Medicine and Health Sciences Commons^™

Perceived Effects Of Kinesiotaping On Muscle Performance Of The Elderly Amongst Physical Therapists From Select Provinces Of Central Visayas, Alkiah Belle B. Cielo, Chiara Vivan C. Cudal, Elijah Emil Angelo C. De Leon, Khristine F. Dimagiba

Student Dissertations

Kinesiology Taping (KT) is a therapeutic intervention used to improve muscle performance in older adults. Its effectiveness, however, is subject to varying perceptions influenced by clinical exposure and outcomes. This study explored Filipino physical therapists’ agreement on KT’s physiological and therapeutic effects for the elderly in Central Visayas, aiming to address gaps between research and practice.

Healthcare Barriers And Supports To Healthcare Participation Within The Lgbtqia+ Community: A Systematic Review, Jordan Bradley

Department of Occupational Therapy Entry-Level Capstone Projects

Background: Historically the LGBTQIA+ community has faced many barriers to healthcare participation resulting in significant disparities.

Objective: The purpose of this review is to highlight the barriers and supports that affect the LGBTQIA+ communities’ participation in healthcare and highlight the inclusive practices and policy reforms needed to advance healthcare equity for this population.

Methods: ProQuest Central was utilized, identifying thirty-seven peer reviewed articles for synthesis. Included articles were written within the last 3 years and addressed LGBTQIA+ individuals’ participation in healthcare within the United States.

Results: The most prevalent barrier identified was discrimination appearing in overt and implicit forms. Environmental …

Quality Improvement Project Integrating Telemedicine To Reduce Patient No-Shows, Ferdinand Akoko

Doctor of Nursing Practice Projects

No-show among psychiatric outpatient clinic patients is a major problem due to disrupted clinical flow, reduced productivity, and financial losses. This quality improvement project implemented telehealth services to decrease the no-show rates in an outpatient psychiatric clinic in Texas. This project employed quantitative methods to compare the no-show rates pre- and post-intervention for 90 days. The quantitative data were analyzed by paired t-tests. A total of 1,790 appointments were sampled during the implementation period. The obtained results are statistically significant in decreasing the rates of no-shows for all adult appointments from 18% to 13% (p ≈ 0.0067). New appointment no-shows …

Impacts Of Social Media Use On The Wellbeing Of Older Adults : Evidence From China During The Covid-19 Pandemic, Xuying Dong

Lingnan Theses (Doctoral degree)

Given the trend of increasing use of information and communication technologies among Chinese elder population, more attention should be drawn on the relationship between social media use and wellbeing of older adults. This research explores the social media use situation among older adults in mainland China as well as its influences on their wellbeing, and employs a mixed approach including quantitative questionnaire distributed via WeChat social media platform and qualitative interview among Chinese older adults who are over 60 years of age in Jingzhou, Hubei Province. Generally speaking, social media use can improve the wellbeing of Chinese older adults, more …

A Comparison Between Inverse-Planning Imrt Versus Forward-Planning Imrt For Left-Sided Breast Cancer With Breath Hold Technique, Dien Tran

Masters Projects

Abstract

Introduction:

Radiation therapy using tangential fields is a common treatment for breast cancer, targeting the tumor while reducing radiation exposure to surrounding healthy tissues such as the heart and lungs. Forward-planned "field-in-field" IMRT (FP-IMRT) is widely used for its ability to provide uniform dose distribution and spare normal tissue, despite requiring high planning skill and time. Inverse-planning IMRT (IP-IMRT) offers better conformal dose to targets with reduced planning variability and time. This study compares FP-IMRT and IP-IMRT in left-sided breast cancer patients using the deep inspiration breath hold (DIBH) technique.

Method:

A retrospective analysis was conducted on 10 patients …

Obstetric Education For Critical Care Nurses, Anna Forberg

DNP Projects

Background The purpose of this study was to educate ICU nurses on the care of obstetric women in critical care through the use of a toolkit with intentions to increase knowledge and confidence.

Method The toolkit was created via the platform WordPress™ and topics were chosen based on the most common admission diagnoses found during the literature review. Data were collected via forms manager and voluntary participation among ICU nursing staff was obtained.

Results Mean scores from the pretest to the post-test showed improvement from 7.08 to 8.50 and the minimum and maximum scores increased from pretest to post-test supporting …

Intermittent Fasting As An Adjuvant To Standard Drug Therapy For Drug Resistant Epilepsy, Jake Smiech

Yale School of Medicine Physician Associate Program Theses

Epilepsy affects about 70 million people worldwide, making it the world’s second most common neurological disease. The first line treatment for epilepsy are anti-seizure medications, but only two-thirds of patients respond to the first two medications given. We propose a randomized controlled study utilizing intermittent fasting as a therapeutic lifestyle modification as an adjuvant to standard drug therapy for those that experience drug-resistant epilepsy. We will assess the efficacy and safety of intermittent fasting for a period of six months, and statistically determine if there is a significant reduction in the mean frequency of seizures participants experience compared to a …

Utility Of Serum Uromodulin In Predicting Kidney Injury In Acute Decompensated Heart Failure, Isabel Bautista

Yale School of Medicine Physician Associate Program Theses

Heart failure is widespread and associated with high mortality and healthcare costs. Patients hospitalized with acute decompensated heart failure are at risk for developing kidney injury, a high-risk complication known as cardiorenal syndrome. Elevated uromodulin has reno-protective effects and is associated with a lower risk of kidney dysfunction. Compelling evidence suggests that elevations in uromodulin levels may help improve clinical outcomes among other kidney disease populations yet, it has not been explored in patients with heart failure. This study aims to investigate the relationship between baseline serum uromodulin levels and risk of incident acute kidney injury among acute decompensated heart …

Cardiovascular Versus Resistance Training In Lgbtq+ Adolescents With Overweight Or Obesity, Cordelia Cluett

Yale School of Medicine Physician Associate Program Theses

Obesity prevalence in the U.S. is predicted to reach 50% by 2030, accompanied by negative health consequences. At-risk populations, including LGBTQ+ youth, are disproportionately afflicted by obesity. Exercise is known to help improve obesity and reduce associated comorbidities; however, the research community lacks consensus on the best type of exercise for reducing obesity parameters. We seek to determine whether aerobic training or resistance training results in a greater reduction of adiposity within an adolescent LGBTQ+ population. Our randomized control trial will compare mean change in waist circumference and body fat percentage after a yearlong resistance training intervention compared to an …

Transesophageal Echocardiography During Prehospital Cardiopulmonary Resuscitation, Carlie Dominguez

Yale School of Medicine Physician Associate Program Theses

Cardiac arrest is a sudden, life-threatening emergency that demands rapid and effective intervention. Ultrasound is used during cardiac arrest to guide resuscitation, characterize cardiac rhythm, and possibly identify cardiac arrest etiology. However, it is associated with significant limitations. Transesophageal echocardiography is a type of ultrasound that overcomes the limitations associated with traditional ultrasound and provides unique advantages, including the ability to optimize chest compressions and provide continuous cardiac imaging throughout CPR. The aim of this study is to investigate whether the use of transesophageal echocardiography during prehospital resuscitation of adults experiencing nontraumatic out-of-hospital cardiac arrest improves the proportion of sustained …

A Retrospective Quantitative Comparison Of Auto-Planning Vs. Manual-Planning For Large Breast Patients, Olivia R. Smiley

Masters Projects

Breast cancer is the most prevalent cancer among women in the United States, with many patients undergoing whole breast irradiation (WBI) following lumpectomy. Dosimetrists face challenges in planning WBI for patients with large breasts due to issues related to hotspots, dose uniformity, and extended planning times. Auto-planning tools like EZFluence, which use artificial intelligence, offer potential improvements in planning efficiency and dose distribution. This retrospective quantitative study compares auto-planning using EZFluence with manual planning for 10 large breast patients, aiming to reduce hotspots, achieve a more homogeneous dose, minimize doses to organs at risk (OARs), reduce monitor units (MUs), and …

Sociocultural Effects On Suicidal Ideation Among South Asian Immigrants, Rezwana Ahmed Choudhury

Walden Dissertations and Doctoral Studies

With the growing South Asian immigrant population in the West, it is necessary to conduct suicide-related studies among this population to understand the reasons behind suicidal ideation faced by this population. This quantitative cross-sectional survey design study aimed to examine sociocultural factors that may be associated to the risk level of suicidal ideation among South Asian immigrants in the United States. A survey questionnaire was developed using a combination of demographic questions and existing instruments: the Suicide Ideation Attributes Scale, Religious Belief Salience Scale, Suinn-Lew Asian Self-Identity Acculturation Scale, and Rapid Eating Assessment for Participants—S. Data were collected from a …

A Shield-Bearer’S Tale: Elucidating The Roles Of Estradiol And Choline In Mitigating Chemotherapy-Related Cognitive Impairment, Robert W. Botelho Jr.

USF Tampa Graduate Theses and Dissertations

Chemotherapy-Related Cognitive Impairments (CRCIs) are significant consequences of chemotherapy that affect a substantial portion of breast cancer survivors, potentially persisting long after treatment cessation. This series of studies investigated the neuroprotective roles of estradiol and choline against CRCIs induced by cyclophosphamide and doxorubicin (CYP/DOX), commonly known as Adriamycin/Cytoxan (AC) chemotherapy. Utilizing the MMTV-PyVT mouse model of breast cancer, this body of work spans several experimental studies, the first of which evaluates the impact of dietary choline supplementation on spatial memory and cholinergic function in tumor-bearing mice undergoing chemotherapy. The subsequent study tests whether impaired ovarian function and resulting reductions in …

Bayesian Beta-Binomial Mixed Models For Longitudinal, Clustered, And Spatiotemporal Data, Chun-Che Wen

MUSC Theses and Dissertations

Overdispersed binomial data arise in many clinical and public health research studies. Examples include timeline followback data (TLFB), which are used in addiction research to monitor recent substance use. This dissertation proposes novel beta-binomial (BB) mixed models to address the challenges associated with overdispersed binomial data, including zero-inflation, heterogenous effects, and spatiotemporal correlation. Motivated by a 12-week randomized controlled trial evaluating the efficacy of varenicline tartrate for smoking cessation among adolescents, Aim 1 develops a Bayesian zero-inflated beta-binomial (ZIBB) model to analyze longitudinal and bounded TLFB data — namely, the number of abstinent days in the past week. Because treatment …

Improving Patient Awareness And Compliance With Telephone Follow-Up Calls Post Visit, Ajibola Kutti

Student Scholarly Projects

Practice Problem: In a high-volume clinic without current follow up practices post visit, a telephone follow-up (TFU) intervention was implemented within three days of patient outpatient appointments.

PICOT: The PICOT question that guided this project was: In adult patients in a high-volume clinic (P), does the implementation of telephone follow-up calls by nurses (I) compared to current practices (C) improve patient compliance and post-office follow-up visits (O) over 10-weeks (T)?

Evidence: The literature provided recommendations and evidence that supported the effectiveness of following up with patients within three days of leaving the healthcare clinic. TFU’s are a cost-effective intervention that …

Nurse Leaders Promoting Well-Being Through Mindfulness, Laura G. Cockrell

Walden Dissertations and Doctoral Studies

Becoming a nurse is not just a career but a calling. With this calling comes an ethical duty to the patient, but the duty remains to provide care for oneself. During the COVID-19 pandemic, a strained nursing profession felt the effects of a self-care deficiency. Mindfulness is one self-care tool that can allow nurses to maintain a state of well-being. This project followed Orem’s self-care deficit theory, in which people can use self-care to maintain wellness. The purpose of this project was to develop, deliver, and evaluate an education program for registered nurse leaders on mindfulness activities to address whether …

Barriers To Implementation Of Practice Guidelines In Heart Failure, Mary Geisenhof

DNP Projects

In 2022, the most recent guidelines for care of the patient with heart failure (HF) were released by the American Heart Association (AHA), the American College of Cardiology (ACC), and the Heart Failure Society of America (HFSA). In summary, this group did not recommend fluid restriction for patients with heart failure, unless they are in the end stages of heart failure, and only if fluid restriction may be beneficial (Heidenreich et al., 2022). Despite this recommendation, some providers and nurses continue to restrict fluids. The aim of this DNP project, therefore, was to analyze barriers to implementation of best practices …

Student Nurse Experiences Of Retention Strategies And The Perceived Contribution To Academic Progress, Jessica Dugas

Walden Dissertations and Doctoral Studies

There is a worldwide nursing shortage that has been heightened by the COVID-19 pandemic. Several factors have contributed to the worsening shortage, including high attrition rates in nursing programs. Retention strategies have been suggested to support nursing students during their education to have success and graduate. The purpose of this descriptive qualitative study was to explore how nursing students experience retention strategies and their perceived contributions to academic progress. Bandura’s social cognitive theory was the theoretical framework used to guide the study. Data were collected from one-on-one interviews with 12 nursing students recruited using purposeful and snowball sampling. Data were …

Using Home Telehealth To Reduce Hospital Readmission Rates In Heart Failure Patients In The Emergency Room, Margaret Ashby

Student Scholarly Projects

Practice Problem: In one hospital, the readmission rates and emergency room visit for patients who are diagnosed with heart failure (HF) was increasing.

PICOT: Among veterans who are hospitalized for HF (P) does the enrollment into a care coordination program for these veterans (I) compared to current practices (C), reduce the hospital readmission rates and emergency department visits (O) within 10-weeks (T)?

Evidence: The literature supports the idea that home telehealth as a home monitoring program for patients who have chronic diseases such as heart failure (HF) and has had success in patients with hypertension amongst patients. Transition strategies from …

Psychological Impact Of Ebola Disease On Survivors: A West Africa Study, Babatunde Moses Irinoye

Walden Dissertations and Doctoral Studies

Survivors of Ebola virus disease often experience social isolation. Understanding the psychological impact of Ebola virus disease on these survivors was the focus of this study. The study encompasses assessment of experiences in re-integration back into communities, and psychological implications (post-recovery), among Ebola infection survivors (EIS) in Republic of Liberia. The purpose of the study was to explore the psychological impact of Ebola as the EIS continue their re-integration journey in their communities in Liberia. The conceptual framework for this study was based on principles of system theory, based on interrelatedness of the biopsychological experience of the EIS, and the …

Quality Improvement Project: Incivility In Nursing Education: Utilizing An Educational Module And Professionalism Guide To Address Incivility In A Nursing Students, Jennifer Schadler

Doctor of Nursing Practice Projects

Incivility is a well-documented issue in the nursing profession that begins in nursing education and follows graduates into nursing practice. Nursing academia has a responsibility to address incivility to prevent inappropriate behaviors from becoming embedded into the culture. The problem addressed in this quality improvement project is incivility among nursing students at a private college. The purpose of this project was to apply evidence-based incivility interventions to address uncivil behaviors of nursing students. The hypothesis was that the implementation of a civility mentor module and professionalism guide would impact perceived incivility among nursing students. The project was conducted using the …

Reducing Rates Of Blood Culture Contamination In The Emergency Room, Erika Goldberg

Student Scholarly Projects

Practice Problem: In one emergency room (ER) blood cultures (BC) drawn by nurses had a high contamination rate due to lack of collection standards, which lead to poor patient outcomes.

PICOT: The PICOT question that guided this project was; In adult emergency room patients where blood cultures are drawn (P), how does implementation of an evidence-based practice method (I), compared to the standard method of obtaining blood cultures (C), affect blood culture contamination rates (O), within ten weeks. (T)?

Evidence: Based on multiple sources within the literature; best evidence for lowering blood culture contamination rates (BCC) is done using EBP …

The Impact Of Hourly Safety Rounding On Pediatric Fall Rates, Natalie Doskal-Poe

Dissertations

The Impact of Hourly Safety Rounding on Pediatric Fall Rates

Abstract

Problem: Falls are a common adverse event in the inpatient pediatric setting and are a significant risk to patient safety. Environmental factors, such as unclear pathways, bed rails down, beds in high position, and call lights out of reach, are considered avoidable causes of patient falls. The site’s fall data in a 12-month period from January 2023 to January 2024 showed (n=9) patient falls occurred with (n=5, 55.6%) due to environmental factors. The purpose of this Quality Improvement (QI) pilot project was to assess the …

Self-Harm In Female Youth With Undiagnosed Adhd: Implementing American Academy Of Pediatrics Screening Guidelines, Roselie M. Woodard

Dissertations

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. If undiagnosed or untreated, ADHD can lead to severe psychosocial issues such as academic failure, substance abuse, unplanned pregnancy, and incarceration. The financial burden in the U.S. from diagnostic errors creates an immense, rising fiscal impact. Early diagnosis and management are crucial to prevent these complications.

Females with ADHD, particularly those with the inattentive subtype, often face diagnostic challenges due to symptom masking and over-compensation. This results in poorer cognitive functioning and self-esteem compared to males with ADHD. ADHD is linked to autonomic nervous …

Relationship Between Geographic Location, Race, And Socioeconomic Status On Adolescent Male Hpv Vaccination In The United States, Stacy Herb

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) represents the most prevalent sexually transmitted infection in the United States. Despite readily available safe and effective vaccines and established knowledge of influencing factors, HPV vaccination rates in the United States remain suboptimal, particularly among adolescent males. This quantitative study addressed this gap by investigating the association between geographic location, race, and socioeconomic status with HPV vaccination uptake in adolescent males. A secondary data analysis was conducted using the 2022 National Immunization Survey (NIS)—Teen, comprised of 22,667 adolescent males. The fundamental cause theory served as the theoretical framework, guiding the exploration of why a safe and effective …

Occupational Therapy's Role In Maternal, Infant, And Family Wellness: Policy, Procedure, And Program Development, Emilee Armstrong

Department of Occupational Therapy Entry-Level Capstone Projects

This capstone project aimed to advocate for maternal, infant, and family wellness through occupational therapy services. The focus areas of my capstone project included administration, advocacy, policy and program development. I developed two post-cesarean delivery policies for maternal rehabilitation and father-infant bonding, a Kangaroo Father Care program, and an occupational therapy position proposal. The Kangaroo Father Care program included healthcare professional educational modules, an administration checklist, and facility and patient flyers. My project aimed to develop the foundation for implementing acute maternal rehabilitative services for a regional hospital in Northeast Indiana. The knowledge and skills I gained throughout my capstone …

Relationship Between Sports Participation, Weight Intentions, And Insufficient Sleep On E-Cigarette Use Among U.S. High School Students, Stephanie Deivert

Walden Dissertations and Doctoral Studies

Despite public health efforts, e-cigarette use among youths persists, posing risks due to high nicotine content and the potential for transitioning to traditional cigarette smoking. Although sports participation has shielded individuals from traditional cigarette use, recent studies revealed a higher susceptibility to e-cigarette use among young athletes, though influencing factors were unexplored. Using the socioecological model, this retrospective cross-sectional study examined the relationship between sports participation, weight intentions, insufficient sleep, and e-cigarette use among U.S. high school students by analyzing 2021 National Youth Risk Behavior Survey data. Binary logistic regression assessed associations between variables. An interaction term examined the moderating …

Optimizing Adherence To Antiretroviral Therapy Among Adolescents Living With Hiv In Low And Middle-Income Settings, Samuel Kizito

Brown School Graduate Student Theses and Dissertations

Globally, 1.8 million adolescents are living with HIV (ALHIV), of whom 89% (1.5 million) are in Sub-Saharan Africa (SSA) (UNAIDS, 2021b). Unfortunately, despite advances in prevention—such as the prevention of mother to child transmission (PMTCT) and pre-exposure prophylaxis—new infections continue to occur. For example, in 2021 alone, the number of new HIV infections among adolescents aged 10 to 19 was 160,000 cases. Moreover, the rate of HIV-related deaths among adolescents has only declined by 10% in the last decade, which is not fast enough to meet the 2030 global targets. Despite antiretroviral therapy (ART) playing a crucial role in controlling …

Long G4-Rich Enhancers Physically Interacts With Promoters Via A G4:G4 Dna-Based Mechanism, Jeffrey David Demeis

Graduate Theses and Dissertations (2019 - present)

Enhancers are genomic sequences that function as regulatory elements capable of increasing the transcription of a given gene often located at a considerable distance. The broadly accepted model of enhancer activation involves bringing an enhancer-bound activator protein complex into close spatial proximity to its target promoter through chromatin looping. Equally relevant to the work described herein, roles for guanine (G) rich sequences in transcriptional regulation are now widely accepted. Non-coding G-rich sequences are commonly found in gene promoters and enhancers, and various studies have described specific instances where G-rich sequences regulate gene expression via their capacity to form G-quadruplex (G4) …

Caregiver Attitudes Toward Sexual Behavior And Sex Education For Children With Down Syndrome, Shawna Urban

Walden Dissertations and Doctoral Studies

This quantitative correlational study investigates caregivers’ attitudes toward sexual behavior and sex education for children with Down syndrome, drawing upon the theories of reasoned action and planned behavior. Data was collected from a convenience sample of 112 caregivers. The analysis revealed significant positive associations between caregivers’ attitudes toward sexuality and their perspectives on sex education. Binary logistic regression indicated that higher POS scores predict increased likelihood of endorsing sexual behavior and supporting sex education for children with Down syndrome. Notably, demographic factors such as gender, age, and educational level did not significantly influence caregivers’ decisions regarding sex education support. The …