Medicine and Health Sciences Commons^™

Trust In The Nurse And Perceived Quality Nursing Care By Adult Oncology Patients With Implantable Vascular Access Port Devices: A Mixed Methods Study, Lois Rajcan

Electronic Theses and Dissertations

Objective: The purpose of this study was to obtain an understanding of nurse behaviors that promote trust and quality nursing care as perceived by oncology patients with totally implantable vascular access devices (TIVAD).

Methods: An explanatory sequential mixed-method design was used to answer the study questions. This design was comprised of two phases: 1) a quantitative online survey of oncology patients with TIVADs followed by; 2) qualitative interviews using purposively selected patients from the survey sample.

Results: Trust in the nurse and perceived quality of nursing care by patients with TIVADs were determined to be of average levels. Two qualitative …

Pharmacological Characterization Of Novel Serotonin Transporter Inhibitors Identified Through Computational Structure-Based Virtual Screening, Michael Wasko

Electronic Theses and Dissertations

Depression is a mental health disorder affecting greater than 350 million people worldwide with roughly 7% of the United States population diagnosed as of 2017. The selective serotonin reuptake inhibitors (SSRIs) have been the mainstay of pharmacotherapies for depression for the last 40 years. The SSRIs target the serotonin transporter (SERT), a monoamine transporter (MAT) responsible for terminating serotonergic neurotransmission. The SSRIs are not perfect therapeutics and suffer from delayed response times, inconsistent efficacy among patients, and often produce intolerable side effects. Therefore, a strong need exists to develop new antidepressants that are more efficacious and have fewer adverse effects. …

The Ethical Accountability Of Organizational Leadership To Communities Of Stakeholders In Healthcare, Lisa Martinelli

Electronic Theses and Dissertations

ABSTRACT

THE ETHICAL ACCOUNTABILITY OF ORGANIZATIONAL LEADERSHIP TO COMMUNITIES OF STAKEHOLDERS IN HEALTHCARE

By

Lisa A. Martinelli, JD, MA

October 2020

Dissertation supervised by Professor Gerard Magill

While much is written on organizational ethics in healthcare, this dissertation uniquely links organizational ethics and stakeholder theory to the ethical accountability of leadership to their distinct, vulnerable stakeholder communities. It does so by examining the healthcare organization’s moral agency in relation to stakeholder theory and applies those considerations to three major stakeholder categories: confidentiality and privacy of healthcare information, research and attention to specific pediatric populations, and ethics of care concerning the …

Examining The Intersectionality Of Religious Faith, Spirituality, And Healthcare Communication, Felix Okeke

Electronic Theses and Dissertations

This dissertation is my own contribution in responding to the concern raised by certain communication scholars. Their concern was that little research and few publications have been done in the communication field by communication scholars that trace the relationship among religious faith, spirituality, and healthcare communication. While Parrott (2004) describes this apparent neglect as “collective amnesia,” others label it “religion blindness.” Thus, in trying to trace this relationship, this project uses Christian, biblical, and bioethics backgrounds to establish the value, sacredness, and dignity of human life, since these concepts make healthcare and healthcare communication necessary in the first place. These …

Retrospective Cohort Study Of Patients With Chronic Low Back Pain In An Outpatient Pain Specialist Clinic, Gauri Desai

Electronic Theses and Dissertations

Background: Chronic low back pain (LBP) is a back pain that lasts for three or more than three months in the lumbar region of the spinal cord. A nerve injury or damage in the spinal cord region (neuropathic pain) requires multimodal treatment approach for pain reduction. With various treatment options utilized in the pain management of these patients, identifying demographical and clinical characteristics of patients with chronic LBP utilizing interventional procedures and pharmacologic treatments is imperative.

Objective: (i) To describe the demographics (age, gender, race, ethnicity, smoking status, alcohol consumption status, drug use status) and clinical characteristics (procedures, medications) …

Design And Synthesis Of Pyrimidine Based Fused Heterocyclics In The Potential Treatment Of Cancer And Opportunistic Infection, Farhana Islam

Electronic Theses and Dissertations

Dose-limiting toxicities of clinically used agents and development of resistance are two significant limitations in cancer chemotherapy. Microtubule targeting agents (MTAs) are a structurally diverse set of compounds that disrupt microtubule dynamics and exert their anticancer effect. Combination chemotherapy with antiangiogenic agents and microtubule targeting agents has shown an advantage against both these drawbacks. Single agents with dual antiangiogenic activity and cytotoxicity would afford a therapy that circumvents pharmacokinetic problems of multiple agents, avoid drug-drug interactions, lower the drug dose, decrease overlapping toxicities, and delay or prevent tumor cell resistance. The work in this dissertation reflects the progress of fused …

The Ethical Challenge For Hipaa’S Privacy Rule In The Genomics Era Of Data Analytics., Reem Shinawi

Electronic Theses and Dissertations

The thesis of this dissertation focuses on the Ethical Challenge for HIPAA’s Privacy Rule in the Genomics Era of Data Analytics. Data Analytics in Genomic Medicine challenges the individuals’ right to privacy. Hence, a balance is needed between the previous centrality of individual privacy and the need for population information to make breakthroughs in Genomic Medicine using Data Analytics. Such a problem demands regulatory solutions. And such solutions require the collaboration of professionals. Genomic Medicine is a field that deals with sensitive genetic information in both medicine, and research, it is essential to view it through HIPAA as it is …

The Contribution Of A Global Ethics Approach To Health And The Environment In The Niger Delta Region, Augustine Wayii

Electronic Theses and Dissertations

ABSTRACT

THE CONTRIBUTION OF A GLOBAL ETHICS APPROACH TO HEALTH AND THE

ENVIRONMENT IN THE NIGER DELTA REGION

By

Augustine Lezorgia Wayii, M. ED, M.A.

May 2020

Dissertation supervised by Gerard Magill, PhD

The dissertation presents a global ethics approach that connects health and the environment in the context of the Niger Delta Region. The people of the Niger Delta region in Nigeria are experiencing major catastrophes that connect health and the environment. In the bid to ameliorate these pivotal problems, this dissertation undertakes an ethical analysis that connects health and the environment. Insofar as these problems can be characteristic …

Epidemics, Politics And Public Health: Ludwig Rajchman, Md, The League Of Nations Health Organization And The Creation Of A Transnational Health Institution, Paul J. Weinbaum

Electronic Theses and Dissertations

Traditional scholarship on the League of Nations labels the organization as a failure because it did not prevent the outbreak of the World War II. Recent research examines League activities in a more comprehensive manner and concludes that the organization should be credited with important and enduring achievements. Perhaps the most successful work was carried out by the Health Section led by Dr. Ludwick Rajchman. Using primary sources from the League archives in Geneva, documents from organizations such as the Rockefeller Foundation, articles from medical journals and other relevant secondary sources, I argue that the Health Section, became the world’s …

The Impact Of A Digital Intervention On Perceived Stress, Resiliency, Social Support, And Intention To Leave Among Newly Licensed Nurses: A Randomized Controlled Trial, Lisa Concilio

Electronic Theses and Dissertations

The nursing shortage has been deemed a public health crisis with the turnover rate of newly licensed nurses (NLNs) growing (Robert Wood Johnson Foundation, 2014). One out of five NLNs are leaving the profession due to work dissatisfaction and feelings of inadequacy (National Academy of Medicine, 2017). NLN attrition during the first year of hire has been associated with feelings of overwhelming stress and decreased sense of support which negatively impact patient safety (Spence Laschinger et al., 2016). As seasoned nurses are attempting to retire amidst a nursing shortage (American Association of Colleges of Nursing, 2018), NLNs require more support …

Aphasia Friendly Medication Instructions: Effects On Comprehension In Persons With And Without Aphasia, Anna Saylor

Electronic Theses and Dissertations

Accessible health information supports people to understand and manage chronic medical conditions and is frequently presented via text. Comprehension of written health information becomes more difficult for people with language impairments, such as aphasia. Nine people with aphasia (PWA) and nine people without aphasia (PWoA), participated in this study. Each participant reviewed two unmodified medication instructions and two modified medication instructions using aphasia-friendly principles, then answered eight multiple choice questions and provided their preferences. Results showed that PWA demonstrated improved comprehension given modifications, but PWoA’s comprehension did not improve with modifications. Group comparison in the modified condition demonstrated that PWoA …

From Case Study As Symptom To Case Study As Sinthome: Engaging Lacan And Irigaray On "Thinking In Cases" As Psychoanalytic Pedagogy, Erica Freeman

Electronic Theses and Dissertations

This dissertation accomplishes two goals. First, this dissertation articulates a Lacanian account of the epistemological and historical presuppositions of the psychoanalytic case study genre, while engaging reflexively with extant Foucauldian scholarship on this genre as well as feminist psychoanalyst Luce Irigaray’s criticisms of Lacan. Irigaray’s critique is engaged in order to tarry with its implications for a Lacanian approach to the psychoanalytic case study genre. Second, this dissertation critically examines the significance of Lacan’s (re)reading, in Seminar V, of Joan Riviere’s (1929) “Womanliness as Masquerade” in the midst of his oral teachings on the psychoanalytic concepts of castration and …

A Bioethical Paradigm For Enhanced, Post Or Transhumans In Medicine And Biological Research, Roderick Williams

Electronic Theses and Dissertations

In this dissertation the question addressed is the ethical protocol that should be used when enhanced, post or transhumans present themselves as patients to hospitals, or as subjects for scientific research. With the advent of the birth of four children who were genetically engineered in China to be resistant to HIV, I contend that transhumans are already here, and the prevailing Western paradigm of principlism, while good, is not adequate to the task. I explore the basic religious argument that can be used against or in favor of what I call human-directed human evolution. I show how the fears of …

Without Words: Relational Neuropsychology And Creative Arts Therapies With People Managing Aphasia, Autumn Marie Chilcote

Electronic Theses and Dissertations

Aphasia describes the broad experience of disrupted language production or comprehension acquired after structural changes in the brain. These changes, usually associated with stroke, tumor, or cortical degeneration, are often co-occurring with other symptoms, such as emotional dysregulation, partial paralysis, and difficult social, occupational, and community relationships. Common approaches to research and rehabilitation with persons managing aphasia highlight conversation and semantic retrieval, with a lack in literature considering the diversity of symptoms and responses. Questions arise as to the ways that psychotherapies, typically language- centered, can be adapted to collaborative, low-verbal approaches that attend to the range of individual symptoms …

Cystic Fibrosis Transmembrane Conductance Regulator Modulator Therapies In Cystic Fibrosis: A Retrospective Evaluation Of A Nationwide Specialty Pharmacy Database, Zumi Mehta

Electronic Theses and Dissertations

Background: Cystic fibrosis (CF) is a progressive, genetic disorder caused by a mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Patients with CF experience excessive mucus build up and infections leading to complications in the pancreas, lungs, and other organs. There has been a paradigm shift in the treatment of CF with the introduction of CFTR modulator therapies and given their high acquisition cost, assessing their economic burden along with the adherence rate of patients is imperative. Objective: (i) To assess the utilization of CFTR modulator therapies in a specialty pharmacy CF patient population and (ii) to calculate …

Risk Factors Associated With Pressure Injury In Pediatric Congenital Heart Disease Patients, Ashlee Shields

Electronic Theses and Dissertations

Pediatric congenital heart disease (CHD) patients have unique risk factors associated with the pathophysiology of abnormal heart function. This vulnerable population is likely at an increased risk of acquiring a pressure injury during hospitalization. There are limited studies that include congenital heart disease patients and more specifically, factors unique to these patients. The purpose of this study was to identify risk factors associated with development of pressure injury in pediatric CHD patients. This retrospective study used a convenience sample from hospital-acquired data including subjects with congenital heart disease. The results demonstrated an association between pressure injury development and variables both …

Caring For Victims Of Child Maltreatment: Pediatric Nurses’ Moral Distress And Burnout, Angela Karakachian

Electronic Theses and Dissertations

Background: Moral distress is a significant concern for nurses as it can lead to burnout and intentions to leaving the profession. Pediatric nurses encounter stressful and ethically challenging situations when they care for victims of suspected child maltreatment. Data on pediatric nurses’ moral distress in this situation are lacking, as most research in this field has been done in adult inpatient and intensive care units.

Aims: The purpose of this study was to describe pediatric nurses’ moral distress and determine the impact of caring for victims of suspected child maltreatment on nurses’ moral distress, burnout, and intention to leave.

Design …

British Eugenics Failure And Success, Angela Gallagher

Electronic Theses and Dissertations

The historical narrative of eugenics often focuses on those eugenic societies and movements that ‘succeeded’ in part or in full in achieving a eugenic society. Less studied are those societies that failed, whether due to social backlash or internal incoherence. The British Eugenic Educational Society as the foundational point of eugenics, has therefore been overlooked as a result of it’s perceived lack of contribution to eugenic thought and its failure to pass eugenic legislation. Founded by Francis Galton, the originator of the philosophy of eugenics, the British Eugenic Educational Society should have been successful given it’s reputation and the numerous …

Pilot Study Exploring The Effect Of Targeted Cox-2 Inhibition In Macrophages Responding To Neuronal Injury; Promoting Enhanced Axonal Regeneration, Alyssa Brauckmann

Electronic Theses and Dissertations

Celecoxib nanoemulsion (CXB-NE) has been developed as a macrophage targeted analgesics by Dr. Janjic and her team at Duquesne University, (Janjic et al, 2018; Liu et al, 2020; Saleem et al, 2019b; Vasudeva et al, 2014). The CXB-NE nanoemulsion carrying a Nonsteroidal Anti-inflammatory (NSAID) inhibitor of COX-2 activity result in a reduction in PGE2 expression in macrophages. Using CXB-NE in rats that have peripheral nerve injury constricting the sciatic nerve relieves hypersensitivity, a pain-like behavior. The treatment also decreases inflammation associated with this chronic constriction injury (Janjic et al, 2018; Saleem et al, 2019b; Stevens et al, 2019). In this …

Gene Delivery To The Blood-Brain Barrier For Ischemic Stroke Therapy, Wanzhu Zhao

Electronic Theses and Dissertations

Stroke is a major cause of death in the United States. We aim to develop safe and efficient approaches for the treatment of stroke. Regenerative therapies have been identified as the major need for curing stroke [1]. We explored two different carriers (poly (ethylene glycol)_5k-poly (L-aspartate-diethylenetriamine)₄₈ (PEG-DET) / Pluronic P84 (P84) and exosomes (EXOs) / microvesicles (MVs)) to deliver brain-derived neurotrophic factor (BDNF) plasmid DNA (pDNA), a functional gene encoding a neurotrophin. In the first project, our data showed that DNA nanoparticles (NPs) with 0.03% P84 was a promising formulation to deliver Luciferase pDNA into immortalized human …

Coping Behaviors Of African Americans With Inflammatory Bowel Disease: A Focused Ethnography, Patricia Scott

Electronic Theses and Dissertations

Background: Increasing numbers of African Americans are being diagnosed with inflammatory bowel disease (IBD) in the United States (Dahlhamer, Zammitti, Ward, Wheaton, & Croft, 2016). Little is known about the influence of culture on coping with the disease. Method: Twelve African American adults with IBD were interviewed and observed using a focused ethnography. Results: Data analysis resulted in four major themes: (1) spending time living in the bathroom; (2) time and food restricted eating practices and cultural food avoidance; (3) dealing with a life full of stress; and (4) the practice of seclusion to promote health. Discussion: Participants described coping …

Exploring The Relationship Between Dietary Self-Monitoring With A Mobile App And Weight Change, Jason Payne

Electronic Theses and Dissertations

Background: Approximately 70% of the adult population in the United States has overweight or obesity and increased risk for developing chronic diseases. Dietary self-monitoring adherence using a paper diary is associated with weight loss; however, few studies have examined this association with dietary self-monitoring apps. Objectives: 1) explore if an association exists between app-based dietary self-monitoring and weight change among adults with overweight or obesity and 2) explore the relationships between the frequency, consistency, and completeness of self-monitoring and weight change. Methods: Participants self-monitored dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned …

Quality In All Levels: A Model Defining And Measuring Quality In Bioethics Education, Ercan Avci

Electronic Theses and Dissertations

Due to the lack of academic studies in the quality assessment of bioethics education, this dissertation aimed to propose a normative model, Quality in All Levels (QAL), to define and measure quality in bioethics education. The QAL model described quality in bioethics education as conformance to the goals and determined these goals as (1) increasing ethical knowledge, (2) improving ethical skills to strengthen ethical sensitivity, awareness, and judgment, (3) developing ethicalbehavior, and (4) promoting cultural competence. The dissertation utilized Avedis Donabedian’s three approaches: structure, process, and outcome to formulate quality standards and indicators in bioethics education. In respect of …