Medicine and Health Sciences Commons^™

Dying For A Diagnosis: The Impact Of Racial Discrimination In Healthcare, Danielle Owusu

Student Research Posters

Discrimination is the act of negatively behaving towards a person or group of people due to the social group these individuals belong to. Although, as a society we like to believe that discrimination does not occur as often as it does, it can take many forms that we can be oblivious to. As a healthcare provider, one is held to a higher standard that many often forget are still human susceptible to the same vices. Discrimination in healthcare is a topic that many are not aware of the prevalence in our healthcare system. It might seem that the societal perceptions …

Assessing Patients' Perception Of Diabetic Educational Methods In An Urban Primary Care Clinic, Jennifer S. Tilley

DNP Projects

BACKGROUND: From 1980 through 2014, the number of adults with diabetes in the United States has nearly quadrupled, from 5.5 million to 29.1 million. When diabetes education is combined with appropriate medical management, this result in improved participation in diabetes self-management, improved glycemic control, and improved medication adherence. Health education materials, including diabetic education material, are often written at a higher reading level than patients with lower health literacy can understand.

PURPOSE: The purpose of this study was to evaluate the educational information, both verbal instructions as well as written material, provided to patients with type 2 diabetes mellitus This …

Filmmaking As Artistic Inquiry: An Examination Of Ceramic Art Therapy In A Maximum-Security Forensic Psychiatric Facility, Serena Duckrow

Expressive Therapies Dissertations

This Art-Based Research (ABR) illuminates the power of creativity to inspire and heal people living in a maximum-security forensic psychiatric hospital. The study comprises: the individual and group artwork from the Collaborative Ceramic Art Therapy Studio with thirteen participants; a culminating thirteen-minute film found at https://www.youtube.com/watch?v=PytlFZVvlig, Conversations in Clay: Creativity, Collaboration, and Community; an artistic inquiry and examination of the project footage; and a discussion of how the therapeutic filmmaking process helped capture the essential therapeutic elements of clay, filmmaking, and the art therapy studio environment.

University Of Nebraska At Omaha 2017-2018 Course Catalog, University Of Nebraska At Omaha

Graduate Catalogs

The University of Nebraska Omaha (UNO) is a premier metropolitan university that combines the resources of a doctoral research institution with a thriving community in the heart of Omaha.

With a global reach and vision, UNO is large enough to provide opportunities students seek, yet personal enough to include the mentorship they need to achieve academic excellence, creativity, and engaged learningat competitive tuition rates.

UNO is committed to and engaged with the city surrounding it, allowing students unique hands-on opportunities, internships, service learning,applied research, and other collaborative activities that enhance time in the classroom.

This is the ”O” we want …

Management Of Penetrating Injury To Thoracic Inlet And Lower Neck With Retained Foreign Body Using Video Assisted Thoracoscopic Surgery, Muhammad Adeel Samad, Hamza Abdur Rahim Khan, Faiza Urooj, Usman Ali Hyder, Fazal Wahab Khan, Saulat H. Fatimi, Jamal Kabeer Khan

Section of Cardiothoracic Surgery

Penetrating neck and chest injuries are a common form of occupational injuries. We hereby report a unique case in which a metallic rod had penetrated the left chest and neck of a plastic factory worker. The patient was vitally stable when he presented to Emergency Room. Chest X-ray was performed and the patient was rushed to the operating room. VATS (video assisted thoracoscopic surgery) and neck dissection was done for retrieval of the metallic rod. On table, endoscopy was also done to rule out injury to oesophagus. No injury to vital structures was found and the subsequent recovery was uneventful.

Development Of A Plan For A Navigator Program, Linda Dunaway

Walden Dissertations and Doctoral Studies

Following implementation of the Patient Protection and Affordable Care Act, hospitals have seen a reduction in Medicare reimbursement for 30-day post-discharge readmissions of acute myocardial infarction patient. The purpose of this project was to develop a plan for a navigator program to improve a patient's health status post discharge and reduce readmission rates. The Johns Hopkins nursing evidence-based practice model and guidelines were used in determining the quality of obtained experimental and non-experimental studies with or without meta-analysis and popular source articles. The literature revealed the most successful programs involved providing best practices for a navigator program allowed better patient …

Cultural Distress: An Emerging Paradigm, Christine Dewilde, Candace W. Burton

School of Nursing Publications

Although cultural competence in practice is a common goal within the health care professions, little is known about the consequences of a lack of such competence in health and healing. We propose a novel theoretical framework of cultural distress to describe patient experiences of and reactions to care that does not incorporate attention to cultural needs. Use of the cultural distress model to guide research offers an innovative framework by which researchers may identify potential interventions such that patients never reach a level of cultural distress.

Quality Improvement Initiative To Reduce Fall Risk In The Snf, Ramona C. Lancaster

Walden Dissertations and Doctoral Studies

Residents who fall in SNF either sustain significant decline to quality of life or die from their injuries. The average fall costs about $34,000 per incident. On average, 19.8% of residents fall at least once per month. The purpose of this project was to assess, identify, and advance nursing practice to decrease falls by evaluating current facility standard of practice, fall policy, procedures, and protocol. The objective was to create actions that would close the communication gap between clinicians and residents. This project encourages clinicians to intertwine resident feedback and strategies into the plan of care to help reduce fall …

Influencing Food Choice: Effects Of Stress And Sleep Deprivation On Dietary Habits Of Young Adults, Amy L. Leiferman

The Journal of Undergraduate Research

Introduction: Lifelong dietary habits are shaped during young adulthood; hence, preventing poor food choice practices during this period is vital. Stress and sleep deprivation are two important lifestyle elements that affect eating habits. The purpose of this study was to evaluate stress and sleep deprivation as factors contributing to poor dietary choices of college-aged students. Methodology: During finals week, a survey inquiring about sleep duration, perceived stress, and dietary patterns throughout the semester (typical week vs. finals week), was administered to university students (n=83). Fifty-five participants (21 male) provided an ID number, which allowed university-collected demographic and food-purchasing …

Exploring The Role Of Dopamine Circuits In Eating Behavior, Kara Elizabeth Furman

Yale Medicine Thesis Digital Library

In its simplest terms, obesity is a disease of exaggerated food intake. While current treatment of obesity focuses on changing behavior, few successful models of behavior modification have been developed. Even those treatments that are successful in the short-term, have failed to demonstrate lasting effect. The problem of over-eating, then, needs to be studied in terms of basic motivational programs that are encoded by the brain’s reward system. Understanding the way in which reward system activity directs eating behavior will allow more sophisticated and efficacious treatment options in the future. Several studies have focused on the nucleus accumbens (NAc) as …

Insights On Fibrotic Diseases Using Single-Cell Analysis Methods, Azim Munivar

Yale Medicine Thesis Digital Library

Idiopathic pulmonary fibrosis is progressive, fatal lung disease with unclear mechanistic etiology and a dearth of treatment options. Transcriptional profiling has served a valuable tool in understanding the underlying perturbations in the lung tissues of patients and disease model systems, however whole tissue profiling obscures both the contribution of individual cells types in the diseased tissue as well as the contribution of non-fibrotic tissue surrounding the diseased tissue. The averaging effect confounds the ability to extract a strong disease signal and understand the cell-of-origin. Single-cell techniques have recently emerged that allow profiling of the transcriptomes of individual cells. In this …

Health Professional Students As Providers Of Behavioral Health Services To Uninsured Immigrants, Juan Gabriel Rodriguez Guzman

Yale Medicine Thesis Digital Library

Using the principles of lay counseling, health professional students were trained to deliver psychosocial educational interventions and administer substance use screenings to uninsured monolingual Spanish-speaking Latino immigrants with symptomatic depression and/or substance use disorders. Changes in depressive symptoms were assessed with the PHQ-9. Twenty-five patients enrolled in the lay counselor program for depression. PHQ-9 data were available from the 15 individuals who completed the program, among whom the mean baseline score was 11.7 (SD = 6.2) and mean final score was 4.6 (SD = 4.2) (p

An Educational Teaching Intervention For Patients Taking Warfarin, Sheryl D. Davis

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

A trial fibrillation (AF) and venous thromboembolism (VTE) are serious medical disorders that require anticoagulation to prevent potential problems such as stroke and/or death. Warfarin has been the anticoagulant used for over 50 years and continues to be prescribed despite the development of novel oral anticoagulant (NOAC) agents. Many studies mention the perils associated with patients' inadequate knowledge about warfarin and highlight the importance of patient education on warfarin anticoagulation in their conclusions (Vormfelde et al., 2014). By augmenting current instructive strategies with a validated, standardized questionnaire designed to assess sustained knowledge, areas needing reinforcement were targeted. Method: For this …

Relationship Between Engagement And Level Of Functional Status In Older Adults, Thomas A. Dombrowsky

Nursing Faculty Publications & Presentations - Archive

Functional status is an important component of quality of life for older adults and for their caregivers. Factors associated with level of functional status include age, comorbidity, cognitive status, depression, social support, and activity. Of the types of activity linked with functional status, the strongest evidence is for physical exercise, with weaker evidence for social and productive activity. Engagement is a construct including motivation, commitment, and participation. Objective: The objective of this study was to determine whether or not engagement is associated with level of functional status after controlling for age, comorbidity, and depression among older adults. Methods: In all, …

Designing And Testing A Comprehensive Fall Prevention Program With Mastery Outcomes: A Case Study, Emily C. Piercy

Theses and Dissertations--Curriculum and Instruction

Existing research demonstrates the usefulness of multi-factorial approaches to the challenge of patient fall prevention (Spoelstra, Given, & Given, 2012; Wexler, D’Amico, & Rolston, 2011; Hart-Hughes, Quigley, Tatjana, & Scott, 2004). Some of the current strategies include assessment of a patient’s risk for falling based on a valid assessment instrument, management of a patient’s environment to provide a safe space, medication monitoring and management to avoid use of medications that could lead to falls, patient teaching, post-incident evaluation, and more. Implementation of these strategies is dependent upon patient care employees including nurses, nursing assistants, and physical therapists.

Instructional systems design …

The Effects Of A Worksite Wellness Program On Prescription Claims, Carrie Deann Davidson

Theses and Dissertations--Kinesiology and Health Promotion

The purpose of this study was to determine the effectiveness of the worksite wellness weight loss program called Weight Loss Matters (WLM) for employees at the University of Kentucky. The three main objectives were to measure the effect of Weight Loss Matters for employees from June 2006 to December 2011 in the following areas (1) prescription claims for hypertension, diabetes, and dyslipidemia, (2) weight loss, and (3) food diary compliance. Participants included 591 employees who participated in WLM for at least one session from 2006 to 2011 for whom there were data. This study employed a Quasi-experiment, longitudinal design. Data …

The Effects Of Golf Stance On The Peak Knee Adduction Moment During The Golf Swing, Quenten L. Hooker

Theses and Dissertations--Kinesiology and Health Promotion

INTRODUCTION: The knee joint is one of the most frequently injured structures in the game of golf. The loads experienced by the knee during the golf swing are typically greater than those experienced during walking. In particular, a heightened lead limb peak external knee adduction moment has been linked to the progression of medial compartment knee osteoarthritis (OA). Altering movement patterns is a common strategy that can be used to reduce loading on the knee joint but has received little attention during the golf swing. Also, while such manipulations may be beneficial from an injury prevention perspective, they may have …

Center Of Pressure Excursion During A Single Leg Standing Test In Ambulatory Children With Cerebral Palsy, Ryan Thomas Callahan

Theses and Dissertations--Kinesiology and Health Promotion

INTRODUCTION: Cerebral Palsy (CP) is the most common disabling motor disorder found during childhood, occurring in 2.1-3.2 of every 1,000 births. Motor functionality of children with CP is commonly compromised and is classified with a gross motor function classification score (GMFCS) and with the gross motor function measure (GMFM). Balance ability has typically been assessed using single leg stance test (SLST) time but more recently, center of pressure excursion (COPE) has shown to be a more valid measurement in populations with altered motor abilities. However, COPE has not been used to test balance in the CP population, yet. This study …

Self-Reported Adherence To Physical Activity For Cancer Survivors: An Update From The 2015 Nhis Database, Andrew Jackson Shearer

Theses and Dissertations--Kinesiology and Health Promotion

Cancer is the second leading cause of death in America. It’s been suggested that regular physical activity (PA) can improve health outcomes in cancer survivors. An estimate from BRFSS data (2009) suggested that 47% of all cancer survivors met recommended guidelines and that this estimate was not different from the population at large (48%). Several factors were examined from these BRFSS data to determine whether subgroups of survivors existed who might benefit from interventions aimed at improving their PA status. The purpose of this investigation was to obtain more recent estimates of adherence to established PA guidelines for cancer survivors. …

The Effect Of Personal Protective Equipment On Firefighter Occupational Performance, Ashley Y. Lesniak

Theses and Dissertations--Kinesiology and Health Promotion

Firefighting is a strenuous occupation that requires high-intensity work, resulting in prolonged periods of stress and physical exertion. The physical demand of performing firefighting tasks is augmented by the weight of personal protective equipment (PPE) worn (i.e., load carriage: LC) and the use of a self-contained breathing apparatus (SCBA). These factors have been shown to increase metabolic demand at submaximal workloads and decrease maximal aerobic capacity in laboratory settings. However, there is limited research evaluating the effects of these factors on occupational performance. Therefore, the primary purpose of this study was to quantify the detrimental effect of LC only and …

Examination Of Volume And Intensities Of Weekday Practices And Competitive Games In Collegiate Football Players, Tyler Lindon

Theses and Dissertations--Kinesiology and Health Promotion

The aims of the present study were to characterize the typical volume (total distance) and intensities (high-speed distance > 75% of maximum speed for weekday practices, Monday through Friday and competitive games on Saturday; compare the daily practice volume and intensities to competitive games to determine if the targeted volume and intensities are achieved as part of the periodized strategies using GPS software; and examine the relationship among total distance, high-speed distance in the prediction of player-load . Thirty NCAA Division I Football players (187.9 ± 5.5 cm; 107.4 ± 24.6 kg) were monitored using GPS receivers with integrated accelerometers during …

Age-Related Differences In The Lumbopelvic Kinematics During The Trunk Motions In The Anatomical Planes, Milad Vazirian

Theses and Dissertations--Biomedical Engineering

Management and control of the low back pain as an important health problem in the industrial societies necessitates to investigate how the risk of this disease is affected by aging. Since the abnormalities of the lumbopelvic kinematics are related to the existence or risk of low back injuries, the objective of this dissertation was set to find the age-related differences in lumbopelvic kinematics when performing basic trunk motions reaching to range of motion in different anatomical planes.

A cross-sectional study was designed where sixty asymptomatic individuals between 20–70 years old with no confounding health condition, no current or previous highly …

Validation, Optimization, And Image Processing Of Spiral Cine Dense Magnetic Resonance Imaging For The Quantification Of Left And Right Ventricular Mechanics, Gregory J. Wehner

Theses and Dissertations--Biomedical Engineering

Recent evidence suggests that cardiac mechanics (e.g. cardiac strains) are better measures of heart function compared to common clinical metrics like ejection fraction. However, commonly-used parameters of cardiac mechanics remain limited to just a few measurements averaged over the whole left ventricle. We hypothesized that recent advances in cardiac magnetic resonance imaging (MRI) could be extended to provide measures of cardiac mechanics throughout the left and right ventricles (LV and RV, respectively).

Displacement Encoding with Stimulated Echoes (DENSE) is a cardiac MRI technique that has been validated for measuring LV mechanics at a magnetic field strength of 1.5 T but …

A Theory Of Veteran Identity, Travis L. Martin

Theses and Dissertations--English

More than 2.6 million troops have deployed in support of the wars in Iraq and Afghanistan. Still, surveys reveal that more than half feel “disconnected” from their civilian counterparts, and this feeling persists despite ongoing efforts, in the academy and elsewhere, to help returning veterans overcome physical and mental wounds, seek an education, and find meaningful ways to contribute to society after taking off the uniform. This dissertation argues that Iraq and Afghanistan War veterans struggle with reassimilation because they lack healthy, complete models of veteran identity to draw upon in their postwar lives, a problem they’re working through collectively …

Riding Through Life: A Lifespan Study Of The Attitudes, Behaviors, And Areas Of Educational Opportunity For Female Equestrians Toward Bra Use And Health Outcomes When Engaged In Equestrian Sports, Karin Pekarchik

Theses and Dissertations--Community & Leadership Development

Equestrian sport is a popular exercise choice for females of all ages, although the links between this exercise choice, health outcomes, and risk to health have not been thoroughly examined. These issues are of particular interest because the female equestrian has the opportunity to ride and/or compete for decades, from early to very late in life, covering almost the full sequence of the female lifespan. Equestrian sports provide physical activity through riding and caring for the horse, and promote positive mental outcomes through tangible practices, such as engaging in physical activity and hard work, goal-setting, acquisition of skills, and participation …

Suppression Of Anti-Tumor Immunity In Chronic Lymphocytic Leukemia Via Interleukin-10 Production, Sara Alhakeem

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

The most common human leukemia is B-cell chronic lymphocytic leukemia (B-CLL), which is characterized by a progressive accumulation of abnormal B-lymphocytes in blood, bone marrow and secondary lymphoid organs. Typically disease progression is slow, but as the number of leukemic cells increases, they interfere with the production of other important blood cells, causing the patients to be in an immunosuppressive state. To study the basis of this immunoregulation, we used cells from the transgenic Eμ-TCL1 mouse, which spontaneously develop B-CLL due to a B-cell specific expression of the oncogene, TCL1. Previously we showed that Eμ-TCL1 CLL cells constitutively …

The Default Mode Network And Executive Function: Influence Of Age, White Matter Connectivity, And Alzheimer’S Pathology, Christopher A. Brown

Theses and Dissertations--Neuroscience

The default mode network (DMN) consists of a set of interconnected brain regions supporting autobiographical memory, our concept of the self, and the internal monologue. These processes must be maintained at all times and consume the highest amount of the brain’s energy during its baseline state. However, when faced with an active, externally-directed cognitive task, the DMN shows a small, but significant, decrease in activity. The reduction in DMN activity during the performance of an active, externally-directed task compared to a baseline state is termed task-induced deactivation (TID), which is thought to ‘free-up’ resources required to respond to external demands. …

Role Of Intracellular Growth During The Gastrointestinal Stage Of Listeria Monocytogenes Infection, Grant Steven Jones

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

Listeria monocytogenes is a facultative intracellular bacterium that causes foodborne disease in humans. L. monocytogenes invade the gut mucosa and then disseminate, causing systemic infections associated with high mortality rates in immunocompromised individuals. It is unknown how L. monocytogenes traffic to the mesenteric lymph nodes, which represent an important bottleneck for systemic spread. In addition, little is known about the gastrointestinal stage of infection due to the general resistance of mice to oral infection with L. monocytogenes. Our laboratory developed a novel foodborne mouse model of listeriosis utilizing a murinized strain of L. monocytogenes to investigate the gastrointestinal stage …

The Effects Of Exercise Preconditioning On Focal Ischemic Stroke, Gillian Grohs

Theses and Dissertations--Medical Sciences

Cleaved fragments of the extracellular matrix protein perlecan have been shown to promote neuroprotection and repair after ischemic stroke. The cysteine proteases cathepsin B and L as well as the metalloprotease bone morphogenic protein 1 (BMP-1) are capable of releasing the biologically active C-terminal laminin-like globular domain (LG3) of perlecan. Exercise, a known method of reducing stroke risk and severity, has been shown to increase the expression of some proteases associated with perlecan processing. Using a transient distal middle cerebral artery occlusion (MCAo) model for focal ischemic stroke we show that while 7 days of running only slightly decreased infarct …

Examining Biological And Psychological Variables In Hypertensive Disorders Of Pregnancy, Stephanie A. Kehler

Theses and Dissertations--Nursing

Despite advances in obstetric care, hypertensive disorders continue to complicate pregnancies at a high rate. Worldwide, hypertensive disorders affect up to 10% of pregnancies. The United States has seen a 25% increase in the incidence of hypertensive disorders over the last two decades (American College of Obstetricians and Gynecologists, 2017). These complications constitute one of the greatest causes of maternal and perinatal morbidity and mortality with an estimated 50,000 to 60,000 deaths per year across the world (American College of Obstetricians and Gynecologists, 2017). Although the etiology of hypertensive disorders remains unclear, there may be an association with both maternal …