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Best-Practice Patient Education On Glp-1, Low-Glycemic Diet, Intermittent Fasting, And Exercise For Weight Loss In Obese Nondiabetics, Clara Green

Walden Dissertations and Doctoral Studies

Executive Summary: Clinical Practice Guideline Best-Practice Patient Education on GLP-1, Low-Glycemic Diet, Intermittent Fasting, and Exercise for Weight Loss in Obese Nondiabetics by Clara Green MS, Walden University, 2020 BS, University of Texas at El Paso, 2014 Executive Summary Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2026

A Clinical Accuracy Study Protocol For A Saliva-Based Point-Of-Care Lateral Flow Test To Assess Protective Immunity To Tetanus (Tetanus Study), H F Kwok, R Agarwal, Y Takwoingi, Semukunzi H, C Umuhoza, A Richter, J Nyombayire, C M Muvunyi, J Heaney, C A Green

Faculty, Staff and Students Publications

Introduction: Despite the availability of a safe and effective vaccine, 2000-3000 neonates die of tetanus yearly, predominantly in low- to middle-income countries (LMICs). Inaccurate coverage estimates and vaccination records, together with variability in vaccine response, make identifying individuals who lack protective immunity and may benefit from vaccination difficult. A more direct measure of protective immunity is widely accepted as anti-tetanus IgG concentration at or above 0.1 IU/mL. This study aims to evaluate the performance of a novel saliva-based point-of-care lateral flow test (CIS-IMMUNE Tet) for the binary classification of tetanus protective immune status (protected/unprotected) against WHO threshold-based classification of IgG …

Myoelectric Transradial Prosthesis Motor Control With Temporal Convolutional Neural Network Signal Processing, Carolyn Ascha Richardson, Katherine Clark, Francis Genco, Hope Lea, Tobiah Rosser

Discovery Day - Daytona Beach

Transradial (below-the-elbow) amputees account for more than half of all upper limb amputations. Myoelectric prosthetic arms, which use electromyography (EMG) sensors on the surface of the forearm to convert electrical signals from residual limb muscles and mimic hand movement, are popular options for these amputees. However, these prostheses are limited in residual muscle detection and movement accuracy. The objective of this project is to affordably manufacture an externally-powered transradial prosthesis prototype through EMG time-versus-voltage readings collected with six Delsys Trigno Avanti and eight Thalmic MYO EMG sensor channels placed along the extensor digitorum, extensor carpi radialis, extensor carpi ulnaris, flexor …

Home-Use Oct For Neovascular Age-Related Macular Degeneration: A Rapid Review, Sneh S. Shah

inSIGHT

Neovascular age-related macular degeneration (nAMD) requires frequent monitoring to identify recurrent exudation and guide treatment with anti-vascular endothelial growth factor (VEGF) therapy.1 Clinic-based optical coherence tomography (OCT) plays a central role in management but provides only intermittent assessments of a disease that changes over time. Home-use OCT technologies have recently been developed as a possible solution, allowing patients to perform self-imaging with remote clinician review and artificial intelligence (AI)-assisted analysis. This rapid review summarizes current evidence on home-use OCT for nAMD, including feasibility, diagnostic performance, clinical usefulness, and challenges related to implementation. Findings from feasibility studies, AI validation analyses, observational …

Enhancing Patient Understanding: Standardizing Cardiac Medication Education Using Teach-Back For Heart Failure, Nicole Valerie Hediger

Master's Projects and Capstones

Problem: The transition from hospital to home places heart failure (HF) patients at risk for medication errors, nonadherence, deterioration, and rehospitalization. In a 28-bed medical-surgical telemetry microsystem, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores indicated an opportunity for improvement: “Communication About Medicines” composite score of 47.9%; 62.5% of patients reported being informed about the medication purpose, and 33.3% reported that staff described potential side effects.

Context: A cohort of HF patients was selected to test teach-back methodology and improve patient understanding. Nurse champions volunteered for a 5-month improvement project.

Interventions: Teach-back methods were implemented. Nurse leader rounding …

Improving Pain Reassessment Within One Hour Of Pain Medication Administration, Geraldine B. Macalma

Master's Projects and Capstones

Abstract

Problem: Timely reassessment of pain is often missed or inconsistently documented, creating a gap between evidence-based standards and actual nursing practice. This inconsistency prevents evaluation of intervention effectiveness and contributes to unmanaged pain, reduced patient satisfaction, and safety concerns.

Context:  Pain reassessment is a critical component of evidence-based pain management, ensuring that nurses evaluate the effectiveness of interventions and adjust care accordingly.  Competing priorities and documentation challenges often lead to inconsistent reassessment, affecting patient comfort, safety, and overall quality of care.

Interventions: Guided by a Plan-Do-Study-Act framework, the intervention included documentation of a safety round, purposeful hourly rounding, …

Improving Documentation Of Skin Assessment In The Med-Surg Overflow Microsystem, Min Kim, Mikeal A. Swift

Master's Projects and Capstones

Abstract

Problem

Hospital-acquired pressure injuries (HAPIs) remain a costly patient safety concern with increased morbidity and prolonged hospitalization. Inconsistent admission skin assessment documentation in a 24-bed overflow medical–surgical microsystem led to delayed wound identification and misclassification.

Context

A baseline needs assessment (n = 15) identified key barriers, including low nurse confidence utilizing Rover (mobile software application) and linking photos to the LDA (lines-drains-airway) in the electronic health record.

Intervention

A bundle of 6 components was tested over 12 weeks: standardization of the two-RN skin assessments within 8 hours of admission or transfer; optimization of Rover photo capture and LDA linkage; …

Staff Education To Address Verbal De-Escalation Skills In Correctional Mental Healthcare, Mary L. Goodman

Walden Dissertations and Doctoral Studies

This staff education project evaluated the effects of a structured verbal de-escalation training program on self-efficacy among staff in a federal correctional mental health unit. Staff at the site often reported uncertainty managing escalating behaviors, leading to frequent use of restrictive interventions like restraints and seclusion—practices that can compromise safety, quality of care, and raise ethical concerns. To address this gap, an evidence-based curriculum was implemented for 41 multidisciplinary staff, including nurses, certified nursing assistants, and correctional officers. The curriculum included a PowerPoint presentation, role play, and group discussion. A pre–post design measured changes in staff confidence using a modified …

Staff Education To Improve Knowledge And Confidence In A1c Screening For Adults With Serious Mental Illness, Veronica Akweley Odoi

Walden Dissertations and Doctoral Studies

This project was conducted to observe the effects of staff education on staff knowledge and confidence regarding metabolic risk and hemoglobin A1c (A1C) monitoring for adults with serious mental illness in a crisis response unit. The lack of a streamlined system in metabolic testing in recent times has led to nuances in metabolic testing for patients with serious mental illness. The practice-focused question asked whether evidence-based staff education on A1C monitoring, and provider roles would improve staff knowledge and confidence. The purpose of the education is to strengthen knowledge of metabolic risk, A1C screening expectations, role clarity, workflow, and staff …

Staff Education To Providers Prescribing Glp-1 Medications For The Treatment Of Obesity, Madeleine Williams

Walden Dissertations and Doctoral Studies

The utilization of glucagon-like peptide 1 (GLP-1) medications has skyrocketed over the past 5–8 years, with an average weight loss of 15–21% of initial weight. Unfortunately, not all providers offer evidence-based patient education when starting a GLP-1 medication for the treatment of obesity. A practice gap I have identified is the lack of consistent evidence-based education providers utilize when prescribing GLP-1 for obesity treatment in the primary care setting. The project site was a hospital-based primary care clinic located in a suburban community in Washington. This staff education aimed to evaluate whether a standardized, evidence-based educational tool on GLP-1 medications …

Stemless Arthroplasty For Avascular Necrosis Of The Humerus: Implant Survival And Outcomes, Alyssa R. Henriquez, Damon V. Briggs, Eoghan T. Hurley, Samuel Lorentz, Christopher S. Klifto, Michael A. Moverman, Oke Anakwenze

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Avascular necrosis (AVN) of the humeral head often affects younger patients and may lead to progressive pain and functional deficits. While stemmed hemiarthroplasty and total shoulder arthroplasty (TSA) are established treatments for advanced-stage AVN, stemless arthroplasty offers potential advantages including bone preservation and facilitation of future revision. However, the impact of bone necrosis on stemless humerus fixation is yet to be elucidated. Therefore, the purpose of this study was to evaluate the outcomes of stemless hemiarthroplasty and TSA in treating humeral head AVN and, further, to determine if stemless humeral fixation is appropriate in this population.

METHODS: This retrospective …

Belonging And Whole Person Formation In Graduate Education: A Conceptual Framework For Student Flourishing, Cynthia Hickman

Papers

Graduate students experience substantial academic, personal, and professional demands that can negatively affect well-being and persistence. For students enrolled in professional programs, belonging may develop within two overlapping communities: the academic institution and the emerging profession. Institutional and professional belonging can provide connection, support, engagement, and opportunities for identity and professional development. This paper synthesizes literature on these two forms of belonging and proposes a conceptual framework describing their potential relationship with whole-person formation and flourishing. Whole-person formation extends graduate education beyond knowledge acquisition and professional competence to include development across interconnected dimensions of the person. Within the proposed framework, …

Transient Activation Of Potent Progenitor Cells Is Required For Spinal Cord Regeneration, Chase Alexander Weinholtz

Arts & Sciences Graduate Student Theses and Dissertations

Mammalian spinal cord injury is an intractable biomedical problem driven by interlocking maladaptive cellular responses that prioritize acute stabilization over long-term recovery. However, this deficient regenerative capacity is not an inherent limitation. The zebrafish, for example, capably regenerates and regains motor function with 2 months of a full transection injury. This ability is thought to rely on the transient expansion of stem cell-like progenitors marked by sox2 expression. Yet our understanding of the identities and contributions of this crucial population remains limited. Here, we determine the molecular identities and cellular contributions of sox2+ progenitors during innate spinal cord repair in …

Comparison Of Training Background And Characteristics Between Osteopathic And Allopathic Team Physicians In Professional Sports Leagues., Brandon D Rust, Ambika Singh, Matthew T Mckinley, Joseph Imler, Mackenzie Elting, Ryan Callahan, Christopher L Rennie, Leighann C Krasney

Orthopedic Surgery Resident Research

CONTEXT: Team physicians (TPs) play a critical role in professional sports, providing medical care for athletes under high-pressure conditions. These positions are highly competitive, influenced by previous affiliations, training pedigree, and institutional connections, with fellowship training increasingly essential. Although the number of osteopathic (Doctor of Osteopathic Medicine [DO]) physicians in the United States has grown substantially, TPs in professional sports remain predominantly filled by allopathic (Doctor of Medicine [MD]) physicians, and the training pathways of DO TPs are not well characterized.

OBJECTIVES: The objective of this study is to compare the training and demographic characteristics of DO and MD TPs …

What Do Children Think About Bouncy Bands: A Mixed Methods Examination Of Bouncy Bands' Influence On Attention And Physical Activity, Ken Murfay, Sarah Collins

International Journal of Physical Activity and Health

Purpose: To examine how bouncy bands put onto elementary students’ classroom desks influenced students’ physical activity and attention/concentration, in addition to exploring students’/teachers’ opinions of the bands. Methods: Students within both experimental and control groups wore pedometers to assess movement during instruction and completed the d2 test for attention. Results: The group with bouncy bands on the desks had significantly more movement compared to the control group. For d2 scores, there was no significant difference between the two groups, nor was there a significant linear relationship between movement and d2 scores. Interviews were conducted with the students in the experimental …

Dosimetric Comparison Of Hybrid 3d Conformal Radiation Therapy And Volumetric Modulated Arc Therapy Versus Vmat-Only Planning For Accelerated Partial Breast Irradiation, Erjona Jusufi

Masters Projects

Abstract

Purpose: To compare dosimetric outcomes between volumetric modulated arc therapy (VMAT)-only and hybrid VMAT plus three-dimensional conformal radiotherapy (3D-CRT) techniques for accelerated partial breast irradiation (APBI) in patients with early-stage left-sided breast cancer.

Methods and Materials: Thirty patients treated with APBI at a single institution were retrospectively replanned using both VMAT-only and hybrid (VMAT + 3D-CRT) techniques. All plans were prescribed 26 Gy in 5 fractions. Each patient was planned using the same target volumes, optimization objectives, and evaluation criteria for both techniques. Planning target volume (PTV) coverage, conformity index (CI), homogeneity index (HI), hotspot control, organ-at-risk (OAR) doses, …

Staff Education To Reduce Stress In Assisted Living Nursing Staff, Cherechi Onyenso

Walden Dissertations and Doctoral Studies

In this staff education doctor of nursing practice (DNP) project, I addressed a practice gap associated with inadequate staff knowledge of workplace stress-management strategies in an assisted living facility. Workplace stress in nursing practice is a contributing factor to burnout, reduced job satisfaction, poor teamwork, and a decline in the quality of resident care. The practice-focused question for this project was about whether staff knowledge would be enhanced over an 8-week period in comparison to baseline knowledge as a result of their participation in a structured staff education program on workplace stress management. The purpose of the project was to …

Staff Education To Standardize Chronic Pain Patient Education In Primary Care, Jessica Okpara

Walden Dissertations and Doctoral Studies

Inconsistent delivery and documentation of chronic pain patient education may contribute to variations in patient knowledge, treatment expectations, and engagement in self-management. This Doctor of Nursing Practice staff education and quality improvement project was designed to standardize chronic pain patient education in a primary care setting. The practice-focused question examined whether implementing standardized chronic pain education, compared with non-standardized education, would improve patient knowledge and use of self-management strategies over 10 weeks. Guided by the Johns Hopkins Evidence-Based Practice Model, the project included development of evidence-based education materials, staff preparation, workflow integration, and a standardized documentation process. Clinic staff identified …

Reducing Nurse Burnout, Oluwarotimi Tunde Aborisade

Walden Dissertations and Doctoral Studies

Nurse burnout is a severe job-related condition that significantly impacts nurses' well-being. Nurse burnout is a growing concern amid the increased demand for healthcare professionals. Research has been conducted to explore nurse burnout and how it affects the quality and safety of patients. Different research has also been conducted to review different interventions to address nurse burnout, including individual and organizational interventions. Some interventions include self-care, mindfulness and meditation, coping and resilience, as well as lifestyle adjustments. Some organizational interventions include workload management, psychological safety, and job redesign. This study was conducted to evaluate the effectiveness of individual interventions to …

Prenatal Health Factors Of Pregnant People Associated With Second Degree Postpartum Hemorrhage Across The United States, Elizabeth Simpler

Walden Dissertations and Doctoral Studies

Secondary postpartum hemorrhage (SPPH) is a significant contributor to maternal morbidity in the United States and occurs after hospital discharge during the postpartum period. Persistent disparities in terms of maternal outcomes suggest access to prenatal care alone may not adequately address clinical and social factors associated with SPPH. Guided by the Social Ecological Model, which recognizes that health outcomes are influenced by a collective approach to examining health. The purpose of this study was to examine associations between SPPH, prenatal care access, and social determinants of health from 2019 to 2022 while controlling for maternal age, race, and delivery type. …

Improving Identification And Initial Management Of Perimenopause In Primary Care, Yewande Banire

Walden Dissertations and Doctoral Studies

Perimenopause is a common but frequently underrecognized stage of reproductive aging that can significantly affect women's physical, psychological, cognitive, and sexual well-being. In primary care, inconsistent provider education and the absence of standardized screening and assessment processes often contribute to delayed recognition and fragmented management. The purpose of this Doctor of Nursing Practice quality improvement project was to develop, implement, and evaluate an evidence-based clinical practice guideline to improve the identification and initial management of perimenopause in a primary care setting. Guided by the Johns Hopkins Evidence-Based Practice Model, the project involved synthesizing and critically appraising the literature to develop …

Assessing Non-Thermal Plasma In Cutaneous Regeneration, Arden Rodriguez, Meliah Martin, Graeme Grainger, Arineh Shahbazi

Discovery Day - Daytona Beach

Chronic and acute wounds remain a significant clinical challenge, particularly in austere and resource-limited environments where access to advanced care is restricted. Non-Thermal Plasma (NTP) has emerged as a promising, non-invasive modality with reported antimicrobial and regenerative properties; however, its mechanisms of action and effects on human skin tissue require further characterization. The scope of this project is to engineer and utilize a 3D human skin epithelial model to evaluate the effects of NTP on wound healing. We will first build a 3D epithelial tissue model that will simulate human skin, followed by modeling and evaluation of wound pathology and …

Extracting Aromatic Compounds From Dehydrated Rose Buds, Lana Sheridan

Discovery Day - Daytona Beach

Eugenol (C10H12O2), methyl eugenol (C11H14O2), and 2-phenylethanol (C8H10O) are chemically aromatic, natural compounds commonly present in various botanical sources and essential oils. Structurally, eugenol is a methoxyphenol bearing an allyl side chain; its methyl ether derivative, methyl eugenol, shares a similar framework but features a methoxy group replacing the free phenolic hydroxyl group found in eugenol. 2-Phenylethanol is an aromatic alcohol comprised of a benzene ring linked to an ethanol moiety. The objective of this project was to isolate and characterize these compounds in dried rose buds using distillation followed by chromatographic and spectrometric analysis. For the experiment, a steam …

Steam Distillation Star Anise, Makayla Maso, Kiara Maso

Discovery Day - Daytona Beach

Star anise (Illicium verum) contains several volatile organic compounds responsible for its characteristic aroma, including trans-anethole, estragole, limonene, and linalool. These compounds differ in structure and chemical properties, which influence their behavior during isolation and analysis. Trans-anethole and estragole are classified as aromatic phenylpropene derivatives that contain benzene rings and ether functionalities. In contrast, limonene and linalool are non-aromatic terpenes, with linalool additionally possessing an alcohol functional group. These compounds are widely utilized as flavoring agents and fragrance components, while terpenes such as limonene and linalool are also commonly employed as solvents and in formulation chemistry due to their volatility …

Extraction Of Cedarwood Essential Oils Via Steam Distillation, Forrest Dohner

Discovery Day - Daytona Beach

Many natural materials, including pine and eucalyptus, produce distinct scents due to the presence of volatile organic compounds. In cedarwood, this aroma arises from a combination of aromatic molecules, which are organic compounds containing conjugated carbon ring systems that interact with olfactory receptors. Specifically, cedarwood contains three primary compounds responsible for its scent: cedrol, cedrene, and thujopene. The objective of this experiment was to extract these essential oils from cedarwood and identify their chemical composition. Steam distillation was used to isolate the volatile components by passing steam through the cedarwood, causing the essential oils to vaporize at temperatures below their …

Production And Analysis Of Lavender Essential Oil: Extraction, Composition, And Applications, Mary Zoeller

Discovery Day - Daytona Beach

Steam distillation was performed to extract essential oil from lavender and analyze its chemical composition. Lavender is known to contain several compounds such as linalool, terpinen-4-ol, and linalyl acetate, which contribute to its characteristic aroma and biological activity. The purpose of this experiment was to isolate these compounds without decomposition and identify them using gas chromatography–mass spectrometry (GC-MS). Approximately 14.851 g of lavender was heated with water to generate steam, which carried the volatile compounds into a condenser where the vapor was cooled and collected. The distillate was transferred to a separatory funnel to isolate the organic layer from the …

Improving Diabetes Self-Management Through A Partnership Between Clinical Providers And Community Educators In Appalachian Communities, Soghra Jarvandi, Lydia Hoskins, Karen Carver, Andrew May

Journal of Appalachian Health

Introduction: The burden of diabetes is an increasing public health challenge, especially in the Appalachian Region.

Purpose: This study assessed the impact of a community-based diabetes education program on glycemic control.

Methods: Health Extension for Diabetes (HED) is a 4-month diabetes education program offered by Extension educators in collaboration with clinical providers. Participants’ data were collected via phone interviews at baseline and after completing the program. Assessments included self-reported HbA1c, socio-demographics, diabetes knowledge, self-efficacy, and self-management behaviors. Data were analyzed by SAS software using paired analyses.

Results: Of the 105 participants in the program, 87 (83%) completed the post-assessment. Among …

Disparities In Access To Medicare-Approved Medical Specialists In Rural Kentucky, Logan Hurm, Jacob A. Welch, James Adkins

Journal of Appalachian Health

Introduction: Approximately 20% of the United States population resides in a rural community; however, only 10% of all healthcare resources and physicians are dedicated to these areas. Appalachia, and Kentucky (KY) in particular, have higher populations living in rural areas which leads to a greater number of individuals affected by medical access disparities. As of 2026, 21% of KY’s population is eligible for Medicare, making access to Medicare-accepting specialty physicians crucial for the state’s population.

Purpose: This research aims to quantify healthcare disparities among rural communities in KY through quantification of the potential distance required to travel to access specialty …

Exercise Intensity And The Effects On Mood And Wellbeing, Emily Amortegui, Ashley Albert, Riley Ensor, Keyanna Keyanna Jackson

Discovery Day - Daytona Beach

With many students dealing with anxiety, sadness, and high levels of stress, mental health issues among college students have grown in intensity. A lot of research has been done on the possible benefits of physical activity for mental health, but most of it focuses on correlations rather than the biological mechanisms. The purpose of this study is to examine the effects of varying exercise intensities on physiological stress markers and mood in college students ages 18 to 25. To assure precise intensity levels, participants from Embry-Riddle Aeronautical University will work out at low, moderate, and high intensities while wearing heart …

Effects Of Sleep Duration And Perceived Stress Of Reaction Time In Undergraduate Students, Caitlin Wescott, Edna Urrutia, Ryan F. Rednick, David Still

Discovery Day - Daytona Beach

Sleep deprivation and psychological stress are common among undergraduate students and can negatively affect cognitive performance. Reaction time is an important indicator of attention and processing speed and plays a critical role in both everyday activities, such as driving, and high-performance environments where rapid responses are required. This study aims to examine how sleep duration and perceived stress levels influence reaction time in undergraduate students. Participants will report their sleep duration and perceived stress levels through short surveys and wearable sleep data, while reaction time will be measured using a standardized computerized reaction time test. By comparing reaction time across …