Medicine and Health Sciences Commons^™

Exploring The Immune System’S And Silybin’S Impact On Cancer Cachexia, Patrice Cunningham

Theses and Dissertations

Cancer cachexia is a complex syndrome that is characterized by the unintentional loss of body weight with or without fat loss. During cancer cachexia, there is an increase in inflammation consistent with various inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), Interleukin-1 beta (IL-1β ), and interleukin-6 (IL-6); all of which are known to increase proteolysis and aid in the progression of muscle loss and weakness. Immune cells such as macrophages are increased during cachexia and are known to have varying effects on muscle inflammation, regeneration, and the progression of fibrosis in a disease state. However, therapies aimed solely at …

The Effect Of Covid-19 Restrictions On The Social Support Experiences Of Black Women Giving Birth In South Carolina Hospitals During The First Year Of The Covid-19 Pandemic (2020) As Compared To A Previous Birth, Tiffany Eva Byrd

Theses and Dissertations

The United States is experiencing a maternal health crisis, which disproportionately affects Black women. Black women die from pregnancy-related causes two to three times as often as their White counter parts, and the majority of maternal death are preventable. In recent years, public health and national governing authorities have devoted resources to monitoring the health crisis and raising the public’s knowledge of warning signs; however, maternal mortality rates continue to rise. Noted contributors to Black maternal mortality include, but are not limited to, racism, delayed treatment and response to health emergencies, and lack of social and emotional support during childbirth, …

Dysregulation Of Dopamine Dynamics Through Monoamine Transporters By The Hiv-1 Protein Transactivator Of Transcription, Sarah Davis

Theses and Dissertations

Prevalence of HIV-1 Associated Cognitive Disorders (HAND) persists in the era of combined antiretroviral therapies, causing impaired memory, motor function, and decreased quality of life. Evidence from clinical samples of persons with HAND has implicated dopamine, as well as the HIV-1 viral protein transactivator of transcription (Tat) as key molecules associated with disease progression. Through molecular modeling, in vitro and in vivo mutagenesis our lab has characterized Tat as a negative allosteric modulator for monoamine transporters, including the dopamine transporter (DAT), vesicular monoamine transporter (VMAT-2), and norepinephrine transporter. While this work has shed light on how Tat impacts the function …

Addressing A Crisis In Nursing Practice: Exploring The Impact Of Multimedia Case-Based Learning On The Clinical Judgment Of Undergraduate Nursing Students, Macy Jenette Bennett

Theses and Dissertations

Clinical judgment is a priority nursing skill to ensure the delivery of safe and effective nursing care. New graduate nurses and nursing students lack the clinical judgment skills that are necessary for entry-level nursing practice. Nurse educators must therefore implement teaching strategies that facilitate clinical judgment. This study evaluated the clinical judgment of undergraduate nursing students after the implementation of multimedia case studies related to the concept of perfusion. Two research questions guided this study: (a) in what ways do undergraduate nursing students demonstrate clinical judgment after completing a series of perfusion-related multimedia case studies and (b) to what extent …

Impacts Of Covid-19 And Taliban Takeover On U.S. Afghan Refugee Women’S Mental Health: A Socio-Ecological Approach To Resilience Resources, Atefeh Aghaei

Theses and Dissertations

In response to the escalating global refugee crisis, intensified by ongoing conflicts and environmental changes, this dissertation research focuses on the mental health of Afghan refugee women in the United States (U.S.), particularly in the context of the COVID-19 pandemic and the 2021 Taliban takeover. With over 114 million people displaced globally, Afghan refugees, notably women, encounter heightened mental health risks due to violence, deprivation, systemic persecution, and the challenges of migration. This vulnerability is exacerbated by recent mass traumatic events, including the pandemic and political upheaval in Afghanistan. Our study, conducted through semi-structured interviews with Afghan refugee women and …

Nutrition And Mental Health Related Factors Across Historically Black College And University Students, Nancy Anai Uriegas

Theses and Dissertations

The prevalence of food insecurity across college campus in the United States has been widely explored, with the primary focus placed on large, 4-year, primarily White institutions. Less is known about the prevalence of food insecurity and the impact it may have on health behaviors among minority serving institutions, including Historically Black Colleges and Universities (HBCU). Young adults attending college, and more specifically student-athletes (SAs), are typically in a new place, facing new stressors and high rates of food insecurity, which in turn may play a critical role in their current health status as it pertains to meeting their energy …

Associations Between The Use Of Ssri Medication In Older Adults And Cognitive Decline And Impairment, Paige Jones

Theses and Dissertations

Previous research has indicated that depression is a risk factor for dementia. Since SSRI medication is the most common treatment for depression, it is important to determine if SSRIs are associated with reduced dementia and better cognitive outcomes. Using longitudinal data from the 2004-2014 waves of the Health and Retirement Study merged with the 2005 Prescription Drug Study, we examined potential associations between SSRI and TCA medication and cognitive impairment and cognitive decline. The study population consisted of 1,775 older adults who participated in the PDS in 2005. We found that SSRIs were associated with significantly higher odds of cognitive …

Internalizing Mental Health Symptoms And Nicotine Use Among Adolescents In Canada, England, And The Us From 2020-2022, Emily E. Hackworth

Theses and Dissertations

Background: There is a well-established bi-directional relationship between cigarette smoking and internalizing mental health (IMH) symptoms (e.g., symptoms of depression, symptoms of anxiety). However, it is unclear whether IMH symptoms are associated with using different types of nicotine products among adolescents, as adolescents are using a variety of nicotine products, including combustible products (cigarettes), non-combustible products (e-cigarettes), or combinations of both types of products. This dissertation examines associations between IMH symptoms and current use of various types of nicotine products across three countries from 2020-2022.

Methods: Data come from the 2020-2022 waves of the International Tobacco Control (ITC) Adolescents Tobacco …

The Role Of Telehealth And Obstetrics Capacity On Maternal Health Care: A Mixed Methods Approach, Shanikque L. Barksdale

Theses and Dissertations

Background: The United States (US) is experiencing a maternal health crisis, with rising severe maternal morbidity and mortality rates and persistent racial, ethnic, and geographic disparities. While telehealth can address access challenges, there is limited evidence of its impact on access to maternity care and outcomes among rural and minoritized communities. The overall objective of this study was to analyze the disparities in maternal outcomes and user satisfaction by hospital-based telehealth and obstetric care availability.

Methods: A convergent parallel mixed methods approach was used. A multinomial logistic regression was used to analyze whether the changes in the proportions of hospitals …

Cell Based Sodium Alginate Microcapsules Within Ocular Disease: A Proof Of Concept, Chelsea Marie Zizzi

Theses and Dissertations

Sodium alginate is a natural polymer that has been widely used as a drug delivery system due to its controlled-release qualities and low cellular toxicity. These capsules are effective at transporting therapeutics in various diseased animal models. Retinitis Pigmentosa is an incurable genetic disease affecting the retina, which causes gradual blindness as the disease progresses. In our study, we injected cell-based sodium alginate capsules into the vitreous cavity of C57BL/6 and Pde6b^rd10/J mice to observe the migration of these capsules in both wildtype and diseased mouse models over a course of 2 weeks. Our intention was …

Neural Mechanisms Of Estrogen And Inflammation In Female Stress Susceptibility, Samantha Jane Bouknight

Theses and Dissertations

Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are highly debilitating psychiatric disorders that notably share stress as an etiological factor. Stress is a common occurrence experienced daily by virtually everyone and, while most people are resilient, a substantial portion of the population exhibit risk factors that yield them susceptible to developing stress-related psychiatric disorders. One prominent factor that has long been known to increase this risk is the female biological sex with women presenting at least twice as often with disorders like PTSD and MDD compared to men. Interestingly, this bias exists distinctly during the reproductive years and …

Association Between Autoimmune Diseases And Lymphoma Risk Using The Uk Biobank, Hannah Grace Dice

Theses and Dissertations

Background. Lymphoma is a blood cancer that develops when white blood cells multiply in an abnormal way and collect in the lymph nodes. Autoimmune diseases result when the immune system is overactive, causing it to attack and damage the body’s own tissues. Limited studies have been conducted to investigate the association between autoimmune diseases and lymphoma risk.

Literature review. Based on prior research, six autoimmune diseases (rheumatoid arthritis (RA), lupus, Sjögren’s syndrome, sarcoidosis, Crohn’s disease, and ulcerative colitis (UC)) were examined to better understand their association with lymphoma risk. Prior research has concluded that certain aspects of these autoimmune diseases …

Standardizing Documentation Of Patients’ Measurable Decline To Increase Medicare Compliance In The Hospice Setting, Julia A. Gines

Master's Projects and Capstones

Problem: Staff nurses have difficulties standardizing documentation of patients’ measurable decline during the admission and recertification process to justify the need for hospice services. Context: According to Murrin (2016), the average Medicare compliance rate of hospice organizations is 86%. This quality improvement (QI) project aims to increase an outpatient hospice organization’s Medicare compliance rate of 66% to the average, nationwide level through standardization of documentation (Frontz, 2021). Interventions: The proposed intervention is to implement a QI project of the following assessment tools: Palliative Performance Scale (PPS), Functional Assessment Staging Tool (FAST) and Mid-Upper Arm Circumference (MUAC). Clinical nurses will attend …

Interventional Radiology's Exploration Into Artificial Intelligence, Raymond Nguyen

Master's Projects and Capstones

Background: Artificial intelligence (AI) has become more prominent in our daily lives in recent years. This includes various aspects of healthcare. Interventional radiology (IR) is one of these specialties that has taken strides in understanding how AI can be leveraged for patient care. This literature review aims to understand what areas will be most impacted by AI in IR and how it will influence both the patient and interventional radiologist.

Methods: Twenty-six publications from 2019-2024 were selected from PubMed and Scopus. Publications were sourced through a combination of keywords, subject headings (MeSH terms), and citation searching.

Results: This literature review …

Femoral Geometry And Activity Type: Factors That Influence Loading In The Dysplastic Hip, Molly C. Shepherd

WUSM Theses and Dissertations – All Programs

Developmental dysplasia of the hip (DDH) is a bony condition characterized by a shallow hip socket that reduces coverage of the femoral head and leads to instability, resulting in altered joint loading and an increased risk for early onset osteoarthritis (OA). Understanding the factors that influence loading in the dysplastic hip is necessary for developing effective treatment strategies and improving patient outcomes. The purpose of this dissertation was to examine multiple factors that could impact joint loading in DDH: 1) sport specific activities, 2) femoral version (FV) deformities, and 3) derotational femoral osteotomy (DFO) correction for FV deformities. Analyzing how …

Manualized Occupational Therapy Intervention For Children And Adolescents With Post-Traumatic Stress Disorder, Adam Mcmahon

Student Capstone Papers

Post-traumatic stress disorder (PTSD) in children can cause physiological and psychological reactions that can lead to impaired executive functioning and self-regulation skills that interfere with occupational engagement. Occupational Therapy (OT) utilizes an occupational perspective to treat children with PTSD. However, there is an absence of a manualized OT intervention in the literature that incorporates an occupation-based approach, utilizes graded occupation as the primary intervention, and tracks treatment progress and outcomes. The purpose of this capstone project was to create a manualized OT intervention protocol for OT practitioners to treat children with PTSD guided by the model of human occupation and …

Recruitment And Retention Of Physician Assistants In Rural Medicine: A Novel Approach, Sean Grabbe

Theses and Graduate Projects

Improving the health of patients requires having access to well trained medical providers. This is one of the main goals of the physician assistant profession. For many years research has documented how to recruit and retain physician assistants in the rural areas of the United States. Although created to fill the gaps in primary care medicine physician assistants have moved as all of medicine has into specialization. This gap in primary care has not closed and is most significant in rural areas. This paper reviews the plethora of research and elaborates on the known and best methods for recruitment and …

Feasibility Study Of Mim Auto-Contouring For Head And Neck Patients That Have Dental Artifact Using A Metal Artifact Reduction Scan, Allison C. Munyer

Masters Projects

Introduction

Accurate contouring of organs at risk (OARs) is essential in the treatment of head and neck cancer, particularly in patients with metal dental artifacts that can obscure critical structures. The ability to precisely define these OARs is crucial for minimizing radiation exposure to healthy tissues and improving patient outcomes. To address the challenges posed by metal artifacts, Metal Artifact Reduction (MAR) technology, including iterative MAR (IMAR) scanning, has been widely adopted in radiation oncology.

Methods

This retrospective study evaluated the impact of IMAR scanning and Medical Image Merge (MIM) auto-contouring software on the accuracy and efficiency of contouring OARs …

Thinking Long-Term: Nursing Education On Long-Acting Injectable Antipsychotics, Arslan Rashid

DNP Qualifying Manuscripts

Schizophrenia cases and their associated healthcare costs have drastically increased over time in the U.S. Antipsychotic non-adherence is a primary contributor to the high rates of relapse and rehospitalization among the schizophrenic adult population. The development of long-acting injectable antipsychotics (LAIs) has positively impacted medication adherence, however, this treatment modality is still underemployed in practice due to barriers, such as physician and patient negative attitudes toward LAIs and lack of education. Nurses are in a great position to address these barriers as they serve as mediators between providers and patients. This literature review aims to discover evidence that LAI education …

A Systematic Review Of Racial Disparities In Emergency Department Pain Evaluation And Treatment In The United States, Cyrus Wolff

Theses and Graduate Projects

Background: Providers working in emergency departments (ED) must balance the need to relieve patients’ pain with the dangers of overprescribing opioids. Lack of standardization of pain evaluation and treatment may contribute to inequities in the management of pain in emergency departments. Evaluating differences in how different populations receive care in emergency departments can help to identify problems and areas where improvements need to occur.

Purpose: The purpose of this literature review is to evaluate what current research states about the prevalence and causes of racial disparities in pain evaluation and treatment in United States emergency departments and determine what gaps …

What Are The Most Effective Non-Pharmacologic Practices For The Management Of Primary Insomnia In Adults?, Alexis Myhre

Theses and Graduate Projects

Objective: Primary insomnia is a mental health condition in which individuals struggle with falling asleep, staying asleep or early morning awakenings. As there are many treatments available that claim to help those with primary insomnia, this review looks specifically at therapy, exercise and acupuncture as management strategies.

Methods: This is a review of 15 peer-reviewed, randomized controlled trials completed in 2018 or later with one additional study completed in 2010. Also, there are four non primary insomnia based studies used to support the efficacy of alternative therapies to cognitive behavioral therapy (CBT). All the studies used in this review come …

This Is A Call To Action For All Primary Care Providers: Do Better For Your Transgender Patients, Kate Castor

Theses and Graduate Projects

Background: Patients of all ages benefit from primary care. However, not everyone has equal access to primary care. Transgender patients often face a multitude of barriers to receiving basic healthcare.

Purpose: Improve health outcomes for transgender patients, enlighten providers on significant disparities, and offer solutions to these disparities faced by transgender community in the healthcare setting and when receiving cancer screening.

Methods: Literature review comprising results from Augsburg University Lindell Library databases, American Journal of Medicine, and Google Scholar.

Conclusions: Everyone can do better for their transgender patients, but primary care providers should take extra care cultivating relationships with these …

A Review Of The Literature On The Utilization Of Stem Cells In Knee Osteoarthritis, Katrina Krist

Theses and Graduate Projects

Background: This literature review evaluates the utilization of various types of stem cells in the treatment of osteoarthritis.

Purpose: To assess the different types of stem cell therapy available in an attempt to determine its effectiveness and viability as a long term therapy option.

Methods: Articles were found by searching Augsburg Library Services, Google Scholar, and PubMed for recent, original studies using both allogeneic or autologous stem cells from a variety of cell lines including bone marrow and adipose tissue.

Conclusions: The utilization of stem cells as a viable treatment option for osteoarthritis shows improvement in pain management and return …

Optimizing Nutrition Status And Patient Outcomes In Adults Receiving Post-Icu Care, Rachelle Pass

Theses and Graduate Projects

Background: Nutrition interventions for hospitalized patients can provide meaningful benefit on patient recovery outcome, length of hospital admission, and overall healthcare costs. Preventing and treating malnutrition is one aspect of optimizing patient outcomes following a prolonged clinical course, including stays in the intensive care unit (ICU).

Purpose: This literature review aims to address how nutrition status can be maximized for a patient’s post intensive care unit clinical course. While early enteral nutrition (EN) when appropriate is accepted as optimal care, there is little standardization for removal of devices to provide artificially administered nutrition and hydration (AANH).

Methods: A comprehensive literature …

The Efficacy Of Cannabis As A Substitute Addiction For Opiates, Clark Furlong

Theses and Graduate Projects

Background: Approaches to opiate addiction focus on abstinence and/or a harm reduction model that often utilizes substitute medications. Methadone and suboxone are the most prescribed drugs for opiate maintenance therapy. The long-term side effect profile and health consequences are undesirable. Research is looking for healthier alternatives.

Purpose: Opiate maintenance therapy participants have a mortality rate greater than twelve times that of the normal population, we seek to discover if cannabis can be a useful/safer alternative.

Methods: Following a comprehensive literature review a 7-question online survey was designed with SurveyMonkey to gauge current Augsburg students’ perception of cannabis as an alternative …

How Has Telehealth Impacted Access To Mental Health Services In The Hispanic Population In Minnesota?, Jesse Ochoa

Theses and Graduate Projects

Background: The Hispanic population in the US continues to grow and mental health services still have barriers lowering access to care.

Purpose: The purpose of this literature review is to look at the stressors and perceptions of mental health in Hispanics and analyze how telehealth has impacted access to care despite the barriers present.

Methods: A comprehensive literature review was conducted using google scholar using the search terms With this search criteria, 600 articles were available. Inclusion criteria were studies that provided a comprehensive view about specific topics like telehealth with the hispanic population, mental health specific to Hispanic needs, …

Education For Nursing And Primary Care Providers On Nonpharmacological Management Of Chronic Pain, Ma Teresita Gonzales De Jesus

Walden Dissertations and Doctoral Studies

Chronic pain is one of the leading causes of disability worldwide, with a significant financial burden on those individuals affected, the communities, the healthcare systems, and the government. Chronic pain also interferes with individuals’ daily activities and alters the quality of life. The treatment for chronic pain includes a variety of medications, including prescription opioids and nonprescription such as NSAIDS, acetaminophen, and muscle relaxants. Pharmacological treatments can result in untoward effects. The CDC has recommended nonpharmacological alternative treatment modalities that promote self-management but are not emphasized or utilized in the primary care setting. The staff education program was framed within …

The Worry Of Food Insecurity And The Manifestation Of Generalized Anxiety In Relation To Perceived Health Status, Ramona Lynnette Taylor

Walden Dissertations and Doctoral Studies

This study examined the association between the worry of food insecurity and the manifestation of generalized anxiety, and how these factors related to perceived health status among adults aged 18 years and older in the U.S. The study controlled demographic factors such as gender, age, race, and education. Utilizing data from the 2019 National Health Interview Survey (NHIS), a binomial logistic regression analysis was employed. The findings indicated a significant association between those persons who often worry about food insecurity, severe (OR = 7.324, p < .001) and frequent generalized anxiety (OR = 5.185, p < .001) suggesting that individuals who worry about food insecurity have higher odds of experiencing severe and frequent (more than 3 times per week) generalized anxiety. Furthermore, both the worry of food insecurity in persons not sure (OR = 0.120, p = 0.004) and generalized anxiety (OR = 0.623 for severe anxiety, p = 0.009) were found to be significantly associated with lower perceived health status. These results suggest a potential association between worry about food insecurity and negative impacts on mental health and perceived overall well-being. Overall, these findings underscore the significant impact of food insecurity on mental health. Further research, including experimental and longitudinal studies, is necessary to elucidate the causal relationship between food insecurity and the manifestation of generalized anxiety in order to impact positive social change.

Association Between High Health Literacy, Doctor's Recommendation, And Prostate Cancer Screening Among Men In The United States, Felicia Njideka Akunna

Walden Dissertations and Doctoral Studies

To efficiently identify and prevent the advancement of prostate cancer and decrease mortality rates, it is crucial to examine the impact of health literacy. Despite potential advantages associated with enhanced health literacy and early detection, the United States continues to witness a significant rise in both new prostate cancer cases and mortality rates, emphasizing the severity of the condition. However, it is unclear if those with high health literacy are discouraged from participating in prostate cancer screening due to the risks associated with screening. Based on the stimulus organism response model, 2016 Behavioral Risk Factor Surveillance System data were analyzed …

Secondary Trauma Amongst Emergency Shelter Volunteers: An Intervention To Identify, Assess, And Respond To Secondary Trauma Exposure, Ashlyn K. Yokom

Master's Projects and Capstones

Purpose: Emergency shelter volunteers are experiencing secondary traumatic stress (STS) symptoms during their deployments. The purpose of this paper is to create an intervention that protects the volunteers from developing STS.

Design: Questionnaires were distributed to current and previous emergency shelter volunteers along with conducting interviews. This design allowed important information to be collected that was used to determine the level of STS symptoms experienced by the volunteers.

Trends: Three STS symptoms were focused upon, intrusion, avoidance, and arousal. It was determined that intrusion symptoms were experienced more frequently than avoidance and arousal symptoms.

Summary: It was determined that emergency …