Medicine and Health Sciences Commons^™

Real Individuals Striving For Excellence (Rise): An Occupational Therapy Based Re-Entry Program For A Rural Jail Facility, Kennedy Tooke

Occupational Therapy Capstones

Title: Real Individuals Striving for Excellence (RISE): An occupational therapy based re-entry program for a rural jail facility.

Introduction: The United States criminal justice system continues to be known for currently holding over 2 million people within state, federal, local, and juvenile correctional facilities (prisonpolicy.org, 2021). Jail incarceration rates have increased 15% from 2020 to 2021 following a 26% decline from midyear 2019 (Zeng, 2022). Many individuals involved in the criminal justice system will be arrested again within the same year due to unsuccessful transitions back into the community. The purpose of this scholarly project was to develop a program …

Reducing Mortality Among African American Mothers Related To Postpartum Hemorrhage By Implementing Early Education And Risk Assessments, Don'ya Truesdale

Theses and Dissertations

African American women are at the highest risk for hemorrhaging during childbirth (Okunlola, 2022). A hemorrhage can occur among postpartum mothers for many reasons, with the main causes being uterine atony, tissue trauma, and clotting issues. However, risks for Black mothers differ. The comorbid and social factors within the Black community greatly influence the likelihood of Black mothers experiencing postpartum hemorrhage. Additionally, the lack of assessment and attention catered towards those risk factors lead to an increased mortality among African American (AA) mothers compared to Caucasian mothers and all other ethnicities. Nonetheless, as maternal risk assessments and education increase, mortality …

A Scoping Review Of Perceptions And Fears Experienced By Families With Children With Developmental Disabilities In Sub-Saharan Africa., Isaac Twum Boamah

Theses and Dissertations

The prevalence of perception and fear surrounding families with children with developmental disabilities in Sub-Saharan Africa reveal a complex interplay of cultural, social, economic, and healthcare factors. This interplay of factors results in stigma, which often leads to societal misconceptions and discrimination, exacerbating the challenges faced by affected families. This study seeks to identify the individual and family perception of developmental disabilities, document the stigma experienced by the individual and their families, and document the resources available to help alleviate the plight faced by the individuals and their families. It further seeks to find gaps in the literature on developmental …

Improving Healthcare Provider Knowledge And Confidence With Treating The Lgbtq Population Through A Web-Based Education Module, Logan Price

DNP Projects

Background: There is a need for improved healthcare staff and provider knowledge and confidence when treating the LGBTQ population, as many healthcare providers are insufficiently prepared to treat LGBTQ patients (Rowe et al., 2017). This population is at greater risk for mental illness, substance use, and physical illness than the general population due to societal factors such as minority stress and stigma (Cochran et al., 2004; Cochran & Mays 2007; Cochran et al., 2003; Meyer, 2003). Purpose: The purpose of this project is to educate healthcare staff and providers about the LGBTQ population to improve their knowledge and confidence when …

Point Of Care Ultrasound (Pocus) For Advanced Practice Providers (Apps), Crystal S. Rogers

DNP Projects

Background: Advanced practice providers (APPs) routinely lack the skillset to perform Point of Care Ultrasound (POCUS) because currently, there is not a standardized curriculum within scholarly programs (Santos et al., 2018) and/or inadequate hospital training to perform these competencies (Huang et al., 2021). The absence of a standard curriculum has limited the ability of APPs to practice with full scope, provide care that is comparable to physician partners in the acute care setting, and deliver highest quality of patient care. Implementing standard education to train APPs for POCUS addresses this identified gap.

Purpose: The purpose of this project was to …

Investigating The Correlation Between Social Determinants Of Health And Drug Selling Among People Who Use Drugs In Rural Appalachia, Kentucky, Grace A. Debo

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract

Aims: To identify demographic, socioeconomic, health and access to resources, and drug use correlates associated with drug selling among adult, people who use drugs (PWUD) in rural Appalachia.

Methods: This cross-sectional study analyzed survey data from the ongoing KyOSK and SNAP projects. The surveys included information on participant characteristics (demographic, socioeconomic), and health and drug use behaviors. Our analysis was restricted to only those who answered the question regarding drug selling (n=738). Both univariate and multivariate logistic regression models were employed to identify correlates of drug selling.

Results: Among 738 participants, 20.6% reported selling or attempting to sell drugs …

Pharmacy Involvement In Increased Access To Opioid Treatment Programs, Catherine O'Rourke

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The opioid epidemic still affects many Americans today. Despite approved medication treatments for opioid use disorder (OUD), a majority of the population with OUD have not received treatment. Since pharmacists are the most accessible health care professional and had an important role providing care during the COVID-19 pandemic, there has been a push to expand pharmacists’ scope of practice. The primary purpose of this investigation was to identify the benefits and barriers to community pharmacist-led treatment of OUD. The secondary purpose was to determine whether pharmacist participation in opioid treatment programs (OTPs) or office based opioid treatment (OBOT) would be …

The Effects Of Stigma Within The Prep Care Cascade Among People Who Inject Drugs In Rural Kentucky, Abby Burton

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Injection drug use has increased HIV burden in low-prevalence communities, specifically within rural Kentucky. Pre-exposure prophylaxis (PrEP) has been successful in terms of HIV prevention, yet uptake remains low among people who inject drugs (PWID). PWID living in rural areas face unique challenges to receiving PrEP care, including significant barriers of substance use- and HIV-related stigma. Recent studies have only started to explore the overlapping effects of these two stigmas. Considering the barriers each stigma independently poses to PrEP care, it is important to investigate their role in tandem for any compounding effects. This paper is a secondary analysis …

A Case Study In Program Evaluation, Lydia Williams

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The three core functions of public health are assessment, policy development, and assurance, and program evaluation falls under the latter category. A program is incomplete without an in-depth understanding of how well it works and what steps can be taken to make sure there is continuous progress and improvement.

In this case study, I developed an evaluation plan for the Lexington-Fayette County Health Department’s (LFCHD) infectious disease outbreak education program. The need for such a program was realized after a MRSA outbreak among a Kentucky high school football team. This case study employed the Center for Disease Control and Prevention …

Trust In Local Health Departments: A Cross-Sector Analysis Of Urban And Rural Communities, Kelsie Kwok

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Cross-sector collaboration is being looked to as best-practice for addressing complex issues. Given that trust is an important aspect of a well-functioning network, partners may have varying perceptions of trust regarding their counterparts. The primary objective is to examine partnerships and trust scores among six Kentucky communities (three urban, three rural) and their efforts to address unmet social needs. The secondary objective is to discuss differences among urban and rural communities regarding local health departments and the role of trust. A social network analysis (SNA) was conducted using the Program to Analyze, Record, and Track Networks to Enhance Relationships (PARTNER) …

Patterns Into Pathways For Improving Safety Culture: Refined Latent Class Analysis Informs Tailored Decision Support For South Carolina Dss Safety Culture Improvements, Michaela Voit

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The rising prevalence of exposures to adverse childhood experiences (ACEs) demands a coordinated public health response, as a significant body of research details the cumulative impact of ACEs on chronic morbidities contributing to reduced life expectancy. Child welfare workers (CWW) are embedded in this public health effort, tasked with preventing and mitigating the impacts of ACEs through family and prevention services. The National Partnership for Child Safety (NPCS) may improve the wellbeing of CWWs and the effectiveness of Child Welfare (CW) services by improving the quality of safety culture within CW organizations. To inform NPCS quality improvement efforts, our project …

Health-Related Social Needs Before And After Critical Illness Among Medicare Beneficiaries, Tamar A. Kaminski

Yale Medicine Thesis Digital Library

Health-Related Social Needs (HRSNs), such as financial strain, food insecurity, social isolation, and transportation disadvantage, are unmet social needs associated with poor health outcomes and increased healthcare utilization. In qualitative work, survivors of the intensive care unit (ICU) report financial strain; however, little is known about food insecurity, social isolation, and transportation disadvantage after critical illness. The objectives of this study were twofold: (1) to ascertain changes in three HRSNs—food insecurity, social isolation, and transportation disadvantage—from the year before critical illness to the year following discharge among older adult survivors of critical illness, and (2) to evaluate demographic, pre-admission, and …

Evaluating The Length Of Clinical Rotations In Medical Laboratory Science Education, Kendal Beazer

Dissertations and Theses

Medical laboratory scientists and technicians play a crucial role in healthcare by utilizing advanced methods to aid in the diagnosis, monitoring, and prevention of a wide range of diseases. Certifying as an MLS or MLT professional is detailed and specific, requiring years of laboratory training that is crucial to accurately perform testing that impacts patient care. Shortages of qualified medical laboratorians have persisted for decades, causing laboratory administrators to hire individuals who lack basic laboratory training. Laboratory education programs are not keeping up with the staffing demands, in part due to the lack of clinical rotation placements needed for MLS …

A Cost-Effectiveness Analysis Of Oropharyngeal Cancer Post-Treatment Surveillance Practices, Rema Shah

Yale Medicine Thesis Digital Library

Post-treatment surveillance imaging for oropharyngeal squamous cell carcinoma (OPSCC) is guided by the National Comprehensive Cancer Network (NCCN) and often is routinely performed beyond the suggested guidelines. With the advent of biomarker-based disease surveillance, there may be an alternative option that can reduce the cost-burden of post-treatment imaging for OPSCC. This study investigates the comparative cost-effectiveness of a hypothetical miRNA biomarker test for specifically HPV-negative (HPV-) OPSCC post-treatment surveillance and also investigates whether the extra imaging practices that are often employed for both HPV+ and HPV- OPSCC are truly cost-effective in order to inform evidence-based decision making after OPSCC treatment. …

Prevalence Of Metabolic Comorbidities And Viral Infections In Monoclonal Gammopathy, Mansen Yu

Yale Medicine Thesis Digital Library

Monoclonal gammopathy (MG) encompasses a spectrum of related diseases, with monoclonal gammopathy of undetermined significance (MGUS) being the most prevalent, serving as a precursor of smoldering and clinical multiple myeloma. While the association between gammopathies, metabolic conditions and antigenic stimulation has long been recognized, the precise mechanism remains unclear. Prior research has shown that a subset of MGUS and MM is driven by chronic antigenic stimulation of B cells by endogenous lipids and exogenous microbial antigens. The aim of this study is to assess the prevalence of metabolic comorbidities and viral infections in a large population with monoclonal gammopathy, providing …

Racial Disparities In Behavioral Crisis Care: Investigating Restraint Patterns In Emergency Departments, Erika Chang-Sing

Yale Medicine Thesis Digital Library

AbstractImportance: Black patients were more likely than White patients to be brought to the hospital by police, and they were also more likely to be restrained and sedated during behavioral crises in emergency departments (EDs). Although the perils of policing mental health conditions for Black individuals are recognized, it is unclear whether or to what extent police transport mediates the relationship between Black race and physical restraint use in emergency departments. Hispanic/Latino patients were less likely than White patients to be restrained in Emergency departments but more likely to be brought to the hospital by police. They were also less …

Preoperative Psychosocial Risk Burden Among Patients Undergoing Major Thoracic And Abdominal Surgery, Emily Park

Yale Medicine Thesis Digital Library

Objective: Patient-related, biological risk factors such as age, diabetes, and smoking are associated with worse outcomes and increased postoperative complications rates in patients. However, not much is known about the effects of psychosocial risk factors on surgical outcomes. This study aimed to characterize the psychosocial risk burden in patients undergoing major surgery for malignant and benign conditions. Methods: A prospective, comprehensive psychosocial risk assessment of adult patients undergoing major thoracic or abdominal surgery within the Yale New Haven Health system was conducted from July 2023 to December 2023. The study was delivered over telephone, and was comprised of validated survey …

Association Between Fine Particulate Matter And Eczema: A Cross-Sectional Study Of The All Of Us Research Program And The Center For Air, Climate, And Energy Solutions, Gloria Chen

Yale Medicine Thesis Digital Library

A chronic inflammatory skin disease characterized by disruption of the epidermal barrier, eczema has increased in prevalence in tandem with industrialization. Ambient air pollution is a ubiquitous exposure resulting from industrial processes that includes fine particulate matter with aerodynamic diameter measuring less than 2.5 µm (PM2.5). Studies on the potential association between PM2.5 and eczema have produced conflicting results. The objective of this study was to determine the risk of eczema with exposure to PM2.5 in a diverse national cohort of American adults.

In this cross-sectional study, eczema cases were identified via electronic health records (EHR) in the All of …

Healthcare Expenditure On Atrial Fibrillation In The United States: The Medical Expenditure Panel Survey 2016-2021, Claudia See

Yale Medicine Thesis Digital Library

Introduction: Atrial fibrillation (AF) is the most common cardiac arrythmia affecting up to 6 million people in the United States (US). With an aging population and increased detection through self-monitoring devices, AF prevalence will substantially rise in the future. AF often co-exists with other comorbidities and is associated with significant morbidity and healthcare costs. AF management has also been evolving with increased use of anti-arrhythmics, newer anticoagulants, and procedures to maintain sinus rhythm. In this backdrop, our study aims to provide a contemporary national assessment of AF costs using the Medical Expenditure Panel Survey (MEPS), the largest all-payer nationally representative …

Confronting Cte: A Blog Dedicated To Increasing Awareness In Chronic Traumatic Encephalopathy, Caden Shea

Honors Program Theses

The variation on a creative thesis that I formed was a website and blog that utilized research about Chronic Traumatic Encephalopathy and how it affects athletes of all kinds, specifically athletes in the National Football League. The reason that I chose this topic is because the field that I hope to go into is that of sports journalism. One of the biggest problems facing sports leagues all over the world is the issue of safety. One of the biggest safety concerns in sports is that of head injuries, and one of the most prominent head injuries is CTE. I chose …

Near-Infrared Paired-Agent Imaging For In Vivo Quantification Of Receptor Occupancy In Tumor, Yichen Feng

Dartmouth College Ph.D Dissertations

Accurate assessment of drug receptor occupancy (RO) holds significant importance in both drug development and personalized medicine, as it facilitates quantitative characterization of dose-response relationship for a given drug. This information not only aids appropriate dose selection for clinical trials but also guides personalized dose optimization in precision medicine.

Molecular imaging, utilizing receptor-specific imaging agents for tissue visualization, has emerged as the major option for in vivo measurement of tissue RO. Nonetheless, the abnormal yet complex structure and hemodynamics of tumors often lead to substantial non-specific uptake and retention of imaging agents, thus introducing significant bias to RO measurements. To …

Autonomic Modulation Of Cardiac Function In Hypertrophic Cardiomyopathy, Jenna Rose Disser

Dissertations, Master's Theses and Master's Reports

Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disorder. HCM is characterized by cardiac hypertrophy, fibrosis, and an increased risk of fatal arrhythmias and sudden cardiac death. Previous studies in humans with HCM have demonstrated increased cardiac norepinephrine spillover and reduced beta-1 receptor (β1R) expression in the left ventricle (LV). We have previously demonstrated that cardiac sympathetic tone is elevated in an alpha-tropomyosin mutant mouse model of HCM. We hypothesized that HCM mice would demonstrate reduced β1R expression in the LV and attenuated heart rate (HR) and dP/dt max responses to ramped infusion of the β1R agonist, dobutamine. …

New York City’S Health Governance And Activism From The 1950s To The 1970s, Andres Valcarcel

Theses and Dissertations

New York City's expansive network of hospitals and preventative health services has an intense history outside of the popular narratives of biomedical and technological advancement. This thesis will discuss the period between the 1950s and 1970s and the various movements and parties that shaped the city's health and hospital system. During this period, New York City's healthcare delivery system became increasingly privatized and commercialized; processes that improved the quality of healthcare yet simultaneously barred the poorest from accessing it. Communities, healthcare workers, and civil rights organizations worked to address perceived faults and extend their agency in health and hospital policy; …

Synthetic Neuroactive Steroids Targeting Gaba-A Receptors As A Potential Therapy For Contraceptive-Associated Mood Disorders, Alexandria A. Davis

Scripps Senior Theses

4-10% of women who use hormonal oral contraceptives (HOCs) discontinue use after experiencing symptoms of anxiety, irritability, and depression in the first 3 months of administration. Previous studies have acknowledged a relationship between HOCs and emotional dysregulation but have not identified mechanisms by which HOCs have this effect. As a result, effective treatment options for HOC-induced mood disorders are lacking. Current theories implicate combined-HOCs, particularly those containing ethinyl estradiol and levonorgestrel (EE-LNG), in reducing neuroactive steroid levels. Specifically, HOC users show decreases in allopregnanolone, a positive allosteric modulator associated with neuronal inhibition and emotional regulation. The objective of this study …

Racial Disparities In Plea Bargaining: An Examination Of Coercive Dynamics In The Negotiation Process, Naszya Iman Heidi Bradshaw

Scripps Senior Theses

This research addresses the enduring concerns about the ethical and legal intricacies of coercion in plea bargaining within the U.S. criminal justice system, with a focus on its correlation with racial disparities. This study acknowledges an existing research gap in comprehending the subtle dynamics of coercion and its differential impact on Black and Latin individuals. By employing the Cumulative Disadvantage Theory and Dual Processing Theory, the research aims to investigate the differential susceptibility to coercion during plea bargaining among individuals from Black and Latin communities compared to their white counterparts. Variables such as the severity of criminal charges, the quality …

Psychotropic Polypharmacy On Heart Rate Of Daphnia Magna, Gwendolynne Miller, Brian Bagatto

Williams Honors College, Honors Research Projects

The prevalence of patients being prescribed multiple medications concurrently is significantly rising, and so is the importance of investigating any interactions between medications. One common example—sertraline and clomipramine have been used together to treat obsessive compulsive disorder. Clomipramine, however, is known to cause tachyarrhythmias in some patients. The present study set out to investigate the role of this drug combination on the heart rate of a simple animal model, Daphnia magna, or the water flea. The water flea was exposed to saline, sertraline, clomipramine, or sertraline plus clomipramine, and heart rate was measured subsequently. It was found that the …

Creation Of A Survey And Study On Sleep Habits Of College Students, Sierra Stein

Williams Honors College, Honors Research Projects

Sleep is extremely important in all aspects of life. From the time someone is born to the time they pass they need sleep. It is crucial for their abilities to function and live their day to day lives. However, in different parts of life sleep is more crucial than ever. Young adults/college age students are one of those groups who need sleep but tend to pass up on adequate sleep. Throughout this, there will be the detailed importance of sleep and one way in which sleep can be studied in correlation to academics, physical health, eating habits, mental health and …

The Effects Of Social Support On Recovery Outcomes Of Hip Fracture Patients, Preshecca Ragavan

Williams Honors College, Honors Research Projects

This literature review, completed under the guidance of Ms. Anuja Sarode-Paciorek from Summa Health - Akron, will investigate the effects of social support on the recovery outcomes of hip fracture patients. As part of this literature review, I will collect and analyze several scientific journal articles previously published on this topic to gain an overview of what prior knowledge clinical researchers have already gathered about this topic. As part of the analyses, each article will be thoroughly read and briefly summarized. Then, these summaries will be used to compile a list of a few strengths and a list of a …

Observed Effects Of Physiological Melatonin Dosing On Mda-Mb-231 Breast Cancer Cell Proliferation, Wenli Wu

Williams Honors College, Honors Research Projects

This project seeks to evaluate pharmacological dosing of melatonin on the cell proliferation of MDA-MB-231 breast cancer cell line in culture, using the two solubility carriers: DMSO/water and ethanol. This experiment is a component of ongoing research at the Eaton lab which will elucidate melatonin dose-response toxicology in zebrafish and a possible breast cancer xenograft model for novel treatment therapies.

African American Adolescent Suicidality And Prevention From An Urban School Counselor Perspective, Shannon Franklin

Master's Theses and Doctoral Dissertations

African American adolescent suicidality has become more prevalent, and urban school counselors are positioned uniquely to intervene. This research studied the overarching societal factors in the sociocultural, economic, and political spheres that influence increased suicidality behaviors in African American adolescents from the perspective of urban school counselors. The focus of this research was to hear the lived experiences of urban school counselors regarding the impact of racial discrimination on African American adolescent suicidality. The two theoretical frameworks that were used to support this study are the world-systems analysis theory and critical race theory. This study took a qualitative phenomenological approach …