Medicine and Health Sciences Commons^™

Increasing Nurses’ Knowledge Of Cultural Preferences Influencing Diabetes Self-Management Among Sierra Leoneans, Winstina Aminata Taylor

Walden Dissertations and Doctoral Studies

The practice problem identified at the project site was the lack of nurses’ knowledge of how cultural preferences influence diabetes self-management practices among African Americans with diabetes mellitus. An educational program focused on the cultural preferences of Sierra Leoneans that influence diabetes self-management practices was provided for 48 nurses who worked in the agency. The doctoral project included concepts from nursing education and cultural competence theories to inform the approach. The project followed the ADDIE model process steps to develop and implement the educational program. The sources of evidence included pre- and posteducation surveys administered to participating nurses to assess …

The Health Risks Of Deportation: Impacts Of Family Separation On Relationships And Wellbeing In Latinx Communities, Shantay Rhea Rocha

University Honors Theses

Anti-immigration policy and deportation practices create multifaceted implications for Latinx communities in the United States. A comprehensive literature review drawing from public health and immigration studies was used to examine the direct and indirect implications of separation of families due to deportation. This thesis synthesizes existing research to illuminate the health threats pertaining to Latinx wellbeing in the context of being undocumented and fearing being separated from their family. Addressing the dimensions of deportation-related health risks, policy makers, health care professionals, and community organizations can work towards promoting Latinx health and well-being in the U.S. to mitigate the health consequences …

Compassionate Practice: A Review And Framework For Integrating Medical Humanities Into Pre-Medical And Medical Curricula, Megan Mccoy

University Honors Theses

The article presents the findings of a comprehensive narrative literature review aimed at addressing the question: What are the current frameworks of the medical humanities discipline in terms of purpose, methodology, curriculum, and student learning outcomes? Thematic analysis and qualitative coding highlighted key themes and areas of concern, including the purpose of medical humanities, methodology, current curriculum, and student outcomes. Recommendations are provided to address disagreements within the discipline, proposing a conceptual framework and definition for medical humanities, alongside advocating for a mixed-method approach as the primary methodology. Curriculum guidelines emphasize the importance of a quality integrated curriculum focusing on …

The Cost Of Healthy Eating, Diana Prychyna

University Honors Theses

Background: Each year in the United States, 15-20% of 1 million visits to the Emergency Department for Acute Heart Failure result in home discharge, with patients often experiencing adverse health outcomes within 30 days. The study, Get With the Guidelines in Emergency Department Patients With Heart Failure, utilized 'Self-Care Coaches' who meet participants via telehealth calls to discuss self-care maintenance after discharge as a strategy to mitigate adverse health outcomes; and offer provisions of resources, including a cookbook by the American Association for Heart Failure Nurses (AAHFN).

During telehealth calls, we observed gaps in self-care for retired older adults (62+), …

Flattening Morrison's Beloved: The Limits Of Psychoanalysis In Literary Criticism, A Literature Review, Isaac Vanhook

University Honors Theses

Toni Morrison's Beloved was first published in 1987 and has amassed a wide range of scholarship throughout the years; with some literary scholars using psychoanalysis to suggest a reading of Beloved. Because of the volume of scholarship and Beloved's plot--dealing with a mother who represses the memory of killing her daughter, Beloved--I found it to be perfect for the scope of this project. This literature review focuses on the sometimes reductive qualities of psychoanalyzing Beloved (such as the Freudian universal psychoanalytic subject, and the 'drawbacks' of object relations theory), while also discussing some revelatory qualities via the same …

Health Equity In Stroke Prophylaxis For New Atrial Fibrillation In The Emergency Department, Mariam Anwar

University Honors Theses

Objective: Atrial fibrillation (AF) is the most common cardiac arrhythmia, and often, first diagnosed in the emergency department (ED). AF increases the risk of stroke, which can be decreased by 64% if the appropriate oral anticoagulation (OAC) is prescribed. However, many patients are not prescribed OAC for new AF. We investigate whether patient ethnicity, specifically Hispanic-Latino & Russian/Ukrainian, affects OAC prescription.

Method: This retrospective chart review study included patients at an academic tertiary care center and a community hospital >17 years old with a primary ED diagnosis of AF or paroxysmal AF from January 2020-2024. Patients with valvular heart disease …

Biofeedback Gaming For Substance Use Disorder, Rebecca L. Chevrel

University Honors Theses

Substance Use Disorder (SUD) and stress are often predictive of one another, bidirectionally causal, and mutually intensifying. This thesis describes the bi-directional connection between physiological stress-modulating systems and Substance Use Disorder, and explores some emerging biofeedback stress-reduction gaming technology as a potential adjunct to recovery treatments. Improving autonomic balance, often described by Heart Rate Variability, has been shown to be beneficial for physical and psychological recovery, as well as improving self-control. For this reason, regular biofeedback for stress relief could be helpful in augmenting SUD treatment and preventing relapse. This exploration found that presenting it through a gaming lens may …

Biophilic Design Strategies In Healthcare: Using Nature To Promote Wellness In Small-Scale Mental And Behavioral Health Facilities, Skyler Peckham

University Honors Theses

Designing spaces that promote the health and well-being of the general public has been a highly debated topic for several centuries within the disciplines of architecture, urban planning, and other similar fields. As more research has been done throughout the years, the notion of utilizing nature to promote wellness has become a prominent design strategy. Through the examination of a wide range of scholarship regarding the benefits that nature has for human health and connecting this research to the biophilic evidence-based design strategies of healthcare facilities, I aim to highlight what design aspects truly promote wellness for patients in small-scale …

Evaluation Of Sleep Outcomes After Traumatic Brain Injury In Children Using Questionnaires And Actigraphy, Connie Tran

University Honors Theses

Traumatic brain injuries are the result of a sudden external blunt force to the brain and can result in long-term complications or death. In pediatrics, it is the leading cause of acute and chronic sleep-wake disturbances, as well as cognitive deficits, which can lead to a reduction in the quality of life for these children. These impairments can later result in lowered performance in work and school settings or decreased psychosocial function. Currently, there is a need to determine the relationship between traumatic brain injury (TBI) and sleep. There is a need for more research on whether or not sleep-wake …

Cannabis Exposure During Pregnancy And Neural Mechanisms Of Parenting: Assessing Neural Responses To Infant Cues And Parenting Outcomes, Shannon Powers

Electronic Theses and Dissertations

As legalization of cannabis and cannabinoids spreads in the United States, access and use of cannabis during the prenatal period has increased. There is limited knowledge on the effects of prenatal cannabis use on the parental brain. One way to identify potential effects of cannabis on parenting is through studying parenting brain functions and behavior. Cannabis use disorder (CUD) has been shown to be associated with lower positive parenting and lower sensitivity to infants, but it is unclear by what mechanisms. The following two studies address this gap in knowledge by examining the association between cannabis use during the prenatal …

Neuroinflammation In Alzheimer’S Disease Mouse Brain Following Repetitive Mild Traumatic Brain Injury, Lujain Almuhanna

Electronic Theses and Dissertations

Traumatic brain injuries (TBIs) are a common form of head injury, with mild TBIs (mTBIs) making up 75-90% of the TBI severity scale. It’s been suggested that repetitive mild TBIs (rmTBIs) may enhance effects of Alzheimer’s Disease (AD). With dementia linking TBI and AD together, we investigated the memory hub of the brain - the hippocampus. Astrocytes and microglia are two glial cells that respond to neuroinflammation and therefore imaged in hippocampal regions of the 3xTg-AD mouse brain. We hypothesized that AD brain pathology (i.e., neuroinflammation) would be accelerated in 3xTg-AD mice following rmTBIs early in life. Analyses revealed that …

Exploring The Experiences Of Hiv Positive Pregnant Women On Prevention Of Vertical Transmission Of Hiv/Aids In Rural Malawi, Gertrude Finyiza

Electronic Theses and Dissertations

Mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) continues to be the primary conduct that HIV is transmitted to children worldwide. The problem of HIV/acquired immunodeficiency syndrome (AIDS) is having a great impact on the world's children. The prevalence of HIV/AIDS in Malawi continues to be a serious public health issue, especially for expectant mothers. The health outcomes of mothers and children remain significantly threatened by vertical HIV transmission, even with improvements in preventive and treatment efforts. The purpose of this thesis was to explore the experiences of HIV-positive pregnant women in Malawi. I conducted semi structured interviews with thirteen …

Colocalization Of Odc And Amyloid Plaques In Patients With Alzheimer’S Disease And Down Syndrome, Julia S. Gielczynski

Undergraduate Theses, Capstones, and Recitals

Polyamines, and their rate-limiting enzyme ornithine decarboxylase (ODC), are crucial for many functions in the central nervous system but levels decrease with age. In neurodegenerative diseases, like Alzheimer’s Disease (AD), polyamine levels begin to increase again. Yet, there are still many unanswered questions surrounding polyamine’s possible role in AD, especially in those with Down Syndrome (DS), who also have an extra copy of the amyloid precursor protein (APP) and tend to get AD far earlier than the general population. We aim to investigate if there is colocalization between amyloid plaques and Ornithine Decarboxylase (ODC) in patients with AD and AD/DS, …

Investigating The Role Of Ebf3a In Craniofacial Development, Shujan A. Sharafeldeen

Undergraduate Theses, Capstones, and Recitals

Proper craniofacial development requires many genes. Single-cell RNA sequencing (scRNA-seq) allows us to identify genes expressed in precursor cells for craniofacial structures, but the function of many of these genes in craniofacial development has yet to be characterized. In our scRNA-seq of cranial neural crest cells (NCCs), which are precursor cells for the craniofacial skeleton, we found a gene called early B-cell factor 3 (ebf3a) that may be involved in craniofacial development. In our scRNA-seq data, ebf3a expression is restricted to cranial NCCs of the dorsal and ventral domains of pharyngeal arches 1 and 2. In humans, damaging variants in …

Leadership In Extreme Contexts: An Emerging Typology, Ashley Williams

Electronic Theses and Dissertations

This study investigates the relationship between leadership and extreme contexts through the lens of rural hospitals facing environmental jolts. Rural hospitals offer a unique setting for this research, given their inherent geographic isolation, lack of resources, and the critical role these facilities play in their communities. Through a qualitative analysis of interviews with Chief Executive Officers of rural hospitals, this research takes a grounded approach to build theory surrounding how leadership not only shapes but is shaped by extreme contexts and environmental jolts. The research results in four primary contributions. Namely, this study extends existing typologies on leadership in extreme …

The Effects Of Covid-19 On Asian American Perception Of Mental Health, Emily Tseung

Electronic Theses and Dissertations

This study describes a qualitative study using a grounded theory, constructivist approach, which sampled (N = 6) Asian American college students who lived in the United States during the peak of the COVID-19 pandemic. Research shows that COVID significantly impacted the Asian American perception of mental health, including mental health help- seeking behaviors and discrimination experienced. The long-term effects of this are still largely unknown. In depth, semi-structured interviews were used to explore the lived experiences of these Asian Americans. Qualitative analysis revealed thematic differences for the following themes: (a) experience with mental illness, (b) mental health help- seeking …

Determining The Impact Of A Diabetes Logbook In Improving Self-Care Among African Americans With Type 2 Diabetes, Winifred Moore

Doctor of Nursing Practice Projects

Type 2 diabetes is a prevalent chronic disorder that is associated with defects in the metabolism of glucose. The management of type 2 diabetes depends on patients’ adherence to self-care activities. However, patients at the project site reported poor glycemic control, which increased their risk of diabetes complications. The purpose of this quality improvement project was to educate nursing staff on the use of diabetes logbooks to improve self-care among African Americans with type 2 diabetes and thereafter have the nursing staff educate diabetic patients. A quasi-experimental pre-post-intervention design involving 30 African American adults (mean age 43.70 years) with uncontrolled …

Deciphering The Microbial Fingerprint Of Covid-19: A Multi-Layered Exploration Of The Oral And Gut Microbiome Dysbiosis, Iman Mostafa Sultan

Theses and Dissertations

The impact of SARS-CoV-2 infection on the human microbiome remains a dynamic and intricate puzzle. This study delves deeper into this mystery by revisiting the oral and gut microbial compositions of 53 COVID-19 patients before and after viral clearance, alongside comparisons to 76 healthy individuals. Through a comparative lens, we have emploed two distinct differential abundance methods – DeSeq2 and ANCOM – while drawing upon the thorough SILVA database encompassing the full-length 16S rRNA gene. The analysis underscores the crucial role of a diverse methodological choir in microbiome research. In certain instances, the congruence between DeSeq2 and ANCOM may exhibit …

Effect Of Selective Head-Neck Cooling Therapy On Specific Brain Biomarkers After Concussive Injury, Mateusz Conrado

Yale School of Medicine Physician Associate Program Theses

Selective head-neck cooling therapy as novel treatment for concussion has been researched in pilot studies for several years using symptom severity as the primary outcome. As of 2018, brain biomarkers glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) have been FDA approved as indicators of Traumatic Brain Injury (TBI). This study aims to investigate the effects of selective head-neck cooling therapy on the serum levels of the biomarkers, alongside patient symptom severity, in adults aged 18 years and older with mild Traumatic Brain Injury diagnosed in the last 72 hours. A randomized controlled trial will compare two intervention …

Strength Training Versus Aerobic Exercise On Glycemic Control In Adults With Type 1 Diabetes, Elizabeth Encarnacion

Yale School of Medicine Physician Associate Program Theses

Poorly controlled Type 1 Diabetes can lead to micro- and macrovascular complications (retinopathy, neuropathy, cardiovascular disease), but managing glycosylated hemoglobin A1c levels can decrease incidence rates. However, current guidelines recommending exercise for management have low evidence ratings, and less than one third of adults achieve target hemoglobin A1c levels. For those looking to begin an exercise regimen, it is unclear which type of exercise is best for maintaining glycemic control. This study will compare the effectiveness of thrice-weekly (45-minute) sessions for 12 months of aerobic exercise versus strength training against a non-exercise control group in non-active Type 1 Diabetic adults. …

Nutrition Education To Prevent Bone Stress Injuries In Collegiate Male Athletes: A Randomized Trial, Brianna Brite

Yale School of Medicine Physician Associate Program Theses

Male Athlete Triad is a syndrome of three interrelated conditions, low energy availability, functional hypogonadism and low bone mineral density, leading to adverse outcomes including bone stress injuries. Evidence-based techniques for preventing bone stress injury in those at risk for Male Athlete Triad have not been identified in existing research. Nutrition education programs can increase athletes’ energy intake and subsequently, energy availability. Therefore, we seek to determine whether a nutrition education program will reduce the incidence of bone stress injuries among collegiate athletes at risk for Male Athlete Triad. Our randomized controlled trial will assess the relative risk of bone …

Determining The Effectiveness Of Deep Breathing Exercises In Alleviating Stress In Veterans With Post-Traumatic Stress Disorder (Ptsd), Lovette Okoh

Doctor of Nursing Practice Projects

Posttraumatic stress disorder (PTSD) is a common psychiatric disorder that affects veterans following deployment from combat. Medication side effects and re-exposure to trauma while undergoing psychotherapy hinder the effectiveness of recommended treatments. There is evidence supporting the effectiveness of deep breathing exercises in stress management, which is a common feature among PTSD patients. The purpose of this quality improvement (QI) project was to evaluate the effectiveness of deep breathing exercises in alleviating stress among veterans with PTSD. Nursing staff at the project site were educated about the benefits of deep breathing exercises and how to perform them and educated veterans …

Project Management Hurdles In Public Health Interventions In Developing Countries, Irene Ogbuefi

Harrisburg University Dissertations and Theses

Wealth disparity between developing countries and developing countries has created a gap yearning to be filled in certain sectors of the economy. The health sector in resource-poor settings struggle to provide human, capital and financial resources needed to combat some of the diseases plaguing them. To improve global healthcare goals, Development Assistance for Health (DAH) has been the saving grace. DAH provides technical and financial resources required to combat diseases like HIV/AIDs, Malaria and TB. However, the wind of change is blowing in the direction of in-country ownership for public health projects. DAH funding is dwindling but sustainability efforts from …

From Knowledge Gap To Empowerment: Patient-Operated Insulin Pump Management For Bedside Nurses, Bernadette J. Amao

Doctor of Nursing Practice Projects

Acute care nurses often struggle with the complexities of managing patient-operated insulin pumps (PIPs) due to limitations in training. With the rising prevalence of insulin pumps, equipping nurses with the necessary skills to navigate these devices effectively is essential. This quality improvement project addressed this critical gap by enhancing bedside nurses' self-efficacy in PIP management. Drawing upon Bandura's self-efficacy theory, this project hypothesized that targeted educational interventions could significantly improve nurses' confidence in managing PIPs. A four-week educational program was implemented to cover basic knowledge, troubleshooting, and patient interaction aspects of insulin pump management. The intervention tool was designed to …

Impact Of Gamification In An Online Rn To Bsn Program, Deosha Anderson

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance student engagement in an online RN to BSN program by incorporating gamification strategies into the curriculum. Traditional teaching methods often fail to maintain student interest, leading to low engagement and reduced program completion rates. This project sought to determine the impact of gamification on student engagement compared to no gamification. The intervention involved integrating gamified elements into the online RN to BSN program to create a more interactive learning environment. The project employed a quantitative, quasi-experimental design with a pre-intervention and post-intervention assessment. Data on student engagement metrics, including login frequency, time spent …

Improving Student Perceptions Of Collaboration By Using Interprofessional Education, Valerie L. Beshears

Doctor of Nursing Practice Projects

Educators must include interprofessional education (IPE) in the healthcare provider curriculum. Including IPE is the first step in changing the healthcare culture toward interprofessional practice. The project aims to increase nursing students' perceived ability to collaborate with patients, nurses, and other healthcare professionals by introducing IPE to first-semester nursing students. The students will participate in an IPE activity and score a pre-test/post-test survey to assess their perceived ability to collaborate before and after the IPE activity. The data collected from this activity answered the quality improvement question: Among first-semester nursing students in a BSN program, how does incorporating an IPE …

Enhancing Student Simulation Debriefing Using Video Recording, Lisa Hall

Doctor of Nursing Practice Projects

This quality improvement project aimed to show how video recording can increase vivid feedback by expanding the students' memory by reviewing the recording to recall and reflect on their roles during the simulations. This project sought to help the learner understand how well the simulation ran and what was done to improve its performance. The interventions involved video recording each simulation scenario. The recording was used during the debriefing session to help the students recall and reflect on their actions during the scenario. The project employed a quantitative, quasi-experimental design with a pre-intervention and post-intervention assessment. Data was collected using …

The Covid-19 Pandemic & Language Development Of Preschool Children Living In The Arkansas Delta, Molly Grace Williams

Student Theses and Dissertations

This study investigated the potential effects of the COVID-19 pandemic on preschool children’s language development. Children from the Arkansas Delta Region were examined to determine the significance. Existing data consisting of BRIGANCE III screeners from the 2019 cohort and 2022 cohort were analyzed. Researchers examined the scores from the screener's language and cognitive/academic sections. BRIGANCE III screeners from 73 three-year-olds were collected from the School of the 21st Century Preschool in Paragould, AR. Data from the screeners analyzed the 2019 and 2022 cohorts. A two-tailed t-test was used to measure the relationship between the eight dependent variables. The results yielded …

Effect Of Plumbagin On Chemo-Resistant Metastatic Retinoblastoma, John J. Soto

Theses and Dissertations

Retinoblastoma, which is an ocular malignancy, usually results in poor prognoses in pediatric patients worldwide. Retinoblastoma in some events, can develop metastatic phenotypes which can lead to secondary tumor formation, furthering deleterious patient outcomes. It is of paramount importance to identify and research potent novel compounds that can be used to increase the likelihood of remission. Plumbagin (PLB) is a plant-derived, neuroprotective agent, which exhibits significant anticancer activities during in vitro study. PLB has been shown to have a high therapeutic efficacy against chemoresistant sublines as well as their normal counterparts. We attempted to show that the chemoresistant ABCC1 could …

A Qualitative Study Cultural Components Contributing To Resilience And Its Importance To Trauma-Informed Care Of Veterans, Tineka L. Banks

College of Science and Health Theses and Dissertations

Background: Trauma-informed care (TIC) creates an environment of safety, empowerment, and healing. It provides services in a way that encourages mindfulness and promotes the feeling of well-being. Resilience, described as a protective factor to decrease the risk of suicide, is imperative to the delivery of TIC. However, research also suggests resilience is culturally affected.

Purpose: The purpose of this study was to identify cultural components that contribute to resilience in African American female (AAF) veterans, and its relevance to the delivery of TIC and suicide prevention.

Method: Individual interviews were conducted using a semi-structured questionnaire to identify supporting factors, based …