Medicine and Health Sciences Commons^™

Standing Posterior Trunk Rotation With Adaptive Proprioceptive Toss, Jennifer Elvir

Electronic Theses and Dissertations

Parkinson’s disease (PD) is a remarkably individualized disease. Nearly every person’s trajectory is unique. One person may experience tremor at an early stage of the disease, while another may experience tremor at a later stage or even not at all. For all PD patients, for certain can expect increasing difficulty as the disease progresses. Parkinson’s disease is responsible for the loss of dopamine which displays itself most notably through motor and cognitive symptom disruption. Although Parkinson’s is a chronic and progressive condition that is irremediable, significant strides have been facilitated to help control and manage the trajectory of the disease. …

Representation Learning For Generative Models With Applications To Healthcare, Astronautics, And Aviation, Van Minh Nguyen

Theses and Dissertations

This dissertation explores applications of representation learning and generative models to challenges in healthcare, astronautics, and aviation.

The first part investigates the use of Generative Adversarial Networks (GANs) to synthesize realistic electronic health record (EHR) data. An initial attempt at training a GAN on the MIMIC-IV dataset encountered stability and convergence issues, motivating a deeper study of 1-Lipschitz regularization techniques for Auxiliary Classifier GANs (AC-GANs). An extensive ablation study on the CIFAR-10 dataset found that Spectral Normalization is key for AC-GAN stability and performance, while Weight Clipping fails to converge without Spectral Normalization. Analysis of the training dynamics provided further …

Loss Of The Sac Components Slda Kinase Or Sldb Or In Vitro Adaptation To Triazole Produces Aneuploidy Associated With Triazole Heteroresistance In Aspergillus Fumigatus, Ashley Nywening

Theses and Dissertations (ETD)

The opportunistic pathogen Aspergillus fumigatus represents the chief causative agent of human and animal invasive filamentous fungal infections. Triazoles, the primary therapeutic options to combat invasive aspergillosis (IA), target the fungal biosynthesis of ergosterol, a vital component of the fungal cell membrane. Unfortunately, resistance to this class of medical therapeutic has arisen globally and now threatens the future usefulness of these compounds for antifungal treatment. Infection with A. fumigatus that has acquired triazole resistance increases an already high associated mortality rate and reduces the limited arsenal of therapeutic options to combat IA. Moreover, how this specific fungal pathogen obtains resistance …

Regulation Of Piezo Channels By Membrane Lipids, Luis Octavio Romero Garcia

Theses and Dissertations (ETD)

In cellular physiology, the transformation of energy from mechanical cues into electrical and/or chemical signals is called mechanotransduction. This ability to sense and react to external and internal mechanical forces is essential for the survival of single cell to multicellular organisms. As such, it is no surprise that mechanotransduction appeared early in the evolutionary history of life on our planet. At the cellular level, mechanotransduction is mediated by proteins and/or protein complexes that respond to mechanical stimuli in different timescales, including but not limited to changes in membrane electric potential, Ca2+ signaling, and gene expression. Among such protein complexes, mechanosensitive …

Assessing Impact Of Food Structure On Oral Tribology And In-Vitro Digestion Of Dairy Products, Lamis Ali

All Graduate Theses and Dissertations, Fall 2023 to Present

In this research, we focused on understanding the critical elements impacting consumer experience and the nutritional value of dairy products, specifically their texture, mouthfeel, and protein breakdown in the gastrointestinal tract. Our study aimed to accomplish two main goals. First, we performed analysis of the tribological attributes of various commercially dairy products. The second objective was to investigate the process of disintegration and protein release in selected dairy products.

The study included an assessment of eight dairy products of varied consistencies: solid like cheddar, cheese curd, and parmesan; semi-solid such as cottage cheese, ricotta cheese, and yogurt; and liquid represented …

Acoustic-Perceptual Relations Between Fundamental Frequency And Expressiveness In Speakers With Hypokinetic Dysarthria, Alena Portnova

All Graduate Theses and Dissertations, Fall 2023 to Present

Hypokinetic dysarthria is a motor speech disorder that occurs in patients with Parkinson’s disease (PD) and affects not only their speech intelligibility but also how their attitudes and emotions are perceived by listeners. People with PD have been judged as less happy, involved, friendly, and interested based only on their speech samples. A lack of speech expressiveness is one of the characteristics that is likely to be related to these negative listener judgments. Specifically, it has been suggested that a lack of fundamental frequency (F0) variation reduces speakers’ ability to express various emotions. To investigate whether speech expressiveness is related …

Final Scholarly Project: Development Of Evidenced-Based Practice Guidelines For Female Patients Undergoing Anesthesia For Breast Cancer Surgery, Alexa High

Doctor of Nursing Practice Scholarly Projects

In the United States, the rate at which cancer is diagnosed is on the rise. In women, breast cancer is the second most common cancer diagnosis, following skin cancer, with approximately one in eight women developing breast cancer in their lifetime. When a patient receives a breast cancer diagnosis, the oncologic team will discuss the most suitable treatment plan for the patient, this often includes chemotherapy, radiation therapy, and surgery. Within the last few decades, research has shown that there may be a correlation between anesthetic medications and breast cancer metastasis. This project aims to create an evidence-based anesthesia guideline …

Telehealth Utilization In Clinical Trials: Facilitators, Barriers, And Future Directions, Michael Carpenter

MUSC Theses and Dissertations

Purpose: Telehealth implementation in clinical trials is not as well developed as compared to telehealth utilization in other areas of medical care. The focus of this project will explore the factors that foster and hinder the effective use of telehealth in clinical trials and how these insights can inform future strategies and policies.

Method: The project synthesizes empirical research and theoretical literature on the integration of telehealth into clinical trial. The research utilizes an online survey via REDCap to gauge the level of acceptance, perceived effectiveness, and potential barriers to the implementation of telehealth in clinical research.

Results: The responses …

A Developmental Exploration Of The Role Of Catp-6 Gene In Model Organism C. Elegans Relating To Parkinson’S Disease, Kaiser Kate Weafer

Undergraduate Theses

Parkinson’s disease (PD) is considered a common and complex neurogenerative disease characterized by the complete loss of dopaminergic neurons located in the substantia nigra pars compacta. With the incomplete understanding of this neurological disorder, Caenorhabditis elegans (C. elegans), a microscopic nematode, could serve as a model organism of study due to specific gene analogs, relating to PD, present in both C. elegans and humans. The gene of interest for this project is catp-6 in C. elegans an ortholog of the human ATP132A gene. Mutations in the ATP132A gene correlate with an abnormal form of early onset PD called Kufor-Rakeb Syndrome, …

Spatial Ability Tests And Course Performance In Human Anatomy And Physiology I Students, Madeline Hinton

Honors Theses

Madeline Hinton: Spatial Ability Tests and Course Performance in Human Anatomy and Physiology I Students

(Under the direction of Dr. Carol Britson)

Visuospatial perception processing is our ability to make inferences about what an object might look like from different angles just by looking at one angle of the object or by looking at a two-dimensional representation of it. This is a skill tested on the perceptual ability portion of the Dental Admissions Test (DAT), and it is also crucial for Human Anatomy and Physiology (HAP) students to be proficient in this skill in order to successfully navigate the organ …

Using Nurse-Assisted Telemedicine To Reduce Healthcare System Utilization By Rural Congestive Heart Failure Patients, Melissa Diehl Weidner

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is among the most common reasons for emergency room utilization and hospitalizations in those over age 65. With the rapidly aging population in the United States, the number of CHF patients is projected to continue to rise, disproportionately affecting rural communities. This research study evaluated an innovative nurse-led telemedicine program developed by one rural healthcare system to address the care and economic influence of rural CHF care. The purpose of this causal comparative analysis was to determine the impact a nurse-assisted telemedicine program had on the number of emergency room visits and hospital admissions for CHF …

Investigating The Role Of Diet In Modulating Neuroinflammation In Health And Disease, Rasa Valiauga

Dissertations

An estimated 55 million people worldwide suffer from dementia, with the prevalence expected to drastically increase in the coming years as the population ages. Alzheimer’s disease (AD) is the most common form of dementia and the substantial burden associated with AD has been recognized as a growing public health issue. Despite significant advancements in uncovering the mechanisms which play a role in disease pathology, there is currently no cure or effective treatments. AD is highly complex and multifactorial, with accumulation of misfolded protein, oxidative stress, and inflammation among the numerous etiological processes implicated in disease pathogenesis. While genetic risk factors …

Effectiveness Of An Educational Intervention On Post-Traumatic Stress Disorder Screenings For Healthcare Providers In Ambulatory Settings, Avis Simon

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

PTSD affects 3.6% of the United States adult population about 9 million people each year. Studies have found that 52% of the mental health population seen by healthcare providers who met the diagnostic criteria for PTSD are often undiagnosed. This quality improvement clinical project conducted at two military ambulatory clinics in the southeastern United States, aimed to evaluate the effectiveness of an educational intervention in improving post-traumatic stress disorder (PTSD) screenings and outpatient referrals among healthcare providers in ambulatory settings. Specific goals were to improve ambulatory providers' awareness and utilization of PTSD screening instruments in patients experiencing PTSD. The secondary …

The Effects Of Music On Physiology, Perception, And Performance (Mp3) During Resistance Training, Madison Vinovrski

Health Sciences Honors Papers

The purpose of this study was to investigate the effect of different types of music on the physiology, perception, and performance during a resistance training workout in men and women.

Enhancing Metabolic Syndrome Surveillance For Adults Taking Second Generation Antipsychotic Medication, Ilanit Marx

Doctoral Dissertations & Projects

Background: Individuals prescribed Second-Generation Antipsychotics (SGAs) face an increased risk of developing metabolic syndrome (MetS), characterized by a higher prevalence of metabolic abnormalities such as diabetes, dyslipidemia, hypertension, and obesity. This heightened susceptibility significantly raises the chances of developing cardiovascular disease and type 2 diabetes (Abdulhaq et al., 2021; Chen & Nasrallah, 2019).

Objectives: This quality improvement project aims to address the management of MetS in patients with severe psychiatric disorders prescribed SGAs. Applying the theory of planned behavior (TPB) framework, this project seeks to gain insights into the determinants shaping clinician behavior and provide a comprehensive understanding of the …

A Comparative Analysis Of Agile Vs. Traditional Project Management Methodologies In Healthcare App Development, Kruti Calcuttawala

Harrisburg University Dissertations and Theses

This study examined the effectiveness of Agile and traditional project management methodologies in developing healthcare apps. While traditional approaches like the waterfall model were commonly used in healthcare IT, their inflexibility could impede app development. Agile methodologies, with their iterative approach and collaborative nature, offer a potential solution. The study assessed both methodologies by comparing their project duration, budget, user satisfaction, and success rates and provided recommendations to optimize healthcare app development processes. It also identified the strengths and weaknesses of each methodology and their suitability for different scenarios. This study used a quantitative approach to analyze data by conducting …

An Undergraduate Baccalaureate Simulation On Weight Bias And Caring For A Patient With Obesity, Kathy Andrews

DNP Projects

Background: There is considerable evidence showing the correlation between weight related bias among healthcare professionals, and poor health outcomes for patients with obesity. Educating healthcare professionals on both safe and effective care practices and compassionate patient-centered care techniques can reduce the negative health impact of weight bias on this patient population. Purpose: This scholarly project adjusted the existing curriculum to address existing weight bias among a cohort of undergraduate baccalaureate nursing students and to inspire improvement in their care of patients with obesity. Methods: Using Kolb’s ELT a sequence of learning activities were adapted and implemented as a …

Kinetic And Kinematic Effect Of Flag-Carrying On Referee Agility And Sprinting Performance, William Reed

Master's Theses

Within competitive soccer, assistant referees are expected to keep up with the top speed of players on the field, despite being hindered mechanically by a flag held down at their side. This ability to keep up with speed-of-play can determine effectiveness of calls on the field, yet while being tested, referees are not required to replicate the game-like state of flag-carrying. The purpose of this study was to examine kinetic and kinematic effects of flag-carrying within sprinting and change-of-direction performance in assistant referees to better inform training programs and testing protocols. 18 male referees (mean age 32.11 ± 9.08 years) …

An Evidence-Based Strategy For The Use Of Simulation To Assess Situation Awareness In Applicants To Nurse Anesthesia Programs, Angela Lee

Doctor of Nursing Practice Scholarly Projects

Medical errors are considered one of the top causes of patient death. Closed claims analysis reveals an estimated 50% of claims are associated with preventable events by the anesthesia provider. Errors in anesthesia leading to critical incidents are associated with errors in situation awareness (SA). Identification of human factor variables, such as SA, provides an analysis of observable behavior and intuition necessary to guide crisis management, maintain clinical performance, and mitigate errors in patient safety. The human factor components of human error and SA play critical roles in patient safety and overall clinical anesthesia practice. The viability of simulation assessment …

Evidence Based Practice Guidelines For The Pediatric Autistic Spectrum Disorder Population, Calvin Sparks

Doctor of Nursing Practice Scholarly Projects

Children with autism spectrum disorder (ASD), as well as caregivers, experience significant challenges in their interactions with healthcare providers in a clinical setting. This is primarily due to their issues with communication, social interaction, and sensory sensitivities to anesthetic treatment during premedication or preoperative environments. Due to these characteristics, it is important to maintain and update the current standards of care for children with ASD while utilizing evidence-guided strategies to provide a pre-operative assessment effectively. The pre-operative assessment is a critical component that renders impact throughout the surgical experience with the purpose of risk stratification, preparation of altering the normal …

Development And Implementation Of An Evidence Based Practice Guideline Related To The Management Of Adult Angioedema, Megan Przybysz

Doctor of Nursing Practice Scholarly Projects

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for …

General Anesthesia Clinical Practice Guidelines For Patients With Posttraumatic Stress Disorder, Bradley Closson

Doctor of Nursing Practice Scholarly Projects

General anesthesia is an induced state of unconsciousness administered by anesthesia providers to obtain patient amnesia, analgesia, and akinesia. Adult patients with posttraumatic stress disorder (PTSD) are at risk for general anesthesia-related complications throughout the perioperative setting. Emergence delirium is a clinically significant postoperative complication that patients with PTSD have an increased risk of developing. Postoperative complications of emergence delirium include patient or medical staff injury, surgical site damage, prolonged postanesthesia care unit (PACU) stay, and increased medical care costs. Evidence demonstrates that implementing preventive interventions decreases the incidence of emergence delirium. There are no standardized, evidence-based general anesthesia guidelines …

Preprocedural Ultrasound For Labor Neuraxial Anesthesia: Evidence-Based Practice Recommendations, Nicholas Anderson

Doctor of Nursing Practice Scholarly Projects

Central neuraxial blockade (CNB) is the most widely used method of anesthesia provided to laboring patients and includes epidural, spinal, combined spinal-epidural, and caudal techniques. Studies have shown that using preprocedural ultrasound is a safe and effective tool to facilitate the placement of neuraxial needles, especially in patients with predicted difficulty. With the prevalence of obesity increasing, laboring patients with predicted difficulty of neuraxial needle placement is increasing as well. In addition, the traditional method of palpation and visualization of anatomical landmarks to place neuraxial needles can produce inaccurate results due to inconsistencies between patients. Use of preprocedural ultrasound to …

Development Of An Evidence-Based Crna Preceptor Training Program, Emmanuel Mensah

Doctor of Nursing Practice Scholarly Projects

A preceptor is an experienced clinician who is expected to facilitate a student's learning experience. Preceptorship is the relationship between a staff nurse and student, focusing on the development of clinical skills and knowledge. Initially introduced by Florence Nightingale in the 1800s, the concept was quickly adopted by nurse anesthetists and is a staple of the anesthesia practice today. As it stands, many Certified Registered Nurse Anesthetists (CRNA) preceptors do not receive formal training in their role, which may lead to a decrease in teaching ability and confidence to face broad teaching-learning issues. A lack of preparation hinders preceptor outcomes …

Incorporation Of Mindfulness Application Use In Doctoral Nurse Anesthesia Curricula For Mitigation Of Stress And Anxiety In Student Registered Nurse Anesthetists, Kerrie Rodgers

Doctor of Nursing Practice Scholarly Projects

The nurse anesthesia specialty is highly stressful, with educational training being no exception. High didactic demands and intensive clinical experiences are placed on student registered nurse anesthetists (SRNAs), increasing stress and anxiety in their personal and professional lives. High levels of psychological distress can lead to inadvertent consequences in students’ mental, emotional, and physical health and can contribute to illness, burnout, substance use, and compromise in patient safety. Some degree of stress is necessary for motivation to succeed and perform at high levels, and encountering stress while enrolled in a doctoral nurse anesthesia program is expected and unavoidable. A search …

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

Evaluating Nurses’ Turnover Intention And Organizational Commitment Following Stroke Unit Staffing Changes: An Evidence-Based Quality Initiative, Heather Tatusko

Doctor of Nursing Practice Scholarly Projects

Nurses are known to be overworked, overwhelmed, undervalued, and understaffed at dangerous levels throughout various inpatient hospital units across the United States (U.S.). Hospital registered nurse (RN) turnover is a significant issue that has accelerated since the COVID-19 pandemic, resulting in economic impacts and other burdens for organizations, individuals, and communities. Evidence suggests that evaluating Registered Nurses’ Turnover intention (NTI) and Organizational Commitment (OC) can help maintain a ready and capable team of skilled RNs; however, most healthcare organizations (HCOs) do not collect or analyze NTI and OC data and focus on staffing numbers and monetary incentives to get adequate …

Development Of Evidence-Based Practice Anesthesia Guidelines For Brain-Dead Organ Donors, Kelly Dzialowski

Doctor of Nursing Practice Scholarly Projects

Organ donation is a gift of life for both donors and recipients that can come from living donors, donors after cardiac death, or brain-dead donors (BDDs). Treating the donors with optimal care throughout the entire donation process is crucial due to organ supply shortages. Organs from BDDs are a large contributor to the number of organs donated each year and require critical care from the time of admission, declaration of brain death, and throughout the organ procurement surgery. Although each BDD requires meticulous care for successful retrieval and donation, there is a lack of evidence-based practice (EBP) guidelines for anesthesia …

Viscoelastic Monitoring In Major Hepatic Surgery: An Evidence-Based Practice Project, Randy Kinietz

Doctor of Nursing Practice Scholarly Projects

Patients undergoing major hepatic surgery are at high risk for intraoperative transfusion of allogenic blood products. These patients are at increased risk due to pre-existing hepatic pathology, surgical stress, and the complexity of surgical procedures. While blood product transfusion may be necessary to support hemostasis and hemodynamics, it is not without risk. Current literature states that viscoelastic monitoring is superior to traditional laboratory values when guiding transfusion during major hepatic surgery. Viscoelastic monitoring is a term used to describe the measurement of change in viscoelastic properties of whole blood during clot formation. There are two readily available point-of-care types – …

Routine Evaluation With Gastric Ultrasound To Reduce Gastric Aspiration (Regurga), Joel Jackson

Doctor of Nursing Practice Scholarly Projects

When a patient undergoes anesthesia, there are inherent risks that the providers should protect the patient from. Despite adherence to fasting guidelines established by the American Society of Anesthesiologists (ASA), patients undergoing anesthesia continue to experience intrapulmonary aspiration of gastric contents. There are several factors that delay gastric emptying, including coexisting disease, trauma, pain, and opioid use. Gastric ultrasound assessment of the gastric antrum is a relatively new technology in anesthesia and can be used to assess the gastric antrum and provide information to anesthesia providers regarding the risk of aspiration in the perioperative period. The primary aim of this …