Medicine and Health Sciences Commons^™

Initial Refugee Health Assessment Educational Session, Yolondra Cochnan

Doctor of Nursing Practice Projects

The initial refugee health assessment presents an excellent opportunity to identify communicable diseases in newly arriving refugees. As the number of refugee arrivals increases, so will the need for nurses who possess the skills necessary to conduct the initial refugee health assessment. Prior to the pandemic, the United States was facing a nursing shortage. The impact of the pandemic devastated the nursing community, leaving them exhausted and burnt out, which led many nurses to retire and leave the field of nursing (National Council of State Boards of Nursing [NCSBN], 2023). Skilled nurses are needed to prevent the spread of communicable …

Understanding Emerging Adult Mental Health And Attachment: The Roles Of Parental Factors In Childhood, Trauma, And Gender, Christiana A. Howell

Dissertations

Problem

The experience of the parental environment growing up, parental psychopathology in childhood, exposure to trauma throughout the lifespan, insecure adult attachment, and social support have been established as factors that influence mental health in adulthood. These factors have not yet been studied together as a complex model of emerging adult mental health and attachment. The purpose of this study was to develop a theoretically and empirically supported model of these factors to understand how these factors interact to influence mental health in emerging adulthood. Additionally, the purpose was to understand if these factors interact differently based on gender.

Method …

Implementing A Nurse-Driven Protocol To Reduce Routine Gastric Residual Monitoring: A Quality Improvement Project, Alondra N. Abreu Carlo

Master's Theses and Capstones

The American Society for Enteral and Parenteral Nutrition (ASPEN) and the Society for Critical Care Medicine (SCCM) updated the Adult Patient Enteral Nutrition Guidelines in 2016. These updates included discontinuing routine gastric residual monitoring due to its contribution to poor patient outcomes and mentioning the lack of evidence proving its relevance to gastric motility. Per ASPEN and SCCM, best practice suggests monitoring patients for intolerance symptoms and then checking gastric residual volume (GRV) if symptoms are present. If the GRV is greater than 500ml and intolerance symptoms are present, the recommendation is to perform further assessment, potentially leading to stopping …

Social Networks As Predictors Of Musculoskeletal Injury In U.S. Army Soldiers (Snap-Mski), Kristen L. Zosel

Theses and Dissertations

INTRODUCTION: Musculoskeletal injuries (MSKIs) are the leading cause of medical non-readiness among U.S. Army Soldiers, costing the Military Health System an estimated $4.7 billion annually in direct and indirect costs. Current MSKI mitigation efforts focus on individual attributes such as body mass index and gender. However, emerging research highlights the significance of social ties on health outcomes and behaviors. This study examined the patterns of MSKI within military social networks and how social interactions, along with health behaviors such as sleep, physical activity (PA), and diet, co-occur in Soldiers with and without MSKI. METHODS: Phase 1 involved a cross-sectional sociocentric …

Neural Hyperactivity During Value-Based Decision-Making In People With Daily/Near Daily Cannabis Use, Miranda Ramirez

Theses and Dissertations--Psychology

Value-based decision-making involves the coordinated effort of multiple brain regions to guide future choices based on past experiences. These processes are disrupted in cannabis use disorder, where individuals continue to use cannabis despite negative consequences. Reinforcement learning (RL) paradigms can be used to capture changes in the value of available options and may inform how the brain is impacted by frequent cannabis use. This study combined fMRI with behavioral modeling of probabilistic choice task data to compare value-based choices between young adults reporting daily/near daily cannabis use (CAN) and controls (CTRL). Participants selected one of two options reinforced ($0.25) at …

Extracellular Free Water As An Imaging Biomarker Of Neuroinflammation, Cristina N. Pinheiro

Theses and Dissertations--Psychology

Older adults experience a chronic state of heightened immune response referred to as “inflammaging” which can be observed by detecting levels of proinflammatory cytokines in blood serum. These proinflammatory cytokines are secreted in the central nervous system and may also enter the brain through the blood brain barrier. Previous literature has suggested that extracellular free water, a magnetic resonance imaging metric, may allow us to detect alterations in the extracellular space which are thought to correlate with inflammation in the central nervous system. This study examined the correlation between two proinflammatory cytokines, IL-6 and TNFα, collected longitudinally and cross-sectionally imaged …

Establishing The Feasibility Of Crowdsourcing To Study Value-Based Decision-Making In Substance Use Disorders, Thomas Shellenberg

Theses and Dissertations--Psychology

Substance use disorders (SUDs) are characterized by repeated choices to use drugs despite adverse consequences. Value-based decision-making theory posits that choices are guided by predicted values of available options which are updated based on outcomes. Computational modeling of reinforcement learning (RL) during choice tasks has shown promise for uncovering latent mechanisms of decision-making. Recruiting people with SUD is difficult, but crowdsourcing offers an alternative for accelerating data collection. However, the validity of computational modeling using online choice task data has not been well-established. This thesis aimed to use the online crowdsourcing platform Prolific to 1) compare online and in-person choice …

Mental Health In College Students: Efficacy Of A Telehealth-Delivered Occupational Therapy Program, Amy Marie Nelson

Dissertations and Theses

The number of college students in the United States struggling with mental health issues has increased tremendously over the past decade. Specifically, undergraduate students report stress and anxiety as significant inhibitors to academic performance. Colleges are investing resources to combat this problem, but increased counseling services are insufficient. Novel approaches beyond traditional college counseling services are recommended. Occupational therapy, not traditionally offered on most college campuses, may be one solution. A few occupational therapy programs exist on college campuses, but there is limited evidence of their efficacy, and most lack solid theoretical underpinnings. More evidence is needed on the effectiveness …

Neural Correlates Of Executive Functioning In Preschool Children, Michelle Lobermeier

Master's Theses and Doctoral Dissertations

Healthy development of executive functioning (EF) provides an important foundation for emotional and behavioral regulation as well as academic success. Preschool is a time of rapid EF development, making this a target age group for identifying and intervening on EF weaknesses. Since EF has been historically difficult to behaviorally measure in preschoolers, the current study explores neural correlates of EF as another method by which to understand its development. The goal of the present study is to explore associations between resting state electroencephalography (EEG) power (i.e., theta, alpha, beta) and EF ability in preschool and examine how early regulatory ability …

Lateralization Of Motor Behavior As A Measure Of Cognitive Functioning And Resting-State Electrocortical Activity, Alina Dillahunt

Master's Theses and Doctoral Dissertations

Background. Research has shown that the laterality between hands in self-report and motor measures maps onto hemispheric lateralization and this has important implications for psychopathology (e.g., depression) and cognition. The present study evaluates the relationship between performance on finger-tapping tasks (FTT), alpha power during resting-state electroencephalography (EEG), handedness, and relevant psychological outcomes. Methods. A sample of 48 individuals between the ages of 18 and 35 completed online assessments including a modified FTT paradigm, the Edinburgh Handedness Inventory, and a common depression measure. A subset of 20 participants completed assessments of motor and executive functioning including a self-report executive functioning measure, …

การทดลองแบบสุ่มเพื่อแสดงผลการรักษาความผิดปกติของเส้นประสาทขนาดใหญ่ด้วยวิตามินดีในผู้ป่วยเบาหวานที่มีโรคเส้นประสาท และมีภาวะพร่องวิตามินดี, ธันยพร อังศุวัชรากร

Chulalongkorn University Theses and Dissertations (Chula ETD)

วัตถุประสงค์ : เพื่อศึกษาผลการรักษาความผิดปกติของเส้นประสาทขนาดใหญ่ด้วยวิตามินดีในผู้ป่วยเบาหวานที่มีโรคเส้นประสาท และมีภาวะพร่องวิตามินดี วิธีวิจัย : ศึกษาแบบสุ่มเปรียบเทียบผลการรักษาระหว่างกลุ่มวิตามินดีและกลุ่มยาหลอกในโรงพยาบาลจุฬาลงกรณ์ โดยคัดเลือกผู้ป่วยที่มีอาการหรืออาการแสดงของเส้นประสาทขนาดใหญ่จากเบาหวาน และมีภาวะพร่องวิตามินดี แบ่งเป็นสองกลุ่ม ได้แก่ กลุ่มที่ได้รับวิตามินดีสอง ขนาด 60,000 IU ต่อสัปดาห์ และกลุ่มที่ได้รับยาหลอก เป็นระยะเวลา 12 สัปดาห์ ผลลัพธ์หลักคือ การเปลี่ยนแปลงของคะแนน modified NDS หลังได้รับการรักษา 12 สัปดาห์ ผลลัพธ์รองคือ การเปลี่ยนแปลงของการนำไฟฟ้าของเส้นประสาท การรับรู้การสั่นสะเทือน และประเมินคะแนนความรู้สึกของอาการชา ผลการศึกษา: ผู้เข้าร่วมการศึกษาครบ 12 สัปดาห์ จำนวน 60 ราย แบ่งเป็นกลุ่มละ 30 ราย ผลการรักษาที่ 12 สัปดาห์พบว่าคะแนน modified NDS ดีขึ้นอย่างมีนัยสำคัญทางสถิติในกลุ่มวิตามินดี (P = 0.045) อย่างไรก็ตาม เมื่อเปรียบเทียบระหว่างกลุ่ม ไม่พบความแตกต่างอย่างมีนัยสำคัญ (P = 0.060) เช่นเดียวกับการเปลี่ยนแปลงการนำไฟฟ้าของเส้นประสาท การรับรู้การสั่นสะเทือน และคะแนนความรู้สึกของอาการชา ไม่พบความแตกต่างกันระหว่างกลุ่ม สรุป: การรักษาด้วยวิตามินดีสองในผู้ป่วยเบาหวานที่มีโรคเส้นประสาทขนาดใหญ่ และมีภาวะพร่องวิตามินดี ไม่ทำให้คะแนน modified NDS ดีขึ้นอย่างมีนัยสำคัญทางสถิติ

The Impact Of Language Status On Bilingual Language And Literacy Development, Ashley Ippolito

University of the Pacific Theses and Dissertations

This study investigated narrative and literacy differences between monolingual and bilingual children with Developmental Language Disorder (DLD) and examined caregivers' perspectives on their language and literacy development. This mixed methods project involved semi-structured ethnographic interviews and case histories for caregiver measures, and it included a narrative production task and a literacy skills assessment for child measures. There were two participant groups: monolingual children with a DLD in kindergarten to sixth grade (Group 1) and bilingual children (English + additional language) with a DLD (Group 2). Thematic analysis of caregiver interviews revealed that monolingual families engaged in storytelling and reading activities …

Fueling Identities: A Study Of Ethnic And Athletic Identities On Dietary Choices, Tally Chavez

Cal Poly Humboldt theses and projects

This study examines the intersectionality of athletic and ethnic identities and their influence on food choices among college-aged active individuals. Using the Multigroup Ethnic Identity Measure (MEIM), Athletic Identity Measurement Scale (AIMS), and Athlete Food Choice Questionnaire (AFCQ), this research explores how these identities impact nutritional attributes, usual eating practices, and performance-related food choices in a sample of 109 participants (58% female, mean age = 25.02 years) from diverse ethnic backgrounds. The hypothesis that a salient athletic identity combined with a salient ethnic identity would predict food choices prioritizing nutritional attributes was supported, suggesting that individuals with both identities salient …

Advancing Small Molecule Therapies For Myotonic Dystrophy Type 1, Sawyer M. Hicks

Electronic Theses & Dissertations (2024 - present)

Myotonic dystrophy type 1 (DM1) is a multisystemic disorder caused by the expression of expanded CUG (CUG^exp) repeat RNA from the myotonic dystrophy protein kinase (DMPK) gene. This CUG^exp repeat RNA’s gain-of-function mechanism leads to the sequestration of muscleblind-like (MBNL) proteins, resulting in widespread alternative splicing dysregulation across tissues. Despite significant research, there are currently no approved therapeutics targeting the underlying causes of DM1. This dissertation explores the development and optimization of a novel class of small molecules, Modified Polycyclic Compounds (MPCs), designed to address splicing dysregulation in DM1. MPCs were designed from previously published …

Comparing Effectiveness Of Intrauterine Devices Versus Oral Contraceptives For Management Of Dysmenorrhea, Mackenzie Holland

Physician Assistant Scholarly Project Papers

The purpose of this research and systematic literature review is to determine if oral contraceptives or intrauterine devices are more effective in the treatment of dysmenorrhea pain. It is estimated that at least 50% of women worldwide live with dysmenorrhea and there is very little research determining what the best treatment options are for it. The main treatment recommended by health care providers for dysmenorrhea are non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. However, this treatment option may not provide the relief that women with this condition need. This review used three main databases, including PubMed, Embase, and Clinical Key …

Lifestyle Changes And Medication Vs. Medication Alone: Symptom Control Of Parkinson Disease, Rachel Duncan

Physician Assistant Scholarly Project Papers

Parkinson disease is multifactorial, and predominantly affects the geriatric population. The mainstay of treatment for patients diagnosed with Parkinson disease is currently symptomatic treatment with dopamine replacement. The goal of this literature review is to identify possible lifestyle modifications that can delay progression of the disease or help prolong OFF time of symptoms. Lifestyle modification predominantly considered during this review included diet and physical activity. Included in the study were MIND, Mediterranean, and DASH diets. Considering the role of medication in this disease levodopa, dopamine agonists, monoamine oxidase B inhibitors and the addition of ropinirole to levodopa and their efficacy …

Poly Adenosine Diphosphate-Ribose Polymerase (Parp) Inhibitors Versus Traditional Therapy In Brca Positive Her2 Negative Breast Cancer, Tania Schnepf

Physician Assistant Scholarly Project Papers

Of the women diagnosed with breast cancer, approximately 5% will be found to have a germline breast cancer gene mutation (BRCA). This mutation increases the risk for developing a triple negative breast cancer, of which treatment options are limited. PARP inhibitors are a new pharmaceutical that act on the PARP enzyme to stop repair for cancer cells in BRCA mutations (Robson et al., 2017). The purpose of this literature review is to compare efficacy and safety of PARP inhibitor pharmaceuticals to traditional therapy for treatment of BRCA positive HER2 negative breast cancers. A literature review was preformed using the electronic …

Beyond The Strong Black Woman: Navigating Resilience And Mental Health Using Social Media For Culturally Tailored Resources, Muchaneta N.M. Chikawa

College of Graduate Studies: Theses & Dissertations

Society views the strength of Black women as commendable as it shows positive qualities such as resilience and perseverance. While these traits are characterized as positive, Black women’s survival in American society has heavily depended on their strength, resulting in mental health illnesses such as anxiety and depression. The idea that Black women must exude strength and fortitude through adversity is labeled the Strong Black Woman Schema (SBWS). The SBWS is a race-gender schema that prescribes culturally-specific feminine expectations for Black women.

There are limited culturally-tailored resources for Black women to address mental health at collegiate institutions. As a result …

Chronobiology Of Meal Timing In Early-Stage Hypertension: Effects On Renal And Vascular Function, Natalie J. Bohmke

Theses and Dissertations

Introduction: Previous research determined that a Western-style meal acts as a stressor to the kidney and contributed to impaired blood pressure and vascular function. Despite an understanding of acute postprandial physiology in humans, studies have not investigated the impact of the time of day of meal consumption on physiology. Methods: Ten participants with elevated or stage-one hypertension underwent a randomized crossover trial with a controlled feeding intervention of a Western-style meal in the morning or the evening. Participants completed a run-in day to standardize diet followed by the experimental day. On day 2, participants completed ambulatory blood pressure, core temperature, …

Assessing Associations Between Emergency Room Visits For Respiratory And Cardiovascular Diseases And Criteria Air Pollutants Exposure In New York State, Tamba Solomon Lebbie

Electronic Theses & Dissertations (2024 - present)

Abstract

Air pollution is a major environmental health hazard for the general population. Approximately 90% of the global population is at risk of both indoor and outdoor air pollution, and it accounts for an estimated 7 million premature deaths every year according to the World Health Organization (WHO). Multiple studies including epidemiological and molecular analyses have confirmed the negative effects of air pollutants on human health even at levels within the WHO guidelines. This study examines the health impacts of releases of criteria air pollution from point sources in New York State (NYS). There is evidence from population studies that …

Optimizing The Community Health Worker (Chw) Program In Belize And Understanding Its Unique Intermediary Position Within The Health System: Perspective From The World Health Organization (Who) Health Systems Approach, Andrei R. Chell

Electronic Theses & Dissertations (2024 - present)

Human resources for health (HRH) are the backbone of a well-functioning and resilient health system. Issues related to HRH recruitment, retention, planning, leadership and governance have been amplified by the coronavirus disease 2019 (COVID-19) pandemic and have posed additional and unprecedented challenges in many countries. Community health workers (CHWs) in particular, are uniquely positioned to be frontline health care workers (HCWs) that are considered a vital link between communities and the formal health system. Globally, the benefits of CHW programs have been well documented, and there is substantial evidence of the efficacy and effectiveness of these programs. However, countries are …

Pdgfra And B Copositive Fibroblasts Drive Fibrosis In Mouse Salivary Glands Through Tgfβ Signaling, Renae Williams Atkinson

Electronic Theses & Dissertations (2024 - present)

Fibrosis is of significant concern to the medical community as numerous disease processes are characterized by progressive fibrosis leading to organ damage. We begin the process of examining the mechanism of fibrosis to salivary gland hypofunction and briefly consider Sjögren’s Disease (SjD). Method: We employed single-cell RNA sequencing data from a reversible mouse salivary gland injury model and from NOD/ShiLtJ mice, a model of secondary SjD. We performed treatment comparisons with the help of Seurat dotplots and UMAPS. Using differential gene expression analysis and the publicly available R packages: clusterProfiler, WikiPathways and Cytoscape, we identified the processes and pathways …

Ribosome Hibernation Factor Induces Antibiotic Persisters Of Mycobacterium Tuberculosis In Neutrophil-Rich Lung Lesions, Jamie Corro

Electronic Theses & Dissertations (2024 - present)

Mycobacterium tuberculosis (Mtb), the etiological agent of tuberculosis, is a prescient global health threat and the leading cause of death by an infectious agent. Treatment of Mtb infection involves administering 2-4 antibiotics for a minimum of 6 months. This extended drug regimen is required to target a subpopulation of persistent bacilli. As their name implies, these bacteria can “persist” by acquiring nonhereditary and transient antibiotic tolerance. Although the precise mechanism is unknown, it’s often attributed to slowing cellular growth and metabolic processes. During zinc deprivation, bacteria can remodel their ribosomes by replacing their zinc-binding paralogues containing the CXXC motif (C+) …

The Effect Of Presenting Concerns On Providers’ Assessment Of Patients' Suicide Risk, Alexandria Brunkow

Electronic Theses & Dissertations (2024 - present)

Objective: Suicide is the 10^th leading cause of death in the U.S. with nearly 50,000 people per year dying by suicide. Public health approaches to suicide prevention focus on screening people in primary and mental health care settings and offering treatment to those who screen positive. Research shows that mental health providers may not recognize risk factors for suicide and miss opportunities to screen patients who may be at risk. Providers’ mental representations of suicide risk may be influencing their perception of patient risk and contributing to low screening rates. This study used an experimental vignette case design to …

Evaluating The Impact Of Instruction Mode And Experience On Meditation Intentions And Outcomes In Self-Taught Meditators And Mindfulness-Based Stress Reduction Completers, Leah Howard

Electronic Theses & Dissertations (2024 - present)

Objectives: The widespread availability of mindfulness-based practices has led to growing concern about the potential for misuse, namely the use of such practices as a control-based strategy rather than in an acceptance-based manner consistent with research. Thus, the present study aimed to elucidate factors (e.g., mode of instruction, meditation experience, psychological [in]flexibility [PF/PI]) that may relate to intentions guiding meditation use. Methods: Self-taught (ST) and Mindfulness-Based Stress Reduction (MBSR) meditators (N = 122, Mage = 46.54, SDage = 16.49, 65.6% Female) completed a battery of measures assessing meditation intentions (control- or acceptance-based), meditation experience (in months), PF/PI, psychological distress, …

A Descriptive Analysis Of Depressive Symptoms And Body Image By Race/Ethnicity And Nativity Status Among Adolescents, Radhika Prasad

Electronic Theses & Dissertations (2024 - present)

Previous research on the immigrant health paradox among children and adolescents show a mental health advantage yet it is unclear if this applies in a similar magnitude to females (Fillion et al., 2018; Zarei et al., 2023). Immigrants may be exposed to stressors related to immigration and acculturation. Some research suggests that females respond more to stress through internalizing symptoms relative to males (Hall-Lande et al., 2007; Adkins et al., 2009). Given these gender differences in stress response, female immigrants may be particularly vulnerable to the psychological consequences of immigration related stressors. The immigrant health paradox has also overlooked subjective …

Developing Cellular Systems To Elucidate Rna Structural Dynamics Of Cag Expansion Transcripts In Spinocerebellar Ataxias, Victoria Demeo

Electronic Theses & Dissertations (2024 - present)

Spinocerebellar ataxias (SCAs) are a diverse group of over 40 genetically heterogeneous neurodegenerative disorders, many of which are caused by a trinucleotide CAG repeat expansion in the coding region of specific genes. These expansions lead to the production of polyglutamine (polyQ) tracts that interfere with normal protein function, triggering cellular dysfunction and contributing to disease pathogenesis. The most well-known of these SCAs, such as SCA1, SCA2, and SCA3, exhibit progressive neurodegeneration, yet the precise mechanisms through which these mutations cause disease remain poorly understood.

A significant challenge in studying CAG repeat expansion disorders lies in the complexity of the disease …

Student Perspectives On The Adequacy Of Mental Health Curriculum Within The College Of Health And Human Services At Unh, Brianna Lee Meyer

Honors Theses and Capstones

This study aims to understand the confidence students in future healthcare oriented majors feel in regards to treating or interacting with individuals with mental health conditions. It also aims to understand the effect of students' in-major education, outside-major education, and lived experience on this confidence level. Students within the College of Health and Human Services at UNH were the participants who completed a short Qualtrics survey online. The survey collected data from Likert scales and short-answer questions. The Likert scales were then analyzed with a regression and descriptive statistics, while the short-answer questions were analyzed with thematic analysis. The study …

Nursing Education And Comfort Level In Caring For Patients With Eating Disorders, Jaylyn E. Jewell

Honors Theses and Capstones

Nurses are integral to providing care to patients with eating disorders, who often present to the generalized hospital setting related to physical complications from their disorder. Despite the vital role nurses play, a lack of education is cited. This project sought to assess knowledge on eating disorders of nurses at a local hospital through dissemination of a survey. A total of n=18 responses were gathered. Results supported the fact that many nurses have received inadequate education on eating disorders, and consequently have low knowledge and competency in the care of these patients. This project seeks to identify this lack of …

Distribution Of Tick Species On Free-Ranging Ungulates In Northern New England, Karisa Graham

Honors Theses and Capstones

In Northern New England, ungulates are often parasitized by ticks, which is one of the leading causes for the decline in population. Ungulates are a good host for ticks, specifically deer ticks and winter ticks, and these ticks cause many tick-borne diseases in humans as well. The purpose of this study was to assess passive sampling from harvested animals as a means of tick surveillance in Vermont and New Hampshire. Ticks were collected from deer and moose and mapped throughout the two states by ArcGIS to visualize the trends in distribution. Relative abundance was greater in southeastern Vermont, with no …