Digital Commons Network^™

Evaluation Of Stratified Antibiograms For Use In Laboratory And Antimicrobial Stewardship, Linsey Donner

Theses & Dissertations

Antibiograms are critical for choosing empiric antimicrobial therapy. Cumulative antibiograms, which aggregate susceptibility data, can mask differences within specific patient subsets or clinical syndromes. This dissertation was done to determine if antibiotic susceptibilities showed substantial differences when comparing stratified antibiograms to cumulative antibiograms.

Antibiotic susceptibility data was retrospectively obtained from Nebraska Medicine January 1, 2017 – December 31, 2019 for Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, and Enterococcus faecalis. The University of Nebraska Medical Center’s web antibiogram clinical decision support tool was used to export the data. Bacteria-antibiotic susceptibility rates of stratified antibiograms …

Surgical Site Infections And Hand Hygiene Discharge Teaching, Jesus A. Rodriguez Hernandez

Master's Projects and Capstones

Problem: During the span of a nine-month period, the PACU of a perioperative unit in an acute care hospital in the East Bay Area saw an incidence of 13 surgical site infections (SSIs). SSIs have been associated with negative patient health outcomes, diminished quality of life, and increasing healthcare costs.

Context: The PACU consisted of 20 beds and a competent staff of registered nurses, medical assistants, patient care technicians (PCTs), and management staff. It served mostly adults from diverse backgrounds receiving elective and emergent surgeries.

Intervention: A Standardized 3-Step Hand Hygiene Discharge Teaching model with nurse self-audits for every surgical …

Mobility Matters: Improving Average Maximum Mobility (Amm) Scores In A Medical-Surgical Telemetry Unit, Marlon Macalanda De Vera

Master's Projects and Capstones

Problem: There has been a national crisis of immobility in hospitalized patients. Of the 1 in 3 hospitalized patients who develop a new onset of physical disability, 50% of them will not return to normal function (Holroyd-Leduc et al., 2019). The impact of immobility could result in increased hospital costs, longer lengths of stay, higher events related to hospital-acquired pneumonia (HAP), falls, and readmission rates (Growdon et al., 2017; Larsen et al., 2019).

Context: Microsystem assessment was conducted to identify a quality performance gap. When compared to the regional Average Maximum Mobility (AMM) benchmark score, the patients’ mobility scores …

Preventing Maternal Falls, Blair Burkhart

Master's Projects and Capstones

Patient falls are unfortunate events in healthcare that are an essential quality improvement focus during patients’ hospital stays. At Hospital X, a private institution located in the suburbs of a large city, there had been 23 maternal falls within the last three years. This increase in maternal fall rate puts this hospital’s maternity unit above the average of other hospital’s fall rates according to the National Database of Nursing Quality Indicators. This quality improvement project aimed to reduce the rate of maternal falls on postpartum units through various forms of staff education. Education included Morse Fall Scale scoring, Sara Stedy …

Parental Perceptions Of Family Management Styles In Families With A Child With Asthma, Annette Hines

Dissertations

Asthma is the most common chronic illness among children in the United States, and families who have a child with asthma face daily challenges to maintaining a normal family life. A descriptive, cross-sectional study was performed that studied four risk factors and four protective factors derived from the literature that impact these families, in order to better understand how nurses can meet the health care needs of the children with asthma and their families. Knafl's (1990, 1996) family management styles framework was applied as the theoretical framework of the study, and the concept of normalization was measured using the Family …

Variedades. Second Edition. Intermediate/ Advanced Spanish Conversation, Carmela V. Mattza

Faculty Publications

VARIEDADES. Second Edition. Intermediate/ Advanced Spanish Conversation is a textbook for the student at the intermediate / advanced intermediate level. Through audiovisual activities, the student is expected to put their previous knowledge into practice and improve their ability to understand, write, listen, and speak in Spanish. VARIEDADES offers communicative activities that can be easily adapted into courses of different levels. In addition, it offers an appendix of activities with films and a Spanish grammar section that by subject directs the student to electronic databases that are freely accessible or are part of the Open Access platform.

Development Of Polymeric Cxcr4 Targeting Carriers For Sirna Delivery To Treat Acute Kidney Injury, Weimin Tang

Theses & Dissertations

Acute kidney injury (AKI) is a major kidney disease that is characterized by a sudden loss of renal function which manifests by a decrease in urine output and an increase in serum creatinine. AKI is a global healthcare burden associated with high morbidity, mortality, and increasing cost. Currently there are no effective pharmacological treatments available. Apoptosis induced by p53 has been demonstrated as an important pathological mechanism for the development of AKI. Meanwhile, CXCR4/SDF-1 axis has been associated with the inflammation during AKI, and CXCR4 is overexpressed on injured tubules. This dissertation hypothesized that polycations with CXCR4 targeting ability could …

Using Prompt Delay And Instructive Feedback To Teach Pretend Play Skills To Children With Autism Spectrum Disorder, Gabriella R. Van Den Elzen

Theses & Dissertations

Pretend play involves carrying out routines, acting out roles, referencing absent or imaginary properties of objects, or substituting one object for another. Pretend play skills emerge in typically developing children by preschool age but are often absent or delayed in children with autism spectrum disorder (ASD). In the present study, we evaluated use of prompt delay, instructive feedback, and prompt delay with instructive feedback for the acquisition and maintenance of pretend play skills with children with ASD. Throughout training, we conducted free-play probes to evaluate generalization to a naturalistic setting. The results of the current study suggest that combining the …

Relationships Between Dress And Gender Identity: Lgbtqia+, Alyssa Dana Adomaitis, Diana Saiki, Kim K. P. Johnson, Rafi Sahanoor, Arsha Attique

Publications and Research

No abstract provided.

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

Probing The Role Of Astrocytes In The Pathology Of Fragile X Syndrome With Human Stem Cells, Baiyan Ren

Theses & Dissertations

Fragile X syndrome (FXS) is an X-linked neurodevelopmental disorder related to intellectual disability and the most common monogenic cause of autism spectrum disorder. FXS is mainly caused by an expansion of CGG repeats in the 5’-untranslated region of fragile X mental retardation 1 (FMR1) gene, leading to the loss of expression of fragile X mental retardation protein (FMRP). Astrocytes are the most abundant glial cells in the central nervous system (CNS). Loss of FMRP in astrocytes has been found to contribute to structural and functional synaptic deficits in the Fmr1-KO mouse model. The contribution of human astrocytes, however, to the …

Glad To Be Out. I Was Running Out Of Womb: A Study Of Omega-6 And Omega-3 Fatty Acid Metabolites At Delivery And Their Relationship To Infant Growth, Prematurity, And Admission To The Neonatal Intensive Care Unit, Maranda Thompson

Theses & Dissertations

Normal pregnancy relies on inflammation for implantation, placentation, and parturition, but uncontrolled it can lead to poor infant outcomes. Maternal diet is one modifiable factor that can impact inflammation. Omega-3 and omega-6 fatty acids have been shown to be metabolized into bioactive metabolites that effect inflammation. The presence and importance of these metabolites at the time of delivery are not well understood. Therefore, the purpose of this dissertation was to first quantify omega-3 and omega-6 metabolites in maternal plasma, cord plasma, and placental tissue. Then the relationships between metabolites and infant outcomes, including birth weight percentile, length percentile, head circumferences …

Functional Characterization Of Cancer-Associated Dna Polymerase Ε Variants, Stephanie R. Barbari

Theses & Dissertations

Replicative DNA polymerases ε (Polε) and δ (Polδ) achieve high fidelity DNA synthesis through a precise balance of polymerization and exonucleolytic proofreading. Errors that escape proofreading are corrected by DNA mismatch repair (MMR). Ultramutated human cancers with proficient MMR carry alterations in the exonuclease domain of Polε, which were initially predicted to abolish proofreading. However, functional studies in yeast of the most recurrent Polε-P286R variant suggested defects beyond a loss of exonuclease activity. Indeed, biochemical analysis of the yeast Polε-P286R analog revealed increased polymerization capacity in addition to decreased proofreading, which enables efficient mismatch extension and bypass of replication-blocking non-B …

Integrative Analysis Of Multi-Omics Kinome Data And Virtual Screening Of Identified Targets With Pan-Cancer Application, Siddesh Southekal

Theses & Dissertations

Cancer is a heterogeneous disease characterized by the uncontrolled growth and dissemination of abnormal cells. Unfortunately, it is also challenging to treat due to the heterogeneous nature of the tumors and the lack of known drugs that are effective against all tumor subpopulations.

The human protein kinases represent an essential and diverse family of enzymes and are often dysregulated in cancer. The human kinome comprises only around 2% of all coding genes of the human genome but phosphorylates about 30% of cellular proteins critical for regulating various biological processes such as cell proliferation, cell cycle progression, apoptosis, motility, growth, differentiation, …

Understanding The Impact Of Chlamydia Trachomatis Infection On Host Vesicular Trafficking, Lisa M. Jorgenson

Theses & Dissertations

Chlamydia trachomatis is a highly evolved obligate intracellular bacterial pathogen. During infection, organisms reside within a host epithelial cell in a membrane-bound vacuole called the inclusion. The inclusion membrane contains both pathogen and host components, including unique chlamydial type III effector proteins called Incs and host lipids like cholesterol and sphingomyelin. The inclusion membrane serves as the main barrier between the bacteria and the host cytosol, and thus, functions as the platform supporting host-chlamydial interactions. Via the inclusion membrane, C. trachomatis intercepts components of host vesicular traffic including many host SNARE proteins, which are a conserved family of eukaryotic proteins …

Humanized Mice For Brain Infection Of Emerging Viruses, Edward Makarov

Theses & Dissertations

Studies on the pathogenesis of emerging viruses that present a global threat are critical for pathogen classification and therapeutic development. Humanized mice enable investigation of viral pathogens, including Human immunodeficiency virus (HIV-1), Zika virus (ZIKV), Coronavirus 2 (SARS-CoV-2), and Dengue virus (DENV), offering an advanced understanding into the mechanisms of viral perseverance in its natural human host cells and for therapeutic discovery. Realizing the diverse dynamics of various viral infections with the capacity to establish an innovative acuity for therapeutics and mechanics when utilizing humanized mice contributes a formerly inaccessible insight into human-specific viral pathogenesis and treatment. We recently developed …

Immunological Factors Associated With Siv/ Shiv Persistence In Diverse Tissue Niches, Omalla A. Olwenyi

Theses & Dissertations

The significant challenge towards a successful HIV cure lies in eradicating persistent viral reservoirs across diverse tissue niches. As a result, HIV-infected individuals have to resort to lifelong antiretroviral therapy. Recent news of supposed HIV eradication in a second patient has further re-invigorated the fields of HIV cure. However, a few barriers remain, such as the lack of currently available assays to accurately quantify viral reservoirs, limited information on cellular factors associated with persistence, and varied dynamics of the viral reservoir in various body compartments. Lastly, HIV-infected individuals live different lifestyles stemming from comorbid substance abuse including consumption of morphine, …

Metabolic Heterogeneity And The Roles Of Cody And Ccpa In Central Metabolism And S. Aureus Biofilm Formation., Logan L. Bulock

Theses & Dissertations

Staphylococcus aureus is a metabolically versatile human pathogen, causing disease in many areas of the body. Its versatility can be attributed to the fact that it utilizes a variety of tools to adapt to many different environments, including toxins to scavenge from the host and multiple transporters to compete for its preferred carbon sources. S. aureus can also survive in harsh conditions through biofilm development, which are notoriously recalcitrant to antibiotics and immune defenses. Biofilms exhibit marked heterogeneity, with division of labor for production of matrix components and differential gene expression among various niches within the biofilm.

In this study, …

Nuclear Receptor Coactivator 3 In Endoplasmic Reticulum Stress And Stress Granule Dynamics In Pancreatic Cancer, Andrew Kisling

Theses & Dissertations

Pancreatic cancer is predicted to be the second-leading cause of cancer-related deaths within the next decade. Nuclear receptor coactivator 3 (NCOA3/SRC3/AIB1) regulates an array of metabolic and signaling pathways and has been established by our group and others as a critical regulator pancreatic cancer progression and metastasis. A recent study demonstrated NCOA3 regulation by the IRE1α-XBP1 axis of the unfolded protein response (UPR), suggesting a link between NCOA3 and cellular stress management. Furthermore, NCOA3 has been shown to directly bind to a scaffolding protein of stress granules (SGs). Since SG assembly is regulated by the UPR, we hypothesized that NCOA3 …

The Contribution Of Bioethics To Home Healthcare (Hhc) In Saudi Arabia, Saeed Alghamdi

Electronic Theses and Dissertations

This dissertation examines the contribution of bioethics to Home Healthcare (HHC) In Saudi Arabia (SA). Through exploring the critical bioethical issues that have influenced the implementation of home health care, the dissertation highlights the significance of incorporating bioethics in home health care. Organizational ethics has led to the regulation of healthcare professionals, patients, and the stakeholders within clinical care settings. Healthcare organizations and other stakeholders, such as global health bodies, should formulate laws and policies that promote bioethics in contemporary healthcare. The Kingdom of Saudi Arabia, through the Ministry of Health, should promote the adoption of home health care services …

Winsupply Inc. To Double Internship Opportunities For Students, University Of Dayton

News Releases

Winsupply Inc. is working with the University of Dayton to double the number of internship opportunities, providing work experience and hands-on learning opportunities to 20 students next year.

Does Speech-To-Text Assistive Technology Paired With Graphic Organizers Improve The Written Expression Of Students With Traumatic Brain Injuries?, Kayla Cuifolo

Electronic Theses and Dissertations

A traumatic brain injury (TBI) can range from mild to severe and can cause debilitating outcomes that require children to need specialized medical or educational services post-injury. Outcomes vary and are dependent on the location of injury, age, severity, and environmental factors. Some common deficits that happen as a result of a brain injury are fine motor and executive functioning skill difficulties. Fine motor and executive functioning skills are an important component of written expression. Therefore, this current study utilized a brief experimental analysis in order to determine the effects that speech-to-text assistive technology along with a graphic organizer has …

The Lived Experiences Of Self-Concealment Among Lgbq+ Counselors In The Workplace, Richard Charette Ii

Electronic Theses and Dissertations

This study sought to unearth the narratives of LGBQ+ counselors’ experiences of self-concealment in the workplace. Self-concealment was an identity management strategy that was defined as an active, and sometimes persistent effort to conceal LGBQ+ identity. Self-concealment of affectional identity was well researched in workplace contexts, however only one study existing study examined self-concealment among LGBQ+ counselors. In that previous qualitative inquiry, Jeffery and Tweed (2014) called for further exploration of self-concealment among LGBQ+ counselors when self-concealment emerged as a surprising finding.

The phenomenon of self-concealment was under-researched in counseling but has been extensively conceptualized as both a developmental stage …

Loneliness, Interpersonal Goals, Life Satisfaction, And Subjective Well-Being In Older Adults, Francesca C. Ezeokonkwo

Electronic Theses and Dissertations

Background: Loneliness is detrimental to health and is linked to numerous physiological and psychological problems. People across the age spectrum can be affected by loneliness at one point or another in their lives; however, older adults are disproportionally affected.

Aims: This study investigated the effect of interpersonal goals (compassionate and self-image goals), life satisfaction, and subjective well-being on loneliness in older adults and the influence of demographics and social support. The Ecosystem-Egosystem Theory of Social Motivation served as the theoretical framework.

Design and Method: This descriptive cross-sectional correlational study used the 2016 Health and Retirement Study. Participants were 65 years …

Using Eugenecid And Eugenecim Computational Tools For Synthetic Biology, Wheaton L. Schroeder, Anna S. Baber, Rajib Saha

Department of Chemical and Biomolecular Engineering: Faculty Publications

Synthetic biology often relies on the design of genetic circuits, utilizing ‘‘bio parts’’ (modular DNA pieces) to accomplish desired responses to external stimuli. While such designs are usually intuited, detailed here is a computational approach to synthetic biology design and modeling using optimization-based tools named Eukaryotic Genetic Circuit Design and Modeling. These allow for designing and subsequent screening of genetic circuits to increase the chances of in vivo success and contribute to the development of an application development pipeline. For complete details on the use and execution of this protocol, please refer to Schroeder, Baber, and Saha (2021).

Motivated2move: Icu Liberation And Early Progressive Mobility In Ventilated Patients, Leslie S. Bigler

Master's Projects and Capstones

The Motivated2Move: ICU Liberation and Early Progressive Mobility in Ventilated Patients project was implemented in a 24-bed intensive care unit (ICU) in a 241-bed general care, stroke certified not-for-profit community hospital in northern California. The primary purpose of this project was to educate the nurses on the structure and implementation of the Society of Critical Care Medicine’s evidence-based ICU Liberation (ABCDEF) Bundle (Society of Critical Care Medicine, n.d.). A secondary purpose of this project was to coordinate an early progressive exercise and mobility protocol for all ventilated patients. The primary goal of the project is 100% compliance with the ICU …

Barriers To Discharge: A Retrospective Medical Record Review Examining Potential Barriers To Patient Discharge At The End-Of-Life, Pauline Felker, Kelly Purdy

Doctor of Nursing Practice Projects: College of Nursing

It is estimated that 70% of Americans would prefer to die at home, but less than one-quarter do so. Patients near the end of life often face several barriers that prevent them from successfully transitioning from an acute care setting to their preferred place of death. These barriers include but are not limited to a lack of trust between facilities and community care providers, ineffective communication, delayed discharge planning, difficulty accessing medications and supplies, lack of control, feelings of uncertainty, and feelings of burden. This study utilized a survey of 102 medical records of patients who died in the hospital …

A Public Health Ethics Approach To Substance Use Disorder, Adele Flaherty

Electronic Theses and Dissertations

The goal of the dissertation is to undertake an analysis of substance use disorders that focuses on a public health ethics perspective. The ethical argument focuses upon justifying the use of harm reduction and is primarily concerned with the current opioid crisis. While substance abuse/misuse over the course of history has been identified as a public health concern, this dissertation presents substance use disorders over the course of the lifespan, examining various contexts in which it can affect daily living and health outcomes. It achieves this by analyzing substance use disorders through the lens of the socioecological model of public …

New York State Prison Visit Guide, Carla Canning

Capstones

Visiting a prison facility requires a person to know a lot of information and follow many rules, they must do this while navigating complex emotions around seeing their loved one and interacting with corrections officers.

This project is a website guide to visiting New York State prison facilities, drawing upon information from family members who visit loved ones frequently and have experience with the system and documents from the department of corrections.

www.nysprisonvisitguide.com

Inpatient Observation Safety Assistant Practices, Jennifer Knight

Doctor of Nursing Practice Projects

Abstract

Introduction. Sitter usage is a patient safety practice used across healthcare organizations and the world. Sitters go by many other names, such as patient safety assistants, patient care assistants, care partners, and observation partners. There is literature that supports different variations of practices in healthcare facilities. A scoping review of the literature revealed multiple initiatives to reduce sitter cost and observation through nurse empowerment.

Purpose of Root Cause Analysis. The purpose of this root cause analysis is to determine why personnel inconsistently use the sitter policy. The appraised data will be used to improve the sitter process at this …