Contemporary Analysis Of Reexcision And Conversion To Mastectomy Rates And Associated Healthcare Costs For Women Undergoing Breast-Conserving Surgery, Youngran Kim, Cecilia Ganduglia-Cazaban, Nina Tamirisa, Anthony Lucci, Trudy Millard Krause

Journal Articles

PURPOSE: This study was designed to provide a comprehensive and up-to-date understanding of population-level reoperation rates and incremental healthcare costs associated with reoperation for patients who underwent breast-conserving surgery (BCS).

METHODS: This is a retrospective cohort study using Merative™ MarketScan

RESULTS: The commercial cohort included 17,129 women with a median age of 55 (interquartile range [IQR] 49-59) years, and the Medicare cohort included 6977 women with a median age of 73 (IQR 69-78) years. Overall reoperation rates were 21.1% (95% confidence interval [CI] 20.5-21.8%) for the commercial cohort and 14.9% (95% CI 14.1-15.7%) for the Medicare cohort. In both cohorts, …

Development Of A Food Composition Database For The Estimation Of Dietary S-Methyl Cysteine Sulfoxide From Vegetables, Caroline R. Hill, Emma L. Connolly, Armaghan Shafaei, Lois Balmer, Liezhou Zhong, Taulant Muka, Antonietta Hayhoe, Shikha Saha, Richard J. Woodman, Joshua R. Lewis, Jonathan M. Hodgson, Lauren C. Blekkenhorst

Research outputs 2022 to 2026

A food composition database estimating S-methyl cysteine sulfoxide (SMCSO) was created following a systematic literature search. SMCSO data (705 entries) from 19 vegetables were summarised: brassicas (n = 10) and alliums (n = 9). The highest SMCSO in brassicas was reported in Brussels sprouts (median [range]: 318 [68−420] mg/100 g fresh weight (FW)) whilst the lowest was in radish (19 [4–45] mg/100 g FW). Brussels sprouts were almost twice as concentrated in SMCSO as cauliflower, followed by cabbage, kale, broccoli, kohlrabi, swede, Chinese cabbage, and turnips. The alliums highest in SMCSO were Chinese chives (271 [185−413] mg/100 g FW) followed …

Development Of A Midwifery Student Peer Debriefing Tool: An Interpretive Descriptive Study, Kate Buchanan, Carolyn Ross, Dianne Bloxsome, Jen Hocking, Sara Bayes

Research outputs 2022 to 2026

Background: Psychosocial traumatisation associated with giving birth, can occur in those present with the woman giving birth, a phenomenon known as vicarious trauma. It has been identified that there are currently no interventions available for midwifery students who have experienced vicarious trauma following difficult birth experiences. Objective: To explore whether the counselling intervention developed by Gamble et al. (2005), can be adapted for midwifery students to be appropriately and feasibly used as a counselling intervention with peers who have experienced midwifery practice-related vicarious trauma. Design: Interpretive descriptive methodology. Setting: This study was set at two Australian universities from which pre-registration …

Identification Of Circrna Biomarkers In Osteosarcoma: An Updated Systematic Review And Meta-Analysis, Chunbin Zhou, Lois Balmer, Manshu Song, Gehendra Mahara, Kezhou Wu, Wei Wang, Hu Wang

Research outputs 2022 to 2026

Circular RNAs (circRNAs) play a crucial role in cancer development and progression. This study aimed to identify potential circRNA biomarkers for osteosarcoma. Articles published from January 2010 to September 2023 were searched across eight databases to compare circRNA expression profiles in osteosarcoma and control samples (human, animal and cell lines). Meta-analysis was conducted under a random effects model. Subgroup analysis of circRNAs in different samples and tissues was performed. Diagnostic value was evaluated using receiver operator characteristic curves. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis explored functions of circRNA host genes. A circRNA-miRNA-mRNA axis …

Protocol: Factors Influencing The Implementation Of Non-Pharmacological Interventions For Behaviours And Psychological Symptoms Of Dementia In Residential Aged Care Homes: A Systematic Review And Qualitative Evidence Synthesis, Hunduma D. Ayeno, Gizat M. M. Kassie, Mustafa Atee, Tuan Nguyen

Research outputs 2022 to 2026

This is a protocol for a Cochrane Review. The objectives are as follows. This paper aims to describe a protocol for a systematic review that will synthesise the qualitative evidence regarding factors influencing the implementation of non-pharmacological interventions (NPIs) for behavioural and psychological symptoms of dementia (BPSD) management in residential aged care homes (RACHs). The planned systematic review aims to answer the research question: ‘What are the factors influencing the implementation of NPIs in the management of BPSD at RACHs?’. Additionally, the planned systematic review also aims to generate recommendations to guide stakeholders (e.g., clinicians and aged care staff) and …

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 …

Positron Emission Tomography In Oncology And Environmental Science, Samantha Delaney

Dissertations, Theses, and Capstone Projects

The last half century has played witness to the onset of molecular imaging for the clinical assessment of physiological targets. While several medical imaging modalities allow for the visualization of the functional and anatomical properties of humans and living systems, few offer accurate quantitation and the ability to detect biochemical processes with low-administered drug mass doses. This limits how physicians and scientists may diagnose and treat medical issues, such as cancer, disease, and foreign agents.

A promising alternative to extant invasive procedures and suboptimal imaging modalities to assess the nature of a biological environment is the use of positron emission …

Best Practices For Healthcare Providers When Communicating With Individuals With Hearing Loss: A Systematic Review, Ashley Mccaig

Dissertations, Theses, and Capstone Projects

Objectives: The purpose of this study is to conduct a systematic review of the literature to gather information about strategies to use when communicating with people with hearing loss, specifically in healthcare settings or environments where face masks are frequently used. The compiled literature was used to establish the best practices for healthcare providers to use when communicating with their patients with hearing loss, especially when utilizing face masks.

Methods: A comprehensive search of the literature was conducted using the Google Scholar, PubMed, and MEDLINE Complete databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to …

Adaptations And Transformations: Perceptions Of Change In Academic Motivation, Resilience, And Covid-19 Stress, Ella V. Gregorio

Dissertations, Theses, and Capstone Projects

Of concern to educators, post-COVID-19 assessments have revealed significant achievement gaps in student performance, as well as significant decreases in adolescent mental health. Less is known about changes in achievement motivation. Here we ask how students perceive their own motivation and whether it changed between “before” the pandemic to the present (Fall 2022 - Spring 2023), about three years after the beginning of the pandemic when many school routines were returning to “normal.” To understand how variance in these perceived changes might be related to pandemic-related stressors, trait resilience, and current mental health, we conducted a large survey study (N …

Flanker Task Performance In Young And Older Adults: A Behavioral And Erp Study, Fatima Medrano

Dissertations, Theses, and Capstone Projects

Research suggests that as we get older, executive function abilities decline (Hasher & Zacks, 1988; Salthouse, 1996). One affected ability is that of inhibitory control, which aids in monitoring our responses to non-target stimuli or information. Current research on inhibition reveals inconsistencies across studies. Monitoring brain responses during the Flanker (used to measure inhibitory control) task may add valuable insight into the processes underlying group differences behaviorally, by studying the N200 and P300 event-related potentials which have been associated with inhibitory control processes. This study investigated whether there are differences between older and younger adults in inhibitory control and whether …

A Comparison Of Temporary Threshold Shifts In Dentists, Hygienists, And Dental Assistants, Sabina E. Ciaccio

Dissertations, Theses, and Capstone Projects

Objective: The purpose of this study is to compare the temporary threshold shifts (TTS) in dentists, hygienists, and dental assistants. The specific aim of this study is to compare the differences in temporary shifts caused by the different dental equipment and the proximity to the equipment. The current literature does not compare the change in hearing thresholds of dental personnel.

Methods: Dentists, dental assistants, and hygienists from Hermann Dental Associates will be given a case history form to determine inclusion status for this study. Exclusion criteria will include known hearing loss and significant noise exposure the day prior. …

Efficacy And Safety Of Tepotinib In Asian Patients With Advanced Nsclc With Met Exon 14 Skipping Enrolled In Vision, Terufumi Kato, James Chih-Hsin Yang, Myung-Ju Ahn, Hiroshi Sakai, Masahiro Morise, Yuh-Min Chen, Ji-Youn Han, Jin-Ji Yang, Jun Zhao, Te-Chun Hsia, Karin Berghoff, Rolf Bruns, Helene Vioix, Simone Lang, Andreas Johne, Xiuning Le, Paul K Paik

Journal Articles

BACKGROUND: Tepotinib, a MET inhibitor approved for the treatment of MET exon 14 (METex14) skipping NSCLC, demonstrated durable clinical activity in VISION (Cohort A + C; N = 313): objective response rate (ORR) 51.4% (95% CI: 45.8, 57.1); median duration of response (mDOR) 18.0 months (95% CI: 12.4, 46.4). We report outcomes in Asian patients from VISION (Cohort A + C) (cut-off: November 20, 2022).

METHODS: Patients with advanced METex14 skipping NSCLC, detected by liquid or tissue biopsy, received tepotinib 500 mg (450 mg active moiety) once daily.

PRIMARY ENDPOINT: objective response (RECIST 1.1) by independent review. Secondary endpoints included: …

Application Of Methods To Population-Based Surveys To Reduce Bias In Estimates Of Sars-Cov-2 Infection Burden In The Population, Saba Qasmieh

Dissertations and Theses

BACKGROUND: Population-based surveys designed to randomly sample the population can be a critical and complementary tool to traditional surveillance approaches. Probability-based surveys enable the measurement of SARS-CoV-2 testing and outcomes that avoid issues around self-selection into testing, making them an effective approach to address ascertainment bias in passive surveillance. For surveys to be a useful and reliable surveillance tool for understanding the burden and distribution of SARS-CoV-2 infection, they need to capture prevalence estimates that are both valid and reliable to be optimally informative for public health measures. The dissertation was undertaken to address three main gaps that have implications …

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 …

Performance Analysis Of Hybrid Deep Learning Framework Using A Vision Transformer And Convolutional Neural Network For Handwritten Digit Recognition, Vanita Agrawal, Jayant Jagtap, Shruti Patil, Ketan Kotecha

Journal Articles

Digitization created a demand for highly efficient handwritten document recognition systems. A handwritten document consists of digits, text, symbols, diagrams, etc. Digits are an essential element of handwritten documents. Accurate recognition of handwritten digits is vital for effective communication and data analysis. Various researchers have attempted to address this issue with modern convolutional neural network (CNN) techniques. Even after training, CNN filter weights remain unchanged despite the high identification accuracy. As a result, the process cannot flexibly adapt to input changes. Hence computer vision researchers have recently become interested in Vision Transformers (ViTs) and Multilayer Perceptrons (MLPs). The shortcomings of …

The Missguided Project: Bringing Awareness To The Stigmas And Miseducation Surrounding Women’S Health Through Art And Creative Research, Gwyneth Cunningham, Hayley Newton, Zeen Ari, Claire Portele, Kerlous Aziz, Madelyn Kearns

Belmont University Research Symposium (BURS)

MissGuided is a project that discusses miseducation, shame, and stigma within women's healthcare settings, and the transformative potential of storytelling and artmaking in these contexts. Women encounter systemic miseducation, leading to shame and stigma surrounding their health experiences. However, through the power of community-driven narratives and creative expression, these barriers can be dismantled. Facilitating communal dinner parties as a form of conceptual art making, we aim to explore the diverse experiences in healthcare through conversation. The accumulation of the research, dinner parties, and wellcores will be delivered through a collective cookbook which includes recipes, testimonials, and art. By sharing personal …

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 …

Nature Of The Evidence Base And Approaches To Guide Nutrition Interventions For Individuals: A Position Paper From The Academy Of Nutrition Sciences, Mary Hickson, Constantina Papoutsakis, Angela M Madden, Mary Anne Smith, Kevin Whelan

Journal Articles

This Position Paper from the Academy of Nutrition Sciences is the third in a series which describe the nature of the scientific evidence and frameworks that underpin nutrition recommendations for health. This paper focuses on evidence which guides the application of dietary recommendations for individuals. In some situations, modified nutrient intake becomes essential to prevent deficiency, optimise development and health, or manage symptoms and disease progression. Disease and its treatment can also affect taste, appetite and ability to access and prepare foods, with associated financial impacts. Therefore, the practice of nutrition and dietetics must integrate and apply the sciences of …

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 …

Promoting Engagement Of Male Individuals With Alzheimer’S In A Memory Day Care, Tara Brophy

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Alzheimer’s and related dementias impact an individual's cognitive, psychological, social, and physical functions resulting in impairments within the engagement of activities. Activities offer many therapeutic benefits including improvements in mood, alertness, communication, socialization, sleep, cognitive function, and quality of life. The focus of this quality improvement capstone project was to address the decreased level of engagement in male members within a memory day care center setting through engaging them in male-tailored activities. The project included the development of a website that provided tailored male-oriented activities and educational resources that were shared with the staff to revise their day care activity …