Digital Commons Network^™

Protocol For A Randomized Controlled Trial To Determine If Biomarkers Predict Response To A Pediatric Chronic Pain Symptom Management Program, Rona L Levy, Tasha B Murphy, Margaret M Heitkemper, Miranda A L Van Tilburg, Ann R Mcmeans, Jocelyn Chang, Cynthia Boutte, Katherine Lamparyk, Bruno P Chumpitazi, Robert J Shulman

Faculty, Staff and Students Publications

Background/Objectives: Disorders of gut-brain interaction (DGBI), characterized by chronic abdominal pain and significant disability, affect 15-20% of children and adults and continue into adulthood in ~60% of cases. Costs for adults reach USD 30 billion per year, yet effective management strategies are elusive. Studies support using cognitive behavioral therapy (CBT), but abdominal pain only improves in ~40% of patients. Dietary management (low FODMAP diet; LFD) has also shown promise but it is effective in only a similar percentage of patients. Studies suggest that biologic factors (biomarkers) contribute to CBT response. Similarly, gut microbiome composition appears to influence abdominal pain …

A Single Center Qualitative Study To Improve Coordination Of Follow-Up Care For Patients Diagnosed With Abusive Head Trauma, Ruairi Smith-Dewey, Elise Wright, Daniella Donofrio, Hannah Goebel, Sara Kilbride

Posters

Introduction: Children diagnosed with abusive head trauma (AHT) have subsequent long-term developmental, behavioral, and medical consequences resulting in increased medical system utilization. There were 16 overall potential needs identified, with a single patient having 12. In 2023 at Children’s Mercy Hospital (CMH), 47% (8/17) of patients with AHT had < 50% of follow-up needs addressed at time of discharge. None had 100% of follow-up needs addressed. Needs not being addressed included need not identified or written documentation for need of follow-up without subsequent referral placed/appointment scheduled. Project goal was all follow-up needs to be addressed for at least 50% of children with AHT by January 2025. Methods (include PDSA cycles): Children admitted to CMH from January 2024-December 2024 and diagnosed with AHT by the Safety, Care & Nurturing (SCAN) team were included. Interventions were designed and implemented by a multidisciplinary team to address barriers including variation in scheduling process per specialty, lack of knowledge, and changing caregivers. • PDSA 1 (1/1/24): SCAN added standardized list of potential follow-up needs to documentation. • PDSA 2 (2/1/24): Trauma NP placed ophthalmology outpatient referrals. • PDSA 3 (3/1/24) Social work placed and documented early intervention referrals. Transitioned to SCAN RN responsibility. • PDSA 4 (4/10/24): AHT caregiver handouts with description of all potential follow-up needs added to discharge instructions. • PDSA 5 (12/11/24): AHT Evidence Based Practice guideline created including follow-up needs. Appointments and referrals were tracked by the author. QI tools used included fault tree, fishbone, and PICK Chart. Results: In 2024, 27 children were diagnosed with AHT by SCAN team at CMH. Five children were excluded from the study as 3 died and 2 were transferred to another hospital. The number of patients with < 50% of follow-up needs addressed was reduced from 47% to 43%. All follow-up needs were addressed in 13% (3/23) of patients. Conclusions: While project aims weren’t met, there was progress. Next steps include educating all discharging teams at CMH as there is no single team discharging these patients. Overall, there are few of these patients so standardization of discharge practices is challenging. SCAN created a working group and point person for appointment tracking to ensure follow-up needs established at discharge.

Mental Health Conditions Among Patients With A Disorder Of The Gut-Brain Interaction, Ambia Ahmed, Nicole Smith, Anya Cutler, Mariaelena Terzis, Laura J. Faherty, Julia Fritz

Costas T. Lambrew Research Retreat 2025

Two thirds of pediatric patients with disorders of the gut-brain interaction have mental health comorbidity.

Factors Influencing No Show Rates In Adult Urology Patients, Bruce T. Ndebanje, Ethan Griffin, Evelyn James, Lily C. Wang

Costas T. Lambrew Research Retreat 2025

Our study highlights a strong association between insurance status and no-show rates. Patients with Medicaid or no insurance were significantly more likely to miss appointments (OR 3.25 and 5.99).

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 …

Thoughts From The Frontline - May 2025, Tennessee Center For Nursing Advancement, East Tennessee State University

Thoughts from the Frontline Newsletter

No abstract provided.

How Multidisciplinary Teams (Mdts) Shape The Occupational Therapy (Ot) Experience: Communication, Collaboration, And Challenges, Grace Schmidt

Theses/Capstones/Creative Projects

The goal of this study was to evaluate how occupational therapists (OTs) contribute to patient care within multidisciplinary teams (MDTs), with a focus on the challenges and benefits of collaboration. The research was conducted at Quality Living Inc. (QLI), a rehabilitation center specializing in neurological recovery. Four healthcare professionals (two occupational therapists, one physical therapist, and one exercise assistant) participated in interviews, either in person or over Zoom during the spring 2025 semester. A brief survey was used to collect demographic data, and nineteen open-endemd interview questions guided the data collection process. Responses were analyzed thematically and categorized into three …

A Review Of Studies Assessing Modifiable Risk Factors For Dementia Among Family Caregivers In The United States Based On Behavioral Risk Factorsurveillance System (Brfss), Shruthi Ranjithkumar

2025 Spring Honors Capstone Projects - Archive

Caregivers of individuals with Alzheimer's Disease and Related Dementia (ADRD) face an increased risk of developing dementia due to advanced age and modifiable risk factors. The 2024 Lancet Commission Report identified 14 such risk factors, whose mitigation could reduce dementia cases by 45%. Despite this, research on modifiable dementia risk factors among ADRD caregivers remains limited. This study investigates whether peer-reviewed studies utilizing Behavioral Risk Factor Surveillance System (BRFSS) data assess modifiable dementia risk factors among ADRD caregivers. A PubMed search retrieved 27 relevant articles, which were analyzed for risk factors identified by the Lancet Commission, including traumatic brain injury, …

Exploring Spatial Arrangements And Smart Technology To Manage Cognitive Load In Kitchens For Aging In Place, Monique Chabot

Full-Text Theses & Dissertations

Older adults undergo natural physiological changes in various physical and cognitive functions, including balance, strength, memory, attention, and executive functioning. Memory, attention, and executive functioning integrate to form functional cognition, a skill that allows people to safely and efficiently complete daily tasks. Functional cognition is integral to the ability to age in place and is sensitive to demands in the environment. While a decline in some cognitive functions is expected with age, it is not typically observable except in the presence of pathological conditions or situations of cognitive overload from complex tasks or high environmental demands.

Older adults have identified …

Depression, Anxiety, And Suicide Among Adolescents: Sex Differences And Future Perspectives, Giovana V.R. Toro, Paula Arias, Alejandro De La Torre-Luque, Jonathan B. Singer, Natalia Lagunas

Social Work: School of Social Work Faculty Publications and Other Works

Depression and anxiety are two disorders that significantly increase the risk of suicidal behavior. The disparity between females and males in the prevalence of these disorders becomes more pronounced from adolescence onwards. Specifically, risk factors associated with suicidal behavior in adolescent females are often linked to anxiety and depression, whereas in males, these behaviors are more frequently associated with other types of disorders, such as disruptive behavior. Furthermore, there are notable sex differences in the efficacy and acceptance of treatments aimed at preventing suicidal behavior. This review examines the sex differences in the relationship between depression, anxiety disorders, and suicidal …

At The Table Together: Exploring Child Perception Of Lunch Buddy Mentoring, Lauren K. Primm

Psychological Science Undergraduate Honors Theses

Research suggests school-based mentoring is a promising strategy for helping children who experience school bullying and peer victimization. Lunch Buddy Mentoring (LBM) is a school-based mentoring program that places mentors in the lunchroom and has them sit with the mentee and peers at the lunch table. Research shows that LBM is positively perceived by both parents and teachers, but there is little research on the perceptions of LBM held by children at the lunch table. Negative perceptions of LBM by children who sit with the mentor could reduce its success by further isolating or victimizing children it aims to support …

Commencement Program 2025, Loma Linda University

Commencement Programs

CONTENTS

2 | Message from the President

3 | 2025 Events of Commencement

5 | The Academic Procession

6 | Institutional Administration

7 | Board of Trustees

8 | Significance of Academic Regalia

9 | University History Highlights

11 | Criteria for Institutional Awards

13 | Loma Linda University Health and Loma Linda University Honorees

The Programs, The School Honorees, and The Speakers

29 | School of Medicine

50 | School of Pharmacy

63 | School of Dentistry

81 | School of Public Health

94 | San Manuel Gateway College

101 | School of Allied Health Professions - Allied Health …

Legal Issues And Outcomes Of A Medical-Legal Partnership For Cancer Patients, Allison B. Dowling, Abigail Sweeney, Megan E. Gordon, Lisa Kessler, Deborah Perry, Vicki W. Girard, Shreya Kalra

Georgetown Law Faculty Publications and Other Works

The medical-legal partnership (MLP) model is a multidisciplinary intervention with demonstrated success in addressing health-harming legal needs. We analyzed initial data from the Georgetown University Health Justice Alliance’s Cancer Legal Assistance and Well-being Project (Cancer LAW), an MLP between Georgetown University and MedStar Health serving cancer patients receiving care at an urban, safety-net hospital in Washington, D.C. The sample included 81 patients, who had an average of two legal issues, most commonly in the areas of Social Security, estate planning, housing, and health insurance. Data collected during legal representation captured both financial and non-financial benefits to patients. Patients who responded …

Substance Use And Shame In Minority And Immigrant Communities, Zane Alroshood, Hassan Barade, Jeffrey Guina

Posters

Substance use disorder (SUD) has increased worldwide, especially in the United States, with millions struggling with drug and alcohol problems. Substance use (SU) can lead to significant adverse health outcomes along with stigmatization in healthcare settings. Shame plays a complex role in the development and mitigation of developing substance use problems, influenced by cultural contexts such as dignity, face, and honor. A systemic review attempted to identify the relationship between SU and shame, stating shame was reliably associated with SU, but revealing mixed results in which it served both adaptive and maladaptive functions in its development.

Interpretation Challenges In Healthcare Settings As Experienced By Refugees And Healthcare Providers In The United States, Lydia H. Samoff

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Language and interpretation barriers are significant challenges for refugees receiving healthcare in the United States. Both providers and refugee patients associate effective communication with a positive healthcare experience. Therefore, it is important to identify themes in interpretation barriers to promote productive communication between providers and refugee patients.

Purpose: To identify themes in literature surrounding interpretation challenges between refugees and healthcare workers in the United States and compare them to lived experience in a clinic in Northwest Arkansas.

Methods: Several databases were searched, including CINAHL, Medline, HealthSource, and Google Scholar, and articles were chosen with the inclusion criteria being research …

Assessing And Addressing The Needs Of Socially Vulnerable Populations To Enhance Community Emergency Preparedness And Resilience: A Mixed Methods Study, Jennifer E. Harris

Dissertations: Doctor of Public Health

Background: A robust understanding of the needs of individuals and communities can help reduce the impact of a disaster, especially on those communities that already have associated health disparities. By strategically including these populations into mitigation, preparedness, response, and recovery planning, emergency management plans can be enhanced to be more inclusive and effective by identifying targeted resources during a crisis. Additionally, understanding and improving upon individual resiliency can potentially bolster a community’s resiliency level and reduce overall susceptibility to a disaster event, and expedite the recovery phase. Purpose: The purpose of this study is to assess the emergency …

Useful Measures Of Adult Attachment And Object Relations In Psychotherapy, Matilde A. Torallas Huerta

Dissertations

This is a literature review of objective and projective measures of attachment and object relations in adults, with the objective of reviewing outstanding research to identify the key factors for adult attachment assessment considered within attachment and object relations theories, what measures of adult attachment styles and dysfunction work best, and to provide key themes of assistance in the measurement of attachment and object relations in adult clients in psychotherapy. Theoretical foundations of attachment and object relations theory are reviewed as well as objective and projective instruments grouped by format. The 10 themes found to be useful in the assessment …

Strategies For Reducing Racial Disparities In Maternal Health Outcomes: An Examination Of The Role Of Doulas, Samavi Rafique

Honors Program: Senior Projects (Public)

Comparatively high rates of maternal morbidity and mortality remain a significant concern in the United States, particularly for Black women, who face a risk of maternal mortality that is four times higher than that of white women. Realizing the historical context of this burden requires tracing American obstetric and gynecological medicine to its 19th-century roots, where the medical experimentation of enslaved Black women occurred largely unopposed by the voices of those in power. The legacy of this is embodied in the modern maternal health crisis, marked by stark racial disparities in maternal health outcomes. As non-clinically trained professionals whose supportive …

Pelvic Inflammatory Disease, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Unbridled Healing: Identifying The Barriers Of Equine-Assisted Therapy, Sally A. Hamm

Human Development and Family Sciences Undergraduate Honors Theses

Despite the documented benefits of equine-assisted therapy (EAT) for mental health conditions, this complementary approach remains underutilized. This qualitative study investigated barriers preventing wider EAT implementation by examining challenges faced by clients, facilities, and volunteers. Data collected through open-ended surveys from 33 participants and the researcher's autoethnographic observations revealed eight common barriers: Accessibility (48 mentions), Money (43), Time (30), Awareness (23), Physical Factors (13), Relationships (13), Risk (13), and Weather (7). Clients identified financial constraints as their primary barrier, particularly insurance limitations. Facilitators struggled most with accessibility challenges, including lack of resources, trained staff, suitable horses, and appropriate facilities. Volunteers …

Peer-Led Support Groups For People With Early Onset Parkinson's Disease, Linnea Tabaka

Electronic Theses and Dissertations

Introduction: Early onset Parkinson’s Disease (EOPD) is a diagnosis of Parkinson’s Disease when diagnosed between the ages of 21 and 50. This population faces unique challenges due to family, social, and career demands that correlate with the age of diagnosis. Support groups have been utilized frequently for people with traditional PD and their caregivers but may not meet the unique needs people with EOPD face. This study explores the existing benefits of a peer-led support group (group led by members of the group) for persons with EOPD. Methodology: This is a qualitative case study of an established support …

Perception Of Mental Health Among Students In Higher Education, Kasibah Baig, Leia Aguilar

Electronic Theses, Projects, and Dissertations

Mental health in higher education environments is a topic that has the need for exploration and discussion. Students with poor mental health face additional stressors and challenges in their academic and personal areas of life. It is critical for colleges and universities to address the topic of mental health and understand how it can affect students, as well as to be able to provide the proper support and services. By having more conversations about mental health on campus and providing easily accessible and inclusive resources for students, it can create a comfortable environment on campus for students to be able …

Adolescent Identity And Belongingness: Using Arts-Based Participatory Action Research, Vivian Boyer, Kam Brooks, Emily Camp, Hannah Checkwicz-Grosberg, Jenna Newman, Renee O’Connor, Jacqueline Tardie

LMU Theses and Dissertations

This study explores the concepts of empathy and belonging through the collaborative creative arts process among high school-aged girls at an all-girls Catholic school in Los Angeles County, California. Employing a Participatory Action Research (PAR) framework, researchers and participants collaborated as co-researchers, founded on the principles of cross-cultural art therapy and in the hope of fostering youth advocacy. In partnership with the school community and institution, as well as supported by an Anti-Hate grant from The Jenesse Center, this study examines the intersectional identities of participants and how empathy and belonging can be affected through the art-making process. The project …

Evaluating Triage To Genetic Counseling Using An Online Reproductive Genetics Module, Grace Ra

Dissertations and Theses (Open Access)

The American College of Obstetricians and Gynecologists recommends genetic screening for all pregnant women. As clinical recommendations broaden and demand for prenatal screening increases, obstetric practitioners report time constraints and lack of genetics knowledge as challenges to providing sufficient pretest education. These challenges in offering routine screening are further compounded by the inequities in access to genetic counseling and testing. Thus, alternative education and service delivery models have emerged to meet the demands for prenatal genetics education and help mitigate challenges surrounding access. At UTHealth Houston, an online triage and education module, the Prenatal Genetics Education Program (PGEP), was created …

Navigating Challenges In Palliative Care: A Survey On Asco Guideline Adherence Among Health Care Providers In Low- And Middle-Income Countries., Cristiane Decat Bergerot, Enrique Soto-Perez-De-Celis, Chadane Thompson, Rushil Patel, Jafar Al-Mondhiry, Tingting Zhang, Nathasha Dhawan, Darcy Burbage, Joseph Mccollom Do, Mazie Tsang, Ramy Sedhom, William E Rosa

PCI Publications and Projects

PURPOSE: Integrating palliative care into oncology is essential, yet disparities in access and quality persist, particularly in low- and middle-income countries (LMICs). The ASCO guidelines advocate for early, routine, interdisciplinary palliative care for patients with advanced cancer. Barriers to implementing these recommendations include resource limitations, inadequate training, and cultural perceptions. Recognizing these challenges is essential for improving equitable access to palliative care worldwide.

METHODS: This prospective survey assessed adherence to ASCO recommendations for palliative care integration among LMIC health care providers (HCPs). Participants were recruited via e-mail, social media, and a list of members involved in the ASCO Palliative Care …

#Toomuchcontent: A Quantitative Analysis On Social Media Time Usage And Its Impact On Young Adult Anxiety And/Or Depression In The United States, Sarah Juarez

Electronic Theses, Projects, and Dissertations

As technology continues to advance and grow, society has seen a surge in popularity of various social media sites. Social media has become increasingly popular among young adults, with some spending over 10 hours each day on social media. Social media can be utilized for community building, fostering relationships, providing safe spaces, inspiration, creative expression, and may even provide users with acceptance, validation, and a sense of belonging. Considering these factors, social media may also affect individuals negatively— specifically mental health-wise, in terms of anxiety and depression. This study aimed to identify whether a correlation exists between time spent on …

A Comprehensive Literature Review Of Barriers And Facilitators To Alcohol Use Disorder Screening And Treatment, Lizette M. Orihuela

Capstone Experience: Master of Public Health

Background: Alcohol Use Disorder (AUD) remains a significant public health issue with extensive personal, societal, and economic impacts. Recent studies indicate that no amount of alcohol consumption is entirely safe, linking it directly to increased chronic disease risks, including cancer. Despite well-documented negative health outcomes, clear guidance on what constitutes AUD through diagnostic criteria provided by the DSM-5, AUD continues to be underdiagnosed and undertreated.

Objectives: This comprehensive literature review explores the key barriers and facilitators influencing AUD screening and treatment engagement.

Methods: A comprehensive literature review was conducted, gathering from various databases including, PubMed, PsycINFO, Scopus, Google Scholar, and …

Barriers To Medication-Assisted Treatment For Opioid Use Disorder In Prisons And Jails In The United States: A Comprehensive Literature Review, Amy C. Smith

Capstone Experience: Master of Public Health

Background: The American Society for Addiction Medicine guidelines state that all FDA-approved medication for opioid use disorder should be available for all patients (CDC, 2024). Medication-assisted treatments for opioid use disorders, also known as medication for opioid use disorder (MOUD), are treatments that help diminish the physical symptoms of addiction to opioids. Currently, there are three FDA-approved medications to treat opioid use disorder: buprenorphine, methadone, and naltrexone (FDA, 2024). Despite being at an increased risk for opioid misuse and overdose, incarcerated individuals in the U.S. often do not have access to MOUD. This comprehensive literature review aimed to determine the …

Identifying Predictors Of Student Success During Occupational Therapy Level Ii Fieldwork, Melissa R. Foster

Graduate Theses and Dissertations

The training paradigm for new occupational therapy (OT) practitioners includes both didactic classroom learning and clinical fieldwork experiences in order for them to establish clinical competency. However, many students struggle with the theory-to-practice gap of translating classroom knowledge to clinical experiences. When students struggle in this manner, it causes stress for all stakeholders involved, including the fieldwork educator, clinic managers, OT program faculty, as well as the student.

This study aims to avoid this stress by identifying predictors of student success by analyzing data from recent graduates of the University of Arkansas/University of Arkansas for Medical Sciences OT program through …

Efficacy Of Menstrual Cycle Awareness In The Identification Of Premenstrual Dysphoric Disorder, Rachel Brothers

Physician Assistant Scholarly Project Papers

Premenstrual Dysphoric Disorder (PMDD) is characterized by identifiable psychological and physical symptoms that are present in the week before menses and is estimated to affect 3-8% of women of reproductive age globally. The identification of women who meet criteria for PMDD is important both clinically, to provide proper support and treatment, and for advancing research by identifying appropriate study participants. This literature review aims to investigate the efficacy of current and prospective tools to screen for symptoms of PMDD by comparing a common depression screening tool, the PHQ-9, to tools that enhance menstrual cycle awareness. A literature review was conducted …