD) readmissions severely impact patients’ health, mortality, and quality of life and increase unnecessary healthcare use and spending. Utilization of a protocol and discharge care bundle to reduce the readmission rate for COPD patients is critical to combat the problem.

PICOT: The PICOT question that guided this project was in adult patients 65 years or older admitted to a hospital acute care unit for acute exacerbation of COPD (P), does a protocol and discharge care bundle (I) compared to no protocol and no discharge care bundle (C) reduce the 30-day hospital COPD readmission rate …

Increasing Continuous Positive Airway Pressure Compliance With Various Telemedicine Interventions: An Integrated Literature Review, Tracy Partington

Doctor of Nursing Practice (DNP) Projects

Aims and Objectives. This literature review's objective was to synthesize evidence from previously published literature on telemedicine interventions' effectiveness on CPAP (Continuous Positive Airway Pressure) therapy compliance.

Background. It is estimated that 22 million Americans suffer from a form of Sleep Apnea (SA), and those up to 80 percent of the cases of moderate to severe Obstructive Sleep Apnea (OSA) are undiagnosed (Sleep Apnea, n,d). The first-line therapy for OSA is CPAP. However, CPAP therapy is associated with low compliance rates.

Design. Systematic review.

Method. A multi-database literature search was conducted to identify published literature between 2009 and 2020. …

Superoxide And Pulmonary Hypertension, Tammy Wichman

Theses & Dissertations

Pulmonary arterial hypertension (PAH) is a devastating cardiovascular disease, which is progressive and fatal despite advances in therapy. Animal models have shown that oxidative stress may be pathogenic in PAH. We hypothesize that oxidative stress, as measured by increased levels of a specific reactive oxygen species, superoxide (O₂^•-), mayplay a role in PAH in humans. Using a novel application of electron paramagnetic resonance (EPR) spectroscopy, we initially evaluated whether levels of O₂^•- from whole blood collected from the pulmonary artery collected during right heart catheterization (RHC) would correlate with O₂^•- levels in peripheral …

Pleurodesis Using Hypertonic Glucose Administration To Treat Post-Operative Air Leaks Following Lung Resection Surgery (Plug): Phase I Trial, Mehdi Qiabi

Electronic Thesis and Dissertation Repository

Introduction: Pulmonary air leaks from unhealed lung tissue are one of the most common complications after lung surgery. This adverse event leads to a delay in chest tube removal, prolonged pain, increased infections, prolonged hospital stay, and increased costs to the health care system. Objective: To define the most appropriate safe dose of dextrose 50% (D50) to seal air leaks in patients that have undergone lung resection surgery. Primary outcome was the occurrence of any adverse event. Methods: Prospective, single-arm, single-center, rule-based escalation traditional 3+3 design phase I trial where patients with an active air leak on …

Reducing Disease Exacerbation In Women With Confirmed Copd: A Systematic Literature Review, Jill Essay

All Graduate Theses, Dissertations, and Other Capstone Projects

Abstract

A systematic literature review was conducted to establish whether gender specific treatment exists for patients with Chronic Obstructive Pulmonary Disease (COPD), specifically, women with (COPD). The PICO question developed for this review is as follows: In women with confirmed diagnoses of COPD, does gender-specific treatment, compared to standard treatment, impact the frequency of exacerbations? Could the number of COPD exacerbations in women be reduced by incorporating interventions designed with (female) gender in mind? Four databases were included in the search: CINAHL, Pubmed, Medline, and Nursing and Allied Health. Articles included addressed gender differences in relation to the disease process, …

Translation Into Spanish, Cultural Adaption And Content Validity Of The Bristol Copd Knowledge Questionnaire, Vilma Gómez

Dissertations and Theses @ UNI

COPD is the major cause of respiratory mortality world-wide. The treatment of COPD includes education and self-management to enable patients to control the symptoms, handle the treatment, manage the physical and psychosocial consequences of the disease, and adopt the necessary lifestyle changes for dealing with a chronic condition. Measurement of results of interventions is necessary to demonstrate their effectiveness. Questionnaires help clinicians measure the level of knowledge before and after treatments. However, there are no questionnaires available in Colombian Spanish to measure knowledge of Chronic Obstructive Pulmonary Disease (COPD). This research resulted in the translation into Spanish, cultural adaptation, and …

Nebulizer-Based Systems To Improve Pharmaceutical Aerosol Delivery To The Lungs, Benjamin M. Spence

Theses and Dissertations

Combining vibrating mesh nebulizers with additional new technologies leads to substantial improvements in pharmaceutical aerosol delivery to the lungs across therapeutic administration methods. In this dissertation, streamlined components, aerosol administration synchronization, and/or Excipient Enhanced Growth (EEG) technologies were utilized to develop and test several novel devices and aerosol delivery systems. The first focus of this work was to improve the poor delivery efficiency, e.g., 3.6% of nominal dose (Dugernier et al. 2017), of aerosolized medication administration to adult human subjects concurrent with high flow nasal cannula (HFNC) therapy, a form of continuous-flow non-invasive ventilation (NIV). The developed Low-Volume Mixer-Heater (LVMH) …

A Positive Framed Message To Improve Cpap Compliance For Patients With Osa, Frances Clark

Evidence-Based Practice Project Reports

Obstructive sleep apnea (OSA) affects 24% of the US population (DiNapoli, 2014). Untreated OSA causes many diseases, affects one’s quality of life, and increases mortality (Pengo et al., 2018). Continuous positive airway pressure (CPAP) is the lifelong treatment for OSA; yet 30%-80% of OSA patients are CPAP noncompliant within one year. The purpose of this EBP project was to determine if implementing a positive frame message intervention would improve CPAP compliance for newly diagnosed OSA patients. Based on the evidence, implementation of behavioral interventions, such as a positive framed message, was effective in improving CPAP compliance (Pengo et al., 2018). …

The Role Of Slc7a11 In Controlling Extracellular And Intracellular Redox Environments Of Lung Fibroblasts - Potential Targets For Intervention In Aging And Idiopathic Pulmonary Fibrosis., Yuxuan Zheng

Electronic Theses and Dissertations

Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease characterized by extracellular matrix deposition by fibroblasts. Aging and oxidative stress increase the susceptibility to IPF. Redox couples, cysteine/cystine (Cys/CySS) and glutathione/glutathione disulfide (GSH/GSSG), and their redox potentials (E_h) quantify oxidative stress. Fibroblasts from old mice maintain more oxidized extracellular E_h(Cys/CySS) than young mice. Microarray shows down-regulation of Slc7a11 potentially mediates this age-related oxidation. Slc7a11 is the key component of system X_c^-, an antiporter that imports CySS and exports glutamate. The first aim of this dissertation is to investigate the mechanistic link between Slc7a11 …

Antiresorptive Bone Therapy Use In Advanced Lung Cancer And Associated Outcomes, Noor Naffakh

Theses and Dissertations--Pharmacy

Background/Rationale: Studies have shown antiresorptive agents decrease skeletal related events in metastatic non-small cell lung cancer. However, two prevalence studies have found low utilization rates of antiresorptive therapy in advanced lung cancer. The first study reported a rate of 14.8% during the 1995-2009 time period, while the second study reported a 33% usage rate during the time frame of 2002-2011. We believe these low utilization rates are associated with the poor prognosis of these patients. The prognosis of advanced lung cancer has improved significantly since these trials were conducted, and the utilization of denosumab has not been evaluated. We hypothesize …

Asthma-Copd Overlap: Economic Burden And Medication Adherence, Mona Nili

Graduate Theses, Dissertations, and Problem Reports

In many older adults, asthma and chronic obstructive pulmonary disease (COPD) coexist as “Asthma-COPD overlap” (ACO). This dissertation pursued three Aims: 1) estimate the economic burden of ACO and its contributory factors; 2) evaluate the association of ACO to “cost-related medication nonadherence” (CRN); and 3) identify adherence trajectory patterns and examine the impact of initial maintenance therapies (IMT) type (inhaled corticosteroids monotherapy (ICS) vs. fixed-dose combination of ICS and long-acting beta agonist (ICS/LABA)) on adherence trajectory patterns among older adults Medicare Beneficiaries. The first and second Aims were cross-sectional studies by using Medicare Current Beneficiary Survey data. For the third …

Education-Based Interventions Effects On 30-Day Readmission Rates For Patients With Copd, Gina Hand-Eoloff

Dissertations

Purpose: This Quality Improvement (QI) project evaluated the impact of an existing education-based program for Chronic Obstructive Pulmonary Disease (COPD) and its effect on 30-day readmission rates in one hospital in rural Missouri.

Method: A retrospective chart review was completed on 493 patients with an inclusive diagnosis of COPD from June 1, 2018, to March 31, 2019, using a cohort study design and a two-sample t-test analysis. Additional variables were analyzed to determine if there were predictive factors of an elevated risk of readmission.

Results: The two-sample t-test reveals there is no statistically significant difference between the rates of readmission …

Health Literacy Screening To Increase Antihypertensive Medication Adherence, Boyann Bonjean

Evidence-Based Practice Project Reports

Hypertension contributes to the risk of developing cardiovascular disease (CVD), stroke, heart attack, and chronic kidney disease (CKD) (Abegaz et al., 2016; Weir, 2014; Whelton et al., 2017). Evidence indicates that 30 to 50% of people who are prescribed antihypertensive medication therapy are nonadherent (Hedna et al., 2015). Non-adherence to antihypertensive medications is a major contributor to hypertension treatment failure (Al Ghurair et al., 2012; Hu, 2016; Whelton et al., 2017). Evidence has shown that low health literacy may impact antihypertensive therapy (Slade, 2017). The purpose of this EBP project was to provide an organizational change by implementing a health …

The Effects Of Implementing A Smartphone Application To Improve Asthma Self-Management In Adults, Lindsay J. Humpfer

Evidence-Based Practice Project Reports

Asthma is one of the most common chronic diseases, affecting 20.4 million adults in the United States (CDC, 2018). While asthma can generally be controlled, patients having an exacerbation may experience missed days of work and school, limitations in daily activities, decreased enjoyment of life, and decreased productivity at home, work, and school (MarcanoBelisario et al., 2013). Therefore, the purpose of this project was to improve patients’ overall asthma control and asthma-related quality of life by encouraging self-management through patient education and the implementation of a mobile smartphone application. A total of 26 adult primary care patients with asthma participated …

Sensitivity Of Single Organ Versus Multiorgan Point-Of-Care Ultrasound Compared To Computed Tomography Pulmonary Angiography In Detecting Pulmonary Embolism In Adult Patients, Jessica Stangenes

Theses and Graduate Projects

Background: Pulmonary embolism (PE) is a serious and potentially life-threatening complication of venous thromboembolism and its diagnosis remains a challenge. The current gold standard to confirm diagnosis of PE is multi-row computed tomography pulmonary angiography (CTPA) but has limitations and alternative imaging modalities are being investigated. Point-of-care ultrasound (POCUS) has been applied in the diagnostic process in PE but whether it can safely replace the gold standard is of question.

Methods: A literature review was conducted to evaluate the sensitivity of single versus multiorgan point-of-care ultrasound (POCUS) compared to CTPA in detecting PE in adult patients.

Discussion: Several prospective observational …

The Effect Of Provider Education On Copd Screening Rates In The Primary Care Setting, Kelli Craig

DNP Projects

BACKGROUND: Chronic Obstructive Pulmonary Disease is one of the leading causes of morbidity and mortality in the United States. With early detection, COPD is a treatable disease, highlighting the need for an effective screening measure. The COPD Population Screener Questionnaire (COPD-PS) is a valid, accurate questionnaire that can identify individuals likely to have COPD.

PURPOSE: The purpose of this study was to evaluate the impact of a provider-based educational intervention on the knowledge, attitudes, self-efficacy and screening rates of COPD using the COPD-PS screening tool among primary care providers.

METHODS: This study was a single-center, pre/post implementation study to evaluate …

Quickcough: An Instrumentational Proximal Airway Clearance Technique (Act) For Select Patients With Neuromuscular Disease (Nmd), Sean X. Sullivan, Russell K. Catania, Madison K. Plaster, Sydney E. Kandray, Mariah Costa

Williams Honors College, Honors Research Projects

Patients with neuromuscular disease (NMD) requiring tracheostomy and mechanical ventilation secondary to respiratory failure encounter increased difficulty in removing pulmonary secretions from the airways. To combat issues associated with current treatment modalities for insufficient cough efficacy (cost, poor mobility, discomfort, lack of evidence), we have developed an instrumentational proximal airway clearance technique (ACT) which augments a manual proximal ACT developed by a client with NMD. QuickCough is a 3D-printed PLA attachment to the tracheostomy apparatus which has demonstrated its ability to facilitate pressure changes necessary to increase patient’s peak cough flow (PCF) by providing a stronger exsufflation for the patient. …

Alcohol Drives Oxidation-Dependent Desensitization Of Airway Cilia Motility Responsiveness, Michael Price

Theses & Dissertations

Alcohol abuse, which can impair clearance of pathogens and debris from the airway, is associated with an increase in complications and a higher mortality rate during the progression of pneumonia. With prolonged alcohol exposure, mucociliary clearance (MCC), which depends on the coordinated beating of cilia, is dysfunctional. Effective MCC relies on cAMP-dependent protein kinase (PKA) activation of ciliary beat frequency (CBF). PKA activation and stimulation of CBF are blunted with chronic exposure to alcohol. This phenomenon is known as alcohol-induced ciliary dysfunction (AICD). Previous studies have shown that concomitant feeding of mice with alcohol and antioxidants prevents AICD, suggesting a …

Investigation Of Reactive Oxygen Species Production In The Rat Lung Using Optical Imaging, Nina Friedly

Master's Theses (2009 -)

Oxidative stress, the imbalance between production of oxidants or reactive oxygen species (ROS) and antioxidant activity, plays a key role in the pathogenesis of acute and chronic lung diseases. The objective of this thesis was to develop a robust protocol for measuring the rate of H2O2 production in isolated perfused rat lungs and to determine the cellular sources of that rate using Amplex Red (AR). For a given lung, AR (25 mM) along with horseradish peroxidase (5 U/ml) and ascorbate oxidase (1U/ml) were added to a perfusate reservoir that was recirculated through the lungs and sampled at 5 minute intervals …

Validation Of An Algorithm Allowing Identification Of Primary Spontaneous Pneumothorax Cases From Administrative Databases, Eric Frechette

Electronic Thesis and Dissertation Repository

Introduction: There is no differentiation between primary spontaneous pneumothorax (PSP) and secondary pneumothorax (SP) in the current version of the International Classification of Diseases (ICD-10). Objective: To validate the accuracy of an algorithm that identifies cases of PSP from administrative databases. Methods: The charts of 150 patients who attended the emergency room (ER) with a recorded main diagnosis of pneumothorax were reviewed. The corresponding hospital administrative data collected during previous hospitalizations and ER visits were processed through the proposed algorithm. The results were compared over two different age groups. Results: The results obtained from the PSP algorithm demonstrated a significantly …

Decreased Mortality Of Pulmonary Arterial Hypertension In Duchenne Muscular Dystrophy And Down Syndrome, Mitchell Volin

Physician Assistant Scholarly Project Papers

The genetic cause of significant disorders like Down syndrome (DS) and Duchenne muscular dystrophy (DMD) is well documented. Pulmonary arterial hypertension (PAH), a co-morbid condition, is tied to mortality among these groups. If undetected or untreated, in DS, this condition can lead to complications with coronary and lung disease later in life. If undetected or untreated in DMD it can hasten the inevitable prognosis of the disease. Individuals with the ability to communicate their symptoms and actively participate in treatment are at an advantage with subsequent benefit. DS and DMD significantly decrease physical ability and communication capacity.

Genetic research has …

Antibiotic Therapy In Preventing Exacerbations Of Severe Chronic Obstructive Pulmonary Disease, Jamie Trautner

Physician Assistant Scholarly Project Papers

Chronic obstructive pulmonary disease (COPD) is a progressive disease that has no cure but is treatable. The treatment goal is to have adequate symptom control, decreased exacerbations, prevent hospitalizations and maintain an independent quality of life. The above are attainable by lifestyle changes and pharmacotherapy. The review of literature is to determine if the benefits of long-term antimicrobial therapy outweigh the risks in the treatment of severe COPD. The search included PubMed, Cochrane and Clinical Key databases. Keywords searched include: chronic obstructive pulmonary disease, antibiotics, macrolides, antibacterial, azithromycin, bronchodilators, standard therapy, COPD exacerbations, adverse effects, and long-term. The gold standard …

Does Using Music Therapy Improve Levels Of Perceived Dyspnea In Patients With Chronic Obstructive Pulmonary Disease (Copd)?, Jessica Duong

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective systematic review is to determine whether or not “Does using music therapy improve levels of perceived dyspnea in patients with chronic obstructive pulmonary disease (COPD)?”

STUDY DESIGN: Review of three studies published in English between 2003 to 2009. Studies included two randomized controlled trials and one controlled crossover design trial.

DATA SOURCES: Three trials analyzing the utilization of music therapy and the effects on dyspnea in COPD were found via PubMed.

OUTCOME(S) MEASURED: The outcome measured was level of perceived dyspnea via Visual Analogue Dyspnea Scales (VADS), Basal Dyspnea Index, …

Are Five Sessions Of Individual Based Art Therapy Effective In Reducing Emotional Problems In Swedish Women With Nonmetastatic Breast Cancer Receiving Radiation Therapy?, Sarah C. Hayes

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine “Are five sessions of individual based art therapy effective in reducing emotional problems in Swedish women with nonmetastatic breast cancer receiving radiation therapy?”

STUDY DESIGN: This review is based on three randomized control studies, two which were published in 2009 and one that was published in 2006.

DATA SOURCES: All articles used were published in English, in peer-reviewed journals, and found using PubMed, Ebscohost, and Cochrane Review databases.

OUTCOMES MEASURED: For all studies, factors pertaining to emotional problems were measured through self-assessment questionnaires.

RESULTS: …

The Association Between High Flow Nasal Cannula Therapy And Intubation In Acute Respiratory Failure Patients, A Single Center Retrospective Analysis, Patrick Nolan

DNP Projects

Background: High flow nasal cannula therapy is becoming a more common therapy in the adult population. Multiple studies have been conducted on the potential benefits of this therapy such as increased patient tolerance of the therapy, improved secretion clearance and the ability for providers to deliver a greater range of FiO2 settings at a wider range of flow rates. With the increasing utility of this therapy, the research for best practices, setting (FiO2 and LPM) and duration of therapy to guide clinicians is lacking.

Aim: 1) Does high flow nasal cannula therapy reduce the need for intubation or re-intubation in …

Tissue Factor Expression, Regulation, And Signaling In Human Airway Cells, Michael D. Davis

Theses and Dissertations

Rationale: Tissue Factor (TF) is a transmembrane glycoprotein that canonically functions as the initiator of the coagulation cascade. Increased levels of TF have been associated with inflammatory airway diseases. Since lipopolysaccharide (LPS) is known to elicit and inflammatory response in airway epithelium, we hypothesized that airway epithelial cells release TF when exposed to LPS. Since TF aids in local wound healing, we also hypothesized that inhibition of TF would decrease NHBE growth. The specific aim of this work was to evaluate the effects of LPS exposure on TF production and release from airway epithelia and determine the signaling pathways involved. …