Medicine and Health Sciences Commons^™

Healthy Living For Older Adult And Aapi Populations With Chronic Conditions, Cierilyn Legaspi

Occupational Therapy Student Capstones

No abstract provided.

An Examination Of Self-Identity In Relation To Smoking And Vaping In South Carolina, Jaron Hoani King

Theses and Dissertations

BACKGROUND

This dissertation examines self-identity in the context of smoking and vaping among adults in South Carolina (SC) using data from the 2023 SC Adult Tobacco Survey (n=1370). The conceptual model created to guide this dissertation is called the “Smoker and Vaper Behavior-Identity Model” and draws constructs from theoretical frameworks in health behavior and social identity theories. Behavior was defined as lifetime and past 30 day cigarette or e-cigarette use. Self-identity was defined by asking respondents with a history of cigarette or e-cigarette use “Do you consider yourself a smoker/vaper”, respectively.

METHODS

First, this study assesses the prevalence of mismatching …

Examining Risk Factors For Early-Onset Breast Cancer, Jennifer Grace Taylor

Theses and Dissertations

Introduction: There have been great advancements in screening and in the identifying of risk factors associated with breast cancer, however, there is a lack of information of these factors in women with breast cancer occurring under the age of 45, known as early-onset breast cancer (EOBC). EOBC is often found at later stages, negatively impacting young women’s careers, family planning, and mental health. Additionally, because of the health disparities that exist within the U.S. health care system, women belonging to racial and ethnic groups, specifically young Black women, tend to have poorer outcomes and higher mortality rates of EOBC …

Lexical Access In Women With The Fmr1 Premutation, Nadia Sabeh Ayon

Theses and Dissertations

Background: Emergent research indicates that women carrying the FMR1 premutation (FXpm) may encounter difficulties in language skills, including increased dysfluencies, a reduction in the quantity and diversity of words produced, and increased word retrieval errors with age (Sterling et al., 2013; Bredin-Oja et al., 2021). Objectives: The present study aims to assess semantic and phonological lexical access skills in FXpm women as well as to examine the impact of cognitive load (time pressure) on lexical access.

Methods: Forty-two FXpm women and 25 control women, aged 26-65 years (M=46.22, age-matched: p=.115), participated. The Network Production Task (Oomen & Postma, 2001), featuring …

Validating An Automated Rodent Ultrasonic Vocalization Data Collator, Devin Mark Kellis

Theses and Dissertations

Rodent ultrasonic vocalizations (USVs) are a key dependent measure within behavioral science that have translational relevance with respect to medical, especially neuropsychiatric, illnesses. In recent years, several programs have been developed to enable the recording, labeling, and parameterization of rodent USVs via conventional, machine learning, or deep learning approaches. However, there remains a need to further automate the downstream process of data collation so that labeled and classified USV parameters can be rapidly formatted and analyzed via statistical approaches based on experimenter preferences. The aim of this thesis was therefore to validate an automated vocalization data collator (AVDC) to expedite …

Effect Of Catastrophic Medical Insurance On Healthcare Service Utilization And Quality, Ruiqi Ding

Dissertations and Theses Collection (Open Access)

China implemented catastrophic medical insurance (CMI) program to provide additional reimbursement for individuals requiring extensive healthcare services due to severe illnesses. This study empirically assesses the impact of the CMI program on the healthcare utilization and quality of care for severely ill patients, using medical insurance claim data from 2012 to 2018 in a capital city in China. The analysis yields the following conclusions: First, CMI decreased the medical expenditure of severe patients, but it had no impact on alleviating the financial burden. Second, CMI curbed abuse and saved medical resources, and in the meantime, it increased the use of …

Implementing The Fall Tips Tool To Reduce Falls In Older Adults, Ruth C. Santiago

Master's Projects and Capstones

Problem: In many organizations, falls and associated major injuries create a large barrier to maintaining patient safety. Patient falls impact quality of care and create financial difficulty for all parties involved. It is important that prevention measures are effective and individualized.

Context: A significant increase in falls and major injuries have been documented in unit F1 of Facility A in Northern California. Current strategies to prevent falls have not been successful in reducing fall rates over the past year.

Interventions: The intervention to decrease falls on this unit is the Fall Tailoring Interventions for Patient Safety (TIPS) tool. The tool …

Optimizing Attention Bias Training For Depression, Bridget R. Kennedy

Clinical Psychology Dissertations

Depression has been associated with a negative attention bias. Attention bias modification (ABM) interventions among individuals with depression have demonstrated promising but inconsistent findings in reducing negative attention bias and decreasing depression symptoms. These inconsistent results may be partly due to impaired attention functioning that is common in depression. Mindfulness has demonstrated attention benefits, which may enhance the ability for individuals with depression to benefit from ABM interventions. This study aimed to explore the efficacy of a train-positive dot-probe task ABM intervention when compared to a placebo dot-probe task, both preceded by a series of brief mindfulness activities, among a …

Exploring The Relationships Between Food Insecurity, Wic Participation, Early Life Feeding Practices, Diversity Of Dietary Exposures, And Diet Quality In The First Two Years Of Life, Vivian M. Drewelow

Master's Theses

Diet quality during early childhood is a strong predictor of mental and physical outcomes, as well as future diet quality. Although many factors determine diet quality during childhood, food insecurity is a significant predictor of lower diet quality. On the other hand, participation in nutrition assistant programs, such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a significant predictor of higher diet quality. In addition, specific feeding practices, including timing of complementary food and beverage (CFB) introduction, types of CFB introduced early, and diversity of dietary exposures (DD), in the first year may predict future …

Communication, Electrodes, Appropriateness Setup, And Education (Cease) Bundle Implementation In The Surgical Intensive Care Unit, Tina J. Garcia Miller

All Doctor of Nursing Practice (DNP) Scholarly Projects

An estimated 85-99% of alarms in the intensive care unit (ICU) do not require nursing intervention. This overabundance of non-actionable alarms can contribute to sensory overload and is a significant factor in alarm-related safety events. The aim of this project was to reduce the prevalence of non-actionable alarms through the implementation of an evidence-based alarm management bundle. The CEASE Bundle, a comprehensive five-step protocol encompassing Communication, Electrodes, Appropriateness, Setup, and Education, was implemented in an 11-bed surgical intensive care unit. Continuous alarm data was collected for 12 weeks before and 12 weeks after the implementation of the bundle for comparative …

Examining Risk Factors For Early-Onset Breast Cancer, Jennifer Grace Taylor

Theses and Dissertations

Introduction: There have been great advancements in screening and in the identifying of risk factors associated with breast cancer, however, there is a lack of information of these factors in women with breast cancer occurring under the age of 45, known as early-onset breast cancer (EOBC). EOBC is often found at later stages, negatively impacting young women’s careers, family planning, and mental health. Additionally, because of the health disparities that exist within the U.S. health care system, women belonging to racial and ethnic groups, specifically young Black women, tend to have poorer outcomes and higher mortality rates of EOBC compared …

Antioxidant And Anti-Inflammatory Potential Of Engineered Ceria Nanoparticles In The Management Of Alzheimer's Disease, Shanshan Shi

Theses and Dissertations

Alzheimer's disease (AD) is a devastating neurodegenerative disorder that affects millions worldwide. Unfortunately, there are currently no effective therapies available to prevent or cure the disease. While current therapies aim to change AD progression, there is a growing need for novel therapeutic strategies that can effectively penetrate the blood-brain barrier (BBB) to target the underlying pathology of the disease. The BBB is a highly selective semipermeable barrier that separates circulating blood from the brain. It plays a crucial role in amyloid-β (Aβ) homeostasis and clearance dynamics, as Aβ accumulation is a key factor in the pathogenesis of AD. Aβ aggregation …

Improving Drug Repurposing Success: Integrating Large Database Claims Analysis In Drug Discovery, Joseph Magagnoli

Theses and Dissertations

Drug repurposing has emerged as an innovative strategy to identify new therapeutic uses for existing medications. However, with few notable exceptions, repurposing existing drugs has limited overall success, often failing in randomized controlled trials (RCTs) due to inadequate treatment efficacy in new clinical settings. To improve success rates, I propose a framework titled REMIDY: Retrospective and Experimental Methods Integration for Drug DiscoverY. The REMIDY framework incorporates retrospective claims analysis into the drug discovery process. I demonstrate that retrospective analysis can leverage extensive administrative and clinical data to address translational gaps between pre-clinical experimental models and RCTs. For example, pre-clinical experimental …

Nonverbal Iq Test Performance In Preschool-Age Children With Varying Language, Sandra Danelle Irvin

Theses and Dissertations

Purpose – This study aims to investigate the impact of two types of factors on IQ test performance in children with variation in language ability. The two types of factors studied here are: a) test characteristics (i.e., complexity of test directions) and test-taker characteristics (i.e., language ability). Method – Four participants, ages 4-7, completed norm referenced assessments for language and intelligence. Results – Descriptive results suggest no discernable trends between performance on language assessments and nonverbal IQ measures. The results demonstrated a discernable negative trend between performance on nonverbal IQ measures and linguistic complexity of instructions. Implications – While the …

Exploring The Impact Of Neonatal Transport On The Health Of Black Preterm Infants And Psychosocial Challenges Faced By Parents In Relation To Social Determinants Of Socioeconomic And Racial Inequities, Karen Faye Warren

Theses and Dissertations

Neonatal transport is a unique aspect of preterm birth. This descriptive, exploratory dissertation study used a multiple-case study design, and mixed methods approach to describe the trajectory of Black preterm outborn infants and their mothers from birth, through transport to a referral center through NICU hospitalization until discharge, for a detailed analysis of each case. The specific aims were 1) Describe each infant's transport trajectory, including baseline characteristics of the community hospital of birth (size, level of care, birthing resources), transport characteristics (mode, distance, personnel), and infant health from birth to arrival of regional referral neonatal intensive care unit; 2) …

Medication Adherence Between Long-Acting Injectable And Oral Antipsychotic Medications In South Carolina Medicaid Beneficiaries With Schizophrenia, Pujing Zhao

Theses and Dissertations

Background: Schizophrenia is a chronic and serious mental disorder that affects millions of individuals worldwide. A recent study shows the prevalence of schizophrenia globally is about 1%. The primary schizophrenia treatment goal is to effectively manage symptoms and prevent relapses. Antipsychotic medications are very important for the treatment of schizophrenia. However, the prevalence of nonadherence to antipsychotic medication is high, with mean rates reaching 41.2%. In the realm of schizophrenia treatment, two primary categories of medications are utilized: long-acting injectable antipsychotics (LAI) and oral antipsychotic agents (OAP).LAI are administered at intervals spanning from two weeks to several months and have …

Evidence-Based Strategies For Fall Prevention, Angelia Palmer

All Doctor of Nursing Practice (DNP) Scholarly Projects

Patient falls represent the largest category of preventable adverse events in hospitals, with 700,000 to 1,000,000 falls occurring annually in U.S. hospitals and 30-35% resulting in injuries. The cost of fall-related injuries exceeds $50 billion globally, with an average of $14,056 per fall.

The aim of this project was to introduce a standardized fall prevention approach to improve performance and reduce falls in the medical-surgical department.

A comprehensive literature review indicates multifactorial bundled approaches, clinical pathways, purposeful rounding, and patient and family engagement as effective fall prevention strategies.

This quality improvement (QI) project design was based on the Plan, Do, …

Reducing Patient Falls In A Skilled Nursing Facility, Mariah De Los Santos

All Doctor of Nursing Practice (DNP) Scholarly Projects

Falls in skilled nursing facilities (SNFs) pose a significant safety risk, causing injuries, extended stays, and increased morbidity mortality. With a fall rate 6.08 per 1,000 patient bed days, exceeding the national benchmark of 5.3, this project aimed to reduce falls using an evidence-based prevention bundle in a facility lacking a comprehensive fall prevention program. A literature review indicated multifaceted fall prevention bundles reduce falls in SNFs. Key components include risk assessment tools, patient education, post-fall huddles, and purposeful hourly rounding. This quality improvement project used Deming's Model for Improvement and the OhioHealth Change Management Model. An interprofessional team of …

A School-Based Asthma Initiative To Improve Student Self-Management Behaviors, Jenni R. Newland

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: In a Midwest public school system, students received robust academic education. Health education programs, specifically asthma management, were not offered. Over 400 elementary students with asthma lacked the knowledge and skills to effectively recognize and manage their asthma symptoms resulting in increased school clinic visits and absences, highlighting the urgent need for targeted intervention.

Aim of the Project: The aim of this project was to improve students’ asthma self-management skills by providing education based on the Open Airways for Schools (OAS) curriculum. Improving asthma self-management skills reduces student absences and time away from the classroom.

Review of Evidence: A …

A Quality Improvement Project To Reduce Facility-Acquired Pressure Injuries, Carolina Rosario

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Facility-acquired pressure injuries (FAPIs) pose significant risks to patient outcomes and healthcare costs ($500 to $70,000 per PI) in subacute rehabilitation (SAR) facilities. An assessment in a SAR identified a concerning pressure injury (PI) rate of 15.3%, exceeding the national benchmark of 10% for such facilities. This prompted an evidence-based quality improvement (QI) initiative.

Aim of the Project: This project aimed to reduce FAPI rates by 30% or greater among patients 65 and older using a PI prevention bundle called SSKINS (Skin, Surface, Keep moving, Incontinence/moisture, Nutrition/hydration, Self-management).

Review of the Evidence: A comprehensive literature review indicated that PIs …

Knowledge, Attitudes And Practices Regarding Sexually Transmitted Infections In South Carolina: A Cross-Sectional Survey And Comparison To Geographically-Associated Social Determinants Of Health, Sean Patrick Sweeney

Theses and Dissertations

Sexually transmitted disease (STD) rates are on the rise in the United States. South Carolina ranks consistently among the states with the highest STD burdens, especially for the bacterial diseases gonorrhea and chlamydia. This study sought to determine the opinions, beliefs, and knowledgebase of South Carolina citizens regarding STDs and sexual health/education. In doing so, the study seeks to identify areas of improvement for educators, healthcare workers, and public health employees. Using a web-based cross-sectional survey, this study contacted approximately 900,000 South Carolina residents for participation. Participants were asked a variety of questions focused on STD knowledge, opinions, and practices. …

Sexual Quality Of Life In Sexual And Gender Minority Women After Cancer, Heather Schneider Miles

Theses and Dissertations

Sexual quality of life (SQoL) is a critical aspect of well-being, encompassing physical, emotional, and social dimensions. For sexual and gender minority women (SGMW)—lesbian, bisexual, transgender, or queer—cancer presents unique challenges. This dissertation examined the relationships between cancer treatment symptoms, social support, and communication with the cancer care team (CCT) on SQoL among SGMW survivors of breast, gynecological, and colorectal cancers. Quantitative data from 37 participants were collected using PROMIS® measures, assessing demographics, treatment history, post-treatment symptoms, perceived social support, and communication with the CCT. Additionally, in-depth interviews with five participants provided qualitative insights into their experiences and the meaning …

Understanding Cancer Grade And Survival Disparities Among Young Adults Diagnosed With Non-Hodgkin’S Lymphoma (Nhl) Residing In South Carolina, Prema S. Bhattacharjee

Theses and Dissertations

Introduction. Previous research has shown that age and cancer grade differences must be carefully considered when developing initiatives to improve outcomes for NHL among the young adult population. The aims of this study are 1) to examine differences between low vs. high grade in NHL by race/ethnicity, healthcare insurance, and geographic factors among YAs aged 18-39 years of age in South Carolina, 2) to examine delays in the first course of cancer treatment for NHL by race/ethnicity, healthcare insurance, and county of residence (urban vs. rural) among YAs aged 18-39 years of age in South Carolina, and 3) examine differences …

Sleep Quality And Quantity Assessment Among African American Survivors Of Lung Cancer With And Without Chronic Obstructive Pulmonary Disease (Copd), Amanda Rae Myhren Dyer

Theses and Dissertations

Introduction: Improving the quality of life of survivors of early-stage lung cancer (NSCLC, Stages I - IIIa) requires attention to persistent, burdensome symptoms, including sleep disturbances. While research exists regarding sleep quality, sleep quantity, and sleep disturbances in cancer survivors, minimal research targets this minority survivor population. The purpose of this study was to measure and assess sleep quality, sleep quantity, and sleep disturbances among African American survivors of lung cancer. Based on the Symptom Management Theory, our comprehensive assessment focuses on a racial minority group and multiple diagnostic groups (COPD vs. No COPD). Methods: This two-group, cross-sectional, descriptive study …

Social-Ecological Determinants Of Affective States Among College Students: A Cross-Cultural Ecological Momentary Assessment Study, Abhishek Aggarwal

Theses and Dissertations

Background: College students experience a complex and diverse array of stressors during their college life, making them vulnerable to severe mental health issues. Momentary affective states are linked to major mental health disorders and overall well-being; however, the current social-ecological model of affect lacks a temporal dimension, failing to account for within-person dynamics of affective states over time. This study disentangles the complex temporal dynamics among the momentary, multilevel social-ecological factors and affective states in the real-world setting of college students across the United States (US) and India. However, establishing invariance of the affect model across time, people, and cultures …

Evaluation Of Mechanism Of Action And Toxicity Of Novel Psychoactive Substances (Nps) Identified As Cannabinomimetics, Robert Michael Sears

Theses and Dissertations

Synthetic cannabinoid receptor agonists (SCRA), also referred to as synthetic cannabinoids (SCs), pose a significant public health risk, create an undue burden on local emergency departments, and present significant challenges for law enforcement officers and forensic laboratories. SCs are a diverse group of compounds sold with the intent to illicit psychoactive responses like tetrahydrocannabinol (THC), the primary psychoactive component in marijuana. Since their initial detection in 2004, illicit use of SCs has grown in popularity. Recognizing the dangers of SC use, the Drug Enforcement Agency has moved to schedule the analytes routinely identified in street drugs. Despite these efforts, the …

Implementation Of A Mobile-Based Mindfulness Intervention To Lower Perceived Stress Levels In Undergraduate Nursing Students, Wendy S. Carley

Electronic Theses and Dissertations

This project analyzed the effect of the daily use of a mindfulness-based mobile application on associate degree nursing undergraduate prelicensure students’ perceived stress levels. Nursing students experience elevated stress levels that may be reduced through mindfulness behaviors. Undergraduate, prelicensure nursing students participated in establishing the impact of mindfulness on perceived stress levels in a quantitative pre/postintervention study. The evidenced-based studies chosen for this review consisted of randomized controlled trials, pilot studies, pre/posttest designs, systematic reviews, and quantitative and qualitative studies. The investigator collected presearch data using a pre/posttest design to evaluate the effectiveness of a stress management program in reducing …

Parental View On Hpv Vaccination, Rebecca Elaine Rhodes

Electronic Theses and Dissertations

The human papillomavirus (HPV) is a sexually transmitted infection widely seen in the United States. Millions of Americans are affected by it each year, especially those in their late teens and early 20s. Although most infections will resolve on their own, 1 in 10 will lead to health problems such as cancer. The HPV vaccine can prevent over 90% of associated precancers and cancers. However, uptake of the HPV vaccine and its completion among adolescents are significantly lower than other recommended adolescent immunizations, falling short of the Healthy People 2030 goal of 80% coverage. Understanding parental attitudes, beliefs, and perceptions …

Prevalence Of Sexuality Implicit Bias In Entry-Level Dental Hygiene Students – A Pilot Study, Monica Mercedez Drew

Dental Hygiene Theses & Dissertations

Purpose: Bias and discrimination may create barriers and affect the delivery of culturally competent care to sexual minorities. An awareness of biases early in education may promote equitable care and increase the quality of oral healthcare delivered to diverse populations. The purpose of this study was to determine the prevalence of sexuality-implicit attitudes in entry-level dental hygiene students at one university. Methods: This cross-sectional study included a convenience sample of junior and senior dental hygiene students (n=74) and was determined exempt by a university Health Sciences Human Subjects Review Committee (2151633-2). The Implicit Associations Test (IAT) is a validated tool …

Associations Between Combat Exposure, Moral Injury, And Suicidality Among U.S. Military Members: The Moderating Impact Of Positive Rumination, Jeffrey M. Gabelmann

Psychology Theses & Dissertations

Numerous studies have documented the risk for suicide among recent-era veterans with combat experience. Recently, moral injury has emerged as a possible contributor to suicidality in veterans. To that end, no study has approached the combat exposure-moral injury-suicidality link with a focus grounded in positive psychology. Specifically, the present study explored whether positive rumination, or the reflection on positive emotions and moods, may buffer the deleterious effects of potentially traumatic experiences in warzones on moral injury and suicidality. This study was a secondary analysis of 250 current or former U.S. military members (M_age = 33.3 years) who had …