Medicine and Health Sciences Commons^™

New York City’S Health Governance And Activism From The 1950s To The 1970s, Andres Valcarcel

Theses

New York City's expansive network of hospitals and preventative health services has an intense history outside of the popular narratives of biomedical and technological advancement. This thesis will discuss the period between the 1950s and 1970s and the various movements and parties that shaped the city's health and hospital system. During this period, New York City's healthcare delivery system became increasingly privatized and commercialized; processes that improved the quality of healthcare yet simultaneously barred the poorest from accessing it. Communities, healthcare workers, and civil rights organizations worked to address perceived faults and extend their agency in health and hospital policy; …

Mothers' Perceptions Of Stigma: Implications For Early Identification And Treatment For Children With A History Of Prenatal Opioid Exposure, Pamela Jane Holland

Theses, Dissertations and Capstones

There is a lack of research that specifies the long-term effects on a child’s language development when prenatally exposed to opioids (Fill et al.,2018; Rutherford et al., 2022). Despite this, children prenatally exposed to opioids are more likely to be referred for, qualify for, and receive therapy services secondary to developmental delays and speech/language deficits. (Kaltenbach et al., 2018). Stigma continues to be a barrier to the initiation of early intervention services for children prenatally exposed to opioids (Levickis et al., 2020; Livingston et al., 2011; Peacock-Chambers et al., 2020). This phenomenological study aims to understand the perceptions of the …

The Impact A Nurse Recruiter Has On Nursing Staff Shortages And Nurse Manager Satisfaction In An Acute Psychiatric Facility, Johna Arnett

DNP Projects

Abstract

Background: Nursing staff shortages have persisted for the last few decades. Strategies to resolve this enduring challenge continue to drive the creative efforts to attract and retain new staff. These shortages not only affect patient care but can also impact the satisfaction of nurse managers. Little information is available on the effects of a nurse recruiter role on nursing staff shortages as well as nurse manager satisfaction.

Purpose: The purpose of this project is to assess how implementing a designated nurse recruiter impacts nursing staff shortages and nurse manager satisfaction in an acute psychiatric facility. This project examines two …

The Impact Of Early Screening For Severe Alcohol Withdrawal Syndrome On Delirium Tremens And Hospital Length Of Stay, Erin Lopes

West Chester University Doctoral Projects

Alcohol use disorder (AUD) is a prevalent condition and is a leading cause of death for adults aged 20 to 64 (Esser et al., 2022). Patients with AUD who present to acute care hospitals seeking medical treatment are at risk for alcohol withdrawal. Undertreated alcohol withdrawal can progress to delirium tremens, which can result in increased transfers to ICU level of care, increased need for sedative medications, and has been shown to prolong hospital length of stay. Early screening with the validated Predictors of Alcohol Withdrawal Severity Scale (PAWSS) tool has been shown to be both reliable and effective for …

Utilizing A Structured Music Therapy Program For Adolescents With Anxiety And Depression, Amy Haagen

West Chester University Doctoral Projects

Anxiety and depression are two of the most common mental health issues that affect children and adolescents. It has been noted that twenty percent of adolescents will have a depressive episode or be affected by anxiety by the time they are 18 years old. Mental health issues affecting children and adolescents majorly impact all aspects of their lives, most notably academic success, behavior, growth, and development (Porter et al., 2017). Current treatments for mental disorders, including depression and anxiety, include pharmacological and psychotherapeutic treatments. In the adolescent population, there are conflicting opinions on the use of antidepressants due to risks …

Utilizing The Stop-Bang Questionnaire To Assess Risk Of Obstructive Sleep Apnea In Hospitalized Patients With Heart Failure To Facilitate Sleep Medicine Referrals Upon Discharge, Chelsea Mitchell

DNP Projects

Background: Obstructive sleep apnea (OSA) is the most common sleep-breathing disorder. Undiagnosed OSA is highly prevalent in the population, especially in those with heart failure. OSA and heart failure combined create a negative feedback loop that can lead to poor clinical outcomes. Unfortunately, many cardiac patients are never screened for OSA.

Purpose: The purpose of this project is to improve screening rates for OSA via the STOP-Bang questionnaire and establish an efficient and effective process for referrals to sleep medicine for heart failure patients screening high-risk.

Methods: The design was a quality improvement project with pre- and post-testing and a …

Implementation Of Unit-Based Preceptor Orientation: The Effects On Perceived Orientee Competence And Self-Confidence Of The Precepting Cvicu Nurse, Laura K. Marcum

DNP Projects

Purpose: The purpose of this study was to assess how unit-specific preceptor training impacted the perceived readiness of new graduate nurses, self-confidence of preceptors, and the correlated job satisfaction.

Background: The nurse attrition rate is resulting in inexperience at the bedside. Nursing inexperience leads to lower quality patient care. If improving the efficiency of training and education can improve perceived readiness, then in turn we can increase the longevity of our new nurses. Improving the longevity of nurses has significant implications on the budget of each hospital, the patient outcomes, and the staff’s resulting job satisfaction.

Methods: New graduate nurse …

Increasing Breast Cancer Screenings In The New American Population, Tuhina Venkatayogi Mph, Bs, Rn, Erin Leighton Dnp, Aprn, Fnp-Bc

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: Breast cancer poses a significant health risk globally, with routine screenings pivotal for early detection. The New American population in Vermont face many barriers to accessing mammogram screenings and have a 0% participation rate in breast cancer screening, thus necessitating targeted interventions. The purpose of this project was to improve mammogram participation among New Americans by at least 15% by January 2024.

Methods: The intervention at a New American clinic included an educational infographic presented during initial health center visits, supplemented by tangible pamphlets. Patient understanding was assessed through teach-back questions. Appointment scheduling was facilitated during the visit, with …

On The Brink: Unveiling The Crisis Of Burnout Among Va Clinic Physicians, Aaron Clarke

Theses, Dissertations and Capstones

Introduction: This study investigates the significant challenge of burnout among physicians at Veterans Affairs (VA) clinics. Characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, physician burnout is a growing concern that compromises the well-being of the doctors and the quality of healthcare they provide. Recent studies have shown an alarming increase in burnout symptoms among healthcare providers, reflecting systemic issues that adversely affect patient care and the operational efficacy of healthcare institutions.

Purpose of the Study: The research aimed to dissect the intricate effects of physician burnout on medical outcomes within the VA healthcare system’s outpatient settings. …

Impact Of The Methamphetamine Epidemic On Healthcare, Amanda Brumfield

Theses, Dissertations and Capstones

Introduction: The surge in methamphetamine use in the U.S. has presented various challenges for individuals and healthcare systems. Research has shown high relapse rates, oral health issues, and increased susceptibility to blood-borne viruses among users, underscoring the gravity of the situation. Furthermore, the absence of approved pharmacological treatments and systemic barriers to effective treatment highlighted the pressing need for holistic approaches to address this epidemic successfully.

Purpose of the Study: The purpose of this research was to identify the challenges faced by treatment providers specializing in substance use disorder treatment amid rising instances of methamphetamine abuse, including managing heightened relapse …

Empowering Caregivers In The Prevention Of Clinical Delirium For At Risk Older Adults Boarding In The Emergency Department Setting, Danielle Brewer

DNP Projects

Background: Emergency Department (ED) overcrowding is a global healthcare crisis documented in the literature for more than a decade, impacting patient outcomes and resource availability. While awaiting delayed transfer to an inpatient room, older adults in the ED remain vulnerable to developing acute delirium. Boarding potentiates the risk for worsening health outcomes, which are further compounded by delirium. Scarcity of resources and time constraints delay delirium detection and increase risk for down-stream hospital-acquired complications, higher cost, and prolonged length of stay. Current ED models do not prioritize caregiver partnership or involvement in delirium-conscious care, which is a holistic approach to …

Improving Knowledge, Confidence, And Competency Among Icu Nurses Concerning The Benefits Of Using The Uk Ventilator Separation Protocol, Brittany Monroe

DNP Projects

Background: The trauma intensive care unit (ICU) at University of Kentucky (UK) Healthcare uses a ventilator separation protocol which provides specific guidelines on the successful weaning of patients from mechanical ventilation. However, many of the nurses are not aware of this protocol as formal education is not included in their orientation or training. This lack of knowledge can lead to risks such as increased patient morbidity, mortality, ICU length of stay, and healthcare-related costs. Research shows that using structured mechanical ventilator weaning tools in the ICU can shorten the duration of mechanical ventilation, which in turn, lowers these associated risks. …

The Impact Of Lung Cancer Screening Education On Knowledge And Screening Rates In A Kentucky Cancer Survivorship Clinic, Alexandra Isler

DNP Projects

Background: Lung cancer is a significant problem in Kentucky, which ranks fourth in the nation in adults who currently smoke. Early detection, through lung cancer screening, can prevent untimely deaths. Several barriers to screening exist including lack of knowledge and awareness among patients regarding lung cancer screening. By increasing knowledge, at risk patients can take the necessary steps to decrease incidence of late stage diagnoses.

Purpose: The purpose of this project was to evaluate patients’ knowledge of lung cancer screening and referral and screening rates before and after one-on-one patient education.

Methods: This was a quality improvement project that used …

Boiling Behind Bars: Exploring The Hidden Toll Of Extreme Heat On Mental Health In Texas Prisons, Sandra K. Miller

Social Work Theses

The State of Texas supports the largest prison system in the US and held 132,859 people in 100 units scattered across the state as of December 2023. Approximately 70% of Texas prison beds are not air conditioned, despite the state’s reputation for dangerously hot, humid summers. The State has officially recorded temperatures inside Texas prison facilities as high as 120 degrees with heat index values of over 150. Although there is a growing body of research on the negative physiological and psychological consequences of extreme heat among the general public, little is known about the physical and emotional toll of …

A Neuroscience-Based Curriculum For Addiction Prevention For Fourth-Grade Students, Paola Andrea Benitez

Social Work Theses

Substance use is one of the main problems affecting adolescents and young adults. While the consumption of alcohol has decreased, the consumption of marijuana has increased rampantly due to youth's positive perception after being legalized in 24 states with no clear message of the many adverse effects this drug causes. Different approaches to prevention have been used throughout the years: scare-led tactics, socio-emotional learning skills, and neuroscience-based curriculums. Since substance use results from the conjunction of different biopsychosocial factors that lead to this relapsing brain disease, the solution should integrate different preventive solutions as well. Public policy, schools, social workers, …

A Multidisciplinary Approach To Managing Financial Toxicity In Oncology Patients, Katelin Muse

Walden Dissertations and Doctoral Studies

Patients with a cancer diagnosis are counseled at length about the standard of care treatment options, which may include surgery, radiation, anticancer medications, and chemo/immunotherapy through an informed consent process. Unfortunately, the potential economic burden and the accompanying psychological burden is seldom discussed up front. There is a significant need for routine screening and a multidisciplinary approach to the prevention of financial toxicity for the oncology patient. The purpose of this doctoral project was to lead an interprofessional team in the development of a clinical practice guideline for routine financial screening using the Comprehensive Score for Financial Toxicity (COST) tool …

A Multidisciplinary Approach To Managing Financial Toxicity In Oncology Patients, Katelin Muse

Walden Dissertations and Doctoral Studies

Patients with a cancer diagnosis are counseled at length about the standard of care treatment options, which may include surgery, radiation, anticancer medications, and chemo/immunotherapy through an informed consent process. Unfortunately, the potential economic burden and the accompanying psychological burden is seldom discussed up front. There is a significant need for routine screening and a multidisciplinary approach to the prevention of financial toxicity for the oncology patient. The purpose of this doctoral project was to lead an interprofessional team in the development of a clinical practice guideline for routine financial screening using the Comprehensive Score for Financial Toxicity (COST) tool …

“Your Legs Don’T Look All That Good” An Analysis Of Impoliteness And Politeness In Individuals With Traumatic Brain Injuries In The Workplace, Grace Kozal

Theses and Dissertations--Communication Sciences and Disorders

Background: Social communication disorders are a common outcome from traumatic brain injury (TBI). This social communication disorder can be seen through impolite speech acts during conversation. While politeness is a social norm for workplace discourse, instances of impoliteness may have poor consequences. This research explores the use of impoliteness in persons with TBI within computer generated work-based conditions.

Methods: Language samples from the Voicemail Elicitation Task (VET) and Feedback/Advice Spoken Task (FAST) were transcribed word-for-word. Transcripts from all 62 participants were coded for impoliteness using a developed Impoliteness Codebook and were analyzed to identify significant differences in the number of …

Division Of Labor And Relationship Satisfaction: Examining The Mediating Role Of Self Esteem, Ellen Keith

Theses and Dissertations--Family Sciences

As a result of feminist movements, rejections of gender roles, and changing economic conditions, profound changes have occurred within the structure of American families. This study delves into the intricate dynamics of divisions of household labor (DoL), self-esteem, and relationship satisfaction within the context of contemporary relationships. Drawing on data from the Panel Analysis of Intimate Relationships and Family Dynamics (Pairfam), this study tested five hypotheses, and investigates how perceptions of fairness in DoL tasks influence self-esteem and relationship satisfaction. Significant associations were found between reported share of DoL and indicated fairness of DoL, indicated fairness of DoL and relationship …

Investigating A New Drug Target In Alzheimer’S Disease: Nox2, Tiffany Adams

Theses and Dissertations--Pharmacy

Introduction: Alzheimer’s disease (AD) is a neurodegenerative disease with neuropathological changes in the blood-brain barrier that offers possible therapeutic targets. Oxidative stress is one driving factor for AD. NADPH oxidase 2 (NOX2) in the capillary endothelium produces reactive oxygen species, leading to oxidative stress-mediated blood-brain barrier dysfunction. We hypothesized that using a specific NOX2 inhibitor, PhoxI2, has the potential to reduce reactive oxygen species and repair amyloid-β (Aβ)-driven blood-brain barrier leakage in an AD mouse model.

Methods: For this study, 5xFAD (Familiar Alzheimer Disease) mice were treated with vehicle or PhoxI2, a NOX2 inhibitor. Techniques utilized were Enzyme-Linked Immunosorbent Assay …

Nutrition Counseling Practices Among Psychologists, Wibecke Stromsnes

University of the Pacific Theses and Dissertations

There is a lack of treatment guidelines for how to address the impact of nutrition on clients’ mental health. Prior research is limited regarding psychologists’ practices of nutrition counseling and has mostly focused on practices of dieticians and medical doctors. The purpose of this study was to examine psychologists’ beliefs and attitudes about nutrition counseling, amount of training and use of nutrition counseling, self-rated knowledge in the use of nutrition counseling and perceived benefits and barriers to using nutrition counseling. Data was collected using an online survey of 76 licensed psychologists’ training in nutrition and use of nutrition counseling. Findings …

Senior Mental Health Clinicians’ Understanding Of Their Self-Efficacy While Providing Services At Community-Based Agencies, Rukiya Symister

Walden Dissertations and Doctoral Studies

Many mental health clinicians strive to provide their clients with rehabilitative and psychotherapy services resulting in a client gaining stable income and housing. However, the role of a senior mental health clinician (SMHC) is not without its challenges of trying to balance their well-being while dealing with increased coworker turnover, demanding caseloads, and limited access to community resources to provide clients with getting their lives back on track, thereby impacting clinicians’ understanding of their self-efficacy. Much of the research on self-efficacy has focused on mental health clients, mental health graduate students, and mental health trainees, often leaving out the lived …

Impact Of Traditional Education And Learner-Centered Education On Standardized Tests, Courtney Marie Winslow

Walden Dissertations and Doctoral Studies

There is a current shortage of approximately 45,000 nurses and nursing faculty to train student nurses, a number that is projected to grow. One proposed method to combat the shortage is to transition from traditional lecture-based classrooms to a learner-centered approach. Asking or requiring faculty to transition an entire nursing program from one teaching method to another without supporting data could be a waste of valuable time and resources. It could also prove detrimental to a program if students were unable to pass the NCLEX-RN exam, and a program was forced to close. The current study examined whether there was …

Impact Of Traditional Education And Learner-Centered Education On Standardized Tests, Courtney Marie Winslow

Walden Dissertations and Doctoral Studies

There is a current shortage of approximately 45,000 nurses and nursing faculty to train student nurses, a number that is projected to grow. One proposed method to combat the shortage is to transition from traditional lecture-based classrooms to a learner-centered approach. Asking or requiring faculty to transition an entire nursing program from one teaching method to another without supporting data could be a waste of valuable time and resources. It could also prove detrimental to a program if students were unable to pass the NCLEX-RN exam, and a program was forced to close. The current study examined whether there was …

The Impact Of Human Attachment To A Pet Bird On Psychological Well-Being, Kathryn Marie Trautann

Walden Dissertations and Doctoral Studies

Few studies have addressed human attachment to a pet bird and psychological well-being, and the research that has been conducted is largely anecdotal and anthropomorphic perspectives on human relationships with birds. In this quantitative study, the relationships between humans and their birds were explored using Bowlby's attachment theory and Fredrickson and Losada's broaden and build theory. The study consisted of a randomized experiment, in which individuals were randomly assigned to either an attachment (n = 81) or detachment (n = 88) group. The security priming manipulation was used to prime the groups. The attachment group was asked to list things …

The Use Of Vascular Endothelial Growth Factor In Ligament And Tendon Repair, Caroline O'Connell

Honors Theses

The studies in this review have shown that VEGF increases tensile strength, decreases inflammation, and increases vascularization. In studies using exogenous VEGF, it was found that VEGF increases collagen type III fibers, which increases biomechanical strength, and improves graft revascularization. From the research, it can be concluded that endogenous injection of VEGF is more beneficial than exogenous due to endogenous not causing laxity of the connective tissue. VEGF is beneficial when compared to normal post-operative results due to it decreasing the duration of symptoms and decreasing healing time. Using VEGF injection treatments, patients can return to pre-injury activity at a …

“Their Body, Their Choice. Your Body, Your Choice. Your Baby, Your Choice.”: A Reflexive Thematic Analysis Of Vaccine Access And Acceptance Among U.S. Pregnant People On Reddit, Sydney Marie Perlotto

Public Health Theses

Compared to the general population, pregnant people and newborns are at a higher risk of contracting infectious diseases and experiencing worse adverse outcomes. Vaccines delivered during pregnancy, known as prenatal vaccines, represent a critical yet underused form of preventive care for these populations in the United States. Increasing successful prenatal vaccination uptake requires a focus on both access and acceptance, which pregnant people may experience differently than non-pregnant people due to their unique physiological and social state. Given the evolution of vaccine hesitancy following the COVID-19 pandemic, coupled with the recent expansion of the U.S. prenatal immunization schedule, this study …

“I Didn't Want Them To Feel Like I Was Fragile”: A Qualitative Analysis Of Disability, Intimacy, And Sexual Culture At Yale, Mafalda Von Alvensleben

Public Health Theses

This thesis examines how Yale as an educational institutional shapes disabled students’ sexual and romantic lives. It explores the ways in which the institution's policies, culture, and physical environments influence these experiences via a qualitative and landscape analysis. The analysis was based off nine semi-structured interviews with students who self-identified as disabled from both undergraduate and graduate programs, as well as a landscape analysis that incorporates formal, journalistic style interviews with eleven Yale faculty, staff, and administrators. Taken together, this study illuminates the challenges posed by systemic ableism within the university's academic and social frameworks. It highlights the inadequacies of …

Comparing Hpv Vaccination Uptake In Democrat And Republican Us States Using Presidential Elections Voting Patterns In 2016 And 2020, Omar Guerrero

Public Health Theses

Abstract Objective: To investigate the association between state-level voting patterns and Human Papillomavirus (HPV) vaccination coverage in teenagers in the US. Methods: States were categorized as either Democratic or Republican based on the 2016 and 2020 Presidential election results. A paired t-test was conducted to examine the difference between vaccination coverage between the two groups. A multivariable linear regression model was conducted to examine how state-voting patterns are associated with HPV vaccination coverage after adjusting for confounding (percentage of people living in poverty, percentage of uninsured people, percentage of non-white population, and the percentage of people living in rural areas …

Associations Among Psychosocial Factors, Health-Related Quality Of Life, And Adherence In Pediatric Inflammatory Bowel Disease, Cecelia I. Nelson

Graduate Theses, Dissertations, and Problem Reports

Inflammatory Bowel Disease (IBD) is a prevalent disorder among youth in the United States. IBD is one of the leading causes of chronic pain in adolescence and symptoms can lead to reduced quality of life, social embarrassment, and lower self-esteem. Adherence to medical regimens for IBD is incredibly important to prevent morbidity, mortality, and impaired health-related quality of life (HRQOL). However, adolescents struggle generally with adherence and the regimen for IBD can be complicated and include aversive side effects. Psychological factors, such as depressive symptoms, are key factors associated with non-adherence. Nevertheless, gut-specific anxiety (GSA) is a psychological factor that …