Medicine and Health Sciences Commons^™

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 …

Connecting Human Dignity, Non-Violence, And Environment For Healthcare Ethics In Nigeria, John Mark Ogu

Electronic Theses and Dissertations

Abstract

Connecting Human Dignity, Non-violence, and Environment in Health Care for Nigeria

By

John Mark Chinaemerem Ogu

December 2021

Dissertation supervised by Peter Ikechukwu Osuji, Ph.D.

This dissertation presents a global public health ethical approach based on social justice that connects human dignity, non-violence, and the environment in Nigeria. Recently, different places globally are witnessing uprisings and violence; some of these are linked to environmental scarcity. These are threats to global health, peace, development, and security because violence of any type or form is a global public health and security menace and an affront to human dignity. Environmental scarcity, especially …

Implementation Of Cervical Cancer Screening Protocol (Ccsp): A Quality Improvement Project, Emilee Lenhart Hawk

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Background and significance: Cervical cancer is the fourth most commonly occurring cancer in women and the eighth most commonly occurring cancer overall (WCRF, 2020). Papanicolaou (Pap) testing is the primary screening for cervical cancer. In the past 40 years the number of cases and deaths from cervical cancer has decreased significantly, resulting from cervical cancer screenings (CDC, 2021). Healthy People 2030 reports to increase the proportion of females ages 21-65 who receive a cervical cancer screening based on the most recent guidelines. The 2030 target is 84.3%. Human papillomavirus (HPV) is a virus that is transmitted through sexual contact …

Optimizing Postpartum Care By Ongoing Care Coordination Initiatives (Cci) In Screening And Management Of Postpartum Depression (Ppd) Among Clients In An Obgyn Practice: A Quality Improvement Project., Jennifer Broussard

Doctor of Nursing Practice (DNP) Manuscripts

Background: Postpartum depression (PPD) is defined as physical, emotional, and behavioral changes that occur after the birth of a child. Postpartum depression is complex and a mix of physical, emotional, and behavioral changes (Cleveland Medical Clinic, 2018). Postpartum depression screening is of high importance at a comprehensive postpartum visit. The consequences of a patient suffering postpartum depression can be serious and early recognition and interventions improve outcomes for the patient as well as the infant. Problem: There is a lack of screening for PPD among postpartum clients and this period is critical for the mother and the infant (American College …

Program Evaluation Of Adolescent Intervention Program (Aip): Substance Abuse Education Program For At Risk Adolescents, Shanea Clancy

Doctor of Nursing Practice (DNP) Manuscripts

The purpose of this project is to evaluate the effectiveness of the Adolescent Intervention Program (AIP), a faith-based drug and alcohol recovery program for teens. This is an alternative to jail program. Nearly 1 in 10 Americans, 12 years or older (20.1 million people), have a substance use disorder (SUD), involving alcohol or illicit drugs (National Center for Drug Abuse Statistics, 2019). The average age of first-time alcohol or substance use is 13 years old and nine out of ten addictions start in the adolescent years (National Center for Drug Abuse Statistics, 2019). Adolescents with first-time drug and alcohol arrests …

Reducing Opioid Related Deaths And Improving Rehabilitation Access Through The Elk Grove Village Cares Program: A Program Evaluation, Rebecca Barron

Doctor of Nursing Practice (DNP) Manuscripts

Abstract The goal of the Elk Grove Village Cares program is to decrease the deaths and overdoses of those who abuse opioids through harm reduction strategies and provide access to treatment. The article is a program evaluation of the Elk Grove Village Cares program. Surveys, interviews and the synthesis of program data is used to evaluate the efficacy of program activities. Results: The rate of death from opioid use has decreased an average of 1.7 deaths since program implementation in 2018. Law enforcement officers (LEO) and the community responded similarly to many survey questions regarding attitudes surrounding addiction. Within the …

Improving Care Of Children With Acute Decompensated Heart Failure (Adhf) Through Implementation Of A Heart Failure Communication Checklist & Discharge Plan, Dana M. Schneck

Doctor of Nursing Practice (DNP) Manuscripts

Background: Children admitted to the hospital with ADHF have been identified as a low volume high complexity population with high morbidity and mortality rates. Hospitalizations are fraught with prolonged lengths of stay and frequent readmissions prompting increased resource utilization and significant healthcare costs. Pediatric collaborative learning networks, such as the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) seek to close quality gaps by engaging multidisciplinary multi-institutional teams along with patients and caregivers to share expertise, experience, and data prompting translation of evidence into higher quality, safer, cost-effective care.

Methods: A13-item pediatric-specific Heart Failure Communication Checklist (HFcc) and Heart Failure Discharge …

A Public Health Ethics Approach To Substance Use Disorder, Adele Flaherty

Electronic Theses and Dissertations

The goal of the dissertation is to undertake an analysis of substance use disorders that focuses on a public health ethics perspective. The ethical argument focuses upon justifying the use of harm reduction and is primarily concerned with the current opioid crisis. While substance abuse/misuse over the course of history has been identified as a public health concern, this dissertation presents substance use disorders over the course of the lifespan, examining various contexts in which it can affect daily living and health outcomes. It achieves this by analyzing substance use disorders through the lens of the socioecological model of public …

Increase Access To Community-Based Health Care For Underserved Individuals: A Quality Improvement Project, Piper Oneal

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Background: Health care access disproportionately affects certain populations. Health care opportunities for uninsured adult members of a rural community can be limited. Suwannee County is a rural community with a population of 43,814 of which 40.8 % live below the 200% poverty income level (WellFlorida Council, 2020). Problem: In 2016, 23.8% of adults in Suwannee County were unable to see a doctor in the past year due to the inability to pay and lack of insurance (Florida Department of Health, 2020). Community-based health care initiatives can address such issues by targeting underserved individuals, reducing barriers, and making health services …

Improving Lymphedema Self-Management And Screening In Newly Diagnosed Breast Cancer Clients Through The Use Of A Self-Management Lymphedema Toolkit, Kescia Gray

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: With breast cancer effecting women at much younger ages and modern treatments prolonging the life span, survivors are at increased risk of developing breast cancer-related lymphedema (BCRL), a chronic, progressive condition that can cause disability.

Purpose: The purpose of the project was to determine the level of knowledge and awareness of BCRL in newly diagnosed breast cancer clients; and to provided education on self-care after treatment, using of a self-management lymphedema toolkit (SMLT), to decrease risks of treatment-related lymphedema, improve self-efficacy, and enhance quality of life (QOL).

Methods: Newly diagnosed breast cancer clients (N=10) from the Breast …

Program Evaluation Of The Rapid Response System Prior To And During A Covid Surge, Sarah Born

Doctor of Nursing Practice (DNP) Manuscripts

Between the years 2004-2008, the Institute for Healthcare Improvement (IHI) and The Joint Commission made a recommendation for healthcare facilities nationwide to implement rapid response systems (RRS). Rapid response systems consist of four limbs: recognition and alert (afferent); response and providing timely patient management (efferent); delivering support and oversight (administrative), and monitoring the RRS patient outcome data (quality improvement). The intent of implementing RRS was to increase patient safety and outcomes within the acute care setting. The following question (PICO) formed the basis of the project: “How does the current rapid response system workflow compare to the rapid response system …

The Contribution Of Bioethics To Home Healthcare (Hhc) In Saudi Arabia, Saeed Alghamdi

Electronic Theses and Dissertations

This dissertation examines the contribution of bioethics to Home Healthcare (HHC) In Saudi Arabia (SA). Through exploring the critical bioethical issues that have influenced the implementation of home health care, the dissertation highlights the significance of incorporating bioethics in home health care. Organizational ethics has led to the regulation of healthcare professionals, patients, and the stakeholders within clinical care settings. Healthcare organizations and other stakeholders, such as global health bodies, should formulate laws and policies that promote bioethics in contemporary healthcare. The Kingdom of Saudi Arabia, through the Ministry of Health, should promote the adoption of home health care services …

Exploring And Understanding The Culture Of Young Adults Who Vape: A Focused Ethnography, Beth Tremblay

Electronic Theses and Dissertations

Introduction: Vaping, the act of inhaling an aerosolized liquid, is associated with health risks. The 18- to 25-year-old age group has the highest rate of vaping among adults. Understanding culturally held values, beliefs, and experiences associated with the behavior of vaping in young adults may uncover the social mechanisms that underpin vaping initiation and influence continued use. The purpose of this study was to explore and understand the cultural values and beliefs about vaping among young adults. Method: The method used for this study was a focused ethnography. Young adults who currently vape nicotine (N=24) were recruited via snowball method …

Engaging Middle School Students And Parents/Guardians Via Structured Virtual Media On Food Allergy And Anaphylaxis Awareness: A Quality Improvement Project, Jodi Licata

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Background and Significance: More than 40% of children with food allergies have experienced anaphylaxis, a life-threatening condition (Food Allergy Research & Education [FARE], 2021). Anaphylactic reactions require immediate treatment with an intramuscular injection of epinephrine by a health care professional or by a self-injectable epinephrine auto-injector device. If anaphylactic symptoms are not promptly recognized and treated, fatal consequences may occur (FARE, 2021). Repeated education, training, and a supportive social environment, specifically with adolescents, have been found to facilitate self-management with food-induced anaphylaxis (Comberiati et al., 2019). Purpose: In this quality improvement project, virtual education interventions to increase food allergy …

Technological Change And The Practice Of Healthcare Communication: Implications For Patient-Centered Care, From A Communication Ethics Perspective, Emmalee Torisk

Electronic Theses and Dissertations

Written in a historical moment marked in many ways by the COVID-19 pandemic and the changes it has wrought, including the increased availability and use of telehealth services, this project attempts to consider the implications of the continued integration of technology into health care, centering on the following essential question: How do technological changes affect the contemporary practice of healthcare communication, particularly that which occurs between the patient—the consumer of health care—and their provider? This dissertation thus considers the ways in which such linkages of technology and health care seem to fit into a larger shift within health care …

Development Of A Combined Feedforward-Feedback Quality Control System For Extended-Release Granules Using A Quality By Design Approach, Yuxiang Zhao

Electronic Theses and Dissertations

Objectives

For a fluid bed film coating process to consistently deliver quality products, its control system needs to be robust against the variability of input materials and environmental disturbances. Presently, limited studies have been reported to understand the effects and interactions of the material attributes, environmental variables, and process parameters on the product in vitro drug dissolution. A control system can be developed with a proper understanding of the coating process, by adjusting the process parameters in feedback and feedforward manners to compensate for the undesired effect caused by disturbances, and ensure consistent product quality.

Methods

The control system was …

Patient Portal Use, Health Information Technology Self-Efficacy, Electronic Health Literacy, And Self-Management Among Patients With Heart Failure: A Cross Sectional Study, Pamel Kallmerten

Electronic Theses and Dissertations

Background: By the year 2030, the prevalence of heart failure (HF) is anticipated to rise by 46%, impacting over 8 billion persons. Self-management of HF is key to maintaining a healthy lifestyle and quality of life. Yet many have sub-optimal self-management skills necessitating innovative strategies to enhance self-management. An innovative strategy to support the person with HF is the use of health information technology (HIT) such as a patient portal (PP). Additionally, self-efficacy and health literacy are important to self-management of HF. Further understanding is needed of the relationship between PP use, HIT self-efficacy (HIT SE), electronic health literacy …

Towards A "Universal Chemical Biology Toolbox" For Tackling Human Diseases, Christopher Swank

Electronic Theses and Dissertations

A lack of new drug targets and drug mechanisms, coupled with drug-pipeline attrition, represent significant problems in oncology drug discovery. Towards addressing this challenge, “fully-functionalized small-molecule probes” (FFSMPs) have been established, which are compounds that can be immediately used as “bait” to capture their protein targets under the same assay conditions used for oncology-based phenotypic screening. Specifically, each FFSMP library member contains one or more structural-diversity elements to promote interactions of the probe with different protein targets in living cells, an electrophile or photoreactive functional group for covalent attachment of the probe to interacting proteins via affinity or photoaffinity labeling, …

The Role Of Mek1/2 And Mek5 In Melatonin-Mediated Actions On Osteoblasts And Osteoclasts Differentiation, Bone Formation, Bone Microarchitecture, And Bone Biomechanics, Fahima Akter Munmun

Electronic Theses and Dissertations

Melatonin, the main endogenous hormone to entrain the circadian system, is not limited to its role in regulating the sleep-wake cycle; rather, it affects a wide variety of systems involving antioxidant, anti-inflammation, blood pressure regulation, seasonal reproduction, ovarian physiology, and immune function. Driven by the diversity of its action, melatonin for a long time has also been studied in the field of bone and mineral research both clinically and pre-clinically. Exogenous administration of melatonin in clinical trials in perimenopausal women (MOPS; NCT01152580); or postmenopausal women with osteopenia (MelaOST; NCT01690000 and MOTS; NCT01870115) confirmed improvement of bone mineral density (BMD) (MelaOST; …

The Impact Of A Structured Civility Educational Module And Cognitive Rehearsal Training (Crt) On Job Satisfaction And Turnover In Rural Healthcare Employees: A Quality Improvement Pilot Project, Laurel Matthews

Doctor of Nursing Practice (DNP) Manuscripts

Incivility is a top-cited stressor resulting in decreased job satisfaction and turnover. Uncivil behaviors jeopardize patient safety through poor communication and team ineffectiveness. This project aimed to determine if a structured civility educational module with CRT positively impacted job satisfaction and turnover of healthcare employees.

A pretest using the Workplace Civility Index (WCI) and investigator generated questions determined current civility behaviors, notable civility issues, and attitudes surrounding job satisfaction and turnover. The interactive, virtual modules highlighted dilemmas regarding incivility and their consequences to patient care. During CRT, the participants responded to filmed, uncivil conflicts using provided frameworks to curate civil …

Effectiveness Of The Purewick External Urinary Collection Device In A Long-Term Acute Care Hospital: A Program Evaluation, Charlotte Sheppard

Doctor of Nursing Practice (DNP) Manuscripts

In December 2017 a 77 bed Long Term Acute Care Hospital (LTACH) added PureWick External Urinary Collection Devices (ECD) to their Hospital Acquired Infection (HAI) Bundle. The PureWick ECD is utilized in the female patient population when urinary management is necessary and can be achieved without an indwelling urinary catheter.The PureWick ECD is a flexible wick like external catheter that allows for collection of urine through the hospital wall suction system. A program evaluation was performed relative to a program beginning in January, 2018 through September 2020 to determine if the implementation of the PureWick ECD reduced the catheter associated …

An Evalution Of Sepsis Initiatives To Reduce The Severity Of Severe Sepsis In A Two-Hospital System, Rosemary Reiner

Doctor of Nursing Practice (DNP) Manuscripts

Sepsis is the most expensive clinical condition to treat, with a very high mortality rate (Torio & Moore, 2016). The goal of sepsis treatment is to intervene as early as possible utilizing established criteria. Several evidence-based approaches in the literature address early identification of sepsis, decreasing sepsis severity and reducing morbidity and mortality. Clinical Decision Support (CDS) are tools within certified electronic health records that provide clinicians with patient-specific knowledge presented at appropriate times that enhance decision-making and improve patient outcomes (Villegas & Moore, 2018). Electronic sepsis alerts are examples of CDS that are developed to monitor changes indicative of …

Improving Progressive Care Nurses’ Confidence And Performance During In-Hospital Cardiac Arrest (Ihca): A Continuous Quality Improvement Initiative, Katelyn Barley

Doctor of Nursing Practice (DNP) Manuscripts

The literature is clear regarding the benefits of high-quality cardiopulmonary resuscitation (CPR) in relation to patient outcomes. The American Heart Association (AHA) guidelines recommend immediate initiation of chest compressions and defibrillation as soon as possible to increase the chance of survival from cardiac arrest. The development of automatic external defibrillators (AEDs) have increased the survival rates of out-of-hospital cardiac arrest, however rates of survival from in-hospital cardiac arrest (IHCA) have not improved over the past several decades despite an increase in resuscitation research.

This project was to develop a system of quality improvement related to patient outcomes from IHCA. The …

Use Of A Remote Patient Home Telemonitoring System (Engage Practice Solutions) In A Rural Health System To Decrease Rural Patients’ Utilization Of Acute Healthcare Services: A Quality Improvement Project, Christopher Baker

Doctor of Nursing Practice (DNP) Manuscripts

Individuals in rural areas of the U.S. have less healthcare access in large part due to access barriers, and include travel and wait time, distance to a provider, cost, transportation, and social and cultural components. Rural individuals have been found to be in poorer health and have higher rates of being uninsured and having chronic disease. These disparities lead to rural individuals requiring more expensive acute care once they are at the point of receiving care. A significant burden is placed on the individual and health system. The rates of emergency department (ED) use in rural areas increased 70% from …

University Student Health Services Covid-19 Pandemic Response: A Program Evaluation, Joy Dougherty

Doctor of Nursing Practice (DNP) Manuscripts

The COVID-19 pandemic began in China in December 2019, and continued to spread globally throughout the following months. The impact of the virus led to Universities nationwide closing their campuses. Strategic COVID-19 master plans were created to ensure that students, faculty, and staff could return to a safe environment for the fall semester. The role of University Student Health Services (SHS) departments became critical.

The SHS team incorporated telemedicine visits along with new policies, procedures, protocols, and guidelines to maximize the safety of the students, faculty, and staff upon their return to campus. This program evaluation focused on the strengths …

"Program Evaluation On The Use Of The Screening, Brief Intervention And Referral To Treatment (Sbirt) Process In Primary Care Physician Offices", Lisa Sanchez-Navarro

Doctor of Nursing Practice (DNP) Manuscripts

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an early screening intervention tool for individuals with non-dependent substance use, which is employed to identify and provide care before a patient needs extensive specialized treatment. SBIRT can be used in primary care settings, to methodically screen individuals who might not seek help for a substance use issue (Centers for Medicare & Medicaid Services, [CMS], 2020). Gaps in using the SBIRT screening process were identified within the insurance organization’s PCP practices, therefore, a program evaluation was completed to: (a) determine whether Primary Care Physicians (PCPs) were using the SBIRT process, (b) …

Evaluation Of Nurse Staffing, Engagement And Satisfaction In A South Carolina Rehabilitation Facility: Impact On Patient Outcomes, Eileen Klang

Doctor of Nursing Practice (DNP) Manuscripts

An acute care rehabilitation facility in Horry County, South Carolina was the setting for this program evaluation of nurse staffing, engagement and satisfaction and if those factors had any effect on patient outcomes in the facility. Nursing department staffing, engagement and patient outcome data was evaluated for trends and themes. Through stakeholder meetings, data was collected, a qualitative and quantitative satisfaction survey was administered to nursing staff. Evaluation of the data occurred and revealed multiple factors that led to nursing department turnover between 2018 and 2020. During the increase in turnover, it was noted that patient falls, and catheter associated …