Digital Commons Network^™

Bridging The Gap In Patient Attendance: A Dnp-Led Quality Improvement Project To Reduce No-Show Rate By Implementing Text Message Reminders, Charles D. Rogers

Master's Theses or Doctor of Nursing Practice

Missed medical appointments contribute to revenue loss, workflow inefficiencies, increased staff burden, and reduced patient access to care in primary care settings. This Doctor of Nursing Practice (DNP) quality improvement project evaluated the impact of an automated text message (SMS) reminder system on no-show rates in a privately owned, medium-sized family practice in a rural setting, aiming to reduce the baseline no-show rate of 11.4% to 10% or less. Guided by the Model for Improvement and the Plan-Do-Study-Act (PDSA) framework, automated SMS reminders were sent 48 hours prior to scheduled appointments. Existing 24-hour phone call reminders were maintained. Formative assessments …

Embracing The Green Thumb: Occupation-Based Resources For Stroke Recovery, Brianna Padovano

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2026

Stroke recovery requires ongoing effort from survivors, caregivers, practitioners, and communities to promote meaningful participation in long-term engagement in daily life. Despite the growing amount of evidence supporting continued recovery beyond the acute stages of stroke, accessible resources that address the needs of these stakeholder groups remain limited (Chen et al., 2019). This doctoral capstone experience aimed to bridge these gaps through the development and dissemination of educational, clinical, and advocacy-based resources designed to support stroke rehabilitation across various stakeholders. An evidence-informed, occupation-based stroke recovery guide, which includes relevant theories, decision-making flowcharts, sample protocols, and resources, was created for new …

Breaking Barriers In Bariatric Care, Morgan Lapshanski

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2026

The doctoral capstone project titled Breaking Barriers in Bariatric Care was established to promote equitable care and increase the quality of healthcare services provided to bariatric patients. Breaking Barriers in Bariatric Care was implemented to address the areas of education, research, and advocacy. With the focus being on these areas, the student worked to promote levels of accessibility and inclusivity within the healthcare system. The capstone project included an asynchronous virtual educational program for healthcare students at Misericordia University to enhance knowledge in the areas of bias reduction, safe handling, and providing appropriate care to bariatric patients. The student conducted …

Hardin Health Link: A Community-Integrated Paramedicine (Cip) Program In Hardin County, Kentucky, Samantha Jones

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Rural and mixed rural–urban communities face persistent disparities in access to timely emergency medical services (EMS), contributing to preventable morbidity and mortality from time-sensitive conditions such as cardiovascular disease, stroke, and injury. Hardin County, Kentucky, reflects these challenges due to its geographically dispersed population, high burden of chronic disease, and variability in EMS response times. This capstone proposes Hardin Health Link, a Community-Integrated Paramedicine (CIP) program designed to expand the traditional role of EMS providers through in-home health assessments, chronic disease monitoring, post-discharge follow-up, medication reconciliation, and connection to clinical and social services.

Guided by an evidence-informed framework, the program …

Promoting Maternal And Infant Health In Franklin County, Ky: A Community-Based Physical Activity And Education Intervention, Subin Kim

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Maternal and infant health outcomes are key indicators of population health, yet persistent disparities exist in rural communities across the United States. In Kentucky, Franklin County reflects this pattern, with concerning maternal and infant health indicators despite relatively favorable socioeconomic conditions. Identified challenges include elevated rates of poor physical and mental health days, high drug overdose mortality, provider shortages, and ongoing reproductive health concerns such as tobacco use during pregnancy and increased infant mortality associated with elevated maternal body mass index.

To address these gaps, a three-pronged, community-based prenatal and postpartum physical activity and education program is proposed. The program …

Simulating Social Attitudes With Llms: Accuracy, Demographic Effects, And Refusal Behavior In The Sensitive Domain Of Suicide Prevention, Cristina J. Perez, Michael P. Vasquez Jr., Philippe J. Giabbanelli, Patrick Y. Wu

VMASC Publications

Large language models (LLMs) are increasingly used to simulate public opinion, yet their validity in sensitive policy domains remains underexplored. We evaluate whether LLMs can reproduce attitudes toward suicide prevention policies using 32 questions drawn from seven nationally representative U.S. surveys (2023-2025). We systematically vary demographic conditioning (race/ethnicity, gender, age, education, income, party), prompt framing (direct elicitation, respondent embodiment, specialist embodiment), and model architecture (GPT-5 Nano, DeepSeek V3.2, Meta Llama 3.1 8B, Mistral Small 24B). Across 811,560 prompts, the mean absolute error—the average gap between predicted and human response distributions—is 23 percentage points. We also find that LLM responses to …

Culturally Responsive Dialectical Behavior Therapy With Chinese Sexual And Gender Minority Individuals: A Qualitative Study, Weiyi Liao M.S.

Selected Full Text Dissertations, 2011-

Professional guidelines emphasize the importance of adapting evidence-based treatments to the cultural and contextual needs of minoritized populations. Although substantial research has examined lesbian, gay, bisexual, transgender, and queer (LGBTQ+) mental health, comparatively little is known about the psychotherapy experiences of Chinese sexual and gender minority individuals or how dialectical behavior therapy (DBT) may be delivered responsively with this population. DBT is an evidence-based treatment for emotion dysregulation, self-harm, and suicidal behavior that explicitly addresses the effects of invalidating environments. Because Chinese cultural contexts and LGBTQ-related minority stress may both shape emotional expression, help-seeking, and treatment experiences, this qualitative study …

Self-Assembly Of Anti-Inflammatory Peptide Amphiphiles For Mucosal Health, Maria José Gómara, Ignacio Pérez-Pomeda, Ramon Pons, Paul Ziprin, Carolina Herrera, Isabel Haro

CONRAD Publications

Broad spectrum anti-inflammatory peptide amphiphiles (AIF-PAs) have been developed as an innovative strategy for the treatment of chronic mucosal inflammation and the prevention of HIV transmission. Novel lipopeptides based on two linear sequences of anti-inflammatory peptides were obtained by solid-phase peptide chemistry. In a pilot study, ex vivo exposure of colorectal tissue explants from Crohn's disease patients to AIF-PAs induced a downregulation of the proinflammatory profile. Furthermore, the HIV inhibitory potency of AIF-PAs was evaluated ex vivo in colorectal tissue explants, obtaining sub-micromolar IC₅₀ values. Characterization of AIF-PAs self-aggregation in aqueous solution revealed that the net charge distribution within the …

Expanded Scorpionate And Siderophore-Inspired Ligands: From Foundational Designs To Modern Applications, Austin Winfield Medley, Trandon Allen Bender

Chemistry & Biochemistry Faculty Publications

Scorpionate ligands have been advanced significantly through systematic modifications of their apical atoms and heterocyclic arms, expanding their structural diversity and chemical reactivity. Recent biologically inspired variants now enable accurate modeling of complex bioinorganic motifs, such as the Fe₄S₄ clusters of nitrogenase, and support enzyme‐like reactivity under mild aqueous conditions. These developments have broadened the impact of scorpionate chemistry across bioinorganic modeling, homogeneous catalysis, and biorthogonal transformations. In particular, expanded tripodal scaffolds provide modular, tunable platforms for mimicking enzyme active sites and probing biological nitrogen fixation pathways. Beyond fundamental insight, these ligands present practical opportunities for sustainable catalysis by enabling …

Stronger Isn't Always Better: 1.5 Tesla Vs 3 Tesla Magnetic Resonance Imaging Scanners, Taylor Deiter

Student Research Poster Presentations 2026

Abstract

Magnetic resonance imaging (MRI) is an imaging modality that does not use ionizing radiation. Instead, MRI uses magnetic fields, gradience, coils, and radio frequency to provide anatomic and physiologic information. The purpose of the research study is to examine the strengths and weaknesses of a 1.5 tesla to a 3-tesla magnetic resonance imaging scanner. Cross sectional images are produced to better visualize muscles, organs, and soft tissues for diagnostic purposes. MRI screening and safety is a crucial part of the modality. The most common magnetic strength used for clinical diagnosis are 1.5 and 3 teslas. The higher the strength …

Moving Forward Together For Cancer Recovery: Collaborative Guide For Researchers And Cancer Care Organizations, M. Madison Kindred, Karen E. Wickersham, Daneille E. Ostendorf, Bernardine M. Pinto

Faculty Publications

No abstract provided.

Standards For Leadership In Oral Healthcare: Applying Local And Regional Standards In Practice, Teresa A. Dolan Dds, Mph, Facd, Robin Henderson Dds, Facd

Journal of the American College of Dentists

The dental profession has well-established standards governing clinical practice, education, and research, yet has lacked comparable standards to guide leadership behavior. The American College of Dentists (ACD) Standards for Leadership in Oral Healthcare Task Force developed a comprehensive framework spanning four levels: 1) core; 2) team; 3) local and regional; and 4) national and international. This article describes the local and regional standards, which include 10 standards organized into three themes—Building Foundation, Leading with Purpose, and Developing Others—and their application through interactive workshops at the ACD Spring Leadership Conference 2026. Using structured role-playing exercises, Section leaders and Regents stress-tested the …

Project Connect: Social Participation For Deafblind Individuals In Kentucky, Rebecca Jade Riegler

Occupational Therapy Doctorate Capstone Posters

For my capstone project, I collaborated with Kentucky DeafBlind Project (KDBP) to develop Project Connect, a pilot initiative aimed at encouraging social participation by creating regional social opportunities for DeafBind individuals across Kentucky. As my primary ACOTE focus area was program development, the goal was to create an accessible, sustainable model for ongoing social engagement and reduce isolation through structured community-based events.

A literature review and needs assessment identified a need for accessible, ongoing social opportunities for DeafBlind individuals across Kentucky, supporting the development of Project Connect.

Project Connect was designed as a replicable framework for regional Connect Day events. …

Designing Inclusions: Strategies For A School Multi-Sensory Room, Sarah K. Barker

Occupational Therapy Doctorate Capstone Posters

The purpose of the ALE and Capstone Project was to address the predetermined need for a sensory room in Bullitt East High School stated by the ECE Department Chair. My project focused on education, advocacy, and program development by promoting neurodiverse inclusion and increasing awareness of occupational therapy among staff and the community. A needs assessment and SWOT analysis confirmed the value of creating a sensory room and identified an appropriate location within the school. Students will learn to regulate their emotions in a safe and controlled environment, improve focus and regulation, practice self-advocacy skills, further develop motor skills, and …

Caring For Your Child With Duchenne Muscular Dystrophy, Emma H. Overstreet

Occupational Therapy Doctorate Capstone Posters

This capstone project took place in collaboration with UK Pediatric Therapies and UK NEMO Clinic in Lexington, KY. This project focused on the ACOTE areas of Program Development, Education, and Advocacy, with the goal of determining a need for caregivers and children with Duchenne Muscular Dystrophy (DMD), and to develop a comprehensive educational resource to fill the gap and meet this need. DMD is a progressive neuromuscular disease that impacts motor function in boys. As the disease progresses, motor function becomes increasingly impacted, resulting in decreased functional independence. A needs assessment, literature review, observation of evaluations and doctors appointments, discussions …

The Restorative Effects Of Virtual Reality Nature Simulations: An Empirical Investigation, Isabel T. Folger, Yichen Zhang, Kenneth B. Abrams

Psychology Faculty Work

Although extensive research demonstrates that nature films can facilitate recovery from stress and cognitive overload, it remains unclear whether more immersive media, such as virtual reality (VR), are more effective than similar two-dimensional films. The present study examined the effects of immersiveness on affective, cognitive, and physiological restoration. Three levels of immersiveness for film viewing were employed: 2D (computer monitor), standard VR (visual and auditory input), and enhanced VR (standard VR plus olfactory and haptic input). All participants were exposed to parallel versions of a six-minute nature film. We hypothesized that greater immersiveness would produce stronger restorative effects. All versions …

J Am Coll Dent 2026 92 2b

Journal of the American College of Dentists

This special issue of the Journal of the American College of Dentists responds to a growing but long-underrecognized demand for humanities and ethics in dental education, practice, and scholarship. It emerges from the work of the National Collaborative on Humanities and Ethics in Dentistry (NCHED), a multi-institutional partnership formed in 2023 to address the persistent exclusion of dentistry from broader health humanities conversations. Through national webinars and scholarly collaboration, NCHED has demonstrated substantial interest in ethical reflection, historical analysis, narrative inquiry, and the arts as essential to understanding oral health and dental care.

The unexpectedly strong response to the call …

A Narrative Review Of The High-Carbohydrate Fueling Revolution (≥100 G/H) In The Professional Peloton, Patrick B. Wilson

Exercise Science Faculty Publications

High-carbohydrate fueling in cycling (defined as ≥ 100 g/h for this paper) has received significant media attention in recent years. Whether this practice improves performance, however, remains an unresolved issue in the scientific literature. The purpose of this narrative review is to provide an up-to-date analysis of the practice of high-carbohydrate fueling, with a specific focus on potential performance implications in professional cycling. Topics covered include historical carbohydrate intake guidelines, research directly comparing high-carbohydrate fueling with traditional fueling guidelines, theorized benefits of high-carbohydrate fueling specific to cycling, potential risks associated with high-carbohydrate fueling, and personalizing carbohydrate intakes. Among a small …

Granulomatous Cellular Signatures In Nontuberculous And Tuberculous Mycobacterial Infections, Brianna M. Doratt, Ethan G. Napier, Mahdi Eskandarian Boroujeni, Sarah Douglas, Michael H. Davies, Luiz Bermudez, Eliot Spindel, Erin F. Mccaffrey, Ilhem Messaoudi

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Mycobacterium tuberculosis (Mtb) and nontuberculous mycobacteria (NTM) are acid-fast bacilli that trigger granuloma formation, a hallmark immune response aimed at containing infection. While the biology of Mtb granulomas has been widely investigated, far less is known about granulomas caused by NTM infection, despite the increasing prevalence and clinical challenge of NTM cases worldwide. Because granulomas influence infection control, pathology, and treatment response, understanding their cellular organization and signaling is critical to improving therapeutic strategies. Therefore, we characterized granulomas formed following infection of rhesus macaques with Mycobacterium avium subsp. hominissuis (MAH) and compared them to granulomas from cynomolgus macaques infected with …

The Impact Of Community-Based Educational Workshops On The Sexual Health Literacy And Sexual Satisfaction Of Lgbtq+ Adults, Meaghan Burns, Kathryn Burke Otd, Otr/L

Occupational Therapy Doctorate Capstones

A large number of adults who were brought up in the United States have limited sexual health literacy because of incomprehensive sexual education in adolescence. Many adults view sexual activity as an important component that contributes to their quality of life. Occupational Therapists can address sex and intimacy to improve literacy and satisfaction for adults with limited knowledge. The proposed study uses a quasi-experimental design with pre/post surveys to assess the efficacy of educational programming surrounding topics on sexual health literacy and satisfaction. The intended setting and population are adult members who attend programming and events at the Taunton location …

Exploring Sexually Explicit Material Literacy In Compressive Sex Education, Ashton Payne

2026 Honors Symposium

Background: Pornography has become increasingly accessible in recent years, particularly for younger audiences. Many individuals now report first exposure before the age of fourteen, underscoring the need for early, developmentally appropriate interventions within public education. To address students’ existing norms, misconceptions, and media‑driven expectations, especially those related to sexually explicit material (SEM), educators and researchers have emphasized the importance of pornography literacy as a critical component of modern comprehensive sex education (CSE). Purpose: This review synthesizes current research on pornography literacy pedagogy, with particular attention to its implementation, delivery methods, and documented impacts on adolescent knowledge, attitudes, and …

“Treatment Not Tents:" The Medicalization Of Homelessness In California’S 2022-2025 Legislative Agenda, Elana R. Straus

Yale Medicine Thesis Digital Library

Modern homelessness emerged in the 1980s due to political choices that cut the social safety net and decreased the availability of affordable housing. Medicalized views of homelessness that frame homelessness as driven by individual pathology, particularly mental illness and addiction, emerged in research, media, and politics at this time. Homelessness has persisted since and remains particularly high in regions, including California, where the housing markets are most constrained. In this context, California advanced multiple legislative changes between 2022 and 2025 that increased pathways to involuntary treatment and criminal-legal control over people experiencing homelessness. In this thesis, I demonstrate how legislators …

Measles Vaccine Hesitancy Improvement Bundle To Improve Vaccination Rates In A Rural Outpatient Clinic, Ramie Malone

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction

Despite the Centers for Disease Control and Prevention's recommendations to vaccinate children against measles, a decline in measles vaccination rates has been observed at a rural family medicine clinic. While numerous factors contribute to the decline in vaccination rates—including parental doubts about the necessity of vaccination, concerns about vaccine side effects, and insufficient education—the latter remains a fundamental underlying cause of suboptimal vaccination coverage.

Objectives

This project focused on surveying, educating, and boosting parents' confidence in measles vaccines for children under five to raise the measles vaccination rate.

Methods

This project used a pre- and post-intervention bundle over an …

Starting Strong: Improving Mmr Vaccination Rates In Kindergartners, Regina Bryan

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

During the 2023–2024 academic year, measles, mumps, and rubella (MMR) vaccination coverage among kindergarten students in this school district did not meet the Healthy People 2030 target, thereby elevating the risk of disease outbreaks. This quality improvement project aimed to improve MMR vaccination initiation and completion through coordinated, school-based interventions.

Methods

Guided by the Plan-Do-Study-Act framework, an eight-week immunization bundle was implemented across 14 elementary schools in South Texas. Interventions included reminder calls, multilingual education, districtwide communication, and a partnership with a nonprofit clinic that provides free or reduced-cost vaccines through on-site and community clinics. Pre- and post-intervention …

Implementing A Standardized Resilience Bundle For Neonatal Intensive Care Nurses, Jennifer Bouzid

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Nurse resilience is associated with improved psychological well-being, professional satisfaction, and retention. Neonatal intensive care unit nurses are frequently exposed to emotionally traumatic clinical events that may contribute to burnout, compassion fatigue, and turnover. A women’s hospital in central Texas identified increased nurse turnover and lower employee engagement scores related to well-being and intent to stay within the neonatal intensive care unit.

Purpose: The purpose of this quality improvement project was to implement and evaluate a standardized resilience support bundle for nurses following traumatic clinical events.

Methods: Guided by the Plan-Do-Study-Act framework, the project implemented a resilience bundle that …

Legislative Debate-Attributed Suicidality Among Lgbtq+ Adults: The Buffering Effect Of Community Belongingness, Keith J. Watts, Shawndaya S. Thrasher, Laneshia R. Conner, Nicole Campbell, Louis G. Baser, Dekeitra Griffin, Sydney P. Howard, Missy Spears, Justin X. Moore

Counseling & Human Services Faculty Publications

Background: In recent years, the sociopolitical landscape in the United States has shifted due to an increase in state-level legislation regarding LGBTQ+ rights, a trend that has been particularly pronounced in the Commonwealth of Kentucky. While the mental health impacts of enacted laws are increasingly documented, a critical gap remains in understanding the psychological toll of the legislative debates themselves—the prolonged periods of public discourse surrounding the restriction of rights. Methods: Utilizing data from the 2025 Queer Kentucky Survey (N = 817), this exploratory study examined the association between LGBTQ+ community belongingness and acute suicidality attributed specifically to anti-LGBTQ+ legislative …

Optimizing Kidney Allograft Years: Underutilization Of Pediatric Donors, Nicholas Herrera, Ana Cortez, Diane Cibrik, Bradley A. Warady

Manuscripts, Articles, Book Chapters and Other Papers

Background. 

The Kidney Donor Profile Index (KDPI) score drives kidney allocation in the United States for both adult and pediatric donors, despite the calculation being primarily derived from adult donor data. A KDPI of ≤20% is considered to have the longest graft survival potential and is typically prioritized for recipients who have a low Estimated Posttransplant Survival (EPTS) score. Using KDPI to assess pediatric donor quality may underestimate graft survival and result in underutilization of these kidneys for recipients with a low EPTS score.

Methods. 

Using Scientific Registry of Transplant Recipients data, we analyzed 5-y posttransplant death-censored graft survival of …

Enhancing Leisure Opportunities For People With Disabilities In Rural Communities, Joslyn Mary Nordmark

Occupational Therapy Capstones

Purpose. The purpose of this scholarly project was to promote access to leisure opportunities for people with disabilities in rural areas. The author addressed unmet needs among this population considering personal, occupational, environmental, cultural, and socioeconomic factors. The goal was to develop a product that provided opportunities regardless of abilities to promote leisure exploration and participation, social engagement, and life skill development for people with disabilities

Methods. The author conducted a needs assessment through a literature review following the Model of Human Occupation (MOHO), collaborations with site staff, and an on-site observation and environmental analysis. Data was examined to identify …

Socio-Spatial Patterns Of Suicide Mortality In The United States, Kushagra Tiwari, M. Amin Rahimian, Marie-Laure Charpignon, Philippe J. Giabbanelli, Praveen Kumar

VMASC Publications

Suicides cause more than 49,000 deaths per year in the United States, including 55% associated with the use of a firearm. Across states and counties in the US, suicide mortality exhibits substantial geographical and sociodemographic heterogeneity. However, the role of large-scale social networks in shaping this variation remains underexplored. To assess how both the risk of suicide mortality and the effect of firearm restriction policies propagate through inter-county social ties, we integrate data on county-level suicide mortality (2010–2022) and the Facebook Social Connectedness Index (SCI), a continuous measure of the strength of social ties between counties used to derive weighted …

Synergistic Sensitization Of Pancreatic Cancer Cells By Nanosecond Pulsed Electric Fields And Cold Atmospheric Plasma Via Amplifying Ros And Apoptotic Signaling, Zobia Minhas, Edwin A. Oshin, Lifang Yang, Chunqi Jiang, Siqi Guo

Bioelectrics Publications

Pancreatic cancer remains a highly lethal malignancy, with standard therapies offering limited benefits in advanced stages; thus, novel strategies that exploit specific cancer cell vulnerabilities are urgently needed. Building on our previous findings that nanosecond pulsed electric fields (nsPEF) combined with cold atmospheric plasma (CAP) produce enhanced cytotoxicity, this study investigates the molecular mechanisms underlying this synergy. Pan02 pancreatic cancer cells were subjected to nsPEF, CAP, or a combination of both. We assessed cell viability, reactive oxygen species (ROS) production, and mitochondrial integrity using metabolic assays, flow cytometry, and fluorescence microscopy. Apoptotic markers were evaluated via Western blotting and caspase …