Medicine and Health Sciences Commons^™

Grounds For A New Normal: Integration Of Telenephrology In Rural Communities, Carolyn J. Mattson

Doctor of Nursing Practice Projects

Patients with kidney disease represent a group of people who are known to have comorbidities, high costs of care, decreased quality of life, and invasive interventions. In rural communities of Western Washington State, many nephrology patients experience factors evidenced to impede access to quality and timely management of their disease, compounding the risk for poor outcomes. Telenephrology is a novel modality of service delivery with the potential to make care more efficient, cost-effective, flexible, and accessible. The author created this project to develop a telenephrology program plan and evaluation for rural settings in Western Washington, informed by relevant epidemiology, pathophysiology, …

Reducing Weight Bias: Creating An Anti-Weight Stigma Educational Simulation For Nurse Practitioner Students, Andrea A. Eickelmann

Doctor of Nursing Practice Projects

Background: Large-bodied people make up the majority of the American population, but healthcare providers are rarely taught specific techniques and strategies for management of their care and medical spaces are designed with furniture and equipment that does not accommodate large bodies. This alienation has resulted in a measurable detriment to the population’s mortality and morbidity, such increased mortality of 60% from experiencing weight stigma and over 50% high combined cancer death rates as compared to the rates of those with normal BMIs (Sutinet al., 2015; Calle et al., 2003).

Objective: This project will examine the evidence about weight stigma, efficacy …

Racial Disparities In Liver Disease In The Us: Addressing The High Prevalence Of Hepatitis B Infection In The Apia Community, Lindsey L. Trinh, Lindsey Trinh

Scripps Senior Theses

Chronic liver disease and hepatocellular carcinoma are some of the leading causes of death in the United States, resulting in a number of annual deaths that has only increased over the past several decades. A vast proportion of these liver-related deaths is due to chronic hepatitis B infection, which currently affects approximately 1.2 million people in the US. However, the hepatitis B virus does not affect every racial group in the United States equally: Asian Americans experience a disproportionately high prevalence of HBV infection. In fact, even though the APIA community comprises only 4% of the US population, they account …

Telehealth During Covid-19: A Look At Healthcare Providers’ Experiences, Sabrina Webb

Honors Program Theses

Healthcare providers were placed under considerable strain during the COVID-19 pandemic. To exacerbate matters more, a sudden shift to telehealth became necessary to provide safe provider-patient visits. The increased strain created by the sudden need to implement a telehealth protocol is believed to have decreased workplace satisfaction. This study aims to investigate how the rapid shift to telehealth during the COVID-19 pandemic affected healthcare providers’ workplace satisfaction, how virtual visits created challenges and opportunities for provider-patient communication, and how the use of telemedicine during the COVID-19 pandemic affected healthcare providers’ capacity to engage in patient-centered communication. For this study, 15 …

Safety And Efficacy Of Bioidentical Hormone Therapy In Menopause: A Literature Review, Kathryn Akre

All Graduate Theses, Dissertations, and Other Capstone Projects

Vasomotor symptoms (VMS) experienced during menopause can negatively impact a woman’s quality of life, productivity, sleep, and mood. Systemic hormone therapy (HT) is the most effective treatment for moderate to severe VMS, however safety concerns raised by the 2002 Women’s Health Initiative (WHI) trial have led to a decrease in overall HT use and a growing demand for custom-compounded bioidentical HT. Misconceptions regarding the superior safety and efficacy of custom-compounded hormones and lack of clinician expertise in menopause management contribute to ongoing uncertainty and low uptake of United States (U.S.) Food and Drug Administration (FDA) approved bioidentical HT products. This …

Treatment Of Adults With Attention-Deficit/Hyperactivity Disorder: A Systematic Literature Review, Bethanie M. Miller

All Graduate Theses, Dissertations, and Other Capstone Projects

Objective: To compare treatment with stimulant medications to nonstimulant medications and/or nonpharmacologic interventions on professional and interpersonal functioning in adults with attention-deficit/hyperactivity disorder (ADHD).

Method: Systematic literature review of five databases; 22 articles containing 323 studies (N=21,370) were included in this review.

Results: Psychostimulants remain the most studied treatment for adults with ADHD and boast larger effect sizes than nonstimulant and nonpharmacologic therapy. Among nonpharmacologic therapy, cognitive behavior therapy (CBT) has proven most successful in randomized controlled trials. Effects of CBT are enhanced when combined with pharmacotherapy.

Conclusions: Psychostimulants continue to be the most frequently prescribed treatment for adults with …

Reducing Disease Exacerbation In Women With Confirmed Copd: A Systematic Literature Review, Jill Essay

All Graduate Theses, Dissertations, and Other Capstone Projects

Abstract

A systematic literature review was conducted to establish whether gender specific treatment exists for patients with Chronic Obstructive Pulmonary Disease (COPD), specifically, women with (COPD). The PICO question developed for this review is as follows: In women with confirmed diagnoses of COPD, does gender-specific treatment, compared to standard treatment, impact the frequency of exacerbations? Could the number of COPD exacerbations in women be reduced by incorporating interventions designed with (female) gender in mind? Four databases were included in the search: CINAHL, Pubmed, Medline, and Nursing and Allied Health. Articles included addressed gender differences in relation to the disease process, …

Cannabis As A Prescription Opioid Substitute For Adults With Chronic Pain: A Systematic Literature Review, Lani Kranz

All Graduate Theses, Dissertations, and Other Capstone Projects

Objective: To determine whether the use of cannabis improves pain control and/or reduces the amounts of opioids needed to control pain in adults with chronic pain.

Methods: A systematic literature review of research conducted from the past five years. Five databases were searched, resulting in 14 peer-reviewed articles relevant to the objective.

Results: The majority of the literature reviewed demonstrated the use of cannabis by adults with chronic pain resulted in better pain control and/or fewer opioids required to control pain in this population. The two articles which contradicted these findings only evaluated illicit, not medical, cannabis use by individuals …

The Impact Of A Plant-Based Diet On The Prevention And Management Of Type 2 Diabetes Mellitus, Megan E. Ziola

All Graduate Theses, Dissertations, and Other Capstone Projects

Background: In the United States, type 2 diabetes is on the rise. Through lifestyle modifications, adults can prevent, delay, or help manage diabetes. Consuming a plant-based diet means limiting or eliminating animal products while focusing on fruits, vegetables, and whole grains. This dietary habit may be beneficial when it comes to diabetes prevention and treatment.

Objectives: A literature review was conducted to determine the effects of a plant-based diet on the prevention and treatment of type 2 diabetes in adults.

Methods: The search process was limited to 2010-2020. The databases including Academic Search Premier, CINAHL, Cochrane Database of Systematic Reviews, …

Supporting Resilience In Reserve Component Spouses During Deployment: The Impact Of Family Life Cycle Phase And Deployment History On Social Support Needs, Jennifer L. Ceminsky

All Graduate Theses, Dissertations, and Other Capstone Projects

This exploratory study used a researcher developed survey to examine the relative value of instrumental, emotional, and informational support for Reserve Component spouses during deployment. Although all types of support were valued by nearly all study participants, significant differences were found between ratings of helpfulness for each type of support. Emotional support was the support type most valued by 73.1% of spouses in this study. Instrumental support was most valued by21.1%, and only 2.8% of spouses valued informational support most. Regression analyses were used to identify factors that were predictive of value placed on each type of social support. The …

Treatment-Resistant Hypercalcemia From Ectopic Pth Hypersecretion Suspected Secondary To Disseminated Ovarian Cancer, Alexander M. Balinski, Neil J. Khatter, Jeffrey M. Gold, Krishna S. Pothugunta, Vamshi K. Garlapaty, Steven M. Rankin, Christopher A. Thornburn, Jamal Abu-Khaled

Articles

Hypercalcemia of malignancy (HCM) can present secondary to hypersecretion of parathyroid hormone (PTH)-related protein (PTHrP) from malignant tumors, but rare cases of HCM have also been documented due to inappropriate PTH secretion from ectopic neoplasms. Here, we report an unusual case of HCM due to hypersecretion of PTH suspected secondary to a disseminated mucinous ovarian adenocarcinoma. A 45-year-old female presented with severe hypercalcemia and significant elevations in both PTH and PTHrP two weeks after total abdominal hysterectomy with bilateral salpingo-oophorectomy and suboptimal debulking of a newly discovered left ovarian mucinous adenocarcinoma with numerous metastases. Ectopic PTH secretion was highly suspected …

Interprofessional Collaboration In Healthcare: Case Studies Lab, Amanda L. Rotondo

Open Educational Resources

This document includes 4 case studies that can be utilized for interprofessional collaboration in healthcare disciplines including Physical Therapy Programs, Physical Therapist Assistant Programs, Nursing Programs, Occupational Therapy Programs, and Speech Therapy Programs.

Protocadherin-19 Expression And Function In Vertebrate Brain Review, Makana Mcguire

Williams Honors College, Honors Research Projects

For this project, a systematic review will be conducted on published studies on protocadherin-19 expression and function in vertebrate central nervous system development in the last 10 years. Protocadherin-19 (pcdh19) is a member of the cadherin superfamily. Cadherins are calcium-dependent cell adhesion molecules show to play important roles in vertebrate tissue development including the formation of the central nervous system. Understanding molecular and cellular mechanisms underlying the function of pcdh19 will help aid in understanding disease(s) caused by malfunction of this molecule, and lead to potential strategies for treatment. Data will be collected via online search of databases. The project …

A Conceptual Proposal For The Epigenetically Causal Relationship Between Parental Ptsd And Inflammatory Disease In Post Hoc Offspring., Emma Griffith

Williams Honors College, Honors Research Projects

Could a combat veteran's horrific experiences in early-2000s Afghanistan have a direct, biological impact his now-adult daughter's risk of a heart attack later in her life? This concept would have been unapologetically mocked a mere twenty years ago, and it has only been in the past decade that the new field of epigenetics has revealed a distinct possibility for this event to actually take place—for parents' experiences to profoundly influence the biology of their children. The major objective of this research project is to argue for the legitimacy of this theoretical phenomenon by discussing the latest data regarding PTSD's interaction …

Effects Of E-Cigarette Vapor On Zebrafish Cell Regeneration And Wound Healing, Alyssa A. Grismer, Jenna E. Pumneo, Brian Bagatto

Williams Honors College, Honors Research Projects

In regards to wound healing, smoking traditional tobacco cigarettes is known to have negative effects on wound healing (Akoz, 2002). An increased risk of skin necrosis has been observed in patients who smoke throughout the surgical process (Akoz, 2002). It is known that nicotine, whether introduced through inhalation or intravenously, leads to peripheral skin vasoconstriction (Akoz, 2002). The full physiological effects of e-cigarettes are not known and research is being done to improve our understanding on the effects that these products may have on our bodies. This research is intended for that purpose. Zebrafish have recently been used as a …

The Characterization Of Purified Citrate-Coated Cerium Oxide Nanoparticles Prepared Via Hydrothermal Synthesis, Matthew L. Hancock, Robert A. Yokel, Matthew J. Beck, Julie L. Calahan, Travis W. Jarrells, Eric J. Munson, George A. Olaniyan, Eric A. Grulke

Chemical and Materials Engineering Faculty Publications

Hypothesis

Cerium oxide nanoparticles were synthesized using a hydrothermal approach with citric acid as a stabilizing agent. Citric acid adsorption onto the nanoceria particle surface can cease particle formation and create a stable dispersion for an extended shelf life. The product was dialyzed immediately following the synthesis to remove unreacted cerium that could contribute to biological effects. Nanoparticle characterization results are expected to help identify the surface citrate bonding structure.

Experiments

Many characterization techniques were utilized to determine size, morphology, surface properties, and citrate complexation on the nanoceria particle surface. These included transmission electron microscopy, electron energy loss spectroscopy, dynamic …

Research News, Publications, 2021, Volume 4, Soumyajit Majumdar

Publications (2015-)

Publications that appeared during the period of October 1 through December 31, 2021

Research News, Grants, 2021, Volume 4, Soumyajit Majumdar

Grants (2015-)

Grants and contracts awarded during October - December 2021.

Analysis Of Circadian Rhythm Irregularities On The Health Of Shift Workers, Sahil Rajan

Williams Honors College, Honors Research Projects

Circadian rhythms involve the natural 24 wake-sleep cycle that governs proper maintenance of biological sleep schedules. Circadian rhythm disruption has been associated with health issues such as diabetes, obesity, and mental health disorders such as bipolar and sleep disorders. In this study, a survey method was utilized in order to analyze specific population demographics to determine whether working day or night shifts predisposed individuals to health issues due to disruptions in their circadian rhythms. This study was also carried out to observe popular coping strategies among night shift workers. Of all the variables tested comparing the difference between day and …

Identifying Molecular Pathways Underlying Noise-Induced Tinnitus, Mckenzie Rice

Williams Honors College, Honors Research Projects

Tinnitus is a serious neurological condition effecting 10-15% of adults, and can lead to other symptoms such as difficulty concentrating and sleeping, anxiety, and depression. Currently there are no FDA approved drugs to prevent or treat tinnitus, mainly due to a lack of understanding of its cellular and molecular pathways. T- and L- type calcium channels have been implicated in the modulation of tinnitus, as well as the dysfunction of gamma-aminobutyric acid (GABA) neurons. This study used the sound-based avoidance detection (SBAD) method in order to detect tinnitus and determine whether pharmacological treatments had an effect in mediating tinnitus. T-type …

Examination Of Nurses’ Perceptions, Beliefs, And Conceptions Related To Rapid Bedside Implementation Of Prone Therapy During The Covid-19 Pandemic, Alyssa Poghen, Emily La Riviere

Doctor of Nursing Practice Projects

The COVID-19 pandemic of the SARS-CoV-2 virus created significant challenges for healthcare agencies and front-line healthcare workers. The SARS-CoV-2 virus has demonstrated a unique propensity to induce severe lung injury in the form of acute respiratory distress syndrome (ARDS). High rates of COVID-19 illness in the initial months of the pandemic in the United States led to a rapid influx of patients admitted to critical care units (CCUs) for ARDS. Prone positioning therapy (PPT) has shown substantial promise in treating refractory hypoxemia in people with severe ARDS but historically received poor acceptance as a first-line therapy. With the onset of …

Catching Up With Hpv Immunization: An Educational Video For College Students, Behrooz R. Soleimani

Doctor of Nursing Practice Projects

HPV is the most common sexually transmitted infection in the US, and it can lead to minor health problems such as genital warts and serious problems like cancer in men and women. HPV vaccination can effectively prevent HPV-related cancers and is recommended by ACIP to individuals aged 9-26. HPV vaccine uptake is low among adolescents and young adults in the US. College students have a window of opportunity to catch up with their HPV immunizations, and are often uninformed about HPV, the HPV vaccine, their eligibility to receive the HPV vaccine, and where they can obtain the HPV vaccine. An …

Implementation Of A Proactive Rapid Response Team Nurse Rounding Protocol To Address Afferent Limb Failure In A Mature Rapid Response System, Sarah Welch

Doctor of Nursing Practice Projects

Background: Rapid response system afferent limb failure (ALF) is associated with increased hospital mortality rates, unplanned transfer to the ICU, and increased hospital length of stay. Factors contributing to ALF are complex, including individual, team, organizational, and systemic barriers. The aims of this study were to evaluate the impact of implementation of a proactive rapid response team nurse (RRT RN) rounding protocol on the frequency of ALF preceding adverse events, patient disposition following RRT activation, and discharge disposition of patients experiencing adverse events during their hospital stay at a 281 bed community hospital.

Methods: This was a two part quantitative, …

Pain Neuroscience Education As An Intervention For Chronic Pain, Corissa A. Sutton

Doctor of Nursing Practice Projects

Purpose: The purpose of this project was to evaluate the ability of Pain Neuroscience Education (PNE) to increase knowledge of pain as a biopsychosocial process and influence more health-promoting interpretations of pain among low-income adults as a preventative health education approach.

Background: PNE is a promising treatment approach for addressing chronic pain. However more data is needed to understand how to most effectively utilize this intervention.

Design: A program evaluation was conducted using a pre- and post- test design to elicit quantitative and qualitative data. Nine Seattle Housing Authority (SHA) buildings were invited to participate in two online pain neuroscience …

Context Matters: Evaluating The Influence Of Patient Demographics And In-Patient Care Parameters On Breastfeeding Outcomes Associated With The Baby Friendly Hospital Initiative, Sarah Vivian Martin

Doctor of Nursing Practice Projects

Objective: Evaluate the effectiveness of the global Baby Friendly Hospital Initiative (BFHI) as an intervention to improve breastfeeding outcomes and to explore factors that are most supportive and predictive of exclusive breastfeeding.

Design: Program evaluation of the BFHI using a retrospective pre and post implementation electronic health record chart review.

Setting: A tertiary level hospital in WA. BFHI designation was achieved in November 2017.

Participants: Patients with a low-risk pregnancy, who gave birth (vaginal or cesarean) to a healthy term infant in Quarter one of 2015 (N=145) and Quarter four of 2018 (N=131).Patient and infant must have been discharged home …

Building Resilience: Piloting A Mindful Self-Compassion And Stress-Management Program For Youth, John A. Hinrichs

Doctor of Nursing Practice Projects

Anxiety disorders, representing the most prevalent classification of mental health disorders across the world, pose a significant public health problem associated with burdensome costs (Baxter, Vos, Scott, Ferrari, & Whiteford, 2014; Greenberg et al., 1999). Although understanding about the etiology and effective treatments for anxiety disorders has grown, general preventative measures are not well-understood or implemented but are needed to reduce the disability and morbidity associated with this debilitating class of disorders. Research has identified perfectionism and self-criticism as risk factors for the development of anxiety disorders and mindful self-compassion (MSC) as a promising intervention to alleviate anxiety disorders (Dunkley, …

Screening For Adverse Childhood Experiences And Other Determinants Of Health In School Based Health Centers: A Program Evaluation, Olivia A. Domini

Doctor of Nursing Practice Projects

Introduction: Adverse Childhood Experiences (ACEs), such as abuse, neglect, and various household stressors, are common, connected, and contribute to multiple adverse health and wellbeing outcomes throughout life. Consequently, there has been a push to screen for adversity and toxic stress in primary care to facilitate prevention and early intervention. The purpose of this project was to evaluate and optimize the use of the Broad Level Integrated Screener (BLIS) in Neighborcare Health (NCH) School Based Health Centers (SBHCs) in Seattle, WA.

Methods: An online survey including nineteen Likert-scale questions and five open-ended free response questions was administered to all middle school …

Barriers To Effective Implementation Of Contingency Management In Outpatient Treatment Of Methamphetamine, Emma A. Nauman

Doctor of Nursing Practice Projects

The objective of this project is to: 1) identify current understanding, attitudes, and beliefs of clinicians at a midsized urban outpatient substance use treatment clinic regarding contingency management (CM) treatment modality; 2) examine how this data contributes to barriers to implementation of contingency management for methamphetamine treatment; and 3) make recommendations to improve implementation strategies. A ten-question survey was developed based on Social Ecological Theory (U.S. Department of Health and Human Services, 2005), and was administered to 31 clinicians. A key informant interview was conducted using theoretical sampling (LoBiondo-Wood & Haber, 2018) of emergent themes. Three major barriers emerged from …

The Interactive Effects Of Brain-Derived Neurotrophic Factor (Bdnf) Polymorphisms And Posttraumatic Stress Disorder On Neurocognitive Functioning In U.S. Military Veterans, Colton Shafer Rippey

Theses and Dissertations--Psychology

Posttraumatic Stress Disorder (PTSD) is associated with mild-to-moderate deficits in neurocognitive functioning. Single nucleotide polymorphisms (SNPs) in the brain-derived neurotrophic factor (BDNF) gene, namely, the Met allele, may also be associated with mild deficits in neurocognitive functioning. However, findings are inconsistent and may be sensitive to environmental epigenetic moderators such as psychopathology.

The current study analyzed data from European-American U.S. military veterans (n = 1,244) who participated in the 2011 National Health and Resilience in Veterans Study (NHRVS). Multivariate analyses of covariances were conducted to evaluate the unique and interactive effects of the Met allele and probable PTSD on …

Psychosocial Preoperative Preparation In A Non-Children's Hospital Without Child Life Supports, Haley M. Fricke

EWU Masters Thesis Collection

On average, 6 million children undergo general anesthesia for surgery annually in the United States (Shah et al., 2021).Anesthesia can be one of the most stress provoking experiences, with 40% to 60% of children displaying emotional and behavior stress before surgery (Boles, 2016). Psychosocial preoperative preparation in pediatrics has been seen to lower children’s stress levels, enhance understanding, increase compliance, decrease length of time in recovery, and decrease analgesic use (Aranha et al., 2017; Al-Yateem et al., 2016; Dolidze et al., 2013; Tunney & Boore 2013; Wenstrom et al., 2011). The purpose of this exploratory case study was to better …