Medicine and Health Sciences Commons^™

Minimizing The Inappropriate Use Of Physical Restraint, Shiela Marie C. Telmo

Master's Projects and Capstones

The aim of this project is to be able to improve patient safety by minimizing the inappropriate use of physical restraints from 45% to about 20% in the acute respiratory unit which caters to patients with acute respiratory issues, such as exacerbation of chronic obstructive pulmonary disease (COPD), patients with new or old tracheostomy, needing bipap, rigorous nebulizer treatment, and other respiratory-related devices, not to mention the multiple comorbidities that oftentimes very difficult to stabilize which makes the hospital stay longer than usual. The Clinical Nurse Leader (CNL) as an educator and an outcome manager is an agent to empower …

Exploration Of Factors Affecting Nurse Faculty Use Or Resistance To Online Education, Lisa M. Harless

Nursing Theses and Dissertations

The substantial increase in online nursing program enrollment demands that nurse educators be adept in the delivery of online education; however, a significant challenge exists in how to deliver practice-based nursing education in the online environment. Teaching online requires a change in the traditional role of the educator accompanied by the effective use of online learning technologies. Some studies suggest that faculties remain pessimistic to online delivery of education and do not participate, yet few objectively examine variables that influence resistance or use. Included in this dissertation are two manuscripts. The first manuscript defines resistance and addresses prominent concerns associated …

Breast Cancer-Related Lymphedema In Hispanic Women: A Phenomenological Study, Juanita C. Acebedo

Nursing Theses and Dissertations

Objective: This study explored the lived experience of Hispanic/Latino women dealing with BCRL.

Participants: A convenience and purposive sampling of 13 Hispanic women, 42-80 years old with diagnosed breast cancer-related lymphedema for over one year, were recruited December 2015 – April 2016.

Methods: Using interpretive phenomenology, Hispanic women with BCRL were individually interviewed using open-ended questions to explore common themes experienced by this particular ethnic group. Sampling continued until data saturation was met. Recruiting took place through four health care practices in south Texas. Data consisted of field notes, researcher journaling, recorded audio interviews, and the respective transcriptions. Data analysis …

Impact Of Nurse Fatigue And Nursing Handoffs On Patient And Nurse Safety, Melody A. Seitz

Nursing Theses and Dissertations

In healthcare today, patient safety continues to be a major concern. Nurse fatigue from long work shifts and inadequate patient handoffs may lead to errors and near errors that harm patients and nurses. The intent of this study was to fill a gap in understanding the effect shift length has on patient safety and maternal newborn nurses’ personal safety. A cross sectional survey design was administered via Qualtrics, a web-based online software program. Participants included two groups of maternal newborn nurses. One group worked 8-hour shifts (N = 70) and the other group worked 12-hour shifts (N = 151). Statistical …

Pharmacovigilance In Post-Marketing: Risk Assessment And Reporting Standards, Tiffany Jee

Master's Projects and Capstones

While there has been new targeted drug therapies released into the market over the recent years, pulmonary arterial hypertension (PAH) remains to be a rapidly progressive disease with poor prognosis. Over time the arteries stiffen and tighten subsequently leaving the heart to pump harder to try and provide enough blood to the body. The extra stress of the increased pumping leads to weakening and enlargement of the heart. The endothelin targeted therapy, Letairis (ambrisentan), is an oral tablet proven to improve quality of life in patients suffering from PAH, WHO Group I – functional class II and III by helping …

Polymeric Nanocarriers For Delivery Of Small Molecules And Mirnas For The Treatment Of Liver Fibrosis And Pancreatic Cancer, Virender Kumar

Theses & Dissertations

The aim of this thesis is to develop combination therapy of small molecules and miRNAs for treating liver fibrosis and pancreatic cancer. New amphiphilic biodegradable polymers capable of carrying small hydrophobic molecules and hydrophilic anionic nucleic acids were synthesized, characterized and evaluated in vitro and in vivo liver fibrosis and pancreatic cancer mouse models.

In Chapter 1, an overview of liver fibrosis, current treatments and the role of miRNAs in liver fibrosis as well as the design of their delivery systems is given. Further, a general introduction to pancreatic cancer and role of miRNAs in pancreatic cancer is given. In …

Development Of Cxcr4-Inhibiting Nanoparticles For The Treatment Of Metastatic Cancer, Yan Wang

Theses & Dissertations

Metastasis is the main cause of cancer mortality and morbidity, leading to several million deaths every year. Less than 20% of pancreatic cancer (PC) patients are candidates for surgery due to spread beyond the pancreas. Desmoplasia presents substantial barriers to perfusion, diffusion, and convection of antitumor therapeutics into the PC tissues. We focus on developing novel therapies that regulates tumor microenvironment, chemosensitizing tumor to therapeutics and preventing metastasis.

Gene therapy is emerging as a promising new therapeutic agents for cancer treatment. A targeted, systemic, effective and safe gene delivery system should be developed. CXCR4/SDF-1 axis plays a crucial role in …

Effects Of Flash-Free Technique On Plaque Retention, White Spot Lesions, And Bracket Failure: A Randomized Clinical Trial, Payam Ishani Afousi

Theses & Dissertations

A side effect of orthodontic treatment is the development of white spot lesions (WSLs). This thesis attempted to evaluate the effects of the use of APC™ Flash-Free (FF) and conventional adhesives in bonding of orthodontic brackets on plaque formation and retention, WSL development, and bracket failure in-vivo. This was accomplished by collecting plaque samples from around orthodontic appliances and analyzing them using ATP-driven bioluminescence; scanning enamel surfaces using the Canary System™ to evaluate WSL development, and counting the number of spontaneous debonding of brackets of the 4 maxillary incisors in the first 6 months of treatment. It was found …

Bone Loss Quantification Following Extraction In Rats: A Foundation For Grafting And Regenerative Studies, Emily Willett

Theses & Dissertations

Background: Loss of the alveolar ridge width and height following extraction is well-documented and several techniques, including grafting, have been proposed to reduce bone loss. Purpose: To characterize the pattern of bone turnover and inflammation after extraction and to initiate a study of the effect of grafting and local administration of simvastatin (SIM). Methods: Thirty-two retired-breeder rats underwent extraction of the right maxillary first molar and standard surgical defect creation under inhalation anesthesia. The left side of each animal served as the unmanipulated control. Comparison of groups (n=8, ANOVA) was done at days 0, 7, 14, and …

Evaluation Of The Nursing Handoff Process From Emergency Department To In-Patient Unit, Yana Marutyan

Master's Projects and Capstones

Handoff, or transition in care, is known to be a danger point in the patient care process for a long time. Ineffective communication during handoff is one of the most common identified cause of catastrophic or sentinel events in hospitals (The Joint Commission, 2015). Emergency department (ED) to in-patient unit handoff is particularly vulnerable to medical errors due to high workload, time constraints, different approaches to patient care, and lack of established relationships between care providers (Ong & Coiera, 2011; Hilligoss & Cohen, 2012).

The purpose of this project was to examine and review a current process of ED to …

Educating Nurses On The Use Of Bedside Mobility Assessment Tool (Bmat) Through E-Learning/Online Education Module, Wei Li Lee

Master's Projects and Capstones

Background Hospital setting is reviewed the most hazardous workplace comparing to other industries. Nursing assistants and orderlies have the high risk of work-related injury. The study found that the top reason that causes the injuries was due to over-exertion or bodily reaction.

Aim State of California requires hospitals to implement a Safe Patient Handling and Mobility (SPHM) policy as part of an injury and illness prevention program (Department of Industrial Regulations, 2016). Bedside Mobility Assessment Tool (BMAT) is the latest evidence based practice, reliable and valid tool, which helps nurses to assess the patients’ current and ongoing mobility and to …

Inside The Juvenile Justice System, Megan Phalon

Master's Projects and Capstones

The United States of America is known for freedom and integrity and being a nation that stands for justice and equality for all. Within the United States there are systems in place to better the people and communities in order to provide safety and order. However, just as any nation, there is a struggle with violent behavior and tendencies among adults and adolescents. Within the last three decades, the United States has created a correctional system that specifically targets adolescents, and that acknowledges the differences between adult and juvenile development and deviant behavior. Within this literature review, academic databases were …

Adobe Medicus 2016 5 September-December, Unm Hslic

adobe medicus

No abstract provided.

Doctoring Undercover: Updating The Educational Tradition Of Shadowing, Claire D. Clark

Behavioral Science Faculty Publications

Background: Premedical students are educated in basic biological and health sciences. As a complement to traditional premedical coursework, medical school applicants are encouraged to shadow practitioners, with the hope that observation will introduce students to the culture and practice of healthcare. Yet the shadowing experience varies widely across practitioners and institutions; resources that guide students’ critical reflection and structure the experience are scarce.

Development: A pilot experiential learning course, Doctoring Undercover: Shadowing and the Culture of Medicine, was developed to fill this gap. The course consisted of three parts: an introduction to medical culture through the disciplines of medical sociology, …

The Application Of The Literature Review Appraisal Toolkit On Environmental Health Systematic Reviews, Kristen M. Davis

Master's Projects and Capstones

Environmental health systematic reviews have long been of poor quality when comparing them to clinical health systematic reviews. The main reason for the poor quality of environmental health systematic reviews is the lack of a specific protocol. The University of California-San Francisco’s Program for Reproductive Health and the Environment has, because of the discrepancy, created a protocol specific to conducting environmental health systematic reviews. The protocols efforts would be futile without a nonbiased way to evaluate systematic reviews and therefore the protocol used. The Literature Review Appraisal Toolkit is a valuable tool created to navigate and evaluate the credibility of …

The Effects Orthostatic Hypotension Has On Falls: A Study Done In San Francisco With The Patient Population Of The Veterans Affairs Hospital, Sherry A. Ballard Ms.

Master's Projects and Capstones

The Effects Orthostatic Hypotension has on Falls: A Study Done in San Francisco Represented

Population of the Veterans Affairs Hoapital

The global AIM of this project is to Identify patients that are at risk for Orthostatic Hypotension (OH) with in the first 24 hours of addmission. It was identified that 50% of the falls over the last 4 quarters at the VA were OH related. The patients were not identified as a fall risk and over half of them had fallen multiple times. After performing a nursing survey online, a SWOT analysis, and a Root Cause Analysis using a fishbone …

A Green Oasis: What Makes Community Gardens Worth Saving? While Researchers Amass Evidence Of Benefits, Advocates Develop New Strategy To Prove Their Value., Joel Wolfram

Capstones

Green Valley Community Garden in Brownsville, Brooklyn, is one of about a dozen gardens on land owned by the New York City Department of Housing Preservation and Development that are being uprooted by plans to build affordable housing. The gardeners are fighting back to prevent the garden’s destruction, saying that the food-producing green space is a source of healthy eating in a community with high rates of health problems, like diabetes and obesity. Researchers are attempting to tease out the public health benefits of community gardens as one metric of their value, but the science is still catching up with …

Increasing Patient Satisfaction And Decreasing Hospital Readmission Due To Deep Venous Thrombosis By Providing Anticoagulation Education For Orthopedic Patients, Margaret Gniewosz

Master's Projects and Capstones

Abstract

Improving Process on Oral Anticoagulant Education for Orthopedic Patients

The aim of this project is to improve anticoagulation education for orthopedic patients to increase patient satisfaction. The microsystem for this project is a medical-surgical (MS), 50-bed unit in a medium size hospital. Because orthopedic patients are at high risk to develop DVT postoperatively, proper anticoagulants and anticoagulation education is an important aspect of patient care. By implementing a well-designed and easy-to-read patient handout on anticoagulants with instructional script for nurses will empower patients to achieve higher level of anticoagulant knowledge and in result, increase patient satisfaction. A preliminary round …

Admission Handoff Between Emergency Department And Inpatient Units, Amanda A. Briones

Master's Projects and Capstones

When admitting a patient from the emergency department (ED) to an inpatient unit, a handoff report is conducted. There are many ways the ED nurse can go about delivering this report to the inpatient or floor nurse. Each ED nurse tends to this task in their own way, providing the information they deem important. Due to the absence of standardization, handoff reports have the ability to lack important information regarding the patient and can even lead to compromising the safety of the patient.

The purpose of this project was to gain a comprehensive understanding of the current handover process of …

Stigmatizing Attitudes Towards Men And Women Combat Veterans With Combat Related Ptsd, Heather L. Caldwell

Electronic Theses & Dissertations

Veterans with PTSD experience stigma and discrimination. The extent to which women combat veterans with PTSD may experience stigma and discrimination has yet to be investigated. This is critical given the increasing number of women veterans exposed to combat and combat trauma. Level of familiarity may affect stigmatizing beliefs. Gender may also affect stigmatizing beliefs. To assess this, 126 undergraduate students (men, n = 69) were randomly assigned to view videos of a man or woman veteran describing combat experience and their PTSD symptoms. Participants completed questionnaires assessing PTSD symptoms, level of familiarity with veterans, and stigmatizing attitudes toward the …

University Students' Involvement In A Health Promoting Lifestyle: Influencing Factors Of The Health Promotion Model, Madison Estrada

Electronic Theses & Dissertations

Abstract: This is a correlational study utilizing Nola Pender’s Health Promotion Model (HPM) for examining the key influential factors regarding involvement in a health promoting lifestyle (HPL) among undergraduate students at Pittsburg State University. Ninety-six (96) undergraduate students enrolled in general psychology courses at Pittsburg State University completed the Health Promoting Lifestyle Profile-II (HPLP-II; Walker, Sechrist, & Pender, 1987), the Exercise Benefits/Barriers Scale (EBBS; Pender, Walker, & Sechrist, 1987), the Self-Efficacy for Exercise Scale (SEE Scale; Resnick & Jenkins, 2000), and the Physical Activity Stages of Change Questionnaire (Marcus, Selby, Niaura, & Rossi, 1992). Spearman Correlation coefficients (one-tailed tests), were …

Burnout In Radiation Therapy: Examining The Six Leading Influences, Gina C. Passmore

All Theses And Dissertations

Recent studies are highlighting the dangers of burnout amongst healthcare workers, including radiation therapists. Since burnout is associated with an increase in medical errors (Sanchez-Reilly, 2013), it affects both the well-being of the patient and patient satisfaction scores, which are important to a hospital’s reputation. Burnout has a positive correlation with job dissatisfaction and increased employee turnover, making it both a financial and quality issue. Organizations acknowledge that burnout leads to unhappy employees, and unhappy employees are less likely to be engaged in their work, thereby not producing the best “products” (Sehlen, 2009). By examining which components seem to be …

Increasing Chlorhexidine (Chg) Daily Bathing Compliance, Jonathan Lee

Master's Projects and Capstones

Chlorhexidine gluconate (CHG) daily bathing in hospitalized patients in the intensive care setting is one of many interventions implemented by institutions to reduce and prevent central line associated bloodstream infections (CLABSIs) and catheter associated urinary tract infections (CAUTIs). These hospital-acquired infections (HAIs) plague and complicate treatments for critically ill patients in the acute care setting. CLABSIs and CAUTIs increase patient morbidity and mortality as well as place a financial burden with increased costs and hospital lengths of stay. The decrease of CHG compliance in our ICU unit can be associated with an elevated CLABSI rates. The focus of this CNL …

Chna: The Role Of The Hospital In Addressing Specific Community Health Needs, Yesmina L. Zavala

Master's Projects and Capstones

The Patient Protection and Affordable Care Act (ACA) added a requirement for nonprofit hospitals to keep their tax-exempt status under the Internal Revenue System Code 501(c) 3. This code requires all nonprofit hospitals to complete Community Health Needs Assessment (CHNA) reports every three years and must include input from community stakeholders and underserved individuals representing the low-income, minority and chronically ill population.

In addition to the CHNA, implementation strategies are required to be executed in the geographic areas served in order to meet the identified prioritized needs from the CHNA. Oftentimes, CHNAs are difficult to conceptualize and operationalize within the …

Design, Synthesis, And Evaluation Of Aryl Hydantoins And Ureas As Antischistosomal Agents, Chunkai Wang

Theses & Dissertations

Schistosomiasis is a tropical parasitic disease caused by infections with flukes of the genus Schistosoma, affecting as many as 440 million individuals worldwide, with 779 million living at risk of infection. A new drug for schistosomiasis is urgently needed as praziquantel (PZQ) is currently the drug of last resort and the development of resistance cannot be ignored, particularly in view of its large-scale use in many endemic countries. Furthermore, PZQ is active against adult but not juvenile schistosomes; this may be an important factor in the frequently observed treatment ‘failures’ in areas endemic for schistosomiasis.

The introduction of PZQ in …

Cervical Spine Angles, Craniocervical Posture, Neck Length, And Oropharyngeal Airway Analyses Of Sleep Apnea Patients In Both Supine And Upright Positions: A Retrospective 3-D Imaging Study, Brian Tuan Luong

Theses & Dissertations

Obstructive sleep apnea (OSA) is one of the most common respiratory disorders. Previous airway studies of OSA subjects have largely relied on 2-D radiographs.

The purpose of this study is to use 3-D imaging to the analyze the relationships among cervical spine angles, craniocervical posture, cervical spine length and the oropharyngeal airway volume in OSA patients in both the supine and upright positions.

Twenty-eight OSA subjects with 3-D imaging were included. Airway, craniocervical posture, spine angles, and spine length were assessed using Dolphin 11.8. Correlation analyses were utilized to detect associations among the recorded and measured variables. Mean differences were …

Identification And Intervention For Action Planning Deficits In Children With Hemiplegic Cerebral Palsy, Swati M. Surkar

Theses & Dissertations

The primary purpose of this investigation was to describe and quantify action-planning deficits during goal-directed movements in children with hemiplegic cerebral palsy (HCP). Three specific topics were addressed: brain activation, kinematics, and the use of visual input. First, we assessed prefrontal cortex (PFC) activation during complex goal-directed actions in children with HCP. The outcome suggested that children with HCP have higher PFC activation than age matched typically developing (TD) children during action planning, potentially due to the difficulty in allocating attentional resources for simultaneously processing the cognitive (i.e., attention, memory, information processing) and motor demands of the goal-directed task. Reduced …

Vitamin D, Calcium And Blood Pressure In The U.S., Sarah Bean

Master's Projects and Capstones

Vitamin D and calcium have received increased attention for their potential roles in improving cardiovascular health. The active form of vitamin D, 1,25-hydroxyvitamin D (25[OH]D), may influence blood pressure by increasing gastrointestinal calcium absorption. The objectives of this study were to first examine the association between blood pressure and blood serum 25(OH)D levels, and then explore the interaction between 25(OH)D, calcium intake, and blood pressure. Cross-sectional analysis featured 24,844 U.S. adults aged 20-80 years from three cycles of the National Health and Examination Survey (NHANES 2001-2006). Linear regression models were used to determine the adjusted association of 25(OH)D categories with …

Tp53-Inducible Glycolysis And Apoptosis Regulator (Tigar) Metabolically Reprograms Carcinoma And Stromal Cells In Breast Cancer., Ying-Hui Ko, Marina Domingo-Vidal, Megan Roche, Zhao Lin, Diana Whitaker-Menezes, Erin Seifert, Claudia Capparelli, Madalina Tuluc, Ruth C. Birbe, Patrick Tassone, Joseph M. Curry, Àurea Navarro-Sabaté, Anna Manzano, Ramon Bartrons, Jaime Caro, Ubaldo E. Martinez-Outshoorn

Department of Medical Oncology Faculty Papers

A subgroup of breast cancers has several metabolic compartments. The mechanisms by which metabolic compartmentalization develop in tumors are poorly characterized. TP53 inducible glycolysis and apoptosis regulator (TIGAR) is a bisphosphatase that reduces glycolysis and is highly expressed in carcinoma cells in the majority of human breast cancers. Hence we set out to determine the effects of TIGAR expression on breast carcinoma and fibroblast glycolytic phenotype and tumor growth. The overexpression of this bisphosphatase in carcinoma cells induces expression of enzymes and transporters involved in the catabolism of lactate and glutamine. Carcinoma cells overexpressing TIGAR have higher oxygen consumption rates …

Improving Pain Reassessment And Documentation Through Nurse Education, Reina Batto

Master's Projects and Capstones

The aim of the CNL Internship Project is to improve quality of patient care and pain management through improved pain reassessment and documentation. The project is to be implemented in the surgical unit of a community hospital in the California Bay Area. The unit has a maximum capacity of 38 beds and is staffed by 47 RNs and 4 LVNs. A nurse survey was conducted to assess the needs of the staff and the unit, and an education plan was created for the unit. Educational materials, including: highlighted academic articles, posters, handouts, and small posted reminders at nurse computers were …