Aspirin In The Primary Prevention Of Cardiovascular Disease, Briana Stephanie Murar

Doctor of Medical Science (DMSc)

For decades, people have prophylactically used aspirin (ASA), or acetylsalicylic acid, to mitigate their risk for cardiovascular disease (CVD). The role of ASA as a means of secondary prevention for CVD is well established, however there are conflicting schools of thought as to whether or not it should be used as primary prophylaxis. While this indication has been studied for more than 30-years, questions remain pertaining to the risk of bleeding that is associated with ASA usage, which ranges from mild epistaxis to life threatening hemorrhage.1 Lifestyle and behavioral factors play a large role in a person’s CVD risk, however …

Integrating A Biblical Worldview In Nursing Practice, Hannah Malafy

Honors Senior Colloquium

The Christian of today has the weighty task of discerning biblical truth in the midst of widely varying perspectives on every matter imaginable—especially in the healthcare setting. This essay aims to bring clarity to this mission by outlining the basic content of a biblical worldview, the defining characteristics of the nursing profession, and how the Christian with a biblical worldview approaches two specific areas of contention within the nursing profession.

Special Topics In Neuroendocrinology Allopregnanolone: Pathophysiology, Effects On Mood, Emerging Treatments, Sarah Jane Lance

Doctor of Medical Science (DMSc)

KEY POINTS

● Allopregnanolone is a neurosteroid and metabolite of progesterone that has been shown to play a role in mood regulation.

● Low levels and rapid declines in this neurosteroid are associated with mood disorders such as those within the menstrual cycle, postpartum depression, chronic stress, anxiety, post-traumatic stress disorder, and major depression. Studies have also linked it to moodrelated aspects of addiction.

● Medications that increase allopregnanolone, such as serotonin reuptake inhibitors and Brexanolone, are correlated with improved symptoms. These medications represent established and newly developed drugs that increase its level and are currently used for treatments of …

Fertility Considerations In Prescribing Hormonal Contraceptives In Individuals With Polycystic Ovary Syndrome, Andrea M. Reichle

Doctor of Medical Science (DMSc)

Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine disorder and the most common cause of infertility among females of reproductive age.1 While the name “polycystic ovary syndrome” implies people diagnosed with PCOS have numerous cysts on their ovaries, this is not always the case. Clinicians currently use the Rotterdam criteria to diagnose PCOS.2 These criteria include: irregular periods/anovulatory cycles, clinical or biochemical signs of androgen excess (acne, hirsutism, androgenic alopecia, etc.), and numerous ovarian cysts seen on imaging.2 A diagnosis of PCOS can be made when at least two of three criteria are met.2 As this has become a …

The Effect Of Standardized Patient Education On 30-Day Hospital Readmissions For Heart Failure Patients In The Outpatient Setting, Lurie Dimalanta

Master's Projects and Capstones

Problem: Heart failure (HF) is the second leading condition of hospital readmissions. Evidence shows that patient education on self-care and disease management can help reduce and prevent 30-day hospital readmissions. Registered nurse case managers (RN CMs) can help improve patients' ability to self-manage their condition and prevent 30-day hospital readmissions by applying a standard approach to patient education.

Context: The Integrated Care Management (ICM) is an outpatient department that provides post-discharge patient calls. The ICM RN CMs utilized various HF patient education tools for patient teaching. The organization’s HF task force developed health-literate patient resources to be used …

Delirium And Staff Injury, John Olague Jr

Master's Projects and Capstones

Abstract

Problem: From April 2021 to January 2022 there were 17 cases of reported patient aggression and staff injury due to patients in the hyperactive state of delirium. In a stroke/tele unit, diagnosis of delirium was delayed due to subjective assessment from the confusion assessment method (CAM) tool. This delay allowed patients to reach the hyperactive state of delirium which poses a threat to patient and staff safety. An objective form of assessment for delirium was needed on this stroke/tele unit.

Context: Through a microsystem assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis, stakeholders in this performance improvement plan …

Implementing A Health Services Google Classroom In A High School Setting, Christina M. Wilkinson

Master's Projects and Capstones

Abstract

Problem: The present study investigated the use of Google Classroom and the impact of providing students with basic self-care information on nurse office visit times.

Context: A School nurses are often responsible for multiple schools and a large population of students. These demands pose challenges for school nurses to appropriately serve the student population.

Interventions: Disseminate basic health information on self-care to students via Google Classroom.

Measures: The outcome measure is to make nurse’s office visits less than ten minutes. The data source being chart reviews and the target is 80% of students. The process measure is to increase …

Reducing Hospital-Acquired Pneumonia By Educating Patient Care Technicians On Route Bundle Care Measures, Munroop K. Thiara

Master's Projects and Capstones

Hospital-acquired pneumonia (HAP) is an infection of the lungs that can lead to severe and sometimes fatal outcomes. HAP can be prevented by oral care interventions, but without proper patient care, treatment can be very expensive. Evidence-proven HAP preventative measures such as the ROUTE bundle and increased patient mobility can significantly lower the risk of pneumonia as well as prevent additional hospital costs. Hospital X is a private nonprofit health care organization in the urban suburbs of a large Northern California city with a current HAP rate of 2.3 and with targeted goals of 2.0. By creating a project that …

Improving Safe Handling And Administration Of Usp<800> Hazardous Drugs Within The Medical-Surgical Unit, Pavlo Karaputa

Master's Projects and Capstones

Nurses comprise the largest proportion of healthcare providers who make contact with Hazardous Drugs (HDs) during multiple types of clinical activities and have a risk of exposure. Hazardous drugs (HDs) are a class of pharmaceuticals that pose serious health risks to individuals who handle them, including organ toxicity, reproductive and developmental defects, infertility, miscarriage, genetic toxicity, cancer, and even death. This project was implemented in a hospital system within Northern California, on two units that serve medical-surgical, oncology, geriatric, and transplant patients. The Medical Surgical microsystem at this hospital comprises a small group of professionals such as registered nurses (RNs), …

Improving Home Health Nurses' Knowledge Of Heart Failure Self-Care Management, Nenette Hoffman

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Heart failure results in life-altering and devastating illnesses, predominantly among older adults. Heart failure management is complex, and requires patients and their caregivers to actively monitor symptoms and sufficiently understand care management to maintain health-promoting behaviors. While home health nurses have the primary role as patient educators of their patients with heart failure, evidence from the literature indicates that nurses lack sufficient knowledge to fulfill this role.

Local Problem: Nurses’ inadequate knowledge of heart failure self-care management has been associated with insufficient patient education, the inability of patients to perform heart failure self-care management, worse clinical outcomes, and …

Diabetes Prevention And Management Education For Punjabi-Sikh Older Adults, Mandeep K. Gill

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: South Asians from Bangladesh, Pakistan, and India have a higher prevalence of diabetes than the general global population and are also more susceptible to developing diabetes due to biological and lifestyle factors. The South Asian diet is high in refined grains and monounsaturated fatty acids, increasing the risk of diabetes.

Local Problem: Congregants of a Sikh gurdwara (place of worship) lacked knowledge of diet and lifestyle in relation to preventing and managing diabetes. Many senior congregants have been diagnosed with diabetes or are at high risk of developing the disease.

Methods: Knowledge of diabetes prevention and management were …

Decreasing Seclusion And Restraint Events Among Clients Within An Inpatient And Crisis Stabilization Behavioral Health Facility, Karen Lee Richards

Doctor of Nursing Practice (DNP) Projects

Background: Despite global shifts in behavioral health treatment, changes regarding use of seclusion and restraint (S/R) continues to be extremely slow. Local Problem: Increasing S/R events and subsequent staff injuries and financial burden. Methods: A quality improvement project providing education in trauma-informed care (TIC), sensory modulation (SM), and S/R debriefing (S/RD). Interventions: Education and training for S/RD, TIC, and SM using a variety of materials and methods over a 6 to 12-month period was provided to staff within a 16-bed inpatient adult psychiatric health facility (PHF) and a crisis stabilization unit (CSU). Because of positively affecting the use of S/R, …

Engaging Rural Providers About The Potential Of Low-Earth Orbit Internet Satellite Supported Rural Telehealth Programs, Joshua M. Cleary

Doctor of Nursing Practice (DNP) Projects

Abstract

This paper describes a DNP project that was designed to address the issue of rural mental telehealth implementation barriers. One of the main barriers to rural telehealth programs has been a technical infrastructure incapable of adequately hosting the telehealth programs. Low-Earth orbit (LEO) internet technology has emerged as a way to solve the rural telehealth conundrum by offering an improved rural technical infrastructure. An integrated review was completed based on the following PICOT question: In rural providers, how does an educational outreach compared to no educational outreach affect provider adoption of new technologies? The evidence showed educational sessions as …

Implementing Routine Depression Screening In An Urgent Care Setting: An Implementation Science Project, Lori Conyers

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Identifying patients with depression is essential, and early detection of depression leads to early intervention. Routine screening of patients for depression is the responsibility of the primary care provider, but many patients have not had a primary care visit in the recent past. Those patients without a primary care provider are likely not being screened for depression. Urgent care (UC) may be the best opportunity to screen patients who do not have a medical home. However, the dynamic nature of the urgent care setting may dissuade staff from engaging in routine screening. As a quality improvement (QI) effort, regular PHQ …

Postoperative Atrial Fibrillation Prevention: A Quality Improvement Project, Emily O. Schneiderman

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Postoperative atrial fibrillation remains one of the most common complications after cardiac surgery despite surgical and medical advances in the field. While generally transient, postoperative atrial fibrillation increases long-term morbidity and mortality, hospital length of stay, and financial obligation. The postoperative heart's unique chemical and physical properties make tactics for preventing and treating postoperative atrial fibrillation differ from classic atrial fibrillation management. This quality improvement project utilizes a care bundle for non-pharmacologic measures and early beta-blockade administration to reduce the incidence of postoperative atrial fibrillation. Implementation of this care bundle establishes a standard of care, increases clinician knowledge and accountability, …

Limpieza De Asbestos En La Ciudad De Nueva York, Ariana G. Perez-Castells

Capstones

This is the story of how asbestos is removed in New York City, and who carries out the work. It's unclear how much more asbestos abatement is left in the county, and the U.S. has not completely banned the dangerous material, unlike over 50 other countries across the world. Both of these things could change soon. A new study that the U.S. Environmental Protection Agency will carry out by December 2024 would give us a better picture of how much asbestos there is still in buildings and how much more removal work is to be done. At the same time, …

Engagement Journalism In Action: Supporting New Yorkers With Long Covid, Sarah Luft

Capstones

What do asthma and long COVID have in common? 1 in 13 U.S. adults are living with them. This report is a recap of my efforts to address the information needs of New Yorkers with long COVID as a student in CUNY's Craig Newmark Graduate School of Journalism engagement program. For my final project, I partnered with THE CITY, a nonprofit news outlet serving New Yorkers, to expand the MISSING THEM project. The report details the what, why, and how of my engagement reporting process, including a community engagement framework, a service journalism series, and lessons to carry forward. You …

After Being Ignored, Autistic Adults Find Their Place On The Spectrum, Leonardo A. Lopez Carreno

Capstones

Autistic adults have been historically ignored by researchers and clinical psychologists when discussing autism spectrum disorder. But the broadening of the diagnosis requirements for the disorder, as well as the perspectives from autistic adults that have been shared on social media, have made it so that autistic adults are being discussed more now than ever before, both in the autism community and among professionals in the field. This project puts together interviews with autistic people who have found communities online and in person, as well as the perspectives of researchers who have published studies about autism.

https://medium.com/@leonardolpezcarreo/after-being-ignored-autistic-adults-find-their-place-on-the-spectrum-6e131fc00796

Death Doulas And The Changing Face Of Passing On In America, Uvie M. Bikomo

Capstones

This project examines the damages of the current death culture in the country and the ways in which it is evolving to a more communal thing. It focuses on death doulas and how they are changing death in America.

Link to capstone project:https://ubikomo.github.io/doula/

Exploring The Influence Of Contextual Factors And The Caregiving Process On Burden, Quality Of Life, And Outcomes Of Heart Failure (Hf) Dyads After A Hospital Discharge Guided By The Individual And Family Self-Management Theory (Ifsmt): A Mixed Method Study, Tamara Bernard

Theses & Dissertations

ABSTRACT The purpose of this study is to explore the influence of contextual factors and caregiving process characteristics on proximal outcomes of the patient and caregiver after discharge from the hospital. The long-term goal of this research is to reduce caregiver burden and improve patient outcomes. Heart failure (HF) is an increasingly common chronic illness with unique caregiving needs and a high rate of hospital readmissions. Caregiver burden has been researched extensively in other areas of medicine such as oncology and dementia and has been reported for stable chronic HF patients in an outpatient setting. However, there is little research …

Mitochondrial Autophagy In Ischemic Aged Livers, Jae-Sung Kim, William C Chapman, Yiing Lin

2020-Current year OA Pubs

Mitochondrial autophagy (mitophagy) is a central catabolic event for mitochondrial quality control. Defective or insufficient mitophagy, thus, can result in mitochondrial dysfunction, and ultimately cell death. There is a strong causal relationship between ischemia/reperfusion (I/R) injury and mitochondrial dysfunction following liver resection and transplantation. Compared to young patients, elderly patients poorly tolerate I/R injury. Accumulation of abnormal mitochondria after I/R is more prominent in aged livers than in young counterparts. This review highlights how altered autophagy is mechanistically involved in age-dependent hypersensitivity to reperfusion injury.

Detection Of Biomarkers For Filoviral Infection With A Silicon Photonic Resonator Platform, Krista Meserve, Abraham J Qavi, M Javad Aman, Hong Vu, Larry Zeitlin, John M Dye, Jeffrey W Froude, Daisy W Leung, Lan Yang, Frederick W Holtsberg, Gaya K Amarasinghe, Ryan C Bailey

2020-Current year OA Pubs

This protocol describes the use of silicon photonic microring resonator sensors for detection of Ebola virus (EBOV) and Sudan virus (SUDV) soluble glycoprotein (sGP). This protocol encompasses biosensor functionalization of silicon microring resonator chips, detection of protein biomarkers in sera, preparing calibration standards for analytical validation, and quantification of the results from these experiments. This protocol is readily adaptable toward other analytes, including cytokines, chemokines, nucleic acids, and viruses. For complete details on the use and execution of this protocol, please refer to Qavi et al. (2022).

Evaluation Of Mtorc1 Signaling In Mouse Atherosclerotic Macrophages By Flow Cytometry And Immunofluorescence, Xiangyu Zhang, Jeremiah Stitham, Astrid Rodriguez-Velez, Se-Jin Jeong, Arick Park, Yu-Sheng Yeh, Divya Kapoor, Bettina Mittendorfer, Babak Razani

2020-Current year OA Pubs

Previous studies have demonstrated that a high-protein diet leads to increased atherosclerosis in mice, and that this adverse effect is caused by activation of macrophage mTORC1 signaling. Here, we provide a detailed protocol for the evaluation of diet-induced mTORC1 signaling in plaque macrophages in atherosclerosis-prone apolipoprotein E (ApoE) knockout (KO) mice. This protocol includes flow cytometry and immunofluorescence analysis of atherosclerotic macrophages that can be used to study the atherogenic potential of a variety of mTORC1 modulators. For complete details on the use and execution of this protocol, please refer to Zhang et al. (2020).

An Fmri Protocol For Administering Liquid Incentives To Human Participants, Debbie M Yee, Jennifer L Crawford, Todd S Braver

2020-Current year OA Pubs

This protocol describes the materials and approaches for administering liquid incentives to human participants during fMRI scanning. We first describe preparation of the liquid solutions (e.g., neutral solution and saltwater) and liquid delivery setups. We then detail steps to connect the setups to the computer-controlled syringe pump in the MRI control room, followed by procedures for testing the syringe pump dispensing a liquid bolus during the task. Description of custom software and required adapters for implementing the liquid setup are included. For complete details on the use and execution of this protocol, please refer to Yee et al. (2021).

A Whole-Genome Sequencing Study Implicates Gramd1b In Multiple Sclerosis Susceptibility, Federica Esposito, Bryan Bollman, Laura Piccio, Et Al.

2020-Current year OA Pubs

While the role of common genetic variants in multiple sclerosis (MS) has been elucidated in large genome-wide association studies, the contribution of rare variants to the disease remains unclear. Herein, a whole-genome sequencing study in four affected and four healthy relatives of a consanguineous Italian family identified a novel missense c.1801T > C (p.S601P) variant in the

De Novo Non-Alcoholic Fatty Liver Disease After Pancreatectomy: A Systematic Review, Parth Shah, Vanisha Patel, Motaz Ashkar

2020-Current year OA Pubs

BACKGROUND: As operative techniques and mortality rates of pancreatectomy have improved, there has been a shift in focus to maintaining and improving the nutritional status of these patients as we continue to learn more about post-operative complications. Although pancreatic endocrine and exocrine insufficiencies are known complications of pancreatectomy, increased longevity of these patients has also led to a higher incidence of

AIM: To identify and summarize patterns and risk factors of post-pancreatectomy

METHODS: We performed a database search on PubMed selecting papers published between 2001 and 2022 in the English language. PubMed was last accessed 1 June 2022.

RESULTS: Various …

Culture Care Values And Beliefs Of Puerto Rican Adults Related To Suicide: An Ethnonursing Study, Griselle Estrada

Electronic Theses and Dissertations

BACKGROUND: Suicide is a public health issue among the growing U.S. Latinx population; however, Latinx subgroups are diverse and represent different cultural backgrounds. Puerto Ricans are the second largest Latinx subgroup in the nation. Although research points to possible mental health vulnerabilities among Puerto Ricans when compared to other Latinx subgroups, there is a dearth of research exploring cultural influences that can impact suicide prevention efforts for Puerto Ricans living in the U.S. mainland. AIMS: This study aimed to explore the culture care values, beliefs, and needs of Puerto Rican adults pertaining to suicide and its prevention. METHODS: The …

The Health And Health Care Needs And Experiences Of Mexican Heritage Individuals In A Nonmetro Location: An Ethnonursing Study, Karla Adu

Electronic Theses and Dissertations

Introduction: The population of Mexican heritage individuals has grown significantly in nonmetro, emerging communities. The purpose of this study was to explore the health and health care needs and experiences of this population in the Midwest. Methods: Leininger’s Culture Care Theory and Ethnonursing Research Methods were used as the guiding theory and methodology for the qualitative study. Interviews were conducted with 27 informants. Recordings were transcribed and analyzed according to Leininger’s phases of data analysis. Results: Three themes emerged from the data: 1. living a better life in a nonmetro community with and for family, 2. barriers to understanding …

Speciated Isotope Dilution Mass Spectrometry In Combination With Thor’S Hammer Metaspike Technology For The Assessment Of Low-Level Biomarkers For Human Health Evaluation, Ashley Ebert

Electronic Theses and Dissertations

Our research team has been focused on quantifying important biological analytes in human blood samples to delineate the biochemical processes underlying certain states of dysfunction and evaluate treatment efficacy. These efforts have been guided by laboratory measurements with the input of medical experts. Speciated isotope dilution mass spectrometry (SIDMS) explained in detail in EPA Method 6800 has been successfully applied in the quantification of an important biomarker analyte for immune function and detoxification processes: glutathione. Past research has proven the molecule a biomarker for autism spectrum disorder (ASD) in the form of the reduced/oxidized glutathione (GSH/GSSG) ratio, and literature has …

Empowering Lung Cancer Survivors In Post-Treatment Survivorship Care Using Participatory Action Research, Kelly Filchner

Electronic Theses and Dissertations

Purpose: To explore the experiences of lung cancer survivors (LCS) and their informal and professional caregivers with post-treatment care and to empower them to implement action-based study findings.

Participants & Setting: Participants were recruited using purposeful and snowball sampling from an NCI-designated cancer center in Northeastern US.

Methodological Approach: This study used a participatory action research (PAR) four-phase design. Phase one was a focused ethnography; phase two utilized a core group of participants to decide an action to be implemented in phase three; and phase four evaluated the action for the completion of one PAR cycle.

Findings: Twenty-eight categories, eight …