Medicine and Health Sciences Commons^™

Dual Inhibition Of The Pi3k/Akt And Mek5/Erk5 Pathways For The Treatment Of Breast Cancer, Thomas Douglas Wright

Electronic Theses and Dissertations

Breast cancer is a heterogeneous disease state with several challenging frontiers. In particular, aberrations in the Phosphoinositide-3-kinase (PI3K) and Mitogen Activated Protein Kinase (MAPK) pathways have been linked to increased breast cancer proliferation and survival. It has been proposed that these survival characteristics are enhanced through compensatory signaling and crosstalk mechanisms. New evidence suggests that MEK5/ERK5, a member of the MAPK family, is a crucial component in the proliferation and survival of several aggressive cancers. We hypothesize that inhibiting both PI3K/Akt and MEK5/ERK5 pathways will decrease cell viability while maintaining limited collateral toxicity. In this study, we examined the effects …

Reducing The Number Of Falls In On Lok Participants By Enhancing Homecare Services, En Zhu

Nursing and Health Professions Faculty Research and Publications

Falls in elderly are one of the major health concerns in the US. They comprise up to 80% of the key risk factors for injuries in the elderly in the US (Spears, Roth, Miake-Lye, Saliba, Shekelle, & Ganz, 2013). The project aims at reduction of falls among the elderly participants in On Lok program. Based on the findings of the literature review and observations conducted, the proposed intervention to address the practice gap will involve emphasizing the need for carrying the mobility devices, such as canes or walkers, along with clearing the participants’ home environment from hazards. The anticipated measure …

Low Secondary Risks For Captive Coyotes From A Sodium Nitrite Toxic Bait For Invasive Wild Pigs, Nathan P. Snow, Katherine E. Horak, Simon T. Humphrys, Linton D. Staples, David G. Hewitt, Kurt C. Vercauteren

United States Department of Agriculture Wildlife Services: Staff Publications

An acute toxic bait is being developed to deliver micro‐encapsulated sodium nitrite (SN) to stimulate severe methemoglobinemia and humane death for invasive wild pigs (Sus scrofa), thereby providing a new tool for reducing their populations. During April 2016, we evaluated sensitivity to SN and outcomes of secondary consumption in the ubiquitous mammalian scavenger, coyote (Canis latrans), to determine secondary risks of consuming carcasses of wild pigs that died from consuming the SN toxic bait. At the National Wildlife Research Center in Fort Collins, Colorado, USA, we first evaluated whether coyotes fed carcasses of domestic pigs killed by consumption of SN …

Reparation Of Dignity: A Literature Review Of Trauma-Informed Addiction Treatment With Expressive Arts Therapy, Courtney R. Battistelli

Expressive Therapies Capstone Theses

Substance Use Disorder is a public health problem that impacts society and individuals on many levels. In 2016, the National Institute on Drug Abuse (NIDA) documented 64,000 deaths in America due to overdose (NIDA, 2017). The economic burden related to substance abuse is estimated at $740 billion annually in the United States (Priddy et al., 2018). High rates of relapse, approximately 60% in the first year after treatment, (Priddy et al., 2018, p.103), suggest the need for more effective treatment. A combination of trauma-informed practice and creative therapies in the treatment of substance use disorders show promising results. This literature …

Implementing Foot Care Program In A Rural Clinic, Maliheh Bakhshi

Doctor of Nursing Practice (DNP) Projects

Abstract

The prevalence of type 2 diabetes mellitus and its complications have increased in the United States (U.S.) in recent years. Patients with diabetes have a higher risk of foot ulcers due to diabetic peripheral arterial disease accelerated by the direct damage to the nerve and blood vessels in lower extremities by high blood sugar. Foot amputations, and frequent hospital admissions due to these and other diabetes complications are also increasing. Healthcare providers’ have a unique opportunity to prevent these complications and hospital admissions, and to promote patient wellness and physical well-being through the provision of timely education and direct …

The Effectiveness Of Registered Dietitians In Diabetes Case Management, Meghan C. Mclarney

Theses & Dissertations

OBJECTIVE: The objective of this paper is to investigate the effectiveness of diabetes education provided by registered dietitians (RD) in a diabetes case management (DCMs) model, compared to diabetes education provided by RDs in the usual care model (UCM) at an outpatient endocrinology clinic in Omaha, Nebraska. This study hypothesizes that education by RD DCMs will be equal or more efficacious in regards to primary outcomes of A1C and BMI and secondarily, lipid results and adherence (total encounters) when compared to outcomes of UC.

METHODS: This is a cross sectional retrospective review of patients with diabetes (n=946), receiving traditional RD …

Synthesis And Characterization Of Long-Acting Rilpivirine Prodrugs, James R. Hilaire

Theses & Dissertations

Antiretroviral therapy (ART) requires lifelong daily dosing to suppress viral replication, restore or maintain immune function and improve quality of life. As an alternative, long-acting (LA) antiretrovirals (ARVs) aim to deliver therapeutic drug concentrations over an extended period, ultimately requiring monthly or even more extended dosing intervals. Specifically, the success of recent clinical trials examining LA cabotegravir and rilpivirine (CAB and RPV LA) highlight the advent of these novel HIV-1 therapeutics. Further optimization of LA dosage forms are required and rests upon improving dosing frequency, injection volumes and tissue distribution to viral compartments. To this end, we report the synthesis …

Perception Of Bone Mineral Loss On Cone-Beam Computed Tomography (Cbct) & Digital Periapical (Pa) Film: An Ex-Vivo Comparison, David P. Hamm

Theses & Dissertations

Using micro computed tomography (micro-CT) as a reference standard, the purpose of this investigation was to evaluate the influences of bone mineral loss and radiographic contrast in digital periapical (PA) film and cone-beam computed tomography (CBCT). Seven dog and human mandibles were sectioned, followed by modification via cortical bone drilling to create 248 lesions and/or trabecular bone acid demineralization to create 96 coronal slice pairs. Pretreatment and post-treatment radiographs (PA, CBCT, and/or micro-CT) were taken for lesion rating/perception in addition to two-dimensional (area) and three-dimensional (volumetric) measurements of 50 drilling lesions and 20 coronal slice pairs. 4-7% bone mineral loss …

Paging Dr. Strong: A Call To Action Towards Addressing Occupational Stress And Burnout Among Primary Care Health Professionals, Carmen Olmedo

Master's Projects and Capstones

Purpose: Within a rapidly evolving industry, occupational stress and burnout among healthcare clinicians and staff is becoming a pervasive public health crisis across all subspecialties. The purpose of this project was to use the Compassion Satisfaction-Compassion Fatigue (CS-CF) Theory as a method to assess burnout among primary care health professionals, in addition to developing recommendations to assist the promotion of a staff wellness initiative at an urban community clinic.
Methods: A needs assessment was conducted at a Community Health Center (CHC) in San Francisco. Data collection consisted of anonymous distribution of the Professional Quality of Life (ProQOL) Survey and semi-structured …

Preventing Falls In A Medical Surgical Unit, Shalini Singh Rn, Msn

Master's Projects and Capstones

The prevention of patient falls continues to remain a challenge in healthcare. Up to 30% of falls often result in injury, which includes fractures, soft tissue trauma, or even death (Titler, 2016). Out of the recorded number of falls in hospitals worldwide, between 4% to 7% result in severe injuries to the patients. Falls in the hospital can prolong a hospital stay, increase hospital costs, and extend a discharge from home to a long-term care facility. With the prolonged stay of patients who fall in hospitals, hospitals costs are in a rise. Falls can increase the cost for not just …

Maternal Cognitions And The Origins Of Early Sensorimotor Based Play In Infants Born Preterm, Sandra L. Willett

Theses & Dissertations

Maternal cognitions are beliefs, perceptions, and expectations that guide parenting practices. For at-risk infants born prematurely, these maternal constructs may influence the caregiving environment and opportunities for motor experience. The impact of maternal cognitions on motor development in infants born preterm is not well-documented. This three-part dissertation systematically explores: 1) the nature and extent of existing evidence supporting the link between maternal cognitions and motor development of infants born preterm, 2) if maternal perception of infant vulnerability as measured by an adapted Vulnerable Baby Scale (VBS) can be validly and reliably quantified in mothers of infants born preterm and near …

Macromolecular Prodrug For The Treatment Of Ulcerative Colitis, Yuanyuan Sun

Theses & Dissertations

Ulcerative colitis is a chronic inflammatory bowel disease affecting the colon. More than 1 million Americans are affected, with the annual economic burden up to 14.9 billion in the United States. By far, ulcerative colitis still lacks the cure and the current treatment strategies are limited due to severe side effects and in-sufficient efficacy. The tofacitinib (Xeljanz) is the only approved oral medication by for adults with moderately-to-severely-active ulcerative colitis. But the related side effects and serious infections still have to be resolved. In the previous study in our lab, the researchers have successfully developed and characterized multiple hy-drophilic prodrug …

Impediments To The Historical Development Of The Clinical Pap Test In The United States: Their Relevance In Optimizing Cervical Cancer Screening In The State Of Qatar, Nikolaos Chantziantoniou

Theses & Dissertations

Three hundred surveys listing 31 questions were distributed amongst women and men at Sidra Medicine, Doha, State of Qatar, to assess knowledge and perceptions of: Cervical cancer (CxCa); preventive Pap test screening; Human Papilloma Virus (HPV) vaccination; and, need for population-based screening. Survey questions captured categorical statistical data through four categories: (1) Socio-demographic; (2) Healthcare Services; (3) Health Literacy; and, (4) Self-efficacy and Perceptions. Hypothesis 1: 12 survey questions pertaining to CxCa and Pap testing revealed 8 statistically-significant dependencies; notably, 70% of respondents were aware of CxCa; however, 31.8% were unaware that CxCa may be curable; 33.7% were unaware …

Health Literacy Changes In A Technology-Enhanced Diabetes Prevention Program, Cody Goessl

Theses & Dissertations

Background: In 2001, the Diabetes Prevention Program was published evaluating the efficacy of a pharmaceutical intervention, Metformin, and a behavioral lifestyle intervention (LI) to reduce incidence of Type 2 diabetes mellitus. The LI was observed to reduce the incidence of the disease by 58% relative to 31% in the medication treatment. Amongst technology based LIs, little has been done to address different health literacy populations.

Objectives: This dissertation evaluated how teach-back and teach-to-goal can influence the uptake of information obtained in each health education lesson, behaviors and its influence on engagement and weight loss.

Methods: Four hundred forty-two participants …

Delineating Phenotypes Of Rare Disease, Lois J. Starr

Theses & Dissertations

Not available.

Cross-Cultural Adaptation And Psychometrics Properties Of The Arabic Version Of The Positive Thinking Skills Scale, Abir K. Bekhet, Veronica Nakhla, Isis Emile Gohar, Rawan Oudeh, Mary Gergis, Nadia Malik

College of Nursing Faculty Research and Publications

Background

Identifying depressive cognitions in first-generation Middle Eastern immigrants (FGMEI) can be an important step to prevent the development of clinical depression.

Purpose

This study focused on the cross-cultural equivalence and psychometric testing of the Arabic version of the Positive Thinking Skills Scale (A-PTSS) among 100 FGMEI.

Methods

Content/face validity of the measure was conducted. Internal consistency, homogeneity, dimensionality and construct validity were assessed.

Results

Cronbach’s alpha for (A-PTSS) was .89. Factor extraction generated only one factor, which is consistent with the English version. The A-PTSS total score had a strong positive correlation with the positive cognition scores (r …

Getting To Zero: Creating An Infrastructure To Support Fall Prevention In A Medical–Surgical Unit, Krys Elgarico

Master's Projects and Capstones

Problem: Hospital falls are a growing national patient safety concern that cause anxiety, pain, distress, serious injuries, and increased health care utilization. Despite the presence of a well-developed falls prevention protocol since 2017. Internal data from an inpatient medical-surgical telemetry (MST) unit indicate the largest number of fall-related events among the hospital’s departments.

Context: Practice improvement project was initiated in a 217-bed community hospital to determine barriers and potential success factors. This MST is a dynamic, 48-bed unit providing care to mainly geriatric patients who require continuous telemetry monitoring and complex medical, trauma, and surgical services. Senior leaders in the …

Hospital Acquired Pressure Injury Prevention: A Quality Improvement Project, Sukhjit Dhillon

Master's Projects and Capstones

Abstract

Hospital Acquired Pressure Injuries (HAPI) can be costly for the hospitals and devastating for the patients. Most pressure injuries are considered preventable, but despite that a lot of Americans die from pressure injury related complications each year. Hospitals spend billions of dollars on pressure injuries which can be used for other treatments. A quality improvement project was created to address these concerns and improve patient care. There were 5 cases of HAPIs on the telemetry/stroke unit prior to the start of this project. Interventions were created to improve the outcome. After careful review of the related literature, HAPI prevention …

A Study Protocol For An Mhealth, Multi-Centre Randomized Control Trial To Promote Use Of Postpartum Contraception Amongst Rural Women In Punjab, Pakistan, Xaher Gul, Waqas Hameed, Sharmeen Hussain, Ishaque Sheikh, Junaid-Ur-Rehman Siddiqui

Community Health Sciences

Background: Provision of family planning services during the immediate post-partum phase is considered effective and cost-efficient for promoting healthy timing and spacing of pregnancies. This research aims to test the effectiveness of mobile phone-based interventions in promoting use of postpartum contraception. Moreover, it will also test the non-inferiority of text and voice messages compared to interactive phone-based counselling.
Methods: A three-arm, 10-month, multicentre, randomized controlled trial will be conducted at 15 social franchise (SF) health facilities in Punjab province of Pakistan. Pregnant women aged 15-44 years who are in their first or second trimester and have a mobile phone for …

Enhancing Discharge Communication For Timely Patient Discharge: A Quality Improvement Project, Maricel Hiponia

Master's Projects and Capstones

A delay in discharge is a delay in patient care. The complexity of hospital discharge can be challenging and time-consuming in poorly coordinated discharge planning. Generally, older adults and those patients with chronic medical conditions are often met with challenges for after-care services and require more attention to discharge. Variations in discharge practice often resulted in hours, sometimes days in discharge delays with implications to cost, reduced patient satisfaction and outcomes. A well-structured team communication during rounding and bedside shift handoff has the potential to decrease discharge delays advertently increasing patient satisfaction and quality outcomes of care.

Prospectus For Decreasing Lab Specimen Errors, Sabrina Scruton

Master's Projects and Capstones

Abstract

It has been estimated that >160,000 adverse patient events occur each year in the United States because of patient or specimen identification errors involving the laboratory (Sandhu, et. al 2017). The overall effect of specimen labeling errors often leads to patient safety issues related to medication errors, misdiagnosis, and delays in care (Sandhu, et. al 2017). The Women’s Clinic (WC) an outpatient clinic located within a larger northern California acute care facility had noted a significant increase in the number of lab years in the last year. This clinic sees on average four hundred patients and collects hundreds of …

Prospectus For Creating A Nurse Suggestive Acuity-Based Staffing Model In Ambulatory Infusion Settings To Improve Patient Safety And Quality Of Care, Yongli Qiu

Master's Projects and Capstones

Due to the lack of reliable and valid infusion nurse suggestive acuity-based staffing model, ambulatory infusion settings are burden with potentially compromised patient safety, poor quality of patient care with over-scheduling of unexpected complex patients, limited resources related to nurses and infusion chairs, the dissatisfaction of patients and family members, and infusion nurses’ burn out. This project seeks to determine the appropriate nurse to patient acuity-based point ratio in staffing and scheduling factors that influence nurse staffing model, and established nurse staffing strategies. This three-month project was conducted with the infusion nurses, a nurse manager, a nurse supervisor, an assistant …

Preventing Falls In A Medical Surgical Unit, Shalini Singh Rn, Msn

Master's Projects and Capstones

The prevention of patient falls continues to remain a challenge in healthcare. Up to 30% of falls often result in injury, which includes fractures, soft tissue trauma, or even death (Titler, 2016). Out of the recorded number of falls in hospitals worldwide, between 4% to 7% result in severe injuries to the patients. Falls in the hospital can prolong a hospital stay, increase hospital costs, and extend a discharge from home to a long-term care facility. With the prolonged stay of patients who fall in hospitals, hospitals costs are in a rise. Falls can increase the cost for not just …

Mississippi Nurse Practitioners Utilization Of Prescription Monitoring Program And The Reduction Of Controlled Substances, Michaeline Bailey, Chelsea Lyle, Rhagen Nelson, Kristin Patterson

MSN Research Projects

Controlled substance abuse is a common problem in the United States. While the number of controlled substance deaths or injuries is increasing, the number of controlled substance prescriptions is increasing as well. Many providers acknowledge controlled substance abuse as a problem in the United States, but it is unknown how often these providers are taking measures to prevent abuse of prescribed controlled substances. Although all controlled substances are not acquired by legal prescriptions, many are. The aim of the study was to ascertain whether nurse practitioners in Mississippi are using the prescription monitoring program (PMP) to assist in creating a …

Functional Analysis Of Single Nucleotide Polymorphisms Associated With Type 2 Diabetes, Serdjan Rolovic, Zhongming Zhao, Phd, Junfei Zhao, Phd

Journal of Health Disparities Research and Practice

Type 2 diabetes (T2D), a metabolic disorder characterized by insulin resistance and relative insulin deficiency, is a life-long, common, complex disease of major public health importance. To date, there have been 86 published studies that have reported 639 associations between single nucleotide polymorphisms (SNPs) and T2D in the GWAS Catalog database, and others studies in literature. However, the majority (~93%) of the SNPs emerging from these studies are located within noncoding sequence, complicating their functional evaluation. Recently, several lines of evidence have suggested the involvement of a proportion of such variants in transcriptional regulatory mechanisms, including modulation of promoter and …

Effects Of Epac1 On Diabetic Retinal Inflammation, Claire Hawthorne, Jena Steinle, Phd, Youde Jiang, Ms, Li Liu, Phd

Journal of Health Disparities Research and Practice

An ever-growing body of research suggests that inflammation is one of the primary causes of diabetic retinopathy, as the inflammation can lead to insulin resistance. Beta-adrenergic receptor agonists can reduce the inflammation in human retinal endothelial cells (HRECs), but are not a viable treatment due to systemic effects. Epac1 lies downstream of beta-adrenergic receptor signaling, and it may have the capability to reduce inflammation by acting as an alternative pathway for beta-adrenergic receptor agonists to block inflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-1B). We hypothesized that the Epac1 agonist will decrease cytokine levels, leading to …

Assessment Of Childhood Obesity Prevalence And Prevention Efforts In A Wisconsin Tribal Community, Simone Tucker, Lauren Lamers, Mph, Phd

Journal of Health Disparities Research and Practice

American Indian children experience disproportionately high rates of obesity, yet tribal communities often lack capacity to utilize local obesity data to guide prevention efforts. It is estimated the prevalence of childhood obesity in a Wisconsin tribal community and identified local school-based obesity prevention initiatives. Height and weight data were collected for children ages 2-19 years through routine screenings at local Head Start centers and schools. Weight status was determined based on BMI percentile according to year 2000 CDC growth charts.

Summary statistics and chi-square tests were generated to examine differences in obesity prevalence by age and gender. An environmental scan …

Drug Discovery Of Novel Targeted Therapeutics For Metastatic Breast Cancer, Dayralee Torres, Linette Castillo-Pichardo, Ph.D.

Journal of Health Disparities Research and Practice

Metastatic disease is the primary cause of breast cancer mortality, due to the lack of effective therapy. The Rho GTPase Rac is integral for the promotion of cancer cell migration/invasion, proliferation, and survival. Since metastatic breast cancers often overexpress or exhibit high Rac activity, inhibition of Rac is a viable strategy against metastatic cancer. Recently, we characterized EHop-016, a small molecule that inhibits Rac activity of metastatic breast cancer cells more efficiently than previously available Rac inhibitors (IC₅₀ of 1µM). EHop-016 inhibits the activity of the Rac downstream effector p21 activated kinase and cell migration of metastatic breast cancer …

Determining Fish Mercury Levels: An Alaska Native/Napaskiak Subsistence Food Source, Jackelyn Steven, Noehealani Antolin, Carolee Dodge Francis

Journal of Health Disparities Research and Practice

Alaska Natives living in rural areas rely on subsistence fishing throughout the year as their primary source of food. The purpose of this project is to determine the levels of mercury (Hg) in fish commonly consumed by Alaska Natives. Mercury naturally cycles throughout the environment between air, water, and land. Because it is a heavy metal, when it enters an ocean, lake, or river it sinks to the bottom where plankton, bottom feeder fish, and organisms consume it. Mercury becomes dangerously concentrated as it passes through the food chain through a process called biomagnification. Biomagnification occurs when a small fish …

Synthesis And Characterization Of Reinforced Chitosan Hydrogels For Bone Tissue Regeneration, Alanis E. Rodríguez-Rosario, Eduardo Nicolau, Phd, Jaime Santillán

Journal of Health Disparities Research and Practice

Chitosan is the second most abundant natural polymer; it is biodegradable, biocompatible and bioactive. Even though chitosan has been used in various biomedical studies due these characteristics, its mechanical properties are the subject of investigations, as they still need to be improved. Therefore, a hydrogel prepared from composites of chitosan, polycaprolactone and nanodiamonds may offer enhanced mechanical properties compared to pure chitosan. We hypothesize that the mechanical properties of the hydrogel composites will be superior to the unaltered chitosan, while preserving the advantages of the material. The solutions were prepared using chitosan 1.5 wt%, PCL 5 wt% and nanodiamonds 0.016% …