Medicine and Health Sciences Commons^™

Novel Anti-Influenza Monoclonal Antibodies, Ozlem Gurses

NYMC Student Theses and Dissertations

There is a continual public threat of influenza virus infections. This is related to viruses evolving in multiple animal reservoirs, making infection prevention in humans difficult to achieve and leading to seasonal epidemics and the semi-regular emergence of pandemics. Novel antibody-based therapies are of great interest to researchers because of a dramatic increase in drug resistant strains of influenza viruses. The identification of cross-reactive and broadly protective monoclonal antibodies targeting the influenza proteins presents a promising prospect for the development of a universal therapy. Although the research related to the monoclonal antibodies targeting the viral internal proteins is limited, multiple …

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 …

Traumatic Brain Injury Severity In Older Adults: Impact On Anxiety And Depression Symptoms And Community Engagement, Ashley Tomford

Theses and Graduate Projects

Background: Traumatic Brain Injury (TBI) is one of the leading causes of physical and cognitive disability worldwide. TBI can negatively impact cognitive, physical, social, and psychological functioning.

Objective: This study investigated interactions between TBI severity, mental health symptom severity, and community engagement among older adults. Specific aims included investigating 1) the relationship between TBI severity at the time of injury and psychiatric symptom severity at one-year post-TBI; 2) the relationship between TBI severity and community engagement at one-year post-TBI; and 3) whether mental health symptom severity moderated the relationship between TBI and post-injury community engagement.

Methods: Archival data was analyzed …

Nursing Care Of The Pediatric Patient With Autism, Cayley Frolik

Honors Capstones

The purpose of this project is to help educate current and future nurses on ways to understand and better connect with pediatric patients with autism. Standard nursing curriculum tends to focus primarily on the clinical approach for mainstream patients. In one short year, I recognized a glaring need for nurses to learn how to care for those with autism, as well as how to support and educate their families to create the best environment for whole success. It is very difficult to understand the needs of these specific patients without the proper toolkit. It is my intention to research and …

The Influence Of English Proficiency In Online Health Information-Seeking: A Comprehensive Model Of Information-Seeking (Cmis) Based Study Using Health Information National Trends Survey (Hints) Data, Lauren M. Perez

Pharmaceutical Sciences ETDs

Understanding language-related challenges is crucial for addressing health and healthcare access disparities. This study examines differences in online health information seeking (OHIS) experiences by English proficiency. It explores factors influencing OHIS that patients in the United States with Limited English Proficiency (LEP) may encounter to shed light on the online health information needs of patients with LEP. The research utilizes data from the 2017 Health Information National Trends Survey (HINTS) 5 Cycle 1 to analyze the OHIS experiences of patients. Findings will inform healthcare providers, policymakers, and researchers, promoting equitable access to reliable health information.

Increasing Medication Adherence In Patients With Bipolar Disorder Using Mobile App Reminder, Emmaculate Ndifor

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

Background: Bipolar disorder (BD) is the fifth leading course of disability in the world, contributing to many co-morbid conditions and complications. Non-adherence to medication is prevalent in patients with BD. The aim of the project was to use an evidence-based technological intervention to enhance medication adherence in BD patients between 18- 65 years old at an outpatient behavioral health clinic.

Methods: Baseline assessment included a pre Morisky Medication Adherence (MMAS-4) questionnaire. The development of an intervention to improve medication adherence was based on Johnson’s (2002) Medication Adherence Model (MAM).

Interventions: Participants downloaded the Medisafe app, registered medications and set …

Strategies To Reduce Chronic Disease: Adding Role To Community Health Workers, Ingrid J. Renwanz Dnp, Pmhfnp-Bc/Aprn, Msn, Rnc

Doctor of Nursing Practice (DNP) Projects

Background: Underserved, rural, immigrant, low-income Latinx communities need to strengthen healthcare access to improve their quality of life (Capitman et al., 2009; McCartney et al., 2019; Save the Children [STC] Organization, 2021). Non-communicable chronic disease of physical and behavioral origin is the leading cause of morbidity for adults and children in Latinx communities (Campbell et al., 2020). Estimates of greater than 30% of the Latinx populations within the United States have these health needs, with projections to reach 28% of the U.S. population by 2060 (Eghaneyan & Murphy, 2019; Ortega et al., 2018).

Local Problem: If poor access to preventive …

An Interdisciplinary Education And Service Bundle To Reduce Hospital Resource Utilization And Decrease Pediatric Asthma-Related Morbidity And Mortality, Emily Yates

Seton Hall University Dissertations and Theses (ETDs)

The purpose of this quality improvement project was to reduce hospital resource utilization and improve health outcomes for children with asthma by providing an evidence-based, interdisciplinary education and service bundle to patients and families admitted to a Children’s Hospital in Northern New Jersey with a primary diagnosis of asthma. The 2020 Asthma Management Guidelines published by the U.S. Department of Health and Human Services (2020), the Global Initiative for Asthma (GINA) and a modified systematic review identified common themes among children at risk for asthma-related morbidity and mortality and high hospital resource utilization. These themes included medication misuse, asthma trigger …

Recovery Perceptions And Techniques Of Ultramarathon Runners, Denise Howard

Doctorate in Kinesiology

Ultramarathons have become increasingly popular over the last few decades. Ultramarathons are run on various terrains in different climates and are extremely distressing physiologically and psychologically. Recovery is crucial to restore physiological and psychological functioning yet is underappreciated. Compared to other sports, research related to ultra-endurance is limited, and a gap in research exists on effective recovery modalities and duration for ultrarunners. This study aimed to examine ultrarunners' practice and perceptions regarding recovery techniques and duration. An electronic survey designed for this study collected participants' perceptions about recovery and included physiological and psychological recovery factors. A total of 159 ultrarunners …

The Impact Of Sitting And Crawling On The Acquisition Of Object Permanence In Infants With Motor Delays And Infants With Typical Development, Karl Jancart

Electronic Theses and Dissertations

Object permanence (OP) is the ability to understand that objects continue to exist even when they cannot be perceived. During play, infants with an understanding of OP will continue searching for toys when the toys have been obscured by other items. Searching requires movement. The theory of embodied cognition maintains that the form and function of an organism’s body influence how the organism learns; Therefore, if a child has difficulties with movement, as demonstrated by children with motor delays, they will likely have difficulty engaging in play, the modality by which children learn about their world. The current research is …

Heparin Induced Thrombocytopenia (Hit), Tanya Yatskiv

Doctor of Medical Science (DMSc)

Introduction:

Heparin was first discovered in 1915 and is still widely used to this day.1 In 1958 however, it was noted that a small percentage of recipients of heparin develop antibodies to the drug which cause a mild to moderate thrombocytopenia and can progress the patient into a severe prothrombotic state.2 The prothrombotic state can be detrimental due to venous and arterial thromboembolisms that lead to life and limb-threatening manifestations. The mechanism of the thrombocytopenia and immune reaction was not identified until 1973.2 The adverse drug effect is induced by platelet-activating antibodies against platelet factor 4 (PF4) and heparin.3 These …

Meta-Analysis Of The Rate Of Unplanned Pregnancies In Rural Areas Of The United States And The Use Of Technology-Based Sexual Education Programs, Hannah Audiss

Doctor of Medical Science (DMSc)

Objective

To discuss rural-urban disparities of adolescent unplanned pregnancies and sexual education availability. The potential of virtual sexual education programs are discussed by examining two studies that have used technology-based interventions to assess variables related to pregnancy prevention.

Data Sources

A review was conducted by gathering randomized controlled trials and systematic reviews utilizing databases such as ScienceDirect, PubMed and Wiley Online Library. Research articles included in this paper were from 1995 to present day and are inclusive of all races.

Study Eligibility Criteria

Studies were included if the interventions worked with young adolescents ages 13-24 year old, utilized technology-based interventions …

The Association Between Prenatal Acetaminophen Use And Adhd Development In Childhood, Jocelyne Blanco

Doctor of Medical Science (DMSc)

Background: The purpose of this article is to produce a review of the literature on a recently growing topic of interest. We believe the widespread use of acetaminophen in pregnancy makes the rising concern for acetaminophen use in pregnancy and the development of childhood attention deficit hyperactivity disorder (ADHD) a national public health matter. The mechanism of action of acetaminophen, the pathophysiology of drug transfer through the placental barrier, and the most up-to-date research studies were analyzed with the goal of bringing clarity and promoting healthy pregnancies for all.

Methods: PubMed, PLOS One, and Google Scholar served as the cornerstone …

Thoughtful Integration Of Active Learning Teaching Strategies Into Physician Assistant Education, Daniel Berger

Doctor of Medical Science (DMSc)

Introduction:

The future of healthcare relies upon how we train student clinicians. It is integral to continually reevaluate our methodologies of teaching and work to better approach the challenging task of educating competent and compassionate physician assistants in a short two-to-three-year window. While the traditional modality of teaching has been primarily lecture-based, there has been a growing movement to incorporate active learning into medical education. This learner-driven model puts students in the driver’s seat and allows for greater amounts of self-directed learning prior to class followed by the reinforcement of concepts during class time. Though lecture-based teaching could be the …

The Role Of Self-Sampling For Hpv In The Primary Prevention Of Cervical Cancer, Divya Patel

Doctor of Medical Science (DMSc)

Introduction:

Cervical cancer is a striking women's health problem worldwide. It is the fourth most common cancer in women and the seventh most common cancer worldwide1. There were roughly 604,000 new cases of cervical cancer and 342,000 deaths in 20202. Most of these cases occur in developing countries due to ineffective screening initiatives2. Screening essentially allows pre-cancerous lesions to be identified at stages where they can easily be treated; screening methods include cytology and HPV testing (Human Papillomavirus)1. HPV has over 100 strains and is one of the most common risk factors for cervical cancer. HPV testing is more sensitive …

Lipoprotein(A): Review Of Existing Guidelines And Application For Practicing Clinicians, Daniella Manarang

Doctor of Medical Science (DMSc)

Purpose A growing amount of research has constituted lipoprotein(a) as an independent risk factor for cardiovascular disease. The main objective of this review is to summarize the current guidelines for testing and managing Lp(a) and provide guidance to clinicians on how to practically utilize Lp(a) with what is known today. Methods: EBSCO, PubMed, and Ovid were searched for this review. Search terms included lipoprotein(a), clinical practice, guidelines, screening, and cardiovascular disease. Sources within ten years were obtained to cover recent material. Results: The current literature on the association between Lp(a) and CVD outcomes and up-to-date guidelines on testing and management …

Interrogation Of The Molecular Mechanisms That Finetune Fcεri Signaling And Mast Cell Outcomes, Derek A. Rinaldi

Biomedical Sciences ETDs

FcεRI is the ITAM receptor primarily responsible for the allergic response and immune hypersensitivity diseases such as asthma. Regulation of the strength of both FcεRI signaling, and the resulting outcomes, is accomplished via a complex array of molecular mechanisms whose interactions remain unclear. Here, I explored how the biophysical properties of antigens, crosstalk between FcεRI and integrin signaling and Arf6-mediated control of trafficking and exocytosis tune mast cell outcomes. I first found significant differences in FcεRI aggregation, phosphorylation and granule secretion after crosslinking with the multivalent antigen DNP-BSA or the small, trivalent antigen DF3. I also revealed a bi-directional, Syk-mediated …

Assessment Of Organizational Readiness Towards Electronic Health Records In A Tertiary Care Hospital, Karachi, Pakistan, A Quantitative Analytical Cross-Sectional Study, Muhammad Javeed

Theses & Dissertations

Background: A medical error is one of the most preventable errors that occur frequently in hospitals, leading to millions of deaths yearly. Medical errors cost hospitals billions of dollars worldwide. Human error is also a common cause of medication errors, but this error is due to the failure of the system to detect errors. The electronic health record (EHR) is a complete set of computerized records of all information related to patient health that is used by one or more users in any care setting. This information includes demographic data of patients, patients’ progress notes, complaints and diagnoses, medications, vital …

Modified Early Warning Score In Detecting Clinical Deterioration: A Continuous Quality Improvement Initiative, Robin Daller

Doctor of Nursing Practice (DNP) Manuscripts

Despite considerable emphasis on patient safety and high-quality care in U.S. hospitals for the past two decades, significant challenges remain in the early detection and treatment of clinical deterioration in adult medical-surgical patients contributing to poor patient outcomes, increased resource utilization and increased costs. Modified early warning scoring (MEWS) systems have been used to identify patients at risk of deterioration. The Modified Early Warning System (MEWS) is effective in supporting the early detection and prevention of clinical deterioration of at-risk patients earlier in their hospitalization and potentially save lives (Institute for Healthcare Improvement, 2017). This project implemented MEWs on medical …

Implementation And Evaluation Of Abcdef Bundle In The Surgical Intensive Care Unit (Sicu): A Quality Improvement Project, Carrie Blasko

Doctor of Nursing Practice (DNP) Manuscripts

Intensive Care Unit (ICU) delirium is highly prevalent in this patient population; however, it is a potentially avoidable hospital complication (Vasilevski et al., 2018). The Confusion Assessment Method (CAM) has been used as a tool to measure delirium in the SICU since 2014 (AHN, 2023). The SICU clinicians deliberated if a better assessment and management bundle is available to better identify and manage delirium as a concerning volume of patients continue to experience ICU delirium even with the current delirium assessment tool in place. Upon reflection, SICU clinicians acknowledge a gap in nurses’ knowledge in connection with identifying signs, symptoms, …

Dna Methylation-Based Epigenetic Biomarkers In Cell-Type Deconvolution And Tumor Tissue Of Origin Identification, Ze Zhang

Dartmouth College Ph.D Dissertations

DNA methylation is an epigenetic modification that regulates gene expression and is essential to establishing and preserving cellular identity. Genome-wide DNA methylation arrays provide a standardized and cost-effective approach to measuring DNA methylation. When combined with a cell-type reference library, DNA methylation measures allow the assessment of underlying cell-type proportions in heterogeneous mixtures. This approach, known as DNA methylation deconvolution or methylation cytometry, offers a standardized and cost-effective method for evaluating cell-type proportions. While this approach has succeeded in discerning cell types in various human tissues like blood, brain, tumors, skin, breast, and buccal swabs, the existing methods have major …

Feasibility Of A Laboratory Model For Evaluating The Use Of An Alternative Response Option In Mitigating Caregiver Treatment Integrity Errors, Jessie K. Weber

Theses & Dissertations

The current study assessed the feasibility of a laboratory model designed to evaluate options for mitigating common caregiver errors in the implementation of destructive behavior treatment. We developed a computer-based analogue to caregiver implementation of extinction for attention-maintained destructive behavior; the model included contingencies on both caregiver errors of commission and adherence to the treatment protocol. We also conducted a preliminary investigation of the effects of participant access to alternative activities as a potential strategy for mitigating integrity errors. Participants included 14 MTurk workers or staff in a severe behavior clinic, and individual response patterns revealed distinct sensitivities to the …

Impacts Of Perinatal Oxycodone Exposed Offspring In Early Adolescence, Adrian Flores

Theses & Dissertations

The Opioid Epidemic has been a point of public health interest for the last twenty years. In this time, use of prescription opioids has grown exponentially, including use by pregnant women. The initial crisis has been focused on mitigating immediate problems such as lowering the significant loss of life in overdoses and providing support to cessation. Despite these advancements a separate phenomenon is on the rise: The rise in neonatal opioid withdrawal syndrome in neonatal care and associated challenges for these children as they age.

Currently preclinical research and epidemiological data suggests that exposed children are at risk for experiencing …

Frequency Of Ciwa Scoring In Patients With Alcohol Dependence In A Mental Health Setting, Heather Mcmanis

Doctor of Nursing Practice Scholarly Project

The purpose of this quality improvement project was too assess the knowledge and attitudes of nursing staff toward assessing patients diagnosed with alcohol dependence who are detoxing from alcohol in a mental health facility. An educational intervention was done with nursing staff to assess their knowledge of the Clinical Institute Withdrawal Assessment for Alcohol (CIWA) scale and to stress the importance of frequent and accurate use of the scale. Data was collected for three months before the educational intervention and three months after the educational intervention on the total number of patients admitted to the facility with a diagnosis of …

Toxic Fashion: Evaluation Of Chemicals In Clothing And Recommendations For The Amended Tsca, Gregory Zajac

Master's Projects and Capstones

The fashion industry is one of the largest polluting industries in the world and its rising environmental impact is partly due to the dominance of fast fashion business models. Recently researchers and advocates have found that large amounts of chemicals are used by textile manufacturers to produce clothing, some proven to be toxic in other applications. The risk of exposure to these classes of chemicals is a growing concern. With the risk management model, a qualitative examination was conducted on existing policies in the United States that regulate chemicals used by the industry. Despite some policy changes regarding chemical exposure …

Reducing Care Companion Utilization In Medical-Surgical And Telemetry Units, Mary Jane B. Sagabaen

Master's Projects and Capstones

Abstract

Problem: The facility highly utilized sitters or care companions, negatively impacting the staffing plan, budget, and productivity. An average of 56 hours of care companions were used daily. This greatly exceeded the budget of 33 hours a day. Reassigning Patient Care Technicians (PCT) as care companions resulted in inadequate nurse support for patient care and increased cost for additional staffing needs. Despite this, the fall rate remained higher than the target.

Context: The patient population is mainly 65 years old and above, sometimes with confusion, dementia, delirium, and at high risk for falls and elopement. The culture included promptly …

Data Quality: Integral To Cauti Surveillance And Improvement In Non-Critical Care Units, Mary Grace Daria

Master's Projects and Capstones

Background: Urinary tract infections (UTIs) are the most common type of healthcare-acquired infection (HAI), with 75% approximately associated with urinary catheter use. The key to preventing UTIs is to avoid the use of indwelling urinary catheters (IUCs). This study explores denominator data extract logic modifications to increase IUC data capture and accuracy. It is set in a 249-bed acute care, teaching hospital in the Diablo Service Area in Northern California.

Problem: The electronic system used to extract the CAUTI denominator data is inconsistently capturing the IUC device days from the electronic medical record (EMR). This has regulatory reporting ramifications and …