Medicine and Health Sciences Commons^™

Investigation Of The Causative Agent Of Canine Leproid Granuloma Infection Cases In The Northeastern United States, Nicole J. Marcotte

Honors Theses and Capstones

Canine leproid granuloma syndrome (CLGS) is a form of disease in dogs of many breeds that is characterized by a skin infection in the subcutis and/or dermis. The granulomas that form as a result of infection are typically non pruritic, alopecic, raised, and firm. These mass-like granulomas can ulcerate, causing further infection beneath the skin surface, and are present in areas of the body such as the ears, head, neck, and extremities. CLGS has been known to infect dogs of different breeds and ages, but has most commonly been reported to infect shorthaired, large sized breeds. This disease is suspected …

Understanding Hospital-Based Nurse End-Of-Life Care, Knowledge, And Comfort: A Quality Improvement Project, Emma Doran

Honors Theses and Capstones

Providing physical, emotional, and spiritual care to patients at the end of life (EOL) can relieve their suffering and the pain experienced by loved ones in their presence. As death approaches, patients’ symptoms may require increased comfort measures, and it is imperative that all nurses be properly trained and prepared to provide this care. In this quality improvement (QI) project, the End-of-Life Professional Caregiver Survey (EPCS) and demographic and experiential questions were administered in the form of a Qualtrics survey to nurses working on an acute care inpatient unit at a healthcare organization in New England. 18 survey responses were …

The Influence Of Drd2 Polymorphism Exon 8 C/T (Rs6276) On Manifestations Of Delirium Tremens & Alcohol Withdrawal Seizures, Naomi Schneider

Honors Theses and Capstones

This study explores the correlation between the DRD2 Polymorphism exon 8 C/T (rs6276) and manifestations of delirium tremens (DT). DT is a condition that is clinically diagnosed utilizing two characteristic symptom manifestations: the presence of delirium and severe alcohol withdrawal. It is not entirely understood why DT can occur in some patients, but evidence has suggested that genetic predisposition can play a role. Utilizing the National Institutes of Health (NIH) All of Us Research database and performing a secondary analysis of existing genomic data, this candidate gene association study aims to determine the genotype frequencies within three cohorts: a healthy …

Deconstruction Of Body Representation Of The Back In Healthy Back Pain-Free Individuals And People With Chronic Low Back Pain, Simon Pratt

Theses

Changes in various body representations have been increasingly investigated and subsequently posited to be potentially important factors in the development and maintenance of chronic low back pain. Three main domains of body representation are considered here: body model, body schema (comprising superficial and postural schema), and body image. Most studies informing our contemporary understanding of these body representations have been undertaken in areas such as the hand and forearm, with a comparative dearth of studies performed on the low back. Consequently, this thesis consists of a comprehensive investigation of body representation initially in healthy back pain-free individuals and then in …

Traumatic Heterotopic Ossification: Pathophysiological Mechanisms, Epidemiological Characteristics, And Risk Factors, Nicola Kate Foster

Theses

Traumatic heterotopic ossification (tHO) refers to the complication of pathological formation of ectopic bone in soft tissues, which follows tissue insult secondary to burn, neurological and orthopaedic injury [2]. Common to these diagnoses is the involvement of central and or peripheral nervous system trauma. Although known risk factors are associated with developing tHO, the underlying cellular and molecular mechanisms are not fully understood. Research to date, primarily in single injury cohorts, has provided minimal translatable results [2]. Thus, clinical guidelines for early screening and prophylactic drug therapy are lacking, and treatment options are limited. To move the body of knowledge …

Prevalence Of Peristomal Skin Complications In The First 12 Weeks Post-Discharge Following Urinary/Faecal Stoma Formation Surgery, Tania Norman

Theses

Background

An ostomy is a surgically created opening and can be performed to divert faecal effluent by exteriorisation of a segment of the small bowel otherwise known as the ilium, or from the large bowel otherwise known as the colon. A urinary diversion of effluent generally involves exteriorisation of a segment of ileum into which the ureters have been anastomosed. The exteriorised segment of bowel is referred to as a stoma and individuals who have had a stoma created often refer to themselves as an ‘ostomate’. The skin surrounding a stoma is referred to as peristomal skin.

Peristomal skin complications …

Cancer Induced Bone Pain: Pain Classification And Management, Merlina Sulistio

Theses

Pain is a multidimensional personal experience influenced by biological, psychological, social and cultural factors. In the context of cancer pain, particularly cancer-induced bone pain (CIBP), it is essential that clinicians assess the multidimensional nature of pain to fully understand the patient’s pain experience, which often involves an evoked sense of both vulnerability and mortality.

Bone metastases are highly prevalent in advanced cancer, resulting in CIBP being one of the most common cancer pain syndromes. CIBP affects a patient’s physical and social functioning, reduces quality of life, increases psychological distress and often results in hospice or hospital admission. Yet, there is …

'Reading The Room': A Mixed Methods Study Of Midwifery Students' Perceptions Of Emotional Intelligence And Its Relationship To Midwifery, Kirstie Jayne Balding

Theses

Midwifery is emotionally challenging work; midwives provide care to women and families at one of the most significant points of their lives and this work is not without impact upon the midwives themselves. Midwifery students require more than just the cognitive ability to learn the requisite midwifery knowledge and competence at performing practical midwifery skills, the knowledge and skills that midwives require intersect with and are influenced by a wide range of emotions and emotional experiences. Emotional intelligence (EI) is the ability to identify and manage one’s own emotions, as well as the emotions of others and within other healthcare …

An Investigation Into The Nature Of The Knee Pain Experience In People With Knee Osteoarthritis, Gemma Mary Orange

Theses

Knee osteoarthritis poses a substantial and escalating socioeconomic burden globally, exacerbated by demographic trends towards an aging population, sedentary lifestyles and increasing obesity rates. Defined by knee pain and functional limitations (Wood et al., 2023; Zhang, Doherty, et al., 2010), traditional approaches have viewed knee OA related pain and disability primarily through a biomedical lens, linking symptoms directly to structural damage and advocating surgical interventions such as total knee arthroplasty to address presumed causative pathology (Bunzli et al., 2019; Darlow et al., 2018). Despite the capacity of surgery to ameliorate structural pathology, patient centred outcomes vary considerably. Up to 30% …

The Efficacy Of A Junior Doctor Led Near-Peer Surgical Teaching Program For Medical Students: A Prospective Study, Wendy Liu

Theses

Background Near-peer teaching (NPT) involves teaching by peers who are at a close, but not the same, level of training. This study investigated whether a novel surgical NPT workshop, designed and delivered by junior doctors using simulation models for acute otorhinolaryngology conditions, improved the knowledge and confidence level of senior medical students.

Methods A one-day NPT workshop was held for medical students in their third year of a four-year postgraduate medical degree at the University of Notre Dame, Sydney, Australia. Four acute otorhinolaryngology/head and neck surgery problems that might be encountered by junior doctors and require prompt management were chosen. …

Best Practice Recommendations For Coaching Gymnasts To Avoid Burnout And Reframe Performance Anxiety, Clare A. Mccall

Theses: Doctorates and Masters

Gymnastics is deemed a psychologically demanding sport, with associated risk factors of burnout and performance anxiety. To date, relatively little research has explored the specific goal and perfectionistic processes of gymnasts, despite these risks. This body of work identified the specific goal-related constructs and perfectionistic orientation of young athletes and examined how these associated with burnout and performance anxiety. It comprised of two studies with a mixed methods design. The first study aimed to systematically review literature investigating how goal-related constructs and perfectionism associate with burnout and performance anxiety in young athletes. This review focused on summer and winter Olympic …

Prevalence Trends Of Foodborne Pathogens, Bacillus Cereus, Non Stec Escherichia Coli And Staphylococcus Aureus In Ready-To-Eat Foods Sourced From Restaurants, Cafés, Catering And Takeaway Food Premises, Nicole Foxcroft

Theses: Doctorates and Masters

The foodborne pathogens of Bacillus cereus (B. cereus), non STEC Escherichia coli (non STEC E. coli) and Staphylococcus aureus (S. aureus) are currently non-notifiable in Australia unless attributed to a food poisoning outbreak. Due to the lack of data around individual cases and isolations in foods, any changes in prevalence may go undetected. The aim of the study was to determine any changes in prevalence of B. cereus, non STEC E. coli and S. aureus in ready-to-eat foods (RTE) sampled from Western Australian restaurants, cafés, catering facilities, and takeaway food premises during the period July 2009 to June 2022. The …

Nutrition Counseling Practices Among Psychologists, Wibecke Stromsnes

University of the Pacific Theses and Dissertations

There is a lack of treatment guidelines for how to address the impact of nutrition on clients’ mental health. Prior research is limited regarding psychologists’ practices of nutrition counseling and has mostly focused on practices of dieticians and medical doctors. The purpose of this study was to examine psychologists’ beliefs and attitudes about nutrition counseling, amount of training and use of nutrition counseling, self-rated knowledge in the use of nutrition counseling and perceived benefits and barriers to using nutrition counseling. Data was collected using an online survey of 76 licensed psychologists’ training in nutrition and use of nutrition counseling. Findings …

Analyzing Sex Differences In Human Performance Through 3d Isotonic Resistance, Jacob M. Cunha

University of the Pacific Theses and Dissertations

Appraisal of scientific literature and understanding continues to grow in the domain of human performance. The effects of sex on concentric resistance training and power output are not well understood. Recent advancements in technology permit more precise measurements of force output and the kinematic changes elicited by training stress. A unique device in capturing kinematic performance output is Proteus Motion. The machine produces an external magnetic load through a protruding apparatus connected to a gyrosphere, which in turn captures concentric movement through all three planes of movement (sagittal, coronal, transversal). The aim of this study is to investigate power output …

An Empirical Predictive Model For Determining The Aqueous Solubility Of Bcs Class Iv Drugs In Amorphous Solid Dispersions, Sridivya Raparla

University of the Pacific Theses and Dissertations

Poor aqueous solubility persists as a significant challenge in the pharmaceutical industry.Ongoing research aims to enhance the solubility of drugs to deliver them more effectively. Amorphous solid dispersion (ASD) is a widely used solubility enhancement technique. The absence of a specific model to predict compound solubility from ASDs resulted in a trial-and- error approach to studying solubility enhancement and makes it a laborious and time-consuming process. Predictive models could streamline this process and accelerate the development of oral drugs with improved aqueous solubilities. This study aimed to develop a predictive model to estimate the solubility of a compound from the …

Structural And Functional Studies Of The Human Members Of The Macrophage Migration Inhibitory Factor Family, Andrew Parkins

University of the Pacific Theses and Dissertations

Macrophage migration inhibitory factor (MIF) and D-dopachrome tautomerase (D-DT) are the two human members of the MIF superfamily, which are implicated in an array of autoimmune disorders, inflammatory diseases, and cancer via their pleiotropic functionality. Despite only sharing 34% sequence identity, MIF and D-DT have high structural homology and overlapping functional traits, including activation of the type II cell surface receptor CD74 and keto-enol tautomerase activity. The MIF and/or D-DT-induced activation of CD74 leads to signaling cascades pivotal for cell growth, proliferation, and inhibition of apoptosis. Such characteristics make MIF and D-DT attractive molecular targets for drug discovery.

Currently, all …

Elaboration Of Diquinanes To Access Trifunctional Angular Triquinanes And Designed Dna Polymerase Α Inhibitors, Spencer M. Webber

University of the Pacific Theses and Dissertations

Natural products are of great significance to the pharmaceutical industry in the development of new drugs. Diquinane or bicyclo[3.3.0]octane is a conspicuous structural unit existing in the carbo-frameworks of a wide range of natural products such as alkaloids and terpenoids. These diquinane-containing molecules not only exhibit intriguing architectures, but also showcase a broad spectrum of significant bioactivities, which draw widespread attention from the global synthetic community. A more specific group of compounds containing a diquinane moiety with one extra 5-membered ring are called the angular triquinanes.In this work, we have developed a general synthetic scheme to the angular triquinanes. We …

Impact Of A Culturally-Grounded And Interprofessional Approach To Managing Latino/Hispanic Patients At Risk For Or Diagnosed With Type 2 Diabetes Mellitus: A Pilot Study, Jahnavi Yalamanchili

University of the Pacific Theses and Dissertations

Background: Despite significant progress in diabetes research, there remain significant health disparities between Hispanic/Latino patients in the United States, particularly those with lower socioeconomic status, compared to non-Hispanic white patients. Previous studies have identified potential reasons behind these disparities, including the need for a multifaceted approach that addresses social determinants of health (SDOH) faced by patients. Social cognitive theory (SCT) stipulates that interventions that promote self-management by improving knowledge, self-efficacy, and problem-solving skills can be successful in improving health outcomes. However, there is a paucity of studies that have evaluated an interprofessional approach to providing culturally relevant care, in particular …

Impact Of Drug-Polymer Interactions On Stability In Simvastatin-Based Amorphous Solid Dispersions, Charina Lampa

University of the Pacific Theses and Dissertations

This study aimed to investigate the drug-polymer interactions between simvastatin (SIM) and three polymers [PVP-VA, HPMC-AS, and Soluplus® (SOL)] in amorphous solid dispersions (ASDs) prepared by hot melt extrusion (HME), and to understand the implications on physical stability. ASDs are of significant interest within the pharmaceutical industry for improving drug bioavailability. However, the amorphous nature of a drug in an ASD presents physical stability challenges. Utilizing novel applications of accessible tools such as ATR-FTIR or DSC aid in understanding the mechanisms of stabilization which are critical to the rational design of ASDs. ASDs were prepared using HME and were characterized …

Chromatin Regulation By Swi/Snf Remodelers In Somatic Stem Cell Maintenance And Transformation, Luke Thomas Deary

Dartmouth College Ph.D Dissertations

Cell identity is defined by the epigenome, whereby chromatin regulators work in concert to promote gene expression programs that serve a cell’s specialized purpose. Mutations in chromatin regulators are amongst the most frequent drivers of human disease, underscoring the importance of understanding their activities in maintaining cell identity and tissue function. In particular, mutations in subunits of the evolutionarily conserved SWI/SNF chromatin remodeling complexes drive diseases across human tissues in both development and adult tissue maintenance5. Three major SWI/SNF complexes exist: BAF, PBAF, and GBAF, which differ in their composition and genomic targeting but share an ATP-dependent catalytic activity to …

Development Of Nano Formulations Of Lipophilic Platinum Complexes Against Lung Cancer, Zizhao Xu

University of the Pacific Theses and Dissertations

Lung cancer remains a leading cause of death worldwide and urges the development of more effective and safer treatment options. Conventional platinum-based drugs like cisplatin, while effective, are associated with significant systemic toxicity, particularly nephrotoxicity. Nano formulations, such as liposomal and micellar delivery systems, represent a promising approach to enhance the anticancer activity and reduce the toxicity of platinum complexes.

This study develops and evaluates novel miriplatin-loaded nano formulations for lung cancer therapy. We prepared and screened various liposomal and micellar formulations of miriplatin by either thin-film hydration or co-solvent evaporation, which identified a number of formulations with appropriate sizes …

Impact Of Traditional Education And Learner-Centered Education On Standardized Tests, Courtney Marie Winslow

Walden Dissertations and Doctoral Studies

There is a current shortage of approximately 45,000 nurses and nursing faculty to train student nurses, a number that is projected to grow. One proposed method to combat the shortage is to transition from traditional lecture-based classrooms to a learner-centered approach. Asking or requiring faculty to transition an entire nursing program from one teaching method to another without supporting data could be a waste of valuable time and resources. It could also prove detrimental to a program if students were unable to pass the NCLEX-RN exam, and a program was forced to close. The current study examined whether there was …

Examining The Impact And Implementation Of Protected Administrative Time On Provider Well-Being And Service Delivery Indicators Within A Multi-State Network Of Primary Care Medical Practices, Lauren Junge-Maughan

College of Graduate Studies: Theses & Dissertations

Background:

Primary care is integral to achieving high-quality health outcomes for the population and decreasing healthcare costs. However, primary care clinicians suffer from conflicting demands, impossible expectations, and burdensome processes. With burnout and mental fatigue increasing, leadership must find innovative programs to implement in their organizations. This mixed-methods research study assessed the impact of one such intervention, protected administrative time (PRAT), on improving provider well-being.

Purpose:

The first aim was to evaluate the association of PRAT on the service delivery indicators of primary care clinicians’ productivity, average appointments per day, patient satisfaction (likelihood to recommend), clinician time to the next …

A Qualitative Exploration Of Spousal Labor Migration And The Postpartum Experiences Of Women In Nepal, Sandhya Lohani

College of Graduate Studies: Theses & Dissertations

Labor migration is a prevalent phenomenon in Nepal, with many men leaving the country searching for employment opportunities, often leaving their families behind. This study explores the impact of this migration on women's postpartum experiences, including factors such as emotional support, financial strain, and childcare responsibilities. A qualitative approach was used, conducting interviews of 31(16 women with labor-migrant spouses and 15 with non-migrant spouses) to gather insights into the unique challenges faced by the two groups of women during the postpartum period. The findings highlight the significant differences in postpartum experiences between women with migrant spouses and those without, shedding …

Factors Associated With Hepatitis C-Related Hospitalizations And Inpatient Mortality In The United States, Pre- And Post-Onset Of The Covid-19 Pandemic, Christina R. Samuel

College of Graduate Studies: Theses & Dissertations

Background: Hepatitis C is a significant public health problem in the United States and imposes a substantial burden on the healthcare system. Previous research shows that the COVID-19 pandemic response efforts have overshadowed hepatitis C testing and treatment measures in health care settings across the country. The purpose of this study was to describe and examine the factors associated with hepatitis C-related hospitalizations and inpatient mortality in the United States, pre- and post-onset of the COVID-19 pandemic. Methods: Data were obtained from the 2019-2020 National Inpatient Sample database. The study population included persons aged ≥18 years with hepatitis C-related inpatient …

Footwear Selection, Foot Type, And Running Biomechanics Of Male Distance Runners With Previous Running Related Injury: A Case Series, Diego Castro I. Diaz

College of Graduate Studies: Theses & Dissertations

With the rise in popularity of running, running shoe companies have researched and designed several models aimed at the purpose of providing comfort and aiding in the decrease of running related injuries. Technology was developed for running shoes to control forefoot and rearfoot impact forces and rearfoot motion during running. However, there is no overwhelming evidence supporting the notion that footwear corresponding to foot type leads to a decrease in running injuries. Thus, the purpose of this study was to describe footwear selection, foot type, and running biomechanics in previously injured male distance runners. Six total participants completed this case …

The Effects Of External Load Type And Eccentric Tempo On Hamstring Electromygraphy During Unilateral And Bilateral Prone Hamstring Exercise, Toraya Hughes

College of Graduate Studies: Theses & Dissertations

Isotonic hamstring exercises are employed to mitigate the risk of a future hamstring strain and after strain, incorporated into return-to-play protocols. However, research has negated leg dominance's influence on muscle recruitment and exercise form. Therefore, the purpose of this study was to compare muscle recruitment between the dominant (DOM) and non-dominant (nonDOM) during prone hamstring exercise (PHSE) variations. METHODS: Twenty trained participants aged 18 – 33 (M = 23 years, SD = 3 years) completed familiarization and experimental protocols > 72 hours apart. Participants underwent four PHSE variations that differed by load type (barbell vs. dumbbell), exercise strategy (bilateral …

Can We Talk About Sex? Exploring Teacher Preparedness Of Comprehensive Sex Education Delivery In Southeast Georgia, Tanya Jules

College of Graduate Studies: Theses & Dissertations

In 2022, the CDC estimated that youth and adolescents between the ages of 15 through 24 accounted for almost half of the 2.5 million cases of sexually transmitted infections in the United States. Teachers who deliver accurate sexual health information increase the accessibility of pertinent details to adolescents during crucial years of cognitive development, which could decrease adverse sexual health outcomes among youth. The utilization of a Comprehensive Sex Education (CSE) curriculum addresses all parts of sexual health by covering topics ranging from physical, biological, emotional, and social aspects of sexuality. However, educators who provide sexual health education must follow …

Increasing Performance Of Bedside Shift Report To Enhance Nurse-Patient Communication, Hannah Schimmer

Doctor of Nursing Practice Projects

Bedside shift report is the recommended form of nursing shift-to-shift handoff and has positive effects on nurse-patient communication, but it is difficult to implement and sustain. The organization’s standard for nursing shift-to-shift handoff is bedside report; however, report was not routinely taking place at the bedside. Key opportunities for nurse-patient communication were lost and the organization’s patient experience scores related to nurse-patient communication were well below state and national averages. A pre- and post-test design quality improvement Doctor of Nursing Practice project was conducted using the Plan, Do, Study, Act framework. The objective of the project was to increase the …

Obesity In Primary Care: A Quality Improvement Project To Improve Diagnosis And Treatment Of Adult Obesity, Lindsey K. Barrett

Doctor of Nursing Practice Projects

Obesity is a common and serious chronic health condition that is impacting individuals, families, and society. According to the Centers for Disease Control and Prevention (CDC), obesity is a body mass index (BMI) of 30 or above (CDC, 2022b). The rate of adult obesity rose from 30.5% in 1999 to 41.9% in 2020 (CDC, 2023). BMI is often measured and documented at adult patient primary care visits but is rarely diagnosed and addressed by primary care providers (PCP) unless it contributes to the patient’s primary complaint or is the patient’s chief complaint. Gaps exist for implementing current evidence-based practice guidelines. …