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Optimizing Tbi Care: Brain Oxygen Monitoring In Nursing - An Evidence-Based Practice, Alyssa Grisham

Loma Linda University Electronic Theses, Dissertations & Projects

Purposes/Aims

This DNP project aims to enhance the care of patients with traumatic brain injury (TBI) by improving nurses’ knowledge, clinical decision-making, and early intervention strategies through the integration of brain oxygenation data into routine neurocritical care assessments. This project seeks to promote personalized patient care, reduce secondary brain injury, and improve neurological outcomes for critically ill adults with TBI by implementing an educational protocol designed to deepen understanding of brain oxygen monitoring.

Background of Problem & Description of Current Practice

TBI remains a leading cause of death and disability worldwide and continues to pose a significant public health burden. …

Assessing The Ecological Vulnerability Of Natural Flood Defences And Risks To Agricultural Land Following Seawater Flooding, Cally Barratt

School of Biological and Marine Sciences Theses

Anthropogenic climate change is intensifying extreme weather events, affecting the natural environment by altering ecosystems, and leading to habitat loss. Pressingly, the frequency and severity of storm surge flooding in low-lying coastal regions is projected to increase under future climate scenarios. There is a growing need to understand how these events will impact coastal ecosystems, and the measures that can be taken to mitigate against these effects and protect natural resources. Furthermore, with increased pressures placed on agriculture to meet food demand, protecting arable land resources in coastal regions from the rising threat of flooding is imperative. This thesis explores …

Physiological And Morphological Responses To Drought Stress In Different Cultivation Environments In Wild Type And Aba-Deficient Barley, Chloe Betts

School of Biological and Marine Sciences Theses

Global food security is increasingly threatened by the effects of climate change. Of the environmental factors affected by climate change, drought is one of the most critical for plant survival and reproduction, shaping plant morphology and physiology and therefore crop productivity. Although the effects of drought on plants are widely studied, studies are often conducted in controlled greenhouse or laboratory conditions rather than more realistic field-like conditions. This is justified by the lower costs, convenience, and ability to disentangle the effects of different factors in more controlled conditions. This thesis explores the effect of the same watering limitations in different …

Plastic Pollution: Investigating Environmental Pathways And Critically Evaluating Interventions, Florence Parker-Jurd

School of Biological and Marine Sciences Theses

Plastics are lightweight, versatile, and durable materials used in the manufacture of a wide range of products. Innovation in the early 1950’s facilitated a dramatic reduction in production costs with the potential to mass produce inexpensive convenience items intended for single use applications. As a consequence, plastic production has grown exponentially over the last 75 years, and a throw away culture of single use has become deeply engrained in modern society. Plastic production exceeds 450 million tonne/yr, substantially exceeding our capacity to manage associated waste resulting in pollution accumulating in every compartment of the natural environment. While plastic pollution has …

Influence Of Ecological Transitions On The Evolution Of Circadian And Light Detection Genes In Squamates, Isobel Sleep

School of Biological and Marine Sciences Theses

Circadian rhythms are self-sustaining, endogenous processes that align behaviour and physiology with daily environmental cycles. Rhythms are regulated by conserved genes forming transcriptional feedback loops and are entrained by environmental cues (e.g., light). Circadian systems are well studied in model organisms, their molecular evolution in squamates (lizards and snakes) remains less understood. Squamates represent the most species-rich reptile group with extensive ecological and sensory diversity, exhibiting multiple independent transitions across ecological niches, including repeated shifts into low-light environments (e.g., nocturnality, fossoriality), making them ideal for examining circadian and light-associated gene evolution. This study investigates how ecological transitions have influenced the …

Autonomous Navigation Development And On-Ground Validation For Satellite Rendezvous And Proximity Operations, Logan Banker

Masters Theses

Spacecraft rendezvous and docking are critical mission phases for various applications of spaceflight, including active debris removal (ADR) and in-orbit servicing, assembly, and manufacturing (ISAM). While previous missions utilized humans to perform rendezvous and docking, this style of mission greatly increases safety risks and cannot be implemented on a large scale. Autonomous servicing satellites provide a path towards scalable rendezvous and proximity operations (RPO) because these autonomous agents do not require human intervention. This work presents a lightweight convolutional neural network (CNN) for the navigation system of an agent which analyzes monocular images and predicts the target's position and orientation …

Wattage- And Composition-Dependent Ocular Surface Toxicity: An In Vitro Study On E-Cigarette Aerosol Exposure In Human Corneal Epithelial Cells, Tzu-Ling Lin

Masters Theses

As electronic cigarette consumption continues to escalate globally, its impact on non-respiratory mucosal surfaces, particularly the ocular surface, remains largely understudied. This study investigated the toxicological effects of e-cigarette aerosols using a human corneal epithelial cell (HCE-2) model. Our findings reveal that aerosol exposure induces a significant, dose-dependent reduction in cell viability, exacerbated by higher device wattage and specific flavor agents such as watermelon. Exposure was found to trigger intracellular oxidative stress and the activation of apoptotic pathways, leading to programmed cell death. Furthermore, the upregulation of proinflammatory cytokines suggests that vaping may predispose users to chronic inflammatory conditions of …

Sources Of Tensions In Ai Adoption For Organ Procurement Organizations, Amaneh Babaee

Masters Theses

"Although medical AI systems have promise, the healthcare system has not fully integrated them for improved organizational operations. Studies have been conducted to identify root causes for this hesitancy without targeting a specific domain in healthcare. This generalization can be enhanced for the nuanced or domain-specific factors that offer practical insights to organizations leader. In this thesis, I focus on the factors and sources of tensions in AI adoption in transplant system, which is highly regulated but encourages innovation. Applying the Extended Technology, Organization, Environment (TOE) framework, 10 interviews were conducted at Organ Procurement Organizations (OPOs).

Although not always technically …

Moth Assemblages Of Fort Leonard Wood, Missouri, Kimberly Anne Steese

Masters Theses

"Moths (Lepidoptera) are ecologically important insects that function as herbivores, pollinators, prey resources, and indicators of ecosystem integrity. Despite their ecological significance, moth communities in the Missouri Ozarks remain poorly documented, particularly within military-managed landscapes. This thesis examined patterns of moth diversity, assemblage structure, and environmental drivers at Fort Leonard Wood (FLW), Missouri, while also assessing the distribution and genetic diversity of species within the genus Papaipema.

Field surveys were conducted from 2019 through 2021 across prairie, savanna, forest, and restoration habitats at FLW using UV bucket traps, sheet trapping, and targeted larval surveys. Across all sampling efforts, 29,116 individual …

Overcoming Resolution Vs. Throughput Trade-Offs In Ceramic Material Extrusion Additive Manufacturing Via Viscoelastic Filament Stretching, Abid H. Rafi, David W. Lipke, Jeremy L. Watts, Gregory E. Hilmas, Ming C. Leu

Materials Science and Engineering Faculty Research & Creative Works

Fabricating large, monolithic ceramic parts using material-extrusion additive manufacturing remains challenging due to difficulty maintaining uniform moisture content during printing, which can lead to drying-induced defects such as warping and cracking, especially as part size and print time increase. Fabricated parts have trade-offs among print resolution, high throughput, and structural fidelity. Our study has shown that increasing the ratio of nozzle traverse speed vs. material extrusion speed increases filament stretching in viscoelastic ceramic paste, helping to overcome the trade-offs between resolution and throughput. Using aqueous ZrB2–SiC (70/30 vol.%) as a representative ultra-high temperature ceramic paste, rheological characterisation revealed viscoelastic yield-stress …

Stall Detection In Hydraulic Excavator Operations Using Heuristics And Machine Learning: A Case Study, Mateo Fernando Montenegro Defaz, Kwame Awuah-Offei, Yixiang Gao

Mining Engineering Faculty Research & Creative Works

This work aims to develop a reliable algorithm for stall detection during excavator digging by analyzing key operational variables such as velocity and angular displacements from machine monitoring data. The work develops and validates a heuristic algorithm to detect stalling events and trains a support vector machine classification algorithm to distinguish between "normal" digging cycles and cycles with stalling. This work is a novel attempt at using a classification algorithm to categorize digging cycles into normal and those with stalling events based on machine monitoring data alone. The developed classification algorithm achieved a sensitivity of 100%, indicating it correctly identified …

Analysis Of Pull-Out Tests For Resin-Grouted Rib Bolts, Khaled Mohamed, Yuting Xue, Dogukan Guner, Alper Kirmaci, Taghi Sherizadeh

Mining Engineering Faculty Research & Creative Works

Resin-grouted rib bolts serve as a crucial means of stabilizing spalling of coal ribs in underground coal mines. A comprehensive investigation into their efficacy was undertaken by a collaborative effort between the National Institute for Occupational Safety and Health (NIOSH) and Missouri University of Science and Technology (MST). This study involved pull-out tests of rib bolts in multiple locations, including six coal mines and the NIOSH research mine. A total of seventy-three (73) pull-out tests were conducted for rib bolts installed at different rotation speeds and a wide range of anchorage lengths, ranging from a short encapsulation length of 0.305 …

Retirement: Broaching Intersectional Identities And Aging, Nichole Tiggs Angieri, Ericka Cables, Mary Martha Abernathy

Adultspan Journal

Broaching intersectional identities in retirement is a crucial counseling skill that fosters trust and connection with older adults as they navigate this major life transition. Using Person-Centered, Trauma-Informed (PCTI) and Relational-Cultural Theory (RCT) as complements to broaching, these theories provide both relational and cultural attunement to facilitate healing and well-being in this specialized population. Through didactic information and case studies, the purpose of this conceptual paper is to provide counselors and counselor educators with insight into broaching intersectional identities in retirement and to advocate for further research on aging and identity. The implications for clinical practice include providing an integrated …

Structural And Intersectional Factors In Full Retirement: Insights For Black Men, Waleed Sami

Adultspan Journal

This interview centers the full retirement experience of Anthony Crawford. This perspective highlights the complex interplay between social determinants, intersectional identity, the psychology of working, and social class/social mobility, as key factors in his lived experiences. The relationship between structural factors and interpersonal factors continues to be a growth edge in counseling, as counselors frequently report lack of knowledge or comfort in their relationship with counseling. This interview seeks to fill the gap and demonstrate a concrete way to develop clinical insights. The full interview is transcribed and provided, along with practical and research implications for counselors working with populations …

A Systematic Review Of Psychosocial Interventions For Improving Well-Being In Retired Adults, Sakir Yilmaz, Mustafa Filiz

Adultspan Journal

The transition to retirement is a critical biopsychosocial stage that often brings challenges such as shifting roles and reduced income, which may lead to psychological distress. In this study, we systematically synthesized quantitative evidence on the effectiveness of psychosocial interventions in enhancing well-being (increase in positive functioning) among retired adults. A comprehensive search across PubMed, Scopus, Web of Science, and Cochrane was completed in October 2025. This was supplemented by Google Scholar and reference list screening, identifying 5,945 database records and 123 additional sources. After screening and eligibility assessment, seven studies met the inclusion criteria. Across these studies, interventions produced …

Feminism, Domestic Abuse And The Singer-Songwriter, Kathryn Ferguson

School of Art, Design and Architecture Theses

This project explores how feminism and domestic abuse can be articulatedthrough songwriting. Research in music therapy, sociology and popular musicincreasingly speaks to the value of songwriting as a tool for personal andcommunity empowerment, but there is space to actively use songwriting toexplore feminist issues independently of the traditional commercial context ofpopular music. Existing feminist music has been deemed as at its mostsuccessful when it is linked clearly to social change in our communities(Greene, 2017, p.8). Modern popular feminist songwriting has been criticised fornot going far enough in deconstructing systemic patterns of patriarchy (Tong,2024, p.9). Considering this, engaging with academic research …

The Career Choices Of Final Year Nursing Students In The United Kingdom: A Qualitative Study., Kevin Hambridge, Frazer Underwood, Gosia Bettache, Matt Carey, Halil Kaya, Lisa Burrows, Rachel Tims, Christian Brailsford

School of Nursing and Midwifery

Aim: The aim of this study is to explore the career choices of final year under-graduate nursing students in the United Kingdom. Background: Worldwide there is a decreasing number of nurses and in the United Kingdom there is a decreasing amount of nursing students. There is sparce evidence relating to the career's choices of nursing students and reasons for those choices. Obtaining a deeper comprehension of these choices may aid healthcare employers, in partnership with universities, to design the future nursing workforce. Design: A qualitative design was used. Methods: Twenty-one final year under-graduate nursing students from across a range of …

Job Satisfaction, Burnout, And Intent To Stay In Neonatal Nursing In England And Wales: A Cross-Sectional Survey Study, Kathy Chant, Yoko Nishimura, Aviva Petrie, Jos M. Latour, Nicola Booth, Kelly Crofts, Lisa Viola, Katie Gallagher

School of Nursing and Midwifery

Objective: To explore job satisfaction, burnout and intent to stay in neonatal nurses in England and Wales. Methods: A cross-sectional online survey study using the McCloskey Mueller Satisfaction Scale (MMSS) to explore job satisfaction, the Copenhagen Burnout Inventory (CBI) to explore burnout and the Nurse Retention Index (NRI) to measure intent to stay. All neonatal nurses working in England and Wales were eligible to take part. Data were collected between February and September 2024. Results: A total of 1590 neonatal nurses completed the survey. Job satisfaction was neutral. Moderate work burnout was reported, with statistically significant differences in mean score …

Digital Marine Citizenship Training Module: Toolkit For Digital Placemaking, Katharine Willis

School of Art, Design and Architecture

As a coastal nation, the UK has long drawn inspiration from the sea - shaping our history through travel, industry, the arts, leisure and more. The coastline remains a place of identity and possibility. It also offers signifi cant benefi ts for health, wellbeing and connection, yet many local people are disconnected from nearby shores.This Training Module is an easy to use resource to reimagine community relationships with the sea and make coastal spaces more inclusive, welcoming and vibrant for all.Connected SeascapesOrigins of the Training Module The Connected Seascapes Toolkit stems from a collaborative project between Plymouth City Council, the …

Mapping The Role Of Occupational Therapy Within Primary Care Services: A Scoping Review, Katie-Mai Davies, Alison Warren, Sam Wakley

School of Health Professions

Introduction:Occupational therapy is named a key profession within primary care, with growing demand due to an ageing population and increase of people living with long-term conditions. Despite this, occupational therapy within primary care remains an evolving, under researched area of practice. This scoping review explored the role of occupational therapy within primary care including the populations and interventions currently provided.Methods:The Joanna Briggs Institute (JBI) methodology for scoping reviews was followed with systematic searches conducted across CINAHL, PubMED and AMED databases with grey literature also sourced. The findings are presented in tabular format and analysed using descriptive statistics and frequency counts …

Connecting The Dots - Recognition Of Artificial And Natural Shapes Relies On Representing Points Of High Information, Gunnar Schmidtmann, Nicholas Baker, Kevin J. Lande, Filipp Schmidt

School of Health Professions

Physiological and psychophysical evidence suggests that the visual system represents object outlines using prominent curvature features, particularly regions of extreme curvature (convex maxima and concave minima). These curvature extrema often coincide with points of high informational content (“surprisal”), but this relationship is only correlational. It remains unclear whether the visual system explicitly encodes curvature extrema or instead prioritizes the most informative contour locations. To address this, we conducted two shape-matching experiments comparing the roles of curvature extrema and surprisal in shape representation. Observers performed match-to-sample tasks in which smooth reference shapes were matched to simplified polygonal versions created by connecting …

Exploring The Acceptability Of Integrating Dietitians Into Primary Care Dental Services For Children, Lauren Hallewell, Raul Bescos, Zoe Brookes, Tracey Parkin, Robert Witton, Patricia Casas-Agustench

School of Health Professions

BACKGROUND: Dental caries is a common childhood non-communicable disease strongly associated with high sugar intake. Beyond oral health, a poor diet can affect children's growth, development, and overall well-being. While dietary advice is central to preventive dental care, some primary care dental clinics have introduced body mass index (BMI) assessments and further dietary advice to address wider nutritional concerns in children. However, these efforts are often constrained by limited nutrition training, time constraints and concerns about sensitivity. Integrating dietitians into primary dental care may help overcome these barriers by enhancing dietary guidance, supporting broader nutritional needs and facilitating structured BMI …

Defining Consensus‐Based Components For Integrating Dietitians Into Primary Dental Care For Paediatric Populations: A Delphi Study, Lauren Hallewell, Raul Bescos, Zoe Brookes, Robert Witton, Patricia Casas‐Agustench

School of Health Professions

Background: Diet is a modifiable risk factor linking oral and systemic health, contributing to dental caries and weight-related outcomes (including underweight, overweight and obesity) in the paediatric population. However, dietary advice provided by dental professionals in primary dental care is often brief and sugar-focused, representing a missed opportunity to address shared risk factors. Integrating dietitians into primary dental care may support more holistic paediatric preventative care. Objective: To develop expert consensus on the components required to integrate dietitians into primary dental care to address diet as a common risk factor in paediatric oral health and weight-related outcomes. Methods: A three-round …

Elevated Temperature Flexure Behavior Of Continuous Carbon Fiber Reinforced Zrb2–Zrsi2 Ultrahigh Temperature Ceramic Matrix Composites, Jacob Stacy, Aaron Ginsparg, Jason Lonergan, Jeremy Watts, Gregory Hilmas

Materials Science and Engineering Faculty Research & Creative Works

Ultrahigh temperature ceramic matrix composites (UHTCMCs) were fabricated from unidirectional prepreg tapes consisting of a matrix of ZrB₂ with 5, 10, and 15 vol.% ZrSi₂ additions and continuous polyacrylonitrile carbon fibers and were densified at 1600°C in a hot press. The relative matrix densities ranged from 88% to 93% with interlayer spacings of ∼72 µm and fiber volume fractions between 30% and 36%. Phenolic resin additions were utilized to react with ZrSi₂ acting as a transient sintering aid to form ZrC and SiC phases. Elastic moduli of the UHTCMCs decreased with increasing temperature during 4-pt flexure testing. …

Space Mining, Richard Painter

Articles

The Trump Administration and U.S. Congress are promoting new ventures to extract valuable minerals from outer space. This Article does not dismiss the idea out of hand, but explores reasons for caution, including practical problems with space mining, its environmental impact, the likelihood that the United States could violate international law, and the risk of armed conflict. These problems are exacerbated by financial conflicts of interest in our government with a handful of billionaires, who have a financial interest in space mining work. The promotion of their agenda could involve wasteful government spending on subsidies for private ventures, with a …

Does In-Bed Cycling Delivered Within 48 Hours Of Mechanical Ventilation, Reduce The Occurrence Of Delirium In Critically Ill Patients: A Mixed-Methods Feasibility Randomised Controlled Trial Protocol, Jacqueline Bennion, Mark Hudson, Mary Hickson, Victoria Allgar, Bridie Kent, David Mcwilliams, Daniel Martin

Peninsula Medical School

Background: Delirium is a severe neuropsychiatric clinical state presenting as an acute onset of cognitive deficits. Patients receiving invasive mechanical ventilation (IMV), have the highest incidence (50%–80%) of delirium amongst patients admitted to intensive care units. Preliminary data indicates that early mobilisation is associated with reduced delirium in critically ill patients. However, definitive evidence is lacking. Current practice varies due to many barriers to patients, who require IMV, receiving early mobilisation interventions. In-bed cycling may address some of these barriers. This research aims to evaluate the feasibility and acceptability of early in-bed cycling to reduce delirium in critically ill patients. …

Microbial Collagenase Activity Is Linked To Oral–Gut Translocation In Advanced Chronic Liver Disease, Shen Jin, Aurelie Cenier, Daniela Wetzel, Bethlehem Arefaine, Mar Moreno-Gonzalez, Marilena Stamouli, Merianne Mohamad, Mariia Lupatsii, Emilio Ríos, Sunjae Lee, Ane Zamalloa, Shilpa Chokshi, Adil Mardinoglu, Saeed Shoaie, Naiara Beraza, Vishal C. Patel, Melanie Schirmer

Peninsula Medical School

Microbiome perturbations are associated with advanced chronic liver disease (ACLD), but how microorganisms contribute to disease mechanisms is unclear. Here we analysed metagenomes of paired saliva and faecal samples from an ACLD cohort of 86 individuals, plus 2 control groups of 52 healthy individuals and 14 patients with sepsis. We identified highly similar oral and gut bacterial strains, including Veillonella and Streptococcus spp., which increased in absolute abundance in the gut of patients with ACLD compared with controls. These microbial translocators uniquely share a prtC gene encoding a collagenase-like proteinase, and its faecal abundance was a robust ACLD biomarker (area …

Prevalence And Determinants Of Diabetes-Related Psychological Distress In A Tertiary Care Setting In Tamil Nadu: India: Cross-Sectional Study, Rohit Shankar, Samuel Tromans

Peninsula Medical School

BackgroundDiabetes distress, whereby people with diabetes experience distressing psychological symptoms associated with living with their condition, is an emerging problem in India. Diabetes distress leads to self-care deficits, suboptimal glycaemic control (which can lead to increasing risks of complications) and impaired quality of life.AimsTo determine the burden of diabetes distress and its associated factors in an Indian tertiary care centre in Trichy, Tamil Nadu, India, covering a population of 1.25 million.MethodThis prospective observational study involved a structured questionnaire covering demographic and clinical details, which was given to patients. The Diabetes Distress Scale 17 (DDS-17) was used to assess diabetes distress …

Investigating The Impact Of Carboxylated Polystyrene Nanoplastics In The Liver Using Cell Lines And Precision-Cut Liver Slices, Namrata Pandey, Paula Boeira, Nathaniel J. Clark, Eleanor T. Walker, Somaiah Aroori, Jemimah Denson, Richard C. Thompson, Matthew E. Cramp, Shilpa Chokshi, Ashwin Dhanda

Peninsula Medical School

Background and Aims: Increasing reports of plastic accumulation in human tissue have raised concerns about potential adverse health outcomes. Evidence of negative effects of nanoplastics is heterogeneous and provides limited insights into the underlying pathogenic toxicity mechanisms in humans. Methods: In the present study, carboxylate-modified fluorescently labelled polystyrene nanoparticles (PS NPs) were used to investigate uptake and cytotoxicity in three different hepatic models of varying complexity, including HepG2 cells, IHH cells, and human precision-cut liver slices (hPCLS). Results: The results show model- and dose-dependent effects on hepatocytes. 74.2% ± 13.4% of the IHH cells showed PS NPs uptake at 0.1 …

Designing A Mobile App For Post Traumatic Stress Disorder: Insights From Lived Experience And Clinical Practice, Rohit Shankar, Richard Laugharne, Michael Loizou, Marius Varga, Sivia Lin, Bojana Daw Srdanovic, Roger Farrell

Peninsula Medical School

Post-traumatic stress disorder (PTSD) is a disabling anxiety disorder precipitated by severe trauma. Many people with this condition have little access to clinical interventions, especially in low-middle-income countries. For the development of any digital health intervention, it is vital to know the opinions of PLE and clinicians to guide the developers. We conducted two focus groups, one with clinicians (n = 5) and one with people with lived experience (PLE) (n = 11), to gain knowledge of their views on the development of a PTSD App. Transcripts of both focus groups were coded and thematically analysed. The key themes that …