Medicine and Health Sciences Commons^™

Evaluating The Symptoms And Treatment-Related Knowledge Of Cancer Patients Receiving Chemotherapy In A Tertiary Care Hospital, Kiran Nawaz Ali

Theses & Dissertations

Background: Cancer has become the leading source of mortality and morbidity worldwide. Its prevalence is rising and high-risk behaviours are being adopted by the people in society. Knowledge about cancer and its management helps in adjusting the resource allocations and in terms of public health policy. Moreover, patient education about symptoms, treatment, and side effects is crucial and must be addressed.
Knowledge about cancer, its side effects, and the possible treatment outcomes is essential, as it helps in deciding about adherence to the treatment. It is observed that many oncology patients have information gaps related to cancer and chemotherapy. However, …

Assessing Medication Compliance And The Usage Of Complementary Therapies Effecting Hba1c Among Patients With Type 2 Diabetes Mellitus In A Tertiary Care Hospital In Karachi, Pakistan, Neelam Nasruddin

Theses & Dissertations

Background: Diabetes Mellitus is a chronic illness. It remains to be a major public health matter and a financial burden on the medical system worldwide. This condition can be managed and better treatment strategies and compliance can reduce the risk of complications. In 2022, there will be around 33,000,000 new cases of diabetes worldwide, with 26.7% of the adults in Pakistan being affected, predicts the (International Diabetes Federation, 2022). However, it is observed that most individuals turn to complementary and alternative methods (CAM)/Traditional medicine because of the rising cost of therapy, adverse effects of anti-diabetic medications, and accessibility concerns.
Purpose: …

Education For Primary Care Providers On Advance Care Planning: A Systematic Literature Review, Lindsey Ward

DNP Qualifying Manuscripts

Background: Healthcare providers in primary care treat patients at various stages of life. As patients age, it becomes necessary for providers to support their older patients throughout the aging process and address patient care even into life’s end stages. Primary care providers (PCPs) are well-positioned to provide this support and can do so through incorporating end-of-life (EOL) conversations in practice. Such discussions are called advance care planning (ACP). Though PCPs can play a crucial role in their patients’ EOL care decisions, providers report their limited knowledge of ACP as a barrier to its application.Consequently, further education for providers on utilizing …

Comparative Analysis Of Rectum Delineation: Inter-Observer Agreement Among Treatment Planners Versus Auto Segmentation In A Single Institution, Haley Douglas

Culminating Experience Projects

Abstract

Introduction

The past 20 years have seen a continuous rise in the cancer patient population, resulting in staffing shortages, longer wait times for patients, and potentially lower-quality care. Artificial intelligence has been incorporated into the healthcare system and has provided ease with understaffing. Using AI technology to delineate structures can reduce planning time and variation between planners. The objective of this research is to assess the level of consistency in the rectum boundary delineation performed by different dosimetrists working at a single institution, as compared to the performance of the AutoContour software. This analysis will help determine the efficacy …

The Impact Of An Educational Cooking Class On Inflammatory Potential Of Diet In Cancer Survivors, Mariah K. Jackson

Theses & Dissertations

Cancer survivors face long-term effects from cancer treatments, with cognitive dysfunction being an important, yet understudied, consequence of cancer treatment. Inflammation is a proposed mechanism for impaired cognition status. As research demonstrates diet is associated with both pro- and anti-inflammatory effects, diet may represent a novel strategy to mitigate cognitive decline in cancer survivors. The purpose of this study was to 1) quantify the impact of an educational cooking class on inflammatory potential of diet (measured by the Dietary Inflammatory Index (DII)) in cancer survivors and 2) determine the relationship between dietary changes and cognitive function in cancer survivors. Dietary …

Non-Clinical Perspectives On Sepsis: A Project For Enhanced Awareness, Anjali Kumari Singh

Master's Projects and Capstones

Problem: This project aimed to enhance non-clinical staff knowledge of sepsis through a targeted awareness campaign, while also seeking to uphold or enhance the organization's sepsis-related performance.

Context: Clinical Nurse Leader students conducted a microsystem assessment in five crucial non-clinical departments of an urban Bay Area hospital, each playing a vital role in the organization's efficiency at different levels.

Intervention: During Sepsis Awareness Month, a sepsis awareness campaign was implemented. This involved a concise presentation on sepsis, its consequences, and the significance of awareness in each department. Additionally, informational fliers detailing sepsis signs and symptoms were distributed.

Measures: A pre-and …

Decreasing Surgical Complications In Diabetic Patients, Bandana Mahato

DNP Qualifying Manuscripts

Executive Summary

Objective: This manuscript aims to determine if controlling diabetes prior to undergoing low back surgery could decrease complications and disability.

Contexts: Despite the overwhelming information on the complications of uncontrolled diabetes, patients continue to have elevated HgA1C before having surgery. Furthermore, there is a plethora of data showing uncontrolled diabetic patients will have higher complications after surgery, yet patients continue to have elective surgery despite having unchecked diabetes. There are no clear guidelines for primary care providers or surgeons on when they should allow patients to have elective surgery. Therefore, it is vital that HgA1c needs to be …

Perioperative Chest X-Ray Interpretation For Anesthesia Providers, Kaitlyn Brown, Jessica Parsons

Doctoral Projects

Currently, a knowledge gap exists among anesthesia providers regarding perioperative chest x-ray (CXR) appropriateness and interpretation (Collins, 2022). The Council on Accreditation (COA) requires that students graduating from a nurse anesthesia program (NAP) interpret a minimum of five CXRs before program completion (Council on Accreditation [COA], 2020). This DNP project aimed to address the knowledge gap by offering an easily accessible online forum that guides anesthesia providers on CXR indications in surgical patients, and in identifying pathologies and invasive line and tube placement using CXR.

The authors created four learning modules regarding perioperative CXRs using Microsoft PowerPoint presentations with animation …

Assessing Social Determinants Of Health In Primary Care, Vicki Carpenter

Doctoral Projects

The social determinants of health encompass the various circumstances and environments in which individuals reside, develop, labor, and experience aging (Social Determinants of Health, 2022). These variables significantly contribute to the existence of health inequities and disparities within populations. In order to effectively mitigate health disparities, it is imperative to consider the various determinants that influence health outcomes, as this consideration is crucial for advancing the goal of achieving health equity. This public health concern encompasses multiple sectors within our society, necessitating the collaboration of various organizations and communities to effectively address and mitigate its impact.

The fundamental …

A Quality Improvement Project On Blood Pressure Measurement: Are We Failing Our Patients?, Michael Baker

Doctoral Projects

Despite billions of dollars invested in research, education, and equipment, high blood pressure remains a significant contributor to mortality rates across the globe. According to the Centers for Disease Control (2019), hypertension was listed as a primary or contributing cause of over a half-million deaths in the United States (Centers for Disease Control [CDC], 2021). Without regard to race, gender, background, or socioeconomic level, this “silent killer” the Mississippi State Department of Health estimated that over 700,000 Mississippi adults were diagnosed with high blood pressure and thousands more at an increased risk each year (MSDH, 2019). Failure to identify and …

The Population-Centered Medical Model: A Theory Of Practice For Public Health And Preventive Medicine, Sudit Ranade

Electronic Thesis and Dissertation Repository

Introduction

Public health physicians occupy a unique place in the fields of both medicine and public health. Trained in each field, and often holding positions of authority in public health systems, public health physicians are sometimes challenged to identify their roles in either field of practice. Public health physicians work to achieve population health, but there has been limited theoretical development in this field of practice.

Objectives

The objective of this research was to develop an empirical theory of practice for public health physicians.

Methods

A literature review of current practice models applicable to public health physicians was performed. A …

Palliative Care Referral Protocol: Best Practice Toolkit For Improving Early Referral Rate For Adult Cancer Patients, Linda Dinh Nguyen

Student Scholarly Projects

Despite the benefits of palliative care being well-documented in studies and early palliative care services being strongly recommended by reputable organizations, such as the American Society of Clinical Oncology, many patients did not receive or received late referrals (Pigni et al., 2022). This mainly occurs because oncologists commonly base their referrals on perceived needs and clinical judgment (Smith et al., 2017). Thus, this program development project aimed to create a toolkit to improve early identification and referral to palliative care for adult patients who would benefit from palliative care services. The PICO question that guides this program is: In ambulatory …

Investigating The Microbiome Of The Eye And The Potential Of Probiotic Use In Optometry, Rachel Hartgerink

Theses/Capstones/Creative Projects

While the eye was once considered free of resident bacteria due to its efficient immunity mechanisms, recent studies have determined that most healthy eyes contain a variety of microbiota. Many studies have been aimed at classifying bacteria that are part of the core microbiome of the eye and the conditions under which they differ. As with gut health, a dysbiosis of ocular bacteria could correlate to disease, which presents the idea of treatment with probiotics to help regulate the microbiota of the eye. This study utilized growth assays to determine a common probiotic’s effect on bacteria that can be found …

Word Reading, Reading Comprehension, And Eye Movements During Reading In Chinese Persons With Aphasia, Xiaobin Wang

<strong> Theses and Dissertations </strong>

Individuals with aphasia (IWA) often exhibit challenges in single word reading as well as in reading comprehension. Recently, eye-tracking technology has become instrumental in delving deeper into reading behaviors. Specifically, it has illuminated the differences in word reading and comprehension abilities among aphasic English speakers. However, there is a noticeable scarcity of research focusing on these aspects among Chinese IWA. The current study aimed to contrast the abilities of Chinese IWA and neurotypical controls in reading single words, with an emphasis on types like regular, irregular, and pseudowords, and reading comprehension abilities. Further, this study investigated the patterns of eye …

A Cross-Sectional Analysis Of Adverse Childhood Experience Exposure On Cancer Diagnosis Utilizing The 2022 Behavioral Risk Factor Surveillance Survey Data, Emma Zipperer

Capstone Experience

Objective: To determine the association between Adverse Childhood Experiences (ACEs) and cancer diagnosis based on ACE exposure levels.

Methods: We utilized data collected in the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey. The study population (n=54,148) was restricted to states that reported on the optional model of experiencing ACEs and those who responded about cancer diagnosis. A univariate analysis, bivariate analysis and a multivariate logistic regression were performed. Odds of cancer diagnosis among those with differing ACE exposure levels were calculated.

Results: High ACE exposure had 20% higher odds of cancer diagnosis when compared to low ACE exposure. White, …

Implementing Community Health Workers To Improve The Management Of Chronic Non-Communicable Diseases In Children, Julia L. Newell

Doctor of Nursing Practice (DNP) Projects

Background: Childhood obesity, asthma, and untreated mental health conditions are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Minority children from low-income families, especially those with environmental disadvantages, face additional risk factors for the development of these diseases. Community health workers (CHWs) are in a unique position to help address these negative health externalities by being attuned with the linguistic, cultural, and socioemotional needs of members of their communities. Research has demonstrated success in CHW-led interventions curtailing the negative impacts associated with these diseases in low-income, minority communities.

Methods: A literature …

Transportation Needs Of Older Adults In Suburban And Rural Areas, Dahai Han

Theses and Dissertations

The fact that the average age of the world's population is increasing, which is more pronounced in developed countries, necessitates the understanding of the challenges faced by older adults in accessing transportation services. With advancing age, individuals may experience age-related changes that can notably affect their driving capabilities, emphasizing the importance of alternative transportation alternatives. This challenge is more evident in suburban and rural settings, where transportation choices are limited, and older adults often find themselves without access to suitable transportation alternatives. Given that mobility plays an essential role in maintaining social connections, accessing healthcare services, and fulfilling daily needs, …

Assessing Virtual Versus In-Person Experiential Learning And Medical High-Fidelity Simulation In Medical Student Pediatric Clerkship Training, Andrew Mitchell Berry

Electronic Theses and Dissertations

Simulation and experiential training have been incorporated into medical school training for decades. The utilization of medical simulations has become an invaluable tool in healthcare education and training. However, circumstances such as limited resources, geographical constraints, or global health crises may hinder the feasibility of conducting in-person medical simulations. In these scenarios, virtual medical simulations emerge as a compelling alternative. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience.

As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, the research …

Nurse Initiated Standing Orders: A Process Improvement At An Emergency Department In Interior Alaska, Justin D. Melberg

Capstone Experience

Emergency Departments (EDs) are a valuable and limited public health resource. In addition to treating acute medical emergencies, EDs bridge the gaps in urgent care and primary care accessibility, operating twenty-four hours a day, seven days a week, providing care regardless of an individual’s ability to pay. EDs across the country operate at or above capacity regularly, and overcrowding is projected to increase due to decreased facilities and available inpatient beds. Innovative measures are necessary to increase patient throughput and decrease length of stay while maintaining quality care. Nurse initiated standing orders, also known as nurse driven protocols, standing orders, …

Development Of A Remote Dosimetric Audit Framework For Carbon Therapy, Paige Taylor

Dissertations & Theses (Open Access)

Carbon ion therapy is available at over a dozen institutions around the world and is being employed for treatment of cancer. The increased biological effect of carbon compared to conventional photon-based radiotherapy holds promise for the therapeutic benefit in historically radioresistant tumors. While ion chamber dosimetry has been used for day-to-day clinical measurements of absorbed dose, there are few options for remote dosimetry. The availability of such tools would support the development of a robust remote audit program for carbon ion therapy.

The Imaging and Radiation Oncology Core (IROC) conducts remote audits of photon and proton therapy. These audits are …

Certified Midwives: An Exploration Of Their Impact On Maternal Health Outcomes – A Comprehensive Literature Review, Heather Hollister

Capstone Experience

Maternal health outcomes in the United States have been consistently worse than other high-income countries, with a disproportionate impact on women of color. Midwives have long played an important role in maternal health worldwide. The literature review examines the evidence for midwives as key contributors to improving maternal health outcomes. The paper reviews the existing literature on midwifery, including the impact on maternal health, labor and delivery outcomes, and patient satisfaction. Electronic searches were conducted through Cochrane Library, CINAHL, Medline and Embase. Articles were screened according to inclusion and exclusion criteria including that they must be a randomized study; participants …

Evaluation Of The Efficacy Of Synthetic Glycovaccines Against Both Murine Acute Chagas Disease And Cutaneous Leishmaniasis, Colin D. Knight

Open Access Theses & Dissertations

Chagas disease (CD) and cutaneous leishmaniasis (CL) are neglected tropical diseases caused by the protozoan trypanosomatids, Trypanosoma cruzi and Leishmania spp., respectively. There are approximately 6-8 million people infected with T. cruzi worldwide and ~300,000 people in the US. Between 700,000 and 1.2 million new cases of CL occur worldwide yearly. The approved chemotherapies for both diseases are partially effective and may cause serious adverse events, resulting in premature treatment interruption. Moreover, no effective vaccine for either disease is available. Therefore, developing a vaccine that would provide effective cross-protection against both diseases would provide a cost-effective alternative to the existing …

Improving Screening Mammography Recommendation And Referral In Primary Care Through Implementation Of A Provider Prompt, Christon Elfring

Doctoral Projects

In the United States, breast cancer has been established as the second most prevalent cancer among women (Centers for Disease Control [CDC], 2022a). There may be no symptoms present in the early stages of breast cancer and a low potential to spread during the early phases (World Health Organization [WHO], 2021). Mammography is the only test that has been shown to reduce deaths from breast cancer as it allows for early detection when cancer is in its most treatable stage improving survival and lessening the need for extensive treatment (American College of Radiology [ACR], n.d.). While the effectiveness of screening …

Exploration Of The Implementation Of An Integrated Electronic Laboratory Information Management System On Quality Diagnostics Service Indicators At A County Level Public Hospital In Western Kenya., Kelly Allen

Capstone Collection

Underinvestment in pathology and laboratory capacity caused by low visibility in research and in prioritization by public health leaders results in limited effective healthcare coverage and an estimated 1.1 million premature deaths annually in Low-and-Middle-Income Countries. Kenya’s public health laboratories provide a median 41% of the Essential Diagnostic List to their patients and in Kisumu County, as much as 44.2% of the population has little to no access to essential diagnostics. The government of Kisumu implemented the county Health Laboratory Strategic Plan 2018-2022 to address this public health challenge. Little information exists on the effectiveness of these initiatives and the …

Clinical Practice Implementation To Address Ascvd Risk: A Practice Change In Primary Care, Elizabeth Wooten

Student Scholarly Projects

Practice Problem: Heart disease stands as the leading cause of mortality in the United States. While healthcare providers strive to identify and optimize prevention strategies, particularly in high-risk patient populations, notable gaps in care persist, notably in the management of modifiable risk factors such as low-density lipoprotein cholesterol (LDL). By harnessing the power of artificial intelligence (AI) integrated software within clinical settings, we can revolutionize the landscape of this devastating chronic disease.

PICOT: The PICOT question that guided this project was: In Primary Care Advanced Practice Providers (APP) caring for high-risk and/or very high-risk patients with atherosclerotic cardiovascular disease (ASCVD) …

Pharmacogenomic Precision Medicine: Best Practice Toolkit For Improving Patient Screening For Adult Metastatic Cancer Patients, Rena L. Stewart

Student Scholarly Projects

Precision medicine utilizes pharmacogenomic testing as a therapeutic approach. Genomic testing can assess the impact of an individual's genome on their reaction to specific medications. The main objective is to find variants that may affect an individual's response to a given medication. The implementation of pharmacogenomics in oncology facilitates informed decision-making by clinicians in drug selection and dosage determination.

Using Simulation To Assess Knowledge And Attitude Amongst Healthcare Provider Regarding Cardiopulmonary Resuscitation At A Tertiary Care Hospital In Karachi, Pakistan- A Pre And Post Test Qausi Experimental Study, Nausheen Barkat Ali Noorani

Theses & Dissertations

No abstract provided.

The Significance Of Injuries And Anatomical Patterns Of Trauma In Pedestrian And Cyclist Fatalities And Their Association With Motor Vehicle Collision Dynamics And Post-Collision Kinematics, Moheem M. Halari

Electronic Thesis and Dissertation Repository

Deaths from motor vehicle collisions (MVCs) are a major global health concern, with over 1.35 million fatalities reported annually by the United Nations. More than half involve pedestrians, cyclists, and motorcyclists. Post-mortem examinations by pathologists determine the cause of death and mechanisms of injury and play a significant role in the investigation of the deaths of vulnerable road users.

The purpose of this study was to understand the injury patterns sustained by pedestrians and cyclists fatally injured in motor vehicle impacts.

This study reviews the development of injury patterns described in the medical literature and identifies their limitations in the …

Dietary Analysis For Hashimoto’S Thyroiditis: An Integrative Review, Evan Thompson, Alison Hultquist

Master of Science in Nursing Final Projects

Abstract

Hashimoto’s Thyroiditis (HT) is the leading cause of primary hypothyroidism in the United States. In HT, there is an infiltration by lymphocytes which leads to the production of autoantibodies against the thyroid gland. Throughout this integrative review, the aim was to evaluate the effectiveness of micronutrient supplementation and dietary management as adjunct treatments in HT. The purpose was to assist primary care providers in the development of a more holistic plan of care. Literature published within the past seven years was gathered and reviewed from PubMed, CINAHL, and Cochrane Library. Findings indicate that many patients with HT may benefit …

Barriers To Early Detection In Women Experiencing A Postpartum Hemorrhage: An Integrative Review, Katie Ragsdale

Master of Science in Nursing Final Projects

Abstract

Aim: The aim of this integrative review is to explore barriers to early detection in women experiencing postpartum hemorrhage.

Background: Women in the United States are more likely to die from childbirth complications than any other women living in other developed countries. Despite advances in maternity care, postpartum hemorrhage is the cause of nearly 70,000 maternal deaths every year, comparable to one woman dying of postpartum hemorrhage blood loss every eight minutes. Most maternal deaths are avoidable, as the solutions to prevent and manage these deadly complications are well known. Risk factors, assessment tools, causes, interventions, and outcomes are …