Medicine and Health Sciences Commons^™

A Quality Improvement Project To Increase Awareness And Utilization Of Employee Assistance Program Services Among Healthcare Providers, Scarlet Gould

Doctoral Projects

Mental health distress among healthcare providers (HCP) is a common problem, yet Employee Assistance Programs (EAP) are consistently underutilized. Unmanaged workplace stress can lead to problems such as provider burnout and increased rates of turnover, which can result in decreased access to patient care. The purpose of this project was to increase awareness and utilization of EAP services by using the Plan-Do-Study-Act cycle (PDSA) for quality improvement. Nurse Practitioners at a community-based hospital were provided with a PowerPoint^® presentation via email that contained information regarding the facility’s employee assistance program, mental health wellness education, as well as ways to …

Encouraging Medication Compliance By Implementing A Medication Adherence Tool, Regina Taylor

Doctoral Projects

Medication non-adherence has been a common and challenging problem in health care, especially among mental health patients. Studies show medication compliance among psychiatric patients has been at a lower rate than patients with physical conditions. Non-compliance with medications has been one of the considerable contributions to rapid psychiatric hospital readmission. Rapid readmissions have been costing health care billions of dollars annually. The stigma behind mental health has a large contribution to why mental health patients are non-compliant with their psychotropics. Utilization of the Medication Adherence Rating Scale (MARS) on a patient to evaluate the patient's willingness and ability to take …

Implementing A Systematic Depression Screening In The Primary Care Setting, Cassandra Moore

Doctoral Projects

The Advanced Practice Nurse is responsible for providing quality care and treatment for the whole person. 3 John 1:2 KJV states, “I wish above all things that you may prosper and be in health, even as your soul prospers” (King James Bible, 2023, para. 2). To prosper and be in health refers to a holistic approach in which the mind, body, and spirit of an individual is considered. Mental health care is an integral part of the holistic health approach.

Mental illness affects approximately one in five adults (52.9 million) in the United States alone (National Institute of Mental Health …

Group Art Therapy With Resilience-Based Cognitive Behavior Therapy For Female North Korean Defectors In The United States, Yuri Kim

Expressive Therapies Dissertations

This study engages in phenomenological qualitative research, focusing on three North Korean defectors residing in the United States. The research comprised six sessions, each lasting ninety minutes. These sessions involved the active participation of the subjects in six face-to-face group art therapy (AT) sessions, adhering to the six guidelines outlined in the Amita Treatment Framework (ATF). These sessions encompassed the following components: 1) analyzing self-image; 2) finding positive qualities; 3) identifying challenges; 4) behaviors driven by emotions in challenging situations; 5) reframing challenges; and 6) reconstructing self-image and goal setting.

Results from the study revealed phenomenological insights into the participants' …

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

Doctoral Projects

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

Moral Distress As A Predictive Variable Of Perceived Job Retention In Senior Nursing Students, Rebekah L. Barber

Honors College Theses

New Bachelor of Science in Nursing (BSN) graduate nurses are leaving careers within inpatient healthcare facilities presumably because of moral distress related to the anticipated workload of registered nurses (RN). BSN curriculums are responsible for providing practical education through clinical instruction; however, many students experience inconsistencies in best practice recommendations. The inconsistencies predominantly originate between didactic nursing instruction and clinical learning within inpatient healthcare facilities. Using a cross-sectional descriptive research design, this thesis utilized the validated Moral Distress Scale-Revised (MDS-R), a 21-item instrument that assesses the frequency and intensity of moral distress experienced by healthcare workers. Student responses to the …

A Credentialing Protocol Education To Enhance Nurse Float Pool Competency, Dalton J. Skipper

Walden Dissertations and Doctoral Studies

No abstract provided.

Overcoming Foreign Language Speaking Anxiety: Practical Approaches In The Classroom, Sarah Day

Honors Projects

Foreign language speaking anxiety is a prevalent issue impacting language learners' confidence, participation, and overall language acquisition. With personal experiences as a language learner, a Spanish teacher in the United States, and an English teacher in Spain, I have observed how foreign language speaking anxiety affects learners from various demographics. Using a combined approach of personal observations, experiences as a language learner and teacher, and secondary research this project aims to address the primary sources of foreign language speaking anxiety among high school students and how both students and teachers can work to lessen the negative effects of foreign language …

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

Electronic Thesis and Dissertation Repository

Introduction

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

Objectives

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

Methods

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

Duchenne Muscular Dystrophy: Age, Disease Stage, And Patient-Reported Quality Of Life, Sheila Jagers

Walden Dissertations and Doctoral Studies

No abstract provided.

Prevalence, Faunal Composition, And Vertical Distribution Of Bioluminescence In The Pelagic Gulf Of Mexico: Fishes, Crustaceans, Cephalopods And Gelatinous Megaplankton, Devynne M. Brown

All HCAS Student Capstones, Theses, and Dissertations

Bioluminescence is the phenomenon of light emission by living organisms. It occurs through a chemical reaction within an organism and serves various purposes. The diversity of bioluminescent capabilities and occurrence in unrelated taxa suggest that bioluminescence has evolved independently numerous times amongst taxa thriving in certain environments. One such environment is the deep ocean, where little to no sunlight penetrates the water column, specifically in the mesopelagic (200-1000 m depth) and bathypelagic (> 1000 m) zones. The mesopelagic and bathypelagic zones have been extensively sampled and well documented in the Gulf of Mexico (GoM), one of the few places globally …

Evaluating The Effectiveness Of The Internal Transcribed Sequences (Its) As Dna Barcodes To Estimate Fungal Diversity, Jailisa Linares

All HCAS Student Capstones, Theses, and Dissertations

Universal phylogenetic markers such as the nuclear ribosomal internal transcribed sequences (ITS), specifically ITS1 and ITS2, are routinely used to estimate fungal diversity in environmental samples. However, numerous studies report differences in the performance and efficacy of ITS1 and ITS2 in documenting fungal diversity. To better understand the implications of using ITS1 versus ITS2, a comprehensive representation of the diverse fungal taxa was necessary to conduct a meta-analysis of their use across multiple fungal taxa. In order to address this, a thorough literature review was conducted to compare and contrast the use of ITS1 and ITS2 as effective DNA barcodes. …

Developing A Blueprint For Health Equity Programs And Investigating Interventions And Metrics, Belita Strudwick

MUSC Theses and Dissertations

Racial and ethnic minority groups and rural and low-income populations are examples of populations who continue to experience health disparities despite policy mandates to eliminate them. This doctoral project will provide a foundational blueprint to aid health plans in addressing and improving health equity internally and with external stakeholders. The blueprint will be based on research comparing the robust health equity initiatives of four states to the NCQA national guidelines. The barriers to achieving and recommendations for advancing the field of health equity by implementing and analyzing policies and data that target health disparities through improved access to quality care …

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

Student Scholarly Projects

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

Fostering Critical Thinking Through Simulation: An Integrative Review, Sarah Knapp, Raymonta Green

Master of Science in Nursing Final Projects

Over the past decade simulation has become a staple of nursing education with increasing use during the COVID-19 pandemic. Both manikin-based and virtual simulation are used to increase the preparedness of nursing students for their roles at the bedside. With the increasing experience-complexity gap, it is important that students enter the workforce prepared to effectively care for patients. Simulation allows students to work with a patient scenario without the possibility of injury; in simulation, mistakes are opportunities instead of harm. This integrative review searched the literature questioning if in pre-licensure Bachelor of Science in Nursing students, do virtual simulation and …

Advance Care Planning: Best Practice Toolkit For Improving Access To Advance Care Planning Using Telehealth Visits, Jae Jackson

Student Scholarly Projects

Advance care planning (ACP) predominately occurs during a life-threatening crisis or during an inpatient admission. The primary care provider (PCP) is generally not the healthcare provider addressing ACP at the time of a crisis or during an inpatient admission. Being proactive in limiting ACP decisions with unfamiliar providers, uncomfortable environments, and increasing access to ACP discussions with PCPs are supportive reasons to utilize an ACP telehealth toolkit in primary care. Patients risk having ACP discussions with random providers, environments that don’t provide comfort when having such personal discussions, or not having the peaceful death they deserve without having an ACP …

Using Noninvasive Calibrated Cuff Plethysmography To Observe The Effects Of Cold-Water Immersion On Arterial Compliance, Rita M. Grigorian

Biomedical Engineering: Graduate Reports and Projects

As the prevalence of cardiovascular diseases continues to exponentially grow in populations across the globe, the necessity of determining underlying factors, effective methods of diagnoses, and universally available preventive measures also grows. Early detection of endothelial dysfunction, a proven precursor of cardiovascular diseases, can be extremely impactful in encouraging preventative measures and early intervention before medical conditions become chronic. In recent years, ice plunging, a form of cryotherapy involving full body immersion in cold water, has gained popularity within circles of fitness and health practitioners, gaining the interest of people of all backgrounds. Certain parallels observed between the human physiological …

Impacts Of Environmental Stressors On Native South Dakota Amphibian Physiology And Survival, Danielle Jean Galvin

Dissertations and Theses

Amphibian populations around the world are declining, with some of the most likely drivers behind these declines including emerging infectious diseases and environmental contaminants. To address major gaps in the current literature, I sought to evaluate the effect of two major environmental stressors on various aspects of amphibian physiology: emerging infectious diseases and environmental contaminants. Emerging infectious diseases of amphibians include fungal, viral, and parasitic pathogens which have expanded in host range, either geographically or in competent host species. Environmental contaminants include chemicals which may be naturally occurring in the environment, or which may be introduced to the environment, often …

Docai, Riley Badnin, Justin Brunings

Computer Science and Software Engineering

DocAI presents a user-friendly platform for recording, transcribing, summarizing, and classifying doctor-patient consultations. The application utilizes AssemblyAI for conversational transcription, and the user interface allows users to either live-record consultations or upload an existing MP3 file. The classification process, powered by 'ml-classify-text,' organizes the consultation transcription into SOAP (Subjective, Objective, Assessment, and Plan) format – a widely used method of documentation for healthcare providers. The result of this development is a simple yet effective interface that effectively plays the role of a medical scribe. However, the application is still facing challenges of inconsistent summarization from the AssemblyAI backend. Future work …

Analyzing Functional Interactions Of Designed Peptides By Nmr Spectroscopy, Wonsuk Choi

Pharmaceutical Sciences (MS) Theses

The development of small peptide-based therapeutics can be accelerated by the knowledge of relationships between the peptide structure and its functional interactions. Here, we report the analysis of two groups of synthetic peptides designed for two applications – broad bactericidal action and inhibition of protein-protein interactions in human cells. Novel amphiphilic peptides designed for antibacterial application incorporated arginine as cationic amino acids and non-natural amino acids that have aromatic side chains with similar hydrophobic properties as tryptophan. The interaction of lead cyclic peptides and their linear analogs with a phospholipid bilayer mimicking a bacterial membrane was studied using nuclear magnetic …

Effects Of The U.S. Veterinary Feed Directive Final Rule On The Prevalence Of Violative Antibiotic Residues And Antibiotic-Resistant Bacteria In Animal Products, Md Shamim Sarkar

Doctoral Dissertations

Antibiotic-resistant is a public health concern. The dissertation objective was to assess the effect of the implementation of the Veterinary Feed Directive (VFD) rule changes on the prevalence of violative antibiotic residues and antibiotic-resistant bacteria in food-animal tissues, retail meats, and cecal samples from food animals compared to the pre-VFD rule change period in the U.S. To understand the effect of implemented VFD rule changes on violative antibiotic residues in food-animal tissues, inspector-generated sampling (IGS) data from the U.S. National Residue Surveillance Program (NRP) was analyzed. An important observation was that implementing VFD rule changes was associated with the decreased …

Ethyl Pyruvate Failed To Reduce Pro-Inflammatory Cytokines Release Following In Vitro Stimulation In Dairy Calves' Whole Blood., Vincent Dore

Doctoral Dissertations

Recent developments in sepsis treatment showed that control of the late mediator of inflammation, High Mobility Box group-1 (HMGB1), improves survival in animal models of endotoxemia. Ethyl pyruvate is a small-molecule inhibitor that has been shown to reduce the systemic release of HMGB1 during experimental treatment of systemic inflammation in different species. The objectives of this body of work were 1) to explore ethyl pyruvate's ability to modulate early pro-inflammatory cytokines production and immune effector function in treated calves, 2) to evaluate the safety of an administration of ethyl pyruvate infusion in neonatal calves, and 3) to explore ethyl pyruvate's …

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

Theses/Capstones/Creative Projects

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

The Evolution Of The Role Of Speech-Language Pathologists In The Nicu: Are Educational Programs Supporting The Change?, Melanie Spinnie

Honors College Theses

The purpose of this thesis was to determine the progressive roles of speech-language pathologists (SLP) in performing feeding and swallowing interventions in preterm infants in the neonatal intensive care unit (NICU) and evaluate the education SLPs receive regarding this topic, as well as how this can affect their work in the NICU and what changes in curriculum and experience should be made for SLPs to best serve this fragile population. SLPs have not always been the primary providers in this field, so it is crucial to understand these established roles and how they have changed and will continue to change. …

Differences In Mental Health Outcomes And Services By Gender Identity Among Sexual And Gender Minorities During The First Shelter-In-Place Order Of The Covid-19 Pandemic In Texas, 2020, Mariah Victoria Alvarez Ramirez

Open Access Theses & Dissertations

Background: Within the United States, sexual and gender minorities (SGM), face unique barriers when seeking health services, such as uninsurance, postponing care, and lack of competent services. Within SGM, transgender and gender-expansive (TGX) individuals are more vulnerable as they have higher rates of discrimination and face more barriers to accessing healthcare services. Purpose: Identify differences in mental health outcomes and services by gender identity among sexual and gender minorities residing in Texas during the COVID-19 pandemic. Methods: This study is a secondary data analysis of the SGM participants of the COVID-19 and You Survey study (n=1288). Descriptive statistics, bivariate associations …

Perceived Risks And Benefits Of Hpv Vaccination: The Role Of Cues To Action, Numeracy And, Literacy, Sierra Rae Galvan

Open Access Theses & Dissertations

Background & Significance: The Human Papillomavirus (HPV) is a risk factor for both genital warts and cervical cancer. HPV strains 16 and 18 are recognized as precursors of cervical cancer. While strains 6 and 11 are estimated to cause 90% of genital warts. Latinas have the highest rate of cervical cancer in the U.S, approximately 66 % higher than non-Latino whites. These cancers are preventable in many cases through the administration of the HPV vaccine. The advisory committee on immunization practices recommends that children as young as 9 receive at least two doses of the three-dose HPV vaccine series. Consequently, …

The Impact Of Medical Device Usability And Accessibility Information On Purchasing Decisions Of People Without Disabilities, Maysam M. Ardehali

Theses and Dissertations

The disparity between people with and without disabilities in timely diagnosis and appropriate treatment is exacerbated by inaccessible medical devices. The industry appears reluctant to address the shortcomings or provide usability and accessibility information to enhance the purchasing decisions of people with disabilities. This reluctance is mainly caused by the lack of market motivation based on perceptions of market size and the profitability of investments in accessibility evaluation and improvement. This study aims to challenge this notion by demonstrating that usability and accessibility information do not solely benefit what may be considered a “niche market,” and the purchasing decisions of …

Exploring The Relationship Between Diabetes, Diabetes Risk, Depressive Symptoms, Chronic Stress, And Inflammatory Markers In Mexican-American Men, Aleli Fernandez

Open Access Theses & Dissertations

Background: Individuals with depression and stress are 60% more likely to develop type 2 diabetes compared to those without (Mezuk et al., 2008). Moreover, biological pro-inflammatory markers associated with psychosocial stress are risk factors for diabetes. Examining the relationship between psychological disorders, inflammation, and diabetes risk among MAH is important as they have high rates of diabetes.

Purpose: To examine the relationship between 1) depressive symptoms, chronic stress, and inflammatory markers, 2) inflammation and diabetes risk factors and 3) depression, stress, inflammation, diabetes risk, and metabolic syndrome (MetS).

Methods: A cross-sectional study of 100 adult men from El Paso, Texas …

Dental Caries Screening For Food Insecure Children, John Joseph Kane

Doctor of Nursing Practice

Background. Dental caries is the most common childhood disease, disproportionally impacting minorities, and socio-economically disadvantaged children. Food insecurity impacts 23.6% of children in Texas; the majority being African American and Hispanic. Food insecurity screening rates are abysmal. Dental caries and food insecurity are significantly correlated and likely syndemic. Purpose. Implement oral examination and the “Hunger Vital Sign” screening tool in detecting dental caries and food insecurity at an urban pediatric urgent care center. Evidence. Food insecure children experience adverse health outcomes, impaired long-term health outcomes, developmental and cognitive delays, psychosocial delays, and oral health deficiencies including caries and malabsorption of …

A Quality Improvement Project To Improve The Management Of Group A Streptococcalpharyngitis Among Children, Tara Denise Gutierrez

Doctor of Nursing Practice

Group A Streptococcal (GAS) pharyngitis is one of the most common pediatric illnesses and accounts for more than ten million yearly medical visits. GAS is commonly misdiagnosed due to overlapping symptoms. The health care provider needs to distinguish which criteria warrant testing for GAS and the recommendations for management and treatment.

The purpose and objectives of this quality improvement project were to improve adherence to the 2021 Canadian guidelines for the management and treatment of GAS pharyngitis in a small community urgent care clinic. Anticipated outcomes for this project included a decrease in unnecessary testing for GAS pharyngitis, a decrease …