Medicine and Health Sciences Commons^™

The Development Of A Brain Penetrating Erythropoietin For The Treatment Of Alzheimer’S Disease, Joshua Yang

KGI Theses and Dissertations

The development of a neurotherapeutic for the treatment of Alzheimer’s Disease (AD) is challenging due to limited endpoint efficacy. Erythropoietin (EPO), a hematopoietic neurotrophin, is a potential therapeutic for AD but has limited blood-brain barrier (BBB) permeability. A chimeric fusion protein of EPO bound to the transferrin receptor monoclonal antibody (cTfRMAb) can act as a molecular trojan horse for brain drug delivery, shuttling EPO into the brain via the transvascular route. However, cTfRMAbs have Fc-effector function adverse effects, and removal of the Fc N-linked glycosylation site by substituting Asn with Gly (cTfRMAb-N292G-EPO) reduces this Fc effector function. Hence, developing this …

Let’S Have A Playdate! Comparing Autistic Children's Social Behavior During Play Sessions With Siblings Versus Peers, Clare Boldt

Scripps Senior Theses

Autistic individuals can struggle with social interactions and forming friendships. While siblings and peers are used for social skills intervention, there is a paucity of research analyzing differences in autistic children’s play with siblings versus peers. Investigating these behavior differences helps clinicians learn how to best support social skill development, improve sibling relationships, and determine ideal peer mediators for interventions. I compare social behaviors of autistic children during play sessions with their sibling versus a non-sibling peer. The behaviors measured were prosocial behaviors, cooperative and parallel play, verbalizations (appropriate and inappropriate), aggressive behaviors, eloping, and stereotypy. Based on previous literature, …

Racial And Ethnic Disparities In Diabetes-Related Healthcare Service Use In The United States, 2016–2020, Gaole Song

CGU Theses & Dissertations

Diabetes is a serious public health issue in the United States. As one of the leading causes of death, the prevalence of diabetes has increased steadily and leads to an enormous medical and societal burden each year. Compared to non-Hispanic White adults, racial/ethnic minority adults have a higher risk to develop diabetes and its complications. Proper healthcare service use is important for reducing the prevalence of diabetes and the risk of complications. However, minority populations receive a lower quality healthcare service and have greater barriers to diabetes self-management. To get a better understanding of racial disparities in diabetes-related healthcare service …

The Impact Of Expanded Tele-Mental Health On Quality-Of-Care Indicators: A Three-Pronged Regression Analysis At Los Angeles County’S Department Of Mental Health, Ami Bhatt

CGU Theses & Dissertations

Background: The use of Tele-Mental Health (TMH) skyrocketed after the COVID-19 pandemic led to the announcement of a public health emergency in March 2020. This rise coincided with soaring rates of mental health issues and increasing demand for accessible and sustainable treatment, all while meeting physical distancing requirements. TMH use is theorized to improve timely access to care and provide opportunities to improve quality of care indicators in individuals and at the health systems level. Research Question: How has the widespread adoption of Tele-Mental Health changed quality of care (QoC) indicators among patients of LA County Department of Mental Health’s …

Physician’S Resistance To Ehr Post Successful Organizational Adoption: Dual Factors Investigative Study, Sawsan Abdullah Altammar

CGU Theses & Dissertations

The introduction of Electronic Medical Records (EMR) has drastically improved the quality of health care, streamlined the processing of its tasks, and enhanced the retention of patient data for the hospitals of today. This research is a response to a call for an investigation of the reasons or factors that could affect health care workers’ decision to use or to resist software once it has been implemented. Physicians form the focus of this study because previous research demonstrates that physicians are an important user group of EMR. Physicians’ attitudes about using and their resistance to correlate with the attitudes of …

Emergency Department Use Among Probationers Enrolled In The Riverside University Health System, Whole-Person Care Pilot Program, Nirshila Chand

CGU Theses & Dissertations

Formerly incarcerated individuals suffer from poor health outcomes and often overuse emergency department (ED) services because of a lack of access to care and insurance coverage upon reentry to their community. The Riverside County Whole Person Care (WPC) pilot program implemented by Riverside University Health System (RUHS) was designed as a reentry program developed to address these challenges and ensure that releasees successfully transition back into the community. The primary aim of this project was to assess whether participating in the RUHS WPC program reduced emergency department (ED) use among recent releasees. This was a cross-sectional retrospective study of formerly …

Papanicolaou (Pap) Test And Human Papillomavirus (Hpv) Test Adherence: Sexual Violence Victims And Fear Of Retraumatization, Murielle Sighe Ngoumkam

CGU Theses & Dissertations

To include all vulnerable women population who faced barriers to participating in preventive cervical cancer screening, the public health community must better understand the factors that affect their decision for getting Pap and HPV tests. Public health must understand the sexual violence victims, a subgroup of women who faced the onset of trauma and explore their adherence to routine screening. This study investigated whether sexual women with a history of sexual violence (SV), likelihood to get screened for cervical cancer would be impacted given the fear of suffering from secondary trauma during conventional screening procedures. Methods: Knowledge of cervical screening …

Examining Structural Racism As A Cause Of Health Inequities Among Pacific Island Peoples In The United States And Aotearoa New Zealand: An Exploratory Comparative Case Study, Jake Ryann Cambia Sumibcay

CGU Theses & Dissertations

Native Hawaiians and Pacific Islanders (NHPI) in the United States are known to experience profound and persistent disparities across most indicators of socioeconomic status and health when compared to the majority population. Similarly, the Indigenous Māori and Pacific peoples in Aotearoa New Zealand parallel the same experiences. Reducing disparities and improving health equity among racial/ethnic minority populations have been regarded as a national priority in both the United States and New Zealand. Improved population health data have provided insights into the social determinants of health (SDoH), which has unveiled multiple factors that contribute to health disparities, including income, education, residential …

The Cost-Effectiveness And Feminization Of The Human Papillomavirus Vaccine, Audrey Jammes

Scripps Senior Theses

Approved in 2006, the Human Papillomavirus (HPV) vaccine provided a medical breakthrough in combating cancer by inoculating first female and then male adolescents in 2010. In 2016, a new HPV vaccine was approved for all adolescents. However, it is the most expensive vaccine created in the United States and its female centered prescription led to debates regarding the vaccine’s necessity and risks. For the STS portion of this paper, analysis of the language in the vaccine’s prescriptions from 2006, 2010, and 2016 demonstrates two implicit assumptions regarding female health built into the vaccine’s rollout. Comparison of the two assumptions to …

Mapping The Milk: Integrating Donor Human Milk Into Infant Nutrition Systems, Delaney Hartmann

Scripps Senior Theses

A human milk diet is an important part of the health and survival of all infants. A human milk diet is especially crucial for the most vulnerable preterm infants as it promotes a healthy gut and protects from Necrotizing Enterocolitis (NEC). However, many preterm infants are unable to consume their mother’s own milk due to breastfeeding challenges resulting from early delivery. Therefore, nutritional supplementation is often necessary for preterm infants and donor human milk (DHM) is highly superior to baby formula. DHM in the United States is processed at the 29 not-for-profit Human Milk Banking Association of North America (HMBANA) …

Understanding The Environmental Implications Of The Microbiome Of Canals In Bangkok, Thailand, Emma Tao

Scripps Senior Theses

The canals of Bangkok, Thailand hold significant economic and social value, yet the increasing urbanization of the city has resulted in increased water pollution. Agricultural runoff and urban waste contribute to the degradation of the water quality, which has impaired its safe usage by the people of the city. This study focused on analyzing the microbiome of the water in the canals in correlation with the surrounding environment, both in and out of the water. Ten sites along the Bangkok canals were analyzed. DNA was isolated for the sequencing of the 16s rRNA gene to determine the microbial diversity of …

Queer Survival Amidst Hiv/Aids, Covid-19 And Homelessness, Julia Young

Pitzer Senior Theses

The treatment and survival of a society's marginalized peoples reveal the true impacts of a pandemic. An analysis of homeless queer youth during the HIV/AIDS and SARS-CoV-2 crises lays bare the systemic failure of the United States government to provide equitable healthcare.

I compare the HIV/AIDS and COVID-19 pandemics in queer homeless youth to demonstrate the dangers of disease moralization via a sociocultural analyses of disease stigma and responsibility politics. Utilizing syndemic theory I draw on the synergistic relationship between disease and illness to describe the unique challenges queer homeless youth face. A syndemic framework is applied to address common …

Physicians’ Perceptions Of The Utility Of Clinical Guidelines In The Management Of People With Type 2 Diabetes In Saudi Arabia, Abdulaziz Eskandarani

CGU Theses & Dissertations

Aim: The aim of this research was to assess physicians’ perception of the utility of clinical guidelines in the management of people with Type 2 diabetes in Saudi Arabia and how their perception is affected by different physicians’ characteristics and whether high perception would result in adherence to guidelines. Methods: This study employed a cross-sectional study design and used a self-administered online survey through Qualtrics software. The survey was distributed through the Saudi Society for Diabetes (SSD) whose membership includes more than five-thousand active physicians from all regions of Saudi Arabia. There were 493 respondents to the survey. Results: Around …

Putative Mechanisms Underlying The Antidepressant Actions Of Ketamine: A Review And Study Proposal, Tristan Reece

CMC Senior Theses

Major Depressive Disorder (MDD) is a highly debilitating and common psychiatric disorder that affects over 250 million people globally; it is among the most financially and emotionally burdensome illnesses in the world. Currently approved antidepressants are suboptimal in their efficacy and latency of therapeutic action. In contrast, single administrations of sub-anesthetic ketamine have been shown to rapidly alleviate depressive symptoms within hours, even in treatment-resistant patients. Ketamine is believed to exert these effects by increasing glutamatemediated neurotransmission and promoting rapid neurotrophic factor release, restoring the integrity of neural circuits that are compromised in depression. However, uncertainty surrounding its specific antidepressant …

Horticultural Therapy Program For Individuals With Substance Use Disorder: A Mixed-Method Evaluation, Emily Maia Bisaga

CMC Senior Theses

Substance Use Disorder (SUD) is a chronic brain disorder caused by both biological and environmental factors. Although there is no panacea for addiction, holistic adjunctive therapies have been found to improve outcomes for this population. Horticultural Therapy (HT) is one such adjunct therapy that may improve treatment outcomes. Although HT has been found to support holistic healing for many mental and physical ailments, the efficacy of this intervention has not been evaluated in patients with a SUD. The goal of this controlled, mixed-method study is to evaluate whether HT could be an effective component of a holistic SUD treatment program. …

A Serological Analysis Of Sars-Cov-2 Infection In The Obstetric Population, Sophia Rose

CMC Senior Theses

In December 2019, the surfacing and spread of a novel coronavirus, SARS-CoV-2, resulted in the global COVID-19 pandemic. As a viral antigen, SARS-CoV-2 poses a particular threat to the obstetric population due to physiological and immunological changes that women face during pregnancy. While recent studies have found that SARS-CoV-2 may have better clinical outcomes as compared to other betacoronaviruses, adverse pregnancy events such as ICU admission, preeclampsia, and/or preterm birth have been associated with COVID-19. Progress has been made in better understanding the pathophysiology of SARS-CoV-2 in pregnancy, but there is still much to be known about the interaction …

A Proposed Method To Verify Physician Visual Estimation Of Intraoperative Corneal Edema From Refractive Measurement Images During Cataract Surgery, Karalee Corley

CMC Senior Theses

A patient’s resultant vision quality in a restorative Femtosecond Laser Assisted Cataract Surgery (FLACS) can be fine tuned via an intraoperative measurement of refractive power and axis of astigmatism in the aphakic state. Standard preoperative measurements often disagree with intraoperative measurements (Optiwave Refractive Analysis; Alcon, Inc.) on account of the inclusion or exclusion of posterior corneal curvature, leaving the ultimate lens selection to physician discretion. One additional suggested cause of disagreement is swelling at the corneal incision site (Corley and Carmack 2020).The following proposes a method to verify visual estimation of intraoperative corneal swelling from 2D gray-scale images collected during …

Cultural Resistance In The African Diaspora: A Historical And Contemporary Analysis Of Land-Based Community Care, Toluwani Roberts

CMC Senior Theses

“Cultural Resistance in the African Diaspora: A Historical and Contemporary Analysis of Land-Based Community Care” explores the use of land for the self-liberation and sustenance of African and African descendant peoples. It argues that collective cultivation of land is key to the development of African-derived cultures and forms the foundation of resistance against Western-capitalist cultural domination. Maroon societies, also known as runaway communities, of the 16th to 19th centuries are one of the earliest examples of land-based resistance in slave colonies that have contributed to the development of what we now call the African Diaspora. Maroon Societies: Rebel Slave Communities …

A Study Of Limited Bedding And Nesting On Maternal Behavior For Postpartum Depression, Emma Brezoczky

CMC Senior Theses

Postpartum depression (PPD) affects up to 20% of mothers in the US and can detrimentally affect both the mother and psychosocial development of the child (Pearlstein et al, 2009). So far, research on PPD is limited and the underlying neuropathology remains unclear. Low socioeconomic status is one risk factor that increases the risk of PPD tenfold (Goyal et al, 2010). The low resource limited bedding and nesting (LBN) paradigm used for rodents has the potential to model this risk factor. LBN has not previously been studied with PPD, but observations of disrupted maternal behaviors and depressive phenotypes makes it a …

Physician Assisted Dying (Pad): An Investigation Into The Mechanistic Action Of Opioid, Benzodiazepine, And Barbiturate Administration As An Alternative Measure To Forgoing Life Sustaining Treatment And Aggressive Palliation., Jordana Chanel Deighton

CMC Senior Theses

Whilst modern medicine has increased longevity, the rise in life expectancy has brought about new struggles, namely that of aging and age related disease. Thus, humanity has been presented with a new problem: at what point is death preferable to aggressive life-prolonging treatment in the face of inevitable death? And if so, what right do individuals have to control the circumstances of their death? In the West, traditionally, individuals who seek to end their own lives in the face of terminal illness opt for forgoing artificial hydration and nutrition. Driven by an increase in desire for autonomous dignified death, a …

Planning Patient Safety: Philosophical, Political, And Economic Changes Required For Preventable Death Abolition, Catherine Kiani

CMC Senior Theses

Preventable medical errors are an epidemic. Between 250,000 and 400,000 people die from preventable errors each year in the USA. This investigation questions mechanisms for quality care improvement to eliminate preventable fatalities. I evaluated current patient safety protocols, analyzed their shortcomings, and with additional research recommended actions for better results. Such actions to improve patient safety are explored from three different perspectives: philosophical, economical, and political aspects. In chapter one, improvements within hospitals are reviewed – namely cultural changes needed from both physicians and hospital leadership. Abolishing hierarchical systems which preclude healthy collaboration among medical teams, diverting focus to patient …

An Agent-Centered Approach To Covid-19 Vaccinations, Nila Venkat

CMC Senior Theses

The rise of COVID-19 has dramatically affected the global economy, healthcare systems, and individuals’ daily lives. One of the most controversial attempts to ameliorate the effects of the virus in the United States has been the distribution of COVID-19 vaccinations. In this thesis, I propose a novel agent-centered approach to motivating COVID-19 vaccinations. I begin by exploring the origins and evolution of the virus, along with the growing demographic of “vaccine-hesitant” Americans, to contextualize the debate surrounding vaccinations. I then propose two potential action-based response strategies for vaccine motivation: a vaccine mandate and nudges. Concerning a mandate response strategy, I …

Not Coming Home: The Flaws In Skilled Nursing Facilities And Their Contribution To Cyclical Hospitalizations Of Post-Acute Patients, Kate Eisenbraun

Pitzer Senior Theses

This literature review will discuss the experience of patients within the US healthcare system, focusing on skilled nursing facilities (SNFs) and their contribution to cyclical hospitalizations. SNFs differ from nursing homes and other long-term care facilities by providing short-term, post-operational rehabilitation at a cost lower than what is offered at hospitals. Despite their critical role, SNFs often face fundamental issues, such as understaffing, underfunding, and staff burn-out, which result in lower quality patient care. This thesis argues that the issues faced by SNFs are a result of inconsistencies with state and federal staffing regulations, as well as inadequate insurance reimbursements. …

Mental Disorders, The Positivity Effect, And Questions Of Identity And Responsibility, Liam Jones

Pitzer Senior Theses

In order to judge how behavior caused by the positivity effect should be considered, comparisons were made between the positivity effect and two mental disorders. These disorders, Tourette’s syndrome and psychopathy, were selected due to their extreme differences in what Strawsonian attitudes they inspire and how they are perceived relative to disordered patients’ will. Disorder-affected behavior of Tourette’s patients inspires the objective attitude and is seen as a condition affecting an individual’s will, while disorder-affected behavior of psychopaths inspires the interpersonal attitude and is seen as a character trait. Relevant distinctions between psychopathy and Tourette’s syndrome were found to include …