Medicine and Health Sciences Commons^™

Lxr Acts As A Differentiator In The Regulation Of Fas And G6pdh Gene Expression Under Insulin Resistant Conditions, Jaafar Hachem

Dissertations

Diabetes is a chronic disease that effects 10 percent of the world’s population and causes more than 1.5 million deaths a year and billions of dollars in associated health care cost. It can lead to very serious complications such as renal failure, liver cirrhosis, heart attack, and vision loss. The most common type of diabetes is type 2 diabetes. Type 2 diabetes arises when blood glucose levels remain chronically high due to insulin resistance. The reason for this elevation is due to the failure of insulin to allow tissues to uptake glucose causing problems in subsequent metabolic pathways. Over the …

Evaluation Of Lifestyle Modification Program For Polycystic Ovary Syndrome In Infertile Women, Kelly Batton

Dissertations

Abstract

Problem: Polycystic Ovary Syndrome (PCOS) affects a large proportion of the female population worldwide. PCOS can have a wide variety of health implications for the woman including difficulty achieving pregnancy.

Methods: A retrospective chart review of 368 patient records were assessed for inclusion criteria yielding 163 patients with PCOS suffering from infertility. Demographic and health data were gathered for each patient to provide a baseline comparison between the first two quarters of 2019 and the first two quarters of 2020.

Results: The results of the study were mixed. Patients who lost weight did have a higher positive pregnancy rate. …

Resuscitation Quality Improvement Mortality Rates, Jordan Priest

Dissertations

This paper explores and answers the question: What is the impact of Resuscitation Quality Improvement on survival at discharge rates after suffering an IHCA when compared to every two-year BLS/ACLS training? Articles are explored that identify positive patients’ outcomes when resuscitation training is repetitively learned. The design consists of a BLS/ACLS and RQI evaluation of quarterly survival to discharge rates prior to the initiation of the new RQI program and after the initiation of the new RQI program. The setting of the study is the east region of a midwestern faith-based health care system, that includes four hospitals in one …

Standardized Screening For Peripheral Artery Disease In Primary Setting, Tamara Tomlin

Dissertations

Problem: Peripheral artery disease (PAD) affects eight million Americans and is the third leading cause of death in the U.S. in people 60-85 years of age. Veterans are at a 45% greater risk to develop PAD than non-veterans. Left untreated, PAD can progress to hospitalization for revascularization, amputation, or death. The American Heart Association (AHA) recommends using a standardized screening tool for the diagnosis of PAD; however, a lack of standardized screening is problematic in veterans receiving proper intervention.

Methods: This quality improvement (QI) project utilized a descriptive, observational design. The American Heart Association (AHA) screening tool was administered by …

Leadership Engagement For Military Hospitals: A Case Study Of The Effects Of Executive Leader Engagement In Military Hospitals That Have Become High Reliability Organizations, Russell Phillips

Dissertations

Purpose: The purpose of this qualitative case study was to explore and explain the leadership strategies that military hospital executive leaders used to engage hospital staff in implementing the six principles of High Reliability Organizations (HROs).

Methodology: A qualitative case study approach was selected for this study. Interviews were conducted with three executive leaders describing their experiences with initiating and managing the change development of HRO. The participants in this study were executive leaders of military hospitals across the Puget Sound Military Health System. All participants had direct experience with the implementation of HRO. Interview transcripts were analyzed and reviewed …

Role Of Ebv In Neuroinflammation: Implications For Multiple Sclerosis Pathogenesis, Asma Hassani

Dissertations

Multiple sclerosis (MS) is a demyelinating disease of the CNS with unknown cause. Individuals who are genetically predisposed and exposed to specific environmental factors have an increased risk of developing MS. Epstein-Barr virus (EBV) infection is linked to MS development, according to a large body of seroepidemiological and pathological evidence. EBV is a ubiquitous human herpesvirus that typically produces silent infection but can also cause a wide range of illnesses. A large cohort of MS and non-MS control cases has been previously examined and revealed the prevalent presence of EBV in MS. However, the role of the virus in the …

Molecular Mechanism Of Action Of The Natural Polyphenolic Compound And The P300 Inhibitor “Carnosol” Against The Triple Negative Breast Cance, Halima Ali Mohammed Salem Alsamri

Dissertations

Carnosol, a naturally occurring Phyto polyphenol found in sage, oregano, and rosemary, has been extensively studied by our laboratory for its anticancer effects in various types of cancer. In human Triple-Negative Breast Cancer (TNBC), carnosol was shown to inhibit cellular viability, colony growth, induced cell cycle arrest, autophagy, and apoptosis. Nonetheless, very little is known about the molecular mechanism of action. In the current study, the ability of carnosol to inhibit metastasis and tumour growth was examined. Wound healing and invasion assays revealed that carnosol inhibited migration and invasion at non-cytotoxic concentrations of MDA-MB-231 cells. Also, carnosol was found to …

Characterization Of The Lining Epithelium Of Normal And Precancerous Uterine Cervix In Mice, Reem Mamoun Shouk

Dissertations

Despite the fact that cervical cancer is a common health issue among women worldwide, little is known regarding the epithelial lining of the uterine cervix where cancer originates. Cancer development involves alterations in carbohydrate expression and changes in the dynamics of cellular proliferation and differentiation. Therefore, the aim of this study was to define carbohydrate moieties and cellular dynamics of the epithelial lining of the uterine cervix in normal mice and then in mice developing cervical precancerous lesions. Since the uterus undergoes cyclic changes, mice in each of the four stages of the estrus cycle were first identified using both …

How Domestic Violence Counselors With Personal Histories Of Trauma Experience Their Clients Who Were Victims Of Domestic Violence: A Heuristic Study, Janis Edralin

Dissertations

The heuristic inquiry-based phenomenological approach values focusing on a question or problem that has been a personal challenge in one’s quest to understand oneself and the phenomenon. Previous research has shown that counselors with a personal history of trauma who provide services to victims with a similar history report a range of negative consequences. The researcher utilized a heuristic research design to answer the following question: How do domestic violence counselors who have personal histories of trauma experience their clients who were victims of domestic violence? The methodology involved interviewing eight counselors, from whom four themes were identified: awareness of …

The Alexander House Apostolate Marital Relationship Education Results: A Quantitative Study, Angel Estrada

Dissertations

According to existing literature, 27 components contribute to the concept of couple’s relationship satisfaction. Some of these components are included in non-religious and religious marital relationship education (MRE) programs. Research on nonreligious MREs spans decades; however, research on Catholic MRE programs is limited and not widely published. The purpose of this research was to evaluate the effectiveness of one Catholic, faith-based, couples’ MRE on impacting relationship satisfaction, and determine if specific religious and behavioral practices contributed to relationship satisfaction. The study was conducted with archival data collected from a population of mostly Catholic Latino and White couples in south central …

Benzodiazepine Reduction Program In A Psychiatric Mental Health Setting, Tracy Pacini

Dissertations

Benzodiazepine Reduction Program in a Psychiatric Mental Health Setting

The purpose of this pilot project was to reduce side effects and adverse effects of long-term benzodiazepines (BZDs) use in a non-profit community health center. This was a quality improvement project. The evidence-based practice (EBP) framework identified for the project was from the Institute for Healthcare Improvement (IHI) Plan-Do-Study-Act (PDSA) framework to decrease BZD use in a non-profit community health center. This model is focused on four stages: 1) gathering a proactive healthcare team to examine and identify solutions to reduce BZD usage, 2) testing the pilot program that the team …

Implementing The Richmond Agitation-Sedation Scale To Assess Delirium In A Pediatric Icu, Leigh Paridy

Dissertations

Purpose: The purpose of this quality improvement project was to establish early identification of delirium in the intensive care setting to reduce the impact of long-term patient outcomes. Description of project: A retrospective-prospective medical chart review was completed. The retrospective chart review looked at fifty-two patients admitted to the pediatric intensive care unit (PICU) between October 1, 2020 and December 1, 2020 for patient demographics and State Behavior Scale (SBS) and the Cornell Assessment for Pediatric Delirium (CAPD) charting compliance especially with children with developmental delay and those with a high susceptibility to delirium. The prospective chart review looked at …

Detection Of Breast Cancer In African American Women Using Walk-In Mammography, Munachi Nwosu

Dissertations

Abstract

Problem: Breast cancer is a life-threatening condition, in which the prognosis could potentially worsen with a delay in the detection and commencement of treatment. Scheduling patients for mammograms continues to allow for long wait times that exist in screening mammography. Lower rates of participation in scheduled screening mammograms contributes to the increased rate of advanced breast cancer diagnosis that exit in African American women and threatens their health outcomes. The purpose of this project was to implement walk-in mammography to increase participation for early breast cancer detection.

Methods: An observational descriptive design with a retrospective chart review. A PDSA …

Telework Intensity, Work-Family Conflict, And Work-Family Balance, During The Covid-19 Pandemic, Timir Jayesh Bharucha

Dissertations

The COVID-19 pandemic has led to increased popularity, application, and utilization of telework. To vastly reduce the spread of COVID-19, governmental agencies worldwide have implemented lockdowns and emphasized businesses and corporations should implement telework wherever possible (Anderson & Kelliher, 2020; Belzunegui- Eraso & Erro-Garces, 2020; Buomprisco et al., 2021; Chong et al., 2020; Contreras et al., 2020; Mouratidis & Papagiannakis, 2021; Nguyen, 2021; Oz & Crooks, 2020; Raišienė et al., 2020; Tavares et al., 2020). States of emergency can disturb employees’ workflow and lead to financial difficulties; thus, telework presents an option to reduce that disruption. In such unprecedented times, …

Impact Of Counselor Wellness On Positive And Negative Consequences Of Covid-19 Shared Trauma, Monique Rahman

Dissertations

This study sought to explore how the shared trauma of the COVID-19 pandemic has impacted Texan counselors both positively and negatively, as well as the mediating or moderating effect of counselor wellness. Negative consequences of stress such as secondary traumatic stress, burnout and compassion fatigue were explored, but also positive consequences such as compassion satisfaction and post-traumatic growth. Measures such as the Five Factor Wellness Inventory (FFWEL), the Shared traumatic and Professional Posttraumatic Growth Inventory (STPPGI), and the Professional Quality of Life Measure (ProQOL) will be utilized in addition to demographic questions and COVID-19 stress related questions mirroring Park et …

Evaluating Loneliness In An Older Adult Population, Kelli Rowland

Dissertations

Problem: Loneliness and social isolation are severe burdens on global public health and can impair overall health outcomes. Unfortunately, both loneliness and social isolation are prevalent in the older adult population. The purpose of this quality improvement project was to evaluate loneliness in older adults enrolled in a weekly socialization program and its impact on loneliness.

Methods: A descriptive cohort design was utilized to analyze surveys completed three months apart. A convenience sample was used with older adults already enrolled in a weekly socialization program. The Iowa Model of Evidence-Based Practice was applied to evaluate and promote quality …

Multi-Stage Stochastic Optimization And Reinforcement Learning For Forestry Epidemic And Covid-19 Control Planning, Sabah Bushaj

Dissertations

This dissertation focuses on developing new modeling and solution approaches based on multi-stage stochastic programming and reinforcement learning for tackling biological invasions in forests and human populations. Emerald Ash Borer (EAB) is the nemesis of ash trees. This research introduces a multi-stage stochastic mixed-integer programming model to assist forest agencies in managing emerald ash borer insects throughout the U.S. and maximize the public benets of preserving healthy ash trees. This work is then extended to present the first risk-averse multi-stage stochastic mixed-integer program in the invasive species management literature to account for extreme events. Significant computational achievements are obtained using …

Stochastic Programming And Agent-Based Simulation Approaches For Epidemics Control And Logistics Planning, Xuecheng Yin

Dissertations

This dissertation addresses the resource allocation challenges of fighting against infectious disease outbreaks. The goal of this dissertation is to formulate multi-stage stochastic programming and agent-based models to address the limitations of former literature in optimizing resource allocation for preventing and controlling epidemics and pandemics. In the first study, a multi-stage stochastic programming compartmental model is presented to integrate the uncertain disease progression and the logistics of resource allocation to control a highly contagious infectious disease. The proposed multi-stage stochastic program, which involves various disease growth scenarios, optimizes the distribution of treatment centers and resources while minimizing the total expected …

Essays On Health Care Quality: Timeliness, Equity, And Efficiency, Abubakar-Sadiq Bouda Abdulai

Dissertations

According to the National Academy of Medicine (NAM) (formerly called the Institute of Medicine), a quality health care system embodies six attributes: timeliness, equity, safety, efficiency, effectiveness, and patient-centeredness. Timeliness is to avoid unnecessary delays in care delivery for patients and caregivers; equity is to ensure that the quality of care that patients receive does not vary based on their personal characteristics; safety is to ensure that the care that is intended to help patients does not harm them; efficiency is to avoid waste and optimize resource allocation to improve care delivery; effective care is one that relies on sound …

Towards Quality By Design (Qbd) Of Pharmaceutical Oral Films Loaded With Poorly Watersoluble Drugs, Eylul Cetindag

Dissertations

Oral films are an emerging drug delivery dosage form with numerous advantages such as ease of handling, the possibility to circumvent the first-pass metabolism, better patient compliance, capability for continuous manufacturing, and as a platform for personalized medicine. As films are different from other final dosages by their dimensions and their matrix form, further research is required to better understand the impact of excipient and drug on product performance to assure a consistent and good quality product. Therefore, this dissertation aims to contribute towards the processability and manufacturability of films by examining the impact of the materials and processes. First, …

Exploring Fused Deposition Modeling (Fdm) Three-Dimensional Printing Tablet Design Options For Pharmaceutical Dosage Forms, Guluzar Gorkem Buyukgoz

Dissertations

This dissertation examines the use of Fused Deposition Modeling (FDM) based three-dimensional (3D) printing approach for developing patient-specific dosage forms and addressing related technical challenges in such drug delivery systems. The first main objective is to explore pharmaceutical tablet design options using novel FDM 3D printing technology as the drug delivery platform such that drug form and tablet properties are tailored by considering patient age-specific formulations and dissolution control. Of the five different design options, two proposed options meet the main objective of providing similar drug release, whereas the popular option of fixed drug concentration but differing tablet size could …

Mobbing And Job Satisfaction Among Registered Nurses In Mississippi, Brenda Collins

Dissertations

The incidences of mobbing or workplace bullying are a common occurrence among nurses. The practice has been associated with overwhelming and long-standing comprising emotional, psychosomatic, and psychosocial distress. Mobbing (workplace bullying) impacts the target, those close to them, and the organization in which they work. The experience of mobbing produces affective reactions in the target. Affective experiences on the job can impact job satisfaction within organizations. Job satisfaction plays an essential role in sustaining an adequate nursing workforce. Subsequently, some nurses become frustrated and opt for resigning or early retirement when they are no longer satisfied with the culture or …

Physical Education Teachers' Instructional Adaptations To Teach Motor Skills To Children With Language Disorders, Kristen Morgan

Dissertations

Children with language disorders have a unique blend of impairments related to communication, memory (Gray et al., 2019; Montgomery et al., 2019), executive functioning (Kapa & Plante, 2015), motor skills (Hill, 2001), imitation, gestures (Wray et al., 2017), and reaching early motor milestones (Diepeveen et al., 2018). These deficits may negatively affect learning motor skills in physical education (PE). Instructional adaptations to overcome these learning impairments in PE has not been greatly explored in the literature. Nor has teachers’ level of self-efficacy in providing adaptations to children with language disorders. The purpose of this study was to examine instructional adaptations …

The Impacts Of Aging, Sedentarism, And Exercise On Neurotrophic Factor Expression And Innervation In The Heart And The Effects Of Treatment With Α-Cgrp On Heart Function, Gabriel Almeida Alves

Dissertations

Neurotrophic factors (NFs) are important molecules responsible for development, differentiation, regeneration, and maintenance of new and mature neurons. Neurotrophic factors act as neurocytokines and may assist with the regulation of axonal and dendritic arrangements and synaptic plasticity between neurons themselves or with other non-neural target tissues. In this study, we analyze the levels of two NFs: glial cell line-derived neurotrophic factor (GDNF) and nerve growth factor (NGF). Cardiomyocytes produce these neurotrophic factors which assist with the innervation pattern of the heart. The heart is innervated by the two branches of the autonomic nervous system; namely the sympathetic nervous system and …

Preclinical Behavioral Assessment Of Chronic, Intermittent Low-Dose Psilocybin In Rodent Models Of Depression And Anxiety, Harmony I. Risca

Dissertations

Recent studies have demonstrated the clinical efficacy of psychedelic-assisted psychotherapy for treatment-resistant depression and anxiety. Amidst the overall success of recent clinical trials using a single high dose of psilocybin, anecdotal reports indicate anxiolytic and antidepressant effects following a repeated low dose regimen. As therapeutic outcomes are often tightly intertwined with the individual’s subjective experience, animal models are used as objective measures to investigate the underlying mechanisms responsible for the putative antidepressant/anxiolytic effects of psychedelics. Three rodent models predictive of anxiolytic or antidepressant effects were used to evaluate effects of chronic intermittent low dose (CILD) psilocybin treatment; the Light/Dark conflict …

A Qualitative Exploration Of The Patient Care Experience As Perceived By Hispanic Patients Receiving Care At A Safety-Net Facility, Silvinia Cuizon

Dissertations

Purpose: The purpose of this study was to understand how English- and Spanish-speaking Hispanic patients seeking kidney and liver transplant care at a safety-net facility perceive and interpret the care experience with the goal of generating a grounded theory model to guide care delivery and improve perception of care for this population.

Background/Rationale: The patient experience is the current federally mandated hospital quality indicator that measures the range of interactions patients have with their hospital admission, which has fiscal and clinical implications for the delivery of care. Many safety-net health care delivery systems, which primarily serve traditionally underserved populations, and …

Exploration Of Patient Variables And Characteristics Best Suited For Medical Marijuana Treatment For Anxiety And Depressive Disorders, Corey Gazoo

Dissertations

Individuals with posttraumatic stress, anxiety and depressive disorders are currently being prescribed medical marijuana as a treatment in many states across the United States. However, marijuana is still considered a schedule one narcotic by the Drug Enforcement Administration and federal government, which provides several barriers and challenges to conduct research such as approval from the U.S. Food and Drug Administration and following guidelines from the National Institute on Drug Abuse issued by the DEA. Additionally, individuals prescribed medical marijuana for mental health disorders are not always thoroughly instructed on the type of medical marijuana, the dosage, and how frequently to …

An Examination Of Types Of Health Insurance And The Reported Prevalence Of Autism In The United States, Jennifer L. Thompson

Dissertations

The prevalence of Autism Spectrum Disorders continues to rise despite barriers of changes to diagnostic criteria and lack of insurance coverage. Increases in prevalence affect costs associated with a disorder since cost of health care services are often estimated based on utilization of services. This can also affect an individual’s ability to access to health care services. To equitably distribute autism services to individuals an accurate estimation of the true prevalence of autism is needed.

Access to health care can be influenced by the type of insurance coverage a person holds. Other factors, such as socio-economic status, ethnicity, location of …

Veteran Social Network: Peer Support Impact On Mental Health Service Utilization, Stacy A. Harris

Dissertations

Of the 20 million US Veterans, approximately 30% receive health care benefits from the Veterans Affairs system. Research confirms that these Veterans are less likely to seek professional mental health services as a result of a belief that mental illness equates with weakness. Research on peer support with Veterans suggests that Veteran social networks reduce stigma and facilitate help seeking behavior. Most studies on Veteran help seeking for mental health services use subjects who receive health care from the Veterans Health Administration or Department of Defense. The purpose of the current study is to gain an understanding of Veterans who …

Profitably Risky: A Study Of Medicare Capitation Contracts For Primary Care Medical Practices, Michael Wieck

Dissertations

The Centers for Medicare and Medicaid Services is seeking to move medical providers from a fee-for-service reimbursement model to a value-based reimbursement model. In this dissertation, we studied the financial rewards and risks that accompany capitation contracts. We employed Poisson regression to estimate health-care utilization of beneficiaries under the care of primary care providers with varying levels of capitation. Then, we calculated capitation contract results for primary care practices using Monte Carlo simulations. We used three methods to predict medical payments for beneficiaries: (1) empirical probability distributions of annual medical payments, (2) theoretical probability distributions of annual medical payments, and …