Medicine and Health Sciences Commons^™

A Geospatial Analysis Of Norovirus Outbreaks In California, And An Investigation Of The Impact Of Environmental Variables, Alexandra Groen

Master's Projects and Capstones

Previous studies and empirical evidence suggest norovirus outbreaks in California exhibit correlation with environmental variables and exhibit spatial spread patterns. Few studies have been done looking at what causes norovirus seasonality in temperate climates and more research is needed on the regional level. This study aims to find what relationships exist with outbreak occurrence and environmental variables in California, as well as any spatial patterns of spread or clustering of outbreaks. Spatial analysis tools were used to find any relationships between California norovirus outbreak data and environmental variables. The results showed a south to north spread of outbreaks in California …

Preop Evaluation/Post Operative Care (Nutrition, Pain Management), Malia Eischen Md, Meghan L. Good Md, Lung-Ching Lee Md

Department of Surgery

No abstract provided.

Pre-Exposure Prophylaxis (Prep) Education Improvement Project, Reginald M. Hilarie

Master's Projects and Capstones

In 2012, the US Food and Drug Administration approved the pill Truvada for use as pre-exposure prophylaxis or PrEP. Its purpose is to help prevent HIV infection by taking one pill every day. This project aims to improve PrEP patient education provided by the multi-disciplinary team and to decrease new HIV infection and sexually transmitted infections (STIs) to zero. The focus of the study is patients on PrEP at the Infectious Disease and HIV Clinic in San Francisco Veterans Administration Medical Center. The Clinical Nurse Leader, in collaboration with the multidisciplinary team, incorporated Pender’s Health Promotion Model Theory in developing …

Improving Hand Hygiene Compliance To Reduce Clabsi Rate In Oncology Icu, Lorenzo D. San Pedro

Master's Projects and Capstones

The aim of this project is to reduce the rate of central line associated blood stream infection (CLABSI) occurrence in oncology ICU by 50% by the last quarter of 2015. This study was conducted in ICU to assess adherence to the facility’s hand hygiene (HH) protocol among the staff nurses and allied healthcare workers. The facility is best known as a non-profit cancer treatment center and designated as a Comprehensive Cancer Center. Evidence showed that hand hygiene is the most effective way of preventing CLABSI, one of the most common types of infection in ICU microsystem. The project utilized The …

Improving Dental Care To The Elderly In A Nursing Home, Cara M. Licavoli

Master's Projects and Capstones

The project is about the collaboration between Peninsula Health Care District (PHCD) and Apple Tree Dental (ATD) in a team approach to address the current issues of improving dental care of frail and elderly patients in nursing home facilities. The specific aim is to improve dental care of clients at the San Mateo County nursing home facility by 100% by May, 2015. The methods use in this project was the adaptation and implementation of existing dental/oral health assessment tools, that is nurse driven for patient assessment upon admission to the nursing facility. The process includes staff education regarding the adapted …

Emergency Response Improvement Project, Ewan Stephen Macdonald

Master's Projects and Capstones

The objective of this CNL internship project is to improve team response to emergencies through staff education and protocol development with 100% participation within six months. This need was determined after an intense analysis following a near code on a pediatric patient. After an investigation, two problems were chosen as a focus for improvement: limited educational opportunities, and poor coordination and delegation during codes. Lewins’s theory of change was used as the theoretical framework, which involves the concept of unfreezing, movement, and refreezing. The method utilized was to offer education and training sessions twice per month in the form of …

Vap Prevention In The Cticu, Pres Lorenzo

Master's Projects and Capstones

The Agency for Healthcare Research and Quality (2015) has cited ventilator-associated pneumonia (VAP) as the most common infection in the ICU. In 2014, four episodes of VAP were identified in the 25-bed adult cardio-thoracic ICU (CTICU), a dynamic clinical environment within an academic medical center in Northern California specializing in complex cardiac surgery patients, including heart and lung transplants. In early 2015, the CTICU embarked on an evidence-based project to decrease the number of episodes of VAP to zero. Using the ACE Star Model of Knowledge Transformation as the theoretical framework and the CUSP (Comprehensive Unit-based Safety Program) standards as …

Perinatal Patient Management, Natalie Whitten

Master's Projects and Capstones

The medical center has lacked the bed capacity and nursing staff to accommodate the needs of maternity patients. Patients are redirected to other network and non-network medical centers due to lack of bed availability, inadequate nurse staffing, and poorly managed patient movement. This project aims to improve patient management in the perinatal departments, including the discharge process. We will have 100% staff participation to facilitate bed management. The patient management project was conducted in a 200-bed hospital serving the residents of an urban area. The perinatal areas of labor & delivery (L&D), antepartum, and postpartum (OB) are highly productive units …

Art Therapy Considerations With Transgender Individuals, Bryan A. Schnebelt

LMU Theses and Dissertations

This qualitative research study examines the use of art therapy as a treatment modality with transgender individuals, as well as provides a brief background into transgender identity, in order to recognize considerations for enhanced care of this population. A semi-structured interview approach was applied with art therapists who have utilized art therapy with transgender clients. This study focuses on areas of identity development, aspects of trauma and transphobia and their effects, treatment approaches, and cultural components to working with transgender individuals. Through this research, a recognition of transgender identity as its own cultural entity was found to be important in …

An Arts Based Exploration Of Immigration And Acculturation Through The Lenses Of First, Second And Third Generation Clinical Art Therapists, Elizabeth Barraza, Christina Sanchez, Carmen Solis

LMU Theses and Dissertations

This research examines the impact of acculturation and immigration through the lived experience of first, second, and third generation Hispanic/Latina clinical art therapists. The objectives include the exploration of cultural identity, processing the immigration experience and the role of art therapy. Topics that emerge in the general literature include development of identity, depression, and immigration-related stressors. Although the art therapy literature is limited within the context of immigration and acculturation, information regarding the role of the art, common imagery in groups, and the importance of cultural awareness is available. An arts-based approach is used in the clinical work to help …

The Role Of Art Making In The Recovery From A Physical Disability Due To Trauma, Erika Y. Schreefel

LMU Theses and Dissertations

This qualitative research study presents an examination of the role that art making fulfills in the recovery efforts following the development of a physical disability due to a trauma. Preexisting literature informed the current study on art making’s ability to manage psychological and physical stressors that can accompany the development of a physical disability due to a trauma experience. The current study utilized a focus group to gain a better understanding of art making’s benefits by obtaining firsthand accounts from individuals with experience incorporating art making in their own recovery process. Data collected during the focus group suggests that the …

A Heuristic Study Of A Wounded Healer, Samantha Mcmullen

LMU Theses and Dissertations

Art therapy and narrative therapy techniques are both used separately in treating sexual abuse, however they are not often used together. This heuristic study explores the experience of a wounded healer when using art within a narrative therapy process, specifically storytelling, to support healing from multigenerational incestuous abuse. This researcher used a science fiction story she is currently writing, to stimulate 8 reflections on the parallels in that story and in her personal trauma narrative, and then made adjoining art pieces about the reflections. The data was analyzed to find themes, such as protection, anger and fear. The art helped …

Adolescents, Social Media, And The Use Of Self-Portraiture In Identity Formation, Sharee Nicole Allen

LMU Theses and Dissertations

Adolescence is a time of maturation, integration of selves, and, in the modern age, digital performance on social media. Conflicts in the identity vs. role confusion stage of Eriksonian development are addressed throughout this research, although the existing literature rarely connects them to online trends. A qualitative survey, sent to high school students, explores the tension between self-doubt and the desire to be seen. Responses indicate that teens who post on social media are attempting to make sense of their formative years via the reactions of this networked world. Certain participants show resistance to the phenomenon of the Selfie, implying …

The Advances In Prosthetics, Jose Garcia

Symposium Of University Research and Creative Expression (SOURCE)

Throughout time, many people have been able to build, create, and do amazing things with their arms and legs. However, those who have lost limbs at birth or through an event in their life sometimes have a harder time being as accomplished as others. While some people without limbs have had a harder life, some have been able to accomplish what others with a normal physiology can by the use of prosthetics. This presentation will focus on the advances of prosthetics, the benefits for the user, and their future development. The main focus will be on prosthetic arms and their …

A Cost Analysis Of The 1-2-3 Pap Intervention, Kristina M. Rabarison, Rui Li, Connie L. Bish, Robin C. Vanderpool, Richard A. Crosby, Mehran S. Massoudi

Frontiers in Public Health Services and Systems Research

Background: Cervical cancer places a substantial economic burden on our healthcare system. The three-dose human papillomavirus (HPV) vaccine series is a cost-effective intervention to prevent HPV infection and resultant cervical cancer. Despite its efficacy, completion rates are low in young women aged 18 through 26 years. 1-2-3 Pap is a video intervention tested and proven to increase HPV vaccination completion rates.

Purpose: To provide the full scope of available evidence for 1-2-3 Pap, this study adds economic evidence to the intervention’s efficacy. This study tested the economies of scale hypothesis that the cost of 1-2-3 Pap intervention per number of …

Migrant Health Education At Broetje Orchards, Megan Baker

Symposium Of University Research and Creative Expression (SOURCE)

Although it is recognized that there is a gap in health education in migrant and other under-served populations, very few programs have been established to address this problem. This research is important because it highlights areas in which health education is lacking and provides suggestions on how to address these issues. The purpose of the research was to assess the health education program present in the migrant community living in the Vista Hermosa community at the Broetje Orchards in Prescott, Washington, and to compare it to other migrant and agricultural communities. The Vista Hermosa Community is a unique case study …

Family Planning And Reproductive Health Experiences Of Latina Women In A United States Border City, Erika Ojeda, Margarita Manzo-Casio

Symposium Of University Research and Creative Expression (SOURCE)

Family planning and reproductive health services are essential protective factors against unwanted, unintended, or mistimed pregnancies. However, underserved women such as those who are low-income, uninsured, or geographically or linguistically isolated may not have optimal access to these essential services. This study explores the experiences of Latina women in a United States’ border city in accessing family planning care through focus group discussions. We conducted two focus groups with Latina women of reproductive age in a border town in the United States, n=16. Focus groups were conducted in Spanish and audio recorded for transcription. Two independent bilingual student researchers transcribed …

Central Washington University Campus Community Garden: A Mural Project, Angie Love, Blanca Soto, Catherine Leger, Alex Johnson

Symposium Of University Research and Creative Expression (SOURCE)

This service-learning project represents the first phase of constructing a mural for the campus community garden at Central Washington University. The purpose of the mural is to bring awareness to the garden by creating a welcoming space that empowers the community to learn from, work with, and teach others. As a group, we became involved with the Campus Community Garden through a Health Education (HED) course, Community Organization and Coalition Development (HED 450). The purpose of this course is to provide public health students the knowledge, practices, and skills necessary to be successful while working with community organizations. We started …

Trends In Youth Drug Behavior In Guam, Jennifer Mccutchen

Symposium Of University Research and Creative Expression (SOURCE)

As a United States territory, the island of Guam is home to 159,358 individuals, including adolescents and young adults. Drug activity among Guamanian youth has increased considerably over the last 20 years. The purpose of this study is to examine trends in drug-related activities and behaviors among adolescents on the island of Guam, using the Youth Risk Behavior Surveillance System (YRBSS) public data set. Participating in drug use, sale, or other distribution during adolescence has been associated with declining grades, dropping out of high school, patterns of criminal activity, and both physical and mental health conditions, making it a concerning …

Preliminary Evaluation Of The Disease Surveillance System During Influenza Outbreaks Of Pandemic Scale, Eric Meisheri, Diana M. Prieto, Peter Holvenstot, Richard Vanenk

Frontiers in Public Health Services and Systems Research

In the United States it is currently unknown whether the influenza surveillance system is capable of producing timely and accurate data for case estimation during an outbreak of pandemic scale. This simulation provides a preliminary evaluation of the surveillance system’s ability to collect data and produce timely and accurate trends of cases confirmed with an influenza virus. For the evaluation, a computer-based simulation of the data-collection process was used, which was validated with real demographic and epidemiologic information. The results were analyzed to determine the most significant behavioral and operational factors influencing the data collection and to propose the exploration …

Amyotrophic Lateral Sclerosis, The Primary Motor Neuron Disease, Jacob P. Naumann

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Amyotrophic lateral sclerosis is a degenerative neurological disease that damages nerve cells in the brain, in particular the neurons that are involved in voluntary muscle movements. Internationally the disorder is also known as Charcot’s disease and motor neuron disease. In the United States, amyotrophic lateral sclerosis is often referred to as Lou Gehrig’s disease, motor neuron disease, and more colloquially ALS. Amyotrophic Lateral Sclerosis is the most prominent of the five motor neuron diseases, distinguishing itself from the others through degeneration of both upper motor neurons (UMN) and lower motor neurons (LMN) respectively. The “Father of neurology” Jean-Marie Charcot founded …

Novel Advances In Alzheimer's Disease, Jacob P. Naumann

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Alzheimer’s disease, the most common form of dementia in adults, is a progressive degenerative neurological disease that affects memory, cognition, and behavior. Dr. Alois Alzheimer discovered and diagnosed the irreversible disease in 1906 after documenting the famous case of Auguste Deter.¹ Since the discovery of the disease, numerous advances have made it possible to not only better understand the causal factors, but also to improve the medical diagnosis and preventative measures that healthcare providers can implement. For the first time since 1984, the National Institute on Aging (NIAA) and the Alzheimer’s Association (AA) proposed and published new diagnostic guideline …

Determination Of Dioctyl Phthalate (Dehp) Concentration In Polyvinyl Chloride (Pvc) Plastic Parts Of Toothbrushes, Ghazal Sadeghi, Elham Ghaderian, Anne O'Connor

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Phthalates are chemicals that are widely used in daily products and polyvinyl chloride (PVC) plastics, mainly because of their ability to enhance flexibility and durability. The presence of phthalates in various products contributes to the substantial exposure that all consumers may experience. Continuity in phthalate exposure has several side effects, including endocrine disruption, neurological damage, asthma, hormonal imbalances, obesity, infertility, genital defects, and testicular cancer. The purpose of this research experiment was to determine the Dioctyl phthalate (DEHP) concentration of PVC plastic parts of toothbrushes. The method used to conduct the experiment was Gas Chromatography/Mass Spectrometry. The result showed that …

Music Therapy As Treatment For The Psychological Distress Of Victims Of Intimate Partner Violence: Comparing Expressive And Receptive Music Interventions, Kristiana Miner

Theses and Dissertations

Domestic violence or intimate partner violence refers to physical, sexual, or emotional harm committed by a current or former intimate partner. Intimate partner violence has varied and serious repercussions in the lives of its victims. The direct consequences of violence combined with the physical aftermath of emotional distress, fear, and anxiety can lead to a variety of ailments. Posttraumatic Stress Disorder and suicide are both major concerns for female victims of IPV. Considering that the issues faced by many victims of DV are pervasive and complex, treatment for survivors needs to be comprehensive and multifaceted. Music therapy is an evidence-based …

Intestinal Colonization Dynamics Of Vibrio Cholerae, Salvador Almagro-Moreno, Kali Pruss, Ronald K. Taylor

Dartmouth Scholarship

To cause the diarrheal disease cholera, Vibrio cholerae must effectively colonize the small intestine. In order to do so, the bacterium needs to successfully travel through the stomach and withstand the presence of agents such as bile and antimicrobial peptides in the intestinal lumen and mucus. The bacterial cells penetrate the viscous mucus layer covering the epithelium and attach and proliferate on its surface. In this review, we discuss recent developments and known aspects of the early stages of V. cholerae intestinal colonization and highlight areas that remain to be fully understood. We propose mechanisms and postulate a model …

Regulators Associated With Clinical Outcomes Revealed By Dna Methylation Data In Breast Cancer, Matthew H. Ung, Frederick S. Varn, Shaoke Lou, Chao Cheng

Dartmouth Scholarship

The regulatory architecture of breast cancer is extraordinarily complex and gene misregulation can occur at many levels, with transcriptional malfunction being a major cause. This dysfunctional process typically involves additional regulatory modulators including DNA methylation. Thus, the interplay between transcription factor (TF) binding and DNA methylation are two components of a cancer regulatory interactome presumed to display correlated signals. As proof of concept, we performed a systematic motif-based in silico analysis to infer all potential TFs that are involved in breast cancer prognosis through an association with DNA methylation changes. Using breast cancer DNA methylation and clinical data derived from …

Angiotensin Ii Is Required To Induce Exaggerated Salt Sensitivity In Dahl Rats Exposed To Maternal Separation, Analia S. Loria, David M. Pollock, Jennifer S. Pollock

Pharmacology and Nutritional Sciences Faculty Publications

We previously reported that maternal separation, rat model of early life stress, enhances pressor responses to acute and chronic stressors. The aims of this study were to determine whether Dahl salt-sensitive (DS) rats subjected to maternal separation (MatSep-DS) as compared to normally reared DS (Ctl-DS) rats show exaggerated blood pressure responses to acute behavioral stressors, such as restraint stress or air jet stress (AJS), or, hypertensive stimuli including chronic high-salt diet (4% NaCl) and angiotensin II (AngII) infusion (200 ng/Kg/min) during 1 week. MatSep was performed in male DS rats for 3 h/day from postnatal days 2-14. At 8 weeks …

Colonoscopy Screening Among Us Adults Aged 40 Or Older With A Family History Of Colorectal Cancer, Meng-Han Tsai, Sudha Xirasagar, Yi-Jhen Li, Piet C. De Groen

Faculty Publications

Introduction
Colonoscopy screening reduces colorectal cancer (CRC) incidence and mortality. CRC screening is recommended at age 50 for average-risk people. Screening of first-degree relatives of CRC patients is recommended to begin at age 40 or 10 years before the age at diagnosis of the youngest relative diagnosed with CRC. CRC incidence has increased recently among younger Americans while it has declined among older Americans. The objective of this study was to determine whether first-degree relatives of CRC patients are being screened according to recommended guidelines.

Methods
We studied colonoscopy screening rates among the US population reporting a CRC family history …

Improving Patient Safety: Reducing Medication Errors In The Microsystem, Erica M. Dent

Master's Projects and Capstones

In a 72-bed for-profit long-term acute care hospital located in an urban setting, there has been a fifteen percent increase of medication errors that the pharmacy department has detected across nursing, and pharmacy departments, as well as with physicians from both day and night shifts. Over the last month there has been a total of twenty-eight medication errors including the transcription, administration, evaluation, and documentation processes. The microsystem consists of a telemetry/medical-surgical unit as well as a small intensive care unit consisting of ten beds.

The prospectus details a project implemented to reduce medication errors within the microsystem. The steps …

In-Patient Self-Management Diabetes Education, Amy Matthews

Master's Projects and Capstones

The diabetes program strives to provide diabetes self-management education to the in-patient with diabetes. The specific aim is to improve and standardize diabetes education for the inpatient with diabetes by June 2015. The microsystem is a medical surgical unit for patients 18 years and older who present with diabetes as either a primary diagnosis or secondary diagnosis. Fifty percent of the diabetes patients on this unit are ages 65-89 years old, twenty nine percent are ages 50-64. The unit has 32 beds and is filled to capacity ninety five percent of the time. The fishbone diagram revealed our microsystem lacked …