Medicine and Health Sciences Commons^™

Barriers And Motivators To Attending Group Exercise Classes In Women With Anxiety, Depression And Post-Traumatic Stress Disorder, Sarah Ford

Theses: Doctorates and Masters

Research has demonstrated the positive effect of exercise on mental health disorders such as anxiety disorder, depression and post-traumatic stress disorder. Studies have also investigated the barriers and motivators that women in particular experience when contemplating the ways in which to engage in physical activity. However, a literature gap exists regarding women who experience anxiety disorder, depression and post-traumatic stress disorder, and the barriers and motivators that they specifically navigate when looking to attend group exercise classes. In this body of research for the award of Master of Medical and Health Science by Research, a scoping review was first conducted …

Family Members’ Experiences Of Post-Cardiac Surgery Delirium In The Intensive Care Unit: A Narrative Inquiry, Amber Coral Mclean

Theses: Doctorates and Masters

Aim: This study explores delirium in the intensive care unit (ICU) following cardiac surgery from the perspective of family members.

Background: Delirium is a common complication affecting 28-52% of people following cardiac surgery in the ICU, which can lead to distress for both the person and their family members. While research has been conducted on clinical outcomes of family involvement in delirium care, there is a lack of understanding of how delirium impacts the family members themselves. This study seeks to provide detailed narrative accounts of families’ experience of witnessing delirium in their loved one following cardiac surgery in the …

Modified Constraint-Induced Movement Therapy After Stroke: A Process Evaluation Of Implementation In An Early-Supported Discharge Rehabilitation Service, Ashan Bimalka Weerakkody

Theses: Doctorates and Masters

Background

Modified constraint-induced movement therapy (mCIMT) improves upper limb (UL) function after stroke, but its routine delivery in rehabilitation settings remains limited.

Aims

The objectives were to determine the feasibility, acceptability, and sustainability of implementing mCIMT within an early-supported discharge (ESD) rehabilitation service, using existing resources and staffing.

Aims were to:

• Develop and deliver a multi-modal behaviour change intervention to clinicians to increase mCIMT delivery.
• Explore the acceptability of mCIMT among stroke survivors, carers, therapists, and allied health managers.
• Identify program adaptations to better suit stakeholder needs.
• Evaluate the process of implementing mCIMT in the ESD service.

Methods

This thesis …

Early, Standardised, And Precise Treatment Of Copd Exacerbations And Covid-19, Sanjay Ramakrishnan

Theses: Doctorates and Masters

Background: Background Chronic Obstructive Pulmonary Disease (COPD) is a common chronic condition causing significant morbidity and mortality. Patients with COPD report sudden episodes of deteriorating respiratory symptoms called exacerbations, often presumed to be precipitated by infections. COPD is in the top 5 causes of death globally. COPD exacerbations drive a large proportion of these deaths. Despite this, there is no standardised model of care for the sickest patients who need hospitalisations for exacerbations. Meanwhile, treatment for COPD exacerbations continues to be guided by symptoms, instead of underlying biology. Most patients are treated with unnecessary and harmful systemic corticosteroids. During the …

Athlete Monitoring And Training Modification Decision-Making: Insights From High-Level Endurance Sports Coaches, Wouter Piet Timmerman

Theses: Doctorates and Masters

Athlete monitoring technology has proliferated in the last decades. However, much of what is known about athlete monitoring tends to come from unpublished personal experiences and anecdotal information. In the last decade, considerable athlete monitoring research has been conducted, leading to multiple reviews and consensus statements mainly on athlete monitoring tools and methods. Recognising that athlete monitoring is a human-driven process, typically with the coach as the decision-maker, it is imperative to study coaches given their extensive knowledge and expertise. The overall aim of the thesis was to gain insights into why and how high-level endurance sports coaches use athlete …

The Role Of Game-Based Learning Simulation To Enhance Leadership In Pandemic Preparedness For Nursing Students, Scott James Andrews

Theses: Doctorates and Masters

During the COVID-19 pandemic, nurses around the world suffered with the impact of resource scarcity on the provision of quality nursing care to patients. Nursing staff were at higher risk of infection than all other healthcare workers, with working conditions during the pandemic resulting in significant staffing pressures. The challenges faced by staff during the pandemic inevitably influenced the quality and delivery of clinical education, highlighting the need for innovative solutions such as digital learning to address emerging training needs. Further, the impact of COVID-19 restrictions on clinical education has highlighted the benefits of digital learning environments as alternatives to …

Optimal Bag Valve Mask Ventilation Efficacy Of Smart Bag Ventilation Compared To Traditional Adult And Paediatric Bag Valve Ventilation During Cardiopulmonary Resuscitation, Ian Dawson

Theses: Doctorates and Masters

Background: Out-of-Hospital Cardiac Arrest (OHCA) is one of the world’s leading causes of mortality. Survival rates are low, ranging from 3.1–20.4% internationally. The most effective oxygenation method for patients during pre-hospital cardiac arrest is ventilating using a self- inflating Bag-Valve-Mask (BVM). Yet, extensive research has identified a lack of compliance with ventilator guidelines during OHCA cardiopulmonary resuscitation (CPR). As a result, clinicians often ventilate patients too aggressively using the BVM, delivering breaths excessively higher than the International Liaison Committee on Resuscitation (ILCOR) recommended rate of 10 breaths per minute (BPM). Hyperventilation can lead to complications such as aspiration, barotrauma, and …

Learning Paradigms For Rhythm Detection And Generation Using Mathematical Models, Biophysical And Artificial Neural Networks, Prianka Bose

Dissertations

Humans possess an inherent ability to recognize evenly-spaced rhythms, known as isochronous rhythms, owing to the brain's predisposition to entrain to external auditory stimuli with regular temporal intervals. The central focus of this research is to understand how the brain learns and retains rhythmic time intervals in the context of music. This dissertation studies rhythm detection and generation through mathematical models, biophysical networks, and artificial neural networks, addressing both isochronous and non-isochronous patterns.

A primary focus of the thesis is on isochronous rhythms. In particular, given a perturbation to an isochronous rhythm such as a tempo change or phase shift …

Machine Learning Methods For Pattern Recognition Analysis Of Genomic And Molecular Data, Kuang Du

Dissertations

While immune therapies achieve remarkable success in treating various cancers, only a subset of patients achieves a durable clinical response, and many exhibit innate or acquired resistance. Precision medicine aims to tailor treatments to individual patients based on specific biological markers, ensuring that each patient receives the therapy most likely to be effective. Predictive biomarkers and gene signatures offer potential for more personalized treatment strategies by identifying patients likely to benefit. Recent studies suggest that gene signatures, comprising sets of genes, hold predictive value for certain clinical variables. Typically derived from biological expert knowledge, these signatures demonstrate substantial predictive potential, …

Automated Segmentation Of The Ulnar Nerve In Mri Using Deep Learning Techniques, Akhil Nagulapalli

Theses

Cubital Tunnel Syndrome (CuTS), a condition caused by compression of the ulnar nerve, results in numbness, tingling, pain, and even muscle atrophy, affecting fine motor skills and diminishing patient quality of life. Accurate diagnosis of CuTS is challenging, as current diagnostic methods—including clinical exams, nerve conduction studies, and unaided MRI—often lack the precision to reliably identify the nerve and detect compression in its early stages. Deep learning-based segmentation offers a promising solution, enabling precise and automated identification of nerve structures in MRI images, which could significantly improve diagnostic accuracy and support timely intervention.

A novel deep learning model for segmenting …

Assessment Of Implementation And Enforcement Of Smoke-Free Laws And Policies Among Malaysian Smokers: A Mixed Method Approach, Gan Shiz Yee

Student Works (2020-2029)

Smokefree laws (SFL) and policies could deter smoking by strengthening anti-smoking norms, impacting cessation behaviour due to decreased social acceptability of smoking in public spaces. With socioeconomic status (SES) affecting smoking risk factors, disparities in health outcomes post-SFL implementation are likely. Furthermore, regional and international assessments show Malaysia’s poor performance due to ineffective smoking bans and enforcement. Local studies revealed inadequate SFL implementation and enforcement, leading to high secondhand smoke (SHS) exposure. Understanding these challenges and opportunities is crucial for improving policy implementation and enforcement to enhance public health outcomes. This study examined the association between SFL and quit intention …

Empowering Schools: Suicide Prevention Education For School Nurses, Navjot K. Singh

DNP Qualifying Manuscripts

Introduction: Suicide among adolescents and youth is such a serious issue that immediate, appropriate interventions are needed to reduce rates of suicide ideation and suicide mortality. The increasing rate of suicide among this population profoundly affects families, friends, and the community. Identifying and implementing appropriate interventions in schools could identify individuals who are suffering from mental illness and support suicide prevention.

Aim: The purpose of this integrative literature review was to examine the literature on suicide prevention interventions for young adolescents and teenagers aged 12-17 years old and identify the best, evidence-based practices for the school setting. The aim …

“But The Trauma Did Not Fade Away” Childhood Sexual Abuse, Adolescent Pregnancy, And Rurality, Cynthia H. Mcniss

Electronic Theses and Dissertations

Childhood sexual abuse (CSA) and adolescent pregnancy are critical public health issues that intersect in complex ways, particularly in rural areas. Adolescents who have experienced CSA are at a significantly higher risk of becoming pregnant before the age of 19 compared to their peers without such a history (Madigan et al., 2014). Rurality is also associated with elevated rates of adolescent pregnancy due to various socio-economic and healthcare access challenges ("Rural Health Information Hub," 2024). This study employed a grounded theory approach to develop a comprehensive understanding of the social and psychosocial processes influencing the choices, actions, and decisions of …

Improving The Preparedness And Confidence Of Healthcare Providers In The Detection And Management Of Preeclampsia And Acute Stroke In Perinatal Patients: A Quality Improvement Initiative, Beth Karasin

Seton Hall University Dissertations and Theses (ETDs)

Pregnancy-related stroke (PRS) is a cerebrovascular injury that occurs during and up to six weeks after pregnancy. This includes hemorrhagic and ischemic strokes, however, regardless of the type, strokes in this special population are on the rise and preeclampsia is a major contributing factor. It is paramount for healthcare providers to not only understand the physiologic changes that occur during pregnancy, but also remain aware of the risk factors, symptoms, and currently accepted management of perinatal preeclampsia and strokes. Aware of the missed opportunities at a single center institution this quality initiative aimed to equip healthcare providers with education in …

Minimizing Infant Injury Risk By Utilizing Parental Education In A Primary Care Setting, Courtney Munroe, Erin Kuehl, Rachel Mahlberg

Doctor of Nursing Practice Projects: College of Nursing

Introduction

Accidental injury and death to infants has been correlated to lack of proper education to parents of infants in the primary pediatric care setting. Sudden infant death syndrome (SIDS) and unintentional injuries were the second and third leading causes of post neonatal death during this period of time (Centers for Disease Control and Prevention [CDC], 2016). Studies have found that motor vehicle accidents are a leading cause of child injury and death for infants under 12 months of age. The CDC found that drowning, suffocation, and poisoning were other leading causes that contributed to child injury and death rates …

Assessing Knowledge, Confidence, And Attitude Toward Virtual Care And Telehealth Among Graduate Nursing Students, Natasha Asante

Doctor of Nursing Practice Scholarly Projects

In response to the COVID-19 pandemic, telehealth and virtual healthcare modalities have become primary care delivery methods. The American Academy of Ambulatory Care Nursing (AACN) and the American Association of Nurse Practitioners (AANP) support using virtual care and telehealth technology in health care services. Although most healthcare institutions utilize telehealth to provide care, emerging research highlights the lack of telehealth training in Advanced Practice Nurse (APRN) education. However, no standard curriculum requirements mandate graduate nursing programs to train APRN students in telehealth or virtual health modalities. Due to the lack of training for APRNs, it can be very challenging for …

Understanding Widowhood Cultural Practices, Values, And Beliefs, Of Nigerian American Women: An Ethnonursing Study, Prisca Anuforo

Electronic Theses and Dissertations

Introduction: Many widowhood cultural practices are detrimental to the health and well-being of widows in Nigeria. Little is known about the experiences of widowhood for Nigerian American women, their cultural practices, and how it affects their health.

Purpose: Understand widowhood cultural practices among Nigerian Americans and how these experiences may affect health and wellbeing.

Methods: The qualitative ethnonursing method was used to collect data from 25 Nigerian American widows. Data were analyzed using NVivo qualitative data manager software guided by Leininger’s four phases of qualitative analysis.

Results: Widowhood cultural practices are modified and undertaken to preserve health and honor the …

Challenges To Reproductive Justice: An Ethical Analysis Of Reproductive Technologies And Disparities, Courtney Brenner

Electronic Theses and Dissertations

This dissertation analyzes the Reproductive Justice Framework to describe possible solutions to the ethical challenges related to reproductive healthcare disparities. Various frameworks to support reproductive equity fail to address the challenges marginalized individuals face in accessing reproductive health services. The four ethical principles of autonomy, beneficence, nonmaleficence, and justice serve as foundational tools to support reducing these disparities. This dissertation uses the Reproductive Justice Framework to analyze the unequal distribution of harms among marginalized women. It highlights how access to care, such as Assisted Reproductive Technologies (ART), is disproportionately inaccessible to marginalized women. Then, it discusses the relationship between marginalized …

How Scientists Can Investigate Perception: Phenomenological Foundations For Qualitative Research, Kimberly Tucker

Electronic Theses and Dissertations

While medicine makes visible symptoms of disease, phenomenology provides a different tool for making illness experience visible. Phenomenology offers a tool for a new kind of description and a different kind of knowledge of disease. It holds a unique epistemic power through the descriptions it generates through the application of the transcendental phenomenological method. Husserl’s method, outlined in Ideas I, provides the steps for its implementation in clinical research. This dissertation explores the application of the transcendental phenomenological method as a foundation for research on perception, with the goal of characterizing phenomenological validity as a proper goal of medical epistemology. …

Advancing Continuous Manufacturing: The Role Of Process Analytical Technology In Process Development, Samuel R. Henson

Electronic Theses and Dissertations

The pharmaceutical industry is actively pursuing technologies which improve manufacturing processes with the goal of producing high-quality pharmaceutical products for patients, manifesting in an industry-wide investment in continuous manufacturing (CM). Process analytical technology (PAT) has been recognized for its successful monitoring of critical quality attributes during routine production and is often cited alongside CM due to its ability to make timely, in-line measurements of intermediate materials. Various PAT tools are valuable in process development, particularly as continuous wet granulation processes are developed for use within pharmaceutical manufacturing. This work applied PAT and chemometric modeling during CM process development to enhance …

Method Development Of [3 + 2] Cycloadditions Using Tertiary Amine N-Oxides And Efforts Towards The First Total Synthesis Of Chrysosporazine D, Alexander Cocolas

Electronic Theses and Dissertations

Nitrogen-containing heterocycles are ubiquitous in bioactive molecules, pharmaceutical drugs, and natural products. For this reason, finding new and efficient ways to make such compounds remains a high priority for the organic and medicinal community. Our current endeavors build upon previously established work by our group, where we generated 1,2-diamines by coupling commercially available aldehydes with trimethylamine N-oxide (TMAO) in two steps. This route proved to be effective in generating 20+ novel 1,2-diamines and imidazolidines with a demonstrated ability to undergo transformations. Using this chemistry, we have developed a diastereoselective synthesis of 50+ novel 7-azanorbornanes using tertiary amine N-oxides …

Ethical Considerations In The Diagnosis And Treatment Of Autism Spectrum Disorder, Ferdinand Okafor

Electronic Theses and Dissertations

This dissertation is an ethical response to the ethical issues in the assessment, diagnosis, and treatment of autism. The problems that underlie the discussion are misconception about autism and Autistics. The misconception about autism and Autistics lead to misinterpretation of the neurological functioning, cognition, and the behaviors of Autistics. Consequently, it influences the approach and model of care in the assessment, diagnosis, and treatment of autism. Currently, the analytic approach and biomedical model of disease are applied in the assessment, diagnosis, and treatment of autism. The motive of the analytic approach and biomedical care is to cure autism. The consequence …

Efficient Development Of Density-Insensitive Near-Infrared Methods For In-Line Drug Content Monitoring In Continuous Powder Streams, Natasha L. Velez-Silva

Electronic Theses and Dissertations

A well-defined action plan to respond effectively to sudden changes in product demand is critical for preventing drug shortages within the pharmaceutical industry. An effective way to increase the output of a continuous manufacturing (CM) process is through flow rate adjustments. However, robust analytical methods must be in place to ensure consistent analytical performance across varying flow rates. Existing approaches for mitigating the physical effects of flow rate on Near-Infrared (NIR) measurements are often burdensome. Thus, efficient robust modeling strategies that reduce the current calibration burden and ensure model insensitivity to the physical variations in CM systems are needed. In …

Muslim Spirituality As A Foundation In Bioethics For Patient Encounters In Health Care, Sara Rahman

Electronic Theses and Dissertations

Spirituality plays a major role in decision making for individuals with faith-based values. There is often hesitation to discuss the role of faith in healthcare as a core value and coping mechanism. The growing cultural diversity amongst patients and physicians has increased the need to understand eastern religious principles and incorporate them into bioethical guidance. Even as the 2nd largest religion in the world, Islam has not been sufficiently integrated into religious bioethics in western medicine. Muslim populations of patients and physicians are growing, increasing the need for better understanding of how Islamic principles impact healthcare delivery. Although Islamic law …

Design, Synthesis, And Characterization Of Multi-Targeting Pyrrolopyrimidine Antifolates As Potential Single Agent Chemotherapeutic Entities, Tejashree Magdum

Electronic Theses and Dissertations

In cancer chemotherapy, the currently marketed antifolates have two major disadvantages: dose-limiting toxicities to normal tissues and susceptibility to drug resistance. These are due to their major transport by the ubiquitously expressed transporter and mutagenesis in enzymes present in cancer cells. This thesis describes an introduction, background, and research progress in antimetabolites-antifolates designed to multi-target (a) one-carbon metabolism and de novo nucleotide synthesis pathway and (b) target overexpressed transporter in cancer cells for selective tumor-targeting.

Cancer cells transport folate through three transporters: ubiquitously expressed reduced folate carrier (RFC), limitedly expressed proton-coupled folate transporter (PCFT), and folate receptors (FRs). The research …

Assembly Of Ppsu-Oligomers, Mariam Nesterov

Student Theses and Dissertations

The development of nanostructures for delivering multiple proteins to targeted antibodies has become a promising avenue in biotechnology, driven by advancements in synthetic polymers like poly(propylene sulfone), PPSU. However, the PPSU polymer faces a major limitation - its high insolubility. To address this challenge, this study investigates whether PPSU oligomers can enhance both the solubility and stability of lysozyme, a model protein that is cost-effective and widely accessible. Using dimer, trimer, tetramer, and hexamer configurations, we analyzed the interactions between PPSU oligomer and lysozyme under varying conditions. Our results show that the dimer and trimer are water soluble (no aggregate …

Implementing A Transition Plan For Adolescents With Adhd Transitioning To Adult Care, Emily Anderson

Seton Hall University Dissertations and Theses (ETDs)

Background: Annually in the United States approximately 750,000 children with special health care needs transition from pediatric to adult health care. Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders and nearly two thirds of children who have symptoms of ADHD in childhood have symptoms that persist to adulthood (Inman et al., 2017). The Child Development Center at a large medical center in northern New Jersey, prior to this project, did not have a transition process or procedure in place to aid providers to successfully prepare adolescent patients with ADHD for transition to adult care. Transition …

Design And Investigation Of Small Molecule Drugs For Potential Treatment Of Cns Disorders, Flaviviral Infections, And Cancers, Viktoriya Mashinson

Theses & Dissertations

Chapter 1 discusses the development of antagonists against the dopamine 4 receptor (D4R) that is expressed in the motor, associative, and limbic subdivisions of the basal ganglia network and is involved in Parkinson’s disease (PD). Levodopa is the firstline drug for the management of PD symptoms but its long-term use often leads to development of levodopa-induced dyskinesia (LID). D4R antagonists have been shown to decrease the abnormal involuntary movement scores in mouse models of LID. Chapter 1 outlines the development and optimization of selective D4R antagonists for potential treatment of LID. During the investigation of our D4R antagonists we discovered …

Priorities To Care Within The Military Health System: A Mixed Methods Study On Military Spouse Access To Care During Covid-19 On Okinawa, Elayne L. Wilson

Theses & Dissertations

Military spouses in Okinawa experienced denial of care at military treatment facilities and off base Japanese healthcare facilities during the COVID-19 pandemic. Over two years of travel restrictions further contributed to difficulties accessing healthcare while stationed on the island with their active-duty spouse. This study examined the implications of a priority-based access system through the TRICARE program implemented due to limited resources during COVID-19 and its impact on military spouses in a scarce medical resource environment. This concurrent mixed-methods research used a survey tool developed by Community First Hawaii to quantify access to healthcare and in-depth interviews to further explore …

Sparkled: Social Programming In Kids Affects Risk Of Latent Endothelial Disease, Rebecca Drakowski

Theses & Dissertations

Background: Social Health Programming (SHP) is a holistic intervention that can empower communities to address modifiable risk factors for poor cardiovascular health, including suboptimal nutrition or psychosocial stressors. SHP participation has been shown to increase dietary intake of fruits and vegetables, decrease perceived stress, and improve cardiovascular endurance. However, it is unknown how SHP participation during adolescence affects carotenoid serum levels, hair cortisol concentrations (biological marker of chronic stress), or vascular reactivity index (VRI; measure of subclinical cardiovascular health).

Methods: Adolescent girls and young adult women (12–29-year-old) were enrolled in this observational cohort study. Serum, hair, and saliva samples were …