Toolkit For Users Of Over-The-Counter Hearing Aids, Sabrina Malasarte

Dissertations, Theses, and Capstone Projects

Untreated hearing loss oftentimes has significant adverse effects on the quality of life of older adults. The associations include, but are not limited to loneliness, isolation, anxiety, and a decrease in cognitive function. Hearing aids significantly improve audibility, social interactions, and decrease feelings of loneliness or isolation. However, despite technological advances, and evidence of positive outcomes associated with hearing aid use, uptake and continued use of hearing aids remain low. Accessibility and affordability are considered barriers to uptake. Purchasing a prescription hearing aid from an audiologist is the traditional approach to receiving an amplification device, but the advent of over …

Knowledge And Attitudes Towards Usage Of Hearing Protection In Volunteer Firefighters, Rachel S. Combs

Dissertations, Theses, and Capstone Projects

Background: Occupational noise-induced hearing loss (NIHL) represents a substantial global public health concern. Regulatory agencies such as the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupation Safety and Health (NIOSH) aim to establish noise exposure limits in occupational settings, yet certain professions, such as firefighting, remain at a heightened risk. Although research has been conducted on noise exposure and hearing protection in career firefighters, a lack of research exists on volunteer firefighters. The purpose of this study was to 1) establish the extent that volunteer firefighters are currently educated on hearing conservation and hearing protection 2) …

Strengthening U.S. Jail Systems’ Response To Infectious Diseases: An Evaluation Of The Covid-19 Pandemic, Erinn Bacchus

Dissertations and Theses

Jails across the United States were struck with increased infections and deaths during the COVID-19 pandemic. Studies have shown the structural make up of jails, lack of preparedness plans, and overcrowding contributed to health risks and poor health outcomes both inside jails and local communities. Yet little research has been dedicated to strengthening jail responses to infectious disease outbreaks spanning prevention measures, data collection, and reentry planning. Gaps include information on the (1) myriad infectious disease mitigation strategies used in jails and adherence to CDC prevention guidelines, (2) development of a standardized epidemiologic surveillance system, and (3) experiences working at …

Articulatory Activity Of The Tongue, Jaw, And Lips During The Second Passaggio Transition Of The Soprano Voice, Richard C. Lissemore

Dissertations, Theses, and Capstone Projects

This dissertation describes three experiments designed to explore the acoustic and articulatory activity of a perceptible change in the soprano voice known as the secondo passaggio, or second transition, which typically occurs for the [ɑ] vowel between D♮5 (587 Hz) and F♮5 (698 Hz). Acoustically, the transition involves a shift in resonance strategy from second resonance tracking of the second harmonic (f_R2/2f_o) to first resonance tracking of the fundamental frequency (f_R1/f_o). To quantify the acoustics of the transition, we employed the measure L₁-L₂, the …

Naturify 2300, Yarina Yiwei Dai

Masters Theses

In my art practice, I explore the interplay between human desires to manipulate and anthropomorphize nature, as seen in the technological augmentation of plants and living entities. This investigation delves into how this intersection, alongside empathy towards these creations, contributes to fears of uncontrollability and the risks of addiction and excessive dependence on technology.

Bioengineering and genetic modification have cultivated unprecedented developments, allowing humans to manipulate the fundamental building blocks of life. My research speculates on this technology further, modifying the genetic code of organisms and creating bioengineered wearable entities with enhanced traits or entirely new functionalities. The primary objective …

Blunt Cerebrovascular Injury (Bcvi): Universal Cta Neck Screening At Level 2 Trauma Center, Tamine Gogel

Doctor of Nursing Practice Projects

Blunt Cerebrovascular Injury (BCVI) refers to injuries to the vessels supplying blood to the brain, primarily carotid and vertebral arteries, and can result from trauma, resulting in stroke by vessel dissection, thrombus formation, embolization, and hemorrhage. Timely identification is crucial for effective intervention and improved outcomes. This doctoral project proposes the implementation of universal screening using Computed Tomography Angiography (CTA) of the neck during initial workup for blunt force trauma at a Level II ACS-verified trauma center. The primary objective is to mitigate potential delays in diagnosing and treating BCVI, thereby reducing the likelihood of complications. Patients ≥ 15 years …

Generation And Characterization Of Lipid Nanoparticles For Dna Plasmid Delivery And Pharmacological Characterization, Sahana John

Biotechnology Theses

Lipid nanoparticles (LNPs) have shown promise for delivering nucleic acids like DNA plasmids, but packaging large plasmids remains challenging. The findings and experimental work detailed in this thesis are geared towards providing a proof of concept and providing preliminary confirmation of the guiding principle.

We synthesized LNPs containing cationic lipids (D-Lin-MC3) to encapsulate the large pLVX-ZsGreen and psiCHECK (luciferase) plasmids (~10-14kb) using a microfluidic system. Characterization included size, charge, morphology, plasmid encapsulation efficiency and in vitro/in vivo studies. The LNP-pDNA particles were ~100nm in size with high encapsulation efficiency. The LNPs efficiently transfected 293T cells with low cytotoxicity, enabling strong …

Dissecting The Potential Mechanisms Of Histone Deacetylase 1 Dependent Macrophage Phagocytosis Of Mycobacterium Tuberculosis, Owusu A. Christian

Biotechnology Theses

Histone deacetylases (HDACs) mediate the removal of acetyl groups from the histones of chromatin and regulate the expression of the genes involved in cancer development and immune cell functions. Our previous study showed that HDAC2 enhances IL-1β production by Mycobacterium tuberculosis (Mtb) infected macrophages by promoting inflammasome activation. HDAC1, on the other hand, regulates macrophage phagocytosis of Mtb. However, the mechanisms by which HDAC1 controls macrophage phagocytosis remain unclear.

Using human monocyte-derived macrophages (MDMs) and Mtb strains, we explore the mechanism of HDAC1 in macrophage phagocytosis of Mtb. Our results showed that blocking HDAC1, either chemically or genetically, …

Evidence-Based Practice Guidelines: Anesthesia For Total Knee And Hip Arthroplasty, Amanda Kleinfelder

Doctor of Nursing Practice Scholarly Projects

Abstract

Total knee and hip arthroplasty are the two most common orthopedic surgeries in the United States. Traditional perioperative practice is multidisciplinary, with each professional, including anesthesia, making decisions based on their current knowledge or past experience. Postoperative complications pose a threat to any patient undergoing a surgical procedure. Enhanced Recovery After Surgery (ERAS) protocols were developed to streamline best practice guidelines during the perioperative period. ERAS pathways aim to decrease postoperative complications, accelerate recovery after surgery, decrease narcotic use and promote early mobilization and discharge from the hospital. The aim of this project is the development of evidence-based practice …

Reducing Inpatient Falls Utilizing Multimodal Standardized Patient Education: An Evidence-Based Practice Project, Sheryl Almandrez

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: This project aims to utilize multimodal standardized patient education as an evidence-based practice intervention to reduce inpatient falls.

Background: In 2022, Kaiser Foundation Hospital (KFH) San Diego had 116 falls. Inpatient falls with injury account for the second-highest Joint Commission (TJC) sentinel event and California Department of Public Health (CDPH) adverse events. These injuries include lacerations, subdural hematoma, subdural hemorrhage, hip fractures, and wrist fractures. The Centers for Medicare and Medicaid Services (CMS) have also stopped reimbursing hospitals for the care provided after patients have sustained a fall with injury.

The project was implemented at KFH-San Diego …

Implementing An Abnormal Involuntary Movement Scale At An Outpatient Mental Health Clinic, Amanda Ghamsari

Doctor of Nursing Practice Final Manuscripts

Background: Movement disorders caused from psychotropic medications affect an estimated 500,000 people in the United States. These disorders bring an added cost for treatment to the patient, cause emotional distress, and may hinder daily life. Overall health and additional medication costs were increased for these patients by $25,879 per patient per year compared to patients without a movement disorder.

Purpose of Project: To address the issue, the team of mental health providers at an outpatient clinic assess their mental health patients at start of care and at follow up visits utilizing the Abnormal Involuntary Movement Scale. With the goal of …

Dm Education On Lifestyle Modification To Improve Dm Knowledge Retention And Self-Care Confidence, Jinyoung Sanchez

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: The purpose of this evidence-based practice project was to provide diabetes education to improve diabetes knowledge and self-care confidence for patients with type 2 diabetes admitted to a tertiary hospital in San Diego. First, this study was to assess their DM knowledge and self-confidence before the education was provided. Second, based on the initial assessment and the education on lifestyle modification, 3 months of follow up was assessed to see if the education had been effective. Third, the study was to determine if the education also improved the self-confidence in managing diabetes on their own.

Background: Uncontrolled diabetes …

Enhancing Newer Nicu Nurse Confidence With Resuscitation Through High-Fidelity, In-Situ Crisis Resource Management, Karen Rose

Doctor of Nursing Practice Final Manuscripts

Neonatal resuscitation is a low-volume, high-risk occurrence. Given the infrequency of resuscitation, newer neonatal intensive care unit (NICU) nurses may have little to no exposure to neonatal resuscitation events. This can lead to a lack of confidence in resuscitation skills, contributing to burnout, poor patient outcomes, and the potential for nursing turnover. This evidence-based practice project, guided by the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care, focused on enhancing the perceived confidence in neonatal resuscitation skills among newer NICU nurses. To achieve this, multidisciplinary, high-fidelity, in-situ neonatal resuscitation crisis resource management (CRM) simulated events were implemented. …

Care Of The Critically Ill Nontrauma Patient: Improving Emergency Department Readiness And Patient Care Through The Implementation Of A Dedicated Resuscitation Bay, Martha H. Buck Rn, Bsn, Tcrn

Doctor of Nursing Practice Final Manuscripts

Current best practice among emergency departments worldwide includes the maintenance of a dedicated resuscitation space. This practice allows for team members and equipment to be ready at a moment’s notice to provide care to a patient in need of lifesaving interventions. This evidence-based performance improvement project seeks to implement this standard of care in a busy, urban emergency department in Southern California.

Prior to this study, patients at this facility were placed in the next available care space, without the maintenance of a dedicated resuscitation area for critically ill patients. Survey data evaluating staff levels of perceived readiness to care …

Impact Of Mindfulness Education And Resources On Stress In Parents Of Children With Autism Spectrum Disorder, Jacqueline James

Doctor of Nursing Practice Final Manuscripts

The purpose of this project was to reduce stress levels of parents of children with autism spectrum disorder (ASD) by teaching them mindfulness practices and education on free and accessible methods to integrate mindfulness into their daily lives, as well as the benefits of mindfulness in reducing stress and improving psychological well-being.

Parents of children with ASD experience high levels of stress and numerous research studies support the use of mindfulness techniques to reduce stress levels in adults. The participants in this project included mothers who have at least one child with ASD who attend the Thompson Autism and Neurodevelopmental …

Honoring Veterans’ Wishes: Efficacy Of An Evidence-Based Shared Decision-Making Tool In Va Icu Goals-Of-Care Discussions, Stephanie Alexander, Anna Astashchanka Md, Venktesh Ramnath Md

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This Doctor of Nursing Practice project aimed to enhance the knowledge and confidence of the San Diego Veterans Health Administration’s (VASD) Intensive Care Unit (ICU) medical providers in goals-of-care discussions (GOCD). Additionally, this project aimed to improve the documentation of these discussions.

Background: Delays in GOCD can lead to futile medical and surgical interventions, inappropriate antibiotic use, and higher rates of mental health conditions in patients and their loved ones. Earlier GOCD are associated with lower ventilation and resuscitation rates, earlier hospice enrollment, reduced ICU admissions, lower financial costs, and better patient and caregiver quality of life. However, …

A Multimodal Approach: Implementing Omm For Spinal Surgery Patients' Pain And Anxiety, Summer Barnes

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to encourage thorough assessment of pain and anxiety prior to spinal surgery in order to identify the need for implementation of additional modalities, such as osteopathic interventions for pain and anxiety management. It is pertinent that as holistic providers we address this populations often missed psychological distress and ineffective pharmacological pain regimens to promote better patient outcomes.

Background: Research says there are approximately 1.62 million instrumented spinal procedures performed annually in the United States. Spinal surgery is not uncommon, and neither is the chronic pain and …

Keep Our Children Smiling: Fluoride Varnish Education In The Pediatric Primary Care Setting, Isabella Mortola

Doctor of Nursing Practice Final Manuscripts

Background: Dental caries is the most common chronic childhood disease. In early childhood, it is associated with many negative factors such as pain, loss of teeth, and impaired growth. Fluoride varnish (FV) is a protective resin coating treatment that is reimbursable by most insurances and is recommended by the American Academy of Pediatrics (AAP), United States Preventative Services Task Force (USPSTF), and the American Dental Association (ADA) due to its high efficacy in preventing dental caries. FV is a low-cost treatment that can be easily applied in 1-2 minutes during a well-child visit in the primary care setting, where children …

Human Trafficking And Resources Provision In The Ed, Kathryn Patrick

Doctor of Nursing Practice Projects

Human trafficking is both a human rights violation and a national health crisis. Despite nearly 165,000 identified cases in the United States since 2007, studies hypothesize that many more victims remain undetected despite up to 88% of trafficked persons interacting with the healthcare system during the time they are being trafficked. The lack of identification of these victims has often been attributed to healthcare providers' lack of knowledge regarding human trafficking indicators and lack of confidence in how to address trafficking situations when they are encountered. Emergency department care providers of a 500-bed central Illinois hospital received education and resource …

Analyzing The Cognitive Complexity Of The Questions On The Advanced Placement Computer Science Principles Exam, Lauren Zirpoli

Seton Hall University Dissertations and Theses (ETDs)

This convergent parallel mixed methods study with qualitative and quantitative content analysis was conducted to analyze and describe the cognitive complexity of the publicly released Advanced Placement Computer Science Principles Exam questions compared to the language of higher-order thinking found in research literature. Hess’ Cognitive Rigor Matrix was used to determine the frequency and percentage of questions categorized as higher-order thinking within each cell of the matrix. The qualitative method consisted of content analysis of the language of each question analyzed, followed by deductive coding, and culminated with categorizing the depth and type of thinking required on Hess’ Cognitive Rigor …

Moving Forward With Ketamine Therapy: Ensuring Safety, Efficacy, And Accessibility In Depression Treatment, Julienne Desanto

Undergraduate Honors Theses

Ketamine, a medication long used in anesthesia, has emerged as a promising treatment for depression and other mental health disorders. Its rapid onset of action and mechanism, which differs from traditional antidepressants by targeting NMDA receptors, offers a novel approach to managing depressive symptoms. Despite its potential, ketamine's use outside anesthesia, particularly in off-label ketamine clinics, is fraught with regulatory, safety, and accessibility challenges. This paper explores the historical medical use of ketamine and its emerging role in mental health treatment. It compares the efficacies and administration routes of different forms of ketamine, including intravenous (IV) and intranasal (nasal spray) …

Initiating Access To Palliative Care Earlier In Pediatric Oncology Patients, Anita Sharma

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Pediatric oncology patients should be referred to palliative care early but despite research indicating the clear benefits, there is still a delay in referring patients. One of the reasons include lack of understanding amongst providers on what palliative care is. Palliative care provides symptom management, emotional support and helps the patient and family with difficult decision making.

Objectives: This project aimed to increase the number of early referrals to palliative care. The Pediatric Palliative Care Screening Tool (PaPas) was utilized to help identify the triggers which should prompt the referral.

Methods: A chart review of patients diagnosed with …

Do Resilience And Treatment Satisfaction Moderate The Association Between Adhd And Quality Of Life?, Allison Macht

Senior Theses and Projects

This study examined how resilience moderated the association between ADHD symptom severity and general Quality of Life (QoL) in emerging adults. Using data from an anonymous online survey distributed at six US colleges/universities, participants (N=4396; 73% female-identifying; 72% White) reported on ADHD symptomatology and their diagnostic status; resilience; perceived QoL; and satisfaction with pharmacological and behavioral treatment for ADHD (if diagnosed). As hypothesized, overall ADHD severity was inversely associated with the different facets of QoL (rs = -.18 to -.29). However, contrary to our hypothesis, inattentive symptoms showed larger inverse associations with QoL compared to hyperactive/impulsive symptoms. There was a …

Artistic Expression Of Medical Experiences Of Mothers Of Color: Perspectives Using Art Therapy, Lauren Barrett

Expressive Therapies Dissertations

The purpose of this study was to qualitatively examine perspectives of mothers of color living in the US and their experiences in the healthcare system through art therapy. The study aimed to further identify personal narrative experiences of mothers of color navigating the healthcare system, promote individual voices, and acknowledge disparities impacting those within marginalized communities. The participants in this study included a total of eight identified mothers of color (non-White) living in the US. Participants took part in four weeks of consecutive art therapy sessions either in 60-minute group or individual virtual meetings. One art therapy directive was provided …

Lyme Disease In The Northeast: The Unintended Consequence Of Suburban Development, Hayden Neubert

Student Theses 2015-Present

This paper addresses the role of suburban development in the suburbs of the Northeastern United States in increasing human Lyme disease infection. Over the past 50 years, Lyme disease has become the most common vector-borne disease in the United States. In 2021, the two states with the most Lyme disease cases were New York and New Jersey, with a collective 6,524 cases, with Connecticut still representing 541 total cases. It is not a coincidence that case numbers are concentrated in suburban areas with high forest fragmentation. Chapter 1 of this essay analyzes how human land development disrupts bioregulatory ecosystem actors …

Exploring Attachment Through Clay-Based Therapy: A Parent-Child Community Engagement Project, Hilari Stahler

Expressive Therapies Capstone Theses

This research project explores the therapeutic potential of clay, particularly as a creative, sensory-rich process that facilitates access to pre-verbal memories. Grounded in attachment theory and the innovative approach to trauma healing by Cornelia Elbrecht, known as Trauma Healing at the Clay Field®, the study investigates clay's regressive and healing qualities. It examines how its smooth, skin-like texture can activate our implicit memories through sensory experiences. Utilizing a community engagement format, this study aimed to assess the effectiveness of parent-child clay field sessions in addressing intergenerational attachment trauma and unmet attachment needs. The research revealed that the unique properties of …

Re-Member Selfhood A Drama Therapy Intervention, Option 1, Angelique Beauchêne

Expressive Therapies Capstone Theses

Re-member Selfhood is a specific trauma-informed, drama therapy, intervention designed to meet the needs of adults with exposure to trauma and traumatic stress, who have pertinent adverse childhood experience scores and/or experience persistent trauma cycles over the lifespan concurrent with somatization. The aim of this thesis was to introduce an intervention which could function as indirect exposure and assist in the integration process taking the whole being of trauma sufferers into account, including body, mind, and soul. Additionally, the hope of this intervention is to decrease perceived physical pain, assist in the integration of the rejected aspect of self, and …

Playing With International Students From Asia: An Exploration Of Cultural Commonalities And Differences In Developmental Transformations (Dvt), Hazuki Okamoto

Expressive Therapies Capstone Theses

Asian international students in the United States face a multitude of challenges such as language barriers, differences in cultural norms and behaviors, and identity confusion while navigating a foreign landscape. Developmental Transformations (DvT), a form of drama therapy, may apply to these challenges by enabling participants to explore different identities and express themselves creatively beyond the language barrier. This community engagement project was designed for Asian international students to be seen and heard by utilizing DvT. Within an in-person workshop, five participants played with their shared stories, and explored international and cultural roles in group DvT. Key takeaways from the …

A Trauma-Informed Socially Just Approach To Working With Juvenile Justice-Involved Youth Utilizing Expressive Arts Therapy, Ciara Carr

Expressive Therapies Capstone Theses

Youth involved with the juvenile justice system often have a history of trauma and oppression resulting from their positionality and circumstances. Most juvenile justice-involved youth are boys, youth of color, low-income, LGBTQIA2S+, disabled, and traumatized. This literature review explores the history of the juvenile justice system, issues with the present-day model, and trauma-informed and transformative justice approaches to practice. The implementation of socially just, trauma-informed expressive arts therapy programs is proposed as a more equitable practice to replace commonly used punitive practices across the United States. More research is needed to understand the impact of such programs on this population …

Colorful Conversations: Enhancing Communication In Nonspeaking Toddlers Through Art Therapy, Joy Wu

Expressive Therapies Capstone Theses

The purpose of this study was to learn how art therapy helps non-speaking children ages two years old build up their communication with others. Although there are not many early publications on the benefit of art therapy to children ages two, the existing research suggests that art therapy can aid those children in speaking based on the experience of art making. During the art creation process, engaging with art materials and their potential power can enable the expression and conveyance of emotions as art serves as containment. Therefore, art therapy can assist nonspeaking toddlers to begin communicating verbally. This writer …