Medicine and Health Sciences Commons^™

Identification Of Human Trafficking Victims In The Health Care Setting: An Integrative Review, Jami Leigh Castellucci

Doctoral Dissertations and Projects

Most victims who have escaped trafficking report that during their captivity they were taken to health care facilities. Though health care–based trafficking reporting has increased over the last few years, studies show that private practices and most hospitals within the country do not have a human trafficking protocol, policy, nor educational intervention for their frontline staff to be able to identify and refer victims for short- and long-term support. The United States health care system is poised to play a large role in the fight against human trafficking. This integrative review describes the current status of human trafficking victim identification …

Walking Through Smoke: Implementation Of The 5a'S For Smoking Cessation Counseling In Rural Virginia, Cristina Maria Minotti

Doctoral Dissertations and Projects

Tobacco use represents a significant cause of morbidity and mortality in the U.S. and is a contributing risk factor for multiple pulmonary, cardiovascular, and oncologic diseases. Despite documented evidence of these health hazards, use of tobacco products remains high, particularly in rural America. While providers may frequently question patients regarding tobacco use and inform patients of associated health hazards, a standardized, structured process for delivering smoking cessation counseling (SCC) is rarely established in practice settings. One such method for standardization of SCC is the 5A’s (Ask, Advise, Assess, Assist, Arrange) model which has a robust body of evidence to support …

Diabetes Health Literacy In The Rural Community: An Integrative Review, Shannon M. Elrod

Doctoral Dissertations and Projects

Health literacy is paramount for successful management of health and prevention of disease. Yet a majority of adults have low health literacy. The impact of low health literacy on chronic disease management effects health outcomes and health care costs. With six out of 10 adults in the US diagnosed with a chronic disease such as diabetes, health literacy is a serious concern. Diabetes impacts over 30.3 million Americans. Since diabetes is one of the most common chronic diseases in the country, it is imperative that health literacy be addressed as part of this population’s health management. Diabetes health literacy plays …

Development, Expansion And Role Of Myeloid-Derived Suppressor Cells In Post-Sepsis Immune Suppression, Tuqa Alkhateeb

Electronic Theses and Dissertations

Myeloid-derived suppressor cells (MDSCs) numbers increase significantly in sepsis and are associated with high mortality rates. These myeloid cell precursors promote immunosuppression, especially in the late (post sepsis) stage. However, the mechanisms that underlie MDSC expansion and programming are not completely understood. To investigate these mechanisms, we used a cecal-ligation and puncture (CLP) mouse model of polymicrobial sepsis that progresses from an early/acute proinflammatory phase to a late/chronic immunosuppressive phase. Previous studies in our laboratory showed that microRNA (miR)-21 and miR-181b elevate levels of the transcription factor nuclear factor 1 (NFI-A) that promotes MDSC expansion. We report here that miR-21 …

Investigation Of Factors Affecting The Hiv Continuum Of Care In Tennessee, Elaine Loudermilk

Electronic Theses and Dissertations

Introduction: Factors contributing to the HIV continuum of care (HCC) for adults in Tennessee (TN) have not been studied in depth with known predictors for HIV risk, specifically adverse childhood experiences (ACEs), among low annual income or sexual minority groups [lesbian, gay, bisexual, or transgender (LGBT)].

Methods: A mixed methods study design was used to assess factors related to the HCC. Quantitative analysis used the TN Behavioral Risk Factor Surveillance System data to examine at risk and ever tested for HIV, to (1) investigate ACEs among adults with low-income (<$25,000 annually) in 2016-2017 and (2) among LGBT in 2018. Descriptive statistics and multiple logistic regression (MLR) analysis stratified by TN grand division were performed. Qualitative analysis included 11 interviews with persons living with HIV (PLWH) receiving care at a local clinic to evaluate surveillance questions related to ACEs and the HCC to develop a culturally appropriate survey.

Results: Quantitative results found that among LGBT (N=262) and low-income …

A Mixed-Methods Analysis Of Abortion Attitudes And Perceptions Among Women Living In Alabama And South Carolina, Anthony Peluso

Electronic Theses and Dissertations

Legal induced abortion is a safe option for terminating a pregnancy for women of reproductive age in the United States (U.S.), though access has varied since the Roe v. Wade and Doe v. Bolton cases in 1973. Information is lacking on women’s attitudes toward and perceptions of abortion as well as on related constructs such as pregnancy attitudes and contraceptive use. Exploring these constructs is important in that it can provide much needed context to women’s reproductive life planning. This research aimed to explore perceptions of abortion access and safety and examine the potential associations between attitudes toward abortion access …

Serious Mental Illness And Rural Primary Care: Provider Training, Attitudes, And Opinions, Lydia Eisenbrandt

Electronic Theses and Dissertations

Healthcare resources are especially limited in rural regions of the US. The lack of Primary Care Providers (PCPs) and mental/behavioral health services is problematic, as there are high rates of behavioral and medical concerns within rural populations. Special populations, such as rural persons with Serious Mental Illness (SMI), are medically complex and represent a vulnerable and underserved population. Healthcare outcomes for persons with SMI are poor compared to the general population and commonly lead to premature death. Various barriers prevent this population from accessing optimal healthcare, especially in rural areas, due to negative perceptions/stigma, a lack of understanding from PCPs, …

Bdnf-Related Gene Expression Of Laser Capture Microdissected Glutamate Neurons From The Anterior Cingulate Cortex In Mouse Models Of Autism Spectrum Disorder, Misty Owens

Electronic Theses and Dissertations

Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting social behaviors. ASD affects 1 in 59 children with males affected more frequently. ASD is postulated to result from excitatory and inhibitory neurotransmission imbalances. Brain-derived neurotrophic factor (BDNF) signaling affects ASD by influencing synaptogenesis, plasticity, and survival. Studying early in-utero neuropathological changes within ASD requires the use of animal models. Expression of BDNF-associated genes were analyzed within laser capture microdissected pyramidal neurons from the anterior cingulate cortex of male and female BTBR and valproic acid mouse models. No expression differences were found in any gene comparing the three groups. Gender comparisons …

The Effects Of Increasing Running Speed On Vgrf And Asymmetry, Kaela M. Hierholzer

Electronic Theses and Dissertations

Biomechanical and physiological parameters related to running performance are usually studied separately. However, evaluating both aspects together could be beneficial in improving athletic performance. The purpose of this study was to observe the change in peak vGRF and asymmetry as speed increases, while observing physiological responses during a O_2maxtest. Data from athlete monitoring of 12 cross-country and triathlon athletes were analyzed. The athlete monitoring protocol included three unweighted countermovement jumps and a O_2maxtest performed by the athletes. The athletes had an average O_2maxof 53.4 ± 7.7 mL/kg/min, while their average vGRF asymmetry throughout the …

Tumor Organoids To Study Gastroesophageal Cancer: A Primer, Ramon U Jin, Jason C Mills

2020-Current year OA Pubs

Gastroesophageal cancers are leading causes of cancer death. Our attempts at adopting molecularly based treatment approaches have been slow and ineffective even though we begin to identify specific targetable gene mutations and pathways. It is clear that we should no longer treat all gastroesophageal cancers as a homogeneous disease, which is what we do when we use non-specific chemotherapy. However, we currently cannot monitor successful gene/pathway targeting, nor understand how/when tumors develop resistance, nor predict which patients will derive maximal benefit. To improve outcomes, we must precisely detail the heterogeneity of these tumors to then individualize cancer therapy as well …

Obesity And Its Effect On Outcomes In Same-Day Bilateral Total Knee Arthroplasty, Ethan A Remily, Nequesha S Mohamed, Wayne A Wilkie, Tyler Smith, Anthony Judice, Salvador Forte, James Nace, Ronald E Delanois

Orthopedic Surgery Resident Research

Background: The niche surgery of same-day bilateral total knee arthroplasty (sd-BTKA) continues to create debate amongst specialists in arthroplasty. To date, there is a significant lack of literature on obese patients undergoing sd-BTKA, and no study has evaluated outcomes of this procedure when compared to non-obese patients. Therefore, this study will perform a retrospective analysis to compare (I) incidence, (II) demographics, and (III) complications of sd-BTKA in non-obese, obese, and morbidly obese patients in the United States from 2009 to 2016.

Methods: The National Inpatient Sample (NIS) database was queried for all individuals that underwent sd-BTKA from 2009 to 2016. …

Percutaneous Coil Embolization To Manage Pulmonary Artery Hemorrhage After Distal Endarterectomy, Chirantan Mangukia, Paul Forfia, Anjali Vaidya, Veronica Williams, Dmitry Niman, Parth Rali, Yoshiya Toyoda

Internal Medicine Resident Research

Selective pulmonary artery coil embolization can be a viable treatment option for acute pulmonary hemorrhage after pulmonary thromboendarterectomy.

The Scoop, Vol. 7 Issue 5, August 2020, Health Sciences Library

Volume 7

Latest news and updates from the Health Sciences Library in our monthly newsletter for August 2020.

Reduced Vip Expression Affects Circadian Clock Function In Vip-Ires-Cre Mice (Jax 010908), Deborah A.M. Joye, Kayla Rohr, Danielle Keller, Thomas Inda, Adam Telega, Harshida Pancholi, Vania Carmonia-Alcocer, Jennifer A. Evans

Biomedical Sciences Faculty Research and Publications

Circadian rhythms are programmed by the suprachiasmatic nucleus (SCN), which relies on neuropeptide signaling to maintain daily timekeeping. Vasoactive intestinal polypeptide (VIP) is critical for SCN function, but the precise role of VIP neurons in SCN circuits is not fully established. To interrogate their contribution to SCN circuits, VIP neurons can be manipulated specifically using the DNA-editing enzyme Cre recombinase. Although the Cre transgene is assumed to be inert by itself, we find that VIP expression is reduced in both heterozygous and homozygous adult VIP-IRES-Cre mice (JAX 010908). Compared with wild-type mice, homozygous VIP-Cre mice display faster reentrainment and shorter …

Improving Identification Of High-Risk Obstructive Sleep Apnea Patients In Primary Care: An Integrative Review, Lauren Ashley Paulson

Doctoral Dissertations and Projects

Obstructive sleep apnea continues to be an area that is underdiagnosed and therefore undertreated. Left untreated, the condition is associated with increased morbidity and mortality as it can amplify the risk of multiple health conditions. Due to the negative impact of obstructive sleep apnea it is necessary for healthcare providers to provide timely detection. Primary care providers are in a position to identify high-risk individuals and refer them for further follow up testing. High-risk identification can be accomplished by integrating validated screening tools into patient assessments. This integrative review provides an overview of current screening tools for use in the …

Increasing New Orienting Emergency Department Nurses' Awareness Of Mass Casualty Incident Emergency Preparedness And Disaster Response Core Competencies To Improve Mass Casualty Incident Response, Christopher C. Deramo Ii

Doctoral Dissertations and Projects

Mass casualty incidents (MCI) impose a substantial threat to healthcare. Despite the increasing frequency of MCIs many healthcare organizations and nursing programs do not adequately prepare nurses to be effective responders during an MCI. This evidence-based practice pilot project was purposed to increase new orienting emergency department nurses’ confidence and ability to effectively respond to an MCI. This project involved implementing an MCI educational program consisting of a disaster nursing framework to educate new orienting emergency department nurses on emergency preparedness and disaster response core competencies. The project leader utilized a quasi-experimental design to collect data pre- and post-intervention utilizing …

Bystander Cpr Training For Laypersons And Caregivers Of Those At High Risk For Sudden Cardiac Arrest: An Integrative Review, Ragan Scott

Doctoral Dissertations and Projects

Sudden Cardiac arrest (SCA) is the leading cause of death in the United States (U.S.) with approximately 475,000 deaths annually (AHA, 2018). Approximately 70% of these deaths occur as out-of-hospital cardiac arrests (OHCA; AHA, 2018). Currently, the survival rate for OHCA is 10% with the lack of bystander CPR being a large contributor to the high mortality rate (AHA, 2018). This project evaluated the literature related to bystander CPR training to determine if this training improves willingness to perform bystander CPR and overcomes common barriers that inhibit the initiation of bystander CPR in OHCA. The projected outcome for this project …

Nutraceutical Potential For Alzheimer's Disease Treatment, Alex Gewecke

Undergraduate Research Journal

Alzheimer’s disease (AD) is a progressive disorder involving buildup of excessive amounts of proteins such as beta amyloid in the brain that leads to memory loss, inability to perform daily functions, and an early death. By 2060, the number of cases is forecast to nearly triple current numbers. Age is the primary risk factor for AD and no new drugs have been approved since 2003. Nutraceuticals, a broad category of substances that can be utilized for both medicinal and nutritional purposes may be able to help, which is why they are being more widely researched. Overall, a number of attempts …

Using Speech Screening Process For Preschool-Age Children: Do Results Lead To Action?, Autumn Rhoads

Undergraduate Research Journal

In this paper, we will discuss the concerns of a microstrip two patch antenna system. Coupling of the two-port system can be miniaturized using Electromagnetic Bandgap Structures (EBG) or Defected Ground Structures (DGS) centered between the two patch antennas half a wavelength in size. Different miniaturization methods were used in the design of the antenna system to change the properties of the signal. Changing via locations that are not found on EBG strips themselves, rather found on interleaved ledges between EBG strips allowed for further change in shifting the signals frequency.

Pain Management In Orthopedic Patients, Anna Dockstader Bsn, Rn, Alexa Reich Bsn, Rn, Jessica Snyder Bsn, Rn, Sarah Scalici Bsn, Rn, Molly Woytowicz Bsn, Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

A Grief All Its Own, Mary Blumenfeld

Student Papers, Posters & Projects

No abstract provided.

Chronic Pain, Sleep Disruption, And Work Performance In The Military, Jeffrey Ransom

Dissertations

Abstract

Background and Significance: Managing pain is a challenge for many organizations, including the U.S. military. The added complication of managing sleep disruption compounds the issue. Examining pain and sleep disruption in the context of work performance within the military is critical to understanding the impact of these conditions on our nation’s fighting forces.

Purpose: Examine the associations of chronic pain and sleep disruption in the context of work performance among active duty military service members.

Research Aims: 1) Describe sociodemographic characteristics, military service characteristics, clinical characteristics, and work performance of active duty service members, 2) Examine relationships between these …

Creating A Quality Improvement Toolkit To Identify & Address Gaps In The Care Of Older Adults With Hip Fracture, Amanda J. Covell

Doctoral Projects

Introduction: Traumatic hip fracture remains a major cause of disability, decline, and mortality for adults over 65. Gaps remain in the consistency of care and services hip fracture patients receive during hospitalization and post-discharge, leading to adverse outcomes, including MI, surgical site infection, poorly managed pain, and increased mortality. To help address these inconsistencies, the AAOS released updated clinical practice guidelines for management of hip fracture care in the elderly in 2014. These guidelines examine the entire hospitalization process for this population and set forth evidence-based standards to assist with improving outcomes for hip fracture patients.

Objectives: Five of the …

Video Education For Improved Education Of Newly Diagnosed Multiple Sclerosis Patients, Theresa Mccrumb

Doctoral Projects

Anxiety and depression are prevalent in multiple sclerosis (MS) patients, especially those newly diagnosed. Receiving a diagnosis of MS can be overwhelming and impact patients in multiple areas including physical issues, cognitive changes and anxiety and depression (Kantor, Bright & Burtchell, 2017). This anxiety and depression can cause patients to be less engaged in their plan of care and thereby reduce their quality of life (Rieckmann, et al., 2015). According to the Multiple Sclerosis Association of America (MSAA), four of 10 MS patients are diagnosed with depression and anxiety, with the highest incidence at diagnosis (Multiple Sclerosis Association of America, …

From The Dinner Pot To Smoking Pot; How A Better Understanding Of Cannabidiol In Crayfish Could Alleviate Anxiety And Modulate Hunger, Christopher Michael Timmer

Masters Theses

Anxiety affects approximately 1/3 of the US population and presents in many different forms, ranging from social to panic disorders. It also presents with high comorbidity for other mental disorders. One treatment is Selective Serotonin Reuptake Inhibitors (SSRIs) which allow for increased activation of serotonin (5-HT) receptors. SSRIs come with an extensive list of side effects, which can fail to maintain quality of life. Cannabidiol (CBD) is a cannabis derived compound which has been shown to decrease anxiety by activation of multiple subtype 5-HT amine receptors. CBD has few side effects, is not psychoactive, and exhibits anti-psychotic properties. The current …

Psychometric Analysis Of A 9-Item M-Hooked-On Nicotine Checklist For Vaping Among College Students, Joshua B. Devine

Graduate Theses/Dissertations

Background: Adolescent participation in electronic vapor products (EVP) is on the rise and with it many new health concerns present themselves. EVP use tripled among high school and middle school students from 2013-2014 and has continued to grow. Previous nicotine related studies have shown that the earlier the age of initiation to nicotine, the higher likelihood to develop a nicotine dependence. Methods: Using the “Hooked on Nicotine Checklist” (HONC) current rates of nicotine dependence among college students at a southwest Missouri university was assessed. One hundred and fifty-six students were recruited from a KIN 210 class as a convenience sample. …

Guided Imagery And Deep Breathing: Minimizing Anxiety Experienced By Pediatric Cancer Patients, Bethany Grace Aney

Graduate Theses/Dissertations

This particular research study examined the impact of guided imagery and deep breathing as coping tools to reduce the anxiety levels experienced by pediatric cancer patients ages 6-12 years of age at a children’s hospital in Central Pennsylvania. This quantitative study utilized a pretest-posttest design, in addition to utilizing the State-Trait Anxiety Inventory for Children (STAIC™) as the baseline and post-test assessment. The STAIC™ is a questionnaire tool that assesses individuals’ state and trait anxiety through a total of 40 questions. This particular study had a total of five patients, two male and three female that consented to undergoing three …

The Legacy Of Mining In Southwest Missouri: Past And Present Conditions Of The Tri-State Mining District, Anastasia M C Mcclanahan

Graduate Theses/Dissertations

The historic Tri-State Mining District (TSMD) of southwestern Missouri, southeastern Kansas, and northeastern Oklahoma has a history of lead and zinc mining that extended over a hundred years. During the district’s peak production period, the TSMD was one of the world’s largest producers of lead and zinc. The mining activities in the TSMD produced economic growth that supported the local communities and were essential to the victory of the Allied Forces during World War I and World War II. Beginning in the 1920s, the mining activities in the district slowly began to cease due to depletion of metal ores and …

The Use Of Animal-Assisted Therapeutic Interventions In The Hospital Setting During The Covid-19 Pandemic, Alicia Cesare

Graduate Theses/Dissertations

Handlers of therapy and/or facility dogs working within hospital settings have experienced various barriers and challenges within their practice during the COVID-19 pandemic. Animal-assisted interventions, specifically therapeutic working dogs, are a valued source of support to individuals, communities, hospital settings, and disaster sites during times of community distress. The purpose of this study was to identify barriers and solutions to the continued use of animal-assisted therapeutic interventions in support of patients and families within the hospital setting during the COVID-19 pandemic. This researcher’s position within the research is the knowledge and experience of being a facility dog handler within the …

Racial Differences In Arterial Stiffness During Recovery Following Repeated Bouts Of Maximal Anaerobic Cycling Exercise In Young Women, Noelle Merchant

Graduate Masters Theses

African Americans (AA) experience a differential cardiovascular response during recovery from aerobic exercise compared to Caucasian Americans (CA). There is also evidence that local and systemic vasculature responds differently to aerobic exercise stimulus. No study has examined racial differences in arterial stiffness following maximal anaerobic exercise in AA and CA women. Purpose: To compare local and systemic arterial stiffness during recovery from repeated bouts of maximal anaerobic exercise in young, healthy AA and CA women.

Methods: Twenty (AA=8; CA=12) young, healthy women without hypertension completed two bouts of maximal anerobic exercise on a cycle ergometer with 30 minutes of recovery …