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Improving An Electrocardiogram Competency Assessment Tool For Registered Nurses, Laurel K. Ng

Master's Projects and Capstones

Abstract

Problem: Rapid and accurate interpretation of an EKG rhythm is an advanced-level competency required for all acute care nurses working in a cardiac monitored/telemetry unit. Observational data collected over a 4-month period by the facility clinical nurse educators identified that less than half of the nurses required to take the EKG exam passed on the first attempt.

Context: The education department at the facility onboards approximately 550-600 nurses annually for the 241-bed community hospital in the San Francisco Bay Area of Northern California, part of a larger healthcare organization.

Interventions: A total of 19 nurses from various …

Increasing Lactation Consultant Support To The Mch Unit, Daniella Grace Mcclendon

Master's Projects and Capstones

Problem: Breastfeeding is the most beneficial feeding choice for newborns and one of the best ways for mothers to bond with their newborns. In the current Maternal Child Health (MCH) unit, exclusive breastfeeding rates have fallen lower than the unit’s goal of 82%.

Context: Exclusive breastfeeding, when a newborn consumes only human breastmilk, is not always an easy process to initiate immediately after birth and in the early postpartum period. On this specific unit, there is not enough lactation consultant support to provide all patients on the unit.

Interventions: This project considers adding additional lactation consultants to support the MCH …

Oral Care Experiences Of Palliative Care Patients, Their Relatives/Carers And Healthcare Professionals: A Qualitative Systematic Review, Delgado M Bernardes, Anastasios Plessas, Lorna Burns, Helen Neilens, Sarah Griffiths, Jos Latour

Peninsula Dental School

No abstract provided.

Examining The Interaction Of Adverse Childhood Events, Dental Issues, Asthma And Autism, Cathy Koetting

Electronic Theses and Dissertations

Dissertation supervised by Dr. Rebecca Kronk

Purpose: Adverse childhood events (ACEs) have a profound and long-term effect on the health outcomes of many children and adults. However, few studies have focused on specific ACEs and health outcomes in children with autism spectrum disorder (ASD). The aim of the study was to investigate if ASD moderated the relationship between ACEs and specific health outcomes in children who had been the subject of a child welfare system report.

Design and Methods: Using the second National Survey of Child and Adolescent Well-Being (NSCAW II), a secondary analysis was performed on a sample of …

A Bible Study Series: The Family-Centered, Church-Supported Paradigm Shift For Raising Children In The Faith At Salem Lutheran Church, Michael J. Nielsen

Doctor of Ministry Major Applied Project

Nielsen, Michael J. “A Bible Study Series: The Family-Centered, Church-Supported Paradigm Shift for Raising Children in The Faith at Salem Lutheran Church.” Doctor of Ministry. Major Applied Project, Concordia Seminary, 2021. 160 pp.

In many Christian churches there is the question: “How do we keep our children after confirmation?” The answer is a simple one: Parents. This MAP examines the relationship of the family and the church when it comes to raising children in the faith. Biblically parents are called to be the primary faith formers in the lives of their children. A multi-part Bible study was created to teach …

Improving Medication Administration Safety In A Correctional Facility With An Electronic Medication Administration System, Rosalinda Salazar

Master's Projects and Capstones

Problem: According to the World Health Organization (2020), medication errors are one of the leading causes of injury and avoidable harm in health care globally.

Context: The county jail houses approximately 700 inmates/patients on a daily basis, and the potential for error when administering medications is high as medications are prepared manually using a paper medication administration record.

Interventions: The jail began using an electronic health record/barcode administration system on October 19, 2020.

Measures: Unusual occurrence reports related to medication errors were reviewed. The time frame included 6 months before electronic implementation, and 6 months after implementation.

Results: Unusual occurrence …

Distribution, Abundance And Natural Enemies Of The Invasive Tomato Leafminer, Tuta Absoluta (Meyrick) In Kenya, G. Kinyanjui, F. M. Khamis, F. L.O. Ombura, E. U. Kenya, S. Ekesi, S. A. Mohamed

All Peer-Reviewed Publications

Tuta absoluta (Meyrick) has become a serious menace to sustainable production of tomato in Kenya. A survey was conducted between April 2015 and June 2016 to determine its distribution, abundance, infestation, and damage levels on tomato, and associated natural enemies. Trap counts of T. absoluta moths were recorded in all surveyed 29 counties, which indicated its nationwide distribution irrespective of altitude. Tuta absoluta was present in both open fields and greenhouses. The highest moth/trap/day was 115.38 ± 15.90. Highest leaf infestation was 92.22% and the highest number of mines and larvae per leaf were 3.71 ± 0.28 and 2.16 ± …

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 …

Chromatic Quasisymmetric Class Functions For Combinatorial Hopf Monoids, Jacob A. White

School of Mathematical & Statistical Sciences Faculty Publications

We study the chromatic quasisymmetric class function of a linearized combinatorial Hopf monoid. Given a linearized combinatorial Hopf monoid H, and an H-structure h on a set N, there are proper colorings of h, generalizing graph colorings and poset partitions. We show that the automorphism group of h acts on the set of proper colorings. The chromatic quasisymmetric class function enumerates the fixed points of this action, weighting each coloring with a monomial. For the Hopf monoid of graphs this invariant generalizes Stanley's chromatic symmetric function and specializes to the orbital chromatic polynomial of Cameron and Kayibi.

We also introduce …

Multicultural Music Education: Preparedness, Perceptions, And Practice Among Virginia Elementary Music Educators, Benjamin J. Luna

Masters Theses, 2020-current

Benjamin Joel Luna, M. M.

James Madison University, 2021

Supervisor: Lisa M. Maynard

The purpose of this study was to examine the Multicultural Music Education (MME) practices of established (i.e. more than three years of music teaching experience) Elementary Music Teachers in the state of Virginia by examining their responses to a series of survey questions specific to the topic. Participants (N=18) were all current Elementary Music Teachers in the state of Virginia with more than three years of experience.

Participants were asked to use Likert-scale ratings for the majority of the questions but were also given the …

Assessing Moral Distress And Substance Use Among Nurses In The Time Of Covid-19 To Improve Patient Safety, Lauren Childers

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

The COVID-19 pandemic has brought rapid changes, increased stress, and ethical challenges to nurses across the globe. These factors may place nurses at increased risk for developing moral distress and substance use disorder. This stress can also increase nurse vulnerability to substance use. Previously there was little evidence about the rates of moral distress and substance use disorder among nurses during the COVID-19 pandemic. The primary objective of this evidence-based project was to describe levels of moral distress and substance use among nurses in a community hospital during the COVID-19 pandemic and to make recommendations for interventions to improve nurse …

Ultrasound Modulation Of Macaque Prefrontal Cortex Selectively Alters Credit Assignment–Related Activity And Behavior, Davide Folloni, Elsa Fouragnan, Marco K. Wittmann, Lea Roumazeilles, Lev Tankelevitch, Lennart Verhagen, David Attali, Jean François Aubry, Jerome Sallet, Matthew F.S. Rushworth

School of Psychology

Credit assignment is the association of specific instances of reward to the specific events, such as a particular choice, that caused them. Without credit assignment, choice values reflect an approximate estimate of how good the environment was when the choice was made—the global reward state—rather than exactly which outcome the choice caused. Combined transcranial ultrasound stimulation (TUS) and functional magnetic resonance imaging in macaques demonstrate credit assignment–related activity in prefrontal area 47/12o, and when this signal was disrupted with TUS, choice value representations across the brain were impaired. As a consequence, behavior was no longer guided by choice value, and …

The Analysis Of Microdroplet Arrays, Alex Austin

Mechanical Engineering and Materials Science Independent Study

The primary objective of my research this semester was the investigation into the optimization of the micropillar array both through simulations and physical testing. Where ancillary objectives include the familiarization of SEM imaging, Surface Evolver, and COMSOL. Significant progress has been made in all these objectives. Specifically in the construction of different asymmetrical droplets that were combined to form an array.

Daphne Camille Jones

African American Funeral Programs

No abstract provided.

Fasting Status Of Steller Sea Lion Pups, Stephanie G. Crawford

Biological Sciences

Following population declines in species of concern, wildlife managers often seek to identify underlying causes to understand and predict population dynamics for better future management. Often, physiological and/or behavioral metrics are measurable markers of decline, and these are often detectable well before declines are measurable through population surveys. During the 1970's, 80's, and 90's Steller sea lion (SSL; Eumetopias jubatus) populations in the western portion of their breeding range declined by ~85%. Though declines in most regions have since stabilized or exhibited modest recovery, some subpopulations breeding in the Aleutian Islands continue to decline. In contrast, SSL subpopulations in eastern …

Naturally Occurring Etiologic Factors Affecting The Health Of Breeding Seabirds In The Bering Sea, Maile Branson

Biological Sciences

Seabird populations across the globe have experienced both significant instability and consistent overall declines in recent history. Seabirds in the Bering Sea of Alaska, USA appear to be severely affected by environmental changes, exhibiting large-scale shifts in behavior and distribution and increases in unusual mortality events (UMEs) in recent years. I analyze a selection of the naturally occurring pathogenic and toxicological factors affecting breeding seabirds in the Bering Sea region using an approach focusing on zoonoses and bioaccumulating toxins. Specimens were collected at three breeding colonies in the Bering Sea in 2018 and 2019, and were evaluated for the presence …

Rooted In Environmental Justice: Phytogeography And Ethnoecology Of Serianthes, Else Demeulenaere

Biological Sciences

Serianthes Benth. (Fabaceae) is one of the most endangered plant genera in the world, with 12 of the 18 species listed on the IUCN Red List of Threatened Species. Serianthes trees are culturally important to island communities of the Indo-Pacific region for canoes, boats, traditional houses, and medicine. Habitat loss and ecosystem degradation increased pressure on these trees, also threatening its Indigenous cosmology and traditional practices. This interdisciplinary study integrated genomic, biogeographic and ethnoecological approaches to develop appropriate policies that protect the Indigenous biocultural diversity of Serianthes. Phylogenomics of 401 nuclear exons and non-coding flanking regions using both a multi-species …

Implementation Of Maternal Fetal Triage Index To Improve Nurse Knowledge And Timeliness In Obstetric Triage: A Pilot Project, Emilie Long

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this project was to implement an obstetric triage acuity scale in a labor and delivery setting and study the effect on nurse knowledge and timeliness of care.

Design: A quasi-experimental pre and post-test design was used for this pilot project.

Setting: This project was conducted in an obstetric triage unit located within a fourteen-bed labor and delivery unit in the Midwest.

Methods: This pilot project was conducted over a two-month time period. Fifteen registered nurses qualified to care for obstetric triage patients were given education on the chosen triage acuity scale. A pre-test was administered before …

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 …

Development Of A Muc16-Targeted Near-Infrared Antibody Probe For Fluorescence-Guided Surgery Of Pancreatic Cancer, Madeline T. Olson

Theses & Dissertations

Pancreatic cancer (PDAC) is an extremely lethal disease with an overall survival rate of 10%. Surgery remains the only potentially curative treatment option, but resections are complicated by infiltrative disease, proximity of critical vasculature, peritumoral inflammation, and dense stroma. Surgeons are limited to tactile and visual cues to differentiate cancerous tissue from normal tissue. Furthermore, translating preoperative images to the intraoperative setting poses additional challenges for tumor detection, and can result in undetected and unresected lesions. Thus, PDAC has high rates of incomplete resections, and subsequently, disease recurrence. Fluorescence-guided surgery (FGS) has emerged as a method to improve intraoperative detection …

Usp11 And Usp7 Deubiquitinases Regulate Sprtn Auto-Proteolysis And Sprtn-Mediated Dna-Protein Crosslink Repair, Megan C. Perry

Theses & Dissertations

DNA repair pathways that recognize and remove damaged DNA are vital for maintenance of genomic stability and prevention of tumorigenesis. Conversely, these pathways may be robust in tumor cells, thus diminishing the anti-cancer potential of available therapies. DNA-protein crosslinks (DPCs) are particularly deleterious DNA adducts that occur when proteins become irreversibly covalently bound to the DNA. DPCs represent a diverse group of lesions, as any protein can be crosslinked to the DNA duplex by non-specific crosslinking agents like reactive aldehydes and radiation. Additionally, functional DNA-binding proteins such as topoisomerases may become permanently crosslinked to DNA ends by abortive enzymatic processes …

The Rotator Cuff Tendon-To-Bone Interface: Maturation, Aging, And 3d Bioprinting For Regeneration, Xiping Jiang

Theses & Dissertations

Rotator cuff tendon injuries often occur at the tendon-to-bone interface (i.e., enthesis) area with a high prevalence for the elderly population. In addition, regeneration of the gradient structure of the enthesis is still a significant clinical challenge. Our studies aim to identify the histological, molecular, and biomechanical alterations of the rotator cuff enthesis with maturation and aging, and develop a novel therapeutic method using three-dimensional (3D) bioprinting technique to regenerate a functional enthesis. Striking variations of the entheses were observed both histologically and biomechanically during the maturation process. The histological features did not show many differences at the insertion site …

Approximate Likelihood Based Estimations For Joint Models With Intractable Likelihoods, Karl Stessy M. Bisselou

Theses & Dissertations

This dissertation focuses on the development of approximation approaches for the joint modeling (JM) of repeated measures data and time-to-event data in the presence of analytically or numerically intractable likelihoods. Current likelihood-based inferences for JMs show several limitations including (i) intractability of integrals during marginal likelihood derivations due to the complexity in computations, and (ii) the large number of nuisance parameters (unobserved) posing a problem with convergence. The h-likelihood (HL) and synthetic likelihood (SL) are two computationally efficient estimation approaches that overcome these challenges.

In the presence of extremely high censoring rates, the HL can produce bias parameter estimates. We …

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 …

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 …

Molecular Investigation Into The Biologic And Prognostic Elements Of Peripheral T-Cell Lymphoma With Regulators Of Tumor Microenvironment Signaling Explored In Model Systems, Tyler Herek

Theses & Dissertations

Peripheral T-cell lymphoma (PTCL) is heterogenous group of mature T-cell neoplasms characterized by distinctive transcriptional and genetic lesions. Herein, we investigated DNMT3A mutations in angioimmunoblastic T-cell lymphoma (AITL, n = 176) and novel molecular subtypes (i.e., PTCL-GATA3, n = 61 and PTCL-TBX21, n = 80) within PTCL- NOS and observed significant biological and prognostic differences associated with DNMT3A mutations. DNMT3A-mutated PTCL-TBX21 cases showed inferior overall survival (OS; p < 0.005), with DNMT3A mutations (DNMT3A-MT) skewed toward the methyltransferase domain and in the dimerization domain (S881-R887). Transcriptional profiling demonstrated significant enrichment of activated CD8⁺ T-cell cytotoxic gene signatures in the tumor microenvironment of DNMT3A-MT PTCL-TBX21 cases. Genome-wide methylation analysis of DNMT3A-R882/Q886 versus wild-type in PTCL-TBX21 cases demonstrated hypomethylation in target genes regulating T-cytotoxic genes, TCR …

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 …

A Pkcα-Mediated Growth Suppressive Mek-Erk Signaling Axis In Intestinal Epithelial Cells, Navneet Kaur

Theses & Dissertations

Members of the protein kinase C (PKC) family of serine/threonine kinases are involved in regulation of fundamental cellular functions, including proliferation, differentiation, survival, migration, and transformation. Increasing evidence points to anti-proliferative and tumor suppressive role of PKCs. Our laboratory and others have reported that the classical PKC isozyme, PKCαnegatively regulates proliferation and tumorigenesis in the intestinal epithelium. Our laboratory has further determined that PKCα signaling induces a program of cell cycle withdrawal in intestinal epithelial cells that involves downregulation of the pro-proliferative proteins, cyclin D1 and Id1, and upregulation of the cyclin dependent kinase (CDK) inhibitor, p21^Cip1. Unexpectedly, …

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, …