Medicine and Health Sciences Commons^™

Population Burden Of Rare Infectious And Inflammatory Diseases Of The Heart, Meera Marji

Theses and Dissertations--Epidemiology and Biostatistics

Rare diseases of the heart, such as infective endocarditis (IE), myocarditis, and pericarditis, have earned limited attention in cardiovascular research despite their potential for severe morbidity and mortality. Amidst the opioid crisis in the United States, there has been a notable increase in endocarditis hospitalizations among people who inject drugs. Kentucky, at the epicenter of the opioid epidemic, lacks available data on IE hospitalizations. Moreover, the COVID-19 pandemic has introduced unprecedented challenges to healthcare systems, influencing hospitalizations and healthcare utilization patterns. While trends before, during, and after the pandemic have been extensively studied for common cardiovascular diseases, such as heart …

The Way Of Eldering: Spiritual Maturation Across The Lifespan, Kineret Yardena

Social Work Theses - Archive

Background and Objectives

People in midlife are often encumbered with uncertainty about how to transition toward later life without regret. Many sense the need to spiritually mature as they age, but lack practical guidance. Elders are those in later life who have made this transition and who have become sources of wisdom, nurturance and guidance for those younger than they. This phenomenological study explores the spiritual maturation journey of eldering.

Research Design and Methods

Ten people who were identified as elders took part in intuitive life story interviews. Using Story Method, this phenomenological study sought to identify key themes in …

A Neuroscience-Based Curriculum For Addiction Prevention For Fourth-Grade Students, Paola Andrea Benitez

Social Work Theses - Archive

Substance use is one of the main problems affecting adolescents and young adults. While the consumption of alcohol has decreased, the consumption of marijuana has increased rampantly due to youth's positive perception after being legalized in 24 states with no clear message of the many adverse effects this drug causes. Different approaches to prevention have been used throughout the years: scare-led tactics, socio-emotional learning skills, and neuroscience-based curriculums. Since substance use results from the conjunction of different biopsychosocial factors that lead to this relapsing brain disease, the solution should integrate different preventive solutions as well. Public policy, schools, social workers, …

Disparities In Low Birthweight And The Influence Of Access To Food, Maternity Care, And Medicaid Coverage Of Doula Services, Marissa Ann Beldon

Graduate Research Theses & Dissertations

This dissertation explores the ways in which access acts as both a barrier and facilitator to healthy birth outcomes. In particular, access to food, maternity care, and Medicaid coverage of doula services are explored alongside low birthweight in this dissertation through both population health and health disparity lenses. Low birthweight is a leading cause of infant mortality and thought to reflect nations’ long-term public health problems such as maternal malnutrition and inadequate receipt of maternity care. As such, sufficient access to healthy food and maternity care is essential for healthy birth outcomes.

Chapter 1 of this dissertation contains an introduction …

Effect Of Relationship Motivation On Cnm Relationship Satisfaction, Keigan Clark

Graduate Research Theses & Dissertations

This paper explored the impact relationship formation motivation had on the satisfaction of consensual non-monogamous (CNM) relationships. Using the Self Determination Theory (SDT) concept of autonomy this study tested if more intrinsically motivated open and polyamorous relationships had higher levels of relationship satisfaction compared to more extrinsically motivated relationships. A total of 564 participants completed a web survey distributed through social media and snowball sampling. Participants filled out basic demographical data as well as completing the Couples Satisfaction Index and the Couples Motivation Questionnaire. There was no difference found in relationship satisfaction in polyamorous or open relationships based on intrinsic …

When Brain Meets Artificial Intelligence, Lu Zhang

Computer Science and Engineering Dissertations - Archive

When we review the history of development of artificial intelligence (AI), we will find that brain science plays a pivotal role in fostering breakthroughs in AI, such as artificial neural networks (ANNs). Today, AI has made remarkable strides, particularly with the emergence of large language models (LLMs), surpassing expectations and achieving human-level performance in certain tasks. Nonetheless, an insurmountable gap remains between AI and human intelligence. It is urgent to establish a bridge between brain science and AI, promoting their mutual enhancement and collaborations. This involve establishing connections from brain science to AI (brain-inspired AI), and reversely, from AI to …

Step Squad Bundle In Older Adults With Multiple Myeloma Hospitalized For An Autologous Stem Cell Transplant, Nadya Panjwani

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Multiple Myeloma (MM) is a hematological malignancy with demographic disparities. MM is a debilitating cancer mainly affecting older adults, with 66% over the age of 70. Additionally, 33% of older patients with MM are frail with weakness, fatigue, slow gait, weight loss, and malnutrition.

PICOTS: The purpose of this Doctor of Nursing (DNP) scholarly project is to implement an evidence-based practice (EBP) change consisting of a Step Squad Bundle that will identify frailty in older patients with MM hospitalized for an Autologous Stem Cell Transplant (ASCT) to reduce morbidity and mortality and increase the chances of a quality of …

Increasing Colorectal Cancer (Crc) Screening In Hispanic Adults Using An Evidence-Based Social Determinants Of Health-Oriented Guide For Patient Navigation, Joyce A. Acquah Dnp, Aprn, Fnp-C

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. It affects over 140,000 individuals and results in over 50,000 deaths per year. It is estimated that increasing screening to 80% could potentially prevent approximately 300,000 new cases and over 200,000 deaths by 2030. Screening disparity among the Hispanic population is influenced by socio-economic and socio-cultural factors. The aim of this project was to develop a balanced scorecard (BSC), using publicly available data and research files from three databases (Behavioral Risk Factor Surveillance System [BRFSS], Texas Health Care Information Collection [THCIC], and Healthy North Texas …

A Clabsi Guideline For Healthcare Personnel During A Pandemic, Abiodun O. Adejumobi Dr

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Objective: The purpose of the guideline is to recommend and implement the new guidelines to the standard central line-associated bloodstream infection (CLABSI) guidelines for use during a pandemic.

Method: Articles from three different databases was conducted: PubMed, Medline, and CINAHL. One hundred articles were retrieved, and 74 articles were reviewed and evaluated. The articles were categorized based on the Johns Hopkins Hospital/Johns Hopkins University (2017) hierarchy level of evidence. Four new guidelines were created and added to the ten standard guidelines. Eleven stakeholders rated the recommendations. The stakeholder rates were sent to a statistician for analysis. Most of the ratings …

Guideline For Sbhc Provider Education To Start The Hpv Vaccine At Nine Years Old, Jasmine K. Serrano

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

It is estimated that 80% of people worldwide, regardless of gender, will contract human papillomavirus (HPV) at some point in their lives. The HPV vaccine series prevents high-risk strains that are known to cause cancer and genital warts (Osaghae et al., 2022). School-based health clinics (SBHC) can increase access to and completion of the HPV vaccine series, which remains low throughout the United States (Javaid et al., 2017; Rane et al., 2021; Shah et al., 2020). This guideline was created to increase SBH provider education to start the HPV vaccine at nine years old. The project lead conducted a systematic …

Guideline For Breastfeeding Difficulty, Collin Naugher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background

The American Academy of Pediatrics recommends exclusive breastfeeding for all infants until six months of age. In the United States, the exclusive breastfeeding rate is 52%, with a goal of 73% by Healthy People 2030 at six weeks of age. Breastfeeding difficulty will occur 70% of the time in mother-baby dyads, requiring some intervention by the primary care provider during the breastfeeding course. This study aims to build a clinical practice guideline that can guide interventions to improve successful breastfeeding rates in a birthing center.

Methods

The literature search was performed and condensed to an evidence table where studies …

Evaluation Of A Simulation-Based, E-Learning Intervention To Develop Prelicensure Nursing Students' Clinical Competency To Recognize Tracheostomy Airway Complications, Ruth Bargainer Tobin

Nursing Dissertations - Archive

Tracheostomy airway patient safety errors are a global, yet preventable problem. Unrecognized tracheostomy airway complications lead to patient deterioration, resulting in hypoxic brain damage and death or permanent disability. The majority of preventable tracheostomy events occur after patient discharge from the intensive care setting. These catastrophic events are attributed to deficiencies in competent and safe nursing care. Prelicensure nursing students have few clinical opportunities to learn tracheostomy management and may enter nursing practice lacking the clinical competency (CC) to recognize a tracheostomy airway problem. Simulation is a modality for learning high-risk skills such as tracheostomy care (TC) in a setting …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Cognitive Functioning In Well-Controlled Asthma, Erin Walsh

West Chester University Doctoral Projects

Asthma is a common lung disease that impacts lung functioning through inflammatory based mechanisms. Past research suggests that decreased blood oxygenation due to asthma attacks may impair cognitive capabilities (Irani et al., 2017). Moreover, the observed differences in cognition between those with and without asthma may be associated with disease severity or asthma control respectively in asthma populations. The current study explored differences in cognitive functioning between college students with and without self-reported asthma. Sociodemographic data, self-reported asthma severity, and measures of asthma control were collected. The current study did not find significant differences in measures of cognitive efficiency between …

Information Impact On Home-Based Palliative Care Admissions, Donna Rugh

West Chester University Doctoral Projects

Patients appropriate for Home-Based Palliative Care services are fragile with increased risk for mortality and hospital readmissions. Utilization of Home-Based Palliative Care skilled nursing services have been proven to decrease these risks and improve quality of life. Information deficits negatively impact nurse clinical decision making during the admission process, potentially misguiding the nurse resulting in a non-admission to service. This project focused on the impact of both nurse education and clinical information sharing at admission. Pre and post data was compared to examine the impact of these interventions on non-admissions rates for the reasons of “no skilled need” or “not …

The Impact Of Early Screening For Severe Alcohol Withdrawal Syndrome On Delirium Tremens And Hospital Length Of Stay, Erin Lopes

West Chester University Doctoral Projects

Alcohol use disorder (AUD) is a prevalent condition and is a leading cause of death for adults aged 20 to 64 (Esser et al., 2022). Patients with AUD who present to acute care hospitals seeking medical treatment are at risk for alcohol withdrawal. Undertreated alcohol withdrawal can progress to delirium tremens, which can result in increased transfers to ICU level of care, increased need for sedative medications, and has been shown to prolong hospital length of stay. Early screening with the validated Predictors of Alcohol Withdrawal Severity Scale (PAWSS) tool has been shown to be both reliable and effective for …

Enhancing Commercial Driver Safety Screening For Obstructive Sleep Apnea Through Educational Intervention, Wendy Mortimer

West Chester University Doctoral Projects

This quality improvement project aimed to identify if an educational intervention will increase obstructive sleep apnea (OSA) screening in commercial medical drivers over six weeks. Eight healthcare providers certified as commercial medical examiners from a national occupational company in central Pennsylvania engaged in an optional educational poster for two weeks. A pre-and post-educational retrospective chart review was performed on 80 charts, 40 from pre-educational and 40 from post-educational. Each chart was reviewed to determine if the commercial driver was at risk for OSA and, if so, if the commercial medical examiner performed an obstructive sleep apnea screening. The educational intervention …

Instructional Practices To Foster The Development Of Autonomy: A Qualitative Phenomenological Study Of The Resident Experience, Rachelle Musgrave Aker

Theses and Dissertations--Education Sciences

A growing concern in graduate medical education (GME), research indicates that some graduating residents are unprepared to enter unsupervised practice. The aim of this qualitative phenomenological study is to illuminate the resident experience surrounding the development of autonomy in clinical decision making relative to teaching practices. Research questions include: (1) What is the dual role of learner/teacher like for residents as they attend to their own and others’ development of autonomy in clinical reasoning and decision making? (2) Which teaching methods do they commonly experience as the learner and practice as the teacher relative to this development, and which methods …

Psychological And Psychosocial Effects Of Contemplative Practices In The Athletic Population: A Systematic Review, Victoria Baker

West Chester University Master’s Theses

Mental health concerns in athletes are becoming a primary focus for institutions, companies, coaches, and more. An athlete carries an abundant load of stressors due to their lifestyle. The stressors can negatively impact an athlete by producing anxiety, depression, insomnia, and other mental health issues. Previous studies have found a connection between the use of contemplative practices on psychological and psychosocial effects in athletes, creating an opportunity to evaluate the research of contemplative practices in the athletic population. A systematic review was conducted using nine electronic databases. Seven studies were included in this review, each assessing how contemplative practices affect …

Sars-Cov-2 Infectivity, And Interaction With Ace2 In The Human Oral Cavity: A Comprehensive Study, Blake Joseph Henkel

Undergraduate Honors Theses

The oral cavity has the ability to transport infections throughout the body and be infected by bacteria, fungi, protozoa, and viruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the virus that led to the most recent pandemic. SARS-CoV-2 has unique ways of interacting with the human body to infect individuals, which has led researchers and scientists to have limited knowledge on its long-term impact on human health. However, there are ways to identify various oral cavity infections and prevent infection now and in the future. Many studies have been conducted in an attempt to understand the body’s …

From Heel To Toe: Investigating Plantar Fasciitis Causes, Diagnosis, And Treatment Strategies, Breanna Littlejohn

Undergraduate Honors Theses

This presentation informs plantar fasciitis patients. The cause of plantar fasciitis is multifactorial but most cases result from overuse stress. The cause of plantar fasciitis is multifactorial but most cases result from overuse stress. The classic presentation is of sharp localized pain at the heel. In some cases, a heel spur may be found. This presentation explains how exercise can improve plantar fasciitis. Reviewing risk factors will help you identify and manage plantar fasciitis when undergoing treatment. Understanding plantar fasciitis is crucial as it is a common and painful condition affecting the bottom of the foot. This inflammation of the …

Dying Is The Easiest Part: Implications Of Palliative Care In America, Sophia Jordan

Undergraduate Honors Theses

The purpose of this paper is to uncover why Americans fear death. What are the foundational principles that cause most individuals of the American society to prolong the dying process? The topics discussed will include physician bias, disease mongering by pharmaceutical companies, consequences of aggressive treatment, the barriers to palliative care and the specific effects of pediatric palliative care. There is a small amount of research on this specific topic, therefore, this paper also seeks to bring awareness to the benefits of palliative care. It is the overall aim of this paper for society to shift their beliefs towards the …

Lived Experiences Of People With Substance Use Disorder As Healthcare Education To Develop Empathy For This Population, Whitney Bynum

Nursing | Senior Theses

The negative attitudes and feelings of healthcare workers towards patients with substance use disorder are well documented. These include, but are not limited to, believing a person with this disease is “drug seeking”, “violent”, and “unmotivated”. While this population has challenging issues to address, these beliefs can decrease the quality of care provided and results in less people seeking out needed treatment. Reducing stigmas through alternative education methods, like learning the life story of a patient, can help health care workers develop feelings of empathy and compassion. Subsequently, this education can result in better care and outcomes for these patients. …

Racial And Geographic Disparities In The Management And Care Of Sepsis, Luke Dommaschk Burwell

Nursing | Senior Theses

Sepsis, a severe condition triggered by the body's response to infection, requires prompt treatment to prevent tissue damage and organ failure. The SEP-1 Sepsis bundle, developed by Center for Medicare and Medicaid Services (CMS), aims to standardize care, particularly in rural hospitals with limited resources. However, disparities in bundle adherence and mortality rates persist, with rural areas facing more significant challenges. Studies show racial differences in care quality, emphasizing the need for interventions to address systemic biases. While sepsis bundle adherence and simulation training are strong indicators of care improvement, the literature review underscores the need for targeted interventions in …

Exploring The Impact Of Swimming On Asthma Management In Asian Americans, Trishtine Tran

Nursing | Senior Theses

Asthma is a respiratory disease that leads to narrowing of the airways in the lungs due to inflammation and mucus. Common symptoms include cough, wheezing, asthma attacks, excess mucus production, and decreased exercise tolerance. Pharmacological treatment methods for asthma include bronchodilators, corticosteroids, and allergy medications. Nonpharmaceutical treatments include monitoring of exposure to allergens and breathing exercises, however swimming is not as commonly suggested. The purpose of this study is to investigate whether implementation of a swimming education class will influence the effectiveness of swimming on asthma management in Asian Americans. This study aims to examine quality of life, changes in …

Empowering Caregivers In The Prevention Of Clinical Delirium For At Risk Older Adults Boarding In The Emergency Department Setting, Danielle Brewer

DNP Projects

Background: Emergency Department (ED) overcrowding is a global healthcare crisis documented in the literature for more than a decade, impacting patient outcomes and resource availability. While awaiting delayed transfer to an inpatient room, older adults in the ED remain vulnerable to developing acute delirium. Boarding potentiates the risk for worsening health outcomes, which are further compounded by delirium. Scarcity of resources and time constraints delay delirium detection and increase risk for down-stream hospital-acquired complications, higher cost, and prolonged length of stay. Current ED models do not prioritize caregiver partnership or involvement in delirium-conscious care, which is a holistic approach to …

Increasing Awareness Of Implicit Bias And Systemic Racism Among Clinical Staff Caring For Non-Hispanic Black Maternal Patients, Melissa Courtney

DNP Projects

Background: Kentucky is ranked 17^th in the nation for the highest maternal mortality rate in the U.S. with a rate of 22.9 per 100,000, and 78 percent of those maternal deaths were considered preventable. The Non-Hispanic Black maternal death rate in the U.S. and Kentucky is 2.9 times higher than that of the Non-Hispanic White maternal counterparts (Kentucky Department of Public Health Division of Maternal and Child Health (KDPHDMCH), 2022). The fundamental cause of maternal health inequities is structural racism, which leads to poor treatment and experiences in the healthcare system (Chinn et al., 2020). Structural racism and implicit …

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

Plasma Per-And Polyfluoroalkyl Substance (Pfas) Mixtures And Maternal Cardiometabolic Health, Yuting Wang

Dartmouth College Ph.D Dissertations

Food is a common exposure pathway to per- and polyfluoroalkyl substances (PFAS) but dietary factors related to PFAS concentrations in pregnant people have not been adequately evaluated. PFAS have been linked to the increased risk of gestational hypertension, preeclampsia, and adiposity. However, less is known regarding the effect of PFAS mixtures on blood pressure (BP) trajectories in normotensive pregnancies or weight retention postpartum. We used data from the New Hampshire Birth Cohort Study (NHBCS) to examine dietary intake and PFAS concentrations and associations of PFAS with BP trajectories and postpartum weight retention. PFAS concentrations were measured in plasma collected at …

Examining Potential Causal Associations Of Sedentary Time And Physical Activity With Heart Failure Using Subjective And Objective Measures: A Mendelian Randomization Analysis, Jessica Geller

UNF Graduate Theses and Dissertations

Purpose: The objective of this study was to assess the causal relationship between both subjectively and objectively measured sedentary time (ST) and physical activity (PA) with heart failure (HF) risk, utilizing Mendelian Randomization (MR) approach.

Methods: The present MR used genetic instruments identified for self-reported ST and PA extracted from 51 genome wide association studies (GWAS), encompassing data from 703,901 individuals. The GWAS identified 89 independent single nucleotide polymorphisms (SNPs) associated with leisure screen time. Eleven loci were reported to be associated with moderate to vigorous physical activity (MVPA). From another GWAS examining accelerometer-based activities, three loci were found to …