Medicine and Health Sciences Commons^™

No More Loosies: A Mixed-Methods Study On The Implementation And Enforcement Of The Loose Cigarette And Bidi Sale Ban In India, Mayank Sakhuja

Theses and Dissertations

Background: Sale of loose cigarettes and bidis (loosies) is widely accepted as a key factor in promoting the tobacco epidemic in India. This mixed-methods study aimed to broaden understanding around the sale and purchase of loosies addressed three aims: 1) To determine the prevalence and correlates of loosies purchase in India; 2) To examine the association between purchase behavior and health warning labels (HWLs) exposure and responses, and 3) To conduct a stakeholder analysis regarding the ban on the sale of loosies in India. Methods: Data from the 2018-19 Tobacco Control Policy (TCP) India survey (643 current cigarette users and …

Social Network Attributes Associated With Conversations About Smoking And Cessation And Differences By Socioeconomic Status, Victoria Catherine Lambert

Theses and Dissertations

Conversations about smoking and cessation in response to cessation messages appear to encourage quit attempts, yet there is some evidence that smokers with lower income and education have these conversations less often than their counterparts with higher income and education. No research has investigated the social network characteristics that encourage smokers to have these conversations or the mechanisms for SES differences in these conversations. Because social factors play a role in SES disparities in smoking and cessation as well as other health behaviors and outcomes, social network characteristics likely explain some SES differences in conversations about smoking and cessation. The …

The Genetic Associations Of Circadian Rhythm And Sleep Disorder Traits With Risk Of Monoclonal Gammopathy Of Undetermined Significance And Multiple Myeloma, Brittany Crawford

Theses and Dissertations

Background: Circadian rhythm disruption and sleep have been widely studied for their roles in immunity and cancer development. Evidence for an association of circadian rhythm and sleep traits with multiple myeloma (MM) risk is inconclusive. No studies have investigated these traits in relation to monoclonal gammopathy of undetermined significance (MGUS). Given that MGUS precedes almost all MM cases, investigating sleep and circadian rhythm in relation to both MM and MGUS is necessary. The purpose of this dissertation was to explore the genetic influences of circadian rhythm and sleep traits on the risk of MGUS and MM. Methods: Data were leveraged …

A Response Team Approach To Reducing Restraint Use In The Emergency Department, Sarah Place

Doctor of Nursing Practice Scholarly Projects

Assaults on staff are doubling in the healthcare field, and due to the urgent need to secure the environment, the use of restrictive measures is at times, the safest choice. The following project examined the implementation of a Behavioral Emergency Response Team approach in an Emergency Department, and the effects it had, on reducing the use of violent restraints, assaults on staff, and increase confidence of staff in managing difficult situations. An anonymous survey was used to measure staff confidence while handling agitated patients, and an event report was used that identified if de-escalation techniques were employed to assist in …

Use Of A Palliative Care Trigger Tool In A Surgical-Trauma Intensive Care Unit, Courtney Thomas

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Patients are not habitually screened for palliative care consultations, and there is no protocol for initiating communication with palliative care. Not only is this a problem at the local and state level, but only about 5% of acute care patients nationally are estimated to utilize palliative care services. This delay in specialty care that palliative consultations could provide negatively impacts patients. Purpose: This evidence-based practice (EBP) project aimed to determine if a palliative care trigger tool in an intensive care unit (ICU) would increase the number of palliative care consultations. Methods: A pre-implementation survey was distributed to ICU …

Early Palliative Care Screening Among Solid Tumor Oncology Patients, Kaitlin Lothe

Doctor of Nursing Practice Scholarly Projects

While there are extensive benefits of integration of early palliative care, referral to this specialty tends to occur late in the disease course after some form of suffering has already occurred (Hausner et al., 2021). The purpose of this DNP student’s quality improvement project was to improve care coordination and increase rate of palliative care referrals of solid tumor oncology patients through implementation of an evidence-based trigger tool for palliative care screening. Participants were recruited from a 36-bed inpatient adult medical oncology unit where identified patients meeting criteria were included in the study. Data for this study included participant demographics, …

Patient Outcomes Following The Implementation Of A Cardiogenic Shock Algorithm, Alana E. Hall

Doctor of Nursing Practice Scholarly Projects

Problem Statement: ST-elevated myocardial infarction (STEMI) is one of the leading causes of cardiogenic shock (CS) associated with increased in-hospital mortality. Despite multiple efforts to improve outcomes, mortality remains high.

Purpose: This quality improvement project aimed to analyze the impact of a cardiogenic shock algorithm on survival to discharge for STEMI patients.

Methods: A CS algorithm was implemented at a cardiac catheterization laboratory on October 3, 2022. Using the Plan-Do-Study-Act quality improvement framework, data was retrospectively collected on patients presenting with a STEMI who meet CS criteria to determine if there was improved survival to discharge after implementing …

Implementation Of A Nurse Driven Urinary Catheter Protocol: A Quality Improvement Project For Adult Patients, Jamie H. Dagenhart

Doctor of Nursing Practice Scholarly Projects

Introduction: Studies have shown a relationship between management and use of indwelling urinary catheters on catheter days and catheter-associated urinary tract infections (CAUTIs), in adult patients in intensive care units (ICUs). Globally, increases in catheter days and CAUTI rates have led to poor patient outcomes, increased lengths of hospital stay, and increased hospital costs. In efforts to inhibit these adverse effects, institutions have developed protocols specific to reducing CAUTIs in hospitalized patients. This paper argues that a multifaceted nurse driven indwelling urinary catheter protocol will positively influence number of catheter days and change in practice, in the proposed institutional settings. …

Analyzing African American College Student Willingness To Participate In Clinical Trials, Caitlin B. Ulmer

Senior Theses

Previous studies regarding African American participation in clinical trials have found that African Americans participate at a significantly lower rate than other ethnic/racial groups. Scholars argue that this lack of participation in clinical trials is a direct result of historical trauma linked to unethical experiments and African American distrust in the healthcare system. However, there is a gap in the literature because these studies focus on African American individuals above the age of 30. This study aimed to fill the gap by examining clinical trial participation among African American college students within the ages 18 to 23. This study also …

Dietary Inflammatory Index During Pregnancy And Changes Over Time: Associations With Post-Partum Sleep Duration And Quality And Depressive Symptoms., Nowrin Tamanna

Theses and Dissertations

STUDY OBJECTIVES: Sleep and mental health are two important factors for a new mother, as adequate sleep and a healthy mind help her prioritize self-care, seek support when needed, and create a nurturing environment for both her and her baby. Among various plausible theories exploring the etiology of sleep disturbances and depression, the concept of inflammation is gaining attention. This study examined the hypothesis that more pro-inflammatory diets during pregnancy are associated with a decrease in sleep quality and duration, abnormal sleep timing and higher Edinburg Postnatal depression score (EPDS) scores 6 months and 12 months post-partum.

METHODS: A secondary …

Correlates Of Immunization Timeliness In Three South Asian Countries: Secondary Analysis Of Demographic And Health Surveys, Tanzir Ahmed Shuvo

Theses and Dissertations

Despite the availability of effective vaccines, 1.5 million children under the age of 5 years die every year because of vaccine preventable diseases. Improvements in vaccine delivery infrastructure have resulted in relatively high coverage of vaccines, but many children are not receiving their vaccines on a timely basis. Timely administration of routine vaccines recommended by the Expanded Programme on Immunization (EPI) ensures maximum efficacy. It is vital to explore rates of vaccination timeliness and the correlates of timely vaccination among children to design targeted interventions for improving both coverage and timeliness. We conducted a secondary data analysis of the Demographic …

Progressive Neurochemical, Neuroinflammatory And Cognitive Deficits In An Experimental Model Of Gulf War Illness, Hannah Elizabeth Burzynski

Theses and Dissertations

Gulf War Illness (GWI) is a multi-symptom illness that presents with cognitive disturbances and immune dysregulation and continues to affect over 25% of Gulf War veterans. While soldiers were exposed to several hazards in the Gulf, the prophylactic use of the acetylcholinesterase inhibitor, pyridostigmine bromide (PB) and war-related stress have been identified as chief factors in GWI pathology. As both PB and stress alter acetylcholine (ACh), a critical mediator of cognition and inflammation, the focus of my dissertation work was investigating the lasting effects of PB and stress on peripheral and central cholinergic signaling. Specifically, I assessed hippocampal-dependent learning and …

Effects Of Chronic Stress On Working Memory Are Sex-Specific And Age-Dependent, Tyler Jamison Cox

Theses and Dissertations

As the aging demographic of the United States expands, the convergence of age-related cognitive decline and stress-related dysregulation emerges as a substantial concern, impacting not only the lifespan but also the overall well-being of American citizens. In the realm of research, there has been a pronounced focus on Alzheimer's Disease, leading to an imbalanced allocation of resources compared to the study of normal aging. It is widely acknowledged that executive function deteriorates as individuals age, a concept substantiated by numerous investigations conducted in labs dedicated to the study of normal aging. Significantly, even among individuals afflicted with neurodegenerative disorders affecting …

The Correlation Between Bilingual Children’S Self-Reported Language Proficiency And Their Scores On Dual-Language Standardized Assessments, Andrea Elise Vargas

Theses and Dissertations

This study aimed to evaluate the relation between bilingual Spanish-English speaking children’s self-reported language proficiencies and bilingual experiences and their scores on norm-referenced standardized dual-language assessments. Additionally, the relation between bilingual children’s self-reported language proficiencies and bilingual experiences and parent reports of children’s Spanish and English input and output was examined. The Houston Questionnaire, a novel tool designed to provide insight into bilingual children’s self-perceptions of language proficiencies and experiences, was administered to gather such information for this study. A sample of bilingual children local to Columbia, South Carolina completed a battery of dual-language standardized assessments in kindergarten, and then …

Academic Impacts Of Intergenerational Trauma: Assessing The Relationship Between Ace Scores Of Parents And The Language And Literacy Development Of Their Elementary-Aged Children, Paige Lee Banaszak

Theses and Dissertations

This paper contributes to the current literature by investigating factors that may contribute to language and literacy difficulty among children, to support the future development of effective intervention techniques. The data analyzed in this paper was collected from children and families participating in Reach Every Reader, a research study currently being conducted to improve literacy outcomes in the U.S. by developing a computer-adaptive screening assessment tool to identify children at risk for language and literacy difficulties early in their educational development. Children enrolled in kindergarten through third grade completed tasks that target language and literacy skills, and their parent(s) completed …

The Effect Of Visual Feedback On Vocal Compensation Abilities In Individuals With Post-Stroke Aphasia, Marissa Rylee Olson

Theses and Dissertations

Speech production is a complex and highly organized process comprised of various sensory and perceptual components. Post-stroke aphasia can impair speech production abilities by interrupting individuals’ ability to detect and correct speech errors and produce their targeted behavior. Contemporary models of speech production aim to understand the relationship between sensory systems and the human ability to produce perceptually accurate speech. This study seeks to understand the relationship between visual feedback and vocal compensation abilities in individuals with post-stroke aphasia to determine the effectiveness of incorporating visual feedback into therapeutic expressive language intervention. It was hypothesized that that the multi-sensory experimental …

Phoneme Stability In Speech Production Of Cognate And Non-Cognate Nouns In A Bilingual With Aphasia, Katherine Vlach

Theses and Dissertations

With the growing bilingual population in the world comes a greater incidence of bilingual aphasia, a communication disorder characterized by expressive or receptive language impairment in one or both of a bilingual speaker’s languages. The cognate facilitation effect, which has greatly been explored in healthy bilingual studies, has shown that cognates are named faster and more accurately than non-cognates; as the cognate facilitation effect is also retained in bilingual speakers with aphasia, it is thought that cognates could potentially be used as a treatment tool to facilitate lexical access, particularly when a bilingual speaker with aphasia presents with one of …

Michigan Appropriateness Guideline For Intravenous Catheters And The Impact On Utilization And Infection Ratios In Peripherally Inserted Central Catheters, Kasey Smith Bustamante

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Adult patients are at increased risk for central line-associated bloodstream infections when central line utilization rates are increased and are inserted inappropriately, based on patient criteria. Purpose: Determine if utilization of the Michigan Appropriateness Guidelines for Intravenous Catheters (MAGIC) will reduce central line utilization ratios (focusing on peripherally inserted central catheters (PICC)) and reduce risk of central line-associated bloodstream infections among an adult population in the Trauma Surgical Care Unit (TSCU) and Medical Intensive Care Unit (MICU) at a tertiary care center in the South Carolina Pee Dee Region. Methods: The Plan Do Study Act (PDSA) quality improvement …

Impact Of A Standardized Checklist On Post Discharge Appointment Attendance And Readmission Rates Of Veterans With A Mental Health Diagnosis, Henretta N. Milton-Williams

Doctor of Nursing Practice Scholarly Projects

Inpatient readmissions are among the most severe problems facing hospitals. Readmissions are most common in the first two to five days after discharge, especially among veterans with mental illnesses at the Columbia Veteran Administration Hospital System (CVAHS) inpatient units. The discharge planning process should begin as soon as a patient is admitted and should be updated throughout the inpatient stay to ensure a safe transition of care from inpatient to outpatient. This Doctor of Nursing Practice (DNP) quality improvement project is aimed to develop and implement a standardized checklist to streamline and organize the discharge planning for all veterans admitted …

Implementation Of A Peer To Peer Concussion Management Program And Its Effect On Concussion Knowledge And Reporting Behaviors In Collegiate Club Sports Athletes, Brian Wallace Stefan

Doctor of Nursing Practice Scholarly Projects

Problem: Concussions continue to be a common injury in both athletes and non-athletes across the world. In college, symptoms and recovery time from concussion injuries can lead to loss of social interaction, class time, and participation in school events such as sports. For collegiate club athletes at the University of Pittsburgh, there is currently no mandated concussion protocol, making injury management more difficult. Purpose: This project's purpose was to determine whether a peer-to-peer concussion education tool is a viable implementation option to improve the concussion environment for this population compared to their current structure with no protocol. Method(s): A five-step …

Using The Buzzy Device To Decrease Pain, Fear, And Anxiety With Venipunctures And Injections, Lisa Santiago Sauls

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Anxiety, fear, and pain related to initiating peripheral venous access or injections are a high priority in the ambulatory infusion clinic setting for both children and adult populations.

Purpose: To determine if the Buzzy device will decrease anxiety, fear, and pain related to adult patients undergoing peripheral venous access or injections in ambulatory infusion clinics.

Methods: Age, sex, route of medication the patient is receiving. A post-procedure questionnaire assessed the participant's satisfaction with the Buzzy device. Pain, fear, anxiety, and patient satisfaction were all measured using a visual analog scale.

Inclusion Criteria: Patients aged eighteen and above receive …

Implementation Of Daily Multidisciplinary Rounding Audits Of Adherence To An Indwelling Catheter Protocol Impact On Catheter-Associated Urinary Tract Infections, Jacqueline April Wright

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Catheter-associated urinary tract infections (CAUTIs) among critical care patients negatively impact the trajectory of the patient’s hospitalization through increased mortality, morbidity, length of stay, and cost. To combat this, hospitals have implemented bundles in compliance with evidence-based practice models to reduce CAUTIs. Purpose: Determine if implementing a daily multidisciplinary rounding audit of established CAUTI prevention protocol decreases the occurrence of CAUTIs in critical care patients with indwelling urinary catheters. Methods: Participants in this quality improvement project included critical care nurses and providers participating in daily multidisciplinary rounds on all critical care patients with indwelling urinary catheters admitted to …

Laboratory Management Models In Core Facilities, Karmen Michael Owen

Theses and Dissertations

Core biotechnology facilities are often defined as laboratories that house shared resources for research. These laboratories are of great importance to research communities because a large portion of scientific research data is generated at these facilities. Different investigators can use core facilities to help further their research. In a university setting, there are several management strategies from small cores that house a specific type of instrument, to large cores that house many different technologies. Funding strategies also differ significantly, from those that are funded by a small group of well-funded investigators, to cores managed by a specific department or school, …

The Emergence And Predictive Utility Of Early Markers Of Social Anxiety In Young Children With Fragile X Syndrome, Conner James Black

Theses and Dissertations

Fragile X syndrome (FXS) is a monogenic neurodevelopmental disorder characterized by elevated rates of intellectual disability, autism, and anxiety. Social anxiety affects approximately 60 percent of individuals with FXS and is cited as one of the most impairing comorbid disorders in FXS; however, little is understood about the developmental patterns of social anxiety markers in young children with FXS. The current study investigates cardiac and behavioral markers of social anxiety across the first five years of life and tests the predictive utility of these variables on social anxiety symptomatology. Participants included 80 children with FXS and 50 neurotypical controls. Participants …

Cardiac Imaging In Mice With Micro-Computed Tomography: An Assessment, Kyle Porter Stegmann

Theses and Dissertations

While echocardiography continues to be a renowned imaging approach to study LV function and geometry in mice, contrast enhanced micro-CT has recently gained popularity because of the high-resolution three-dimensional images produced. However, comparative analyses between echocardiography and micro-CT are limited and conflicting. Therefore, to demonstrate the validity of micro-CT against echocardiography, this study aimed to compare identical measurements of LV function and geometry in wildtype and genetically modified mice in which confounding parameters such as time and anesthetic conditions were taken into consideration. Globally deleted FAP knockout mice (n=12) and age-matched wild type mice (n=14) were included in this study. …

The Associations Of Built Environments On College Students' Physical Activity Levels, Catherine M. Neel

Senior Theses

The issues with American physical activity infrastructure have been causing The United States to have lower levels of physical activity compared to other developed countries. The social and physical built environments of college students typically provide more access for students to be able to be active; however most students still do not meet the recommended amount of physical activity. The purpose of this study was to determine what in their physical and social environment that students utilize in order to participate in physical activity and what aspects of their environment discourage physical activity or limit access to being active. This …

The Ethical Challenges Of Newborn Screening Programs In The United States, Devin Donovan

Senior Theses

Newborn screening programs have been mandated throughout the United States since the 1960s, and technological advancements have allowed for their evolution into the essential public health entities they are today (Arnold 558). These programs screen newborns for a variety of congenital and genetic conditions in all states, but each state varies in conditions screened and policies for collecting and using samples. Residual blood spots are a key component of these programs because they are often used for secondary purposes, such as for quality assurance and public health or biomedical research (Botkin et al. 121). Ethical challenges have arisen related to …

Atomic Utopia: Nuclear Power At The Oconee Power Station In Seneca, South Carolina, Dalton Bridges

Senior Theses

In this thesis, I propose that South Carolina residents have developed a perception of their communities as “nuclear utopias.” I focus specifically on the Oconee Nuclear Power station in Seneca in the northwestern part of the state. I argue that the state’s extensive connections to the nuclear industry, coupled with the fact that many individuals have profited from the job opportunities and economic benefits that this sector provides, have led to a general acceptance of and even appreciation for nuclear power. Nuclear utopia suggests that individuals in South Carolina may view the nuclear industry as a source of hope and …

Accuracy Of Therapeutic Drug Monitoring In Vancomycin And The Pharmacist Role: A Retrospective Case-Series, Kateryna Parkhomenko

Senior Theses

Vancomycin is a mainstay of therapy for treating virulent and resistant infections, especially methicillin-resistant Staphylococcus aureus (MRSA). However, vancomycin requires therapeutic drug monitoring (TDM) for optimal dosing and treatment. This requires pharmacists to calculate a dosing regimen that correlates to appropriate goal vancomycin concentrations in the blood. Dosing vancomycin can be difficult, as it varies on a patient’s weight, renal function, age, etc. Doses may have to be adjusted in response to out-of-range concentrations, which requires further pharmacy calculations. Inaccurate dosing poses a risk to patient safety and places a resource and time burden on pharmacists. If vancomycin dosing methods …

Fixing The System: A Comparative Review Of The United Kingdom, Germany, And United States’ Healthcare Systems And Lessons Learned For Potential Improvements In The United States, Jessica Goddard

Senior Theses

In an effort to provide recommendations to the United States’ considerations of a universal healthcare system, this thesis analyzes the United States healthcare system alongside the sophisticated systems of the United Kingdom and Germany. Literature review and an analysis of 10 health outcomes and indicators guided the framework for a set of interview questions to be asked of healthcare professionals in all three countries. The interview response data was then organized and used to guide the suggested recommendations to the United States in its path towards universal healthcare. While a limited number of solutions could be provided given the time …