Digital Commons Network^™

Staff Education To Enhance Home Care Staff Knowledge, Competence, And Confidence In End -Of-Life Communication, Pamela Rene Stubbs-Price

Walden Dissertations and Doctoral Studies

No abstract provided.

Adherence To The Eat-Lancet Diet And The Risk Of Heart Failure In Individuals With Cardiovascular-Kidney-Metabolic Syndrome Stages 0–3: A Prospective Cohort Study, Peng Fu, Hong Zheng, Kuangyi Wu, Yulong Lan, Dan Wu, Weiqiang Wu, Huancong Zheng, Zefeng Cai, Yuxian Wang, Qiuyue Lin, Bo Zhang, Youren Chen

Research outputs 2022 to 2026

Background and objective – In 2019, the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems proposed the EAT-Lancet planetary health diet as a universal reference dietary pattern aimed at promoting human health while minimizing environmental degradation. However, epidemiological evidence regarding the association between adherence to the EAT-Lancet diet and the risk of heart failure (HF), particularly among individuals with cardiovascular-kidney-metabolic syndrome (CKMs) stages 0–3, remains limited. Therefore, this study aimed to examine the associations between adherence to the EAT-Lancet dietary pattern, its individual dietary components, and the risk of HF among individuals at CKMs stages 0–3. Materials and methods …

Assessment Of Platelet Activation In Dogs With Naturally Occurring Acute Pancreatitis, Guhyun Kwon, Seulgi Bae

The Thai Journal of Veterinary Medicine

Recent studies have demonstrated that platelets are crucial in inflammation and immune responses. Alteration in platelet activity impact morbidity and survival due to the formation of intravascular clots or bleeding resulting from impaired platelet function. Aiming to evaluate changes in platelet activity in dogs with naturally occurring acute pancreatitis (AP), we identified differences in quantitative and morphological platelet indices, as well as the ratio of platelets expressing P-selectin on their surface (activated platelet ratio; APR) between dogs with naturally occurring AP and healthy dogs. The study included 9 client-owned dogs with AP (the AP group) and 28 client-owned healthy dogs …

Breastfeeding Promotion For Infants With Neonatal Abstinence Syndrome (Nas), Olivia Czerwonka

Evidence-Based Practice Project Reports

Neonatal abstinence syndrome (NAS) is the exposure in utero to drugs with the incidence in the United States increasing from 4 to 6.3 per 1000 births (Wei et al., 2023). The purpose of this quality improvement project was to implement a breastfeeding support intervention to increase breastfeeding frequency and reduce hospital length of stay of newborns with NAS. A tailored multicomponent guideline based upon the current Ten Steps to Successful Breastfeeding as established by WHO and UNICEF (2017) was implemented. Mothers of infants diagnosed with NAS were recruited using convenience sampling from a Northwest Indiana Hospital. Key stakeholders within the …

Incorporating The Use Of Puppets And Puppetry-Based Approaches In Nutrition: A Scoping Review Of Interventions, Basil H. Aboul-Enein, Nada Benajiba, Majd Jan, Sarah Ali Alasmari, Patricia J. Kelly, Stephen F. Gambescia, Elizabeth Dodge

College of Nursing Faculty Papers & Presentations

Puppetry-based activities could serve as a low cost and manageable intervention in improving health-related outcomes. This review aims to identify the research to date and gaps in practice of the role and application of puppetry interventions in nutrition education. A scoping review was conducted using the PICOS framework and PRISMA-ScR guidelines, identifying studies across eight databases between January, 1980 and July, 2025.Twenty-five studies were identified, with the majority (n = 19) aimed at pre-school and school-aged children. Fifteen studies used quasi-experimental, pre-post designs. The use of hand and finger puppets was common, as well as videos and puppet theatre. …

Leveraging Mobile Health To Prevent Coronary Artery Disease Through Physical Activity Promotion Among Underserved Youth, Alina Yang, Jessh M. Mavoungou, Matthew C. Miller, Zarmina Amin, Zan Gao

International Journal of Physical Activity and Health

Coronary artery disease (CAD) develops earlier than often recognized, with underserved youth facing disproportionate cardiometabolic risk. Low participation in moderate-to-vigorous physical activity (PA) is a key driver. This viewpoint explores how mobile health (mHealth) technologies can serve as tools to increase PA engagement among underserved youth, guided by a combined Self-Determination Theory and RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. It highlights current barriers to mHealth adoption, limited cultural relevance, engagement challenges, and accessibility gaps, and presents key considerations for designing culturally informed, age-tailored, and youth-centered mHealth interventions. Overall, the paper calls for a more inclusive and targeted approach …

Restless Legs Syndrome And Neurological Comorbidities: A Narrative Review, Kyrillos Ghattas, Helen Hernandez, Yongwoon Huh, Zhanna Fast, Zhikui Wei

Department of Sleep Medicine Faculty Papers

Restless legs syndrome (RLS) is a common yet underrecognized neurological disorder characterized by uncomfortable sensations and an irresistible urge to move he legs, typically following a circadian pattern. RLS frequently co-occurs with various other neurological diseases, raising questions about shared mechanisms and clinical consequences. This review synthesizes evidence on the prevalence, outcomes, and pathophysiology of RLS in various neurological disorders, including Parkinson's disease, multiple sclerosis, migraine, dementia, stroke, epilepsy, and peripheral neuropathy. In Parkinson's disease, RLS is linked to disease progression and dopaminergic therapy. In stroke and multiple sclerosis, RLS is associated with structural lesions at specific locations, such as …

Reducing Burnout Among Psychiatric Practitioners And Therapists, Sarah Lemaine

Walden Dissertations and Doctoral Studies

No abstract provided.

Glp-1 Receptor Agonists And Disordered Eating: Clinical Indicators And Patient Narratives, Samantha E. Schulz

Masters Theses

Introduction: The use of the medication, GLP-1 receptor agonist (GLP-1 RA), for weight loss has increased exponentially in the United States over the past decade. The continuing rise in demand for the use of GLP-1 RAs for weight loss justifies the need to better understand the physical and psychological effects that can occur with significant weight loss. By combining a standardized screening tool for eating disorder (ED) risk with narratives from patients undergoing GLP-1 RA treatment for weight loss, this study examines associations between GLP-1 RA use patterns and risk of ED and explores patient experiences, including the role of …

Boosting Psychological Well-Being In One Session: A Rapid Counseling Approach To Digital Detox And Music Therapy, Aryobimo Oentarto

Buletin Konseling Inovatif

The rapid acceleration of technology has trapped modern youth in a digital connectivity paradox, where constant social media exposure triggers cognitive distortions and maladaptive behaviors that erode psychological well-being. This study evaluates the effectiveness of a Rapid Counseling approach integrated with Single-Session Music Therapy (RC-SSMT) in enhancing the psychological well-being of youth by breaking the cycle of digital addiction. Using a pre-test and post-test experimental design, the study focused on six youths (aged 15–17) at Church "X" in Jakarta who were identified as having low psychological well-being. The intervention combined a mandatory digital detox as a behavioral task with music …

Preparing A Qualified Workforce To Support The Disability Community Through The Lend Interprofessional Learning Experience, Megan K. Roberts, Beth W. Degrace, Mark J. Fisher, Sandra H. Arnold

Developmental Disabilities Network Journal

Leadership and workforce preparation are vital roles of the nation’s academic institutions to advance health care services for the members of our communities. Leadership Education in Neurodevelopmental and other Related Disabilities (LEND) programs aim to prepare leaders in health care services and advocacy to improve systems and the quality of care and supports for the disability community, specifically children with developmental disabilities. LEND programs enhance standard health care pre-service training by providing interdisciplinary learning experiences for student trainees from a minimum of ten disciplines in 300 hours of learning activities over one academic year. An innovative feature of LEND programs …

Aligning Nutrition Screening Workflows To Improve Early Identification Of Pressure Injury Risk In Hospitalized Adults, Stephanie M. Vigil

Walden Dissertations and Doctoral Studies

No abstract provided.

Establishing The Division Interprofessional Council By Using Magnet Principles, Warisara Manuel

Walden Dissertations and Doctoral Studies

No abstract provided.

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.

Confederate Women In The Field Of Nursing And Their Impact On Southern Women’S Roles In Society, Laura Leigh L. Prater

Theses

During the Civil War, Confederate women had the opportunity to go to work as nurses. The majority of these women had never been allowed to take on roles beyond the domestic sphere in antebellum society.  Despite most of these women having limited medical training, they developed an expertise in nursing, extraordinary organization skills and gained respect for their achievements.  Their achievements proved that women were able to do far more than many in the South believed prior to the war.  This paper will show how the demands of war opened doors of greater opportunity for women in the South for …

More Than Mealtimes: The Role Of Occupational Therapy In Pediatric Feeding For Children With Developmental Disabilities, Anika J. Peters

Occupational Therapy Capstone Presentations

Feeding is a foundational occupation essential for growth, development, and family participation. However, children with developmental disabilities often experience significant feeding challenges that impact nutrition and participation in mealtime routines. This capstone project examines the role of occupational therapy in pediatric feeding assessment and intervention within an outpatient setting. Using a descriptive mixed-methods approach, outcomes were evaluated for pediatric clients (N=18) and occupational therapists (N=15) through goal attainment tracking, the Canadian Occupational Performance Measure (COPM), clinician needs assessment data, and resource feedback. Results demonstrated improvements in food acceptance, texture tolerance, oral-motor skills, and engagement in mealtime participation. COPM scores reflected …

Menstruation Behind Bars: A Mixed-Methods Study On Menstrual Product Access And Distribution Practices In Mississippi County Jails, Eron Hendrix

Honors Theses

This study examines menstrual product access and distribution practices in Mississippi county jails. It highlights the impact of period poverty as a critical yet underexplored public health and human rights issue within the corrections system. While existing research documents widespread inequities in access to menstrual products women’s healthcare in the correctional system, limited attention has been given to menstrual health at the local jail level. Using a mixed-methods approach, this study combines qualitative interviews with jail correctional staff and quantitative survey data from formerly incarcerated women to better understand institutional practices and lived experiences.

Interviews were conducted with sheriffs, jail …

Care Without Barriers: Dei And Cultural Competency In Athletic Training Education Programs, Sydney Hotz

Graduate Theses, Dissertations, and Capstones

In the field of athletic training, cultural competency is a topic that is highly under-researched. Athletic trainers (ATs) are healthcare professionals who provide care in a variety of settings, including secondary schools, where their patient population often includes student-athletes experiencing adverse social determinants of health and barriers to healthcare access. Only since 2022 has the governing body of athletic training education mandated that programs include cultural competency and DEI education in their programs, and to this day does not require programs to report adherence and methods of implementation. A quantitative, cross-sectional analysis was conducted to assess the relationship between cultural …

"First, Do No Harm": Ethical Failures And Preventive Solutions In The United States Pharmaceutical System - A Narrative Review, Rebekah R. Bailey

Honors Theses

The United States pharmaceutical system is highly advanced but faces growing ethical concerns related to drug development and marketing, overprescription, and high drug costs. This thesis examines how pharmaceutical marketing, regulatory practices, and prescribing behaviors may conflict with the ethical principle of “first, do no harm.”

Using a narrative review of interdisciplinary literature in public health, medical ethics, and applied ethics, this thesis analyzes patterns in drug development, marketing strategies, and regulatory oversight. The findings suggest that ethical issues are systemic, driven by commercial incentives, inconsistent regulatory standards, and an increasing reliance on pharmaceutical solutions. These factors contribute to overmedicalization, …

What You Don't Hear About Barriers To Healthcare In The Deaf Community: Analyzing Interpreter Experiences In The Deep South, Ryan Augustine

Honors Theses

Deaf and hard-of-hearing individuals experience significant health disparities in the United States, yet the perspective of the ASL interpreter has remained largely absent regarding the barriers documented in existing literature. This pilot case study examined the barriers Deaf individuals face when seeking healthcare through the unique vantage point of eight ASL interpreters across the Deep South: Alabama, Georgia, Louisiana, and Mississippi. Guided by grounded theory methodology, eight semi-structured interviews were conducted and analyzed to find recurring themes. Findings confirmed and revealed barriers that would not have surfaced without the perspective of the interpreter. Four themes emerged from this study: healthcare …

It’S Up To The States: The Role Of State-Based Safety Net Programs In Maternal Health Outcomes, Brooklyn Hall

Honors Theses

This thesis explores the relationship between state-based safety net programs and maternal health outcomes in the United States. Using the case studies of five states, namely Mississippi, Alabama, Wisconsin, Minnesota, and California, this research examines how variations in programs such as Medicaid, the Earned Income Tax Credit (EITC), Temporary Assistance for Needy Families (TANF), and Paid Family Leave (PFL) influence maternal mortality rates and overall maternal health outcomes. The analysis shows that states with more generous and comprehensive safety net programs, like California and Minnesota, tend to report lower maternal mortality rates. In contrast, states with less robust programs, such …

Quantifying Black Carbon Concentrations In Georgia And Analyzing Associated Public Health Risks, Khloe R. Osborne

Honors Theses

Quantifying Black Carbon Concentrations in Georgia and Analyzing Associated Public Health Risks

One of the most daunting challenges of the industrial world is air pollution. Within this broad spectrum, there is an inhalable particle group named PM2.5, which contains black carbon. Black carbon has evidence that supports the generation and worsening of adverse health impacts, which may include birth complications, cognitive deficits in children, pulmonary aggravation, asthma, cardiovascular issues, neurological degenerative patterns, and cancer risk. This is especially seen in vulnerable populations, like children, elderly, and those who already suffer from weakened health, many of which reside in the southern …

The Influence Of Fermentation Duration And Secondary Fermentation Conditions On The Bioactive Compound Profile Of Kombucha, Jordan Vereen

Honors Theses

Kombucha is a fermented sweet tea produced using a symbiotic culture of bacteria and yeast (SCOBY) and has gained widespread popularity due to its proposed health benefits. Kombucha has been studied to understand these advantages in cardiovascular support, improved metabolism, increased antioxidant effects, enhanced antimicrobial properties, and even potentially slowing the progression of certain diseases. Despite its increasing popularity, the way in which the specific bioactive compounds responsible for these effects and the fermentation conditions that influence their production remain unclear. The present study, conducted in collaboration with Dr. Budner, focuses on quantifying bioactive compounds in kombucha to better understand …

Bio 340 Final Project: Rural Population Structure And Food Production Interact To Shape Global Undernourishment, Ava Ripanti

Biology Student Scholarship

Ava Ripanti - Environmental Biology '27

Undernourishment remains a major global public health challenge, reflecting the proportion of a population lacking sufficient dietary energy intake. While food availability is central to food security, undernourishment is also shaped by structural and socioeconomic factors such as population distribution and access to resources. Although rural populations are closely tied to agriculture, they often experience higher food insecurity due to limited infrastructure, market access, and healthcare. Prior research emphasizes that broader determinants, particularly inequality and development, are stronger predictors of undernourishment than agricultural output alone, that food insecurity exists in both rural and urban …

Comparative Effectiveness Of Low Versus High Dose Upadacitinib As Maintenance Treatment In Patients With Ulcerative Colitis: A Real-World Cohort Study From The United States, Priya Sehgal, Gursimran S. Kochhar, Harpreet Kaur, Himsikhar Khataniar, Raina Shivashankar, James D. Lewis, Aakash Desai

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: There is limited real-word data comparing efficacy of low dose upadacitinib (UPA) to high dose UPA as maintenance therapy for ulcerative colitis (UC).

METHODS: This was a retrospective cohort study utilizing the U.S. Collaborative Network in adults ≥18 years old with UC who initiated UPA 15 mg compared to 30 mg for maintenance therapy between April 2022 and December 2023. The primary outcome was a composite of intravenous steroid use, oral steroid use, or colectomy from 12 to 60 weeks from the index UPA prescription. Propensity score matching (PSM) was performed for demographics, co-morbid conditions, laboratory, and IBD medication …

Development Of An Evidence Based Pressure Ulcer Prevention Bundle For The Medical Surgical Unit, Fanhelea Morency

Walden Dissertations and Doctoral Studies

No abstract provided.

Measuring Effectiveness Of A Mobility Aide On A Medical-Surgical Unit, Jamie L. Granatowicz, Laura N. Rogers, Leeza A. Struwe

Doctor of Nursing Practice Projects: College of Nursing

Purpose: To evaluate the effectiveness of a mobility aide on a medical-surgical inpatient unit to improve patients’ surgical outcomes, decrease hospital length of stay, and decrease the number of falls.

Design: A retrospective review was conducted to determine the effects of a mobility aide implemented on a medical-surgical unit. The intent was to ensure the utilization of the Enhanced Recovery After Surgery (ERAS) protocol for early mobilization before and after implementation. Two-month periods were analyzed before and after implementation.

Findings: The results demonstrated clinical significance for patients when implementing a mobility aide. The mean length of stay was 1.044 days …

Using Geospatial Analysis To Compare Metropolitan Greenspace And Adolescent Obesity, Rachel Schild, Denyelle Kenyon, Zachary Schild

Scholarship Pathways Program

Using Geospatial Analysis and Machine Learning to Compare Metropolitan Greenspace and Rates of Adolescents with Obesity

 Rachel Schild MD | DenYelle Kenyon PhD

 Introduction: Insufficient outdoor activity, influenced by limited access to exercise-friendly greenspaces, may contribute to increasing childhood obesity rates. However, rigorous evaluation of greenspace quality on a citywide scale is lacking. This study aims to characterize greenspace vegetation types and correlate them with adolescent obesity outcomes, identifying optimal characteristics for promoting health. This data could aid city planners in optimizing greenspace allocation and improving vegetation choices.

Methods: Satellite imagery and municipal data were used to map ten cities, …

Program Development And Implementation Of A Sensory-Based Self Regulation Curriculum For Adults With Down Syndrome At Gigi’S Playhouse, Grace Blair

OTD Capstone Projects

This doctoral capstone project was completed through partnership with Gigi’s Playhouse Nashville, a non-profit organization offering free programming and services to individuals of all ages with Down syndrome and their families. The goal of this project was to develop and implement an educational curriculum for adult education programs focused on daily life skills, money management, physical health, self confidence, and a variety of other topics. A secondary focus of this project was to support sensory regulation in individuals with Down syndrome to promote overall health and participation. The results were physical and digital materials to be used for future adult …

Neuroprotective Effects Of Estradiol And Genistein And Interactions With Aromatase Inhibitions Post Cerebellar Lesion In Male Zebra Finches, Grace E. Thompson, Anthony P. Irovic

Honors Theses

Across vertebrates, peripheral and brain-derived estradiol (E₂) promotes neuroplasticity. After injury, E₂ can be derived locally from testosterone via aromatase (AROM), an enzyme that is upregulated in glia at the site of neural injury. E₂disrupts testicular function and elevates cancer and stroke risk, primarily via binding to estrogen receptor alpha (ER α). Genistein (GEN), a phytoestrogen, is similar to E₂ but binds preferentially to estrogen receptor beta (ER β). It may offer neuroprotection without adverse effects of E₂. We used adult male zebra finches (ZF) to model neuroprotective effects of E_{2 …}