Diseases Commons^™

Chronic Stressors, Obesity Pathogenesis, And The Moderating Effect Of Internalized Weight Stigma; A Quantitative, Illinois Study, Karyn Byrne

Dissertations

The obesity epidemic is a ‘wicked’ problem with a complex web of determinants and outcomes. While generally higher for minoritized populations, prevalence rates manifest in surprising, nonlinear patterns. There is no consensus regarding treatment protocols or mitigation efforts, except that current efforts remain largely ineffective. Much research evidence that a profusion of determinants of health support obesity pathogenesis through various physiological processes and mechanisms, including the allostatic load, mitochondria functioning, the gut microbiome, and epigenetics. Intervening to support markers of the allostatic load (immunity, inflammation, and metabolic health) may provide a more effective treatment outcomes than traditional approaches, which tend …

Patient-Centered Preimplant Education Session And Bi-Weekly Text Message Adherence Reminders In Patients With A Newly Implanted Cardiomems® Device: A Quality Improvement Study, Elizabeth M. Miller, Alicia Abboud, Audrey Cooper

Doctor of Nursing Practice Projects: College of Nursing

Rationale

Heart failure is a deadly disease, affecting over 6.2 million individuals and costing the United States an estimated 30.7 billion dollars (Virani et al., 2020). By 2023, heart failure costs in the United States are estimated to grow to 70 billion dollars with 75-80% of these costs attributed to inpatient hospitalizations (Heidereich et al., 2022). The CardioMEMs® is a small device placed in the patient’s pulmonary artery via a minimally invasive procedure by an interventional cardiologist. The use of remote patient data from the CardioMEMs® device has been shown to reduce hospital re-admissions, facilitate tailored medication management, detect increased …

Implementing A Standardized Protocol For Early Detection Of Undiagnosed Hypertension Patients, Jenscena Hansen, Chris Bell

Doctor of Nursing Practice Projects: College of Nursing

Introduction: Hypertension is a preventable disease that frequently goes unrecognized and undertreated. Early diagnosis can prevent further comorbidities such as heart disease, stroke, and chronic kidney disease. Implementation of this protocol aims to decrease the number of patients with undiagnosed hypertension and increase the identification of patients with elevated blood pressure who did not have a pre-existing diagnosis of hypertension. The goal of implementing a standardized protocol would help eliminate the number of patients who go undiagnosed.

Methods: This quality improvement design had clinical staff flag patients with elevated blood pressure. Identified patients without a diagnosis of hypertension were educated …

Development And Implementation Of An Evidence Based Practice Guideline Related To The Management Of Adult Angioedema, Megan Przybysz

Doctor of Nursing Practice Scholarly Projects

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for …

Playing It Sun Safe: A Quality Improvement Project, Sarah P. Tarr, Kathryn K. Dambrino, R. David Phillippi, Ashley Karpinos

DNP Scholarly Projects

Background: Athletes who play outdoor sports have multiple risk factors for the development of skin cancer. Literature highlights the need for the use of evidence-based strategies to improve the knowledge and utilization of sun protection practices in this high-risk population. Methods: Playing it Sun Safe was a multifaceted skin cancer prevention initiative implemented in a population of collegiate soccer athletes in collaboration with a university athletic department and campus health clinic. Evidence-based interventions were designed through application of the Health Belief Model (HBM) and were implemented using the Institute for Healthcare Improvement (IHI) quality improvement framework. Purpose: The two-fold aim …

Best Screening: Introducing The Neonatal Assessment Visual European Grid To Nicus In Tennessee, Gabrielle Sledge

OTD Capstone Projects

Blind Early Services Tennessee (BEST) is an early intervention agency that serves children ages 0-5 with visual impairments across Tennessee. BEST serves over 200 children and families across the state offering early intervention (BEST Start), parent empowerment (BEST Advocate), and family support (BEST Together) programming. The purpose of this project was to assist in the implementation of an early identification initiative (BEST Screening) using the Neonatal Assessment Visual European Grid (NAVEG). The NAVEG is a newborn vision screening shown to identify neurological risk for visual impairments. The long-term goal of this program is to promote the screening and early identification …

Diabetic Coaching Program To Improve African American Patients Glycemic Control, Shonda Moore

Student Scholarly Projects

Practice Problem: The purpose of the practice problem was to find out if, among African Americans with type II diabetes who are over 18, adopting a diabetic coaching program that emphasizes diet management can result in better glycemic control over 10 weeks than for those who do not receive coaching.

PICOT: In African Americans with type II diabetes over 18 years of age (P), does a diabetic coaching program on diet management (I), compared to no coaching program (C), improve glycemic control (O) over 10 weeks (T)?

Evidence: The evidence used to guide this project came from databases, including PubMed, …

The Impact Of Covid-19 On The Utilization Of Early Magnetic Resonance Imaging (Emri) In The Assessment Of Acute Uncomplicated Low Back Pain (Lbp) And The Subsequent Effect On Health Care Service Utilization And Patient Outcomes, Kimberly Radcliffe

MUSC Theses and Dissertations

OBJECTIVES: To examine changes in MRI rates between Pre-COVID-19 period (Feb-April 2019) and COVID-19 period (Feb-April 2020) among commercially insured patients aged 18-60 with a diagnosis of acute LBP, and to analyze differences in patient characteristics and outcomes between the time periods. Additionally, to examine the impact of eMRI on patient outcomes and health care costs for patients in the COVID-19 period.

DESIGN/METHODS: Using IBM® MarketScan® Commercial Database (MarketScan) we performed a quantitative pre-post comparative retrospective observational study of 117,150 total patients to examine adjusted differences in patient characteristics and rates of MRIs between time periods. We analyzed 49,020 patients …

Hand Tremor Stabilizer, Krishna Sai Bathini, Ryan Herrmann, Madeleine A. Beaupre

Biomedical Engineering

The Hand Tremor Stabilizer project represents a significant advancement in assistive device technology, aimed at improving the lives of individuals affected by hand tremors due to conditions such as essential tremor or Parkinson's disease. Throughout the design process, our team engaged in a comprehensive approach that included rapid prototyping, iterative testing, and direct feedback collection from potential users. This process was instrumental in refining the device to meet specific user needs effectively.

Key customer requirements that guided the design of the Hand Tremor Stabilizer included ease of use, portability, washability, accuracy of motion control, comfortable grip, breathability, a natural feel …

Can Mirna Be The Missing Link Between Parkinson’S Disease And Pesticides?, Fatma Gobba

Theses and Dissertations

Parkinson’s disease (PD) is a common neurodegenerative condition that leads to significant morbidity and a decline in the quality of life. It develops as a consequence of the loss of dopaminergic neurons in the substantia nigra pars compacta. Nevertheless, the development of PD is influenced by environmental factors, and the intricate nature of these relationships is further complicated by a multitude of factors, including the genetic backgrounds that are specific to populations and variations in environmental exposures, such as pesticides. Pesticides, consisting of a diverse family of chemicals commonly used in both agricultural and household settings to protect crops against …

Impairment Of The Glial Phagolysosomal System Drives Prion-Like Propagation Of Huntington’S Disease, Graham Davis

Theses and Dissertations

The ability of glia to tightly regulate neuronal health and homeostasis in the CNS is conserved across species. Yet, despite the ability to degrade protein aggregates, glia are vulnerable to the accumulation of neurotoxic amyloid aggregates during neurodegenerative disease progress, and even exacerbate their spread. A developing narrative highlights glia as a double-edged sword in neurodegenerative diseases: initially capable of dynamically responding to amyloid aggregate-ladened dying neurons but also capable of inducing chronic inflammation and creating seeding-competent amyloid oligomers. Thus, uncovering the mechanisms that allow glia to control aggregate deposition while preventing the neurotoxic effects and seed generation is vital …

Clustering Of Patients With Heart Disease, Mukadder Cinar

Dissertations, Theses, and Capstone Projects

Heart disease, a leading cause of mortality worldwide, presents complex challenges in public health due to its varied manifestations. Accurate diagnosis and patient stratification are essential for effective management and improved outcomes. In response, this study employed machine learning techniques to analyze heart disease data obtained from UCI Machine Learning Repository, aiming to enhance patient care through advanced data analysis.

The study began with the application of K-Nearest Neighbors (KNN) classification, which categorized patients into 'Disease' and 'No Disease' groups. This preliminary step provided initial insights into the structure of the dataset. Subsequently, K-means clustering was applied in two rounds, …

The Impact Of Simulated Image Acquisition Time Reduction On Image Quality And Parameters Of Myocardial Perfusion Imaging Using A Dedicated Cardiac Camera, Alireza Khatami

Electronic Thesis and Dissertation Repository

Heart disease is the second leading cause of death in Canada, highlighting the crucial role of early diagnosis in disease management. Myocardial perfusion imaging (MPI), is widely employed for this purpose, involves injecting a radiopharmaceutical into the body, imaging its distribution with a gamma camera, and revealing cardiac blood flow patterns. A significant challenge in MPI is the lengthy 8 to 10 minutes required for stress and rest imaging, potentially causing patient discomfort and compromising image quality due to movement. In a clinical study with 26 patients, post-processed data manipulation simulated a reduction in MPI imaging time. The findings indicated …

Effect Of Acute Care Discharge Delays On Inpatient Rehabilitation Facility (Irf) Utilization, Eric Garrard

Student Dissertations

Discharge delays present hospitals with challenges in managing costs for Medicare admissions. Meanwhile, Inpatient Rehabilitation Facilities (IRF) are subject to strict pre-admission requirements that can complicate efficient transitions of care for patients with intensive rehabilitation needs. The purpose of this retrospective quantitative correlational study was to examine any relationship between acute care discharge delays and IRF utilization. This study investigated whether length of stay (LOS) and Medicare Advantage prior authorization requirements impact IRF referrals by reviewing 3,747 medical records of acute stroke patients aged 65 years and older at a regionally integrated healthcare system over a 3-year period (2020- 2022). …

Gut Dysbiosis Correlates With Covid-19 Severity, Ednita Escobar

CMC Senior Theses

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) impacts not only respiratory but also gut and oral microbiomes, influencing the manifestations of COVID-19. Each person’s unique microbiome consists of microorganisms such as bacteria, fungi, and viruses, some of which are symbiotic and others potentially harmful. Alterations in the gut microbiome, specifically, can affect the severity and symptoms of COVID-19. A review of studies indicate a pattern of gut dysbiosis in COVID-19 patients characterized by a decrease in beneficial microbiota and/or an increase in opportunistic pathogens. This gut imbalance correlates with disease severity, suggesting that the gut microbiome plays a significant role …

Addressing Disparity: A Waiting Room Intervention For Preeclampsia Prevention In African Americans, Morgan Semana

Nursing | Senior Theses

Maternal mortality is a pressing, global concern that particularly affects African American women in the United States. African American women face disproportionately a high maternal mortality rate (MMR), with rates more than double that of white women. Preeclampsia emerges as the leading cause of maternal mortality in African American women, driving the need for targeted interventions. To address this issue, a proposed research study aims to investigate the impact of a nurse-led, waiting room, preeclampsia and aspirin effectiveness educational intervention on the knowledge and preeclampsia rates among African American women. The study draws upon existing evidence that supports the use …

Driven By Change: The Impact Of Macroeconomic Shifts And Covid-19 On New Vehicle Sales, Jackson Aldrich

CMC Senior Theses

This paper examines the impact of macroeconomic factors and the COVID-19 pandemic on new vehicle sales. In order to address these two topics, a two-pronged approach was used with separate regression models. The macroeconomic variables include monthly supply of new homes, CPI for urban public transportation, unemployment rate, disposable personal income, inflation expectation, consumer sentiment, average gas prices, and total vehicle miles traveled which were regressed on total vehicle sales from 1978-2022. The regression results confirmed and supported current literature and highlighted the importance of the housing market and unemployment rate on new vehicle sales. The COVID-19 pandemic model variables …

Employees' Perception Of The Management Of The Covid-19 Crisis At Najran University, Saudi Arabia, Noora Nasser Alsuhaibani

Dissertations

Problem

During the COVID-19 crisis, particularly in the context of Saudi education, the ability to physically attend schools and colleges was greatly hindered due to the widespread transmission of the virus and the resulting obstacles. The issues necessitated the use of crisis management strategies. Some Saudi universities are capable of implementing an organized plan both before to and during crisis management, whereas others lack this competence. This is a substantial problem. Several universities in Saudi Arabia effectively managed the COVID-19 epidemic, whereas others did not. Furthermore, prior studies on crisis management indicate that administrators exhibit diverse responses. By participating in …

Numerical Investigation Of Subglottal Stenosis Effects On Human Voice Production, Dariush Bodaghi

Electronic Theses and Dissertations

This dissertation aimed to advance knowledge of how subglottal stenosis impacts voice production physiology. An in-house fluid-structure-acoustic interaction approach based on the hydrodynamic/acoustic splitting technique was employed. This technique was rigorously verified for simulating phonation by matching the acoustic behavior to a compressible flow solver for phonation-relevant geometries. Simulations of an idealized 2D vocal tract model demonstrated the effects of supraglottal acoustic resonance on vocal fold kinematics and glottal flow waveform. Results showed that the acoustic coupling between higher harmonics and formats generated pressure oscillations, modifying vocal fold dynamics and glottal flow rate.

A major novelty was the incorporation and …

Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso

Master's Projects and Capstones

Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.

Context: The endocrinology clinic serves a patient population, …

Patient Education Improvement Initiative For Self-Management Of Congestive Heart Failure Among Senior Residents Of A Long-Term Care Facility, Abigail A. Abella, Brooke Sheck, Daniela Ramos, Ivy H. Nguyen, Mary Tran, Roshni Nagarajan

Master's Projects and Capstones

The purpose of this quality improvement project was to use evidence-based practices to determine if personalized education on disease self-management would lead to improved treatment adherence in a residential facility. The target population consisted of four elderly female patients who had been diagnosed with congestive heart failure (CHF) and were struggling with the self-management of their disease. Contributing barriers to effective CHF self-management were determined using a root cause analysis, and included a lack of educational templates, declining cognitive ability of the residents, and no electronic health record (EHR). Using the Self-Determination theory, the interventions were implemented. Phase one was …

Using Noninvasive Calibrated Cuff Plethysmography To Observe The Effects Of Cold-Water Immersion On Arterial Compliance, Rita M. Grigorian

Biomedical Engineering: Graduate Reports and Projects

As the prevalence of cardiovascular diseases continues to exponentially grow in populations across the globe, the necessity of determining underlying factors, effective methods of diagnoses, and universally available preventive measures also grows. Early detection of endothelial dysfunction, a proven precursor of cardiovascular diseases, can be extremely impactful in encouraging preventative measures and early intervention before medical conditions become chronic. In recent years, ice plunging, a form of cryotherapy involving full body immersion in cold water, has gained popularity within circles of fitness and health practitioners, gaining the interest of people of all backgrounds. Certain parallels observed between the human physiological …

Impacts Of Environmental Stressors On Native South Dakota Amphibian Physiology And Survival, Danielle Jean Galvin

Dissertations and Theses

Amphibian populations around the world are declining, with some of the most likely drivers behind these declines including emerging infectious diseases and environmental contaminants. To address major gaps in the current literature, I sought to evaluate the effect of two major environmental stressors on various aspects of amphibian physiology: emerging infectious diseases and environmental contaminants. Emerging infectious diseases of amphibians include fungal, viral, and parasitic pathogens which have expanded in host range, either geographically or in competent host species. Environmental contaminants include chemicals which may be naturally occurring in the environment, or which may be introduced to the environment, often …

Investigating The Effects Of Subchronic Dietary Zinc Supplementation On Diet-Induced Metabolic Dysfunction-Associated Steatotic Liver Disease., Oluwanifemi Esther Bolatimi

Electronic Theses and Dissertations

Zinc deficiency is associated with metabolic dysfunction-associated steatotic liver disease (MASLD). Previous studies show zinc supplementation improves steatosis, but its therapeutic effects in established MASLD remain unclear. We developed a model to characterize the effects of zinc supplementation on high-fat diet (HFD) induced MASLD and hypothesized established MASLD would be attenuated. Mice were fed control diet or HFD for 12 weeks and then grouped into normal or zinc-supplemented diets for 8 additional weeks. At euthanasia, plasma and liver tissues were collected for phenotypic analysis. Twelve weeks of HFD altered glucose clearance and body composition. Eight weeks of subsequent zinc supplementation …

Setting Goals For Patients With Type 2 Diabetes In Primary Care, Courtney Renee Padilla

Doctor of Nursing Practice

Background. Type 2 diabetes is prevalent amongst the Hispanic population and increases the risk of developing chronic serious health issues (CDC, 2022, April 4). Setting attainable and realistic goals for patients with type 2 diabetes is foundational in achieving glycemic control and improving quality of life (ElSayed et al., 2023a). Purpose. To increase goal setting in patients with type 2 diabetes in the primary care setting. Goal. To promote self-management in patients with type 2 diabetes. Objectives. 100% of staff and providers will attend an in-service on goal setting using a self-management goal tool; 75% of patients will choose to …

Ethanol Dysregulates Sirt1-Mediated Lipogenic Signaling Pathways Through Α4*-Nicotinic Acetylcholine Receptors In Hepatocytes., Caitlin Christina Wilkerson

Electronic Theses and Dissertations

Alcohol-associated liver disease (ALD) is a broad spectrum of diseases ranging from steatosis to severe hepatic cirrhosis, none of which have any FDA approved therapies. Downregulation of hepatic Sirtuin 1 (Sirt1) activity by ethanol has been shown to lead to an upregulation of the pro-lipogenic gene targets under its jurisdiction, resulting in increased lipogenesis and triglyceride accumulation. It was hypothesized that ethanol acts on α4*-nicotinic acetylcholine receptors (α4*-nAChRs) in hepatocytes to decrease Sirt1 expression, which ultimately dysregulates lipid metabolic homeostasis. Ethanol’s effects were investigated in cultured AML12 hepatocytes and in WT primary mouse hepatocytes acutely exposed to ethanol. Consistent with …

Interpretable Mechanistic And Machine Learning Models For Pre-Dicting Cardiac Remodeling From Biochemical And Biomechanical Features, Anamul Haque

All Dissertations

Biochemical and biomechanical signals drive cardiac remodeling, resulting in altered heart physiology and the precursor for several cardiac diseases, the leading cause of death for most racial groups in the USA. Reversing cardiac remodeling requires medication and device-assisted treatment such as Cardiac Resynchronization Therapy (CRT), but current interventions produce highly variable responses from patient to patient. Mechanistic modeling and Machine learning (ML) approaches have the functionality to aid diagnosis and therapy selection using various input features. Moreover, 'Interpretable' machine learning methods have helped make machine learning models fairer and more suited for clinical application. The overarching objective of this doctoral …

Human-Bat Interactions In A Disease Emergence Hotspot: Implications For Human Health And Bat Conservation, Reilly Tempest Jackson

Graduate Theses and Dissertations

Bats are an ecologically important taxon that can host zoonotic pathogens. Globally, many bat species are synanthropic and live closely with humans, often roosting in man-made structures. The spatial overlap between humans and bats creates opportunities for human-bat contact, which can lead to human exposure to bat-borne pathogens and conflicts that cause bat mortality. Despite this risk, little is known about the drivers and characteristics of these human-bat interactions in buildings and work is needed to understand this aspect of the wildlife-urban interface. In Chapter I, I present a literature review that identifies the geographic and taxonomic trends in reported …

Relative Hepatotoxocity, Carcinogenicity, And Toxicogenomics Of Select Dehydropyrrolizidine Alkaloids In Mice, Michael J. Clayton

All Graduate Theses and Dissertations, Fall 2023 to Present

Dehydropyrrolizidine alkaloids are arguably the most important plant derived toxins in terms of impact on human and animal health. Dehydropyrrolizidine alkaloids are a large group of chemically related compounds found in 3% of flowering plants worldwide. Human exposure occurs from ingestion of herbal products including teas supplements or contaminated grain. Animals are exposed through contaminated feed or grazing. There are at least 350 identified toxic PAs, from more than 6,000 plants. The toxins primarily cause liver damage, but some are proven to cause cancer. Indidvidual dehydropyrrolizidine alkaloids vary in their toxic effects. Riddelliine is the only dehydropyrrolizidine alkaloid with extensive …

Impact Of A Provider Flagging System On Increasing Ezetimibe Utilization In High-Cardiac Risk Adults, Janessa Creado

Student Scholarly Projects

Practice Problem: Cardiovascular disease continues to be the leading cause of mortality globally. Often, healthcare providers fail to follow evidence-based guidelines in their practice.

PICOT: In high cardiac-risk, adult patients with low-density lipoprotein cholesterol (LDL-C) levels greater than 70 milligram/deciliter (mg/dl) despite being on a maximum tolerated dose of statin (P), what was the effect of a provider flagging system to initiate ezetimibe (I) compared to standard care (C) on increasing the utilization of ezetimibe according to the 2018 American Heart Association (AHA) guidelines (O) within 8 weeks (T)?

Evidence: An extensive evidence literature review …