Digital Commons Network^™

The Effectiveness Of Telehealth For The Management Of Chronic Disease, Mariam Odunewu-Smith

Honors Capstones

Telehealth made a wide appearance in the medical industry during the Covid-19 pandemic due to the necessary decrease of physical interaction. It has continued to thrive and populate more patients since then. The benefits of telemedicine include quick, reliable one-onone sessions with a healthcare provider virtually, and is overall less costly compared to in person visits. Seeing a medical provider online is helpful in aiding patient recovery and management of chronic diseases. It is used to significantly improve the quality of life in the patients seen today. A literature review was conducted using databases such as PubMed and ScienceDirect. Papers …

Enhancing Postoperative Care For Vascular Patients: Pre- And Post-Test Clinical Knowledge Acquisition Of Early Mobilization Education For Interventional Healthcare Providers, Jennifer Wenger

Doctor of Nursing Practice Scholarly Projects

Peripheral vascular disease (PVD) is a chronic, systemic condition that often requires surgical intervention, presenting significant postoperative risks, including complications like thromboembolisms, pneumonia, and delayed functional recovery. Evidence-based practices (EBP), particularly early mobilization guidelines, have proven to improve recovery outcomes but remain inconsistently applied among interventional healthcare providers. The project addresses this critical issue by evaluating the impact of structured educational sessions on interventional healthcare providers’ knowledge and application of mobilization guidelines in postoperative vascular care. Using the John Hopkins Model of Evidence-Based Practice, a quasi-experimental design was adopted to assess the impact of the education. The project includes pre- …

Analysis Of Clinical Outcomes And Cost Effectiveness Of Neuromuscular Blocking Drug Reversal In Patients Classified As Obese, Trevor Mack

Doctor of Nursing Practice Scholarly Projects

Obesity predisposes patients to heightened risks of adverse outcomes following surgery, including residual neuromuscular blockade and postoperative complications. The administration of non-depolarizing neuromuscular agents (NMBAs) is fundamental for muscle relaxation and optimal surgical conditions. However, the subsequent reversal of these blockers with agents like sugammadex or neostigmine is crucial to mitigate these risks. While sugammadex is recognized as a clinically superior choice due to its rapid and more complete reversal, its extensive use is often limited by cost, presenting challenges in obese patients who already face increased susceptibility to complications. This project evaluates the cost-effectiveness of sugammadex versus neostigmine in …

Examination Of Eating Disorder Risks And Body Image Dissatisfaction Among Division Iii Student-Athletes, Maddie Wisener

Masters Theses/Capstone Projects

Eating disorders (ED) and pathogenic behaviors are prevalent concerns among collegiate athletes due to performance pressures and body image expectations. This cross-sectional study examined the risk of ED among 243 student-athletes (Males: 54.9%, Females: 44.3%, Non-Binary: 0.4%) at a private institution in the Midwest. The convenience sample included student-athletes from baseball, basketball, cheerleading, cross country, football, golf, lacrosse, soccer, softball, tennis, track, volleyball, and wrestling teams. The participants were given a demographic survey, the Eating Attitudes Test-26, and Sex-Specific Figural Stimuli Silhouettes to assess eating behaviors and perceived and desired body images. Overall, 22.1% of participants were at risk for …

Development Of A Clinical Pathway For Acute Pain Management As An Element Of The Prevention Of Delirium In Older Adult Trauma Surgery Patients, Stacey Mermigos

Doctoral Scholarly Projects & Capstones

For hospitalized patients, delirium is prevalent and associated with poor outcomes including increased mortality, morbidity, hospital length of stay, and healthcare costs. Although past studies have identified effective interventions to both prevent and manage delirium in critically ill patients, the most widely used evidence is not easily generalized to non-critically ill patients, specifically trauma patients who experience acute pain, serial surgical procedures, and other notable precipitating and predisposing factors. Clinical pathways are structured plans that are useful for encouraging consistent, evidence-based interventions for various medical conditions and situations. At this time, there is no clinical pathway for the prevention of …

Preserving What Matters: A Multimodal Approach To Maintaining Fat-Free Mass During Anti-Obesity Medication Based Weight Loss, Sarah Gore

Evidence-Based Practice Project Reports

Weight loss is often associated with reductions in fat-free mass (FFM), which can negatively impact metabolic rate, thermoregulation, bone density, functional capacity, and overall quality of life (Roth et al., 2022; Sedlmeier et al., 2021). This Evidence-Based Practice project aimed to reduce FFM loss in adults prescribed anti-obesity medications (AOMs) for weight management through a targeted, multimodal intervention. Twenty-two patients beginning AOM treatment at a family practice in northwest Indiana were invited to participate, with 19 consenting to enroll. Each participant received personalized guidance, including tailored calorie and protein intake goals to support a hypocaloric, high-protein diet, alongside evidence-based aerobic …

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Early Childhood Caries In The Primary Care Setting, Rieley M. Hull

Evidence-Based Practice Project Reports

Early childhood caries (ECC) is the most prevalent chronic childhood disease and, if untreated, can lead to significant long-term health and social consequences, posing a substantial healthcare burden (AAPD, 2023; ADA, 2023; USPSTF, 2021; WHO, 2022). This evidence-based practice (EBP) project aimed to implement a multi-modal intervention to reduce ECC risk factors, prevent new dental caries, and halt the progression of existing dental caries. Conducted in a pediatric primary care setting in West Michigan, the project included patients five and under who received an oral examination and dental caries risk assessment following the AAP’s guidelines. Based on their oral health …

Transmission Pathways Of Campylobacter Jejuni Between Humans And Livestock In Rural Ethiopia Are Highly Complex And Interdependent, Nitya Singh, Cecilie A N Thystrup, Bahar Mummed Hassen, Menuka Bhandari, Gireesh Rajashekara, Tine M Hald, Mark J Manary, Sarah L Mckune, Jemal Yusuf Hassen, Helen L Smith, Jonathan C Marshall, Nigel P French, Arie H Havelaar, Caged Research Team Members

2020-Current year OA Pubs

BACKGROUND: Campylobacter jejuni and C. coli are the most common causes of bacterial enteritis worldwide whereas symptomatic and asymptomatic infections are associated with stunting in children in low- and middle-income countries. Little is known about their sources and transmission pathways in low- and middle-income countries, and particularly for infants and young children. We assessed the genomic diversity of C. jejuni in Eastern Ethiopia to determine the attribution of infections in infants under 1 year of age to livestock (chickens, cattle, goats and sheep) and other humans (siblings, mothers).

RESULTS: Among 287 C. jejuni isolates, 48 seven-gene sequence types (STs), including …

Impact Of Menstrual Cycle Phase On Upper Extremity Function, Emma D. Cochran, Kaitlyn M. Armstrong

Honors Theses

Abstract

The Impact of Menstrual Cycle Phase on Upper Extremity Function

Background: There has been a significant rise in the number of female athletes participating across the spectrum of sports. While there are a multitude of research studies looking at physiology in sports on performance, training methods, and injuries; this research is general across genders. When it comes to female-specific physiology concerning training and injuries, there is little research. One such gender-specific physiological focus is the menstrual cycle in the female population. The literature suggests changes in joint laxity and muscle repair throughout the various phases of the menstrual cycle, …

Sweet Snacks Effects On Hispanic/Latino Childhood Obesity, Lemlen Belete, Brisa Rodriguez Alcantar

Undergraduate Research Symposium Lightning Talks

Background:

Obesity rates in children has become a growing concern in the Hispanic/Latino community in Nevada. This study examines the availability of sweet snacks in the home and its association with children's dietary behavior.

Methods:

Data was analyzed from a survey of 155 Latina mothers using logistic regression while controlling for income, education, and acculturation. The survey was conducted in Nevada, between October 2022 and March 2024.

Results:

The frequency of keeping sweets in the home was significantly associated with children's consumption of various sweets. For every increase in keeping sweets at home, the odds of children consuming: • Chocolate …

Beyond The Nursery: Unraveling Maternal And Neonatal Factors Associated With Nicu Admissions In Nevada (2015–2021), Vidhani Goel, Ana L. Reyes, Bertille Assoumou, Dodds P. Simangan, Farooq Abdulla, Deborah A. Kuhls

Undergraduate Research Symposium Podium Presentations

Overview

This project focuses on investigating the relationship between maternal medical conditions, socioeconomic factors, and NICU admission levels among Medicaid beneficiaries in Nevada.

Approach:

•A retrospective analysis was conducted using linked data from the Birth Registry and Nevada Medicaid Claims from 2015 to 2021.

•Infant records were analyzed using univariate and bivariate statistical methods, with a significance level set at 5%.

•Logistic regression models were used to examine associations between maternal characteristics and NICU admission levels.

Key Objectives:

•Analyze NICU admission trends among Medicaid beneficiaries.

•Identify maternal health risk factors linked to NICU admissions.

•Examine neonatal characteristics influencing NICU admissions.

Stress And Glucose Regulation In Adults At Risk For Type 2 Diabetes Mellitus: A Secondary Analysis From A Randomized Controlled Trial, Sophia Lysne, Regina Dispa, Brenna Way, Bea Francene Pilnade, Donya Shahamati, Romina Ballesteros, Christopher Acosta, Keren Morales, Esther Adaji, Ohis Egbaidomeh

Undergraduate Research Symposium Posters

Type 2 Diabetes Mellitus (T2DM) is a major public health concern, significantly increasing the risk of cardiovascular diseases (CVDs). Additionally, prediabetes is a critical precursor, as it elevates the risk of developing both T2DM and CVDs. (2)

Recent literature reveals among individuals with severe perceived stress, there is a higher likelihood of HbA1c% levels meeting the criteria for prediabetes (5.7– 6.4%) as compared to those with lower perceived stress. (3)

Studies show that psychological stress has hyperglycemic effects in individuals with T2DM, suggesting that stress is associated with poorer blood glucose control. (4)

The Interaction Between Physical Activity And Fruit And Vegetable Intake On Body Composition, Om S. Ghetia

Honors Scholar Theses

Objective: Fruit and Vegetable (FV) intake and Physical Activity (PA) are important lifestyle factors associated with body composition. This study assessed the combined impact of meeting FV intake and PA recommendations on body composition measures including body mass index (BMI), percent body fat (PBF), and waist circumference (WC) in adults aged 20–64 years from diverse backgrounds.

Design: A cross-sectional study conducted in Northeastern Connecticut.

Methods: A total of 124 participants completed a one-week dietary and PA record followed by anthropometric assessments. Participants were categorized into groups based on FV intake (≥400 g/day vs. < 400 g/day) and PA levels (≥600 MET-minutes/week vs. < 600 MET-minutes/week). Independent t-tests and chi-square tests were used to compare dietary intake, PA levels, and body composition outcomes across groups.

Results: Participants meeting FV recommendations had significantly …

Quality Improvement Project Impact Of Multidisciplinary Patient Education On Heart Failure 30-Day Readmission Rate, Jeanne P. Williams

Doctor of Nursing Practice Projects

Patients diagnosed with heart failure are at an increased risk for readmission to the hospital within 30 days of discharge, and their care costs are projected to continue to increase. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to implement an evidence-based initiative to mitigate the increased heart failure 30-day readmission rate on a 30-bed medical-surgical telemetry unit in an acute care facility. Using the teach-back communication method, multidisciplinary patient education was implemented to prepare patients diagnosed with heart failure to manage their condition once discharged home. The theoretical and implementation frameworks used were Lewin’s Change Model, …

Know Thyself: A History Of Ancient Neuroscience, Alex Delano

Departmental Honors & Graduate Capstone Projects

Neuroscience is often described as one of the youngest bodies of science, but documented study of the brain begins as early as the Neolithic period. The ancient Mediterranean was a hub for science, mathematics, philosophy, and literature, all disciplines necessary for the study of the brain. Evidence of neurosurgical procedures like trepanation and craniotomy began in the Neolithic period and were practiced and improved upon throughout the ancient Mediterranean. The first detailed studies on brain anatomy were carried out in the 3^rd century BCE in Greece which created a necessary structure for future scientists to build on. While many …

A Multimodal Intervention To Improve Treatment And Clinical Outcomes In Children With Recurrent Otitis Media, Daniel Courtaney

Evidence-Based Practice Project Reports

Acute otitis media is the number one cause for primary health care visits and antibiotic prescriptions in the pediatric population (El Feghaly & Jackson, 2023). Upwards of 27% of children experience multiple episodes of otitis media (OM) that meet recurrent otitis media (ROM) diagnosis criteria (Pelton & Marchisio, 2023). Guided by the Iowa Model (Iowa Model Collaborative, 2017), the project’s purpose was to implement a multimodal intervention to decrease recurrent OM and repeat clinic visits. A comprehensive literature search of 5 databases yielded 16 sources ranging from levels I-IV (Melnyk & Fineout-Overholt, 2023). Using the AGREE II and JBI Critical …

Septic Arthritis Caused By A Rare Yeast, Lodderomyces Elongisporus, Osman Muslehuddin, Daphne Pete, Husam Muslehuddin, Hafeezuddin Ahmed

Conference Presentation Abstracts

Introduction: We present a rare case of septic arthritis caused by Lodderomyces elongisporus, a yeast rarely implicated in human infections. This case highlights the diagnostic challenges and management strategies for fungal septic arthritis in an immunocompromised patient. Case Presentation: A 63-year-old African American woman with a complex medical history, including chronic heart failure (CHF), hypertension, end-stage renal disease (ESRD) on hemodialysis, severe protein-energy malnutrition on total parenteral nutrition, duodenal switch with malabsorption, deep vein thrombosis (DVT) on warfarin, and previous sepsis episodes, presented with worsening dyspnea. She was admitted in August 2024 for acute-on-chronic CHF exacerbation. During her admission, she …

Conflict, Human Development, And Neonatal Health: A Regional Analysis Of The Eastern Mediterranean, Zynub A. Al-Sherri

Honors Theses

Background. The effects of war and conflict on a population are direct and indirect in nature. One of the most devastating consequences is the destruction of healthcare infrastructure, which severely disrupts access to essential services and impedes long-term socioeconomic development. Among those most affected are newborns, as the neonatal period represents the most vulnerable stage of a child’s life and serves as a sensitive indicator of a society’s overall health and socioeconomic conditions. Given the persistent instability in the Eastern Mediterranean Region (EMR), this study aimed to explore how conflict and human development are associated with neonatal health outcomes …

A Storm Within: Anti-Nmda Receptor Encephalitis Mimicking Anxiety In A Young Woman, Izma Khaliq, Omar Sami Abdelhai, Angela Ishaq, Emmanuel Meram, Anointing Onuoha, Ahmed Jabri, William Dillon

Conference Presentation Abstracts

Case Description: A 21-year-old female with a history of asthma presented to the emergency department (ED) with restlessness, anxiety, and loss of appetite shortly after returning from a trip to France, where she and her boyfriend ended their relationship. Her initial evaluation, including unremarkable laboratory results, led to the attribution of her symptoms to anxiety from life stressors. She was treated with supportive measures in the ED and prescribed Xanax by her primary care physician at follow-up. Six days later, the patient returned to the ED with hallucinations and panic attacks. Again, laboratory results were unremarkable, and she was diagnosed …

Assessing The State Of Nutrition Education In Michigan Medical Schools, Sarah Bdeir, James Meza, Kareem Tayeb

Conference Presentation Abstracts

Despite the National Academy of Science recommending a minimum of 25 hours of nutrition education, U.S. medical schools dedicate an average of only 19 hours, and 75% lack mandatory clinical nutrition classes¹. Alarmingly, only 14% of current healthcare providers feel confident discussing nutrition with patients, despite its critical role in disease prevention and management². To address this gap, we surveyed medical students at five of seven Michigan medical schools about their schools' approaches to culinary medicine, self-perceived competence, and recommendations for improving nutrition education curricula. The survey was given to key representatives at each medical school, who distributed the survey …

Epidemiology, Risk Factors And Clinical Outcome Of Candidaemia: A Decade-Long Experience At A University Hospital In Oman, Tasneem Al Salmani, Asmaa S. Mahdi, Abdullah Balkhair, Turkiya Al Siyabi, Hashim Ba Wazir

Sultan Qaboos University Medical Journal

Objectives: This study aimed to examine a decade-long epidemiology of candidaemia to explore the risk factors associated with it, and describe its clinical outcomes in hospitalised adult patients. Methods: This retrospective observational study was conducted at Sultan Qaboos University Hospital, Muscat, Oman. Adult patients with candidaemia hospitalised between January 2007 and December 2016 were included. The hospital infection control department surveillance registry on bloodstream infections (BSIs) was used to identify Candida BSIs. Patients' electronic medical records were searched for demographic characteristics, clinical risk factors and outcomes. Results: Candida albicans was the most common Candida species among 152 …

A Complex Case Of Tracheoesophageal Fistula Following Chemoradiation And Esophagectomy, Mujtaba Moazzam, Usman Bin Hameed, Fady Banno, Rocco Sbrocca, Ramona M. Berghea

Conference Presentation Abstracts

Tracheoesophageal fistula (TEF) is a pathological connection between the trachea and esophagus. It is a rare but serious complication following esophagectomy, particularly in patients who have undergone concurrent radiation therapy, with rates of 5-15%. TEFs often manifest with severe complications such as malnutrition, infections, and life-threatening bleeding, making them exceptionally difficult to manage. This case report highlights a rare presentation of TEF in a patient with esophageal adenocarcinoma treated with multimodal therapy. A 45-year-old male with stage III esophageal adenocarcinoma underwent concurrent chemoradiation, esophagectomy, and immunotherapy. Subsequent oligometastatic disease required further treatment, including radiofrequency ablation and Keytruda maintenance. The patient …

Marathon Miles And Melena: Unmasking Acute Gastrointestinal Bleeding In An Endurance Athlete, Usman Bin Hameed, Mujtaba Moazzam, Nathanial Bartosek, Fady Banno, Naveen Reddy

Conference Presentation Abstracts

Gastrointestinal bleeding (GIB) is a recognized complication of endurance sports, particularly long-distance running. While most cases are mild and self-limited, studies indicate that up to 12% of ultramarathon participants experience occult bleeding. Severe or life-threatening GIB, such as ischemic colitis requiring surgery, has been reported but remains rare. Despite its potential significance, exercise-induced GIB remains poorly understood, with limited organized data on its prevalence and mechanisms. A 38-year-old male presented with a three-day history of melena following a recent marathon. Symptoms began with loose stools, progressing to tarry stools, accompanied by fatigue, exertional dyspnea, dizziness, and mild generalized abdominal discomfort. …

Executive Summary: Development Of An Evidence-Based Prevention Bundle To Reduce Falls On An Inpatient Psychiatric Detoxification Unit, Ramatu Dougrey Jalloh

Walden Dissertations and Doctoral Studies

Following a 16% increase in patient falls from 2023 to 2024 in an inpatient psychiatric detoxification unit, a quality improvement education project was implemented to assess the impact of an evidence-based fall prevention bundle on fall rates and nursing compliance. Nurses received education through a PowerPoint presentation to enhance understanding and implementation of the bundle, which included Edmonson reassessments after high-risk medication administration, ISHAPED bedside shift handoffs, care plan updates, and SWIFT daily safety huddles. Posttests identified that the objective score of 80% knowledge for nurses was met. During the 10-week implementation, the goal was 100% compliance with all bundle …

Time And Location: Physical Activity Trends In Parents And Children In A Rural Region During Covid-19, Brooke C. Towner, Robert Broce, Rebecca A. Battista

Journal of Appalachian Health

Introduction: COVID-19 restrictions altered the structure of the school and workday for families with children and led to changes in active transportation. Continued restrictions impacted access to many community locations and led to changes in physical activity (PA) behavior.

Purpose: The objectives of the study were to describe the changes in the 1) amount of PA time per day, 2) frequency of PA, and 3) sitting time. Information about how PA changed for parents and children during the COVID-19 pandemic will have potential implications for education, public health, and recreation management.

Methods: This cross-sectional study enlisted participants via an online …

Excess Fructose In High-Fructose Corn Syrup Reduces Cell Viability & Promotes Nitric Oxide Release In Raw 264.7 Macrophages, Renzo F. Galarza, Edward L. Villegas

Research and Creativity Symposium

High-fructose corn syrup (HFCS) is an artificial sweetener that contains slightly higher concentrations of fructose compared to standard sucrose. It has been linked to an increased risk of obesity, type 2 diabetes, cardiovascular disease, and fatty liver disease. While both HFCS and sucrose are widely used sweeteners, growing evidence suggests they may differ in their inflammatory potential. We sought to understand the effects of elevated fructose on RAW 264.7 macrophages. To investigate these effects, we treated the cells with either a sucrose solution or a
solution designed to mimic high-fructose corn syrup. Lipopolysaccharide (LPS) stimulation was used to model innate …

Longevity And Cardiovascular Health: Lessons From The Mediterranean Blue Zones, Lyndsay Bancroft, Miranda Daley, Hitomi Tanizawa

NURS 464: Evidence-Based Nursing Capstone

Cardiovascular diseases are the leading cause of death globally, and poor diet is a leading risk factor for adverse cardiac events (Ahmed et al., 2023). The Mediterranean diet provides protection against coronary heart disease, regardless of the common risk factors for cardiovascular diseases like smoking, hypertension, diabetes, etc (Legrand et al., 2019). Those living in the blue zones of Greece and Italy have far fewer deaths from cardiovascular disease than populations living in other parts of the world (Legrand et al., 2021). This project aims to investigate how the Mediterranean diet has influenced the rates of cardiovascular disease amongst the …

Unraveling The Impact Of Oxidative Stress On Sperm Quality, Nicole Macasa, Olivia Mcmahon, Mónica Vidal-Franco

NURS 464: Evidence-Based Nursing Capstone

A substantial body of scientific research has identified oxidative stress (OS) as a main culprit in the development of male infertility. OS is mediated by free radicals, which can result from lifestyle, environmental factors, endocrine imbalances, and infection (Skoracka et al., 2020). Free radicals are unstable molecules with an unpaired electron in their outer shell, making them highly reactive and prone to causing OS damage to other molecules in the body (Łakoma et al., 2023). Spermatozoa are particularly vulnerable to oxidative damage due to their lack of robust cytoplasmic enzyme systems that repair damaged DNA (Saleh & Agarwal, 2002). This …

Pancreatic Ascites: Update On Diagnosis And Management, Lefika Bathobakae, Heba Farhan, Derya Mücahit, Dina Rohira, Kashyap Chauhan, Yana Cavanagh, Walid Baddoura, Derick J Christian

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Pancreatic ascites is a rare condition characterized by the accumulation of high-amylase ascitic fluid in the peritoneal cavity. This condition is often associated with chronic pancreatitis, pancreatic trauma, or pseudocyst rupture. Because of its rarity and ill-defined clinical presentation, pancreatic ascites is often a diagnostic and therapeutic challenge in clinical practice. The current diagnostic criteria include an amylase level >1000 mg/dL, a protein level >3 g/dL, and a serum ascites albumin gradient < 1.1 g/dL. The clinical features vary, but may include progressive abdominal distension, diffuse abdominal pain, weight loss and peritonitis. The management of pancreatic ascites remains controversial, and there is no consensus regarding the optimal approach. Conservative medical management, which includes nutritional support, pain control, therapeutic paracentesis and the use of somatostatin analogs, has been associated with a high failure rate and significant morbidity. Interventional therapies, such as surgery and endoscopic transpapillary stenting, have shown more promising outcomes. However, the choice between these methods is still debated, with some advocating for endoscopic approaches, because of their minimally invasive nature and reduced morbidity compared with surgical options. Endoscopic approaches remain underutilized in practice, probably because of the need for repeated interventions, the potential risks associated with endoscopic retrograde cholangiopancreatography, or a lack of skilled personnel. Although they show significant perioperative morbidity and mortality, surgical options provide definitive resolution of pancreatic ascites. Herein, we provide an updated review of pancreatic ascites, highlighting advances in diagnostic techniques and therapeutic approaches, and summarizing insights from recent clinical cases and retrospective studies.

Breaking Barriers: Exploring The Impact Of Social Media On Women's Behaviors, Attitudes, And Barriers In The Free-Weights Room, Kate Jensen

Master's Theses

The purpose of this study was to determine social media’s impact on women’s habits and attitudes on the weight-room area of a college recreation center. Using non-experimental quantitative methods, the frequency and type of weightroom use by women was measured, as well as the type and frequency of fitness-focused social media use.