Medicine and Health Sciences Commons^™

Implementing A Self-Management Glucose Monitoring Pathway To Improve Glycemic Control, Brian Kozaczka

Doctor of Nursing Practice Scholarly Projects

Introduction: Nationwide and locally in Los Angeles, CA, uncontrolled diabetes remains a complex chronic condition within the primary care setting. Chronically uncontrolled diabetes is costly for patients and health care systems due to high morbidity and mortality rates. As payor sources move in the direction of providing payment based on core measures and value-based care, chronic illness programs designed to improve these outcomes must be developed, implemented, and sustained. The Federally Qualified Health Center (FQHC) in which this quality improvement project was conducted represents the largest of 11 comprehensive care, family practice FQHCs in the South-Central Los Angeles area.

Background: …

Increasing School Personnel Knowledge And Self-Efficacy Of Allergy Management, Sabrina Monzione

Doctor of Nursing Practice Scholarly Projects

Introduction: School-aged children with allergies is a growing population. Allergies are a leading cause of chronic illnesses, are costly to the healthcare system, and can result in death. Allergic reactions in schools negatively impact student outcomes. The sites for this improvement project were four urban, public schools in Suffolk County, Massachusetts that did not have standardized school personnel allergy education.

Methods: The project took place in four, urban public schools in Suffolk County, Massachusetts. The four schools are comprised of three middle schools and one high school serving over 1,400 students. Over 240 teachers and supporting staff members provide instruction …

Implementing Universal Depression Screening In A College Health Clinic, Marilyn J. Grabau

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: College students are at high risk for depression, and this carries a considerable burden. The American College Health Association supports depression screening on college campuses recognizing that early identification leads to better outcomes.

LOCAL PROBLEM: The project site is a public university located in New England. The college campus health center incorporates medical and counseling services. From August 2019 to December of 2019, 67% of students seen in the counseling center described depressed mood as the presenting concern. Currently there is no routine depression screening in place.

METHODS: This QI project implemented universal depression screening at the student health …

The Outcome Of A Multidimensional Intervention Strategy For The Management Of Generalized Anxiety Disorder In An Internal Medicine Setting, Nicholas Davidson

Evidence-Based Practice Project Reports

Anxiety disorders are very prevalent in the United States. The most common type, Generalized Anxiety Disorder (GAD), affects 6.8 million adults every year. GAD can cause significant deficits in a person’s ability to function, decrease their quality of life and increases a person’s risk of attempting suicide. The purpose of this evidence-based practice (EBP) project was to improve the outcomes of adults diagnosed with GAD in an internal medicine setting by implementing a protocol composed of a combination of interventions. A thorough literature search was conducted to find the best available evidence to support the project. A total of 11 …

The School Nurse's Experience Of Secondary Exposure To Trauma, Catherine A. Grano

Seton Hall University Dissertations and Theses (ETDs)

The school nurse (SN) is often the sole health care expert in the school setting, providing for the physical and socio-emotional needs of others. SN may be exposed to reports of trauma, a widespread and costly public health issue. This study sought to explore the experience of the SN when exposed to reports of trauma from those in their care. Seven N.J. certified school nurses participated in two online interviews via Microsoft Teams, spaced one to two weeks apart between June 2021 and September 2021. Interviews were recorded & transcribed verbatim and thematic analysis applied. This study found that SN …

Moral Distress And Ethical Climate In Pediatric Nurses In The Time Of Covid, Katherine Bliss Soriano

Seton Hall University Dissertations and Theses (ETDs)

ABSTRACT

Moral Distress in an increasing problem in nurses and other healthcare professionals due to the many challenges nurses face in proving care to their patients and families. These challenges can be magnified when the nurse is conflicted and unable to successfully navigate the moral and ethical responsibilities of the profession leading to moral distress. The COVID-19 pandemic has had profound and global widespread consequences including the impact on pediatric nurses. This descriptive correlational study examined the relationship between moral distress and ethical climate among pediatric nurses who cared for patients during the COVID-19 pandemic. This study used Corely’s Theory …

Shining A Light On Marginal Food Insecurity In An Understudied Population Comment, Angela D. Liese

Faculty Publications

No abstract provided.

The Relationship Between Quality Of Life Outcomes And Social Hearing For Cochlear Implant Recipients Using The Nciq And Pipsl, Bonnie A. Purtill

Dissertations, 2020-current

Unmanaged hearing loss can have profound cognitive, social, and emotional impacts on a person’s life. Cochlear implants improve functional skills such as auditory detection and speech discrimination, and have also been shown to improve quality of life. Health related quality of life (HRQoL) measures are a great tool to assess mental, physical, and social changes after cochlear implantation. While previous research has established improvement in HRQoL after cochlear implantation, there remains a lack of research evaluating long-term effects of cochlear implants for post-lingually and bilaterally deafened adults. Using a disease specific HRQoL questionnaire—Nijmegen Cochlear Implant Questionnaire (NCIQ) and a social …

Amplitude-Modulated Cvemp (Amcvemps) Versus Transient Cvemp Response Properties: Possible Implications, Andrew Thorne

Dissertations, 2020-current

Cervical vestibular evoked myogenic potentials (cVEMPs) elicited by steady-state amplitude-modulated (AM) tones yield different information than conventional cVEMPs elicited by transient tonebursts, such as signal-to-noise ratio (SNR) and phase coherence (PC). This study systematically examined the effects of tonic EMG activation on AMcVEMP response properties versus conventional transient cVEMPs. Thirty five young, healthy adults (ages 19–23) with normal audiograms and no known vestibular lesions participated in this study. AMcVEMPs were elicited with bone-conducted tones with a carrier frequency of 500 Hz and an amplitude modulation frequency of 37 Hz, and transient cVEMPs were elicited by 4-0-4 Blackman-gated 500 Hz tonebursts …

The Relationship Between The Vestibular Ocular Reflex And Perception In Young Healthy Adults, Susanne Nelson

Dissertations, 2020-current

Vestibular impairments are often identified through measures of vestibular reflexes such as the vestibulo-ocular reflex (VOR). However, in clinical practice measures of the VOR do not always correlate with the patient’s reported symptoms. In contrast to physiologic measures like the VOR, psychophysical methods can be used to assess a person’s perception of movement. Previous psychophysics research shows that perceptual thresholds of angular motion do not correlate with VOR measures, but this has not been assessed at suprathreshold levels. The purpose of this study was to assess whether vestibular reflexive responses (i.e., VOR) were correlated to the patient’s perception of movement …

Temporal Modulation Transfer Functions Of Amplitude-Modulated Cervical Vestibular Evoked Myogenic Potentials In Young Adults, Kerri Lawlor

Dissertations, 2020-current

Cervical vestibular evoked myogenic potentials (cVEMPs) are widely used to evaluate saccular function in clinical and research applications. Typically, transient tonebursts are used to elicit cVEMPs. In this study, we used bone-conducted amplitude-modulated (AM) tones to elicit AMcVEMPs. This new approach allows the examination of phase-locked vestibular responses across a range of modulation frequencies. Currently, cVEMP temporal modulation transfer functions (TMTFs) are not well defined. The purposes of the present study were 1) to characterize the AMcVEMP TMTF in young, healthy individuals, 2) to compare AMcVEMP TMTFs across different analysis approaches, and 3) to determine the upper frequency limit of …

A Survey Of Cochlear Implant Clinical Protocols In India, Ariana Morris

Dissertations, 2020-current

The most recent data published in December 2019 records that approximately 736,900 registered cochlear implantation devices have been received since their approval in the 1980s. While 183,100 of these devices belong to U.S. Citizens, the large majority of cochlear implant recipients live in other countries (U.S. Department of Health and Human Services, 2016). While a lack of standardized practices exists in relation to audiologic care and management of cochlear implant devices and patients, Browning et al. (2020) attempts to assess and analyze common practices amongst audiologists practicing within the United States of America. This survey uses a modified questionnaire based …

Remote-Frequency Masking And Speech Perception In Adults, Taylor L. Arbogast

Dissertations, 2020-current

The primary purpose of this study is threefold: to use SRT measurements to examine the effect of various remote-frequency, narrowband maskers on adult’s perception of narrowband speech, to compare the performance between low and high band speech stimuli, and to evaluate the combination of these approaches by examining the correlation between the masking effect observed with speech and pure tone stimuli. Twelve subjects aged 22-34, with hearing thresholds no worse than 15 dB HL for frequencies 500-8000 Hz, participated in two listening tasks. In the speech perception task, coordinate response measure (CRM) sentences and their maskers were separately filtered into …

Quasi-Experimental Design And Outcomes Of A Graduate Clinician And Caregiver-Infant Coaching Intervention In A University Speech-Language Pathology Program, Shiree C. Harbick

Dissertations, 2020-current

Infants are born ready to learn language as one of their most critical developmental tasks, yet infants subject to environmental risk factors related to poverty and low maternal education have been shown to lag behind their peers in language development as early as 8 months of age. Research also indicates the quality of an infant’s language environment can significantly diminish the effects of these risk factors. This quasi-experimental clinical research study explored the effects of a preventive caregiver-infant coaching intervention delivered by graduate student clinicians in a university speech-language pathology program.

Developed based on a systematic review of preventive programs …

Delivery Of Parent-Child Interaction Therapy In A Telehealth Format: Reducing Disruptive Behaviors In Pediatric Traumatic Brain Injury, Emily D. Pogue

Dissertations, 2020-current

Traumatic brain injuries (TBIs) in childhood have been associated with disruptive behaviors and attentional problems that may worsen over time and are often experienced as challenging for those in caregiving roles. Parents of children with TBI may evoke negative interactions to manage their child’s behavior through reliance on ineffective parenting practices. This results in increasingly maladaptive parent-child interactions that maintain or worsen problem behaviors of the child and further disrupt family functioning. Despite the importance of family functioning on child post-injury outcomes, the availability of family-based treatments for children with TBI is extremely limited. Parent-Child Interaction Therapy (PCIT) is an …

Like, It’S Important: The Frequency And Use Of Like In Autism Spectrum Disorder, Rebekah Jones

Masters Theses, 2020-current

Background & Aims: Discourse markers, such as well or like serve a variety of functions to support conversational reciprocity: filling pauses, aiding word-finding, holding conversational turns, and providing information about pause length. Previous research shows that individuals with ASD use discourse markers less frequently than neurotypical (NT) peers; however, the discourse marker like has been left out of that research, despite its ubiquitous use by NT individuals, and despite the fact that like serves important pragmatic functions that are not encoded by any other discourse marker. Specifically, like signals to the listener that the content of upcoming speech is 1) …

The Effect Of Two Rate Change Approaches On Speech Movement Patterns, Noelle Marie Lewis

Theses and Dissertations

The current study examined the effect of different rate change approaches on speech movement patterns, including increasing and decreasing speaking rate volitionally, as well as with delayed auditory feedback (DAF). There were 10 participants, five male and five female, with a mean age of 25 years. All were typical speakers. Participants spoke the sentence “Don’t fight or pout over a toy car” under slow, fast and DAF speaking conditions. A total of 5 sensors were glued to each participant’s tongue, teeth, and lips. NDI Wave electromagnetic articulography recorded the articulatory movements from these sensors as the participants spoke. Metrics for …

The Development, Evaluation, And Pilot-Test Of A Nutrition Education Tool Kit At A Mobile Food Pantry In Virginia., Caitlin Swanson

Masters Theses, 2020-current

Objective: The purpose of this study was to develop, test and evaluate a nutrition education tool kit at a mobile food pantry (MFP) in rural Virginia.

Design: Cross-sectional, mixed methods approach using both quantitative and qualitative data to evaluate the effectiveness of a tool kit training at increasing participant self-efficacy, basic nutrition knowledge and perceived readiness to conduct a nutrition lesson with MFP guests. The ability for participants to translate the training into practice was also observed and documented.

Setting: Pilot tested on March 11^th 2020 at the Timberville Blue Ridge Area Food Bank MFP site.

Participants …

A Review Of Dietary Monitoring Applications And Eating Disorder/Disordered Eating Symptomatology, Donald Mellott Jr.

Masters Theses, 2020-current

Eating disorders are among the deadliest mental illnesses in the United States. Given their high prevalence and low treatment rates, mitigating risk exposure is necessary for prevention. Dietary monitoring applications are highly popular self-monitoring tools that can inform dietary patterns and improve weight loss efficacy. However, they can also serve as a means for those with body preoccupation to restrict and possibly exacerbate disordered symptomatology. A literature search was conducted to identify research regarding the usage of dietary monitoring applications and eating disorder/disordered eating symptomatology. Twelve articles met inclusion criteria and are discussed in the review. An association between the …

Measuring Referential Communication Dynamically In Older Children With Asd, Caitlin Lee

Masters Theses, 2020-current

Research finds individuals with autism spectrum disorder (ASD) are relatively ineffective and/or inefficient at referential communication. However, this research typically uses static metrics of efficacy (how accurately messages were relayed) and efficiency (overall word count), rather than dynamic ones (e.g., Does the speaker alter subsequent descriptions when the listener previously misunderstood them?). The aim of this research is to use dynamic measures of efficacy and efficiency to examine how speakers with and without ASD adjust their message to meet listener needs across time. Fifteen older children with (n = 8) and without (n = 7) ASD were included. …

The Effects Of A Carbohydrate Hydrogel Beverage On Gastrointestinal Symptoms And Running Performance In Comparison To Conventional Carbohydrate Beverages, Nicholas Minichiello

Masters Theses, 2020-current

PURPOSE: The utilization of hydrogel technology allows carbohydrate beverages to form a gel in the acidic environment of the stomach, potentially enhancing gastric emptying. However, few studies have researched the effects of these beverages on gastrointestinal (GI) tolerance and exercise performance; there is minimal data in a variety of exercise conditions and/or beverage ingestion rates. The purpose of the present study was to assess the effects of a 80 g/h of maltodextrin-fructose hydrogel (MF-H) beverage versus conventional carbohydrate sources on GI symptoms and running performance. METHODS: eight distance runners (26 ± 5 y; VO_2max = 65 ± 7 ml/kg/min) …

Responses To Partner Comments And Acknowledgements In Students With And Without Autism, Kaitlyn Bresette

Masters Theses, 2020-current

Some children and adolescents with Autism Spectrum Disorder (ASD) initiate and respond less frequently than neurotypicals (NT) during language sampling tasks. More information is needed regarding how partner behaviors, such as comments and acknowledgements and the sampling context, influence the types of responses provided by children with ASD. This research study examined responses to adult comments and acknowledgments in two language sampling tasks, a traditional Share and Tell sample and a Double Interview sample (Garcia-Winner, 2002).

Participants. Fifty-eight participants, between the ages of 10 and 17 years, were recruited across two labs. The sample consisted of 28 adolescents with ASD …

Examining Opioid Risk Mitigation Practices In A Rural Pain Management Clinic: A Quality Improvement Project, Stanley W. Hatcher

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Many Americans are dependent on or misuse prescription opioids. Increasing opioid misuse and opioid use disorder rates have led to record opioid-related deaths in recent years. Provider prescribing practices are one part of the problem. Evidence indicates that prescribers should assess for risks related to substance misuse and abuse in high-risk populations, such as patients on long-term opioid therapy. By evaluating risk level, the provider will have additional information to guide treatment decisions and a baseline for assessing future changes in risk status. Identifying high-risk patients is a first step in promoting quality care for this population. This project used …

Alcohol Impairs Immunometabolism And Promotes Naïve T Cell Differentiation To Pro-Inflammatory Th1 Cd4+ T Cells, Patrick M. Mcternan, Danielle E. Levitt, David A. Welsh, Liz Simon, Robert W. Siggins, Patricia E. Molina

School of Medicine Faculty Publications

CD4+ T cell differentiation to pro-inflammatory and immunosuppressive subsets depends on immunometabolism. Pro-inflammatory CD4+ subsets rely on glycolysis, while immunosuppressive Treg cells require functional mitochondria for their differentiation and function. Previous pre-clinical studies have shown that ethanol (EtOH) administration increases pro-inflammatory CD4+ T cell subsets; whether this shift in immunophenotype is linked to alterations in CD4+ T cell metabolism had not been previously examined. The objective of this study was to determine whether ethanol alters CD4+ immunometabolism, and whether this affects CD4+ T cell differentiation. Naïve human CD4+ T cells were plated on anti-CD3 coated plates with soluble anti-CD28, and …

Treatment For Mild Chronic Hypertension During Pregnancy, Lorraine Dugoff, Baha Sibai, Kirsten Lawrence, Brenna L Hughes, Joseph Bell, Kjersti Aagaard, Rodney K Edwards, Kelly Gibson, David M Haas, Lauren Plante, Torri Metz, Brian Casey, Sean Esplin, Sherri Longo, Matthew Hoffman, George R Saade, Kara K Hoppe, Janelle Foroutan, Methodius Tuuli, Michelle Y Owens, Hyagriv N Simhan, Heather Frey, Todd Rosen, Anna Palatnik, Susan Baker, Phyllis August, Uma M Reddy, Wendy Kinzler, Emily Su, Iris Krishna, Nicki Nguyen, Mary E Norton, Daniel Skupski, Yasser Y El-Sayed, Dotum Ogunyemi, Zorina S Galis, Lorie Harper, Namasivayam Ambalavanan, Nancy L Geller, Suzanne Oparil, Gary R Cutter, William W Andrews

Faculty, Staff and Students Publications

BACKGROUND: The benefits and safety of the treatment of mild chronic hypertension (blood pressure, <160/100 mm Hg) during pregnancy are uncertain. Data are needed on whether a strategy of targeting a blood pressure of less than 140/90 mm Hg reduces the incidence of adverse pregnancy outcomes without compromising fetal growth.

METHODS: In this open-label, multicenter, randomized trial, we assigned pregnant women with mild chronic hypertension and singleton fetuses at a gestational age of less than 23 weeks to receive antihypertensive medications recommended for use in pregnancy (active-treatment group) or to receive no such treatment unless severe hypertension (systolic pressure, ≥160 mm Hg; or diastolic pressure, ≥105 mm Hg) developed (control group). The primary outcome was a composite of preeclampsia with severe features, medically indicated preterm birth at less than 35 weeks' gestation, placental abruption, or fetal …

Contextual Factors Associated With Organizational Learning In Hospitals: An Instrument Development Study, Bret Lyman, Kylie C. Thorum

Faculty Publications

Aim: Develop a valid, reliable research instrument to measure contextual factors associated with organizational learning in hospitals.

Background: A valid, reliable instrument for measuring contextual factors associated with organizational learning is needed so nurse leaders and researchers can improve healthcare by facilitating and studying organizational learning.

Methods: The Organizational Learning in Hospitals model guided development of the Organizational Learning Instrument-Context. Content validity was refined and evaluated through cognitive interviews and expert reviews. The instrument was distributed to direct care nurses in Magnet® hospitals in the United States. Intraclass correlation coefficients validated the use of multilevel analyses. Construct validity was assessed …

Factors Associated With Covid-19 Death In The United States: Cohort Study, Xiao Dong

Faculty, Staff and Student Publications

Background: Since the initial COVID-19 cases were identified in the United States in February 2020, the United States has experienced a high incidence of the disease. Understanding the risk factors for severe outcomes identifies the most vulnerable populations and helps in decision-making.

Objective: This study aims to assess the factors associated with COVID-19-related deaths from a large, national, individual-level data set.

Methods: A cohort study was conducted using data from the Optum de-identified COVID-19 electronic health record (EHR) data set; 1,271,033 adult participants were observed from February 1, 2020, to August 31, 2020, until their deaths due to COVID-19, deaths …

Factors Associated With Covid-19 Death In The United States: Cohort Study, Xiao Dong, Xiaoqian Jiang

Faculty, Staff and Student Publications

BACKGROUND: Since the initial COVID-19 cases were identified in the United States in February 2020, the United States has experienced a high incidence of the disease. Understanding the risk factors for severe outcomes identifies the most vulnerable populations and helps in decision-making.

OBJECTIVE: This study aims to assess the factors associated with COVID-19-related deaths from a large, national, individual-level data set.

METHODS: A cohort study was conducted using data from the Optum de-identified COVID-19 electronic health record (EHR) data set; 1,271,033 adult participants were observed from February 1, 2020, to August 31, 2020, until their deaths due to COVID-19, deaths …

College Of Public Heath News, Georgia Southern University

College of Public Health: News & Publications

• Jiann-Ping Hsu College of Public Health Establishes Development Council
• Georgia Southern Enlisted to Help Fight COVID-19 in Georgia’s Confinement Facilities

A Preliminary Investigation Of Neuroantibody Levels, Prevalence, And Environmental Factors In Patients With Neurological Dysfunction, Jihan Azar

Theses and Dissertations

Nervous system damage comprises a large proportion of diseases worldwide. It is also the most difficult to diagnose. Biomarkers for nervous system damage are needed in order to diagnose these diseases early enough to allow for intervention. In this study, we recruited patients from two Egyptian hospitals with MCI, ET and NMS and health references. Serum autoantibody levels against neural proteins and heavy metals were analyzed and compared. Immunoglobulin G (IgG) antibodies against neurofilament H (NFH), Glial Fibrillary Acidic Protein (GFAP), Myelin Basic Protein (MBP) and alpha synuclein (a-SYN) and Immunoglobulin M (IgM) antibody against neurofilament light (NFL) were among …