Medicine and Health Sciences Commons^™

Prelude To A Master Plan: Ware, Massachusetts, Belen Alfaro, Bruno Carneiro, Margaret Engesser, Kathryn E. Fox, Evadne R. Friedman, Timothy Inacio, Anita Lockesmith, Christina Mills, Stephanie Molden, Meagen Mulherin, Russell Pandres, Vinicius Pereira, Brian Reid, Pedro Soto, Jennifer Stromsten

Landscape Architecture & Regional Planning Studio and Student Research and Creative Activity

Prelude to a Master Plan offers ideas, recommendations, and a toolkit to help the town chart its own path towards that future. While the teams and individual students worked to ‘drill down’ into specific topic areas, the Studio defined three basic areas in order to think about how the various assets, challenges and ideas undermine or reinforce one another. The report is loosely organized in those terms: addressing the outlying rural areas and issues specific to these places, considering one of the key growth areas that has extended from town and the conflicts that arise from the many uses occurring …

Food System Planning In Western Massachusetts: A Community Organization Assessment, Arianna R. G. Thompson

Masters Theses 1911 - February 2014

Comprehensive planning for regional food systems is a relatively new focus in the planning field. Heightened national awareness of the economic, environmental and equity implications of our current food system has magnified the importance of planning engagement on food-system issues. While addressing food system concepts is relatively new to planners, community-based organizations have been historic players in the development of food-system programs and critical food-system policy, particularly with regard to food access and local food production. This thesis reviews the status of the regional food system in the Pioneer Valley of Western Massachusetts through an assessment of the efforts of …

Evaluating The Mebactive-Youth As A Measure Of Mental Toughness, Manneh Ghazarians

Masters Theses 1911 - February 2014

The obesity epidemic in youth is increasing, due to the decreasing levels of physical activity within the youth population. One variable that has never been examined as a correlate of physical activity is mental toughness. Mental toughness is a psychological trait characterized by determination, resiliency, and perform optimally regardless of the circumstances. In order to evaluate this trait the MeBActive-Youth was developed. The purpose of this study was to first, evaluate the psychometric properties of the newly developed measure and secondly, to assess the relationship of mental toughness, social support and self-efficacy to physical activity. Participants (N = 106) completed …

Association Between Dietary Intake And Nutritional Status Among Adolescent Girls In Kilosa District, Tanzania, Shanshan Chen

Masters Theses 1911 - February 2014

Underweight and stunting are highly prevalent public health problems in developing countries, particularly among populations exposed to food insecurity and chronic malnutrition. Underweight results from relatively recent malnutrition whereas empirical research has shown that early childhood malnutrition is a strong predictor of stunting. Dietary diversity has been recognized as an indicator of food security, with consumption of more food groups suggesting better nourishment. Greater dietary diversity has been associated with better nutritional outcomes and improved micronutrient intake. Zinc, an essential mineral, plays a critical role in child growth and development. A deficiency in Zinc may contribute to increased risk for …

The Effectiveness Of Point-Of-Purchase Nutrition Education On Improving Beverage Choices And Nutrition Knowledge In A College Foodservice Setting, Heather A. Wemhoener

Masters Theses 1911 - February 2014

College students are among the highest consumers of sweetened beverages, drinking more than 25% of their daily calorie needs from sweetened drinks. They also tend to be low consumers of milk. This is important, as high consumption of sweetened drinks and low consumption of nutrient-dense drinks is associated with obesity, dental caries and bone disease. Point-of-purchase (POP) marketing and nutrition education programs are thought to be effective in changing food selection behaviors of college students. Therefore, we conducted a 2-week intervention that combined POP marketing and nutrition education aiming to 1. decrease sweetened beverage consumption 2. increase milk/milk equivalent consumption …

Urinary Melatonin Levels And Risk Of Postmenopausal Breast Cancer In The Women's Health Initiative Observational Study, Ashley Doherty

Masters Theses 1911 - February 2014

Prior studies have observed a link between night shift work and increased risk of breast cancer. Melatonin, a hormone related to circadian rhythm, has been proposed to lower breast cancer risk by inhibiting cell proliferation. The disruption of peak melatonin that occurs during night shift work could explain the increase in risk observed. Several studies have assessed whether higher melatonin levels are associated with decreased breast cancer risk, but results have been conflicting. We examined the relationship between urinary melatonin levels and breast cancer risk in a nested case-control study conducted within the Women’s Health Initiative Observational Study. First morning …

Sensory Exploration Of Seasonally And Locally Available Vegetables And Its Effects On Vegetable Consumption Of Western Massachusetts Head Start Children, Shannon Sojkowski

Masters Theses 1911 - February 2014

The current exploratory study, as part of the Massachusetts Farm Fresh (MAFF) research project: 1) examined the effect sensory attributes (i.e. taste profile, color, shape, texture, growth pattern) of the target vegetables have on children’s willingness to explore and consumption and 2) compared these outcomes for: facilitator-guided (FG), vs. children’s self-guided (SG) exploration.

We conducted a 6-week multi-sensory nutrition education intervention with Western Massachusetts Head Start preschoolers (3-5 years of age; n=94 children) using eight vegetable pairs; outcome measures were recorded by observers. Data were analyzed using SPSS version 20.0. Results are reported for 50 children with complete data at …

Children's Cancer And Transplant Hospital: A Micro Town Within A Bubble, Kimia Samimi

Masters Theses 1911 - February 2014

As the greatest considerations in health-care design have traditionally been functional —hygiene, efficiency, and flexibility for changing technology— hospitals have evolved to become dehumanizing spaces. In this thesis two specific groups of chronically ill children who have among the longest inpatient stays are studied: cancer and organ transplant patients. Being under immunosuppressive drugs, these children are physically vulnerable thus are kept completely isolated. These long stays and isolation can be very depressing for them.

This thesis undertakes the challenge of designing a fully isolated space that doesn’t feel like one or in other words “a micro-town within a bubble”. The …

Culture And The Emotion Socialization Of Preschoolers, Claudia I. Lugo-Candelas

Masters Theses 1911 - February 2014

Objective:The present study examined mothers’ emotion socialization of 3-year–old children with behavior problems, to determine whether emotion socialization practices, as well as the relation between these practices and child functioning, varied across ethnicities. Method: Participants were 156 preschoolers with behavior problems. Mothers were European American (n = 98), Latina American (n = 40; predominately Puerto Rican), and African American (n = 18). Audio taped mother-child interactions were coded for emotion socialization behaviors. Results: Overall, this study provided evidence for both differences and similarities across ethnicities on parental emotion socialization practices. Ethnic differences in use of emotion …

Investigation Of Compliance With The Ansi Z133.1 - 2006 Safety Standard In The New England Tree Care Industry, Alexandra K. Julius

Masters Theses 1911 - February 2014

Arborists are exposed to many occupational hazards and experience more than three times the overall fatality rate of all U.S. workers. Investigations into fatal incidents lead to a better understanding of industry dangers. However, this knowledge does not extend to how tree workers operate when an injury or fatality does not occur. Current research regarding fatal and nonfatal injuries does not include the accreditation status of the company at which the worker was employed, nor whether certified arborists were on staff. Given the highly skilled nature of the work involved, certification and accreditation might ensure a minimum level of demonstrated …

Notch Regulation Of Adam12 Expression In Glioblastoma Multiforme, Ala'a S. Alsyaideh

Masters Theses 1911 - February 2014

Glioblastoma is the most common malignant brain tumor, accounting for 17% of all primary brain tumors in the United States. Despite the available surgical, radiation, and chemical therapeutic options, the invasive and infiltrative nature of the tumor render current treatment options minimally effective. Recent reports have identified multiple regulators of glioblastoma progression and invasiveness. It has been demonstrated that ADAM12, A Disintegrin And Metalloproteinase encoded by ADAM12 gene, is over-expressed in glioblastoma and directly correlated with tumor proliferation. Additionally, dysregulation of the Notch signaling pathway has been implicated in the pathogenesis of many gliomas. Lastly, an evolving role of microRNAs, …

The Process By Which Physicians Extract Information From Electronic Progress Notes During Handoffs, Brian D. Amster

Masters Theses 1911 - February 2014

A handoff requires that the responsibility for patient patient’s care is transferred from one healthcare professional to another. The goals of this research were to identify, evaluate, and use analytical methods to describe how physicians (n=10) extracted information from electronic progress notes, one important source of information used during handoffs. Participants also verbally summarized the notes as they would during handoffs. Six methods were used to analyze how participants read progress notes, each uniquely contributing to our understanding of physicians’ visual attention patterns during this process. The participants focused their visual attention on the Impression and Plan section of the …

The Effects Of Adolescent Binge Drinking On Corticotropin-Releasing Factor Cells In The Amygdala And Social Predictors Of Alcohol Intake In Male And Female Rats, Chrisanthi Karanikas

Masters Theses 1911 - February 2014

Alcohol is one of the most common drugs of choice among adolescents. Normally, the method of consumption is drinking large quantities of alcohol in short periods of time, otherwise known as “binge drinking.” Corticotropin releasing factor (CRF) stress peptide producing cells in central nucleus of the amygdala (CeA) has been implicated in behavioral responses to stress and addiction. The goals of this thesis were to determine the effects of voluntary binge drinking in adolescence and vapor-induced alcohol dependence in adulthood on CRF cells in the CeA. These studies were done using an operant model of voluntary binge drinking in rodents …

The Impact Of Gestational Diabetes On Maternal And Cord Blood Lipids Among Prenatal Care Patients In Western Ma, Preethi Raj

Masters Theses 1911 - February 2014

Gestational diabetes mellitus (GDM), a pregnancy-induced metabolic disorder that affects 2-10% of pregnancies poses future risk for diabetes mellitus (DM) and cardiovascular disease in mother and child. However, few prospective studies have examined the effect of GDM on altered maternal and cord blood lipids, specifically HDL, LDL, triglycerides, and total cholesterol, both during and after pregnancy. We have evaluated the association between GDM and lipid metabolism in pregnant mothers and their infants using data from a prospective cohort study conducted at Baystate Medical Center’s Wesson Women and Infant’s Unit. GDM was assessed prenatally by 3-hr GTT blood samples and was …

Terahertz Imaging For Cancer Detection, Benjamin A. St. Peter

Masters Theses 1911 - February 2014

This project evaluates the ability of terahertz (THz) radiation to differentiate cancerous from non-cancerous human breast lumpectomy and mastectomy tissue. This is done by aiming a narrow-band THz beam at medical samples and measuring reflected power. THz images of specimens from Breast Conservation Surgery (BCS) were created using a gas laser source and mechanical scanning. The design and characterization of this system is discussed in detail. The images were correlated with optical histological micrographs of the same specimens and discrimination values of more than 70% were found for five of the six samples using Receiver Operating Characteristic (ROC) analysis.

Childhood Body Mass Index Trajectories: Modeling, Characterizing, Pairwise Correlations And Socio-Demographic Predictors Of Trajectory Characteristics, Xiaozhong Wen, Ken Kleinman, Matthew W. Gillman, Sherly L. Rifas-Shiman, Elsie M. Taveras

Public Health Department Faculty Publication Series

BACKGROUND:

Modeling childhood body mass index (BMI) trajectories, versus estimating change in BMI between specific ages, may improve prediction of later body-size-related outcomes. Prior studies of BMI trajectories are limited by restricted age periods and insufficient use of trajectory information.

METHODS:

Among 3,289 children seen at 81,550 pediatric well-child visits from infancy to 18 years between 1980 and 2008, we fit individual BMI trajectories using mixed effect models with fractional polynomial functions. From each child's fitted trajectory, we estimated age and BMI at infancy peak and adiposity rebound, and velocity and area under curve between 1 week, infancy peak, adiposity …

Estimation Of Newborn Risk For Child Or Adolescent Obesity:Lessons From Longitudinal Birth Cohorts, Anita Morandi, David Meyre, Stephane Lobbens, Ken Kleinman, Marika Kaakinen, Sheryl L. Rifas-Shiman, Vincent Vatin, Stefan Gaget, Anneli Pouta, Anna-Liisa Hartikainen, Jaana Laitinen, Matthew W. Gillman, Marjo-Riitta Jarvelin, Philippe Froguel

Public Health Department Faculty Publication Series

OBJECTIVES:

Prevention of obesity should start as early as possible after birth. We aimed to build clinically useful equations estimating the risk of later obesity in newborns, as a first step towards focused early prevention against the global obesity epidemic.

METHODS:

We analyzed the lifetime Northern Finland Birth Cohort 1986 (NFBC1986) (N = 4,032) to draw predictive equations for childhood and adolescent obesity from traditional risk factors (parental BMI, birth weight, maternal gestational weight gain, behaviour and social indicators), and a genetic score built from 39 BMI/obesity-associated polymorphisms. We performed validation analyses in a retrospective cohort of 1,503 Italian children …

Smoking Cessation Increases Short-Term Risk Of Type 2 Diabetes Irrespective Of Weight Gain: The Japan Public Health Center-Based Prospective Study, Shino Oba, Mitsuhiko Noda, Kayo Waki, Akiko Nanri, Masayuki Kato, Yoshihiko Takahashi, Kalpana Poudel-Tandukar, Yumi Matsushita, Manami Inoue, Tetsuya Mizoue, Shoichiro Tsugane

Elaine Marieb College of Nursing Faculty Publication Series

Objective: The effect of smoking cessation on the risk of diabetes has been reported previously. However, it is unknown whether the association is influenced by weight gain and other potential risk factors. Methods: The Japan Public Health Center-Based Prospective Study established in 1990 for Cohort I and in 1993 for Cohort II provided data, and 25,875 men and 33,959 women were analyzed. The response rate to the baseline questionnaire was 80.9%, and 68.4% of the respondents participated both the 5- and 10-year follow-up surveys. Smoking cessation was noted during the initial five years and the development of diabetes was reported …

Using The Internet For Qualitative Research In Nursing, Pamela Aselton

Elaine Marieb College of Nursing Faculty Publication Series

The nature of qualitative research lends itself to the use of the Internet for a variety of reasons. The Internet can be used for recruitment and provide immediate feedback from participants, either through online interviewing, or open ended questionnaires. Interviews may be conducted online with a set list of guiding questions, and follow up can be accomplished with email communication. If information is received in digital form, there is no need for labor intensive transcription that qualitative research often involves.

Rudd Chair Annual Report, 2012, Harold D. Grotevant

Rudd Adoption Research Program Annual Reports

2012 Annual Report of the Rudd Family Foundation Chair in Psychology at the University of Massachusetts Amherst.

Reports on community partnerships, goals reached, teaching, mentoring, and service. Mentions work being conducted by graduate students and postdocs mentored through the Rudd Program, including three clinical doctoral students at UMass: Quade French, Holly Grant- Marsney, and Danila Musante.

Summarized Guidelines Aid Providers In Caring For Patients With Otitis Media With Effusion, Neil Nordstrom

Doctor of Nursing Practice (DNP) Projects

Otitis media with effusion (OME) is a disorder that can cause hearing loss in children, which can lead to speech and language delay. There are recommendations within the OME guideline and primary care providers are aware of these guidelines but do not follow them. For this project a suburban outpatient pediatric medical practice with 8 providers (4 MD’s and 4 NP’s) was studied. The 8 providers were educated and presented with an algorithm, designed by the author, organizing the OME recommendations in a flowchart. Over a 2-month period, providers referred to the algorithm and used the recommendations in practice. Then …

Heightening Mental Health Awareness On A Diverse, Urban Public University Campus Through A Media Outreach Campaign, Kathleen R. Golden Mcandrew

Doctor of Nursing Practice (DNP) Projects

Abstract

Mental health problems among students on college campuses have increased in severity over the last decade. On-campus health providers have reported seeing students with more complex problems such as depression, bipolar disorder, and mixed diagnoses that require frequent and regular follow-up and treatment. Students who require mental health services assistance from on-campus services need to be informed about what resources and services are available and how to access them. Since most on-campus counseling services are set up as short-term treatment models, providing students with community-based resource options is also important.

The purpose of this capstone project was to examine …

The Use Of Probiotics To Prevent Antibiotic Associated Diarrhea: Current Primary Care Practice And Introduction Of An Evidence Based Practice Protocol, Elizabeth Mb Visone

Doctor of Nursing Practice (DNP) Projects

Abstract

Antibiotic associated diarrhea (AAD) is defined as the self limiting diarrhea that occurs during or following a course of antibiotics (Bartlett, 2002; Dendukuri, Costa, McGregor, & Brophy, 2005; Pimental & Choure, 2009; Sullivan & Nord, 2005; Vrabie & Aberra, 2009). Despite strong support for the use of probiotics in the outpatient setting for preventing AAD, there is lack of probiotic utilization by primary care providers in the outpatient setting. Current literature indicates that one of the barriers to probiotic use is medical doctors’ (MDs) and nurse practitioners’ (NPs) attitude and lack of knowledge regarding the use of probiotics in …

Increasing The Rate Of Pertussis Immunity Using The Tdap Immunization In Primary Care Patients 19 To 64 Years Of Age, Dorothy J. Cook

Doctor of Nursing Practice (DNP) Projects

There has been an increase in the preventable communicable disease known as Pertussis as the result of waning immunity in adolescents and adults. Waning immunity is the loss of protective antibodies over a period of time. Despite the availability of a new immunization in 2005, adult immunization rates do not meet Centers for Disease Control (CDC) Healthy People 2020 goal. Adult immunizations remain a challenge. Preventive healthcare is the keystone to providing routine vaccination coverage. It is usually the point of entry into the health care system.

The theoretical model used was the Precaution Adoption Model, which allowed the provider …

Increased Emergency Department Boarding Times, Marija Djokovic

Doctor of Nursing Practice (DNP) Projects

Prolonged boarding times (increased wait times for admitted patients) in the emergency department result in an increase in morbidity and mortality in critically ill adult patients admitted to the ICU. Overcrowding in the emergency department (ED), medication errors, and a delay in transfer to the ICU are the leading reasons for an increase in morbidity and mortality. This project focuses on a comprehensive assessment of a Las Vegas emergency department. The assessment will determine if the issues cited in the literature of: 1) overcrowding, 2) medication errors, and 3) delay in transfer are a current problem in the Las Vegas …

Ptsd Secondary To Childhood Maltreatment: Educating Health Care Providers In Roles And Responsibilities Directed To Improved Patient Outcomes, Virginia Smith-Dunwoody

Doctor of Nursing Practice (DNP) Projects

Researchers have described the connection between childhood maltreatment and adult mental illness such as Post-Traumatic Stress Disorder (PTSD) and depression. Research has also shown a serious lack of recognition of PTSD by the primary care provider. Using the Four Question Primary Care PTSD Screening tool provides information to the primary care provider necessary for ongoing treatment. Education of the primary care provider(s) in the use of the screening tool and in the care of the patient with symptoms of PTSD is based on the process employed by the Department of Veteran Affairs for PTSD identification in the primary care setting.

Using An Evidence Based Practice Informatics Guided Medication Safety Intervention To Improve Medication Safety Among Community Dwelling Older Adults, Raeann G. Leblanc

Doctor of Nursing Practice (DNP) Projects

Medication safety and prevention of medication related problems are important issues in promoting and maintaining health and safety in one’s home for community dwelling older adults. Assessment of medications and management of a medication schedule are essential elements of medication safety, medication review, and medication care coordination. The Framework for Geriatric Homecare Excellence (Collaboration for Home Care Advances and Practices, 2009) is used as the foundation of this project to improve medication management, and promote and maintain health and safety at home. An in-home medication assessment was completed, using a medication management software informatics system to review medications, identify medication …

Using A Dnp-Led Transitional Care Program To Prevent Rehospitalization In Elderly Patients With Heart Failure Or Chronic Obstructive Pulmonary Disease, Moira L. Long,

Doctor of Nursing Practice (DNP) Projects

ABSTRACT: TRANSITIONAL CARE FOR PATIENTS WITH CHRONIC DISEASE

BACKGROUND OF PROBLEM:

The Affordable Care Act of 2010 has put a spotlight on ensuring safe patient transfers between health care settings to prevent rehospitalization. Hospital readmissions are often influenced by a lack of outpatient transitional care programs to ensure the continuity of care during the transition from the inpatient setting to home. This gap in continuity further exacerbates the issues of patient management of medication regimens, adverse drug events, and follow-up with providers. These exacerbations combined with ineffective symptom management can all result in decompensation and rehospitalization. An extensive review of …

Enhancing The Efficacy And Cultural Sensitivity Of Heart Failure Education For Spanish-Speaking Hispanic Patients At Hospitalization And Through Phone Follow-Up., Eduardo A. Rosadio

Doctor of Nursing Practice (DNP) Projects

Heart failure (HF) is a disease with a high morbidity rate and is associated with a high rate of hospital re-admissions and medical complications. Therefore, medical insurance costs and hospital resource utilization are increasing yearly. The American Heart Association, The Heart Failure Society of America, and American College of Cardiology have published different clinical practice guidelines for heart failure management; these organizations have acknowledged the importance of patient self-care administration. Although interventions combining patient education, medical therapy, physical therapy, and post-discharge management in patients with heart failure have demonstrated benefits in patients, the gains attributed to heart failure patient education …