Medicine and Health Sciences Commons^™

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 …

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 …

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

Multimodal Investigations For The Identification Of Surgically Relevant Brain Areas, Kevin Tyner

Theses & Dissertations

Epilepsy is a neurological disease leading to recurrent and unpredictable seizures. Patients can be diagnosed as focal onset, where the seizure focus resides in one hemisphere; generalized onset, where seizure foci reside in both hemispheres; or unknown onset. Anti-seizure medications are the first line of treatment, and those whose seizures cannot be controlled with medication are diagnosed with drug-resistant epilepsy (DRE). For patients diagnosed with focal onset epilepsy to achieve seizure freedom, surgical resection of the epileptogenic zone (EZ), the region of the brain that is both necessary and sufficient for initiating seizures, is required. The EZ is a theoretical …

Patient-Centered Preimplant Education Session And Bi-Weekly Text Message Adherence Reminders In Patients With A Newly Implanted Cardiomems® Device: A Quality Improvement Study, Elizabeth M. Miller, Alicia Abboud, Audrey Cooper

Doctor of Nursing Practice Projects: College of Nursing

Rationale

Heart failure is a deadly disease, affecting over 6.2 million individuals and costing the United States an estimated 30.7 billion dollars (Virani et al., 2020). By 2023, heart failure costs in the United States are estimated to grow to 70 billion dollars with 75-80% of these costs attributed to inpatient hospitalizations (Heidereich et al., 2022). The CardioMEMs® is a small device placed in the patient’s pulmonary artery via a minimally invasive procedure by an interventional cardiologist. The use of remote patient data from the CardioMEMs® device has been shown to reduce hospital re-admissions, facilitate tailored medication management, detect increased …

Implementing A Standardized Protocol For Early Detection Of Undiagnosed Hypertension Patients, Jenscena Hansen, Chris Bell

Doctor of Nursing Practice Projects: College of Nursing

Introduction: Hypertension is a preventable disease that frequently goes unrecognized and undertreated. Early diagnosis can prevent further comorbidities such as heart disease, stroke, and chronic kidney disease. Implementation of this protocol aims to decrease the number of patients with undiagnosed hypertension and increase the identification of patients with elevated blood pressure who did not have a pre-existing diagnosis of hypertension. The goal of implementing a standardized protocol would help eliminate the number of patients who go undiagnosed.

Methods: This quality improvement design had clinical staff flag patients with elevated blood pressure. Identified patients without a diagnosis of hypertension were educated …

Integrating Galectin-3 Into A Computational Model Of Cardiac Fibrosis Progression, Adam Pieratt

Chemical Engineering Undergraduate Honors Theses

Cardiac fibrosis, a large contributor to heart failure, is the excessive accumulation of extracellular matrix in response to stress or injury. There are no approved treatments for cardiac fibrosis, and targeting specific species involved creates complex problems for drug development, so a computational model of the cardiac fibroblast signaling network can be used to observe the interactions involved in the progression of cardiac fibrosis. In this paper, a new protein called galectin-3 is integrated into this existing model, and connections are established to expand the coverage of the network. The additions are described, simulated using Netflux biological system simulation software, …

Isolation Of Aged Mouse Primary Microglia As A Model System For Alzheimer’S Disease Research, Michael Landis

Biology Honors Papers

Microglia and their role as the immune cells of the central nervous system are an emerging area of interest within Alzheimer’s research, particularly as they have shown in a benevolent and malevolent cellular context. Models of Alzheimer’s disease are very light in studying microglia, so in this study a model of microglia isolated from aged mice is established in order to study the phagocytic activity and protein expression of microglia in response to Amyloid Beta. The cells were isolated from aged mice and cultured before being used to confirm cellular identity, as well as to measure phagocytic activity. This study …

Evaluating The Association Of Influenza Vaccination On Long-Term Covid-19 Symptoms In U.S. Adults, Ratnakar Pingili

Capstone Experience

Objective. To evaluate the association of influenza vaccination in the past 12 months with Long COVID effects and clinical and sociodemographic factors.

Methods. Cross-sectional study with data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), covering 415,132 non-institutionalized U.S. adults with a confirmed COVID-19 diagnosis and influenza vaccination reported within the last 12 months. Logistic regression was conducted between influenza vaccination (exposure) and Long COVID (outcome), controlling for demographic variables, pre-existing health conditions, and socioeconomic status.

Results. Of 120,603 participants, 21.89% reported Long COVID symptoms and 42.04% had received an influenza vaccine. Findings indicate a statistically significant 13% reduction …

Cord Blood-Derived Invariant Natural Killer T Cells As A Platform For Allogeneic Chimeric Antigen Receptor Cell Therapy, Maison Grefe

Dissertations & Theses (Open Access)

Chimeric antigen receptor (CAR) T cells have revolutionized the treatment of hematopoietic malignancies achieving >50% complete response rates in numerous refractory/relapsed B cell malignancies. However, there are challenges that hinder CAR-T efficacy and bar the broader use of this therapy in patients. One approach to address these challenges is to create a safe allogeneic CAR cell product by using cells that do not cause graft versus host disease (GvHD). Invariant natural killer T (iNKT) cells are an ideal candidate as they are restricted to the monomorphic CD1d protein in contrast to HLA restricted αβ-T cells and therefore are safe in …

Code For Care: Hypertension Prediction In Women Aged 18-39 Years, Kruti Sheth

Electronic Theses, Projects, and Dissertations

The longstanding prevalence of hypertension, often undiagnosed, poses significant risks of severe chronic and cardiovascular complications if left untreated. This study investigated the causes and underlying risks of hypertension in females aged between 18-39 years. The research questions were: (Q1.) What factors affect the occurrence of hypertension in females aged 18-39 years? (Q2.) What machine learning algorithms are suited for effectively predicting hypertension? (Q3.) How can SHAP values be leveraged to analyze the factors from model outputs? The findings are: (Q1.) Performing Feature selection using binary classification Logistic regression algorithm reveals an array of 30 most influential factors at an …

Identifying Barriers To Healthcare Access And Utilization Experienced By Lgbtq+ Adults With Chronic Diseases Through The Lens Of The Social Ecological Model, Devin Mottier

Capstone Experience

The purpose of this literature review is to comprehensively examine and synthesize existing research on present barriers to health access and utilization that contribute to the disparities in chronic disease prevalence within the adult LGBTQ+ population. In the context of this review, the social-ecological model (SEM) was used to describe the nuanced and multifaceted nature of healthcare access and utilization. This literature review was based upon the following question: ‘Using the social-ecological model, what are the barriers to health access and utilization that contribute to high rates of chronic disease in LGBTQ+ adults?’ Outcome measures of interest included the following …

A Meta-Analysis For Laboratory Diagnostics For Coccidioidomycosis, Mary C. Cowen

Biological Sciences Undergraduate Honors Theses

Coccidioidomycosis, commonly referred to as Valley Fever, is a fungal infection found in arid regions of the southwestern United States and Mexico. Infection occurs through inhalation of airborne spores from Coccidioides species, Coccidioides immitis and/or Coccidioides posadasii, and proceeds in both pulmonary and disseminated fashions. Approximately 60% of patients with coccidioidomycosis remain asymptomatic, while 40% will experience symptoms. Within the literature, there are no papers that summarize sensitivity and specificity values between different tests; therefore, this paper presents sensitivity and specificity results across different tests and companies (Meridian, IMMY, and MiraVista).

The Role Of B Cell Activation State And Sex In Aryl Hydrocarbon Receptor Mediated Induction Of Chemokine Receptor 9 And Alpha4beta7 Expression In Vitro, Logan Bauerle

Master's Theses

Defense of mucosal tissues from microbial infection and allergy is reliant on continual production of antibodies. The aryl hydrocarbon receptor (AhR) is known to regulate B cell development and is associated with suppression of systemic humoral immunity. Recent attention has been paid to the role of the AhR in altering expression of cell adhesion molecules (CAMs). B cells express CAMs and chemokine receptors to migrate around the body for localized secretion of antibodies. AhR agonists promote B cell migration to the small intestine through upregulation of chemokine receptor 9 (CCR9) and integrin α₄β₇. Both the AhR …

Process Modeling The Neuroprotective Effects Of A Plant-Based Diet On Parkinson's Disease, Julia Mitchell

Undergraduate Honors Theses

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms such as tremors, bradykinesia, rigidity, and postural instability. Recent research suggests an avenue for potential neuroprotection through dietary intervention, specifically the adoption of a plant-based diet. A plant-based diet predominantly comprises foods derived from plants, emphasizing fruits, vegetables, grains, legumes, and nuts while minimizing or excluding animal products. This thesis aims to explore the biochemical pathways implicated in PD progression and the potential impact of dietary choices on these pathways. The investigation focuses on several key pathways: alpha-synuclein aggregation, the blood-brain barrier crossing of levodopa, oxidative stress, ferroptosis, …

Mathematical Modeling And Examination Into Existing And Emerging Parkinson’S Disease Treatments: Levodopa And Ketamine, Gabrielle Riddlemoser

Undergraduate Honors Theses

Parkinson’s disease (PD) is the second most common neurodegenerative disease across the world, affecting over 6 million people worldwide. This disorder is characterized by the progressive loss of dopaminergic neurons within the substantia nigra pars compacta (SNpc) due to the aggregation of α-synuclein within the brain. Patients with PD develop motor symptoms such as tremors, bradykinesia, and postural instability, as well as a host of non-motor symptoms such as behavioral changes, sleep difficulties, and fatigue. The reduction of dopamine within the brain is the primary cause of these symptoms. The main form of treatment for PD is levodopa, a precursor …

Development And Implementation Of An Evidence Based Practice Guideline Related To The Management Of Adult Angioedema, Megan Przybysz

Doctor of Nursing Practice Scholarly Projects

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for …

Education Of The Effects Of Obesity Medications And A Stepwise Approach To Mitigate Prevalence And Encourage Lifestyle Medicine For Primary Care Physicians, Kiely M. Curran

Department of Nutrition Student Projects

My Capstone project is an Educational Manual that emphasizes a healthcare team approach to the treatment and management of obesity. The Educational Manual consists of a standardized protocol in management of obesity in patients and a document with summarized references for primary care providers; and a simplified document for patient education. There is a growing interest in the usage of obesity medications. The purpose of my Capstone project is to provide a simplified manual for the primary care provider to reference to make knowledgeable and patient-centered decisions in the prescription of obesity medications and decisions in weight-management. My methodology included …

Home-Based Virtual Culinary Nutrition Education Sessions For Amyotrophic Lateral Sclerosis Patients: Quantitative Experimental Pilot Study, Ciara N. Reistad, Mauricio Lobo

Department of Nutrition Student Projects

Amyotrophic lateral sclerosis (ALS) impairs voluntary muscular activity and often results in malnutrition. The need for specialized dietary therapy for ALS-related illnesses is highlighted by recent research, but it also draws attention to the lack of targeted care and ongoing nutritional status monitoring. Technological developments like telehealth and chatbots hold potential for ALS patients’ nutritional monitoring. The pilot study examined the feasibility and impact of home-based virtual culinary nutrition education sessions on nutritional knowledge, dietary intake of energy (CHO), protein (PRO) and FAT, body mass index (BMI), and functional status assessed by ALSFRS-R scores in patients with Amyotrophic Lateral Sclerosis …

Playing It Sun Safe: A Quality Improvement Project, Sarah P. Tarr, Kathryn K. Dambrino, R. David Phillippi, Ashley Karpinos

DNP Scholarly Projects

Background: Athletes who play outdoor sports have multiple risk factors for the development of skin cancer. Literature highlights the need for the use of evidence-based strategies to improve the knowledge and utilization of sun protection practices in this high-risk population. Methods: Playing it Sun Safe was a multifaceted skin cancer prevention initiative implemented in a population of collegiate soccer athletes in collaboration with a university athletic department and campus health clinic. Evidence-based interventions were designed through application of the Health Belief Model (HBM) and were implemented using the Institute for Healthcare Improvement (IHI) quality improvement framework. Purpose: The two-fold aim …

Type 2 Diabetes Health Beliefs Of College Students, Emily Spindler

Honors College Theses

College students of health-related majors are sometimes assumed to have greater health literacy. The belief can be attributed to the students taking classes discussing health problems, diseases, risk factors, medical management, nutrition, and exercise. How often the health classes discuss type 2 diabetes (T2D) remains undetermined; therefore, the amount of knowledge and beliefs health students have of T2D is unknown. The objective of the study was to examine the relationship between students' majors, health beliefs about T2D, and engagement in behavioral risk factors at a mid-size regional public university. A quantitative, non-experimental, survey design was chosen, and responses were obtained …

Best Screening: Introducing The Neonatal Assessment Visual European Grid To Nicus In Tennessee, Gabrielle Sledge

OTD Capstone Projects

Blind Early Services Tennessee (BEST) is an early intervention agency that serves children ages 0-5 with visual impairments across Tennessee. BEST serves over 200 children and families across the state offering early intervention (BEST Start), parent empowerment (BEST Advocate), and family support (BEST Together) programming. The purpose of this project was to assist in the implementation of an early identification initiative (BEST Screening) using the Neonatal Assessment Visual European Grid (NAVEG). The NAVEG is a newborn vision screening shown to identify neurological risk for visual impairments. The long-term goal of this program is to promote the screening and early identification …

”To Be Or Not To Be – It’S Good”: Actor And Student Experiences In A Drama Club For People With Aphasia, Jade K. Hannan

Senior Theses

Individuals with aphasia, a disorder caused by damage to the brain’s language network, confront a variety of social and emotional struggles. While leaving their cognition largely intact, aphasia tremendously impacts a person’s ability to communicate confidently, fracturing their social network and contributing to feelings of loneliness and frustration. To address this persistent need in the chronic aphasia population, the Play on Words drama club at the University of South Carolina provides a forum for people with aphasia (PWA) to engage in dramatic exercises focused on non-verbal communication of emotions, ideas, and stories, culminating the production of an original devised play. …

Elucidating The Role Of Protease-Activated Receptor 2 In Elastase-Induced Abdominal Aortic Aneurysms, John Pitstick

Senior Theses

Cardiovascular diseases (CVDs) remain the leading cause of mortality in the world despite extensive research. As a type of CVD, abdominal aortic aneurysm (AAA) represents a critical medical condition characterized by the localized dilation of the abdominal aorta. Complications from aneurysm development results in catastrophic aortic rupture, which leads to mortality more than 80% of the time. As aneurysm development is typically asymptomatic, many AAAs remain untreated until they present a serious risk of rupture. Additionally, no pharmaceutical treatment exists for AAAs, with the only option being surgical intervention. Despite advancements in diagnostic methods and surgical techniques, the pathogenesis of …

Malaria, A Burden For Sub-Saharan Africa, Alpha Mamadou Hady Barry

Health and Kinesiology Theses

Malaria has been a worldwide health problem for centuries causing between 1.5 to 2.7 million deaths annually, and mostly affecting children aged 5 and under and pregnant women in Sub-Saharan Africa (SSA) (Phillips, 2001). The discovery of malaria parasites by Laveran in 1880 as well as the finding of mosquitoes as vectors for avian malaria by Ross in 1897, made scientific studies about malaria possible. Between 1898 and 1900, the Italian scientists Grassi, Bignami, Bastianelli, Celli, Golgi and Marchiafava discovered human malaria (Cox, 2010). Malaria has been eradicated from developed countries such as the United Staes and most European countries …

Diabetic Coaching Program To Improve African American Patients Glycemic Control, Shonda Moore

Student Scholarly Projects

Practice Problem: The purpose of the practice problem was to find out if, among African Americans with type II diabetes who are over 18, adopting a diabetic coaching program that emphasizes diet management can result in better glycemic control over 10 weeks than for those who do not receive coaching.

PICOT: In African Americans with type II diabetes over 18 years of age (P), does a diabetic coaching program on diet management (I), compared to no coaching program (C), improve glycemic control (O) over 10 weeks (T)?

Evidence: The evidence used to guide this project came from databases, including PubMed, …

The Impact Of Covid-19 On The Utilization Of Early Magnetic Resonance Imaging (Emri) In The Assessment Of Acute Uncomplicated Low Back Pain (Lbp) And The Subsequent Effect On Health Care Service Utilization And Patient Outcomes, Kimberly Radcliffe

MUSC Theses and Dissertations

OBJECTIVES: To examine changes in MRI rates between Pre-COVID-19 period (Feb-April 2019) and COVID-19 period (Feb-April 2020) among commercially insured patients aged 18-60 with a diagnosis of acute LBP, and to analyze differences in patient characteristics and outcomes between the time periods. Additionally, to examine the impact of eMRI on patient outcomes and health care costs for patients in the COVID-19 period.

DESIGN/METHODS: Using IBM® MarketScan® Commercial Database (MarketScan) we performed a quantitative pre-post comparative retrospective observational study of 117,150 total patients to examine adjusted differences in patient characteristics and rates of MRIs between time periods. We analyzed 49,020 patients …

Remodeling Anaplastic Thyroid Cancer's Aggressive Profile And Metabolic Signature By Natural Alkaloid Berberine, Tara Elizabeth Jarboe

NYMC Student Theses and Dissertations

Anaplastic thyroid cancer is a rare, fatal cancer with a five-year survival of 4%. Universally diagnosed at stage IV, anaplastic thyroid cancer is characterized by its lack of differentiation, rapid proliferative rate, highly inflammatory tumor microenvironment, and metabolic dysregulation. Refractory to all established therapies, anaplastic thyroid cancer requires a novel therapeutic approach that targets all of these drivers of anaplastic thyroid cancer carcinogenesis. We propose natural alkaloid berberine as a therapeutic with multitarget efficacy to alter mitochondrial metabolism and reprogram anaplastic thyroid cancer’s aggressive phenotype. Our in vitro model uses monocyte cell line U937, anaplastic thyroid cancer cell lines T238 …

Hand Tremor Stabilizer, Krishna Sai Bathini, Ryan Herrmann, Madeleine A. Beaupre

Biomedical Engineering

The Hand Tremor Stabilizer project represents a significant advancement in assistive device technology, aimed at improving the lives of individuals affected by hand tremors due to conditions such as essential tremor or Parkinson's disease. Throughout the design process, our team engaged in a comprehensive approach that included rapid prototyping, iterative testing, and direct feedback collection from potential users. This process was instrumental in refining the device to meet specific user needs effectively.

Key customer requirements that guided the design of the Hand Tremor Stabilizer included ease of use, portability, washability, accuracy of motion control, comfortable grip, breathability, a natural feel …

Can Mirna Be The Missing Link Between Parkinson’S Disease And Pesticides?, Fatma Gobba

Theses and Dissertations

Parkinson’s disease (PD) is a common neurodegenerative condition that leads to significant morbidity and a decline in the quality of life. It develops as a consequence of the loss of dopaminergic neurons in the substantia nigra pars compacta. Nevertheless, the development of PD is influenced by environmental factors, and the intricate nature of these relationships is further complicated by a multitude of factors, including the genetic backgrounds that are specific to populations and variations in environmental exposures, such as pesticides. Pesticides, consisting of a diverse family of chemicals commonly used in both agricultural and household settings to protect crops against …