Medicine and Health Sciences Commons^™

Noise In The Acute Care Patient Setting, Taylor A. Cota, Brynn Roberts

Honors Theses and Capstones

Noise levels in hospital environments can negatively impact patient satisfaction and recovery, particularly in high-acuity units such as Progressive Care Units (PCUs) (Choiniere, D. B., 2010). Patient satisfaction surveys at the PCU at Exeter Hospital have consistently identified noise as a concern, highlighting the need for rigorous quality improvement (QI) planning phase to determine whether a structured intervention, such as white noise implementation, is indicated.

This project focuses on the initial planning phase of the Plan-Do-Study-Act (PDSA) cycle (Institute for Healthcare Improvement, n.d.) to assess the feasibility and necessity of introducing white noise machines to enhance patient experience on the …

18s Metabarcode Analyses Of Eukaryotic Species In The Respiratory Microbiomes Of Wild Canids From New Hampshire, Collin Sinclair Blake

Honors Theses and Capstones

This study is of an exploratory nature and focuses on characterizing the eukaryotic microbiota present in the respiratory tissues of six wild canids and one domestic canine. The contents of this document largely pertain to dry lab analyses of 18S barcodes in bioinformatics programs – primarily QIIME2 running in the GitBash command line, service for which was hosted by the UNH Ron Bioinformatics training server. All procedures listed within the section below were performed by second parties at the UNH Hubbard Center for Genomics Studies (HCGS), the New Hampshire Veterinary Diagnostics Lab (NHVDL), and the UNH Microbial Ecology and Emerging …

Implementing A Gerontological Nursing Competencies Programme In Aged Care: Participant Experiences, Victoria Traynor, Nicole Britten, Diane Gibson, Stephanie Munk, Lynn Chenoweth, Jolan Stokes, Tracey Moroney, Karen Strickland, Toni Donaghy, Kasia Bail

Research outputs 2022 to 2026

Aims: To explore the experience of registered nurses and their mentors in the implementation of the Gerontological Nursing Competencies in long-term aged care and the perceived effectiveness and suitability of the programme to support nurse development. Background: The global population is ageing and needs a reliable aged-care nursing workforce. Introduction: Opportunities for education and mentorship for newly qualified and experienced aged-care nurses warrant investigation. Methods: Qualitative evaluation using semi-structured focus groups was conducted following the implementation of the programme into five not-for-profit long-term aged-care organisations and analysed by a reflexive qualitative thematic approach and reported according to COREQ criteria. Results: …

Sleep Discrepancy And Cognitive Function In Community-Dwelling Older Adults, Nadia Soh, Stephanie R. Rainey-Smith, James D. Doecke, Rodrigo Canovas, Romola S. Bucks, Melissa Ree, Michael Weinborn

Research outputs 2022 to 2026

This was the first study to use cluster analysis to characterise sleep discrepancy (the discordance between self-reported and objective sleep) across multiple sleep parameters, in community-dwelling older adults. For sleep efficiency, negative discrepancy (the tendency to self-report worse sleep than objectively-measured) was associated with poorer memory, independent of insomnia severity, depressive symptoms and objective sleep. This suggests a unique role for sleep discrepancy as a possible risk factor for future cognitive decline, and warrants the need for further research.

Application Of Machine Learning And Large Language Models In Healthcare For Data Prediction And Summarization, Chiazam Chisom Izuchukwu

College of Graduate Studies: Theses & Dissertations

This study aims to examine the use of machine learning (ML) and large language models (LLMs) in healthcare to enhance disease prediction, clinical decision-making, and information management. Five supervised ML models—Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF), Decision Trees (DT), and Naïve Bayes (NB)—on three different computing platforms—Google Colab, Databricks, and Snowflake—were employed for disease classification. Data preprocessing included treating missing values, encoding categorical variables utilizing one-hot-encoding, feature scaling when needed, and tackling class imbalance with Synthetic Minority Over-sampling Technique (SMOTE) before an 80-20 train-test separation. Models were created with Scikit-learn (Google Collab), Spark MLlib (Databricks), and …

Effects Of Perinatal Exposure To Lipopolysaccharide And Acetaminophen On Learning In Adult Long-Evans Rats, Lucy A. Sivils

College of Graduate Studies: Theses & Dissertations

The present study investigated the individual and combined effects of elevated perinatal inflammation, oxidative stress caused by acetaminophen (APAP) exposure, or elevated inflammation and oxidative stress on adult learning behaviors in Long-Evans rats. While prior studies have examined these factors independently, the combined effects of inflammation and oxidative stress via APAP exposure during early development on learning-related behaviors remain unexplored. The present research aimed to address this gap by the analysis of potential long-term neurodevelopmental consequences of lipopolysaccharide (LPS)-induced inflammation and APAP-induced oxidative stress. LPS, APAP, or LPS + APAP was administered during the perinatal period: postnatal days (PD) 9, …

Synthesis Of Tu100 Analogs And Biological Assays, Feyisope Tonye Oladapo

College of Graduate Studies: Theses & Dissertations

TU100 (14-methyl-5H-5,12-epiminobenzo[4,5]cyclohepta[1,2-b]naphthalene-6,11,13(12H)-trione) exhibits exceptional chemotherapeutic properties. It operates via a distinct mechanism that triggers cell death to create cytotoxic effects while concurrently inhibiting topoisomerase I and II. Its efficacy rivals that of well-known chemotherapeutic drugs like Daunorubicin. The distinctive characteristics of TU100 have led to initiatives aimed at creating structurally similar compounds to discover even more effective bioactive alternatives.

The analog synthesis incorporated quinoxaline or its derivatives (diphenyl quinoxaline, dipyridinyl quinoxaline, and dibenzophenazine-10,13-dione) that have been shown to have promising chemotherapeutic effects. Synthesizing the hetero naphthoquinones required a multi-step synthetic process, so quinoxaline/ derivatives intermediates are first prepared, then the …

The Relationship Between Nutrition Knowledge And Dietary Behavior Of Student-Athletes, Kerry A. Smith, Kathleen Fritch, James Rost, Amy Jo Riggs, Juliann Sergi Mcbrayer, Monika Krah

Georgia Educational Researcher

The purpose of this study was to examine the relationship between nutrition knowledge and dietary behavior while controlling for academic major, year, and gender among Division III student-athletes. Sufficient nutrition is essential for athletic performance, injury reduction, and overall health. However, student-athletes face unique challenges that can disrupt optimal nutrition, including poor nutrition knowledge and access to available resources. While several studies have examined the relationship between nutrition knowledge and dietary behavior, no known studies have addressed this among Division III student-athletes. This non-experimental correlational study examined dietary behavior using the Rapid Eating and Activity Assessment for Participants (REAP-S) and …

Emcreg-International Multidisciplinary Consensus Panel On Management Of Hyperkalemia In Chronic Kidney Disease And Heart Failure, Natalie Kreitzer, Nancy M. Albert, Alpesh N. Amin, Craig J. Beavers, Richard C. Becker, Gregg Fonarow, W. Brian Gibler, Katherine W. Kwon, Robert J. Mentz, Biff F. Palmer, Charles V. Pollack, Iliana L. Piña

Division of Cardiology Faculty Papers

BACKGROUND: Hyperkalemia, generally defined as serum potassium levels greater than 5.0 mEq/L, poses significant clinical risks, including cardiac toxicity and muscle weakness. Its prevalence and severity increase in patients with chronic kidney disease (CKD), diabetes mellitus, and heart failure (HF), particularly when compounded by medications like angiotensin converting inhibitors, angiotensin receptor blockers, and potassium sparing diuretics. Hyperkalemia arises from disruptions in potassium regulation involving intake, excretion, and intracellular-extracellular distribution. In CKD and acute kidney injury, these regulatory mechanisms are impaired, leading to heightened risk. The management of chronic hyperkalemia presents a challenge due to the necessity of balancing effective cardiovascular …

New Vs. Reprocessed: A Scoping Review On Ilizarov Frame Reuse, James Hughes, Nicholas Obias, Dustin Prins, Amanda Killeen

School of Podiatric Medicine - Student Research

This review examines current literature regarding the viability of reused/reprocessed Ilizarov External Fixation (IEF) – with the end-goal of improving surgical options for complex limb pathologies in austere environments. We hypothesize this review will find no statistically significant difference between clinical outcomes of reused vs. new IEFs

IEF is an important but costly modality for complex limb pathologies, such as trauma, deformity, and nonunion (Chironga et al., 2023). Though effective, the cost of IEF is exacerbated by its single-use deployment (Chironga et al., 2023). A proposed cost-control measure is IEF reuse/reprocessing via (1) antiseptic pre-treatment, (2) structural stability assessment, (3) …

Epidemiologi Kejadian Luar Biasa Malaria Bulan September-November 2024: Studi Serial Kasus Di Kabupaten Indragiri Hilir, Provinsi Riau, Rajunitrigo Rajunitrigo, Irwan Muryanto, Renti Mahkota, Fadhil Armen, Yusni Nuryanti, Fahrul Rizal, Rabiatul Adwiyah

Jurnal Epidemiologi Kesehatan Indonesia

Abstract

Malaria remains a public health issue in Indragiri Hilir Regency, Riau, despite its elimination certification 2018. In 2024, a malaria outbreak occurred, and an epidemiological investigation was then carried out. This study aims to describe the epidemiological characteristics of the malaria outbreak based on person, time, and place. This study used a serial case design, analyzing all confirmed malaria cases reported in the e-SISMAL system of Indragiri Hilir Regency from September 1^st to November 30^th, 2024. Data on Anopheles Sundaicus habitats were obtained from epidemiological investigation reports. Univariate and bivariate analyses were conducted using the chi-square …

Determinan Faktor Dengan Ketidakpatuhan Dalam Mengonsumsi Obat Antiretroviral Pada Orang Dengan Hiv(Odhiv) Di Rumah Sakit Umum Daerah Kabupaten Tangerang Tahun 2023, Dessi Marantika Nilam Sari, Mondastri Korib Sudaryo, Syahrizal Syarif, Helwiah Umniyati, Suyono .

Jurnal Epidemiologi Kesehatan Indonesia

Ketidakpatuhan alasan utama Pasien HIV tidak menerima pengobatan ARV sehingga harus selalu dipantau dan dinilai secara teratur serta didorong pada setiap kunjungan. Penelitian ini bertujuan untuk mengamati determinan faktor terjadinya ketidakpatuhan dalam mengonsumsi obat ARV pada ODHIV yang mendapatkan terapi ARV di Rumah Sakit Umum Daerah Kabupaten Tangerang. Jenis penelitian ini menggunakan penelitian observasional dengan rancangan cross sectional. Penelitian dilakukan di poli HIV RSUD Kabupaten pada bulan November 2023 menggunakan data laporan HIV pada SIHA. Populasi penelitian berjumlah 1.337 ODHIV aktif menjalani pengobatan antiretroviral di RSUD Kabupaten Tangerang dengan menggunakan total sampling sesuai dengan kriteria inklusi dan ekslusi sehingga sampel …

Faktor Risiko Kejadian Hipertensi Dalam Kehamilan Pada Ibu Hamil Di Provinsi Jawa Timur (Analisis Data Riset Kesehatan Dasar Tahun 2018), Putri Amalia Firjatillah, Sudarto Ronoatmodjo

Jurnal Epidemiologi Kesehatan Indonesia

Hypertension during pregnancy is one of the most common pregnancy complications and the leading cause of maternal mortality in Indonesia. One of the regions in Indonesia with a high number of hypertension-related pregnancy complications is East-Java Province with a prevalence rate of 17,8%. This study aims to analyze the risk factors associated with hypertension during pregnancy among pregnant women in East Java. The study adopts a cross-sectional design using secondary data from 758 pregnant women aged 15-54 years in East Java Province who participated in 2018 Riskesdas Survey during which blood pressure measurements were taken. The dependent variable analyzed in …

Implementing Noninvasive Capnography Monitoring To Enhance Early Recognition Of Postoperative Respiratory Decline In High-Risk Patients: A Quality Improvement Project, Trevor A. Messenger

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Implementing Noninvasive Capnography Monitoring to Enhance Early Recognition of Postoperative Respiratory Decline in High-Risk Patients: A Quality Improvement Initiative

Trevor Messenger

Background: Those suffering from chronic respiratory disease, obstructive sleep apnea (OSA), obesity, and other serious comorbidities are at an increased risk of respiratory decline after receiving general anesthesia. Respiratory decline leads to adverse outcomes, including increased hospital length of stay, intensive care unit (ICU) admissions, morbidity, and mortality.

Purpose: To improve the safety of postoperative patients at risk for OSA, and to reduce adverse events and airway interventions by enhancing the monitoring capabilities of bedside clinicians with waveform …

All-Terrain Vehicle Injuries Among Youth: A Multidimensional Analysis Of Injury Patterns In West Virginia And Safety Laws Across High-Fatality States, Sabrina Chyann Beal

Graduate Theses, Dissertations, and Problem Reports (ETD)

All-terrain vehicles (ATVs) pose significant injury risks, particularly among youth. These powerful machines are widely used across recreational and rural settings. West Virginia consistently ranks among the top five states for ATV-related deaths and injuries. Safety equipment and requirements are often not followed nor enforced, causing children and adolescents to be the most vulnerable group because they tend to not wear safety equipment such as helmets, ride on roadways, carry passengers, and operate oversized ATVS. This study examined ATV injury patterns from the WVU Medicine Trauma Registry and ATV laws across the five states with the highest reported fatalities. This …

Code Blue Narrator Documentation: An Evidence Based Quality Improvement Initiative, Stefanie A. Benvenuto

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: The code documenter plays a crucial role in ensuring accurate, real-time documentation during Code Blue events, which is critical for patient care and compliance with established guidelines and protocols. However, nurses have reported discomfort with the Code Narrator tool in EPIC, which has hindered effective documentation during these high-pressure situations.

Purpose: The lack of comfort in using the Code Narrator tool has led to inconsistent and inaccurate documentation during Code Blue events, potentially impacting the effectiveness of the response and patient outcomes, such as the achievement of return of spontaneous circulation (ROSC).

Intervention: An educational competency …

Opportunities For Inter-Cultural Awareness In The Education Of Dental Hygienists, Elizabeth J. Sandell, Lynnette Engeswick

Elementary and Literacy Education Department Publications

Professional standards require that dental hygienists deliver culturally appropriate services and demonstrate respect for patients whose cultural beliefs and values may conflict with normative clinical recommendations. The present study provided a snapshot of undergraduate students in one dental hygiene education program about the students' Intercultural competence (ICC): "the capability to understand and adapt behavior to cultural differences and commonality accurately." Rather than a longitudinal study of a student cohort, investigators sought to understand if program outcomes were congruent with the stated visions and missions of the university, co llege, and department. The participants completed an Informed Consent before taking the …

The Special Issue “The 20th Anniversary Of Pharmaceuticals—Multi-Targeted Natural Products As Therapeutics” Editorial—Multi-Targeted Therapeutics From Natural Sources: What Do We Know?, Elena Y. Enioutina, Katheleen M. Job, Catherine M.T. Sherwin

Pediatrics Faculty Publications

Herbal and marine products in the form of extracts, infusions, and decoctions have been used for centuries in folk and traditional medicine. Preparations typically contain multiple biologically active compounds. The World Health Organization (WHO) estimated that about 65% of consumers worldwide use natural remedies containing bioactive molecules to treat various diseases [1]. Most single-molecule drugs of natural origin were developed in the middle of the 20th century through the active screening of natural products for bioactive molecules [2]. Examples include artemisinin, cyclosporine, taxol, doxorubicin, and many others. However, at the beginning of the 21st century, we saw a decline in …

Communication Interventions For Families With Parental Cancer With Dependents: Findings From A Scoping Review, Cinzia Caparso, Zoe Bowen, Sung Won Choi

Nursing Faculty Research Publications

Background: Since 2019, invasive cancer diagnoses in people younger than 50-years-old have increased by 12.8%, which impacts people of child-bearing age. Currently, interventions in families of parents with cancer are focused primarily on the parent with cancer communicating with their dependents about the initial cancer diagnosis or at end-of-life through in-person interventions. Limited web-based interventions have been developed to increase communication across all family members (e.g., parents with cancer with coparents; children with their parents) about communicating the impact of cancer on the individual’s and family’s well-being cross the cancer trajectory, a key gap to improved outcomes in this population. …

App Assisted Depression Self-Management In Integrated Primary Care: A Pilot Study Exploring Patient And Provider Experiences, David J. Johnson, Margaret R. Emerson, Danae Dinkel, Robbin Thomas, Shinobu Watanabe-Galloway, Maria S. Mickles, Carli Culjat

Journal Articles: Epidemiology

The integrated primary care (IPC) setting is currently the de facto institution for accessing mental healthcare among underserved populations. However, many barriers exist for these populations when seeking regular and adequate mental healthcare, including provider availability and transportation challenges. This study piloted the incorporation of mindLAMP, a mHealth app, into IPC treatment to offer a low-resource intervention designed to improve and expand access to mental healthcare for underserved patients between face-to-face visits. This study gathered data from a sample of both behavioral health providers and patients (N = 6) in IPC settings to pilot the use of the mindLAMP app …

Laryngeal Hypersensitivity From The Perspective Of Pain Science: An Integrative Review Of Empirical Studies On Associated Factors And Processes, William Saint-Jules, Hugo Massé-Alarie, Nicole Y. K. Li-Jessen, Maude Desjardins

Revues de littérature, synthèses de connaissances

Objective

Laryngeal hypersensitivity (LHS) is a state of heightened sensorimotor response to stimuli in the upper airway. Although its clinical picture is becoming progressively clearer with recent research progress, specificities about its associated factors and processes remain to be clarified. The aim of this integrative review was to synthesize published empirical data from human studies on LHS, focusing on related factors and pathophysiology.

Study Design and Data Sources

Integrative review of the literature; Pubmed, EMBASE, and Web of Science.

Methods

Keywords associated with the following three main concepts were used to query databases: (1) manifestations potentially associated with an irritable …

Pediatric Caregiver Interventions: A Scoping Review, Venisa Rodriguez

Student Research Design & Innovation Symposium

Caregivers are an integral component in pediatric healthcare service delivery. Caregiver education/interventions and health beliefs vary greatly, as do barriers and facilitators, including their accessibility, quality, and effectiveness. A family-centered care approach, defined as utilizing the family as a formal member, resource, and collaborator in the care team, has been found to be beneficial and contribute to positive health and wellbeing outcomes for caregivers, their child, and the family unit as a whole. A scoping review was conducted to investigate the utilization and impacts of caregiver education/interventions on their engagement in the therapeutic process. The results of this review will …

The Genetic Role Of Cerebral Palsy, Samantha Bruno

Student Research Design & Innovation Symposium

Cerebral palsy is a group of various disorders that impact a person's mobility, posture, and balance. It affects muscle control and can be caused by abnormal development of the brain or by brain damage. This condition can develop before birth, during birth, within a month postpartum, or during the child's first year of life while the brain is still in the developmental process. Studying the genetic role of cerebral palsy is crucial to ensure an early diagnosis and proper treatment moving forward. In this research study, genes were explored that have been known to play a role in the development …

Impacts Of Ramadan Fasting During Pregnancy On Pregnancy And Birth Outcomes: An Umbrella Review, Abdullah Al-Taiar, Md Estiar Rahman, May Salama, Ali H. Ziyab, Wilfried Karmaus

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Despite a large number of primary research studies, and systematic and narrative reviews, there is no consensus on the impact of fasting during Ramadan while pregnant on pregnancy and birth outcomes. Currently, there is no evidence-based guideline for Muslim women regarding Ramadan fasting during pregnancy and clinicians cannot provide firm recommendations.

Objectives

To review the current evidence regarding the impact of Ramadan fasting during pregnancy on pregnancy and birth outcomes.

Search Strategy

We conducted an umbrella review of all systematic and narrative reviews examining the impacts of fasting during Ramadan while pregnant on pregnancy and birth outcomes by searching …

Politics In Public Health: Growing Partisan Divides In Covid-19 Vaccine Attitudes And Uptake Post-2021 Presidential Inauguration, Hongbin Fan, Zhongliang Zhou, Guanping Liu, Chi Shen, Qi Zhang

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: To investigate whether the 2021 U.S. presidential inauguration contributed to a widening of partisan divides in COVID-19 vaccine attitudes and uptake. Methods: We leverage the presidential inauguration as a natural experiment and analyze data from the Household Pulse Survey and CDC vaccination records. Using a difference-in-differences framework with continuous treatment, we examine how the transition differentially affected state-level vaccine refusal rates and county-level vaccination rates, based on varying levels of partisanship as measured by the Trump-Biden vote gap. Results: Following Biden's inauguration, vaccine refusal declined more in pro-Biden states. Distrust in government and vaccines accounted for approximately 80% of …

Machine Learning Models For Pancreatic Cancer Survival Prediction: A Multi-Model Analysis Across Stages And Treatments Using The Surveillance, Epidemiology, And End Results (Seer) Database, Aditya Chakraborty, Mohan D. Pant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: Pancreatic cancer is among the most lethal malignancies, with poor prognosis and limited survival despite treatment advances. Accurate survival modeling is critical for prognostication and clinical decision-making. This study had three primary aims: (1) to determine the best-fitting survival distribution among patients diagnosed and deceased from pancreatic cancer across stages and treatment types; (2) to construct and compare predictive risk classification models; and (3) to evaluate survival probabilities using parametric, semi-parametric, non-parametric, machine learning, and deep learning methods for Stage IV patients receiving both chemotherapy and radiation. Methods: Using data from the SEER database, parametric models (Generalized Extreme Value, …

Challenge Based Learning For Social Entrepreneurship Education, Koen Depryck, Ilse Wambacq

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Challenge Based Learning (CBL) provides a promising educational framework for teaching social entrepreneurship, addressing the persistent gap between theoretical knowledge and practical implementation. Through a comprehensive analysis of existing literature and theoretical frameworks, this paper demonstrates how CBL’s seven key elements-authentic challenges, stakeholder involvement, interdisciplinary approaches, student agency, work and life skills development, entrepreneurial mindset cultivation, and impact focus-directly align with and support core social entrepreneurship competencies. The integration of Kolb’s experiential learning theory, Santos’ social entrepreneurship framework, and Rogers’ innovation diffusion theory provide a basis for understanding how CBL can enhance social entrepreneurship education. Evidence suggests that CBL particularly …

Pediatric Hearing Loss: Screening For Developmental Delays Among Children With Hearing Aids, Kelsey Wallace

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Children with hearing impairments are at risk for developmental delay, and research has shown that children born with sensorineural hearing loss (SNHL) are at a higher risk for delays in motor, sensory, and social skills development. The literature points to an obvious impact of hearing loss on development, but also a lack of screening for this phenomenon beyond language development skills. A doctoral capstone project was conducted to pilot a process for the implementation of developmental screening for children with hearing aids (HAs), as well as subsequent therapy referrals and parent education, in collaboration with a hospital-based pediatric audiology department. …

Toward A More Accountable And Inclusive Vision Of Health Ethics: Navigating Complexity In Contemporary Clinical Practice, Peter A. Depergola Ii

Journal of Health Ethics

Editor's introduction to Vol. 21, No. 1 of the Journal of Health Ethics.

The Ethics Of Student Attrition In Healthcare Education Programs, Kent Haina Jr, Peter A. Depergola Ii

Journal of Health Ethics

Student attrition is a problem in healthcare education programs, but there is little in the literature regarding the organizational ethics of lowering it. Some argue that lowering attrition is unethical, because it would lower academic and professional standards, potentially impacting patient care. Others say students deserve to make decisions about when to leave a course of study. However, these arguments ignore inequities in attrition, as well as the conflicts of interest in, and moral obligations of colleges and universities. Lowering attrition rates in healthcare education programs is inherently ethical because it levels the playing field for underrepresented minorities that disproportionately …