Medicine and Health Sciences Commons^™

Agnotology Of The E-Cigarette Industry: How The E-Cigarette Industry Continues The Tobacco Industry's Legacy Of Creating Controversy And Confusion Within The Scientific Community And The General Population, Calvin Lewis

University Honors Theses

The purpose of this paper is to determine the extent to which the e-cigarette industry follows in the footsteps of the tobacco industry's attempts to disrupt science and cause controversy. Four tactics are described that the tobacco industry uses to disrupt science: funding research that is designed to show results that support their position, criticizing and suppressing research that goes against their position, changing risk assessment and scientific research standards to fit their aims, and spreading data created by their interest groups to politicians and the nonacademic press. Evidence is found to show that both the tobacco industry and e-cigarette …

Occupational Therapy’S Role In The Success And Positive Outcomes Of Youth Within The Foster System, Cassidy Solomon

Student Capstone Papers

This capstone paper will discuss the development of an occupational therapy program to support the needs of youth within the foster system and prepare this population to live independently. Background information including statistics, the need for occupational therapy, and the program specifics such as rationale, significance, and objective are discussed. The development of an occupational therapy program to aid in the success of children within the foster care system helps close a gap in research that will contribute to this population's success and positive outcomes. The purpose of this capstone was to develop a program for children in the foster …

Educating Nursing Staff On Urinary Tract Infections, Eldarada Rosamay Searcy

Walden Dissertations and Doctoral Studies

The primary objective of this doctor of nursing practice (DNP) project was to educate staff on urinary tract infection (UTI) prevention. A gap in practice was identified among nursing staff at an assisted-living facility who lacked current, evidence-based knowledge. This project was conducted to determine whether educating staff on UTI prevention increased their knowledge. Knowles’s adult learning theory and the analysis, design, development, implementation, and evaluation model were used as the theoretical framework that guided this project. Eighty-eight healthcare workers at the project site voluntarily participated in this project. Before the education session, a 10-question, multiple-choice pretest was administered to …

Five A Day, The Rainbow Way: A Nutrition Education Toolkit For Elementary School Aged Children, Sasha Menard

Department of Nutrition Student Projects

Learning Outcome: Develop a nutrition educational toolkit based on Social Cognitive Theory (SCT) for obesity prevention among elementary school-aged children by improving determinants of fruit and vegetable intake.

Background: Poor consumption of fruits and vegetables is a major contributing factor to childhood obesity, increasing the risk for chronic diseases later in life. There is a need for multicomponent nutrition educational tools to influence children to improve their eating behavior by increasing their awareness and self-efficacy. The current project describes the development of a 3-component toolkit for improving participants’ knowledge and values related to fruit and vegetable intake among 6-11-year-olds.

Methods: …

Clinical Trial Research Nurse New Employee Onboarding 30- 60 -90 Day Checklist, Arin Alesia Urban

Master's Projects and Capstones

Problem: The clinical trials research management team was plagued with high nurse turnover and poor clinical documentation due to a lack of seasoned clinical research nurses.

Context: A regional clinical trials team serving 22 hospitals within a Northern California not-for-profit health system.

Interventions: Mixed methods were used to inform the development of new employee onboarding for novice clinical trial nurses utilizing a structured 30-60-90-day checklist, improved communication channels, and continuous mentor support.

Measures: Monthly quality queries and quarterly staff turnover rates were tracked. Employee feedback was collected to assess the interventions' impact.

Results: The number of quality queries was reduced …

Implementing Maternal Fetal Triage Index (Mfti) In A High-Risk Obstetrical Setting, Erica Bordenkircher Luna

Master's Projects and Capstones

Problem: The Maternal Fetal Triage Index (MFTI) for obstetric triage provides a systematic method for assessing and assigning acuity. Data evaluated for February 2024 and March 2024 identified the need for improved response times for triage Priority Two, which averaged 28.75 minutes (goal 15 minutes) for a provider to present to the bedside. The average percentage of patients with documented MFTI scores was 70.65% ( goal >80%).

Context: A high-risk 24-bed obstetrical department in an acute care hospital in Northern California that triages over 600 patients monthly with over 400 deliveries in the same period.

Interventions: Real-time observations and staff …

Process Improvement To Reduce The Incidence Of Delirium In An Overflow Unit, Raquel G. Chong

Master's Projects and Capstones

Abstract

Problem: This quality improvement project aims to reduce the incidence of hospital-acquired delirium in an overflow unit, which serves a diverse patient population from medical-surgical and telemetry microsystems. The unit averages 96 delirium episodes annually, costing approximately $3,456,000. The goal is to reduce delirium incidence by 25%, decreasing monthly cases from 8 to 6 by October 31, 2024, and annual cases to 72 by April 2026.

Context: Delirium is a prevalent and severe neuropsychiatric syndrome that significantly affects older hospitalized patients, characterized by acute disturbances in attention, awareness, and cognition.

Interventions: The project introduced a bundle of four interventions …

Improving The Diagnosis And Treatment Of Obstetric Sepsis, Edwije Joseph

Master's Projects and Capstones

Problem: Maternal mortality affects women during four phases of obstetrics, including triage, antepartum, labor & delivery, and postpartum. In the U.S., sepsis is the third leading cause of maternal death. Inconsistent screening practices and delays in recognizing symptoms can occur in any phase. These factors were identified as root causes in a northern California community hospital with 600 monthly deliveries.

Context: Two maternal sepsis cases cost $90,000 annually. A standardized pathway was initiated nationally in October 2023 through the California Maternal Quality Care Collaborative (CMQCC). One regional hospital system initiated a quality improvement project over 5 months within a community …

Decreasing Incivility Through Improved Communication And Teamwork, Marvin Ernest Tamayo

Master's Projects and Capstones

Problem: Workplace incivility (WI), lateral violence (LV), and bullying in healthcare settings are pervasive issues negatively impacting staff morale, turnover rates, and patient care outcomes. High turnover and low employee satisfaction scores from a September 2023 culture of safety survey signaled a toxic work environment characterized by ineffective communication and unprofessional behavior. Context: A 24-bed telemetry-stroke unit at a 172-bed acute care facility in the North Bay area of San Francisco.

Interventions: The Transtheoretical Model (TTM) of behavior change and the Crucial Conversation frameworks were used to improve staff communication and reduce incivility.

Measures: September 2023 and March …

Preventing Hospitalization-Associated Disability, Elizabeth M. White

Master's Projects and Capstones

Problem: Hospital-associated disability (HAD) affects one-third of hospitalized adults, diminishing post-discharge independence and contributing to high mortality rates. Identifying at-risk patients through early assessment of nutritional and functional status upon admission is critical to personalizing care and improving discharge outcomes.

Context: A 24-bed adult medical-surgical unit in a 173-bed suburban hospital in Northern California is part of a large not-for-profit healthcare organization. Interventions: Nursing staff received education on the Enhanced Recovery Medicine (ERM) pathway designed to prevent HAD. A visual display board, maintained and updated by unit champions, gave staff performance feedback. Nursing leadership reviewed admission assessments and addressed barriers …

Improving Stroke Education Scores At A Primary Stroke Center, Jesse J. Young

Master's Projects and Capstones

Abstract

Problem: The COVID-19 pandemic precipitated a significant departure from the nursing profession, leaving healthcare organizations grappling with critical staffing shortages and compromising patient care standards. In 2023, an advanced Primary Stroke Center in a Northern California hospital’s STK-8 scores fluctuated between 80-100%, with an average annual score of 92.8%, putting the facility's primary stroke certification and long-term patient outcomes at risk.

Context: A 24-bed acute stroke and telemetry unit in a Northern California hospital and designated primary stroke center.

Interventions: The following measures were implemented to improve the quality of stroke care and enhance STK-8 compliance, including …

Antibody Therapies For Alzheimer's Disease, Alexandra Zerr

University Honors Theses

Alzheimer's Disease (AD) is the leading cause of dementia worldwide. Patients with this condition first experience mild cognitive impairment, followed by the loss of memory, cognitive skills, identity, and the ability to perform daily tasks unassisted, eventually culminating in death.

The dominant hypothesis for the mechanism of Alzheimer's, the amyloid cascade hypothesis, based on early-onset AD, suggests that amyloid plaques formed by Aβ peptides cause a cascading effect involving an increase in toxic tau protein, which is correlated with the disease progression of Alzheimer's patients. While the mechanism of late sporadic AD is not fully understood, this has been used …

A Comparison Of Whole Brain Radiation Treatment Plan Quality Between Radformation Ezfluence Software And Manual Field-In-Field Technique, Julia Legno

Masters Projects

Purpose: To assess time-saving and overall dosimetric differences between EZFluence automated planning software and manual planning methods.

Methods: Ten previously treated whole-brain patients’ data sets were anonymized and used retrospectively by the planner to assess differences in treatment planning methods. A manual and an EZFluence plan was created for each patient. The planner then analyzed the dosimetric qualities of the plan, which included target conformality, OAR doses, and total time spent creating the plans.

Results: Upon comparing the data from both plan types, the EZFluence automated plans had a significantly shorter treatment planning time than the manual plans with an …

Exploring Lived Experiences Of Mothers Raising Children With Down Syndrome In Western Nigeria, Vivian N. Aruwajoye

Walden Dissertations and Doctoral Studies

Having a child with Down syndrome (DS) negatively impacts mothers’ health and well-being. Families raising a child or children with DS encounter significant financial burdens, inadequate support services, and cultural influences, which have adverse effects on the families. The purpose of this phenomenological qualitative study was to understand the accessibility and utilization of support services through the lived experiences of Western Nigerian mothers raising children with DS. The study involved 10 mothers who were recruited using a purposive sampling technique. Data were collected through semi-structured interviews via Zoom and observational notes. Thematic analysis was guided by Bronfenbrenner's ecological model. NVivo …

Health For All: Evaluating The Impact Of Equity-Centered Approaches On U.S. Healthcare Delivery, A Review Of Literature, Angela Leung

Master's Projects and Capstones

This literature review examines the impact of equity-centered approaches on issues affecting U.S. healthcare delivery—multiple databases to identify relevant literature that discussed equity-centered care, associated health disparities, and implementation strategies. Of the 490 search results, ten articles remained after refining the search results to include papers published between 2014-2024 and fit the specific inclusion and exclusion criteria. The key findings highlight the benefits of equity-centered approaches in improving the quality and accessibility issues affecting the U.S. healthcare system. Presently, the status of equity work is siloed between healthcare systems in the U.S., creating an unprecedented roadblock. Nonetheless, the findings suggest …

Developing Project Management Success Criteria For Public Health Response Programs, Priyanka Dutta

Harrisburg University Dissertations and Theses

This study addresses an existing gap in the project management literature in regards to the limited research on its application in public health settings. Specifically, this study intends to identify and develop success criteria to help measure the performance of project management methodologies used for public health response programs. Using a qualitative research design in the form of a case study review, the study will consolidate findings and propose a success criteria by which project management methodologies for public health programs can be evaluated. The criteria will contribute to future research and the development of a standardized measure that will …

Evaluating The Effectiveness Of Hiv/Aids Interventions In Lesotho, Maya Gomez Velardez

Master's Projects and Capstones

Lesotho faces a severe HIV/AIDS epidemic, with one of the highest prevalence rates globally, impacting its public health, economy, and society. Despite numerous efforts, the country continues to struggle with persistently high infection rates, highlighting the need to thoroughly evaluate current interventions. This review examines the effectiveness of various HIV/AIDS interventions in Lesotho, focusing on multi-level strategies within the Social Ecological Model. The paper synthesizes literature from 2013 to 2023, concentrating on antiretroviral therapy (ART) coverage, community initiatives, and efforts targeting high-risk groups. Key strategies involve expanding ART coverage, strengthening community-based healthcare through community health workers (CHWs), and enhancing initiatives …

Effects Of Misinformation And Disinformation On Vaccine Hesitancy And Routine Vaccine Uptake, Cindy Chen

Master's Projects and Capstones

This literature review was conducted to identify the role misinformation and disinformation plays on the rates of vaccine hesitancy and vaccine uptake for routine immunization among the child and adult populations of the United States. Fifteen articles between 2018-2024 were extracted from PubMed and Google Scholar databases. As shelter-in-place and social distancing protocol wanes, the risk of common vaccine preventable diseases (VPDs) reemerges, especially in populations that have not kept up with routine immunization schedules. Current efforts to restore mass vaccination campaigns are underway, but do not provide the necessary modifications to include social, behavioral, and cultural factors that influence …

Maximizing Legged Accelerations: A Matter Of Force, Time, And Gravity, Lance Brooks

Applied Physiology and Wellness Theses and Dissertations

Sprint running accelerations require runners to apply surface forces that: support body weight by pushing downward, accelerate the body horizontally by pushing backward, and align the direction of the push with the body’s mass center to maintain balance and posture, which imposes an upper limit on the average forward acceleration force equal to the average gravitational force (1.0 G) acting on the runner. This expectation arises from the mechanical constraints imposed by the need to generate sufficient vertical force to support body weight against gravity while simultaneously producing horizontal force to accelerate forward and aligning the push through the center …

Multidisciplinary Sensory Recommendations For Functional Neurological Symptom Disorder, Rachael Rice

Department of Occupational Therapy Entry-Level Capstone Projects

The purpose of this capstone experience was to serve the patients and therapists of the Tampa General Hospital Outpatient Rehabilitation at Westshore. Due to the increasing number of referrals to the clinic for Functional Neurological Symptom Disorder (FNSD), there was a need for education and recommendations for the multidisciplinary team, specifically related to sensory related interventions. There was a need for informational resources for patient education, collaboration between the interdisciplinary team to encourage carryover, and sensory recommendations. FNSD patients may experience a variety of symptoms best treated through a multidisciplinary approach that addresses physical and psychological aspects. Aside from clinical …

The Efficacy Of Common Prosthetic Joint Infection Prevention Strategies: A Systematic Review, Cameron Jennings

Theses and Graduate Projects

Thousands of total hip and knee arthroplasty patients suffer from prosthetic joint infections every year, making them a leading cause of arthroplasty failure. As the number of these procedures continues to grow, so will the healthcare and socio-economic burden of prosthetic joint infections. A comprehensive search for up-to-date literature was completed via the PubMed database, identifying eighteen retrospective and prospective cohort studies that focused on the four prosthetic joint infection prevention methods of interest. Tobacco use cessation of all forms is an efficacious prosthetic joint infection prevention strategy. The common practices of withholding intra-articular injections prior to surgery, using prophylactic …

Retrospective Dosimetric Comparison Of Radiation Therapy Treatment Using Hybrid-Vmat Technique For Esophageal Cancer, Colleen Cozzie

Masters Projects

Abstract

Introduction

Esophageal cancer is the fifth most common gastrointestinal cancer in the United States. As oncology treatment includes radiation as a standard of care, it is vital to examine effective treatment delivery options. Understanding the dosimetric differences between VMAT and hybrid-VMAT can help providers choose the most appropriate care plan for patients undergoing esophageal irradiation. The purpose of this study was to evaluate if VMAT or hybrid-VMAT delivery would be the superior planning method for patients with planning target volumes greater than ten centimeters. Adequately covering the tumor volume while sparing dose to adjacent critical structures is the goal …

Integration Of Machine Learning And Quantum Mechanical Calculations For De Novo Drug Design, Ayesh Madushanka Mahamada Kalapuwage

Chemistry Theses and Dissertations

The drug designing process is an intricate and resource-intensive endeavor, spanning approximately 12 years to transform a lead compound into a functional drug. Computer-aided drug design (CADD) plays a fundamental role in this process, mitigating the risk of failures in the later stage and saving valuable time and money. In the last decade, Artificial intelligence (AI) has provided remarkable alternatives for practical challenges, including drug design. Simultaneously, advanced QM calculations have achieved near-experimental accuracy in simulating drug-target interactions. However, introducing QM and AI-based techniques into drug discovery presents considerable challenges. AI techniques require high- quality data and often struggle with …

Comparative Plan Analysis: Helical Tomotherapy Vs. Linac Vmat For Lower Extremity Sarcomas, Marie E. Dibona

Masters Projects

Abstract

Introduction

Soft tissue sarcomas (STS) affect about 13,500 people annually in the United States, and those in the lower extremities present unique challenges in radiation therapy due to the wide variability in tumor sizes, sometimes exceeding 30cm. Traditional treatment involves C-Arm linear accelerators using Volumetric Modulated Radiation Therapy (VMAT), which provides precise targeting while sparing nearby organs. Helical Tomotherapy (HT) is another option, delivering radiation in a helical pattern with a binary MLC for a uniform dose distribution. However, no studies have compared VMAT and HT for lower extremity sarcomas of different sizes. This study aims to compare these …

Can Simultaneous Integrated Boost Provide Better Dosimetric Coverage Compared To Sequential Boost In Prone Breast Treatment Of Large Breast Volumes?, Kinze Kraft

Masters Projects

Introduction: This study investigates the dosimetric differences between sequential boost (SeB) and simultaneous integrated boost (SIB) techniques in prone breast radiotherapy for patients with large breast volumes, utilizing a 3D-CRT planning technique. Prone positioning in radiotherapy has shown to be effective in reducing heart and lung doses, yet limited research exists to compare overall plan quality between SeB and SIB using this technique. This analysis aims to evaluate whether SIB provides better dosimetric coverage and reduced dose to organs at risk (OARs) compared to SeB in prone breast radiotherapy.

Methods: A retrospective analysis was conducted on data from ten patients …

Decreasing Incivility And Bullying Through The Development Of A Healthy, Respectful Work Culture, Bridgette Wilson

Master's Projects and Capstones

Abstract

Problem: Incidents of bullying and incivility, including verbal aggression and exclusionary practices within the Telemetry department.

Context: This quality improvement project addresses workplace incivility, bullying, and harassment. The project aims to develop and implement a Compact Agreement of Unit Norms to foster a healthier work environment.

Interventions: Interventions included leadership education on bullying and conflict resolution, team awareness was heightened through workshops defining bullying and incivility, and a collaborative Compact Agreement of Unit Norms was developed and implemented.

Measures: An analysis of reported incidents for the first quarter of 2024 through the Electronic Reposting System (ERRF) on the Telemetry …

National Institutes Of Health: Clinical Research & Clinical Practice Skills In Occupational Therapy, Arianna Z. Cook

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Understanding Athletes’ Experience When Transitioning To Life Beyond Sport: A Pilot Study, Alyssa L. Moore

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

It’S More Than Skin Deep: Evaluating Mental Health Care In Dermatology Settings, Emma Kraft

Theses and Graduate Projects

Background: There is a high prevalence of mental health comorbidities in those with dermatologic conditions given the visible nature of many conditions. However, mental health often fails to be addressed due to lack of mental health education, stigma around mental health, and lack of mental health resources for patients. Purpose: This research study aims to assess how patients and providers experience and address mental health in dermatology settings. Methods: A systematic literature review was performed analyzing the relationship between dermatologic conditions and mental health. Additionally, a survey was conducted to assess how dermatology providers approach mental health in dermatology settings. …

Educating Nursing Faculty In Mindfulness Practices To Reduce Students’ Anxiety Pre-Simulation, Virginia Gonzalez

Doctor of Nursing Practice Projects

This DNP project examines how mindfulness training for associate degree nursing faculty can enhance educator self-efficacy in implementing teaching methods that reduce anxiety among nursing students before simulation exercises. The primary issue identified is the lack of faculty training in pre-simulation facilitation practices, which is crucial for ensuring students are adequately prepared. Using a pre-test/post-test design, this initiative evaluated changes in educator mindfulness self-efficacy among 14 faculty members. Results indicated a significant improvement in self-efficacy scores. The pre-test mean score was 3.36, which rose to a post-test mean score of 4.60. These project results demonstrate that mindfulness training effectively enhanced …