Encouraging Human Papillomavirus Vaccine Uptake: A Healthcare Improvement Project, Lauren E. Woll

Dissertations

Abstract

Problem: Human papillomaviruses are the causative agents of >95% of cervical cancers, most oropharyngeal and anogenital cancers, yet the vaccination status of the population remains critically low despite Gardasil9 offering robust protection against HPV-related disease.

Methods: This quality improvement project utilized a descriptive, observational design to assess the effect of the HPV Encouragement Bundle, a two-step intervention to improve HPV vaccine uptake. Quantitative data was collected via retrospective chart review to assess the effect of the intervention on first-dose administration of Gardasil9 (series initiation), as well as overall Gardasil9 vaccine uptake.

Results: Following implementation, Gardasil9 first dose uptake increased …

Sexual Dimorphism Of Glomerular Capillary Morphology In Rats, Zackarias Coker

Undergraduate Honors Theses

Chronic kidney disease (CKD) progresses faster in males than females; however, the underlying mechanisms remain poorly understood. Sex differences in glomerular capillary morphology has been hypothesized to contribute, in part, to the increased susceptibility to hypertension-induced renal injury and CKD progression in males, but this has not been investigated. The goal of the present study was to assess glomerular capillary morphology in male vs. female rats with intact kidneys and after uninephrectomy (UNX). We hypothesized that glomerular capillary radii (R_CAP) and length (L_CAP) would be greater in male rats.

Male (n=4) and female (n=4) with intact …

Benefits Of Rooming-In On Infants With Neonatal Opioid Withdrawal Syndrome, Emma Ricioli

Nursing | Senior Theses

Neonatal opioid withdrawal syndrome (NOWS) is a significant public health concern, affecting infants born to mothers who use opioids during pregnancy. Those exposed in-utero exhibit numerous signs of withdrawal after delivery including tremors, gastrointestinal distress, inconsolability, and poor feeding. Typical treatment for infants suffering from NOWS included direct admission to the neonatal intensive care unit (NICU) for close observation and pharmacological interventions. However, NICU stays can interfere with bonding and breastfeeding. They can also lead to increased lengths of stay, higher costs, and more invasive pharmacological treatments. These infants typically do not have any other concerning health issues besides NOWS …

Effects That The Methylenetetrahydrofolate Gene Mutation (Both The C677t And A1298c Polymorphisms) Have On Both Men And Women’S Fertility Abilities And Subsequent Fetal Development, As Well As What Nutritional Changes Can Possibly Do To Aid In Reversing These Supposed Negative Effects., Elizabeth Simkanin

Williams Honors College, Honors Research Projects

This study discusses the perceived negative effects of variants (C677T and A1298C) of the methylenetetrahydrofolate (MTHFR) gene on male and female fertility and fetal development, as well as the potential for nutrition changes to aid in reversing these negative effects. This research project was completed in order to discuss the possible association with and connection between nutrition and fertility in both male and female individuals who have either of the two most common MTHFR gene polymorphisms, 677C>T and 1298A>C. These two polymorphisms are of particular interest because they are associated with the most decreased activity of the MTHFR …

Role Of Decorin At The Fetal-Maternal Interface, Chidambra D. Halari

Electronic Thesis and Dissertation Repository

The human placenta is an invasive tumor-like structure, this invasion being physiological. A subset of placental trophoblast called extra-villous trophoblast invades the uterine decidua and remodels uterine arteries into low-resistance, high-flow tubes to permit adequate flow of maternal blood to nourish the fetus. A poor extra-villous trophoblast invasion and uterine arterial remodeling can lead to fetal growth restriction and a serious pregnancy-associated maternal disease preeclampsia. Decorin, a leucine-rich proteoglycan produced by uterine decidual cells restrains multiple trophoblast functions: self-renewal and differentiation of trophoblast stem cells, migration, invasion, proliferation and endovascular differentiation. Additionally, decidual overproduction of decorin was associated with preeclampsia, …

Epistemic Injustice, Endometriosis And Dance/ Movement Therapy: An Autoethnographic Investigation, Kevana West

Expressive Therapies Capstone Theses

As the field of dance/ movement therapy evolves to meet the demands of a rapidly changing social landscape, it is imperative that clinicians think critically about the degree to which our work is steeped in oppressive frameworks and ideologies. This investigation uses testimony to explore epistemic injustice as it relates to the author’s experience of living with endometriosis and the pursuit of professional licensure. Considering the limited amount of research on the condition, along with the perceived absence of literature within the field of dance/ movement therapy, further study is warranted. The experimentation phase of this research incorporated the use …

Creating A Guideline For Sti Testing In The Pediatric Population, Alexandria Molaro, Alexandra Evans, Alex Niebrugge

Doctor of Nursing Practice Projects

Sexually transmitted infection (STI) prevention, education, screening, and management in pediatric primary care settings are of importance due to the increasing number of cases yearly. Almost half of the 26 million new STIs that occurred in 2018 were among young people 15-24. An opportunity existed in a rural pediatric primary clinic, for improved adherence to Centers for Disease Control and Prevention (CDC) or American Academy of Pediatrics (AAP) recommendations to screen/test patients. An evidence-based project (EBP) was developed to address this concern. Project objectives included: developing STI screening guidelines for pre-teen to young adults, developing a screening algorithm, providing alternative …

The Role Of Mitochondrial Dysfunction In Causing Hypertension During Pregnancy As Observed In The Rupp Model Of Preeclampsia, Michael Franks

Honors Theses

Preeclampsia (PE) is a disease characterized by new-onset hypertension in the third trimester of pregnancy, endothelial dysfunction, and placental ischemia. Contributory to these characteristics are circulating factors such as agonistic autoantibodies to the angiotensin I type II receptor (AT1-AA), CD4+ T cells, natural killer cells (NK), and oxidative stress, which I will show to contribute to renal and placental mitochondrial dysfunction during pregnancy. The adoptive transfer of CD4+ T cells from the Reduced Uterine Perfusion Pressure (RUPP) rat model of PE to a healthy normal pregnant rat has been shown to result in many of these characteristics, including AT1-AA production. …

Healing Through Mother Earth, Taylor A. Russell

Dance (MFA) Theses

This thesis deals with mental health, with a focus on Black women. Historically, Black women are often so compromised, being constant caregivers and helping everyone else, that they forget to help themselves, not having the time and financial means to do so. If we go back in the time of slavery, many Black women were taking care of slave owners' children and suckling the white women’s babies instead of their own. By the time they got home and after diligently caring for other people’s children they were focused on their own children, who they had been away from for hours …

Genital Chlamydia Infection Is Influenced By The Female Sex Hormones Estrogen And Progesterone In Vivo, Amy Gail Gravitte

Electronic Theses and Dissertations

Chlamydia is the most common bacterial sexually transmitted infection in the United States and worldwide. It often goes unnoticed due to lack of symptoms and left untreated it can ascend the female genital tract to cause sequelae like pelvic inflammatory disease and irreversible tubal infertility. In reproductive-aged women, female sex hormones estrogen (E2) and progesterone (P4) concentrations fluctuate during the menstrual cycle and are influenced by hormonal contraceptives and hormone replacement therapy. E2 and P4 influence genital Chlamydia infection in women and mice, but these multifactorial interactions are not entirely mapped out. The complex interplay of E2 and P4 with …

Improving Sexually Transmitted Infection Knowledge In Community College Students: A Path To Prevention, Rebecca F. Halford

Electronic Theses and Dissertations

This DNP project was conducted to identify gaps in knowledge focusing on sexually transmitted infections within Texas and Region one. The research study gathered data from first-year nursing students who have chosen to participate in a sexually transmitted infection-focused educational module. Participants were first-year nursing students and understood the research study was strictly voluntary with no forms of compensation. Currently, the curriculum in the nursing program at which the study took place does not focus on sexually transmitted infections and is directed to speak minimally on the subject. This is a contributing factor to why the rise in sexually transmitted …

The Effects Of Progesterone Induced Blocking Factor And 17-Hydroxyprogesterone Caproate On The Pathophysiology Of Preeclampsia, Kyleigh M. Comley

Honors Theses

Preeclampsia (PE) is responsible for about 20% of the 13 million preterm births each year worldwide, including 100,000 cases annually in the United States. Despite being a leading cause of maternal and perinatal morbidity, the mechanisms of pathogenesis are still largely unknown. PE is progesterone deficient state characterized by hypertension, chronic immune activation, endothelial dysfunction and severe forms can lead to seizures. Treatment of seizures includes the administration of magnesium sulfate (MgSO4) though not all PE patients are responsive, and it does not decrease PE-associated hypertension. To resolve these conditions, PE patients are delivered early thereby making PE the leading …

A Pilot Study Of Oral Health Related Quality Of Life During Gynecologic Cancer Treatment, Stephanie Kushnir

EWU Masters Thesis Collection

Purpose: The purpose of this study was to determine if oral health education increases oral health related quality of life in gynecologic oncology patients.

Methods: In this pilot study, 23 participants (18 - 70+ years) with a history of gynecologic cancer were recruited to participate in the study. Participants completed an Oral Health Impact Profile (OHIP-14) questionnaire prior to and after given education packet.

Results: At baseline, the mean pre-test OHIP-14 score was 6.7 (SD 8.4) and mean OHIP-14 post-test score was 8.8 (SD 8.4). Pearson Correlation was .90. P (T< = t) one-tail p < .008. Demonstrating statistical significance.

Conclusion: OHIP-14 scores increased after four-weeks, higher scores of …

Targeting Epigenetic Mechanisms In Endometriosis, Sarah Elizabeth Brunty

Theses, Dissertations and Capstones

Endometriosis is a complex and elusive gynecological disease in which the inner lining of the uterus grows in locations outside of the uterus and forms lesions. It is known to affect 1 in 9 women of reproductive age worldwide. Symptoms of endometriosis include severe pain, heavy periods, and infertility. While multiple theories of origin exist, none fully encompass all aspects of the disease, although all theories agree that this is an inflammation-driven disease. Due to this, many researchers are turning towards epigenetics to explain the initiation and progression of endometriosis. However, what is causing these epigenetic changes is still a …

Health Outcomes And Utilization Associated With Renal Diseases In Patients With Cancer In The United States, Mitisha Dedhia

Theses and Dissertations

Background: Adverse events and impairments associated with cancer and its treatments causes worse outcomes. Increased incidence of renal diseases among cancer patients is of particular concern. Objective: To determine the risk factors for renal disease in cancer patients and compare healthcare costs, utilization and health-related quality of life (HRQoL) of cancer patients with a renal disease and cancer patients without renal diseases. Methods: Medical Expenditure Panel Survey files from 2009 – 2018 for cancer patients was used for this study. Multiple logistic regression, generalized linear model, Poisson regression and multiple linear regression for analyses after adjusting for demographic, socioeconomic and …

Impact Of Smoking And Hpv Status On Cervical Cancer Survival In Women Living In Kentucky, 2004-2005 And 2014-2015, Brittany M. Mckinley

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

BACKGROUND/ OBJECTIVE: Cervical cancer is the fourth most commonly occurring malignancy in women worldwide, with an estimated 530,000 new cases and 270,000 new deaths each year (Small et al, 2017). While the incidence of cervical cancer has decreased by approximately 1.9% per year between 2007 and 2011, the death rate has remained stable (Bernard et al, 2014). Studies have shown that nearly all cervical cancer cases are associated with the Human Papilloma Virus (HPV). Many studies support the association of smoking with increased risk of invasive cervical cancer in women with high-risk HPV (Castle et al, 2002; Fang et al, …

Methenamine Prophylaxis For Recurrent Urinary Tract Infections In A Tertiary Referral Center, Cameron A. Wade

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Purpose: Methenamine hippurate (MH) is a urinary antiseptic, indicated for prophylaxis of recurrent urinary tract infections (UTIs) but with only few and limited studies regarding its efficacy. To help address this knowledge gap we reviewed our experience with MH for UTI prophylaxis, focusing on women with recurrent uncomplicated UTIs.

Materials and Methods: The University of Kentucky electronic health record was queried to identify adults who were prescribed MH from the Urology clinic between January 2013 and January 2019. Charts were reviewed to assess patient-reported UTI frequency, demographics and relevant health factors. Treatment success was defined as 0-1 UTI in 6 …

The Effect Of Mtor Inhibitor Rapamycin On A Dietary Drosophila Melanogaster Model Of Calcium Oxalate Nephrolithiasis, Michael T. Pignanelli

Electronic Thesis and Dissertation Repository

Impaired cellular tolerance of reactive oxygen species (ROS) has been suggested as a common mechanistic link associated with aging in both metabolic syndrome and nephrolithiasis. The mechanistic (mammalian) target of rapamycin (mTOR) activity is characteristic of metabolic syndrome. When nutrients are abundant, mTOR is active. Conversely, fasting inhibits mTOR. Metabolic syndrome is correlated with an increased risk of self-reported or imaging findings of nephrolithiasis. At the individual level, patients with a higher BMI have an increased prevalence of recurrent symptomatic nephrolithiasis, 24-hour urinary excretion of oxalate, sodium, uric acid, calcium, and phosphorous as well as lower pH. Calcium oxalate crystals …

Developing A Virus-Like Particle (Vlp)-Based Vaccine For Neisseria Gonorrhoeae, Ashvini Vaidya

Biomedical Sciences ETDs

Neisseria gonorrhoeae (Ng) is a sexually transmitted bacterium that infects human reproductive mucosal surfaces. Due to the risk of complications in untreated cases and evolving antibiotic resistance, a prophylactic vaccine is critical for preventing infection. There are four Ng outer-membrane proteins that contribute to Ng survival and resistance: PorB, BamA, TbpA, and MtrE. Each protein contains surface-exposed loops that are targets of bactericidal antibodies. Vaccines were developed by displaying Ng epitopes on the surface of bacteriophage virus-like particles (VLP). VLPs are immunogenic, multivalent, self-assembling complexes composed of viral structural proteins. Antigenic peptide sequences can be displayed on the surface …

Impact Of Parity On Gait Biomechanics, Bekah P. Stein

Masters Theses

Background: Symptomatic knee osteoarthritis (OA) is an incurable condition that affects nearly 50% of adults, and women are twice as likely as men to develop OA. Throughout pregnancy, women experience large changes in morphology and gait mechanics, as well as changes in joint loading. It is possible these adaptations could cause lasting changes postpartum, which may potentially contribute to initiation of OA, thereby increasing the overall risk of OA for women.

Purpose: This exploratory study looked to identify differences between lower limb gait mechanics of healthy nulliparous women and healthy parous women.

Methods: 28 healthy female participants (14 parous, 14 …

Nutrient Sensing Pathways Mediating Igfbp1 Phosphorylation In Fgr, Shapnil Bhuiyan

Electronic Thesis and Dissertation Repository

Impairment of fetal oxygen levels and nutrient delivery contributes to fetal growth restriction (FGR), which affects 20% of pregnancies. Such cellular stress induces hepatic Insulin-like Growth Factor Binding Protein 1 (IGFBP1) phosphorylation, which sequesters Insulin-like Growth Factor 1 (IGF-I) and markedly reduces fetal growth signaling. IGFBP1 hyperphosphoryaltion in hypoxia is mediated through the mTOR signaling pathway and through the Amino Acid Response (AAR) pathway during amino acid deprivation. Hypoxia stimulates upstream mTORC1 regulators, AMPK and REDD1 which are well-established upstream regulators of one of the two mTOR complexes, mTORC1. The molecular mechanisms by which upstream mTORC1-driven processes regulate IGFBP1 phosphorylation …

Hpv Vaccination In Females: The Role Of Primary Health Care And Primary Health Care Providers, Brooke Bouza

Graduate Theses and Dissertations

Two reasons for subpar coverage of the Human papillomavirus (HPV) vaccine are missed clinical opportunities and nonacceptance of the vaccine upon recommendation from a medical provider. The purpose of study one was to examine factors associated with access and adherence to physician’s recommendations in association with HPV vaccine uptake. Data were obtained from National Health Interview Survey (2017). Variables theoretically related to clinical opportunities and adherence to physician’s recommendations were examined in association with HPV vaccine uptake. Univariate logistic regressions were run to determine the associations between the aforementioned variables and uptake of the HPV vaccine. Multinomial logistic regressions were …

A School-Based Sexual Health Education Program, Tracy L. Kendall

Electronic Theses and Dissertations

A small rural community has high incidence rates of chlamydia (4,751 per 100,000) and gonorrhea (970 per 100,000) in females 15–24 years old. Data obtained from Texas Health and Human Services showed that incidence rates of chlamydia and gonorrhea in females 15–24 years old were higher in Navarro County, Texas, than the state of Texas. Texas schools do not mandate sex health education. There is a gap in school-based sexual health education available to 18- and 19-year-old females residing in this rural community in Texas. The purpose of this research study was to evaluate the impact of school-based sexual health …

“Disbelieving Black Women To Death”; The “Double Jeopardy”: Racism And Sexism Affects Black Women’S Access To And Quality Of Care During Pregnancy, Birth, And Postpartum, Madeline St. Clair

Theses/Capstones/Creative Projects

This paper explores possible reasons why Black women in the United States experience a higher maternal mortality rate than their white counterparts. Using books, articles, journals, documentaries, personal experiences and stories of Black women and mothers, I argue that barriers from the societal to the individual level create health and medical disparities for Black mothers in pregnancy, during delivery, and the postpartum period. The paper concludes with a multifaceted solution and call to action.

An Investigation Of Treatments For The Prevention Of Metabolic Complications For Women Suffering From Polycystic Ovarian Syndrome: Diet, Exercise, Weight Reduction And Herbal Remedies, Brenda Martinez-Puente

Nursing | Senior Theses

The purpose of this research study is to compare the views of traditional versus alternative treatments available to women with Polycystic Ovarian Syndrome (PCOS) suffering from metabolic complications. Alternative treatments include diet, exercise, herbal remedies, or any combination of the three. Pharmacological interventions for the conditions associated with PCOS such as metformin, used to control glucose levels, and clomiphene, used to treat infertility. Through the literature review, articles show herbs and plant products to have similar mechanisms of actions as the pharmacological interventions, but with less side effects. For example, cinnamon was shown to increase insulin sensitivity and pomegranate juice …

Relation Of Flt-1 And Endothelial Function In Women Soon After Delivery: Effect Of Physical Activity And Sedentary Behavior, Chloe W. Caudell

Senior Theses

Adverse pregnancy outcomes (APOs) are believed to be caused by poor placental formation. APOs can be characterized by elevated levels of a circulating Fms-like tyrosine kinase biomarker called Flt-1, produced by the placenta when its blood vessels are shallow or inadequately formed. Flt-1 acts directly on the maternal endothelium to impair vascular function during pregnancy and contributes to maternal features of APOs. This study aimed to evaluate the relation of Flt-1 and endothelial function in women soon after delivery. This study also aimed to evaluate the relation of Flt-1 and physical activity and sedentary behavior in women during and soon …

Effects Of Gestational Ozone Exposure On Privileged Placental And Brain Barrier Integrity, Alexander I. Hamm

Theses and Dissertations

Ambient outdoor ozone, a common of component of photochemical smog and urban air pollution, is linked to various neurological and vascular pathologies. Its immediate reaction with lung surfactant after inhalation results in complete reactivity of the gas, with no active ozone passing into circulation. This indicates the presence of secondary and tertiary mediators in ozone-related systemic pathologies after pulmonary insult. In vasculature, ozone exposure is associated with an acute hypertensive phenotype apparent at least 24 hours after dose, such as experienced on a hot summer afternoon in a large metropolitan area like Los Angeles or Mexico City. However, the effects …

Cardiovascular Tissue Remodeling Of Preeclampsia, Rachel Metz

Williams Honors College, Honors Research Projects

Preeclampsia is a hypertensive disorder of pregnancy that leads to a multitude of problems for the mother and fetus during and after pregnancy. While the effects on the mother's body after pregnancy are often overlooked, preeclamptic mothers are prone to cardiovascular diseases from the great deal of stress experienced through the duration of a preeclamptic pregnancy. The associated high blood pressure causes cardiac muscle to work a great deal harder in an attempt to successfully perfuse tissues adequately. This increase in prolonged stress leads to remodeling of the cardiovascular tissues-significantly increasing the risk of heart issues in life beyond the …

Characterizing The Combination Of Rpa Inhibitors With Parp Inhibitors In High-Grade Serous Ovarian Cancer, Yat Tang

Theses & Dissertations

High-grade serous ovarian cancer (HGSC) is the most common and deadly gynecologic malignancy. HGSC patients with BRCA1/2 mutations have homologous recombination deficiency (HRD), requiring parallel pathways to maintain genome integrity (e.g., PARP1, PARP2). Approximately 50% of ovarian carcinomas are estimated to exhibit HRD. For the remaining 50% and the large percentage of HRD patients with acquired or innate resistance to single-agent PARP inhibitors, there is a need to develop alternative therapeutic strategies.

Replication Protein A (RPA) is a heterotrimeric protein crucial for genome maintenance. Phosphorylation of RPA in DNA damage response (DDR) is a negative regulator of DNA end resection. …

Identifying The Risk Factors To Postpartum Depression, Jannica Bondoc Santos

Senior Theses

A woman’s life instantly changes after the birth of their child. Furthermore, culture influences the stigma that a mother is the primary caregiver of their children and are accountable for the health and upbringing of the child. Giving birth to a baby and taking up the responsibility of another human life is a great impact in a female’s existence. In addition to the new tasks that come with motherhood, women are also challenged to cope with their emotional and mental state after giving birth. The most chronic mental illness that can develop after labor is postpartum depression (PPD). Women who …