Medicine and Health Sciences Commons^™

Perceived Barriers And Facilitators To Cervical Cancer Screening In Asian American Women, Bouathong Thepsombath

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this systematic review is to explore barriers and facilitators of cervical cancer screening in Asian-American women. Articles selected for review were found using a database search method using select predetermined key terms. The clinical question this review sought to answer is: In Asian-American women (21-65 years of age), how does perception of cervical cancer screening impact screening compliance? Nine articles addressing the topic of interest were included in the review. Emerging themes related to answering the question under study included the health literacy of Asian-American women, modesty, acculturation, income comfortability, and self-efficacy. This review found information that …

Impact Of Telemedicine On Heart Failure Readmissions And Mortality: A Literature Review, Stephanie R. Ledvina

All Graduate Theses, Dissertations, and Other Capstone Projects

Background: Heart failure is a chronic condition that commonly results in frequent hospitalizations and increases risk of mortality (Kotb et al., 2015; Ong et al., 2016; Pekmezaris et al., 2018). In addition, heart failure places a significant burden on healthcare costs and utilization of resources (Hale et al., 2016; Kotb et al., 2015; Ong et al., 2016). Measures to reduce heart failure readmissions, mortality, and overall costs are needed. Telemedicine interventions may be beneficial in the management of heart failure; however, the current research provides unclear and inconclusive findings in regard to the effectiveness of telemedicine interventions on heart failure …

Understanding The Implications Of Hpv Infection: Does Parental Education Impact Hpv Vaccination Completion Rates?, Heather A. Pederson

All Graduate Theses, Dissertations, and Other Capstone Projects

Up to 80% of United States (U.S.) citizens will contract the human papillomavirus (HPV) at some point in their lives. HPV has the ability to cause multiple types of cancer, including cervical, vulvar, vaginal, penile, anal, and oropharyngeal. The most recent HPV vaccine is effective against nine strains of the virus, which account for most cases of cancer and genital warts caused by HPV. Parents are a key component in reaching Healthy People 2030’s goal to have 80% of all adolescents in the U.S. completely vaccinated against HPV. Objective: The purpose of this systematic review was to determine if …

The Impact Of Social Media On Teenage Females Self-Esteem, Amanda C. Perkovich

All Graduate Theses, Dissertations, and Other Capstone Projects

Social media has become the way we connect with the world. Social networking sites, including Facebook, Instagram, Snapchat, Twitter and TikTok, allow users to share intimate details of their lives, upload photographs, initiate and maintain relationships, plan social gatherings, observe the lives of others and express beliefs, values and emotions. In the last ten years, numerous articles have focused on the relationship between social media use and mental health however, very few studies have concentrated on self-esteem, especially in teenage females. The purpose of this literature review is to explore the associations between increased social media activity (greater than 2 …

Paternal Postpartum Depression Screening: A Critical Measurement That Is Long Overdue, Nicholas C. Mcclellan

All Graduate Theses, Dissertations, and Other Capstone Projects

The birth of a child is one of the most important events in a parent’s life. It is a time of intense emotion, the characteristics of which vary greatly depending on individual circumstances and the relationship between the mother and father. Joy is mixed with feelings of being overwhelmed by the multitude of responsibilities that come with caring for an infant. Changes in relationships and feelings of isolation are common and can be a source of duress for parents. Fortunately, the severity of these emotions is often mild and self-limiting. Sometimes, however, they are severe enough to negatively affect daily …

Reducing Polypharmacy In Older Adults At End Of Life: The Outcome On Quality Of Life, Melissa Jenson

All Graduate Theses, Dissertations, and Other Capstone Projects

Background: Older adults at the end of life are commonly prescribed multiple medications which can lead to polypharmacy. Research has shown that optimizing medications through targeted deprescribing reduces inappropriate medications, reduces adverse effects and improves select outcomes. However, the impact of deprescribing remains uncertain--specifically whether this intervention improves quality of life (QOL). Objective: Explore polypharmacy in older adults at the end of life examining outcomes of deprescribing on the QOL. Methods: A systematic literature search using Academic Search Premier, CINAHL, Medline, JSTOR and Nursing and Allied Health Database was conducted between October 2020 to November 2020. Select articles …

Cannabis Treatment Of Autism In Children: A Literature Review, Mai Xiong

All Graduate Theses, Dissertations, and Other Capstone Projects

Objectives: This literature review aims to summarize the effects of medical cannabis use in children on Autism Spectrum Disorder (ASD) symptoms, side effects and provide recommendations for practice, education, and research. Background: ASD is characterized by core behaviors of significant impairment in social communication and interaction and restricted and repetitive patterns of behavior, interests, or activities (APA, 2013). In addition to these core behaviors, individuals with ASD often have noncore behavioral disorders and several medical comorbidities. Treatment for ASD symptoms includes Cognitive Behavioral Therapy (CBT), aripiprazole (Abilify) and/or risperidone (Risperdal). As of this review, 14 states have added ASD …

The Effects Of Therapist Expertise And Concerns Of Involuntary Hospitalization On The Disclosure Of Suicidal Ideations And Behavior, Zane Hensel

All Graduate Theses, Dissertations, and Other Capstone Projects

Suicide continues to grow as a complex and multi-faceted problem in prevention and treatment, particularly for college students with an increased predictor of risk of suicidal behaviors. Previous research has indicated that one of the largest concerns for suicide disclosure is a fear of involuntary hospitalization. Over 200 college students participated in examining therapist expertise and understanding information on involuntary hospitalization on their rate of suicide disclosure. A 2x2 MANOVA, a 2x2x2 MANOVA that included gender, and a factor analysis were performed on an ad-hoc 11-question survey assessing suicidal ideation and suicidal behavior disclosure. The results indicated that there was …

Predicting Mental Health Counseling Professionals’ Willingness To Discuss Sexuality Issues With Clients, Becca L. Thompson

All Graduate Theses, Dissertations, and Other Capstone Projects

Sexuality is fundamental to the human experience and sexuality issues will affect every individual across the lifespan. Mental health counseling professionals (MHCPs) will likely encounter a client in their practice that presents with some facet of sexuality concern. MHCPs may be challenged by these disclosures or neglect to inquire about these needs due to underlying factors that contribute to decreased willingness to discuss sexuality with clients. This study explored the relationships of some of these factors, including sexual intervention self-efficacy, state anxiety, and trait anxiety, and further examined the extent to which these factors predict willingness to discuss sexuality with …

Comparison Of Standard Dose Vs Higher Dose Low Molecular Weight Heparin And Unfractionated Heparin For Dvt Prophylaxis In Covid-19 Patients, Zachary Brown Pharmd, Munyaradzi Chakabva Md, Tabinda Akhtar Md, Sarah Polina Pharmd, Bcps, Michael Todt Pharmd, Bcccp, Mckenna Brauner Np, Meghan Mcguire Np, Aws Polina Md

Parkview Pharmacy Department

2021 ASHP Midyear Clinical Meeting / Virtual / Poster # 1121810

Objective: To evaluate whether higher dose VTE prophylaxis results in a significant reduction in VTE events without significant increase in bleeding risk when compared to standard dose VTE prophylaxis in patients with COVID-19 infection

Indomethacin Suppository Medication Use Evaluation For Prevention Of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis (Pep) In A Community Health System, Caitlyn Patton, Jamie Gaul Pharmd, Bcps, Jennifer Sposito Pharmd

Parkview Pharmacy Department

2021 ASHP Midyear Clinical Meeting / Virtual / Poster

Objective: To evaluate the use and characterize the patient population receiving indomethacin suppositories for PEP with the goal of ensuring appropriate use.

Assessing Consistency With Standards Of Care Recommendations For Patients With Type 2 Diabetes At Hospital Discharge, Katherine Brown Pharmd, Timothy L. Johnston Bpharm, Pharmd, Bcps, Bcccp, Andrea Sloat Pharmd

Parkview Pharmacy Department

2021 ASHP Midyear Clinical Meeting / Poster ID#1129514

Objective: To assess the number of patients prescribed diabetic regimens consistent with American Diabetes Association (ADA) Standards of Care recommendations upon hospital discharge.

Implementation And Outcomes Assessment Of A 4-Factor Prothrombin Complex Concentrate (4f-Pcc) Tiered Fixed Dosing Protocol In A Health System., Mark Botros Bs, Jamie Gaul Pharmd, Bcps, Dana Lorber Pharmd, Bcps, Sarah Koontz Pharmd, Bcps

Parkview Pharmacy Department

2021 ASHP Midyear Clinical Meeting / Poster

The aim of this study was to evaluate compliance to the newly implemented fixed dosing protocol while assessing for the need for repeat doses of 4F-PCC and the need for further invasive intervention to reverse the bleeding.

Evaluation Of Intravenous Immunoglobulin (Ivig) Utilization After The Implementation Of Indication And Dosing Protocol At A Community Health System., Nicholas Buttermore, Jamie Gaul Pharmd, Bcps, Kate Oetting

Parkview Pharmacy Department

2021 ASHP Midyear Clinical Meeting / Poster

Objective: This study was conducted to evaluate the patient landscape of IVIG use within our community health system, both before and after protocol implementation. Our goals were to identify potential changes with the indication for use along with any prescribed dosing decreases while under protocol.

Evaluation Of Calcitonin Use For Hypercalcemia At Parkview Health, Alison Rydell, Jesse Christman Pharmd, Bcop, Jamie Gaul Pharmd, Bcps

Parkview Pharmacy Department

2021 ASHP Midyear Clinical Meeting / Poster

Objective: Evaluate the appropriateness of calcitonin use for hypercalcemia at Parkview Health, a not-for-profit community hospital health system.

Evaluation Of Emergency Department Treatment Of Pediatric Asthma Exacerbations, Paige Walker Pharmd, Amber Ooley Pharmd, Bcps, Bcccp, Kassandra Foellinger Pharmd, Bcps

Parkview Pharmacy Department

Objective:

Primary: to assess the appropriateness of medications ordered in the emergency department (ED).

Secondary: to assess the appropriateness of discharge medications and new encounters within 30 days for another asthma-related problem.

Preparing Student Dental Hygienists In Care Of Persons Of Developmental Disabilities Using A Virtual Patient Module, Janis Mcclelland

EWU Masters Thesis Collection

Purpose: The purpose of the study was to examine if participation in an interactive virtual patient (VP) module increased dental hygiene students’ knowledge in caring for individuals with developmental disability (DD) and if participation in an interactive, VP module would impact dental hygiene students’ perception of difficulty in caring for individuals with DD.

Methods: The study utilized a mixed-methods study design with a convenience sample composed of eighteen (N=18) dental hygiene students. A pre-test/post-test design was utilized in two measures based on the content of the VP module. The eight-item Disability Situations Inventory (DSI) measured perceived sense of difficulty in …

Developing A Vector For Expressing Serratiopeptidase In Lactococcus Lactis, Taylor C. Mauzy

EWU Masters Thesis Collection

Chronic inflammation stems from the inability of the body to resolve acute inflammation. Chronic inflammation is a growing health concern, as nearly 60% of Americans reported coping with at least one chronic condition (as of 2014). On a world scale, three fifths of deaths result from a chronic inflammation disease. Treatments for chronic inflammation include lifestyle changes (diet and exercise) and a variety of conventional drugs. Beyond these treatments, supplementing the body with systemic enzymes may attenuate inflammation. One promising enzyme is serratiopeptidase. Serratiopeptidase is a serine protease expressed by Serratia marcescens which has demonstrated anti-inflammatory, anti-edemic, and analgesic activity …

Seaweeds Polysaccharides In Active Food Packaging: A Review Of Recent Progress, Carina Dietz, Shubham Sharma, Amit Jaiswal, Swarna Jaiswal

Articles

Background

Due to its short lifetime, food packaging leads to a rapid accumulation of plastic in our surroundings and thereby also has a huge impact on environmental pollution. To reduce these effects and create a more sustainable approach towards food packaging, biodegradable and biobased polymers have been developed and are emerging on the market.

Scope and approach

This review provides the current state of research regarding active packaging and the incorporation of seaweed into food packaging. Further, it summarises the resulting consequences of the seaweed incorporation on mechanical, physical, thermal, antioxidant, antimicrobial, and chemical properties, as well as the release …

Biomolecules As Model Indicators Of In Vitro And In Vivo Cold Plasma Safety, Caitlin Heslin, Daniela Boehm, Brendan F. Gilmore, Julianne Megaw, Theresa A. Freeman, Noreen Hickok, Patrick J. Cullen, Paula Bourke

Articles

The potential applications for cold plasma in medicine are extensive, from microbial inactivation and induction of apoptosis in cancer cells to stimulating wound healing and enhancing the blood coagulation cascade. The safe bio-medical application of cold plasma and subsequent effect on complex biological pathways requires precision and a distinct understanding of how physiological redox chemistry is manipulated. Chemical modification of biomolecules such as carbohydrates, proteins, and lipids treated with cold plasma have been characterized, however, the context of how alterations of these molecules affect cell behavior or in vivo functionality has not been determined. Thus, this study examines the cytotoxic …

Evaluating Integration In Collaborative Cross-Disciplinary Fda New Drug Reviews Using An Input-Process-Output Model., Kevin Bugin, Gaetano R. Lotrecchiano, Michael O'Rourke, Joan Butler

Clinical Research and Leadership Faculty Publications

Background/Objectives: The US Food and Drug Administration (FDA) is responsible for assessing safety (risks) and effectiveness (benefits) of new drug products using the data provided in a Sponsor's new drug product marketing application before they can be marketed. The FDA forms cross-disciplinary review teams to conduct these assessments. Recently, the FDA began implementing more interdisciplinary approaches to its assessments, reducing redundancy in review processes and documentation by increasing team integration around review issues.

Methods: Through a phenomenological descriptive comparative case study, the impact of FDA's new interdisciplinary approach on review team integration was compared with its traditional multidisciplinary review approach. …

The Impact Of The Th17:Treg Axis On The Iga-Biome Across The Glycemic Spectrum, Heather T Essigmann, Kristi L Hoffman, Joseph F Petrosino, Goo Jun, David Aguilar, Craig L Hanis, Herbert L Dupont, Eric L Brown

Faculty, Staff and Student Publications

Secretory IgA (SIgA) is released into mucosal surfaces where its function extends beyond that of host defense to include the shaping of resident microbial communities by mediating exclusion/inclusion of respective microbes and regulating bacterial gene expression. In this capacity, SIgA acts as the fulcrum on which host immunity and the health of the microbiota are balanced. We recently completed an analysis of the gut and salivary IgA-Biomes (16S rDNA sequencing of SIgA-coated/uncoated bacteria) in Mexican-American adults that identified IgA-Biome differences across the glycemic spectrum. As Th17:Treg ratio imbalances are associated with gut microbiome dysbiosis and chronic inflammatory conditions such as …

N95 Respirator Reuse, Decontamination Methods, And Microbial Burden: A Randomized Controlled Trial, Zi Yang Jiang, Zhen Huang, Isaac Schmale, Eric L Brown, Michael C Lorenz, Scott J Patlovich, Karan Goswami, Hannah B Wilson, Jumah Ahmad, Ronda Alexander, William Bryan, Luke Burke, Martin J Citardi, Jose Elias, Tang Ho, Jack Jacob, Garren Low, Pedro Miramón, Aniruddha U Patki, William C Yao, Amber U Luong

Faculty, Staff and Student Publications

PURPOSE: to evaluate the effectiveness and ease of N95 respirator decontamination methods in a clinic setting and to identify the extent of microbial colonization on respirators associated with reuse.

METHODS: In a prospective fashion, N95 respirators (n = 15) were randomized to a decontamination process (time, dry heat, or ultraviolet C light [UVC]) in outpatient clinics. Each respirator was re-used up to 5 separate clinic sessions. Swabs on each respirator for SARS-CoV-2, bacteria, and fungi were obtained before clinic, after clinic and post-treatment. Mask integrity was checked after each treatment (n = 68). Statistical analyses were performed to determine factors …

The Association Between Short-Term Emotion Dynamics And Cigarette Dependence: A Comprehensive Examination Of Dynamic Measures, Anne Buu, Zhanrui Cai, Runze Li, Su-Wei Wong, Hsien-Chang Lin, Wei-Chung Su, Douglas E Jorenby, Megan E Piper

Faculty, Staff and Student Publications

BACKGROUND: The association between short-term emotion dynamics and long-term psychopathology has been well established in the psychology literature. Yet, dynamic measures for inertia and instability of negative and positive affect have not been studied in terms of their association with cigarette dependence. This study builds an important bridge between the psychology and substance use literatures by introducing these novel measures and conducting a comprehensive examination of such association with intervention implications.

METHODS: This study conducted secondary analysis on the data from a community sample of 136 dual users (e-cigarette + cigarette) and 101 exclusive smokers who completed both the two-week …

Addressing The Needs Of African American Grandparents: An Intersectionality Perspective, Dorothy Smith-Ruiz, Kendra Jason

The Journal of Sociology & Social Welfare

This study seeks to demonstrate the intersecting structural and compounding challenges African American custodial grandparents experience collectively, rather than as separate non-competing factors, which has been modeled in prior studies. Using a mixed-method research design, the study explored the challenges faced by African American and white custodial grandparents. These challenges included difficulties attaining different types of support, respite care, and programs for teens and special needs grandchildren. Results showed that caregiving challenges among African Americans were more pervasive than their White counterparts. These findings have significant implications for the development of intervention programs for custodial African American grandmothers and their …

Exploring The Hazards Of Scaling Up Clinical Data Analyses: A Drug Side Effect Discovery Case Report, Franck Diaz-Garelli, Todd R Johnson, Mohammad H Rahbar, Elmer V Bernstam

Faculty, Staff and Student Publications

We assessed the scalability of pharmacological signal detection use case from a single-site CDW to a large aggregated clinical data warehouse (single-site database with 754,214 distinct patient IDs vs. multisite database with 49.8M). We aimed to explore whether a larger clinical dataset would provide clearer signals for secondary analyses such as detecting the known relationship between prednisone and weight. We found significant weight gain rate using the single-site data but not from using aggregated data (0.0104 kg/day, p

Determining Risk Factors That Affect Progression In Patients With Nonproliferative Diabetic Retinopathy, Dalbert J Chen, Jacky C Kuo, Alex J Wright, Alice Z Chuang, Wenyaw Chan, Robert M Feldman, Eric L Crowell

Faculty, Staff and Student Publications

PURPOSE: to determine risk factors that affect nonproliferative diabetic retinopathy (NPDR) progression and establish a predictive model to estimate the probability of and time to progression in NPDR.

RESULTS: Two hundred thirty patients were included. Initially, 65 eyes (28.3%) had no retinopathy; 73 (31.7%) mild NPDR; 60 (26.1%) moderate NPDR; and 32 (13.9%) severe NPDR. Patients were followed for a mean of 5.8 years (±2.0 years; range 2.1-9.4 years). 164 (71.3%) eyes progressed during the follow-up. Time-independent risk factors affecting progression rate were age (hazard ratio (HR) = 0.99,

CONCLUSION: HbA1c level is a significant modifiable risk factor in controlling …

Utilization Of Target Lesion Heterogeneity For Treatment Efficacy Assessment In Late Stage Lung Cancer, Dung-Tsa Chen, Wenyaw Chan, Zachary J Thompson, Ram Thapa, Amer A Beg, Andreas N Saltos, Alberto A Chiappori, Jhanelle E Gray, Eric B Haura, Trevor A Rose, Ben Creelan

Faculty, Staff and Student Publications

RATIONALE: Recent studies have discovered several unique tumor response subgroups outside of response classification by Response Evaluation Criteria for Solid Tumors (RECIST), such as mixed response and oligometastasis. These subtypes have a distinctive property, lesion heterogeneity defined as diversity of tumor growth profiles in RECIST target lesions. Furthermore, many cancer clinical trials have been activated to evaluate various treatment options for heterogeneity-related subgroups (e.g., 29 trials so far listed in clinicaltrials.gov for cancer patients with oligometastasis). Some of the trials have shown survival benefit by tailored treatment strategies. This evidence presents the unmet need to incorporate lesion heterogeneity to improve …

A Multivariable Model Of Parent Satisfaction, Pain, And Opioid Administration In A Pediatric Emergency Department, Candice D. Donaldson, Thomas W. Heyming, Louis Ehwerhemuepha, Brooke N. Jenkins, Michelle A. Fortier, William Feaster, Zeev N. Kain

Psychology Faculty Articles and Research

Introduction: Children and adolescents are not impervious to the unprecedented epidemic of opioid misuse in the United States. In 2016 more than 88,000 adolescents between the ages of 12–17 reported misusing opioid medication, and evidence suggests that there has been a rise in opioid-related mortality for pediatric patients. A major source of prescribed opioids for the treatment of pain is the emergency department (ED). The current study sought to assess the complex relationship between opioid administration, pain severity, and parent satisfaction with children’s care in a pediatric ED.

Methods: We examined data from a tertiary pediatric care facility. A health …

The Influence Of Biological Sex, Athletic Identity And Pressure On Collegiate Athlete's Attitudes And Behaviors Toward Playing Through Pain And Injury, Margaret Anne Willis

Cal Poly Humboldt theses and projects

Injuries are to be expected when participating in all levels of collegiate sports (e.g., recreation, elite, club, intermural). It is common among collegiate athletes to continue practicing or competing despite being in pain/injured. This willingness to play hurt can cause negative consequences for athlete’s future health. The purpose of this study was to examine the influence of biological sex, athletic identity and pressure on collegiate athlete’s attitudes and behaviors toward playing through pain and injury. Student-athletes involved in NCAA (National Collegiate Athletic Association) Division II sports completed two questionnaires and one measurement scale: demographic questionnaire, Risk, Pain and Injury Questionnaire …