Medicine and Health Sciences Commons^™

Bilingual Prescription Drug Safety For Santa Cruz County, Monica Pantoja

Capstone Projects and Master's Theses

Community Prevention Partners (CPP) is a coalition dedicated to improving community health in the Santa Cruz County. CPP helps improve community health and safety through policies and environmental changes and is dedicated to prevention in alcohol, cannabis and prescription drugs. Everyday more than 130 people in the U.S. die from overdosing on opioids. The opioid epidemic has affected the Santa Cruz county greatly as the incidence of overdose and abuse is rising. In the Santa Cruz County, there is lack of awareness on prescription drug safety. This project focuses on making information available to community members about securing, monitoring and …

Demographic Factors, Bmi And Diagnosis That Affect The Administration Of Emergency Treatment Orders In Psychiatric Units, France Leandre Md, Liang Hong, Sarah Fayad Md

Psychiatry

Emergency Treatment Orders (ETOs) are defined by Florida Law as an immediate administration of rapid response psychotropic medications to a person with the purpose of expeditiously treat symptoms that if left untreated, present an immediate danger to the safety of the person or others. Current literature have revealed the effectiveness of psychotropic drugs in treating agitation, however epidemiological studies on this practice are still very lacking.

Swimming Performance Post Blood Flow Restriction Training In Collegiate Swimmers, Amy E. Boettcher

All NMU Master's Theses

PURPOSE: To determine if blood flow restriction (BFR) training improved performance and physiological factors in collegiate swimmers. METHODS: Participants (n=10) separated into 2 groups (control [CON] & experimental [OCC]), completed 9 supervised trainings within 3 weeks. Pre- and post-testing included: VO_2max, Wingate, swim time trials (TT), strength, and DEXA. Training was identical except OCC underwent bilateral thigh BFR [blood pressure (BP) cuffs inflated 70-90% of systolic BP]. Training: treadmill walking 20 minutes (5x3-minutes at 3 mph, 5% grade, 1-minute rest), followed by bodyweight strength training (squats, lunges & step-ups). Pain levels (scale: 1-10) were taken after …

The Effect Of A Novel Rehabilitation Program On Walking Performance In Persons With Multiple Sclerosis, Alyssa J. Rebensburg

All NMU Master's Theses

The purpose of this study was to compare if the addition of the NewGait™ device to traditional therapy in comparison to traditional therapy alone would be more effective at improving walking technique and walking performance in persons with multiple sclerosis. Eighteen patients with multiple sclerosis participated in this study. Pre- and post-testing assessed kinematic gait variables (speed, step length, step width, double limb support time), toe clearance height, ankle range of motion, balance confidence, rating of perceived exertion, and hip-ankle coordination. Participants completed an 8-week physical therapy protocol aimed to improve gait and balance with the experimental group wearing the …

Prevalence Of Molar-Incisor Hypomineralization In Milwaukee, Wisconsin, Usa: A Pilot Study, Megan Davenport, Andrew D. Welles, Matina V. Angelopoulou, Cesar D. Gonzalez, Christopher Okunseri, Lori Barbeau, Naveen K. Bansal, Rodney Vergotine, Brian D. Hodgson

School of Dentistry Faculty Research and Publications

Purpose: This pilot study investigated the prevalence of Molar-Incisor Hypomineralization (MIH) in third-grade school children in Milwaukee Wisconsin, USA.

Methods: A convenience sample of third-grade school children in the Milwaukee Public School System (MPS) participated in the study. Calibrated examiners trained on the European Academy of Paediatric Dentistry (EAPD) MIH recommendations examined the children between December 1, 2014 and June 30, 2015. Children were examined at their schools using a flashlight and mirror after receiving consent from parents/caregivers and assent from each child. Findings were recorded onto a standardized form by one of five trained examiners. Summary statistics were calculated, …

Depletion Of Myo/Nog Cells In The Lens Mitigates Posterior Capsule Opacification In Rabbits., Jacquelyn Gerhart, Liliana Werner, Nick Mamalis, Joseph Infanti, Colleen Withers, Fathma Abdalla, Colby Gerhart, Arturo Bravo Nuevo, Olivia Gerhart, Lori Getts, Kelly Rhodes, Jessica Bowers, Robert Getts, Mindy George-Weinstein

PCOM Scholarly Works

Purpose: Posterior capsule opacification (PCO) is a vision-impairing disease that occurs in some adults and most children after cataract surgery. Contractile myofibroblasts contribute to PCO by producing wrinkles in the lens capsule that scatter light. Myofibroblasts in the lens originate from Myo/Nog cells named for their expression of the MyoD transcription factor and bone morphogenetic protein inhibitor noggin. In this study we tested the effects of depleting Myo/Nog cells on development of PCO.

Methods: Myo/Nog cells were eliminated by injecting the G8 antibody conjugated to 3DNA nanocarriers for the cytotoxin doxorubicin (G8:3DNA:Dox) during cataract surgery in rabbits. The severity of …

Dental Age Estimation Of A Southern Nevada Hispanic Non-Adult Population Employing The London Atlas To Evaluate Archival Orthodontic Cone Beam Computed Tomography (Cbct) Images, Haley Buchanan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Age estimation is of societal importance for legal, forensic, and clinical reasons. The London Atlas of Human Tooth Development and Eruption, hereafter referred to as the London Atlas, was introduced as an improved method for determining dental age estimation. The London Atlas was developed from panoramic images of 528 living British Caucasian and Bangladeshi males and females aged 2 to 24 years and panoramic images of 176 archival human skeletal remains, aged 32 in utero to 2 years old, from two specimen collections (AlQahtani, Hector, & Liversidge, 2010). Further investigation is warranted to determine validity of the atlas’s use in …

Health Literacy Intervention For Low Income Uninsured Population, Laura Larson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Health literacy (HL) requires basic skills in writing, reading, numeracy, and communication all within a health context (Berkman et al., 2011). HL is a critical element for individuals to take an active role in managing their health. The National Assessment of Adult Literacy found only 12% of adults had a “proficient” HL level. Hispanics were found to be at greatest risk for lower HL than all other ethnic groups (Kutner, Greenberg, Jin, & Paulsen, 2006). Low HL can lead to poor health outcomes including: decreased utilization of preventative services, difficulty in managing chronic conditions, and increased disparities in access …

Development Of A Breast Cancer Survivorship Care Toolkit, Lauren Elaine Scott

UNLV Theses, Dissertations, Professional Papers, and Capstones

A breast cancer survivor’s journey does not end with treatment. After treatment, most breast cancer survivors go on to face many life-long physical and mental challenges caused by their cancer and treatment. Once active cancer treatment is completed, patients enter the next important step in cancer care, cancer survivorship. Cancer survivorship is a comprehensive approach to post-oncology management that promotes the best outcomes for survivors as they transition from oncology care to primary care; and new breast-cancer survivorship guidelines have emerged. Research suggests that primary care NPs’ lack of awareness of the current 2016 American Cancer Society/American Society of Clinical …

Exploring The Homeless Persons Perception Of Living In A Long-Term Care Facility, Janice Woods

Dissertations

Objective:The purpose of this study was to explore the lived experiences of homeless persons admitted to a nursing home facility. Originally, the study was to explore their understanding of and their experience with advance health care planning; coincidently, the participants were more open to their experience of living in a long-term care facility.

Method:A convenience sample of 13 participants (12 male, 1 female) at four long-term care facilities in Southern California were interviewed about their perception of advanced health care planning, including the physician’s orders for life sustaining treatment (POLST); a consent form required in all nursing homes. …

Older Adults’ Implementation Of Discharge Instructions Following An Acute Care Hospital Stay, Brenda Miller

Dissertations

Discharge instructions are a self-care guide for patients after discharge from an acute care hospitalization. The discharge process starts on admission to the hospital and continues until discharged. Many patients rely on informal caregivers to provide support after a discharge. However, it is often unclear whether the patients or caregivers completely understand instructions provided during the discharge process. Key concepts related to how discharge instructions were implemented following discharge to home have been understudied from the patient’s and informal caregivers’ perspectives. Developing effective discharge instructions based on study findings may assist in reducing 30-day hospital readmission rates.
This study was …

Health Program Quality Evaluation To Identify Program Improvement Opportunities, Sheila V. Phillips

Capstone Experience: Master of Public Health

Abstract

Objective: to identify Health Program improvement opportunities including reducing risk of unplanned visits.

Background: Health Program is a program in a Midwest community assisting persons with diabetes and Medicaid to help patients better self-manage their diabetes and connect with community resources. Communities are challenged with helping a growing number of persons with diabetes with multiple chronic conditions, medications, and increased use of unplanned visits. Information was needed to understand unmet needs of this population associated with unplanned visits to develop program improvements.

Methods: In a quality evaluation of a single center, a model of baseline prognostic factors associated with …

Assessing Quality Of Life And Mental Health Differences Among Young Adult Informal Caregivers And Non-Caregivers In Nebraska, Emily L. Frankel

Capstone Experience: Master of Public Health

The goal of this project is to identify differences in quality of life and mental health between younger informal caregivers and non-caregivers, ages 19-40, in Nebraska. To address this goal, a demographic and health assessment battery was disseminated to eligible participants (N=60), comprised of informal caregivers (N=30) and age-, education-, and gender-matched non-caregivers (N=30). The health assessment included reliable and validated questionnaires, including the RAND SF-36, EuroQol 5D, Kessler Psychological Distress Scale, and the General Health Questionnaire. By discovering relationships between quality of life and mental health with the length of time providing care, programming and intervention recommendations can be …

Effects Of Perioperative Hyperglycemia In Patients With Diabetes Compared To Patients Without Diabetes: A Retrospective Study Of Treatment And Outcomes, Matthew Anderson

Capstone Experience: Master of Public Health

The main goal of this project was to examine the differences in perioperative hyperglycemia treatment received by patients with a diagnosis of diabetes mellitus (DM) and patients without a diagnosis of diabetes (NDM); and how these treatment differences can affect the length of hospital stay. Studies have revealed that, when comparing DM and NDM patients with the same degree of perioperative hyperglycemia, NDM patients suffer worse outcomes. It has been suggested in previous research that this may be because NDM patients receive treatment that does not measure up to the standard of care treatment that DM patients receive. In this …

Assessing The Workforce Of The Southwest Nebraska Public Health Department For The Development Of A Workforce Development Plan, Arnel Ramos

Capstone Experience: Master of Public Health

The purpose of this project was to assess the capacity and needs of the Southwest Nebraska Public Health Department (SWNPHD) workforce and to develop a workforce development plan that would meet the accreditation standards of the Public Health Accreditation Board (PHAB). An assessment survey was developed online through the Survey Monkey website using competency skills based on the guidelines established by the Council on Linkages Between Academia and Public Health Practice. The selected competency skills were reviewed and approved for relevance by the SWNPHD leadership and the University of Nebraska Medical Center, College of Public Health, Office of Public Health …

Implementation Of A Survey To Reduce Urine Pregnancy Tests Prior To Gynecology Procedures In Primary Care, Rachel Morgan Budihas

Capstone Experience: Master of Public Health

Excluding pregnancy in individuals prior to initiating contraception is important. The Pregnancy Reasonably Excluded Guide (PREG) uses twelve questions related to a patient’s reproductive history to effectively rule out pregnancy without administering a urine pregnancy screen, saving the patient both time and money. The PREG survey was given at Mayo Clinic in Rochester, MN, from 2015 to 2018 to all patients receiving an Intrauterine Device or Subdermal Implant.

This study examined data from the 2018 collection year to determine if urine screening requests by providers were reduced from the pre-PREG data. It also determined whether urine tests were requested disproportionally …

Do Molecular Subtypes Of Breast Cancer Affect Outcomes Following Hypofractionation Or Conventional Fractionation Radiation Therapy?, Richard Sleightholm

Capstone Experience: Master of Public Health

Introduction

Molecular subtypes of breast cancer (BC) are well-established prognostic markers in early-stage BC patients. The addition of radiation therapy (RT) to breast-conserving surgery has improved outcomes in this patient population, with conventional fractionation (CF) and hypofractionation (HF) regimens displaying comparable morbidity and mortality. However, most studies have not taken into account molecular subtype. Thus, it is still unknown if outcomes are similar between CF and HF for each molecular subtype. Herein, the effects of molecular subtype on the efficacy of CF and HF radiotherapy regimens for early-stage BC patients receiving adjuvant RT was investigated.

Methods

A retrospective review of …

Great Plains Behavioral Risk Factor Surveillance System Project, Florence G. Duran

Capstone Experience: Master of Public Health

Background: Great Plains American Indians/Alaska Natives (AI/ANs) experience higher mortality rates than Non-Hispanic Whites from the same region. The National Behavioral Risk Factors Surveillance System (BRFSS) survey can have limitations of the estimates the health risks behaviors and services from one Tribal community to another. Goals and Objectives: The goal of this project is to address the lack of Tribal specific data among AI/ANs in the Great Plains region (ND, SD, NE, IA) by using Great Plains Tribal BRFSS data that captured information for three tribes in the Great Plains region. Tribal specific data will allow tribes to access, …

Creation Of Evaluation Tools For Workforce Development Opportunities Within A Local Health Department, Nancy Ann Esch

Capstone Experience: Master of Public Health

Improving the skills and competencies of the Central District Health Department’s (CDHD) workforce is essential in assuring the public’s health. However, to develop the desired skills and competencies of the workforce requires effective training programs. CDHD provides professional development funds to all staff to attend workforce development opportunities that can be used on specific training relevant to their position. Approved trainings at CDHD, however, are not evaluated for effectiveness. This capstone project aimed to develop evaluation tools to help determine the effectiveness of training programs at the CDHD. Kirkpatrick’s Four Levels of Training Evaluation (2016) was used to help build …

The Association Between Neurocognitive Impairment And Health-Related Quality Of Life Among People Living With Human Immunodeficiency Virus (Hiv)., Philip S. Amara

Capstone Experience: Master of Public Health

Background: Despite the use of combination antiretroviral therapy, HIV associated neurocognitive impairment (NCI) persists in HIV seropositive persons, albeit in milder forms than before therapy was available. Nevertheless, the relationship between NCI and health-related quality of life (HRQoL) is not well known.

Method: Baseline data from the CHARTER study was used to investigate the association between NCI and HRQoL. Factor analysis was employed to summarize the 35-item Medical Outcome Survey questionnaire into physical and mental HRQoL scores. General linear models were employed to investigate the association between NCI, as measured by global deficit scores (GDS), and HRQoL, and to control …

The Influence Of Interpersonal Dyadic Differences On Condom Use Among Men Who Have Sex With Men, Andrew M. O'Neil

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Men who have sex with men (MSM) continue to be disproportionately affected by HIV/AIDS and other STIs. Condom use is one of the most effective methods of prevention, but rates of condom use have been steadily declining among MSM. Therefore, determining what factors influence condom use decision-making among MSM is important. Interpersonal factors such as physical attractiveness, race, and age have been explored in relation to condom use. However, there is a dearth of research exploring the influence of discrepancies between casual partners in these social categories and its influence on condom use directly.

Purpose: The purpose of this …

A Qualitative Analysis Of Men’S Intended Bystander Behaviors In Response To A Sexual Assault Vignette, Evelyn Day

Health, Human Performance and Recreation Undergraduate Honors Theses

Sexual assault is a pervasive problem; there are myriad negative consequences associated with sexual assault victimization. Given the commonality and consequences associated with victimization, preventing sexual assault is paramount. One mechanism thought to reduce rates of sexual assault is bystander intervention, in which third parties are encouraged to intervene when witnessing sexual assault risk factors and to challenge cultural norms regarding rape and assault. Despite the benefits of bystanding, not everyone intervenes. Previous research indicates that compared with women, men are less likely to intervene. Although some men intervene, researchers’ understanding of how men bystand is limited. The goal of …

Assessment Of Factors That Impact Hydration Status Of Professional And Collegiate Mascots, Caroline Atwell

Human Nutrition and Hospitality Management Undergraduate Honors Theses

Mascots have unique physical demands and nutrition needs. They exert themselves tremendously on a variety of game days and at practices throughout the week. Hydration is as significant for mascots as it is for any other athlete, yet there is little to no known research available to help this population achieve a good hydration status. Studying similar populations such as cheerleaders, band members, football players, and firefighters provided a better understanding of mascot hydration. The purpose of this study was to examine the level of hydration knowledge in mascots performing at the collegiate and professional levels and determine the different …

Transcriptional Regulation Of Nlrc4 Inflammasome By Irf8, Ein Lee

Theses and Dissertations (ETD)

The NLRC4 inflammasome is a crucial part of the innate immune response against bacterial infections. We found that NLRC4 inflammasome activation in bone marrow-derived macrophages (BMDMs) is greatly dependent on interferon regulatory factor 8 (IRF8). NLRC4-mediated caspase-1 activation and subsequent production of the inflammasome-dependent cytokines IL-1β and IL-18 and cell death were impaired in IRF8-deficient cells. IRF8 mediated the transcription of genes encoding NAIPs, the receptors for NLRC4 inflammasome, which recognize bacterial flagellin and type III secretion system (T3SS) proteins. IRF8 was critical for host survival following infection with Salmonella Typhimurium or Burkholderia thailandensis. Furthermore, mice deficient in IRF8 were …

Injectable Systems For Long-Lasting Insulin Therapy, Kumar Kulldeep Niloy

Theses and Dissertations (ETD)

Diabetes mellitus is one of the major global health problems and the prevalence rate is ever increasing reaching to 48% increase by the year of 2040 causing significant economic burdens. Insulin therapy has been the mainstay of diabetes treatment since its discovery in 1922. However, insulin is an unstable peptide with a half-life of only 4-6 min which poses significant challenge in prolonging duration of action of insulin. Nevertheless, the advances in recombinant DNA technology and protein engineering have enabled the development of several long-acting insulin analogue products which show duration of action up to 42 h. However, these insulin …

Study Of Natural Killer Cells And Their Therapeutic Role In Pediatric Cancer, Hong Ha Rosa Nguyen

Theses and Dissertations (ETD)

NK cells are known to play an important role in the natural defense against viral infections and tumor immune surveillance. Through complex interactions between NK cell receptors and target cell ligands, transformed or unhealthy cells are identified and rapidly eliminated. NK cells have been used for therapeutic purposes in pediatric oncology, for example by harnessing the mechanisms of NK cell surveillance in acute myeloid leukemia (AML) or intervention-augmented antibody-dependent cell-mediated cytotoxicity (ADCC) in neuroblastoma. However, the underlying cellular mechanisms in these processes are not fully understood. In my thesis research, I sought to gain a deeper understanding of the molecular …

Investigation Of Cell-Type-Specific Effects And Synergistic Interactions Between Genes In Duplication 15q Syndrome, Kevin A. Hope

Theses and Dissertations (ETD)

Duplication 15q syndrome (Dup15q) is a genetic disorder caused by duplications of the 15q11.2-q13.1 region and is characterized by developmental delay, autism spectrum disorder, and treatment resistant epilepsy. Extra copies of the E3 ubiquitin ligase UBE3A and elevated levels of UBE3A expression in neurons are thought to be the primary cause of Dup15q phenotypes. However, animal models overexpressing UBE3A in neurons have not successfully recapitulated all aspects of Dup15q syndrome, especially epilepsy. Here, we used Drosophila melanogaster (fruit flies) to investigate Dup15q syndrome. In Chapter 2 we explored whether Dube3a, the Drosophila homolog of UBE3A, is imprinted in the fly …

Molecular Mechanisms Of Metabolic Reprogramming In Pancreatic Cancer, Sonam Kumari

Theses and Dissertations (ETD)

Pancreatic cancer ranks as third deadliest cancer worldwide in both men and women. The lack of diagnostic methods, chemo-resistance and invasiveness of the disease diminishes the overall survival rate in patients. Dysregulated glucose metabolism and several molecular determinants including oncogenic signaling pathways play pivotal roles in the development, progression and metastasis of pancreatic cancer. The aberrant glucose metabolism is the most prevalent key factor that influences pancreatic tumorigenesis. The cancer cells of pancreas utilize oxygen for the breakdown of glucose to lactate, which is known as Warburg effect. This phenotype of pancreatic cancer encourages proliferation, growth, migration and invasive phenotypes …

Challenging The Paradigm Of Clinical Triazole Resistance In Aspergillus Fumigatus, Jeffrey Michael Rybak

Theses and Dissertations (ETD)

Invasive aspergillosis is a leading cause of morbidity and mortality among immunocompromised populations and is predicted to cause more than 200,000 life- threatening infections each year. Aspergillus fumigatus is the most prevalent pathogen isolated from patients with invasive aspergillosis, accounting for more than 60% of all cases. Currently, the only antifungal agents available with consistent activity against A. fumigatus are the mold-active triazoles and amphotericin B, of which the triazoles commonly represent both front-line and salvage therapeutic options. Unfortunately, the treatment of infections caused by A. fumigatus has recently been further complicated by the global emergence of triazole resistance among …

Using Genetic Diversity To Understand Susceptibility To Cognitive Decline In Aging And Alzheimer’S Disease, Sarah M. Neuner

Theses and Dissertations (ETD)

An individual's genetic makeup plays an important role in determining susceptibility to cognitive aging and transition to dementia such as Alzheimer's disease (AD). Identifying the specific genetic variants that contribute to cognitive aging and AD may aid in early diagnosis of at-risk patients, as well as identify novel therapeutics targets to treat or prevent development of symptoms. Challenges to identifying these specific genes in human studies include complex genetics, difficulty in controlling environmental factors, and limited access to human brain tissue. Here, we turned to genetically diverse mice from the BXD genetic reference panel (GRP) to overcome some of the …