Digital Commons Network^™

Building Adolescents' Social Emotional Wellness Through Physical Fitness Programming, Serena Mora, Tania Rosa Otd, Otr/L

Occupational Therapy Doctorate Capstones

Neurodivergent (ND) adolescents tend to struggle with participating in physical activity (PA) compared to their neurotypical (NT) peers. Current programs available that focus on PA are competitive and can add anxiety to an already difficult adjustment. This scoping review investigates the effect of participation in PA on behaviors and well-being connected to ND conditions.

A Multifaceted Approach To Managing Agitation In Assisted Living Residents With Dementia ​, Emily Hamed

Occupational Therapy Doctorate Capstones

Purpose: Dementia is a growing concern and will continue to increase. One symptom of dementia is agitation, which can be disruptive in an assisted living facility (ALF) and can impact quality of life for residents and caregivers/staff. Evidence shows that creating a conducive environment and equipping staff with skills can lead to better resident outcomes (Wong et al., 2024). This capstone project aims to address agitation by implementing physical and social environmental modifications in an (ALF). Design: This quasi-experimental mixed methods design will be conducted in an ALF to measure resident agitation pre and post intervention and staff confidence in …

Teacher Perceptions Of The Impact Of Sensory Integration And Processing On Student Occupational Engagement, Kyla Campbell, Colleen Cameron Whiting

Occupational Therapy Doctorate Capstones

Sensory Integration (SI) is defined as the brain's ability to organize and respond to information within the body and environment. School-aged children begin school with varying difficulties in SI and processing, which affects their social and academic performances. The field of occupational therapy (OT) promotes engagement in meaningful activities, in which going to school and participating in activities is vital to a child's development and wellbeing. The school setting is the second-largest employer of occupational therapy practitioners (OTPs) in the United States. Children with SI and processing difficulties have decreased participation in the classroom compared to their peers with typical …

Utilization And Impacts Of Pediatric Caregiver Programming On Therapeutic Engagement And Wellbeing: A Pilot Program, Venisa Rodriguez, Tania Rose Otd, Otr/L

Occupational Therapy Doctorate Capstones

Purpose: The proposed doctoral capstone aims to measure the utilization and impacts of pediatric caregiver programming on therapeutic engagement and wellbeing. A scoping literature review and needs assessment of pediatric caregivers of children receiving OT services found that limited access to quality, caregiver-specific resources and programming impact the wellbeing of caregivers, their ability to care for their child, and their confidence and ability to engage in the therapeutic process. The literature points to a want and need for caregiver-specific programming and the use of a family-centered care approach to improve caregiver and child outcomes.

Design: This study will utilize a …

Development Of A Unique Surgical Implant To Address The Development Of Iatrogenic Trigeminal Neuralgia Following Maxillomandibular Advancement Surgery For Osa, Erika L. Manning, Kun Yoon, Robert Diecidue, Joseph Harrington

Department of Oral and Maxillofacial Surgery Faculty Papers

A 58 y/o male with no significant past medical history presented in 2021 with obstructive sleep apnea (OSA), including trouble breathing through his nose due to hypoplastic maxilla, retrognathic mandible and chin, and microgenia. He underwent a LeFort 1 maxillary osteotomy, bilateral sagittal split osteotomy (BSSO), and genioplasty with fat graft on 2/10/2022. Postoperatively, the patient developed moderate pain and facial edema, which progressed into hypoesthesia with pain in the face with a sensation of fullness in the left ear and left masseter tightness. He also developed a positive Tinel sign in the left mandibular area and was diagnosed with …

Evaluating The Impact Of A Meaningful Recognition Bundle On The Health Of The Emergency Department Work Environment And Emergency Nurse Burnout, Sean Truesdell

Doctoral Projects

Background: The health of the work environment significantly influences emergency nurse practice. The Emergency Nurses Association and the American Association of Critical-Care Nurses have called for the establishment of a healthy work environment (HWE) to improve outcomes, reduce burnout and turnover, and increase job satisfaction. Meaningful recognition is consistently among the lowest-performing HWE standards. Purpose: To implement a bundle of meaningful recognition elements in the Emergency Department (ED) and evaluate the outcomes. Methods: A quality improvement project was conducted in the ED of a non-profit community health system in Northern California. The Healthy Work Environment Assessment Tool (HWEAT) and Oldenburg …

Metabolic Dysfunction And Metabolic Management In Episodic Migraine, Delora E. Denney, Michael J. Marmura

Department of Jefferson Headache Center Papers and Presentations

PURPOSE OF REVIEW: Evidence suggests a significant link between migraine and metabolic syndrome,, especially in those with chronic or refractory migraine. Weight loss and exercise may effectively prevent migraine. Here, we review the evidence behind exercise and weight loss as migraine treatments.

RECENT FINDINGS: While metabolic syndrome and pain have long had a known association, only recently have strong studies demonstrated a higher risk of developing metabolic syndrome in people with migraine. Additionally, other sequelae of metabolic syndrome, obesity, hypertension, hypercoagulability, and diabetes also interplay with migraine. New medications like GLP-1 agonists may be a potential treatment for migraine as …

Experiences Of Discrimination, Paternal Support, And Hypertensive Disorders Of Pregnancy (Hdp) In The Miehr Study, Houston, Texas, Kristina Walker Whitworth

Faculty, Staff and Students Publications

Background: Discrimination is a psychosocial stressor that, through activation of stress-response pathways, may influence risk of adverse perinatal health outcomes. However, few studies have evaluated the association between discrimination and hypertensive disorders of pregnancy (HDP), and none have explored effect modification by race or paternal support, which may buffer the adverse effects of discrimination.

Methods: We included 1,847 non-Hispanic Black and White participants from the Maternal and Infant Environmental Health Riskscape (MIEHR) study. Krieger's validated Experiences of Discrimination (EOD) scale was used to assess occurrence (yes/no) and frequency (once, 2-3, ≥ 4 times) of discrimination in nine situations. We created …

Personalized Treatment Of Chronic Tendinopathy Using Ultrasound And Neuroimmune Markers: A Narrative Review, Rohan Phadke, Samer Salman, Kirtan Patel, Jad Wardeh, Akhil Marupudi, Rahul Kumar, Arbaz A. Momin, Alireza Tavakkoli

Department of Neurosurgery Faculty Papers

Introduction: : Chronic tendinopathy affects approximately 30% of musculoskeletal consultations, yet treatment outcomes remain inconsistent despite numerous available interventions. This variability stems from the absence of validated frameworks to match individual patients to optimal treatments based on underlying pathophysiology. To synthesize current evidence on ultrasound imaging biomarkers, neuroimmune mechanisms, and interventional therapies in chronic tendinopathy, and propose a clinically applicable framework integrating ultrasound phenotyping with neuroimmune assessment to guide personalized treatment selection. Methods: A systematic literature search was conducted across PubMed, Scopus, and Web of Science through December 2025. Studies examining ultrasound/elastography imaging, neuroimmune mechanisms, or treatment interventions in chronic …

Innovative Framework And Checklist For Enhancing Interprofessional Education: A Literature Review Of Program Design, Delivery, And Outcome Measurement, Stacy Castronova, Lori Rainchuso

Journal of Innovation in Health Sciences Education

Introduction: This dual-focused study aimed (1) to conduct a comprehensive literature review of interprofessional education (IPE) initiatives across health disciplines to examine collaboration patterns, delivery methods, validated assessment tools, and outcome measures and (2) to develop an evidence-informed framework and checklist, based on the findings and identified gaps, to improve the standardization and reporting of IPE programs.

Methods: A comprehensive literature search was conducted across three professional databases, targeting peer-reviewed publications from 2012 to 2024. Inclusion criteria prioritized studies that provided detailed descriptions of IPE intervention delivery, utilized validated measurement tools, and demonstrated participant engagement to ensure the selection …

Nurse-Driven Palliative Care Screening Tools In The Icu, Olivia Sarkis Bsn, Rn, Fiona Hill Bsn, Rn, Isak Madden Bsn, Rn

Nurse Residency

PICOT Question: In adult ICU patients, how does implementing a nurse-driven palliative care screening tool, compared to provider-discretion palliative care consultation, affect rates of palliative care consultation in the ICU?

Investigating Speech-Language Pathologists’ Perceptions On Bilingual/Multilingual Aac Intervention And Quality Of Care, Lillian D. Griffith

Communication Disorders and Occupational Therapy Undergraduate Honors Theses

This study examined U.S.-based speech-language pathologists' (SLPs) perceptions of bilingual/multilingual AAC service provision and the barriers SLPs encounter to determine if SLP beliefs align with practices. An anonymous survey was distributed to 307 ASHA-certified SLPs, resulting in 21 completed responses. The survey consisted of questions that gathered information on participant demographics, caseload, perceptions/beliefs, and practices, with optional open-ended questions for additional context. SLPs in the participant sample strongly believed that AAC intervention should occur in all the languages spoken by the client. Despite this belief, they struggled to implement it due to barriers. Key barriers identified included SLP language limitations, …

Aspirin And Preterm Birth Among Pregnant People With Increased Heat Exposure: Secondary Analysis Of A Randomized Clinical Trial, Gabriella Meltzer, Luke Duttweiler, Sarah Saleem, Kartik Shankar, Manolo Mazariegos, Antoinette Tshefu, Jackie Patterson, Elwyn Chomba, Waldemar Carlo, Shivaprasad Goudar, Richard Derman, Archana Patel, Patricia Hibberd, Edward Liechty, Fabian Essamai, Edwin Asturias, Denise Babineau, Janet Moore, Cascade Tuholske, Andrew Zimmer, Brent Coull, Elizabeth Mcclure, Robert Goldenberg, Nancy Krebs, Matthew Hoffman, Blair Wylie

Global Health Articles

IMPORTANCE: Scalable interventions are urgently needed to mitigate the adverse effects of heat on pregnancy and newborn health.

OBJECTIVE: To evaluate whether low-dose aspirin modifies the association between heat exposure and preterm birth.

DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis of the Global Network for Women's and Children's Health Research Aspirin Supplementation for Pregnancy Indicated Risk Reduction in Nulliparas (ASPIRIN) randomized, double-blinded, placebo-controlled clinical trial was conducted from March 2016 to June 2018. Statistical analyses were performed from June 2024 to June 2025. The study settings included the Democratic Republic of Congo, Zambia, Kenya, Guatemala, Pakistan, and Belagavi and Nagpur, …

Remimazolam As A Sedative For Endoscopic Procedures: A Scoping Review, Hamzha Aysheh, Megan Henderson, Megan Hinkle, Sara Holton, Spencer Turner, Dwayne Accardo Dnp, Ccrn, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Propofol is commonly used for procedural sedation during endoscopic procedures because of its rapid onset and short duration; however, its use is frequently associated with adverse effects such as hypotension, hypoxemia, respiratory depression, bradycardia, and injection site pain. As diagnostic endoscopic procedures continue to increase, particularly among older and medically complex patients, there is a growing need for sedative agents that provide effective sedation while minimizing perioperative risk. Remimazolam, a novel ultra–short-acting benzodiazepine metabolized by tissue esterases, has demonstrated favorable hemodynamic stability and a reduced adverse effect profile in recent literature. The purpose of this evidence-based quality improvement project …

Impact Of Nitrous Oxide Analgesia On Labor Experience, Kierra Jones Rn, Bsn, Elyzabeth Morales Rn, Bsn, Lanitra Ray Rn, Bsn, Rhonda Johnson Dnp, Cne, Cnm, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

Nitrous oxide (N₂O) has re-emerged in the United States as a labor analgesia option that supports mobility, autonomy, and patient-centered care. As nurses increasingly support low-intervention and physiologic birth approaches, understanding the effectiveness and safety of nitrous oxide for low-risk laboring individuals is essential. This scoping review examines current evidence on nitrous oxide use during labor, focusing on maternal pain management, satisfaction, and neonatal outcomes to inform evidence-based nursing and midwifery practice.

Methods

A scoping review was conducted using PubMed, CINAHL Complete, and the Cochrane Library between September and October 2023. Inclusion criteria consisted of English-language studies published within …

Comparative Effectiveness Of Immunotherapy Alone Or With Chemotherapy As First-Line Treatment For Marginal Zone Lymphoma, Adam Olszewski, Thomas Ollila, Dai Chihara, Geoffrey Shouse, Natalie Grover, Reem Karmali, Pallawi Torka, Colin Thomas, Praveen Ramakrishnan Geethakumari, Stefan Barta, Nancy Bartlett, Narendranath Epperla

Cardeza Foundation for Hematologic Research

No abstract provided.

Patterns Of Acquisition For /ɹ/ Across Phonetic Contexts, Hailey Nielson

All Graduate Reports and Creative Projects, Fall 2023 to Present

Purpose: 

This study examined longitudinal changes in /ɹ/ production (i.e., the “r” sound) among 14 children aged five to seven at risk for persistent speech sound disorders (SSDs). Children at risk for SSDs show slower or atypical development of /ɹ/, yet little is known about which early patterns predict persistent difficulty, making it difficult for clinicians to prioritize caseloads and provide timely intervention. Using perceptual accuracy ratings across varied /ɹ/ contexts, we modeled growth in /ɹ/ accuracy across different word contexts and evaluated the extent to which early accuracy and changes in /ɹ/production predicted mastery at age seven.

Methods: 

Longitudinal …

Challenging Myths In Speech-Language Pathology: A Scientific Review Of Augmentative And Alternative Communication (Aac) Use, Bilingualism, And Late Talking, Mariah Morris

Undergraduate Honors Capstone Projects

Persistent myths within the field of speech-language pathology continue to influence clinical decision-making and contribute to biases experienced by both providers and clients. This scientific review examines common misconceptions surrounding late talking, bilingualism, and augmentative and alternative communication (AAC) by evaluating current evidence-based research. Specifically, this review addresses three central questions: Do children outgrow late talking? Does bilingualism cause language delay in children? Does AAC hinder speech development? 

An analysis of multiple peer-reviewed studies revealed little statistical support for the belief that bilingualism or AAC use causes language delays. Instead, research indicates that factors such as limited access to language-rich …

Connecting With Augmentative And Alternative Communication Users: An Internship Report, Karaline Kerzie

Communication Disorders and Occupational Therapy Undergraduate Honors Theses

This article evaluates and reflects on personal experiences working with children with autism in an early intervention, multidisciplinary setting. Implementation of Applied Behavior Analysis, Speech-Language Pathology, Augmentative and Alternative Communication, and Occupational Therapy techniques created a multifaceted and comprehensive intervention environment in a free-clinic setting.

Voices Of Men In Diabetes Care: Evaluating Participant Satisfaction With A Men's Diabetes Management And Self-Care Program, Elida Herrera

Open Access Theses & Dissertations

Background: Hispanic populations in the US experience higher diabetes prevalence, yet Hispanic men participate in traditional diabetes education programs at lower rates than non-Hispanic White men and Hispanic women, in part because existing programs lack cultural and gender-relevant tailoring. To address this disparity, the Diabetes Garage (DG) program was developed for Hispanic men in Southwest Texas, leveraging car culture by using automotive maintenance analogies to illustrate diabetes self-management concepts to engage men. Purpose: To evaluate participant satisfaction with the DG program among cohorts participating across three predominantly Hispanic communities and to examine their personal opinions on their program experience. Methods: …

Caregiver Experiences During Mealtime In Families Of Children With Feeding Disorders In The Borderland, Chyanne Reveles

Open Access Theses & Dissertations

This study examines the lived experiences of caregivers of children with pediatric feeding disorders (PFDs) in the Paso del Norte Region using interpretative phenomenological analysis (IPA). Pediatric feeding disorders require sustained medical, social, and emotional demand, often placing caregivers in complex decision-making roles. Understanding how cultural beliefs and context shape caregiving practices is essential to improving services provided by speech-language pathologists and other service providers. The qualitative research approach used facilitated the discovery of themes surrounding the lived experience of the caregivers of children with feeding disorders. Semi-structured interviews were conducted via Zoom with caregivers residing in the U.S.-Mexico border …

Qualitative Beta-2-Adrenoceptor Signaling In The Regulation Of Human Airway Epithelia Mucin And Cytokine Production, Fred Graumuller, Diana Cervantes, Tung O. Chan, Niccolette Schaunaman, Dominic R. Villalba, Burton F. Dickey, Julia K. L. Walker, Hong Wei Chu, Raymond B. Penn

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

BACKGROUND: Numerous in vivo studies have demonstrated beta-2-adrenoceptor (β2AR) -agonism as permissive in the development of allergic lung inflammation, and have implicated the arrestin-dependent signaling arm of the β2AR in mediating this effect. However, the specific cell type(s) mediating β2AR regulation of allergic lung inflammation remain unestablished.

METHODS: To explore the potential contribution of airway epithelia in this phenomenon, we compared the ability of ractopamine (RP), recently identified as a Gs-biased beta-agonist, to that of the unbiased/balanced beta-agonist albuterol (ALB), on IL-13-stimulated mucin and cytokine production in human airway epithelia cultures in air-liquid interface (HAE).

RESULTS: ALB, which activates both …

Treatment And Interventions For Sexual Assault In Humanitarian Contexts: Addressing Gaps In Refugee And Idp Camp Care In Myanmar, Erin Nash

Capstone Experience: Master of Public Health

Sexual and gender-based violence (SGBV) remains a pervasive yet under-addressed issue in humanitarian settings. Refugee and internally displaced person (IDP) camps along the Thai– Myanmar border represent a complex nexus of protracted displacement, ethnic conflict, and limited access to medical and psychosocial care. Although the prevalence of sexual assault in these contexts is well-documented, there is a critical gap in the literature regarding effective, context-specific treatment and intervention strategies. This capstone project conducts a comprehensive review of existing research on sexual assault care in humanitarian crises worldwide and assesses its applicability to displaced ethnic minorities from Myanmar. The analysis considers …

Plan To Develop A Theory-Based Diabetes Social Media Campaign For Spanish-Speaking Adults In Finney County, Ks: Integration Of A Promotora, Focused Discussion Groups, And Community Feedback To Ensure Cultural Appropriateness, Julevi P. Bernido

Capstone Experience: Master of Public Health

The 2025 Community Health Needs Assessment (CHNA) shows that over 11% of adults in Finney County, Kansas, have diabetes, which surpasses both state and national averages. Census data from 2016-2020 indicate that 42.6% of residents ages five and older speak a language other than English at home, and 36.1% speak Spanish (United States Census Bureau, n.d.). The CHNA further highlights concerns about language and cultural barriers to care, especially among the Spanish-speaking population. Notably, 21.74% of residents have limited English proficiency—much higher than the state’s 12.1% (CHNA, 2025).

This capstone will develop a theory-based social media campaign plan to support …

A Literature Review Of Estrogen Synthesis And Metabolizing Enzymes Produced By The Human Gut Microbiome And Their Correlation With Cancer, Rebecca Cederberg

Capstone Experience: Master of Public Health

The link between estrogen and cancer initiation or progression has been well established; such that the World Health Organization’s International Agency for Research on Cancer (WHO IARC) has classified several estrogen therapies and estrogenic compounds as group 1 carcinogens. Estrogen and/or its receptors have been associated with reproductive cancers such as breast, ovarian, endometrial, and prostate, as well as lymphomas, lung, and colon cancers. Additionally, elevated levels of estrogen and altered gut microbiomes are also associated with increased rates of breast cancer. More recently, microbial genes that are capable of synthesizing estrogen and deconjugating estrogen metabolites have been identified, and …

A Quality Improvement Project For Seizure Protocol, Billiejo N. Bates

Doctor of Nursing Practice Scholarly Project

Seizure disorders are often misunderstood and can carry stigmas, especially in institutional care settings where direct care staff knowledge and preparedness affect patient safety and quality of life. At Parsons State Hospital and Training Center (PSH&TC), staff lacked standardized training on seizures, and no formal seizure response protocol existed, which created gaps in care and reduced staff confidence. The purpose of this project was to improve staff understanding of seizures and establish a clear, consistent procedure for responding to seizure events. A pre- and post-survey design was used to measure staff knowledge, awareness, and confidence regarding seizure management. Between the …

Implementing An Online Mental Health Intervention For Educators, Angela Cheney

Doctor of Nursing Practice Scholarly Project

The primary objective of this project was to assess the impact of the New Directions Behavioral Health Employee Assistance Program, an online intervention, on teacher stress and well-being. Teacher participation was recruited through email, flyers, and in-person discussions. The study used a mixed-method design, including pre- and post-project surveys of the Perceived Stress Scale (PSS) to measure changes in stress, and the System Usability Scale (SUS) to evaluate the ease of use of online intervention. The intervention aimed to increase teachers’ self-awareness of stress and anxiety, provide strategies for prevention and early intervention, and support overall mental wellbeing. Paired-samples t …

The Critical Period In Stroke Recovery: The Impacts Of Early Physical Therapy, Katherine Cecil

Undergraduate Theses and Capstone Projects

Strokes are the leading cause of long-term disability in the United States, with recovery outcomes varying widely depending on the timing and quality of rehabilitation provided. Evidence suggests that there is a critical neuroplasticity window within the first 72 hours after a stroke's onset. This window can offer heightened potential in recovery outcomes; however, clinical guidelines are inconsistent in giving a timeline for stroke rehabilitation initiation. There are conflicting views and findings regarding early mobilization following a stroke. Some research points towards early initiation of rehabilitation enhancing recovery outcomes, while others caution against early movement and activity, specifically in patients …

Medical Simulation In Toxicology: Enhancing Clinical Competence, Decision Making And Patient Care In Resource-Limited Settings, Rakesh Ghimire, Anjana Thapa, Sanjeev Kharel, Shristi Kharel Ghimire, Rabin Basnet, Farshad Mazda Shirazi, Allan J. Hamilton

Research outputs 2022 to 2026

Medical simulation has emerged as a transformative approach in toxicology education. By providing immersive, hands-on experience, simulation enhances learner engagement, critical thinking, and long-term knowledge retention while offering a safe environment to practice clinical decision-making without jeopardizing patient safety. Despite these advantages, the integration of simulation-based training remains limited in low-and middle-income countries (LMICs) due to resource constraints, lack of standardized curricula, and limited access to high-fidelity simulators. Additionally, little research has explored its optimal application in these settings. This review explores available evidence regarding the effectiveness of medical simulation in the diagnosis and treatment of toxicological emergencies in LMICs. …

Art Therapy And A Strength-Based Approach For Working With Children With Emotional And Behavioral Challenges: A Qualitative, Arts-Based Study, James D. Wyld

Expressive Therapies Theses

Abstract

            Children with emotional and behavioral challenges represent a vulnerable population that needs more attention and innovative forms of treatment. The behavior of these young people is often marked by impulsive behaviors and intense emotions in the process of getting their basic needs met. The current study explores how a combination of art therapy and a strength-based approach is beneficial and appropriate for children in a behavioral based therapeutic school. Progress was traced through one singular client in both group and individual settings over the course of 6 months. Interventions varied with the goals of increasing self-awareness, fostering autonomy, increasing …