Medicine and Health Sciences Commons^™

Meta-Analysis Of The Rate Of Unplanned Pregnancies In Rural Areas Of The United States And The Use Of Technology-Based Sexual Education Programs, Hannah Audiss

Doctor of Medical Science (DMSc)

Objective

To discuss rural-urban disparities of adolescent unplanned pregnancies and sexual education availability. The potential of virtual sexual education programs are discussed by examining two studies that have used technology-based interventions to assess variables related to pregnancy prevention.

Data Sources

A review was conducted by gathering randomized controlled trials and systematic reviews utilizing databases such as ScienceDirect, PubMed and Wiley Online Library. Research articles included in this paper were from 1995 to present day and are inclusive of all races.

Study Eligibility Criteria

Studies were included if the interventions worked with young adolescents ages 13-24 year old, utilized technology-based interventions …

The Role Of Self-Sampling For Hpv In The Primary Prevention Of Cervical Cancer, Divya Patel

Doctor of Medical Science (DMSc)

Introduction:

Cervical cancer is a striking women's health problem worldwide. It is the fourth most common cancer in women and the seventh most common cancer worldwide1. There were roughly 604,000 new cases of cervical cancer and 342,000 deaths in 20202. Most of these cases occur in developing countries due to ineffective screening initiatives2. Screening essentially allows pre-cancerous lesions to be identified at stages where they can easily be treated; screening methods include cytology and HPV testing (Human Papillomavirus)1. HPV has over 100 strains and is one of the most common risk factors for cervical cancer. HPV testing is more sensitive …

Assessment Of Organizational Readiness Towards Electronic Health Records In A Tertiary Care Hospital, Karachi, Pakistan, A Quantitative Analytical Cross-Sectional Study, Muhammad Javeed

Theses & Dissertations

Background: A medical error is one of the most preventable errors that occur frequently in hospitals, leading to millions of deaths yearly. Medical errors cost hospitals billions of dollars worldwide. Human error is also a common cause of medication errors, but this error is due to the failure of the system to detect errors. The electronic health record (EHR) is a complete set of computerized records of all information related to patient health that is used by one or more users in any care setting. This information includes demographic data of patients, patients’ progress notes, complaints and diagnoses, medications, vital …

Dna Methylation-Based Epigenetic Biomarkers In Cell-Type Deconvolution And Tumor Tissue Of Origin Identification, Ze Zhang

Dartmouth College Ph.D Dissertations

DNA methylation is an epigenetic modification that regulates gene expression and is essential to establishing and preserving cellular identity. Genome-wide DNA methylation arrays provide a standardized and cost-effective approach to measuring DNA methylation. When combined with a cell-type reference library, DNA methylation measures allow the assessment of underlying cell-type proportions in heterogeneous mixtures. This approach, known as DNA methylation deconvolution or methylation cytometry, offers a standardized and cost-effective method for evaluating cell-type proportions. While this approach has succeeded in discerning cell types in various human tissues like blood, brain, tumors, skin, breast, and buccal swabs, the existing methods have major …

Toxic Fashion: Evaluation Of Chemicals In Clothing And Recommendations For The Amended Tsca, Gregory Zajac

Master's Projects and Capstones

The fashion industry is one of the largest polluting industries in the world and its rising environmental impact is partly due to the dominance of fast fashion business models. Recently researchers and advocates have found that large amounts of chemicals are used by textile manufacturers to produce clothing, some proven to be toxic in other applications. The risk of exposure to these classes of chemicals is a growing concern. With the risk management model, a qualitative examination was conducted on existing policies in the United States that regulate chemicals used by the industry. Despite some policy changes regarding chemical exposure …

Data Quality: Integral To Cauti Surveillance And Improvement In Non-Critical Care Units, Mary Grace Daria

Master's Projects and Capstones

Background: Urinary tract infections (UTIs) are the most common type of healthcare-acquired infection (HAI), with 75% approximately associated with urinary catheter use. The key to preventing UTIs is to avoid the use of indwelling urinary catheters (IUCs). This study explores denominator data extract logic modifications to increase IUC data capture and accuracy. It is set in a 249-bed acute care, teaching hospital in the Diablo Service Area in Northern California.

Problem: The electronic system used to extract the CAUTI denominator data is inconsistently capturing the IUC device days from the electronic medical record (EMR). This has regulatory reporting ramifications and …

Give Love With Lovenox: Improving Nurse Education On Lovenox Prophylaxis To Reduce Pulmonary Embolism Risk On The Postpartum Unit, Jennifer G. Domingo Rn

Master's Projects and Capstones

This quality improvement project aims to improve nurse education about Lovenox prophylaxis to reduce the risk of pulmonary emboli – post-discharge – amongst high-risk postpartum women who underwent vaginal and cesarean deliveries on the family baby unit. This project took place in a Family Baby/Postpartum Unit at Hospital SC. This unit has a total of 25 beds with an increased prevalence of pulmonary embolism following cesarean delivery. Nurses were given anonymous pre- and post-survey questionnaires and provided educational sessions with distributed handouts. A unit needs assessment was conducted using the 5 P’s. Out of the 72 nurses on the staff …

Improving Intimate Partner Violence Screening In A Women’S Health Practice Through Implementation Of An Evidence-Based Screening Tool, Jasmine Weber

Doctor of Nursing Practice Projects: College of Nursing

The purpose of this quality improvement project was to implement intimate partner violence screening in an outpatient women’s health clinic with no prior screening process in place. Current recommendations are to screen all reproductive age women for intimate partner violence 6 . During a three-month period 170 patients out of 260 eligible patients were screened using the HARK screening tool, 7 of those patients screened positive and were offered referrals to social work. While universal IPV screening was not achieved, a screening rate of 64% is a remarkable improvement from an apparent absence of screening prior to project implementation.

Policy Review And Recommendation For Secondary Education Np-Led Clinics In The Southeastern United States, Shiney Alex Jacob

Student Scholarly Projects

Secondary-level education involves adolescent children aged 11-12 years to 18-19 with unique healthcare needs. Their healthcare is of significant importance as they are transitioning to adulthood, and a majority of them lack access to primary healthcare needs. Advanced Practice Registered Nurses/Nurse Practitioners (APRNs/NPs) provide high-quality, cost-effective, and evidence-based care to people across the lifespan, and there is minimal utilization of their services in meeting the primary care needs of adolescents at the secondary school level. The purpose of the policy project was to determine if current policies and practices related to school health services in three southeastern states of the …

Opportunities For Mental Health Interventions In Rural Mississippi Communities During The Covid-19 Pandemic: A Quantitative Analysis, Brice Fortinberry

Theses and Dissertations

COVID-19 presented unique challenges for rural Mississippi communities including impacts on the mental health of rural individuals. This research study aimed to identify opportunities for mental health interventions to provide health promotion professionals with quantitative data on the accessibility and the likelihood of engagement with mental health-fostering behaviors. A secondary objective of this research was to categorize these behaviors within the constructs of the Social Ecological Model. Demographics for rural Mississippi communities were collected and displayed, and using multivariate analyses including Spearman’s correlation and a Mann-Whitney U test the correlation between mental health fostering behaviors and demographic factors was obtained. …

Assessing Social Determinants Of Health In Primary Care, Vicki Carpenter

Doctoral Projects

The social determinants of health encompass the various circumstances and environments in which individuals reside, develop, labor, and experience aging (Social Determinants of Health, 2022). These variables significantly contribute to the existence of health inequities and disparities within populations. In order to effectively mitigate health disparities, it is imperative to consider the various determinants that influence health outcomes, as this consideration is crucial for advancing the goal of achieving health equity. This public health concern encompasses multiple sectors within our society, necessitating the collaboration of various organizations and communities to effectively address and mitigate its impact.

The fundamental …

Duchenne Muscular Dystrophy: Age, Disease Stage, And Patient-Reported Quality Of Life, Sheila Jagers

Walden Dissertations and Doctoral Studies

No abstract provided.

Effects Of The U.S. Veterinary Feed Directive Final Rule On The Prevalence Of Violative Antibiotic Residues And Antibiotic-Resistant Bacteria In Animal Products, Md Shamim Sarkar

Doctoral Dissertations

Antibiotic-resistant is a public health concern. The dissertation objective was to assess the effect of the implementation of the Veterinary Feed Directive (VFD) rule changes on the prevalence of violative antibiotic residues and antibiotic-resistant bacteria in food-animal tissues, retail meats, and cecal samples from food animals compared to the pre-VFD rule change period in the U.S. To understand the effect of implemented VFD rule changes on violative antibiotic residues in food-animal tissues, inspector-generated sampling (IGS) data from the U.S. National Residue Surveillance Program (NRP) was analyzed. An important observation was that implementing VFD rule changes was associated with the decreased …

Differences In Mental Health Outcomes And Services By Gender Identity Among Sexual And Gender Minorities During The First Shelter-In-Place Order Of The Covid-19 Pandemic In Texas, 2020, Mariah Victoria Alvarez Ramirez

Open Access Theses & Dissertations

Background: Within the United States, sexual and gender minorities (SGM), face unique barriers when seeking health services, such as uninsurance, postponing care, and lack of competent services. Within SGM, transgender and gender-expansive (TGX) individuals are more vulnerable as they have higher rates of discrimination and face more barriers to accessing healthcare services. Purpose: Identify differences in mental health outcomes and services by gender identity among sexual and gender minorities residing in Texas during the COVID-19 pandemic. Methods: This study is a secondary data analysis of the SGM participants of the COVID-19 and You Survey study (n=1288). Descriptive statistics, bivariate associations …

Perceived Risks And Benefits Of Hpv Vaccination: The Role Of Cues To Action, Numeracy And, Literacy, Sierra Rae Galvan

Open Access Theses & Dissertations

Background & Significance: The Human Papillomavirus (HPV) is a risk factor for both genital warts and cervical cancer. HPV strains 16 and 18 are recognized as precursors of cervical cancer. While strains 6 and 11 are estimated to cause 90% of genital warts. Latinas have the highest rate of cervical cancer in the U.S, approximately 66 % higher than non-Latino whites. These cancers are preventable in many cases through the administration of the HPV vaccine. The advisory committee on immunization practices recommends that children as young as 9 receive at least two doses of the three-dose HPV vaccine series. Consequently, …

Exploring The Relationship Between Diabetes, Diabetes Risk, Depressive Symptoms, Chronic Stress, And Inflammatory Markers In Mexican-American Men, Aleli Fernandez

Open Access Theses & Dissertations

Background: Individuals with depression and stress are 60% more likely to develop type 2 diabetes compared to those without (Mezuk et al., 2008). Moreover, biological pro-inflammatory markers associated with psychosocial stress are risk factors for diabetes. Examining the relationship between psychological disorders, inflammation, and diabetes risk among MAH is important as they have high rates of diabetes.

Purpose: To examine the relationship between 1) depressive symptoms, chronic stress, and inflammatory markers, 2) inflammation and diabetes risk factors and 3) depression, stress, inflammation, diabetes risk, and metabolic syndrome (MetS).

Methods: A cross-sectional study of 100 adult men from El Paso, Texas …

Associations Between Mental Health Outcomes And Childhood Trauma And Experiences Of Violence During The First Shelter-In-Place For Covid-19 Among Sexual Minority Men Living In Texas, 2020, Sonam Deki

Open Access Theses & Dissertations

Background: The COVID-19 pandemic significantly increased mental health issues, disproportionately affecting men who have sex with men (MSM). The relationship between mental health and experiences of trauma and violence are understudied in this population. Purpose: To assess if rates of childhood trauma and COVID-19-related violence are higher for those with depression and anxiety than those without such experiences among cisgender sexual minority men in Texas. Methods: This secondary data analysis is among the cisgender sexual minority men in the COVID-19 and You Survey Study in Texas during the first shelter-in-place order. Descriptive statistics and bivariate associations between trauma and experiences …

Improving Post-Discharge Engagement Of Mental Health Patients In The Veterans Affairs South Texas Healthcare System, Nneoma Lewis

Doctor of Nursing Practice

Discharge from a hospital is a high-risk period for mental health patients, as 20% experience an adverse event within 30 days of discharge. Poor discharge engagement can lead to complications for recovery, which include an increased risk for readmissions, longer length of stay, increased risk for suicide, and death. Hospital stays cost the United States $377.5 billion dollars per year; there is pressure for hospitals, health plans, and providers to examine the admission and discharge processes to improve healthcare delivery, transition of care, and patient health outcomes. At a South Texas VA, 67.66% of mental health patients attended all their …

Covid-19 Prevention, Testing, And Treatment Seeking Among People Who Inject Drugs (Pwid) On The Us Mexico Border, Jorge Raul Puentes

Open Access Theses & Dissertations

The outbreak of the COVID-19 pandemic exacerbated the negative social determinants of health that affect medically underserved people who inject drugs (PWID) inhibiting their access to services, promoting infectious disease acquisition such as HIV and HCV, and overdose rates. The effects of the pandemic were more pronounced among Latino PWID communities. Participants of this study are 194 PWID residing in El Paso, Texas, and Cd. Juarez, Chihuahua along the US-Mexico border. Cross-sectional surveys were administered assessing environmental risk factors that impact COVID-19 acquisition and engagement in preventive behaviors. The purpose of this secondary data analysis study was to describe the …

The Power Of Voice: The Role Of Target Voice Achievement In Enhancing Quality Of Life For Transgender Individuals In Gender-Affirming Voice Management Lab, El Paso, Texas, 2016-2022, Mehjabin Alam Hridi

Open Access Theses & Dissertations

Background: Gender-affirming voice management is an essential aspect of transgender people and research shows that achieving a congruent voice can significantly improve the quality of life. The role of voice as a central aspect of gender identity and expression and achieving a desired target voice can improve mental health outcomes, social functioning, and overall well-being. Purpose: The project assesses the impact of quality of life and voice treatment completion on voice disorders among transgender people. Methods: This clinical study included records for transgender individuals attending the Gender-Affirming Voice Management Lab in El Paso, TX, from 2016 to 2022. Measures collected …

Substance Use Patterns Among High School Students - A Replication Study Of The 2020 Youth Risk Behavior Survey, Haley Irons

Capstone Experience

The study selected for replication is “Prescription Opioid Misuse and Use of Alcohol and Other Substances Among High School Students” by Christopher Jones and colleagues published in the Morbidity and Mortality Weekly Report Supplement in August 2020. The original report used data from the Centers for Disease Control’s 2009-2019 Youth Risk Behavior Survey (YRBS), which is a cross-sectional survey administered every two years to a sample of public- and private-school students in 9th–12th grade in the United States. Researchers from the original report aimed to use the 2009-2019 YRBS data to examine substance use among high school students, characterize the …

Big Data Applications And Challenges In Giscience (Case Studies: Natural Disaster And Public Health Crisis Management), Amir Masoud Forati

Theses and Dissertations

This dissertation examines the application and significance of user-generated big data in Geographic Information Science (GIScience), with a focus on managing natural disasters and public health crises. It explores the role of social media data in understanding human-environment interactions and in informing disaster management and public health strategies. A scalable computational framework will be developed to model extensive unstructured geotagged data from social media, facilitating systematic spatiotemporal data analysis.The research investigates how individuals and communities respond to high-impact events like natural disasters and public health emergencies, employing both qualitative and quantitative methods. In particular, it assesses the impact of socio-economic-demographic …

A Cross-Sectional Analysis Of Adverse Childhood Experience Exposure On Cancer Diagnosis Utilizing The 2022 Behavioral Risk Factor Surveillance Survey Data, Emma Zipperer

Capstone Experience

Objective: To determine the association between Adverse Childhood Experiences (ACEs) and cancer diagnosis based on ACE exposure levels.

Methods: We utilized data collected in the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey. The study population (n=54,148) was restricted to states that reported on the optional model of experiencing ACEs and those who responded about cancer diagnosis. A univariate analysis, bivariate analysis and a multivariate logistic regression were performed. Odds of cancer diagnosis among those with differing ACE exposure levels were calculated.

Results: High ACE exposure had 20% higher odds of cancer diagnosis when compared to low ACE exposure. White, …

Opioid Overdose Knowledge And Attitudes Among Undergraduate College Studentsopioid Overdose Knowledge And Attitudes Among Undergraduate College Students, Kaiya Cook

Honors College Theses

No abstract provided.

School Nurses And The Sexual Health And Education Of Public-School Students In Tennessee, Amy Wake

Electronic Theses and Dissertations

Tennesseans have been experiencing increasing rates of sexually transmitted diseases since the year 2000. Those rates are highest among those 15- to 24-year-olds. At the same time, Tennessee policy requires the teaching of abstinence as the primary form of sexual health education and emphasized the use of abstinence-only curriculum. The school nurse represents an available resource in the Tennessee public schools. The purpose of the qualitative study was to explore, describe, and interpret the perceptions and experiences of public-school nurses from rural, suburban, and urban areas of Tennessee related to the sexual health and sexual health education of students. School …

Genetic Risk Scores For Hypertension And Chronic Kidney Disease In African Americans., Aastha Kakar

Electronic Theses and Dissertations

Hypertension (HT) and chronic kidney diseases (CKD) are complex conditions, disproportionally prevalent among African Americans (AA) and are influenced by multiple genetic as well as environmental factors. Genetic risk scores (GRS) enable the analysis of the combined effects of multiple single nucleotide polymorphisms (SNPs). This study investigates the association of blood pressure (BP) and CKD GRS with BP, hypertension (HT) and CKD; early-onset HT and CKD; and investigates interactions of the GRSs with environmental measures in AA. We observed a significant association between the BP-GRS with HT, SBP and DBP. The odds of HT for one standard deviation (s.d.) increase …

Exploring The Mental Health Experience Of Perinatal Military Spouses Based In Sigonella, Italy, Lyndsey Dannenberg

Capstone Experience

The perinatal period can have a profound impact on the mental health of women, their infants, and their families, especially when it comes to depression and anxiety disorders. This study aims to delve into the experiences of perinatal mental health among military spouses stationed overseas, on Naval Air Station Sigonella, Italy, and contribute to the limited research on active-duty military spouses and their perinatal mental health while stationed overseas. The research uses a qualitative phenomenological approach, seeking to provide valuable insights into the lived experiences of military spouses and their perinatal mental health. Risk factors associated with perinatal mental illness …

Associations Between Self-Reported Cognitive Decline And Chronic Diseases: A Cross-Sectional Analysis Of Behavioral Risk Factor Surveillance System (Brfss) 2022, Hailey Child

Capstone Experience

Objective: This study seeks to capture how self-reports measure cognitive decline. The association between chronic conditions and cognition with age consideration in individuals aged 45 and older is investigated.

Methods: Univariate analysis generates frequencies and weighted percentages of 2022 BRFSS data. Chi-square tests and polytomous regressions generate odds ratios for bivariate analyses. A weighted multiple logistic regression model stratified by age group analyzes self-reported cognitive decline.

Results: Respondents ages 45 to 54 with three or more chronic diseases have the highest odds (OR = 6.81; 95% CI = 4.42, 10.48) of cognitive decline. Respondents 75 and older …

Ordinal Logistic Regression Analysis Of The Frequency Of Marijuana Use Among Adult Informal Caregivers In 20 U.S. States, Behavioral Risk Factor Surveillance System (Brfss) 2021, Athena Plichta

Capstone Experience

Objectives. To examine the association between frequency of marijuana use among informal caregivers of persons with dementia (PWD) and other health conditions compared to non-caregivers in 20 U.S. states.

Methods. We used complex survey data from the optional modules Caregiver and Marijuana Use of the 2021 BRFSS survey. Univariate and bivariate analyses were performed to determine the frequency and distribution of sample population characteristics and calculate crude relationships. Ordinal logistic regression modelled the relationship between the three-level outcome and covariates.

Results. Frequency of marijuana use and caregiver status were not associated. There was no difference in increased use among individuals …

Strategies To Encourage Recall And Prevent Relapse After Full Mouth Rehabilitation Under General Anesthesia In Children, Claire Koukol

Capstone Experience

Background: Dental caries are preventable. Dentists utilize many prevention strategies in the office and provide at-home education to families. However, once a child develops Early Childhood Caries (ECC), especially in more severe cases, they may need general anesthesia (GA) to complete treatment. While this is an effective way to achieve full mouth dental rehabilitation (FMDR), this burdens the healthcare systems and families and does not come without risk to the patient. Patients with high caries experience remain at high risk of caries relapse after FMDR under GA, sometimes necessitating additional FMDR under GA. While there has been a significant amount …