Medicine and Health Sciences Commons^™

Applying Data Science And Machine Learning To Understand Health Care Transition For Adolescents And Emerging Adults With Special Health Care Needs, Lisamarie Turk

Nursing ETDs

A problem of classification places adolescents and emerging adults with special health care needs among the most at risk for poor or life-threatening health outcomes. This preliminary proof-of-concept study was conducted to determine if phenotypes of health care transition (HCT) for this vulnerable population could be established. Such phenotypes could support development of future studies that require data classifications as input. Mining of electronic health record data and cluster analysis were implemented to identify phenotypes. Subsequently, a machine learning concept model was developed for predicting acute care and medical condition severity. Three clusters were identified and described (Cluster 1, n …

Twitter Sentiment Analysis: Applications In Healthcare And Finance, Jiali Wang

Dissertations

This research explores the influence of Twitter sentiment on healthcare and finance industries. It assesses how Twitter sentiment and culture measure influence COVID-19 statistics, and it investigates the impact of Twitter sentiment on S&P 1500 stock mispricing. Furthermore, it examines how tweet sentiment predicts major industry returns.

The first part examines how Hofstede’s Culture Dimensions (HCD) and Twitter economic uncertainty index (TEU) relate to COVID-19 infection rate and death rate. The results show certain aspects in HCD, such as power distance index (PDI) and masculinity (MAS) both are negatively and significantly associated with the infection rate, while indulgence (IVR) and …

Host-Pathogen Interactions In A Changing World: Microbes, Mucosal Defenses, And Multiple Hosts, Brandon C. Labumbard

Graduate Doctoral Dissertations

As fungal diseases continue to emerge, research increasingly focuses on host-microbiome interactions and links to disease. Certain skin-associated microbes may benefit hosts by protecting them from invading pathogens. Seasonal changes in the host environment can also result in shifts in the microbial community and pathogen virulence – potentially influencing disease dynamics. I investigated how cutaneous microbial communities differ across hosts, seasons, and Batrachochytrium dendrobatidis (Bd) infection status by sequencing the microbial communities of 1,100 leopard frogs at five locations across the US. Percent anti-Bd function varied seasonally and with Bd infection status. Bacterial communities also varied across locations and time. …

Neighborhood And Environmental Predictors Of At-Risk And Problem Gambling In Massachusetts, Kendra E. Pugh

Graduate Doctoral Dissertations

Despite the widespread impact and negative effects of problem gambling (PG), limited attention has been paid to the environment where PG occurs. This study investigated the relationship between gambling on lottery and the zip code where gambling occurs, as well as the influence of individual-level characteristics that predict at-risk or problem gambling (AR/PG), among Massachusetts residents. A GIS analysis was conducted to identify vulnerable areas based on neighborhood characteristics, lottery sales, and AR/PG. Overall, residents of disadvantaged areas did not spend more money on lottery or have more lottery agents than residents of less disadvantaged areas. Some indicators of disadvantage …

Student Perception On Acceptability And Usefulness Of Sit-Stand Desks In College Classrooms, Abiola Kuilan

Theses

Sedentariness has been proved to be a major cause of various health concerns. Given that a full-time college student in the US spends more than 15 hours per week sitting in a college classroom, it may be an ideal setting for implementation of Sit-Stand Desk (SSD) to reduce college students’ sedentary time. Graduate and undergraduate students (N = 178) of NJIT were randomly recruited to complete a need based online assessment survey. Participants' mean (SD) age was 22.4(4.7) years old, 63% identified as male, 33% identified as female while 4% were of the other gender class. Among the participants, 44.3% …

Implementation Of A Community Health Worker (Chw) Training Program To Improve Birth Outcomes, Emiko Maruri, Trinette Radasa, Jo Loomis

DNP Qualifying Manuscripts

Background

Those who have ever been affected by an adverse childhood experience (ACE) have a greater likelihood of having poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss.

Problem

Latina women have been identified by the Centers for Disease Control (CDC) as those most affected by ACEs. The direct relationship is that Latinas therefore have poor birth outcomes.

Context

For this project, The Save the Children organization in partnership with the University of San Francisco Doctorate of Nursing Practice students and Community Health Workers (CHWs) of the Central Valley of California …

Characterizing The Function Of B Cells That Accumulate In The Inflamed Central Nervous System In Anti-Myelin Autoimmunity, Lika Chowdhury

Electronic Thesis and Dissertation Repository

While the role of autoimmune T cells has been extensively studied in anti-myelin

autoimmunity, little is known about the function of B cells in multiple sclerosis (MS), a chronic inflammatory disease of the central nervous system (CNS). B cells form clusters with T cells in the meninges directly adjacent to demyelinating lesions. Previous studies have shown that disease progression is dependent on the depletion of specific populations of B cells, but it is not clear which contributes to pathology or how. The purpose of this thesis is to characterize the population of meningeal B cells to determine how they differ …

Rapid Rhino Vs. Merocel: A Retrospective Analysis Of Patients With Anterior Epistaxis Visiting Emergency Rooms In London, Ontario, Dhatri Shukla

Electronic Thesis and Dissertation Repository

When patients present to an emergency room (ER) with a nosebleed, one technique that physicians employ is the application of nasal packing. Merocel is a common nasal pack utilized in ER because of their low cost. Rapid Rhino is a nasal packing that is more comfortable for patients but is more costly than Merocel. Costing for epistaxis treatment is more than initial treatment costs and needs to consider rebleed rates. Using a retrospective cohort study design with covariates adjusted by propensity scores, we compared the costs associated with Merocel, and Rapid Rhino from the hospital and provincial healthcare perspectives. Merocel …

S100a7 As A Biomarker For Predicting Transformation In A Potentially Malignant Lesion: Lichen Planus., Jeff J. Lovell

Electronic Thesis and Dissertation Repository

Oral Lichen Planus (OLP) is a potentially malignant disorder that has a malignant transformation rate of approximately 1%. Current management includes incisional biopsy and grading of dysplasia, if present. This may not be a reliable predictive tool for malignant transformation. Tissue biomarkers such as S100A7 may provide a more accurate method of risk determination. The proposed mechanism is an association between S100A7 and the MAPK signalling pathway. Paraffin embedded sections of OLP that progressed and did not progress on serial biopsy were selected. The tissues were stained via S100A7 immunohistochemistry. S100A7 was quantified using an Immunoreactivity score, QuPath and StraticyteÔ. …

Communication Disorders And Mental Health: A Scoping Review, Haven B. Schultze

Honors Thesis

This scoping review examined current research investigating the relationship between communication disorders and mental health disorders. Depression and anxiety disorders were correlated with communication disorders, but this relationship is complex. Next, potential interventions and clinical implications are discussed. The literature suggests that Speech-Language Pathologists and mental health professionals are most effective when working collaboratively to meet the needs of the whole child.

Mental Health Services: Improving Utilization In Homeless Populations, Gurdeep Mann

DNP Qualifying Manuscripts

Emergency shelters provide a unique location to offer easily accessible services for unhoused individuals experiencing mental distress and serious mental illness. Housing First interventions do not improve mental health or social integration. It is important to consider alternative approaches to providing care for homeless individuals. This integrated review was undertaken to evaluate existing evidence of interventions that improve mental health awareness and utilization of mental health services among unhoused populations living in shelters. Assertive outreach is an important strategy that was shown to improve effectiveness of mental health programs in shelters; reconnect individuals with family; and help with psychological integration. …

Registered Nurse-Led Annual Wellness Visits In Rural Health Clinics: A Program Evaluation Of A New Role, Tina Switzer

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

The passage of the Patient Portability and Affordable Care Act had a goal of increasing access for preventive care. The Medicare Annual Wellness Visit (AWV) has been a free yearly, comprehensive preventive care opportunity for most Medicare beneficiaries since 2011. Because of the time intensive nature of these visits, the overall national completion rate for them has been low as providers often perceive time and resource constraints. Registered Nurses (RNs) have the skill set to complete these visits with minimal provider involvement. Rural residents often face health care access barriers and outcome disparities, and Rural Health Clinics (RHCs) are a …

Improving Glycemic Control During The Covid-19 Pandemic: A Quality Improvement Project, Megan Henderson

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

Diabetes is a costly, chronic health condition. The COVID-19 pandemic has significantly impacted the delivery of health care and exacerbated chronic health conditions, such as diabetes. Diabetes is one of the most significant comorbid conditions associated with poor COVID-19 outcomes (Cariou et al., 2020). Control of blood glucose levels during the COVID-19 pandemic has proved challenging to maintain. The purpose of this quality improvement project is to identify gaps in diabetic self-care and then implement a diabetic toolkit to improve self-efficacy of diabetes self-management. According to the American Diabetes Association (2022), self-management of diabetes, education, and support from providers is …

Developing A Quality Improvement Process: Impacting Patient Outcomes And Achieving Ambulatory Accreditation, Colleen E. Nappi

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

Colon cancer is the second leading cause of cancer deaths in the United States (US) and colonoscopy is the best method for screening and detecting cancer before symptoms are present. A colonoscopies' ability to detect precancerous lesions or identify colorectal cancer (CRC) relies on patients having a high-quality bowel preparation. The US Multi Society Task Force (USMSTF) on colorectal cancer set quality standards for colonoscopy including bowel preparation quality, adenoma detection, and cecal intubation times. As a private gastroenterology practice in Northern Virginia was preparing for re-accreditation with the Accreditation Association for Ambulatory Health Care (AAAHC) it was determined that …

The Heart And Soul Of Engagement In The Float Pool Team, Kymberly Dexter

Master's Projects and Capstones

Problem: The assistant nurse manager (ANM) role is considered an entry-level management position and is not intended as a permanent career role. The unintended consequence is that there is a high rate of organizational turnover, making it challenging to build and retain a solid, cohesive, and productive team.

Context: A new manager of a float pool team in a 166-bed community hospital found that with little financial investment, a significant impact is made by holding a safe space for listening to the ANM team and designing education and training around what is most important to frontline managers.

Interventions: A baseline …

Improving Access For Medicare Inpatient Psychiatric Patients: A Health Policy Analysis, Malinda B. Whitfield

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

The Medicare Inpatient Psychiatric Services (IPS) policy, originally developed in the 1960s and without any significant or meaningful updates since the 1980’s, is physician specific, does not reflect the current model of care for psychiatric inpatients, and is restrictive for psychiatric mental health nurse practitioner (PMHNP) practice. The policy is complex, consists of outdated regulations, and results in millions of dollars in compliance costs for Inpatient Psychiatric Facilities (IPFs) annually (NABH, 2019). Although clearly an important part of the inpatient psychiatric services team, PMHNPs are not identified or defined in the policy (Center for Medicare and Medicaid Services [CMS], 2019). …

Improving Elementary Nutrition Education Curriculum In San Francisco - A Program Analysis Of The Food Education Project, Audrey N. Chang

Master's Projects and Capstones

Childhood obesity and food insecurity are problems within San Francisco, California. The purpose of this program analysis is to assess the Food Education Project (FEP), which is one of many projects addressing nutrition education and the long-term public health impact is to solve the problems of food insecurity and childhood obesity. Through primary data collection, students shared their honest feelings about food and were able to openly discuss what they know and do not know about food. A literature review was conducted through research from various databases from the University of San Francisco to identify not only current interventions but …

Examining The Socio-Economic And Gendered Structure Of Canada's Live-In Caregiver Program: A Qualitative Study Of Filipina Women's Health Experiences, Andrea Bobadilla

Electronic Thesis and Dissertation Repository

The primary aim of this critical ethnographic study was to examine how Filipina women in the Canadian live-in caregiver program (LCP) negotiate their own physical and mental well-being while managing the complex health needs of their clients. Using global care chain and postcolonial theoretical frameworks, I also sought to identify how multi-scalar forces including caregiving and migrant policies in Canada and South East Asia exacerbate pre-existing gendered and labour inequities faced by these women. The distressing impact of this precarious form of employment on family dynamics and relationships among family members in the Philippines was also explored. Data collection took …

Monitoring Intraventricular Hemorrhage In Preterm Infants, Lilian Mn Kebaya

Electronic Thesis and Dissertation Repository

Germinal Matrix-Intraventricular hemorrhage (GMH-IVH) remains a significant cause of adverse neurodevelopmental outcomes in preterm infants. Current management options for GMH-IVH rely on serial 2-dimensional cranial ultrasound (2D cUS) ventricular measurements and clinical signs. A need exists for reliable biomarkers to aid in the early detection of posthemorrhagic ventricular dilatation (PHVD) and cerebral palsy (CP). We incorporated 3-dimensional cranial US (3D cUS) and functional infrared spectroscopy (fNIRS) to monitor ventricle volumes (VV) and spontaneous functional connectivity (sFC) in preterm infants with GMH-IVH. Infants with severe GMH-IVH who underwent cerebrospinal fluid diversion showed larger VV, which correlated with decreased sFC. Our findings …

Fertility Preservation Discussions With Transgender People In Canada Prior To Beginning Medical Gender Affirmation, Emily K. Sanders

Electronic Thesis and Dissertation Repository

Background. Prevalence of fertility preservation discussions and procedures, participant characteristics associated with discussions, and prevalence of desire to parent are described.

Methods. Describes, for a clinical sample of < 16-year-olds: medical chart-recorded discussion and procedure prevalence, and desire to parent longitudinally. Describes self-reported discussion prevalence for a community sample of 14- to 39-year-olds. Bivariate and multivariable modified Poisson analyses were conducted for this sample.

Results. Discussion prevalence was confirmed for approximately 80% of the clinical sample, with approximately 20% unconfirmed. Self-reported discussion prevalence was 45% in the community sample. Non-binary gender with female sex at birth, greater family religiosity, and diagnosed mental health condition excluding depression or anxiety were crudely associated with less discussions. Multivariable analyses revealed no statistically significant predictors. Desire to parent was fairly consistent over time.

Conclusion. Discussions should be standard practice for …

Association Of Socioeconomic, Racial, And Regional Factors With In-Hospital Management And Outcomes Of Acute Myocardial Infarction Patients In The United States: National Analyses Of 2.8 Million Admissions, Olivia Haldenby

Electronic Thesis and Dissertation Repository

Social determinants of health contribute to variations in clinical outcomes among acute myocardial infarction (AMI) patients. Using the National Inpatient Sample, we conducted retrospective cohort analyses to evaluate the association of income, race, and geography with in-hospital mortality and revascularization procedures among AMI admissions in the United States from 2015 to 2019. Multilevel logistic regression models were used while accounting for hospital clustering and relevant predictors. A sequential model-building approach produced model 1 (unadjusted patient-level exposures), model 2 (lifestyle factors), model 3 (clinical characteristics), and model 4 (fully adjusted hospital-level factors). We identified 2,798,225 AMI hospitalizations (≥18 years) with 1,567,575 …

Racial And Ethnic Differences In The Receipt Of Metabolic Syndrome Risk Factor Screening And Treatment Among Prostate Cancer Patients Treated With Androgen Deprivation Therapy., Yazan K. Barqawi

Pharmaceutical Sciences ETDs

Background: Racial and ethnic health disparities in prostate cancer prevalence, incidence, mortality, quality of life, screening, and treatment constitute the largest of all cancer disparities. These health disparities are associated with higher morbidity and mortality rates in minority populations. Treatment with androgen deprivation therapy (ADT) has been the most widely used therapeutic modality to reduce the progression of prostate cancer to a worse disease stage and relieve potential obstructive symptoms. However, ADT is associated with possible toxic metabolic and cardiovascular (CVS) adverse events that may occur within six months of ADT initiation. These adverse events include metabolic syndrome, type II …

Tabletop Role-Playing Games As Autism Psychotherapy: A Video-Cued Multivocal Clinical Ethnography, Adina Rubin-Budick

Electronic Theses and Dissertations

This qualitative study is a video-cued multivocal ethnography that analyzed the clinical reasoning and perspectives of psychotherapists using Tabletop Role-Playing Games (TRPG) as a therapeutic treatment for children and adolescents diagnosed with Autism Spectrum conditions. With a growing number of TRPG therapists nationwide using this modality in their clinical practices, this study aimed to develop a clearer understanding of the ways in which their therapeutic orientation, gaming practices, and knowledge of Autism Spectrum Conditions informs their use of TRPG psychotherapy with Autistic clients.

Research that focuses on clinical decision-making and the knowledge that informs clinical interventions and technique generally refers …

Solos Y Juntos: Dos Al Tres Por Ciento De La Población En Los Estados Unidos Tienen Escoliosis. Muy Pocos De Ellos Están Preparados Para Las Tensiones Emocionales Que Trae La Condición., Anacaona Y. Rodriguez Martinez

Capstones

Dos al tres por ciento de la población en los Estados Unidos tiene escoliosis. Muy pocos de ellos están preparados para las tensiones emocionales que trae la condición. Estas son las historias de pacientes que tienen escoliosis y sus viajes en encontrar salud propio (físico y mental) en sus comunidades

Aspirin In The Primary Prevention Of Cardiovascular Disease, Briana Stephanie Murar

Doctor of Medical Science (DMSc)

For decades, people have prophylactically used aspirin (ASA), or acetylsalicylic acid, to mitigate their risk for cardiovascular disease (CVD). The role of ASA as a means of secondary prevention for CVD is well established, however there are conflicting schools of thought as to whether or not it should be used as primary prophylaxis. While this indication has been studied for more than 30-years, questions remain pertaining to the risk of bleeding that is associated with ASA usage, which ranges from mild epistaxis to life threatening hemorrhage.1 Lifestyle and behavioral factors play a large role in a person’s CVD risk, however …

Special Topics In Neuroendocrinology Allopregnanolone: Pathophysiology, Effects On Mood, Emerging Treatments, Sarah Jane Lance

Doctor of Medical Science (DMSc)

KEY POINTS

● Allopregnanolone is a neurosteroid and metabolite of progesterone that has been shown to play a role in mood regulation.

● Low levels and rapid declines in this neurosteroid are associated with mood disorders such as those within the menstrual cycle, postpartum depression, chronic stress, anxiety, post-traumatic stress disorder, and major depression. Studies have also linked it to moodrelated aspects of addiction.

● Medications that increase allopregnanolone, such as serotonin reuptake inhibitors and Brexanolone, are correlated with improved symptoms. These medications represent established and newly developed drugs that increase its level and are currently used for treatments of …

Fertility Considerations In Prescribing Hormonal Contraceptives In Individuals With Polycystic Ovary Syndrome, Andrea M. Reichle

Doctor of Medical Science (DMSc)

Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine disorder and the most common cause of infertility among females of reproductive age.1 While the name “polycystic ovary syndrome” implies people diagnosed with PCOS have numerous cysts on their ovaries, this is not always the case. Clinicians currently use the Rotterdam criteria to diagnose PCOS.2 These criteria include: irregular periods/anovulatory cycles, clinical or biochemical signs of androgen excess (acne, hirsutism, androgenic alopecia, etc.), and numerous ovarian cysts seen on imaging.2 A diagnosis of PCOS can be made when at least two of three criteria are met.2 As this has become a …

Implementing Routine Depression Screening In An Urgent Care Setting: An Implementation Science Project, Lori Conyers

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

Identifying patients with depression is essential, and early detection of depression leads to early intervention. Routine screening of patients for depression is the responsibility of the primary care provider, but many patients have not had a primary care visit in the recent past. Those patients without a primary care provider are likely not being screened for depression. Urgent care (UC) may be the best opportunity to screen patients who do not have a medical home. However, the dynamic nature of the urgent care setting may dissuade staff from engaging in routine screening. As a quality improvement (QI) effort, regular PHQ …

Postoperative Atrial Fibrillation Prevention: A Quality Improvement Project, Emily O. Schneiderman

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

Postoperative atrial fibrillation remains one of the most common complications after cardiac surgery despite surgical and medical advances in the field. While generally transient, postoperative atrial fibrillation increases long-term morbidity and mortality, hospital length of stay, and financial obligation. The postoperative heart's unique chemical and physical properties make tactics for preventing and treating postoperative atrial fibrillation differ from classic atrial fibrillation management. This quality improvement project utilizes a care bundle for non-pharmacologic measures and early beta-blockade administration to reduce the incidence of postoperative atrial fibrillation. Implementation of this care bundle establishes a standard of care, increases clinician knowledge and accountability, …

Limpieza De Asbestos En La Ciudad De Nueva York, Ariana G. Perez-Castells

Capstones

This is the story of how asbestos is removed in New York City, and who carries out the work. It's unclear how much more asbestos abatement is left in the county, and the U.S. has not completely banned the dangerous material, unlike over 50 other countries across the world. Both of these things could change soon. A new study that the U.S. Environmental Protection Agency will carry out by December 2024 would give us a better picture of how much asbestos there is still in buildings and how much more removal work is to be done. At the same time, …