Medicine and Health Sciences Commons^™

Private And Federated Deep Learning: System, Theory, And Applications For Social Good, Han Hu

Dissertations

During the past decade, drug abuse continues to accelerate towards becoming the most severe public health problem in the United States. The ability to detect drug­abuse risk behavior at a population scale, such as among the population of Twitter users, can help to monitor the trend of drug­abuse incidents. However, traditional methods do not effectively detect drug­abuse risk behavior in tweets, mainly due to the sparsity of such tweets and the noisy nature of tweets. In the first part of this dissertation work, the task of classifying tweets as containing drug­abuse risk behavior or not, is studied. Millions of public …

Hydrophobically Modified Isosorbide Dimethacrylates As Biomaterials For Bisphenol A Free Dental Fillings, Bilal Marie

Dissertations

Amalgam and Bisphenol A glycerolate dimethacrylate (BisGMA) are the main dental filling materials in use today. Because of the negative perception of amalgam and its lower esthetic appeal, as well as the desire to replace the endocrine disruptor Bisphenol A, which is the building block of BisGMA, there has been a critical need to search for safer alternatives to these dental filling materials.

Isosorbide is a sugar-based molecule generally recognized as safe. It has been extensively studied as a replacement to the Bisphenol A core in various materials. However, isosorbide is extremely hygroscopic, and water uptake in dental fillings causes …

Itraconazole Nanocomposites Prepared Via Rotary Evaporator Drying Of Nanomilled Suspensions, Alexander Santos Coelho

Theses

The aim of this study is to explore the feasibility of rotary evaporation for drying wetmilled drug suspensions as a novel approach to produce drug nanocomposites that exhibit fast redispersion and immediate drug release. To this end, the physical stability of the nanomilled itraconazole (drug) suspensions, a.k.a., nanosuspensions, during the milling and storage; the drying of the itraconazole nanosuspensions via the rotary evaporator; and the type/loading of various polymers/surfactants (dispersants) on aqueous redispersion and drug release from the nanocomposites were examined. Our results suggest that smaller drug particle size, owing to nanomilling, and smaller nanocomposite particle size, owing to optimized …

Acknowledgment Of Culture And Stereotypes: Black Participants’ Perceptions Of Specific Therapist Behaviors, Tsotso T. Ablorh

Graduate Masters Theses

Mental health disparities for Black people of diverse ethnicities compared to people of other racial identities has been well-documented (Alegría et al., 2008; Maura & Weisman de Mamani, 2017). Research addressing this pervasive systemic and interpersonal problem often focuses on client-related factors that create or intensify barriers to care. However clinician-related factors (i.e., racial identity, multicultural training, implicit biases, behavior, etc.) also have a significant impact on barriers to care, retention in therapy, and clinical outcomes for people of African descent (Larrison & Schoppelrey, 2011; Owen, Imel, Adelson, & Rodolfa, 2012). Researchers suggest that the favoring of historically white perspectives, …

Protective Role Of Cod Liver Oil On Metabolic And Neurological Parameters In Rat Model Of Diabetic Depression, Roweena Sheryl

Kasturba Medical College, Mangalore Theses and Dissertations

No abstract provided.

Nidradevi Namostute-Part 2-News Article, Pramod Dattaram Lambor

Manipal College of Health Professions, Manipal Theses and Dissertations

This article addressed advocatory facet of Occupational therapy in sleep hygiene for general population as well as people with sleep dysfunction. It discussed simple strategies to understand & enhance sleep pattern of the readers.

Spontaneous Coronary Artery Dissection, Amy N. Wagner

Graduate Dissertations and Theses

Spontaneous coronary artery dissection (SCAD) causes 35% of myocardial infarctions in women under the age of 50 years old. Typically, these are healthy, active women without risk factors for atherosclerotic coronary artery syndromes. SCAD is a myocardial infarction caused by a coronary arterial dissection and not atherosclerotic plaques. Because of this, those effected do not present with the typical risk factors associated with acute atherosclerotic coronary syndromes. Therefore, clinicians must maintain a high level of suspicion for SCAD in young, healthy, women presenting with chest pain. Observation and pharmacological therapies are the preferred methods of treatment for a SCAD event. …

Abrupt Changes In Learning Platforms During A Pandemic, Nicole Nelson, Katie M. Villont

Nursing Masters Papers

The purpose of this secondary analysis is to explore academic nurse educators’ perceived changes to accommodate learning for undergraduate (UG) nursing education in the early months of the COVID-19 pandemic. The objective of this secondary analysis is to investigate three research questions: what perceived changes are needed to accommodate learning, what are new/revised teaching innovations applied for undergraduate (UG) students during the pandemic that may be used post-pandemic, and what are concerns about UG students who will enter the workforce following the pandemic.

Increasing Continuous Positive Airway Pressure Compliance With Various Telemedicine Interventions: An Integrated Literature Review, Tracy Partington

Doctor of Nursing Practice (DNP) Projects

Aims and Objectives. This literature review's objective was to synthesize evidence from previously published literature on telemedicine interventions' effectiveness on CPAP (Continuous Positive Airway Pressure) therapy compliance.

Background. It is estimated that 22 million Americans suffer from a form of Sleep Apnea (SA), and those up to 80 percent of the cases of moderate to severe Obstructive Sleep Apnea (OSA) are undiagnosed (Sleep Apnea, n,d). The first-line therapy for OSA is CPAP. However, CPAP therapy is associated with low compliance rates.

Design. Systematic review.

Method. A multi-database literature search was conducted to identify published literature between 2009 and 2020. …

Identifying Micrornas Panel Associated With Hepatocellular Carcinoma In Serum Of Chronic Hepatitis C Patients, Areeg Dabbish

Theses and Dissertations

Introduction: early detection of hepatocellular carcinoma (HCC) will reduce morbidity and mortality rates of this poorly diagnosed widely-spread disease. Dysregulation in microRNA (miRNAs) expression is associated with HCC progression. Objective: Is to identify a panel of differentially expressed miRNAs (DE-miRNAs) to enhance HCC early prediction in hepatitis C virus (HCV) infected patients. Methodology: Candidate miRNAs were selected using bioinformatic analysis of microarray and RNA-sequencing datasets, resulting in nine DE- miRNAs (miR-142, miR-150, miR-183, miR-199a, miR-215, miR-217, miR-224, miR-424 and miR-3607). Their expressions were validated in the serum of 44 healthy individuals, 62 non-cirrhotic HCV patients, 67 cirrhotic-HCV and 72 HCV-associated …

Nidradevi Namostute Part 1-Newspaper Article, Pramod Dattaram Lambor

Manipal College of Health Professions, Manipal Theses and Dissertations

This article addressed advocatory facet of Occupational therapy in sleep hygiene for general population as well as people with sleep dysfunction. It discussed simple strategies to understand & enhance sleep pattern of the readers.

Infusing Evidence-Based Practice Into The Cayman Islands Health Services Authority Nursing Culture, Melissa Ring

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

Background: James Madison University and Cayman Islands Health Services Authority (HSA) entered into a collaborative agreement the summer of 2020. There was a lack of organizational structure surrounding implementation and systemization of evidence-based practice (EBP) models and a disconnect between nurse manager knowledge and EBP implementation within HSA.

Methods: The population for this evidence-based project was 21 HSA nurse managers from the inpatient setting. Pre-intervention survey results informed organizational readiness, nurse manager knowledge and ability to implement, and guided the intervention that included the creation and implementation of a website toolkit for EBP. An EBP model was selected for nursing. …

Discharge Process Optimization, Erin M. O’Neal

Doctor of Nursing Practice Projects

As the demands of the nurse become increased with higher acuity and documentation requirements, the delivery of discharge instructions is often one of the most, and at times, only, formal education opportunities between the nurse and the patient. It is imperative to modify the discharge process to ensure patients have the ability to confidently care for themselves after they leave the hospital. The aim of this project was to create a nursing discharge workflow that meets the educational needs of the patients. This project was a quality improvement project designed to change the nursing workflow to provide a better discharge …

Covid-19 In A Secure Behavioral Rehabilitation Setting: A Program Evaluation, Jennifer G. Jones

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

Problem: The COVID-19 case rate as of June 5, 2020, for prisoners was 5.5 times higher than the United States (US) population case rate (Saloner et al., 2020). A secure behavioral rehabilitation facility in the US was challenged to mitigate the spread of COVID-19 and made many changes to facility and program protocol in order to meet this challenge.

Methods: The purpose of this program evaluation was to examine the COVID-19 facility response, case rates, percent positivity and attack rates between units at a secure behavioral rehabilitation facility to inform further policy and procedure recommendations for the mitigation of COVID-19 …

An Evidence-Based Project: Exploring Nurse Manager Communication Competencies And Skill Development, Micaela Ross

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

Abstract

Evidence supports effective communication skills as essential for patient safety and organizational success. Evidence is also clear regarding ineffective communication and its negative impact. The purpose of this project was to determine an area of communication skill development needed among nurse managers of the participating island hospital and support positive change in knowledge, understanding, and ability to use effective communication skills. The aim was to improve communication skills among these nurse managers.The objectives were to determine a specific skill need, provide a focused educational intervention, and evaluate skill improvement. Pre-intervention survey results revealed a self-identified priority of effective communication …

Implementation Of A Mental Health Environmental Risk Assessment Tool, Alan Le

Doctor of Nursing Practice (DNP) Projects

Background: Patient suicide is a serious safety issue, especially in mental health settings since suicides disproportionately affect psychiatric patients. Environmental hazards are a primary contributing factor in patient suicide cases.

Problem: Mental health staff may lack tools and training to perform proper environmental risk assessments, which is the case at a psychiatric crisis residential center in northern California that utilized no environmental risk assessment tool.

Methods: An environmental risk assessment tool was implemented at the site for four months to increase staff confidence, ability to identify hazards and decrease risk of patient suicides.

Interventions: The Suicide and …

Regulatory Orientation To Support Transition To Academic Leadership, Annmarie Munana

Doctor of Nursing Practice (DNP) Projects

Background: As pre-licensure nursing education is burdened by levels of regulations and standards, it is important the academic leader understand regulatory compliance and the applicable federal, state, and local rules and laws. At a multi-campus university, the leader’s ability to address regulatory issues is critical to the program’s success.

Local Problem: The university’s campus leader regulatory orientation lacks consistency and standardization of content and resources. This situation results in campus leaders having varying degrees of knowledge and competency ensuring academic regulatory compliance.

Context: Regulatory compliance stems from external influences and multiple layers of regulations and accreditation. The university provides onboarding …

Purposeful Nurse Hourly Rounding: Plan To Decrease Patient Falls During A Pandemic, Robbie Masangkay

Doctor of Nursing Practice (DNP) Projects

Problem: Patient falls remain a critical and persistent safety problem in healthcare today. The prolonged impact of the COVID-19 pandemic raises leadership concerns regarding the safe care of high-risk COVID patients and mitigating the increased stress and potential risks of infection to clinical staff.

Context: This Doctor of Nursing Practice (DNP) scholarly project details implementation of an evidence-based purposeful nurse hourly rounding (PNHR) pilot project designed to decrease the incidence of patient falls on a designated COVID-19 unit.

Measure: A modified PNHR rounding tool was implemented to guide focused elements for key nurse/patient interactions.

Interventions: …

Use Of Simulation To Improve Nurse's Response To Covid-19 Code Blue: A Literature Review, Charity Shelton

Doctor of Nursing Practice (DNP) Projects

Background

Healthcare workers in the acute care setting must be ready to respond to emergencies at any given time. The recent COVID-19 pandemic put strains on the healthcare workforce that have brought challenges and new competencies for how healthcare workers safely respond to emergencies. To ensure healthcare workers maintain these competencies, specific training must occur to improve emergency response and outcomes. Specifically, there needs to be training for healthcare workers to respond to COVID-19 code blue emergencies safely and with skilled interventions.

Problem

A code blue in the acute care setting is a medical emergency that requires nurses, physicians, and …

Building Excellence Through Shared Governance And Continuous Process Improvement, Deborah Reitter

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Nursing shared governance in the hospital setting is a well-established structure for shared decision-making between staff nurses and nurse leaders to improve nursing practice, quality of care, and patient safety. Establishing effective, shared governance can take several years: new skills must be acquired, new behaviors accepted, and new professional commitments made. Newcomers to shared governance require support, education, and the opportunity to acquire requisite skills; otherwise, interest, commitment, and achievement of desired outcomes cannot be sustained.

Local Problem: A large hospital in California established a shared governance structure in 2018. Performance gaps between two high-performing Nursing Unit Councils …

Creating A Pipeline To Increase Diversity In Executive Leadership Positions, Trarina Harris

Doctor of Nursing Practice (DNP) Projects

Background: Minority nurse leader presence at the executive leadership level is suboptimal, with insufficient pathways to increase representation. The lack of diversity in executive leadership threatens efforts to improve patient care and reduce disparities (Jerome Harris, 2021).

Local Problem: Practices to increase the diversity of executive nurse leaders at a pediatric medical center have had very little to no impact. Frontline nurses and nurse executives are not racially or ethnically representative of the increasingly minority patient populations served.

Context: As a commitment to increasing workforce diversity, the medical center developed an executive-level Racial Equity Taskforce, which aligned with the …

Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model, Miranda Saint-Louis, Miranda Saint Louis

Doctor of Nursing Practice (DNP) Projects

Background: Communication has become a key performance measure in the shift to value-based healthcare. Given the impact of communication failures on patient harm, length of stay, and dissatisfaction with care, new models of care with better communication through structured teamwork and interdisciplinary collaboration are needed.

Problem: In a 16-bed geriatric medical/surgical unit of a New York City multispecialty community hospital, the workflow structure unintentionally created inconsistent handoff communication, gaps in continuity of care, missed care events, and inattention to the patient’s priorities in the care plan. A gap analysis identified communication deficiencies that impacted team effectiveness and patient care …

Successfully Spreading Improvement Work Using A Proven Framework, Rachel Lynn Wyatt

Doctor of Nursing Practice (DNP) Projects

Background: Hospital-acquired pressure injuries (HAPIs) are rising in the United States, increasing six percent between 2014 and 2017 alone (Agency for Healthcare Research and Quality [AHRQ], 2019). Approximately 60,000 patients die from complications related to HAPI annually (Padula & Delarmente, 2019).

Local Problem: In a Northern California Level II Trauma acute care hospital, HAPIs increased by 422% over two years, 2016-2018, with most of the HAPIs occurring in the Intensive Care Unit (ICU).

Context: This project sought to spread the Interventions by Braden Subscale protocol to seven medical-surgical units in the hospital using the Institute for Healthcare Improvement’s (IHI) Framework …

Providing Hypertension Education For African Immigrants At A Southern California Congregation During The Covid-19 Pandemic, Esther Oshunluyi

Doctor of Nursing Practice (DNP) Projects

Providing Hypertension Education for African Immigrants at a Southern California Congregation During the COVID-19 Pandemic

Abstract

Background: Hypertension (HTN) is one of the major risk factors for cardiovascular disease and the prevalence is highest among African Americans (AAs) (American Heart Association, 2017). The difference in the management and outcomes of HTN between African Americans and Whites is most disparate with lack of education being a major contributor to uncontrolled HTN among African Americans, especially among African Immigrants (Lackland, 2014).

Problem: According to church leadership at the project setting, the majority of their adult African Immigrant population is believed to have …

Post-Transplant Hepatic Graft Fibrosis In Pediatric Liver-Inclusive Transplant Recipients, Hanh D. Vo

Theses & Dissertations

Hepatic graft fibrosis is a common histologic finding following pediatric liver transplant (LT) that may affect the long-term graft outcome. Hence, it is essential to identify hepatic graft fibrosis at a stage where fibrosis is not yet clinically apparent but has the potential for progression to initiate appropriate intervention and prevent its progression. Liver biopsy is the gold standard for fibrosis staging, but it is invasive, requires general anesthesia in children, and has potential complications. Our long-term goal is to implement non-invasive tests to assess and monitor the progression of hepatic graft fibrosis in liver-inclusive transplant children. The work presented …

A Call To Create: Poetry As Healing And One Nurse’S Self-Discovery, Kim Cornett Henry, Kim Cornett Henry

English Theses

Florence Nightingale’s vision for nursing has changed greatly in the past one hundred and fifty years, with nursing’s identity replaced with an emphasis on science over caring. The fast-paced, technologically sophisticated environments, designed to meet the declining health of an American public, have resulted in nurses who are being pulled away from nurse-to-patient caring acts and the reasons they felt called to become nurses. These changes have had detrimental psychological and emotional effects on nurses and are especially evident in Intensive Care nurses. Expressive writing as poetry, autoethnography, and participation in vibrant writing communities offer nurses experiences for healing, voice, …

Loneliness, Interpersonal Goals, Life Satisfaction, And Subjective Well-Being In Older Adults, Francesca C. Ezeokonkwo

Electronic Theses and Dissertations

Background: Loneliness is detrimental to health and is linked to numerous physiological and psychological problems. People across the age spectrum can be affected by loneliness at one point or another in their lives; however, older adults are disproportionally affected.

Aims: This study investigated the effect of interpersonal goals (compassionate and self-image goals), life satisfaction, and subjective well-being on loneliness in older adults and the influence of demographics and social support. The Ecosystem-Egosystem Theory of Social Motivation served as the theoretical framework.

Design and Method: This descriptive cross-sectional correlational study used the 2016 Health and Retirement Study. Participants were 65 years …

Hip Muscle Function In Individuals With Chronic Ankle Instability, Lindsay Carroll

Electronic Theses and Dissertations

Purpose: Hip muscle function has been reported to be altered in individuals with chronic ankle instability (CAI). The purpose of this study was (1) to determine whether the single leg squat test (SLST) could be used to detect differences in proximal muscle activation between individuals with and without CAI and (2) to determine if there was a difference in maximum isometric body weight normalized torque output of the hip lateral rotators, extensors, and abductors between individuals with and without CAI.

Subjects: Forty-eight subjects (14 males, 34 females; median age = 22.00 years, interquartile range (IQR) = 1.00; median height = …

Investigating Relationships Between Diabetes Distress, Diabetes Self-Care Behaviors, Intention To Use And Actual Use Of A Personal Health Record Within 30 Days Of Hospital Discharge In Persons With Type 2 Diabetes, Khaliah Fisher-Grace

Electronic Theses and Dissertations

Background: Diabetes distress (DD) is defined by emotional and behavioral challenges caused from diabetes and its management. Diabetes self-care behaviors can be compromised by DD. Personal Health Record (PHR) use has been associated with improvements in HbA1c, blood pressure, and LDL-C, but the relationship between DD and PHR use is unknown. Aims: 1) to determine differences between sociodemographic variables and intention to use and actual use of PHR in hospitalized persons with Type 2 Diabetes Mellitus (T2DM), 2) to investigate the relationship between DD, intention to use a PHR and actual use of a PHR within 30 days of hospital …

Design And Synthesis Of Fused Pyrimidines As Single Agents With Combination Chemotherapy Potential, As Tubulin Polymerization And One-Carbon Metabolism Inhibitors For Cancer, Tasdique Quadery

Electronic Theses and Dissertations

This dissertation describes the design, synthesis, and biological evaluation of bicyclic fused pyrimidines as single agents with combination chemotherapy potential with both antiangiogenic and cytotoxic effects. The dissertation also discusses one-carbon metabolism inhibitors and tumor targeting proteolysis targeting chimeras (PROTACs).

In cancer chemotherapy, the two major limitations are the dose-limiting toxicities of clinically used agents and the development of resistance to the treatment. Combination chemotherapy with antiangiogenic agents and microtubule targeting agents has shown an advantage against both these drawbacks. Single agents with both antiangiogenic activity and cytotoxicity would afford a therapy that circumvents pharmacokinetic problems of multiple agents, avoid …