Medicine and Health Sciences Commons^™

Presenteeism Among Health Care Personnel With Covid-19, James C. Crosby, Eliezer Santos Leon, Brian Chinnock, Karisa K. Harland, Anusha Krishnadasan, Nicholas M. Mohr, Ian D. Plumb, Melissa Briggs Hagen, Kelli Wallace, David A. Talan, Anne Zepeski, Tracy Young, Howard A. Smithline, Lilly C. Lee, Stephen C. Lim, Gregory J. Moran, Mark T. Steele, David G. Beiser, John P. Haran, Peter C. Hou, Brett Faine, Utsav Nandi, Walter A. Schrading, Anne Chipman, Frank Lovecchio, Alysia Powers, Lisandra Uribe, Kavitha Pathmarajah, Dean M. Hashimoto, Chloe Namias, Efrat Kean, Elizabeth Krebs, Amy Stubbs, Sara Roy, Lucia Solis, Mary Mulrow, Nathan Graff, Jillian M Tozloski, William Mower, Jacqueline Caldera, Michelle Huber, Jacob Hampton, Abigail Lopes, Katherine Elkort, Stephanie A. Eucker, Carla Kingsbury, Jonathan Femling, Silas Bussmann, Jane Yee, Joseph Stuppy, Richard E. Rothman, Gaby Dashler, Marcel E. Curlin, Mastura Wahedi, Laurie Kemble

Department of Medicine Faculty Papers

IMPORTANCE: Presenteeism-defined as continuing to work during an illness-poses a public health risk in the workplace and is especially hazardous within health care institutions where vulnerable patients may be exposed to nosocomial infections. Understanding the frequency and characteristics of health care personnel (HCP) who report presenteeism while ill with COVID-19 may help mitigate SARS-CoV-2 spread in hospitals and other health care institutions.

OBJECTIVES: To determine the frequency of presenteeism among HCP with symptomatic COVID-19, and to evaluate the demographic, occupational, and clinical factors associated with it.

DESIGN, SETTING, AND PARTICIPANTS: This is an observational cohort study that uses data from …

Endoscopic Retrograde Cholangiopancreatography And Primary Sclerosing Cholangitis: A Retrospective Study Of A High-Volume Program, Kristel Leung, Michael Youssef, Yasi Xiao, Catherine Streutker, Aliya Gulamhusein, Bettina Hansen, Natalia Calo, Gary May, Jeffrey Mosko, Gideon Hirschfield

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is valuable in management of primary sclerosing cholangitis (PSC). Herein, we characterize individuals with PSC who underwent ERCP on-demand at a high-volume quaternary centre, with evaluation of pathology results and short-term postprocedural outcomes.

METHODS: This retrospective cohort study evaluated patients with PSC who underwent ERCP at St Michael's Hospital between April 2011 and July 2021. Chart review was conducted to collect clinical, procedural, and pathology data, and reported post-ERCP complications within 90 days. Logistic regression analyses were conducted to evaluate factors associated with post-ERCP complications and placement of a biliary stent.

RESULTS: One hundred and …

The Effect Of Exercise On Dynamic Balance And Walking Endurance In Patients With Relapsing Remitting Multiple Sclerosis: A Systematic Review And Meta-Analysis, Connor Gibson

The Plymouth Student Scientist

Background: Multiple Sclerosis (MS) affects 2-3 million people worldwide, with relapsing remitting MS (RRMS) accounting for 75% of new cases. Exercise has been proposed to alleviate symptoms and enhance quality of life. This meta-analysis aims to evaluate the effect of exercise on dynamic balance and walking endurance in RRMS patients.

Methodology: A comprehensive PubMed search identified exercise interventions that specifically measured walking endurance via the 6-minute walk test (6MWT) and dynamic balance through the timed up-and-go (TUG) test. Mean and standard deviation values at baseline and post-intervention were extracted for analysis. For subgroup comparisons, interventions were classified as either lower …

Assessing Cognitive Performance And Comfort Under Simulated Mri Noise And Its Association With Autistic Like Traits, Jasmin Woodhouse

The Plymouth Student Scientist

Magnetic Resonance Imaging (MRI) scanners produce noise levels between 65 and 130 decibels. This noise, alongside the broader sensory environment of the MRI, poses challenges for individuals with autism spectrum disorder (ASD). Noise exposure has been shown to impair task performance, increase errors, and affect brain activity. ASD traits are associated with decreased sound tolerance, including hyperacusis, misophonia, and phonophobia. In ASD, noisy environments disrupt inferior frontal gyrus function, impairing task response and brain connectivity. Given this, it’s crucial to understand how these sensory challenges specifically affect ASD experience and performance during MRI procedures. This study assesses cognitive performance and …

Detecting Concealed Autobiographical Information Using Feedback And Recognition P300 Erps. Exploring The Impacts Of Changed Feedback Proportions And Social Pressure In The Fcit, Cerys Parkinson-Johns, Grace Shillito, Callum Starr, Rosemary Wilmshurst

The Plymouth Student Scientist

The feedback concealed information test (fCIT) incorporates feedback on memory concealment performance within the classical CIT. Providing feedback facilitates the analysis of feedback related ERPs in addition to initial recognition related ERPs within each trial. Combining multiple ERPs aims to improve the reliability and efficiency of the test. The present study investigated the efficiency of combining recognition and feedback related P300 ERPs in detecting concealed birthdates in a personal item fCIT. Feedback proportions were altered to improve believability in feedback. Detection efficiencies using combined P300 amplitudes within this altered paradigm and the impacts of social pressures on feedback P300s were …

Examining The Correlation Between The Competing Values Framework And Other Scales Of Measure, Jesina Mistry

The Plymouth Student Scientist

Organisational culture is widely acknowledged as a critical determinant of performance and employee engagement, yet debates persist regarding how best to conceptualise and measure it. This study examines the construct validity of two widely used diagnostic tools: the Competing Values Framework (CVF) and the Organisational Culture Inventory (OCI). While the CVF has achieved broad application across sectors, questions remain regarding its empirical grounding and cross-cultural relevance. Using a quantitative, cross-sectional design, this research investigates the degree of convergence between CVF and OCI dimensions within a diverse UK-based sample spanning multiple industries and job levels. In addition, it incorporates three underexplored …

The Lived Experience Of Uk Students Transitioning To University With Type 1 Diabetes Mellitus, Emelia C. Steel

The Plymouth Student Scientist

Transitioning from secondary school to university is a high-risk period for managing type 1 diabetes among UK students. Canadian research identified limited systemic support during this period. However, there is a lack of qualitative insight into how students navigate this transition in the UK, where healthcare and education systems differ. This study addressed that gap through semi-structured interviews to understand what makes this transition particularly challenging and what support students would find most helpful. A purposive sample comprised seven participants aged 19–29 from four UK universities. Thematic analysis, guided by Braun and Clarke’s (2022) six-phase framework, identified three superordinate themes: …

Investigating Deception-Related Moral Conflict Using Electroencephalography (Eeg) Hyperscanning, Madie Ades

The Plymouth Student Scientist

Amplitudes of the early Bereitschaftspotential (BP) and deceptive behaviour have been theorised to be modulated by moral conflict experienced when making deceptive decisions, as the decision to lie can depend upon our moral perceptions of what is right and wrong (Panasiti et al., 2014). However, most Electroencephalography (EEG) deception paradigms lack ecological validity by utilising instructed lying and failing to incorporate genuine social interaction (Ganis & Keenan, 2009) and therefore may fail to elicit genuine moral conflict. The present study combined hyperscanning EEG with a competitive two-player social game, where participants freely chose to respond accurately or deceptively for …

Dna Methylation Markers Of Insulin Resistance Surrogate Measures In The Atherosclerosis Risk In Communities (Aric) Study, Jeewoen Shin, Jan Bressler, Megan L Grove, Michael Brown, Elizabeth Selvin, James S Pankow, Myriam Fornage, Alanna C Morrison, Chloé Sarnowski

Faculty, Staff and Student Publications

Insulin resistance (IR) is a risk factor for cardiovascular diseases and type 2 diabetes. Associations between DNA methylation (DNAm) and IR have been less studied in African ancestry (AA) populations than those of European ancestry (EA). We aimed to identify associations between whole blood DNAm and IR in up to 1,811 AA and 964 EA participants from the Atherosclerosis Risk in Communities (ARIC) study. We quantified IR using three surrogate measures: the homeostasis model assessment of insulin resistance (HOMA-IR), the triglyceride-glucose index (TyG), and the triglyceride glucose-body mass index (TyG-BMI). We used ancestry-stratified linear regression models to conduct epigenome-wide association …

Association Of Epigenetic Age Acceleration And Mitochondrial Dna-Based Aging Metrics Provides Insights Into Mechanisms Of Aging-Related Diseases, Mengyao Wang, Yinan Zheng, Meng Lai, Emmanuel Saake, Xue Liu, Xiuqing Guo, Kent D Taylor, Tianxiao Huan, Roby Joehanes, Drew R Nannini, Kai Zhang, Nicole J Lake, Christina A Castellani, Stephen S Rich, Jerome I Rotter, Yongmei Liu, Laura M Raffield, April P Carson, Myriam Fornage, Jiantao Ma, Dan E Arking, Lifang Hou, Daniel Levy, Chunyu Liu

Faculty, Staff and Student Publications

Investigating the interplay between mitochondrial DNA (mtDNA) variations and epigenetic aging metrics may elucidate biological mechanisms associated with age-related diseases. We estimated epigenetic age acceleration (EAA) metrics from DNA methylation data and derived mtDNA metrics, including heteroplasmic variants and mtDNA copy number (mtDNA CN) from whole genome sequencing. Linear regressions and meta-analyses were conducted to assess associations between EAA and mtDNA metrics, adjusting for chronological age, self-identified sex, and other covariates in 6,316 participants (58% female, 41% non-White Americans). Mediation analysis was conducted to examine whether EAA mediated the relationship between mtDNA CN and metabolic traits. A higher burden of …

Hispanic Academic Leadership In The Health And Human Services, Gabriela Elizabeth Rangel

Theses and Dissertations

In the United States, there are 63.7 million Hispanics (U.S. Census Bureau, 2023), making them the largest racial or ethnic minority in the country. National data from 2019 indicates that only 6% of tenured faculty in the U.S. were Hispanic, highlighting a significant underrepresentation of leaders in academia (NCES, 2024). This study employed a phenomenological approach with purposeful sampling, utilizing semi-structured interviews with ten participants who had leadership experience in academia within Health and Human Services (H&HS). The interviews served to explore various aspects, such as what were their aspirations to become leaders, their perceptions of the characteristics and qualities …

A Picture Tells A Thousand Words—, But Ecg Signals Have More To Say, Ashley N. Gomez

Theses and Dissertations

With the increasing adoption of deep learning classification models in the medical domain, a critical challenge remains: achieving high predictive accuracy while maintaining clinical Inter-pretability. This study examines how model architecture, dataset origin, and the use of full versus subset data affect both classification performance and Interpretability in Electrocardiogram (ECG) signal analysis. ResNet18 is evaluated using an open-source ECG Image Dataset, thus a custom dataset derived from digitized ECG images. Post-hoc explainability methods, such as Integrated Gradients, are applied to determine which time steps have the most significant influence on model decisions. The findings demonstrate that model architecture and dataset …

Categorizing Weight Growth Of Infants Born Before 32 Weeks' Gestation Using The 2023 Postnatal Growth Charts For Preterm Infants., Fu-Sheng Chou, Hung-Wen Yeh, Crystal Hsueh, Jing Zhang, Maria Fe B. Villosis, Karine Barseghyan, Ashwini Lakshmanan, Reese H. Clark

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To categorize growth and correlate growth categories with morbidities in infants born before 32 weeks of gestation.

STUDY DESIGN: This retrospective study categorized weight growth by correlating mean growth velocity (GV) with growth trajectory z-score changes (ΔGTZ ), as measured using 2023 Postnatal Growth Charts for Preterm Infants. The associations between weight categories and morbidities were assessed.

RESULTS: Weight gain of infants without morbidities was categorized into three groups based on correlating ΔGTZ with mean GV: slower ( ΔGTZ < -0.1), in-parallel ( ΔGTZ -0.1 to 0.3), and faster ( ΔGTZ > 0.3). The proportions of infants with and without morbidities in these categories were evaluated across two distinct cohorts, revealing similar …

Left And Right Ventricular Strain Mechanics In Fetal Tachyarrhythmia., Rukmini Komarlu, Janelle R. Noel-Macdonnell Phd, Neha Chellu, Geetha Haligheri

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: Assessment of myocardial function in fetuses with supraventricular tachyarrhythmia is challenging. Speckle-tracking echocardiography (STE) is a newer sensitive method to assess ventricular systolic function. We sought to assess left (LV) and right (RV) ventricular myocardial strain mechanics in fetuses with tachyarrhythmia and hypothesized that strain mechanics are impaired in this patient population even after conversion to sinus rhythm.

METHODS: This was a single-center retrospective review. LV and RV strain parameters were assessed using STE in tachyarrhythmia and after conversion to sinus rhythm and, compared to gestational age (GA), matched control fetuses in sinus rhythm.

RESULTS: Eighteen fetuses with tachyarrhythmia …

Adenovirus Types In Us Children Hospitalized Or Seen In The Emergency Department With Acute Respiratory Illness, 2016-2019., Tess Stopczynski, Varvara Probst, Adam Gailani, Justin Z. Amarin, Olla Hamdan, Haya Hayek, Laura S. Stewart, Herdi K. Rahman, Rangaraj Selvarangan, Jennifer E. Schuster, Christopher J. Harrison, Mary E. Moffatt, Marian G. Michaels, John V. Williams, Julie A. Boom, Leila C. Sahni, Vasanthi Avadhanula, Mary Allen Staat, Elizabeth P. Schlaudecker, Christina Quigley, Geoffrey A. Weinberg, Peter G. Szilagyi, Janet A. Englund, Eileen J. Klein, Aaron T. Curns, Heidi L. Moline, Ariana P. Toepfer, James D. Chappell, Andrew J. Spieker, Natasha B. Halasa

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Human adenovirus (HAdV) is a common cause of pediatric acute respiratory illness (ARI), contributing to 5-13% of cases worldwide. Clinical manifestations vary by HAdV species and type; therefore, delineating type-specific disease presentations and understanding severity of specific HAdV types' disease may help develop targeted interventions.

METHODS: We conducted a multicenter, prospective study within the New Vaccine Surveillance Network to characterize HAdV types. Children < 18 years old with ARI were enrolled in the emergency department or inpatient setting at 7 US children's hospitals from 1 December 2016 to 30 November 2019. Respiratory specimens were collected and tested for HAdV and other viruses. Subsequently, typing was conducted on HAdV specimens using single-plex real-time PCR assays targeting sequences in the hexon gene. Comparisons between HAdV types were performed to determine differences in characteristics and outcomes. Generalized linear mixed effects models were used to evaluate severity.

RESULTS: Among the 1843 HAdV-positive cases, 1402 specimens (76%) were typed. The most common types detected were HAdV-C1 (n = 439), HAdV-C2 (n = 393), and HAdV-B3 (n = 221). Children with HAdV-B7 (n = 78) …

Trends In Hospital Resource Use For Children With Complex Chronic Conditions., Nathaniel D. Bayer, Matthew Hall, Maria Osipovich, John M. Morrison, Christian D. Pulcini, Jana C. Leary, Joanna E. Thomson, Tamara D. Simon, Dennis Z. Kuo, Jeffrey D. Colvin, Eyal Cohen, Jay G. Berry

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Despite a small prevalence, children with complex chronic conditions (CCCs) use substantial inpatient resources.

OBJECTIVE: To assess national trends in hospital discharges, bed days, and hospital charges for children with and without CCCs in the US from 2000 to 2022.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective, repeated cross-sectional study used hospital discharge data from the Kids' Inpatient Database (KID) from the years 2000, 2003, 2006, 2009, 2012, 2016, 2019, and 2022 for US children aged 0 to 18 years, excluding uncomplicated newborn discharges.

EXPOSURE: Presence of 0, 1, 2, or 3 or more CCCs.

MAIN OUTCOMES AND MEASURES: Trends …

Hygiene Heroes: Strengthening Oral Hygiene To Reduce Central Line-Associated Bloodstream Infections In Pediatric Hematology/Oncology Patients, Sidney Clymer-Engelhart, Kirstie Shulman

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background: Central line-associated bloodstream infections (CLABSIs) impact pediatric patient outcomes, increasing mortality, hospital stays, and healthcare costs. At Sutter Medical Center Sacramento (SMCS), the CLABSI prevention bundle includes proper line care, dressing assessments, and hygiene practices, including twice-daily oral care, daily linen changes, and chlorhexidine gluconate (CHG) bathing. Sutter found their CLABSI bundle compliance at approximately 76–78%, with oral hygiene identified as the most frequent gap in care.

Aim: This quality improvement project, partnered with SMCS, targeted oral care compliance to enhance overall bundle adherence, strengthen staff-leadership communication, and ultimately reduce CLABSI rates in the hematology/oncology units. In a wider …

Fall Prevention In The Lobby Of The Emergency Department At Sutter Medical Center Sacramento, Tanya Rodriguez Duarte, Vaneza Espino, Roshni Hayer, Yajari Mendoza

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background: In 2024, Sutter Medical Center Sacramento (SMCS) reported 17 patient falls in the Emergency Department (ED) lobby, with 94% (n = 16) occurring in the triage area. Patients awaiting placement after triage are not classified as admitted and thus are not included in CMS’s inpatient fall reporting program. However, due to the known safety risk, SMCS ED leadership began tracking lobby falls locally and partnered with University of the Pacific nursing students to address this issue.. Aim: This quality improvement project aimed to reduce the incidence of falls in the ED lobby through enhanced fall risk identification, timely reassessment, …

The Kangaroo Care Project: Implementation Of Skin-To-Skin (Sts) In Sutter Medical Center, Sacramento, Neonatal Intensive Care Unit, Bianca Wong, Katherine Do, Martha Calero, Lydia Nambala

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background: Skin-to-skin contact, also known as kangaroo care or kangaroo mother care, is an intervention typically done after birth to promote physiologic stability, bonding, and breastfeeding.

Aim: The Kangaroo Care project aimed to increase the incidence of skin-to-skin contact in the neonatal intensive care unit at Sutter Medical Center, Sacramento.

Methods: A pre-survey was conducted to assess staff comfort with skin to skin. Interventions to increase skin-to-skin rates included staff e-learning, unplanned extubation mock codes, nurse champions, and a policy change to Sutter Medical Center, Sacramento’s handbook.

Results: TBD. Preliminary results indicated use of STS in the NICU and post-results …

Staying Ahead Of The Pressure: A Multimodal Intensive Care Unit Hospital-Acquired Pressure Injury Quality Improvement Project At Sutter Medical Center, Sacramento, Mijung Lim, Daniela Tobler, Raquel Youkhana

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background: Hospital-acquired pressure injuries (HAPIs) are a major quality and safety concern, particularly in the intensive care units (ICUs) where critically ill and immobile patients face elevated risk. At Sutter Medical Center Sacramento (SMCS), nine confirmed HAPIs and two under investigation were reported within the medical ICU, cardiac ICU, and neurosurgical ICU by May 2025, exceeding the hospital’s target and prompting a system-wide quality improvement initiative.

Aim: The aim of this project was to: (a) reduce ICU-acquired HAPIs to fewer than four cases per quarter by December 2025 and (b) increase nursing compliance with early and ongoing prevention strategies, including …

Improving Maternal Mental Health Awareness And Support In Perinatal Black And Latina Women, Jasman Hans, Lesly Carrillo, Kayla Huynh, Brianna Harrison

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background: Black and Latina women in California experience disproportionately high rates of perinatal mental health disorders due to limited access to care, stigma, and systemic inequities.

Aim: In collaboration with BeMomAware, this Quality Improvement project aimed to enhance maternal mental health literacy among Black and Latino individuals in the Oak Park community of Sacramento. The project sought to increase awareness, knowledge, and access to culturally appropriate mental health resources through an educational video and community session.

Methods: Interventions included a short educational video and an in-person community session providing culturally relevant information about perinatal depression and anxiety disorders, available resources, …

Definition Of The 3d Position And Motion Status Of The Moving Heart Based On 2d Projections, Lawrence D. Orijuela

Electronic Theses, Projects, and Dissertations

This thesis presents a novel application of deep learning to the estimation of pulmonary vein coordinates using X-ray image pairs from a FORBILD Thorax phantom derived motion dataset. A Siamese neural network was developed to predict the 3D coordinates of one pulmonary vein at a time, specifically the Right Superior Pulmonary Vein (RSPV), Left Superior Pulmonary Vein (LSPV), Left Inferior Pulmonary Vein (LIPV), or Right Inferior Pulmonary Vein (RIPV), based on two-dimensional projection images.

The input data consisted of over 1.6 million grayscale X-ray image pairs across 1331 virtual patients, each annotated with ground truth 3D coordinates. To manage memory …

Adaptive Compulsion, Amanda A. Santos

Electronic Theses, Projects, and Dissertations

Adaptive

Adjective

Adap.tive ( ə-ˈdap-tiv)

of, relating to, or being a heritable trait that serves a specific function and improves an organism's fitness or survival

Compulsion

Noun

Com.pul.sion (kəm-ˈpəl-shən)

a repetitive behavior or mental act that a person feels driven to perform to alleviate the anxiety and distress caused by an unwanted thought or urge, known as an obsession.

For years we have lived in unprecedented times. From the worldwide quarantine in 2020 resulting from the pandemic, to our current US political crisis. The constant barrage of events is overwhelming and demoralizing.

The work in this gallery is a display …

Assessing Post-Pandemic Engagement In The Supplemental Nutrition Program For Women, Infants, And Children (Wic) In Northeast Tennessee, Christen Minnick

Electronic Theses and Dissertations

Since 1974, the federal Supplemental Nutrition Program for Women, Infants, and Children (WIC) has provided healthy food resources, nutrition education, and provider referrals for families at risk for poor nutrition. Public health professionals have consistently presented evidence that WIC engagement reduces premature births and infant mortality, improves child health and development, and increases specialized care access for participants. While average monthly participation in WIC has increased since the program’s inception, trends indicate that only around half of eligible families have consistently engaged with the program since 2011. Research has linked declining WIC participation to administrative burden, citing learning, psychological, compliance, …

Comparative Value Of Echocardiography Vs. Right Heart Catheterization In Heart Failure With Preserved Ejection Fraction, Nathanael Tran, Mohammad Shaar, Hussein Al-Sudani, Ramy Sedhom, Hamza Akhtar, Kevin Bryan Lo, Gregg S. Pressman

Einstein Health Papers

BACKGROUND: Echocardiography and right heart catheterization (RHC) are useful in the evaluation of heart failure with preserved ejection fraction (HFpEF). We compared the two among decompensated HFpEF patients to determine their relative value in predicting all-cause mortality and a composite of cardiovascular (CV) death and heart failure (HF) readmission at 1 year.

METHODS: One hundred seventy-eight decompensated HFpEF patients who underwent both procedures and survived to hospital discharge were retrospectively identified. Hospital records and the National Death Index were queried to determine outcomes. Echocardiographic and invasive parameters were tested for significant associations with each outcome. Additionally, three predictive models were …

Metabolic Screening In Veterans On Antipsychotics Mood Stabilizer, Joy Nneka Eke

Walden Dissertations and Doctoral Studies

Summary This Doctor of Nursing Practice project was conducted to examine a quality improvement initiative that sought to address metabolic syndrome screening consistency for veterans on antipsychotic medications at a U.S. Department of Veterans Affairs health system located in the Midwest region of the United States. The project centered on whether the quality improvement program assessing compliance with the current metabolic syndrome screening process reflects increased early detection of metabolic syndrome to prevent cardiovascular complications. Data collection involved comprehensive chart reviews of 50 veterans’ records. The data collected were analyzed using a specially designed quality improvement initiative assessment form developed …

Executive Summary: Executive Leadership System Improvement Workplace Violence, Mercedes Ivette Tejada

Walden Dissertations and Doctoral Studies

Introduction This Doctor of Nursing Practice (DNP) Executive Leadership Project is focused on the reduction of workplace violence in a critical access hospital using an organized prevention program. Workplace violence in nursing is increasing, exposing the health of staff, patient safety, and quality of care in critical access hospitals. The question of the DNP project is: In nurses (P) in small critical access hospitals, how does implementing a structured workplace violence prevention program (I) compared to having no formal violence prevention strategy (C) impact the occurrence of workplace aggression and perceptions of safety among staff (O)? This practicum project used …

Pet Ownership And Health-Related Quality Of Life Among Middle-Aged Adults, Kristi Martin

Walden Dissertations and Doctoral Studies

Pet ownership continues to be part of modern society in the United States. Researchers have explored pet ownership’s impact on chronic diseases and aging populations, but research on health-related quality of life is limited. Grounded in the socioecological model, this quantitative study analyzed data from the 2005-2006 National Health and Nutrition Examination Survey (N = 10,348) to investigate the impact of pet ownership on health-related quality of life among low-income adults aged 30-50 years. Chi-square tests were performed to analyze the associations between age, income, gender, and race with three health-related quality of life metrics. Results showed no statistically significant …

Preventing Psychotropic Medication Duplication: Improving Communication Between Primary Care And Psychiatric Providers, Linda Nwachuku

Walden Dissertations and Doctoral Studies

This project is an education-based initiative designed to address the persistent problem of psychotropic medication duplication in integrated care settings. Duplication occurs when patients receive multiple prescriptions of the same or similar psychotropic drugs. The practice gap exposes patients to adverse drug events, complications of polypharmacy, and reduced adherence, and subjects the providers to liability. The practice-focused question guiding this project is: For primary care and psychiatric providers, will an education program on structured communication and medication reconciliation, compared to current usual practices, increase provider confidence and awareness of the risks of duplication, communication strategies, and increased the use of …

A Study On The Influence Of Entity Internet Hospital Platforms And Health Literacy Facilitation On Postoperative Patients’ Platform Usage, Hong Ye

Dissertations and Theses Collection (Open Access)

Entity Internet Hospital (EIH) is emerging online medical service platforms in China. Currently, while EIHs in China are developing rapidly, their usage rates remain low. However, postoperative patients have substantial follow-up consultation needs. Consequently, incentivizing postoperative patients to use EIH from the demand side is a highly challenging proposition in the current era. Grounded in Technology Acceptance Model and Health Belief Model, this study examined the impacts of platform and health literacy facilitation on platform usage (including intention and frequency) among 631 postoperative patients with cardiovascular disease from four medical institutions in Wuhan, and explored the moderating role of literacy …