Medicine and Health Sciences Commons^™

Prevalence Of Depression In Patients With Cardiovascular Diseases, Faryal Ghafoor

Theses & Dissertations

Background: Approximately 17.3 million individuals across the globe lose their lives to cardiovascular diseases (CVD), with a majority of these cases occurring in low-to-middle-income countries. The incidence of cardiovascular disease in Pakistan is 918 cases per 100,000 individuals. Depression frequently impacts the health, expenses, and prognosis of patients with cardiovascular disease.
Purpose: This study aimed to determine the prevalence of depression among CVD patients at Aga Khan University Hospital, Karachi, and explore the influence of co-morbidities, marital status, age, and educational background on one's status, regarding depression.
Method: A quantitative descriptive cross-sectional study was conducted at the Aga Khan University …

Comparison Of Physical Activity Levels Among School-Age Adolescents In The Rural And Urban Areas Of District Swat Kpk, Pakistan- An Analytical Cross-Sectional Study, Imran Uddin

Theses & Dissertations

Background: Obesity and overweight represent significant global public health concerns. Young adolescents are in particular increasingly experiencing obesity and overweight due to their sedentary lifestyles, excessive electronic media use, and lack of physical activity (PA). This trend is linked to the development of non-communicable diseases in later life. Moreover, data regarding the lack of PA is available in Pakistan, but a gap exists in the comparative analysis of physical activity levels between rural and urban adolescents. Rural and urban areas exhibit distinctions in both geographical settings and technological advancements, potentially influencing the PA levels of their respective inhabitants.
Purpose: The …

Factors Hindering The Care Of Geriatric Patients Admitted In A Tertiary Care Hospital In Karachi, Pakistan, Muhammad Shoaib

Theses & Dissertations

Background: Older adult’s patient care presents multiple challenges to nurses due to their growing numbers worldwide. According to WHO in 2020 the number of older adults aged 60 and above is one billion and by 2050 this population will be doubled. The current geriatric population of Pakistan is above eight million and is estimated to reach twenty-seven million by 2050. This increasing trend of the geriatric population poses a greater challenge to the compromised healthcare systems in Pakistan, healthcare workers especially nurses struggle hard due to limited resources, lack of knowledge regarding geriatric, and the frailty of older patients, to …

The Experiences Of Nurses Regarding Practice Change In Maintaining Nine Months Clabsi-Free Medical Intensive Care Unit: A Qualitative Study At A Tertiary Care Hospital, Karachi, Pakistan, Safia Islamuddin

Theses & Dissertations

Background: CLABSI’s are serious healthcare-associated infections resulting from central venous catheters which are predominantly used in ICUs. Nurses, as frontline caregivers, play a critical role in preventing CLABSIs. Their views often highlight the importance of strict protocols, vigilance, and teamwork to minimize CLABSI risks, enhancing patient safety. Studies in low-middle countries like, Pakistan till yet have focused on investigation CLABSI incidents, knowledge of it and associated factors. From a unit with a long-term record of being free from CLABSIs can offer valuable insights into identifying best practices, replicating them, and understanding the obstacles involved in achieving a CLABSI-free environment.
Objectives: …

Experiences Of Indigenous Women With Maternal Nutrition In Climate Change (Cold Weather) In Rural Bajaur, Khyber Pakhtunkhwa, Pakistan: Implications For Maternal-Infant Health, Ihsan Ullah

Theses & Dissertations

Background: Pakistan is one of the countries that is most susceptible to the effects of climate change. The country’s Northern regions have experienced several extreme cold weather events, including floods, heavy snowfall, and heavy rains, in recent years, significantly impacting maternal and infant health. Indigenous child-bearing age women in the northern rural areas are the most vulnerable populations experiencing food insecurity, disruptive food systems, increasing food prices, and disrupting food production due to climate change exacerbation.
Aim of the study: The study aimed to explore the experiences of indigenous women with maternal nutrition in harsh winter caused by climate change …

Nursing Faculty Perspective On Simulation Based Education: A Qualitative Exploratory Study At Public And Private Nursing Schools In Karachi, Pakistan, Saira Mehboob Ali Lalani

Theses & Dissertations

Background: Simulation-based education (SBE) provide novice and proficient student nurses a platform to learn and practice skills in a simulated environment, to become safe and competent nurses. This pedagogy is especially beneficial for those studying healthcare-related domains, as it permits students to gain hands-on expertise that is much more real and facilitating than the traditional methods of teaching. The role of nursing faculty is crucial in this process. Purpose The purpose of this study was to investigate the perceptions of nursing faculty members regarding SBE, as well as the facilitators and barriers of SBE.
Research Methods: An exploratory qualitative research …

Stress And Its Associated Factors In Mothers With Preterm Infants In A Private Tertiary Care Hospital Of Karachi, Pakistan, Salima Akbar

Theses & Dissertations

Background: Preterm births are the leading cause of death worldwide. Preterm births not only have devastating effects on the new born, but they also have psychological effects on the mothers. Identifying stress related to preterm births, and the factors associated with the stress among mothers with preterm infants is of great importance, for providing sound care to the newborns and their mothers. This study aimed to assess the level of stress and the factors associated with increased level of stress among mothers with preterm infants, in a tertiary care hospital in Karachi, Pakistan.
Purpose: The study aimed to answer the …

Experiences Of Sexual And Reproductive Health Among Women Undergoing Haemodialysis In Pakistan: A Descriptive Phenomenological Study, Misbah Zafar

Theses & Dissertations

Background: Sexual and reproductive health is an essential component of a woman’s life that includes respectful and satisfying sexual relationships without coercion and violence, as well as couples' decisions about whether and when to have children. Reproductive-age women undergoing haemodialysis experience numerous sexual and reproductive health challenges as a consequence of their physical and psychological health conditions, negatively impacting their overall well-being. However, they are reluctant to seek assistance from healthcare professionals despite having many sexual and reproductive health issues. Concerning this, it was necessary to explore in-depth, the phenomenon of lived experiences of sexual and reproductive health among reproductive-age …

The Knowledge, Experiences, And Barriers Associated With Male Involvement In Family Planning At Lal Qila, District Dir (Lower), Kpk, Pakistan: A Descriptive Exploratory Study, Jalal Khan

Theses & Dissertations

Background: Pakistan is one of the world’s most populous countries with a high growth rate. The overgrowth in population negatively affects the country’s socioeconomic progress in many aspects, like education, housing, employment, and health. Family Planning (FP) is the best way to reduce the fertility rate and control population overgrowth through contraception. FP positively impacts the mother's health and the productive results of every pregnancy.
Purpose: This study aims to explore the knowledge, experiences, and barriers associated with male involvement in family planning.
Method: A qualitative exploratory design was used with a purposive sampling technique to explore the perceptions of …

Concept Of Health-Related Quality Of Life Among People With Heart Failure In Karachi, Pakistan, Anny Ashiq Ali

Theses & Dissertations

Background: Non-communicable diseases (NCDs), including cardiovascular diseases, are a leading cause of global mortality. The mortality rate for cardiovascular diseases is on the rise, with 80 % to 86 % of fatalities, particularly in low- and middle-income countries, including Pakistan. Among NCDs, heart failure (HF) is a condition for which there is no cure, and patients rely on supportive treatments to maintain their quality of life. HF not only affects physical well-being but also has far-reaching consequences on the emotional, social, and cognitive aspects of life. In the context of Pakistan, where unique healthcare, sociocultural, and economic factors prevail, the …

Nurses’ Perceptions Regarding The Use Of The Nursing Process; A Descriptive Qualitative Study At Hayatabad Medical Complex, Peshawar, Pakistan, Kashif Khan

Theses & Dissertations

Background: The Nursing Process (NP) is a comprehensive approach to care, integrating nursing intuition, goal-oriented tasks, patient-centered care, critical thinking, and evidence-based practice (EBP). It aims to enhance patient outcomes and well-being by identifying, treating, and preventing health problems. Widely acknowledged as a valuable instrument in healthcare, it emphasizes the crucial function of nursing. This study fills the gap in the literature by exploring nurses' perspectives on the utilization of the NP in Pakistan.
Purpose: The study aimed to explore nurses' perceptions regarding the use of the nursing process and to identify the barriers and facilitators to its implementation in …

Experiences Of Counselors Who Assist Women In Midlife Who Display Depressive Symptoms: A Transcendental Phenomenological Study, Carla Pestana

Theses & Dissertations

In this dissertation, I present a transcendental phenomenological study conducted with 12 counselors who worked with women in midlife who displayed depressive symptoms. The purpose of this study was to understand the lived experiences, clinical and personal, of licensed professional counselors (LPCs) who worked with women in midlife who displayed depressive symptoms. Through the study, I sought to recognize the essence and themes that emerged from these LPCs who worked with this population. Moreover, this study was designed to obtain a better understanding of how these LPCs managed their feelings and thoughts, how they helped when working with these women, …

The Relationship Among Emotional Intelligence, Coping Strategies, And Occupational Burnout For Child Protective Service Workers, Yvette Longoria

Theses & Dissertations

There are low retention rates of child protective service caseworkers and this impacts the quality of care of the families served. The purpose of this study was to examine the relationship between emotional intelligence, coping strategies and occupational burnout for CPS caseworkers. In addition, examining the relationship between education type, education level, and caseload size as it relates to emotional intelligence, coping strategies, and occupational burnout among child protective caseworkers. The theoretical framework utilized was the Transactional Theory of Stress and Coping. A convenience sampling was used to collect participants employed as FBSS or CVS caseworkers at Texas Department of …

Inviting The Outside In: Nature's Contribution To Counselor Wellness, Naomi Medina

Theses & Dissertations

The positive influence of nature on client wellness and psychological health (BonhamCorcoran et al., 2022) is well reflected in the emergence of nature-based counseling interventions such as wilderness therapy, walk talk therapy, and horticulture therapy, among other counseling modalities that involve aspects of the natural world (Lewis et al., 2022). This suggests that the inclusion of nature within the counseling session could also contribute to the wellness of the counselor. The purpose of this research was to determine the extent to which presence of nature contributes to counselor wellness and which of the five senses may play a greater role …

The Influence Of Attachment Styles And Mental Health Symptoms On Marital Satisfaction Among Deployed Us Army Soldiers, Leo Mora

Theses & Dissertations

Since 2002, changes in the frequency, duration, and nature of military campaigns overseas have piqued efforts to understand the effects of deployment on the mental health of DoD service members, especially married Army soldiers. However, few studies have examined the influence of attachment styles on the emotional health of combat veterans and the wartime impact they have also imparted to their spouses. Thus, in the context of military deployments, this study examines how secure/insecure attachment styles, posttraumatic stress (PTS), and depressive symptoms significantly influence married soldiers and their perceptions of marital satisfaction. In addition, this study also examines pre-existent, internalized, …

What Covid-19 Tweets Reveal About Risk Perception And Safety Preventative Measures And Behaviors Two Years Into A Pandemic, Elizabeth Vargas

Theses & Dissertations

The purpose of this study was to examine individuals Covid-19 risk perceptions two years into a long running pandemic. Data was collected analyzing risk perception and safety preventative measures to understand how individuals communicated risk in a health crisis that lasts more than two years. 116,401 tweets were collected from March 7-18, 2022, and analyzed utilizing a qualitative content analysis design. Four main classes were identified from the data which looked at how individuals perceived risk, how individuals determined risk from information that was shared, what preventative measures individuals were utilizing, and how individuals were living after the SARS-CoV-2 pandemic …

Lived Experiences Of School Counselors Working In Conjoint Roles In A Multisystem Framework To Address The Mental Health Needs Of Students, Angela Sampson

Theses & Dissertations

The purpose of this phenomenological qualitative study was to explore the lived experiences of school counselors working in conjoint roles as social–emotional leaders and mental health professionals (MHPs) to address the mental health needs of students through multisystem collaboratives (MSCs) and school-based systems of mental health care (SBSMHC).

The role of the school counselor has expanded into becoming a social–emotional leader and school MHP advocating for comprehensive social–emotional learning and the “school-linked” movement that coalesced their exclusive professional proficiency with both school-based and community resources working to enhance initiatives for student psychosocial development in ways that would increase student assets …

Internet Pornography Use, Loneliness, And Adult Attachment Patterns Among Asian Indian Young Adults: An Explanatory Sequential Mixed Methods Design, Anish Baby

Theses & Dissertations

Internet pornography consumption among Asian Indian Americans, an ethnic minority group, is largely underrepresented in current scholarly literature despite their growing population in the United States. The purpose of this research was threefold: (a) to measure the prevalence of internet pornography use among Asian Indian American young adults and adults; (b) to explore the relationship between internet pornography use, loneliness, and attachment patterns; and (c) to describe the lived experience of problematic porn consumers. Using an explanatory sequential mixed methods design, I conducted this study in two distinct phases: quantitative followed by qualitative. In the quantitative phase, I employed an …

Seminarians In The Person-Of-The-Therapist (Pott) Training : A Phenomenological Study, Tomichan Moonnanappillil

Theses & Dissertations

This dissertation presented a transcendental phenomenological study conducted among eight seminarians in one of the theological schools in Southern Texas, who attended the personof-the- therapist (POTT) training program during the fall semester of 2019. This study aimed to examine seminarian participants' experiences in POTT training, their influence on their selfawareness, and their impact on their emotional maturity and the ability to make responsible life choices. The study was guided by an existential-humanistic philosophical orientation as an overarching theoretical orientation with the subjective epistemological worldview and socialconstructionism paradigm. Findings indicated POTT training positively impacted seminarian participants' human formation, which was foundational …

Exploring The Experiences Of Mothers Who Attended The Kangaroo Mother Care Facility In A Tertiary Care Hospital In Swat, Pakistan: A Descriptive Qualitative Study, Muhammad Nasir

Theses & Dissertations

Background: Globally, four million neonates die yearly, and the substantial reasons for the deaths are low birth weight and being preterm. The neonate mortality rate was 18 per thousand live births in the year 2021, which means that approximately 7000 deaths occur worldwide daily. Pakistan is among the top ten countries with many preterm births.
Purpose: To explore the mother’s experiences with KMC, and the motive is that it will reduce the neonate's mortality rate by preventing preterm babies from hypothermia.
Method: A qualitative descriptive study design was used to explore the mothers’ experiences who attended the KMC facility. The …

Exploiting Vulnerabilities In The Ras-Rac Signaling Pathway For The Selective Targeting Of Pancreatic Cancer Cells, Neha Chaudhary

Theses & Dissertations

Deregulation of the KRas (Kirsten rat sarcoma virus) GTPase is one of the early hallmarks of Pancreatic Cancer (PC). The most common genetic alteration found in PC are mutations in the KRas protein that block its ability to hydrolyze GTP to GDP and resulting in higher levels of GTP-bound KRas, its active form. Pancreatic tumors driven by oncogenic mutants of KRas tend to be addicted to the oncogene, to the extent that its repression leads to the induction of cell death. This addiction to the KRAS oncogene makes the KRas protein an ideal target for cancer therapy. However, the globular …

Design And Synthesis Of Small Molecule Drugs For Cns Disorders, Kirsten T. Tolentino

Theses & Dissertations

Dopamine (DA) is an important neurotransmitter for the regulation and long-term function of the central nervous system (CNS). DA binds to Dopamine Receptors (DR) to stimulate or inhibit adenyl cyclase production to further elicit a pharmacological response. DRs were cloned, and it was determined that there are two families separated by their function and five total subtypes distinguished by their amino acid structure. The Dopamine 4 receptor (D4R) is the second least studied subtype but has high expression in the frontal cortex, amygdala, hippocampus, hypothalamus, globus pallidus, substantia nigra pars reticula, and thalamus. Dopamine signaling and transmission, especially in the …

Association Of Inflammatory Markers And Growth Factors With Radiographically Assessed Wound Healing Of Extraction Sockets, Sasha Mohammadi

Theses & Dissertations

The purpose of this prospective cohort pilot study was to investigate the association of the periodontal status and inflammatory markers from the gingival crevicular and wound fluid with the healing outcomes following tooth extraction. The central research hypothesis is that extraction sites and the adjacent teeth that exhibit increased markers of inflammation, or decreased growth factors, at baseline or 2 weeks will be associated with reduced healing outcomes observed radiographically 3 months following surgery. Nine patients at the UNMC College of Dentistry who were seeking care to extract a posterior tooth due to advanced periodontal bone loss, non-restorable caries or …

The Importance Of Contrast Sensitivity, Color Vision, And Electrophysiological Testing In Clinical And Occupational Settings, Frances Silva

Theses & Dissertations

Visual acuity (VA) is universally accepted as the gold standard metric for ocular vision and function. Contrast sensitivity (CS), color vision, and electrophysiological testing for clinical and occupational settings are warranted despite being deemed ancillary and minimally utilized by clinicians. These assessments provide essential information to subjectively and objectively quantify and obtain optimal functional vision. They are useful for baseline data and monitoring hereditary and progressive ocular conditions and cognitive function. The studies in this dissertation highlight the value of contrast sensitivity, color vision, and cone specific electrophysiological testing, as well as the novel metrics obtained with potential practical clinical …

The Efficacy Of Analgesic Subdissociative Dose Ketamine In Trauma Casualties Treated By U.S. Military Special Operations Medical Professionals In A Prehospital Environment, Darin Schwartz

Theses & Dissertations

Research Focus. This study’s main objective was to determine the efficacy of sub-dissociative ketamine to reduce the pain of trauma casualties treated by U.S. military medical professionals in a prehospital environment evidenced by the 0–10 numeric rating scale (NRS) for pain. Research Methods. This quantitative study was accomplished using a pragmatic approach integrating social cognitive theory complemented by mixing methods using qualitative phenomenological influence through narrative inquiry. This exploratory retrospective, cross-sectional study, utilizing a quasi-experimental pretest-posttest design, used deidentified sample data (N = 47) for secondary analysis from U.S. Special Operations medical providers and were included in a casualty …

Effect Of Computerized Cognitive Training In Persons With Multiple Sclerosis, Sam Jack

Theses & Dissertations

Between one million and 1.75 million persons with multiple sclerosis (PwMS) worldwide are estimated to suffer from cognitive impairment. Unfortunately, there is currently no consensus on the best treatment for cognitive impairment in PwMS. Finding non-pharmacological interventions to mitigate cognitive decline is essential to ensure that quality of life for PwMS matches our ability to treat and mitigate their physical symptoms of MS. Computerized cognitive training has emerged as a potential option for PwMS suffering from cognitive impairment. The objective of this study was to determine the effectiveness of computerized cognitive training with BrainHQ on changes in cognitive impairment for …

Evaluating The Impact Of Routine Enteral Iron Fortification On Gastrointestinal Dysbiosis In Premature Infants, Matthew Van Ormer

Theses & Dissertations

The gastrointestinal microbiome in preterm infants bears significant influence on optimal outcomes – dysbiosis is shown to substantially increase the risk of the life-threatening necrotizing enterocolitis, whereas optimal microbiome composition improves nutrient digestion and immune function. Iron is a vital nutrient especially during the perinatal window of rapid hemoglobin production, tissue growth, and foundational neurological development. However, excess colonic iron exhibits potent oxidation capacity and alters the competitive environment of microbes – potentially facilitating the proliferation of pathological bacterial strains in the gut. Of note, breastfed preterm infants routinely receive iron fortification starting at 14 days of life and are …

Variations In Source And Pattern Of Arterial Supply To The Trigeminal Ganglion With Clinical Relevance, William S. Srinivasan

Theses & Dissertations

The trigeminal ganglion (TG) is known to receive its arterial supply from branches of the internal carotid artery (ICA), middle meningeal artery (MMA), accessory meningeal artery (AMA), or superior cerebellar artery (SCA). Existing information about the prevalence and patterns of blood supply to the TG is limited despite their high clinical relevance to basicranial surgeries. The objective of this study is to investigate the source and pattern of arterial supply to TG and discuss their clinical relevance. Left and right TG were examined on 75 embalmed human cadavers from an ethically approved anatomical donor program. A literature review was conducted, …

Cystic Duct Morphology And Heister Valves: A Cadaveric Study, Cierra R. Goerish

Theses & Dissertations

Continued occurrence of cholelithiasis, gallstones, commonly results in cholecystectomy, removal of the gallbladder. Having a comprehensive anatomical, histological, and physiological knowledge of the biliary apparatus is imperative in clinical medicine today. Additionally, the functionality of cystic duct (CD) Heister valves (HV) has been speculatory since being reported in 1732. This study summarizes the morphology, orientation, and variability of the gross biliary system and provides data to help justify HV functionality.

Cadaveric dissection was utilized for gross observation and analysis of the biliary system. The angulation of the CD was found primarily as an acute angle; however, obtuse angulation could be …

Mechanisms Of Mutated Myosin Vb Mediated Cholestasis In Microvillus Inclusion Disease, Melissa S. Holzapfel

Theses & Dissertations

Microvillus inclusion disease (MVID) is a constitutive intestinal epithelial disease which causes definitive intestinal failure and cholestatic liver disease primarily caused by mutations in the Myosin Vb gene. Genotype-clinical phenotype associations suggest that the progression of liver disease can be predicted through a correlation between myosin Vb residual function and variable retention of bile salt transport machinery in intestinal enterocytes and liver hepatocytes. We proposed that aberrant distribution of bile salt transport proteins disrupts enterohepatic regulation of bile acids and contributes to the progression of cholestatic liver disease. To investigate the genotype-phenotype correlation, samples from MVID patients were evaluated for …