Engagement Journalism In Action: Supporting New Yorkers With Long Covid, Sarah Luft

Capstones

What do asthma and long COVID have in common? 1 in 13 U.S. adults are living with them. This report is a recap of my efforts to address the information needs of New Yorkers with long COVID as a student in CUNY's Craig Newmark Graduate School of Journalism engagement program. For my final project, I partnered with THE CITY, a nonprofit news outlet serving New Yorkers, to expand the MISSING THEM project. The report details the what, why, and how of my engagement reporting process, including a community engagement framework, a service journalism series, and lessons to carry forward. You …

After Being Ignored, Autistic Adults Find Their Place On The Spectrum, Leonardo A. Lopez Carreno

Capstones

Autistic adults have been historically ignored by researchers and clinical psychologists when discussing autism spectrum disorder. But the broadening of the diagnosis requirements for the disorder, as well as the perspectives from autistic adults that have been shared on social media, have made it so that autistic adults are being discussed more now than ever before, both in the autism community and among professionals in the field. This project puts together interviews with autistic people who have found communities online and in person, as well as the perspectives of researchers who have published studies about autism.

https://medium.com/@leonardolpezcarreo/after-being-ignored-autistic-adults-find-their-place-on-the-spectrum-6e131fc00796

Death Doulas And The Changing Face Of Passing On In America, Uvie M. Bikomo

Capstones

This project examines the damages of the current death culture in the country and the ways in which it is evolving to a more communal thing. It focuses on death doulas and how they are changing death in America.

Link to capstone project:https://ubikomo.github.io/doula/

Exploring The Influence Of Contextual Factors And The Caregiving Process On Burden, Quality Of Life, And Outcomes Of Heart Failure (Hf) Dyads After A Hospital Discharge Guided By The Individual And Family Self-Management Theory (Ifsmt): A Mixed Method Study, Tamara Bernard

Theses & Dissertations

ABSTRACT The purpose of this study is to explore the influence of contextual factors and caregiving process characteristics on proximal outcomes of the patient and caregiver after discharge from the hospital. The long-term goal of this research is to reduce caregiver burden and improve patient outcomes. Heart failure (HF) is an increasingly common chronic illness with unique caregiving needs and a high rate of hospital readmissions. Caregiver burden has been researched extensively in other areas of medicine such as oncology and dementia and has been reported for stable chronic HF patients in an outpatient setting. However, there is little research …

Culture Care Values And Beliefs Of Puerto Rican Adults Related To Suicide: An Ethnonursing Study, Griselle Estrada

Electronic Theses and Dissertations

BACKGROUND: Suicide is a public health issue among the growing U.S. Latinx population; however, Latinx subgroups are diverse and represent different cultural backgrounds. Puerto Ricans are the second largest Latinx subgroup in the nation. Although research points to possible mental health vulnerabilities among Puerto Ricans when compared to other Latinx subgroups, there is a dearth of research exploring cultural influences that can impact suicide prevention efforts for Puerto Ricans living in the U.S. mainland. AIMS: This study aimed to explore the culture care values, beliefs, and needs of Puerto Rican adults pertaining to suicide and its prevention. METHODS: The …

The Health And Health Care Needs And Experiences Of Mexican Heritage Individuals In A Nonmetro Location: An Ethnonursing Study, Karla Adu

Electronic Theses and Dissertations

Introduction: The population of Mexican heritage individuals has grown significantly in nonmetro, emerging communities. The purpose of this study was to explore the health and health care needs and experiences of this population in the Midwest. Methods: Leininger’s Culture Care Theory and Ethnonursing Research Methods were used as the guiding theory and methodology for the qualitative study. Interviews were conducted with 27 informants. Recordings were transcribed and analyzed according to Leininger’s phases of data analysis. Results: Three themes emerged from the data: 1. living a better life in a nonmetro community with and for family, 2. barriers to understanding …

Speciated Isotope Dilution Mass Spectrometry In Combination With Thor’S Hammer Metaspike Technology For The Assessment Of Low-Level Biomarkers For Human Health Evaluation, Ashley Ebert

Electronic Theses and Dissertations

Our research team has been focused on quantifying important biological analytes in human blood samples to delineate the biochemical processes underlying certain states of dysfunction and evaluate treatment efficacy. These efforts have been guided by laboratory measurements with the input of medical experts. Speciated isotope dilution mass spectrometry (SIDMS) explained in detail in EPA Method 6800 has been successfully applied in the quantification of an important biomarker analyte for immune function and detoxification processes: glutathione. Past research has proven the molecule a biomarker for autism spectrum disorder (ASD) in the form of the reduced/oxidized glutathione (GSH/GSSG) ratio, and literature has …

Empowering Lung Cancer Survivors In Post-Treatment Survivorship Care Using Participatory Action Research, Kelly Filchner

Electronic Theses and Dissertations

Purpose: To explore the experiences of lung cancer survivors (LCS) and their informal and professional caregivers with post-treatment care and to empower them to implement action-based study findings.

Participants & Setting: Participants were recruited using purposeful and snowball sampling from an NCI-designated cancer center in Northeastern US.

Methodological Approach: This study used a participatory action research (PAR) four-phase design. Phase one was a focused ethnography; phase two utilized a core group of participants to decide an action to be implemented in phase three; and phase four evaluated the action for the completion of one PAR cycle.

Findings: Twenty-eight categories, eight …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

Frailty Determination And Responsiveness In Left Ventricular Assist Devices, Sarah Schroeder

Theses & Dissertations

Frailty, the state of being vulnerable with susceptibility to decreased age-related physical reserve, is found in 56-79% of adults with end-stage HF receiving durable left ventricular assist device (dLVAD) therapy. Frailty increases risk of adverse events, including increased mortality in the dLVAD population, but less is known about depression, quality of life (QOL), cognition and frailty responsiveness. Therefore, we aimed to describe and compare frailty (5-Meter Walk Test, 5MWT), depression (Patient Health Questionnaire-9, PHQ-9), quality of life (EQ5D Visual Analog Scale, EQ-5D VAS) and cognition (Trailmaking B) from pre- to 12-months post-dLVAD We also compared demographics, clinical characteristics, and post-dLVAD …

Transcranial Direct Current Stimulation Of Frontal/Occipital Cortices Modulates Neural Correlates Of Cognition In Healthy Young Adults, Yasra Arif

Theses & Dissertations

An exponential rise in the use of transcranial direct current stimulation (tDCS) to modify the human brain and behavior has been observed over the last 20 years, with studies often yielding mixed outcomes. Such heterogeneity is partially attributed to the lack of a concise understanding of the underlying mechanisms. Though considered to exert modulatory effects by changing neuronal membrane polarization and synaptic efficacy, the interactive effects of offline tDCS and the neural underpinnings of cognition, both at the regional and network-level, are yet to be fully understood. Using High-Definition tDCS (HD-tDCS), Magnetoencephalography (MEG), a range of well-established cognitive paradigms, and …

Play Your Aces: Clinical Practice Change For Adverse Childhood Experiences, Jordan Lefevers

Doctor of Nursing Practice Scholarly Project

The study included an educational module provided to healthcare providers in order to evaluate whether an increase in knowledge occurred based on responses to questions specific to Adverse Childhood Experiences (ACEs). The study assessed the providers’ baseline knowledge on ACEs based on pretest data. This study aims to evaluate if there was increased knowledge after review of educational materials. Following the educational module, a follow-up posttest survey was provided via web link to assess the providers’ knowledge specific to this topic after receiving additional education. The study measured if providers lacked general awareness on ACEs, and if there was an …

The Effect Of Standardized Patient Education On 30-Day Hospital Readmissions For Heart Failure Patients In The Outpatient Setting, Lurie Dimalanta

Master's Projects and Capstones

Problem: Heart failure (HF) is the second leading condition of hospital readmissions. Evidence shows that patient education on self-care and disease management can help reduce and prevent 30-day hospital readmissions. Registered nurse case managers (RN CMs) can help improve patients' ability to self-manage their condition and prevent 30-day hospital readmissions by applying a standard approach to patient education.

Context: The Integrated Care Management (ICM) is an outpatient department that provides post-discharge patient calls. The ICM RN CMs utilized various HF patient education tools for patient teaching. The organization’s HF task force developed health-literate patient resources to be used …

Delirium And Staff Injury, John Olague Jr

Master's Projects and Capstones

Abstract

Problem: From April 2021 to January 2022 there were 17 cases of reported patient aggression and staff injury due to patients in the hyperactive state of delirium. In a stroke/tele unit, diagnosis of delirium was delayed due to subjective assessment from the confusion assessment method (CAM) tool. This delay allowed patients to reach the hyperactive state of delirium which poses a threat to patient and staff safety. An objective form of assessment for delirium was needed on this stroke/tele unit.

Context: Through a microsystem assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis, stakeholders in this performance improvement plan …

Implementing A Health Services Google Classroom In A High School Setting, Christina M. Wilkinson

Master's Projects and Capstones

Abstract

Problem: The present study investigated the use of Google Classroom and the impact of providing students with basic self-care information on nurse office visit times.

Context: A School nurses are often responsible for multiple schools and a large population of students. These demands pose challenges for school nurses to appropriately serve the student population.

Interventions: Disseminate basic health information on self-care to students via Google Classroom.

Measures: The outcome measure is to make nurse’s office visits less than ten minutes. The data source being chart reviews and the target is 80% of students. The process measure is to increase …

Reducing Hospital-Acquired Pneumonia By Educating Patient Care Technicians On Route Bundle Care Measures, Munroop K. Thiara

Master's Projects and Capstones

Hospital-acquired pneumonia (HAP) is an infection of the lungs that can lead to severe and sometimes fatal outcomes. HAP can be prevented by oral care interventions, but without proper patient care, treatment can be very expensive. Evidence-proven HAP preventative measures such as the ROUTE bundle and increased patient mobility can significantly lower the risk of pneumonia as well as prevent additional hospital costs. Hospital X is a private nonprofit health care organization in the urban suburbs of a large Northern California city with a current HAP rate of 2.3 and with targeted goals of 2.0. By creating a project that …

Improving Safe Handling And Administration Of Usp<800> Hazardous Drugs Within The Medical-Surgical Unit, Pavlo Karaputa

Master's Projects and Capstones

Nurses comprise the largest proportion of healthcare providers who make contact with Hazardous Drugs (HDs) during multiple types of clinical activities and have a risk of exposure. Hazardous drugs (HDs) are a class of pharmaceuticals that pose serious health risks to individuals who handle them, including organ toxicity, reproductive and developmental defects, infertility, miscarriage, genetic toxicity, cancer, and even death. This project was implemented in a hospital system within Northern California, on two units that serve medical-surgical, oncology, geriatric, and transplant patients. The Medical Surgical microsystem at this hospital comprises a small group of professionals such as registered nurses (RNs), …

Improving Home Health Nurses' Knowledge Of Heart Failure Self-Care Management, Nenette Hoffman

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Heart failure results in life-altering and devastating illnesses, predominantly among older adults. Heart failure management is complex, and requires patients and their caregivers to actively monitor symptoms and sufficiently understand care management to maintain health-promoting behaviors. While home health nurses have the primary role as patient educators of their patients with heart failure, evidence from the literature indicates that nurses lack sufficient knowledge to fulfill this role.

Local Problem: Nurses’ inadequate knowledge of heart failure self-care management has been associated with insufficient patient education, the inability of patients to perform heart failure self-care management, worse clinical outcomes, and …

Diabetes Prevention And Management Education For Punjabi-Sikh Older Adults, Mandeep K. Gill

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: South Asians from Bangladesh, Pakistan, and India have a higher prevalence of diabetes than the general global population and are also more susceptible to developing diabetes due to biological and lifestyle factors. The South Asian diet is high in refined grains and monounsaturated fatty acids, increasing the risk of diabetes.

Local Problem: Congregants of a Sikh gurdwara (place of worship) lacked knowledge of diet and lifestyle in relation to preventing and managing diabetes. Many senior congregants have been diagnosed with diabetes or are at high risk of developing the disease.

Methods: Knowledge of diabetes prevention and management were …

Decreasing Seclusion And Restraint Events Among Clients Within An Inpatient And Crisis Stabilization Behavioral Health Facility, Karen Lee Richards

Doctor of Nursing Practice (DNP) Projects

Background: Despite global shifts in behavioral health treatment, changes regarding use of seclusion and restraint (S/R) continues to be extremely slow. Local Problem: Increasing S/R events and subsequent staff injuries and financial burden. Methods: A quality improvement project providing education in trauma-informed care (TIC), sensory modulation (SM), and S/R debriefing (S/RD). Interventions: Education and training for S/RD, TIC, and SM using a variety of materials and methods over a 6 to 12-month period was provided to staff within a 16-bed inpatient adult psychiatric health facility (PHF) and a crisis stabilization unit (CSU). Because of positively affecting the use of S/R, …

Engaging Rural Providers About The Potential Of Low-Earth Orbit Internet Satellite Supported Rural Telehealth Programs, Joshua M. Cleary

Doctor of Nursing Practice (DNP) Projects

Abstract

This paper describes a DNP project that was designed to address the issue of rural mental telehealth implementation barriers. One of the main barriers to rural telehealth programs has been a technical infrastructure incapable of adequately hosting the telehealth programs. Low-Earth orbit (LEO) internet technology has emerged as a way to solve the rural telehealth conundrum by offering an improved rural technical infrastructure. An integrated review was completed based on the following PICOT question: In rural providers, how does an educational outreach compared to no educational outreach affect provider adoption of new technologies? The evidence showed educational sessions as …

Impact Of Montessori-Based Dementia Programming On Engagement And Affect Of Older Adults With Dementia, Meredith S. Sheppard

Master's Projects and Capstones

The COVID-19 pandemic has profoundly impacted the Adult Day Services program and Adult Day programs across the country. As the Adult Day Services program transitions to an in-person format, goals within the organization include developing appropriate programming, increasing group size, and keeping clients entertained. The framework guiding this quality improvement project is Montessori-Based Dementia Programming ® (MBDP). This project aims to increase client engagement, decrease client anxiety, and decrease staff workload. This will be measured by a self-developed staff workload survey, the Menorah-Park Engagement, and the Affect rating scale. Implementation of MBDP at the Adult Day Center did not meet …

Cost-Benefit Analysis Of A Pediatric Patient Blood Management Program, Karen D. Gibbs

Dissertations & Theses (Open Access)

Introduction

Red blood cell (RBC) transfusions can be a life-saving and important intervention used to replace blood loss or manage anemia, but they also come with risks from transfusion-associated adverse events (TAAEs). Patient blood management (PBM) involves a multidisciplinary approach to optimize care of patients who may need a transfusion, including blood conservation modalities, patient-centered decision making, among others. The impact of PBM in the pediatric setting is not well understood, particularly the impact on TAAEs and the economic impact of these programs.

The following specific aims were pursued: (1) To investigate the effect of a PBM program on transfusion …

The Ethical Imperative Of Inclusion In Healthcare Innovation: Scaling And Sustaining Digital Health Equity, Lukas E. Chandler

Electronic Theses and Dissertations

The COVID-19 pandemic revealed the harm of digital health exclusion. Excluded groups could not benefit from virtual care due to device access gaps, broadband connectivity, and digital and language literacy levels. A lack of engagement with historically excluded populations in digital health innovation is an ethical harm and a maleficent form of social exclusion. Digital tools in healthcare delivery represent more than just a strategy for promoting health equity; they signify an opportunity to address health inequities in the health technology design process.

The historical focus of healthcare ethics on bedside decision-making issues largely explains why the field lacks concerted …

The Association Of Lower Medication Adherence And Increased Medical Spending, Ryan A. Fuchs

Capstone

Medical prescribing is a common occurrence in daily clinical practice. According to the Centers for Disease Control and Prevention, in 2015-2016 45.8% of the U.S. population used prescription drugs in the past 30 days. (CDC, 2019) Although drug therapy can be effective in treating disease, full benefits are often not realized because many patients do not take their medications as prescribed. There is quite a bit of research out there about non-adherence to medication. Some studies focus on the financial impacts of non-adherence, but most of the studies examine the reasons for medication non-adherence. A gap exists in research about …

Assessing The Methodology, Prevalence, And Associated Factors For Adverse Childhood Experiences (Aces) Among Children And Adolescents In The United States, Kiara L. Lyons

Theses & Dissertations

To comprehensively capture the risk and protective factors of ACE exposure and ACE-related outcomes, we propose to consider a social-ecological model framework. The concept of the Social-Ecological Model was originally introduced in the 1970s by psychologist Urie Bronfenbrenner and designed to theoretically capture the multifaceted influence different personal, social, and environmental factors have on health behaviors and outcomes. Additionally, this would help to determine what prevention and intervention methods would be more appropriate to implement. This conceptual framework had five system levels: microsystem (individual), mesosystem (interpersonal), exosystem (community context), macrosystem (societal and cultural influences), and chronosystem (internal and external elements …

A Process Evaluation On The Health Care Transition Process For Youth With Osteogenesis Imperfecta With Special Health Care Needs, Janet Amirkhanian

Doctor of Nursing Practice (DNP) Manuscripts

With medical, surgical, and technological advances, children with childhood diseases with special health care needs (SHCNs) are surviving and living into adulthood (Cohen et al., 2014). Health care transition (HCT) should be a process through which youth are expected to achieve the skills necessary to manage their health as adults (Sawicki et al., 2017). HCT should be a purposeful, organized, and coordinated process involving the youth, family, and health care team (Stringer et al., 2015; Gabriel et al., 2017; White et al., 2018). Evidence supports that adolescents and young adults with SHCNs are often unprepared for transition (Jensen et al., …

Narrative Review: Food Image Use For Machine Learnings’ Function In Dietary Assessment And Real Time Nutrition Feedback And Education, Jason Fee

Masters Theses, 2020-current

Technology has played a key role in advancing the health and agriculture sectors to improve obesity rates, diseasecontrol, food waste, and overall health disparities. However, these health and lifestyle determinants continue to plague theUnited States population. While new technologies have been and are currently being developed to address these concerns, they may not be practical for the general population. Utilizing machine learning advancement in food recognition using smartphone technology may be a means to improve the dietary component of nutrition assessments while providing valuable nutrition feedback. This narrative review was conducted to assess the current state of the literature on …

A Cell Culture Model To Study Tobacco Associated Oral Cancer Progression And Treatment Resistance, Amanda Busch

Theses & Dissertations

Head and Neck Squamous cell carcinoma is the 6^th most common cancer in the world. Risk factors for HNSCC include alcohol and tobacco consumption, infection with Human Papilloma Virus, and exposure to environmental toxins. Unlike many other cancers, the incidence of HNSCC is growing, yet the treatment options and outcomes have not been significantly improved for decades. An increased understanding of the molecular mechanisms of these cancers is needed for improvement in early diagnosis, enhanced treatment effectiveness, and cancer prevention. 4-nitroquinoline 1-oxide (4NQO) is a well-tested, tobacco mimicking, carcinogen. 4NQO produces similar histological and chemical changes found in human …

An Enhanced Enrollment Process To Impact Appointment Compliance In The Hf-Optimize Clinic, Carolyn Coons, Teri Diederich, Kyana Holder

Doctor of Nursing Practice Projects: College of Nursing

Background The HF-Optimize clinic showed improved utilization of guideline-directed medical therapy (GDMT) along with improved clinical outcomes from 2018 to 2020. Appointment compliance was poor with only 44% of patients completing all HF-Optimize visits. Missed appointments led to worse health outcomes, fragmented care, and provider inefficiencies. Interventions to improve appointment compliance are vital to improving heart failure outcomes. Objective The purpose of this quality improvement project is to evaluate the impact that an enhanced enrollment process has on appointment compliance in a culturally diverse, adult population referred to the HF-Optimize clinic at Nebraska Medicine. Methods This prospective quality improvement project …