Medicine and Health Sciences Commons^™

Opening Space For Joy: Play As A Pathway In Dance/Movement Therapy With Adults In Addiction Recovery, Brittany M. Walsh

Expressive Therapies Theses

This literature review examines the cultivation of joy through play in dance/movement therapy (DMT) for adults in addiction treatment. Substance use disorders (SUDs) and addictive behaviors are complex, multifaceted conditions influenced by biological, psychological, social, and systemic factors; however, treatment approaches often prioritize symptom reduction and traditional talk-based models. Although necessary, these approaches often fail to honor the whole person, and can inadvertently reinforce shame, stigma, isolation, and dehumanization. Drawing on trauma-informed, neurobiological, relational, and decolonizing frameworks, this review positions joy as a fundamental aspect of human experience and an affirmation of dignity. Playful processes in DMT have the potential …

From Worry To Invention: Developing The Lunch Bunch As A Multimodal Expressive Arts Model For Regulation, Collaboration, And Peer Connection In Elementary Schools, Pascale Lauren Mimran-Ugbabe

Expressive Therapies Theses

This thesis documents the development of the Multimodal Expressive Arts Lunch Bunch, a small group intervention for elementary students delivered during the school lunch period at a public elementary school in Boston, Massachusetts. Grounded in multimodal expressive arts therapy, intermodal transfer theory, polyvagal-informed co-regulation, and principles of externalization, the intervention was designed as a low-barrier creative support group accessible regardless of diagnosis, referral status, or family pursuit of clinical services. Two cohorts of teacher-nominated students, one group of fourth-grade girls and one mixed-gender third-grade group, participated in a sequenced arc moving from worry externalization through collaborative invention, prototype construction, and …

Rhythms Of Hippocampal Function And Memory After Moderate Prenatal Alcohol Exposure, Lilliana May Sanchez

Psychology ETDs

Fetal Alcohol Spectrum Disorders involve morphologic and neurobiological abnormalities in offspring subjected to prenatal alcohol exposure. Although not as well studied as high exposure, moderate prenatal alcohol exposure represents the most common and undetected form in humans. While learning and memory deficits have been well characterized at the behavioral level in humans with Fetal Alcohol Spectrum Disorders and in animal models of moderate prenatal alcohol exposure, few studies have determined the circuit or systems level mechanisms of the behavioral deficits. A complete understanding of the neural bases of memory deficits after moderate prenatal alcohol exposure is needed to ultimately identify …

Urobiome Composition Varies With Vesicoureteral Reflux Grade And History Of Febrile Urinary Tract Infection, Theresa C. Barrett, Kelvin Li, Adam Fitch, Asha Patel, Bhanu Sharma, Jacqueline Holden, Kermina Abdelsayed, Nina N. Kowalewski, Sridhar Narla, Daniel Bushnell, Barbara A. Methé, Catherine S. Forster

Department of Medicine Faculty Papers

Vesicoureteral reflux (VUR) is a risk factor for urinary tract infection (UTI). However, data describing the urobiome in children with VUR are limited. Here, we characterized the urobiome in children with and without VUR to better understand its potential role in VUR pathogenesis. Catheterized urine samples were obtained from children who presented for voiding cystourethrogram (VCUG) between 12/1/2020 and 10/3/2023. Children were excluded if they had any surgical procedures of the genitourinary tract in the 30 days prior to VCUG or were on treatment antibiotics at the time of VCUG. 16S rRNA gene sequencing and taxonomical classification identified the urobiome. …

Does Adjunctive Low-Level Laser Therapy Provide Additional Benefit Following Temporomandibular Joint Arthrocentesis With Hyaluronic Acid? A Randomized Clinical Trial, Moataz Bahaa, Abdelrahman Fahmy Dr., Hesham Morsi, Mahmoud Elfaramawy

Dentistry

Purpose This study aimed to evaluate whether adjunctive low-level laser therapy (LLLT) provides additional clinical benefit over an optimized arthrocentesis protocol with hyaluronic acid in patients with ADDwoR. Materials and methods From December 2022 to December 2023, a single-blinded prospective randomized clinical trial was conducted at The British University in Egypt’s Department of Oral and Maxillofacial Surgery. The study involved 40 female participants diagnosed with Anterior Disc Displacement without Reduction (ADDwoR). Following TMJ arthrocentesis, subjects were assigned to one of two parallel cohorts: Group A received ten subsequent sessions of low-level laser therapy (LLLT), while Group B served as the …

Postoperative Pain After Dental Procedures: The National Dental Practice-Based Research Network Observational Study Using An Mobile Health Platform, Muhammad F Walji, Alfa-Ibrahim Yansane, Sayali Tungare, Rahma Mungia, David Holmes, Kim Funkhouser, Celeste Machen, Janelle Urata, Christoffer Redlund, Gautam Shirodkar, Hans Malmstrom, David H Yu, Oluwabunmi Tokede, D Brad Rindal, Gregg H Gilbert, Heiko Spallek, Joel White, Elsbeth Kalenderian

Faculty, Staff and Student Publications

Background: Managing postoperative dental pain is essential, but patient-reported data on pain and medication practices are scarce. The authors examined patient-reported pain, functional interference, and medication use after common dental procedures.

Methods: In this prospective observational cohort study, 2,674 adults in a multicenter US practice-based network reported pain intensity and interference via a mobile application. Outcomes were collected on days 0, 1, 3, 5, and 7 to assess trajectories across endodontics, periodontal surgery, oral surgery, and implant dentistry as well as multiple procedures within these 4 categories.

Results: Among 2,674 participants (mean age, 49.8 years; 55.6% were female), mean (SD) …

Pneumomlpred: Innovating Pneumonia Management With Guideline Adherence Review And Explainable Machine Learning-Based Mortality Prediction - A Single-Centre Retrospective Study, Kamel A. Samara, Hiba Jawdat Barqawi, Saryia Adra, Batool Aldaher, Drishti D. Kampani, Enad Haddad, Hebah Soudan, Islam Ibrahim Anwar, Mohamad Besher Adi, Omar Hamadi, Yumna Almour, Mohamed Nassef, Zaher Al Aghbari, Eman Abu-Gharbieh

Abington Jefferson Health Papers

Introduction: Community-acquired pneumonia (CAP) is one of the leading causes of death globally. Changing antibiotic resistance profiles, paucity of reliable CAP mortality prediction models, and ageing populations will increase its burden. This study aims to evaluate adherence to CAP management guidelines as well as develop an ML-based mortality prediction model.

Methods: This retrospective, chart review included all CAP cases between 2016 and 2021. Variables collected included patients' demographics, comorbidities, vitals, laboratory, imaging, and culture findings, as well as initial and targeted antibiotic regimens. Data was pre-processed and analysed in python-3. Adherence to the American thoracic society/infectious diseases society of America …

Improving Health Literacy And Self-Management In Adults With Heart Failure: A Nurse-Led Virtual Intervention In Outpatient Support Groups, Vivian Efosa Osunde

Doctoral Projects

Heart failure is a leading cause of morbidity and hospital readmissions, with limited health literacy contributing to poor self‑management and adherence challenges. The purpose of this Doctor of Nursing Practice project was to evaluate the feasibility and preliminary outcomes of a nurse‑led, virtual education-intervention designed to improve health literacy, self‑care behaviors, and medication adherence among adults with chronic heart failure who participate in an outpatient support group. A quality improvement design was used. Convenience sampling yielded nine adult participants with a documented diagnosis of chronic heart failure who attended at least one virtual support group session. The intervention consisted of …

Whiny Women: How Medical Gaslighting Becomes Medical Trauma, Neena Marcus

Honors Projects

Background: The idea of “medical gaslighting” has been present since 1969, but it has increased in popularity in the recent century. Women in particular are at increased risk of being dismissed by their healthcare providers, as throughout history they have been deemed “hysterical” or untrustworthy when recounting their symptoms.

Methods: Articles were compiled from CINAHL Complete, Google Scholar, and the University of Washington library. A total of 33 articles were chosen and reviewed.

Results: Medical gaslighting results in lasting medical trauma, a decreased quality of life and detachment from standard healthcare. Six themes were recurrent in the papers utilized: sexism, …

Perception, Payment, And Pollution- Examining The Effects Of Air Quality On Health And Healthcare, Colin Sleeper

Economics ETDs

Abstract

This dissertation examines how air quality and public attention to environmental shock affect perceived health status and healthcare utilization. The first chapter uses publicly available survey data from BRFSS and a triple difference framework to analyze the effects of the 2018 wildfire season in Oregon on self-reported mental and physical health. Findings indicate that those in Oregon in 2018, during the period of heightened attention to wildfire smoke, experienced approximately 1.4 additional poor mental health days, on average. The second chapter includes Merative MarketScan commercial insurance claims data to test whether these changes translate into a behavioral response. Results …

Impact Of Third Trimester Alcohol Exposure (Ttae) On Oligodendrocyte Development And Behavior In Mice, Estrella Villicana

Biomedical Sciences ETDs

Prenatal alcohol exposure (PAE) during late gestation can cause cognitive, behavioral, and motor impairments associated with fetal alcohol spectrum disorders (FASDs). The third trimester corresponds to a critical period of brain growth and maturation. This study examined the effects of Third Trimester-equivalent Alcohol Exposure (TTAE) on oligodendrocyte development and adult behavior. Neonatal mice were exposed to ethanol or air vapor from postnatal day (P) 4–8. Immunohistochemical analyses were performed at P8 and P30 to assess myelination, apoptosis, and oligodendrocyte lineage progression. TTAE significantly reduced myelin basic protein (MBP) expression at P8, which was recovered by P30, indicating delayed developmental myelination. …

Design And Optimization Of Epitope Based Malaria Vaccine Targeting Pre-Erythrocytic Stage, Yogesh Nepal

Biomedical Sciences ETDs

Malaria remains a major global health challenge. Currently available vaccines provide only modest and transient protection. In this work, we developed virus like particles (VLPs) based vaccine to target vulnerable epitopes of circumsporozoite protein, a key surface protein of pre-erythrocytic sporozoite stage, across different structural contexts. The immunogenicity of these highly immunogenic vaccines were further enhanced using immune stimulating agents, adjuvants, and the most promising VLP and adjuvant combinations were evaluated in preclinical challenge models to assess efficacy. In parallel, we performed research in an antigen agonistic manner using VLP library immunization that displays different fragments of a target protein …

Brain-Based Mechanisms Of Behavioral Impairment In Fetal Alcohol Spectrum Disorder (Fasd): The Neuroimaging Biomarkers Of Inhibitory Control, Zinia Pervin

Biomedical Engineering ETDs

The developing brain is highly susceptible to alcohol-induced toxicity, often resulting in long-term deficits in executive function and behavioral regulation. Inhibitory control impairments are among the most prominent deficits observed in Fetal Alcohol Spectrum Disorder (FASD). This study investigated the neural mechanisms of inhibitory dysfunction using a multimodal MEG–DTI approach in 67 children aged 6–8 years (34 with FASD, 33 controls) who performed a Go/No-Go task. Source-level MEG analyses revealed reduced stimulus-locked cortical activation in the anterior cingulate cortex and significant group-by-hemisphere interactions in the superior parietal cortex and cuneus. Time–frequency analyses showed diminished response-locked beta power in the sensory-motor …

Policy Concerning Student Use Of Magnification Loupes By American Dental Hygiene Schools, Amye M. Burruss

Dental Hygiene ETDs

This descriptive study was to assess whether dental hygiene schools require students to purchase magnification loupes, at what point in the program they implement the use of loupes, and which type of loupes they require students to purchase. A survey link through Microsoft Forms consisting of nineteen multiple-choice questions was emailed to 327 dental hygiene program directors and was open for a total of three weeks. With a response rate of 13% (45 respondents), results indicate that most dental hygiene programs mandate or strongly encourage the use of magnification loupes and allow students to start wearing loupes in the first …

The Effects Of Behavior Skills Training To Teach A Clinician To Implement A Structured Work System, Megan E. Bowling

Masters Theses, 2020-current

Many children with autism spectrum disorder present with deficits in completing daily living tasks, which may be due to the sequencing of information required to complete these skills. Structured work systems present a support for children to visually organize and sequence events, though they are most used in the classroom setting. The study tested the effectiveness of behavior skills training to teach a behavior support clinician to implement a structured work system via least-to-most prompting. Data was collected on the clinician’s percent of accurate implementation, which was then analyzed across three daily living behaviors in a multiple probe design. Results …

Pediatric Home-Based Hospice And Palliative Care: A Scoping Review, Ellen Davis, Daniel H Grossoehme, Toluwalase Ajayi, Justin N Baker, Pamela S Hinds, Lisa Humphrey, Jill Ann Jarrell, Rachel Thienprayoon, Sarah Friebert

Faculty, Staff and Students Publications

Pediatric palliative and/or hospice care is provided across a broad spectrum of settings, ranging from inpatient to outpatient to a child's home. Pediatric home-based hospice and/or palliative care teams offer a specialized, interdisciplinary approach to care, allowing children to stay in the home while offering comprehensive support. This scoping review seeks to summarize what is known about pediatric home-based hospice and/or palliative care and to identify gaps in the current research. Following Arskey and O'Malley's scoping review framework, we searched four databases for studies focused on pediatric home-based hospice and/or palliative care programs. Studies were included if they were published …

Developing A Durable, Memory-Driven, Cspz-Targeting Lyme Disease Vaccine By Rationale Adjuvant Selection\, Miranda Mccarty, Sergio A Hernández, Jill Malfetano, Ana Carolina Leão, Maria Jose Villar, Xiuli Yang, Yi-Lin Chen, Jungsoon Lee, Zhuyun Liu, Ulrich Strych, Maria Elena Bottazzi, Utpal Pal, Klemen Strle, Wen-Hsiang Chen, Yi-Pin Lin

Faculty, Staff and Students Publications

Rational adjuvant selection is a systematic approach based on adjuvant-mediated immunomodulation to identify safe vaccine regimens that enhance protective immunity. Transmitted through ticks and caused by the bacterium Borrelia burgdorferi (Bb), Lyme disease (LD) is the most common vector-borne disease in the Northern hemisphere. There are no approved human vaccines, making it suitable for testing the concept of rational adjuvant selection. Here, we formulated our previously developed and effective LD vaccine antigen, CspZ-YAC187S, with different adjuvants suitable for human use; we analyzed the immune response by transcriptomics and tested the vaccine efficacy after Bb infection. We identified Alum-CpG and Alum-αGal …

Ai Tools For Research Teams, Sandra Desjardins

Library Class: Lunch & Learn

Join us for a fast-paced, practical session on using free and low-cost AI tools to save hours on your research workflow, from initial discovery to final synthesis. We'll have an overview of tools like Rayyan, ResearchRabbit, and Elicit.

Birth Control Use Alters Memory For A Stressful Experience, Julia N. Gross, Kristie Payment, Boyd R. Rorabaugh, Phillip R. Zoladz

Aurora

Hormonal birth control methods are widely used; however, some users suffer considerable side effects. Previous research suggests oral contraceptive users exhibit a blunted cortisol response to psychosocial stressors and alterations in emotional memory, including differential recall of emotional images and details of emotional stories. However, no studies have examined how birth control influences memory for a stressful experience.

The present study analyzes data previously collected from female undergraduate students. In this study, participants reported contraceptive use, then underwent a modified version of the Trier Social Stress Test (TSST) or the friendly-TSST (f-TSST). The TSST required participants to deliver a ten-minute, …

The Academic Workplace Climate Measure: A New Instrument To Measure Counselor Education Faculty Climate, Ryan Holliman, Ryan D. Foster, Pedro Blanco

Journal of Counselor Preparation and Supervision

Research indicates that between 32% and 62% of faculty in higher education have experienced some form of incivility (Cassell, 2011; Fox, 2010; Heffernan & Bosetti, 2020; Hollis, 2012; Keashly & Neuman, 2008; McKay et al., 2008). Incivility among faculty can be associated with declining health, decreased faculty retention, diminished self-esteem, and lowered psychological well-being (McClendon et al., 2021; Miner et al., 2012; Raskauskas & Skrabec, 2011). Although counselor educators are presumably experts in effective communication and conflict negotiation, anecdotal reports of conflict in counselor education departments are frequent. This study developed an instrument called the Academic Workplace Climate Measure. In …

Analyzing Outcome Research In Aca Counseling Journals: A Content Analysis, Lisa Rickman, Marangelie Velez, Serene Hasan, Elizabeth Lugo, Sejal Barden

Journal of Counselor Preparation and Supervision

To assess the current state of evidence-based practices within counseling and counselor education, researchers conducted a comprehensive content analysis of outcome research published in counseling journals. Using quantitative methods to examine publication trends and frequency, the study reviewed 5,266 articles across 21 journals over a ten-year span (2013–2023), identifying 405 outcome studies for inclusion. Findings revealed a substantial gap in outcome research within professional counseling, particularly with respect to methodological diversity and representation of diverse populations. The authors emphasize the need for counselor educators and practitioners to prioritize outcome research to enhance clinical effectiveness and strengthen the profession. Furthermore, the …

Negotiating Professional Identity Development Across Contexts: A Collaborative Autoethnography, Clark D. Ausloos, Rebecca J. Vannest, Hayley Ostlund

Journal of Counselor Preparation and Supervision

This collaborative autoethnography (CAE) explores how two counselor educators and one doctoral student navigate professional identity formation across three intersecting contexts: school counseling, clinical mental health counseling, and counselor education. Through critical reflection and collaborative analysis of focus-group data and individual reflections, we identify four themes: Career Flexibility & Adaptability, Identity Formation in Supportive and Restrictive Systems, Role Strain & Stigma, and Values-Driven Practices. Implications call for counselor education programs and higher education systems to embrace multiplicity, non-linear careers, redefine mentorship structures for doctoral students and faculty, and revise promotion criteria to value relationality, and creative, student- and community-engaged …

Understanding Counselor Burnout From An Ecological Systems Perspective, Stephanie Thorson-Olesen, Lisa Belknap, Emily Velidow, Jessica Gaul, Phoenix Rosewood, Nayara Aparecida Da Costa Silva Beall

Journal of Counselor Preparation and Supervision

Using Bronfenbrenner’s Ecological Systems Theory as a guiding framework, this study explored the experiences of licensed counselors who self-identified as having recovered from burnout. Burnout was conceptualized as a prolonged response to chronic occupational stress, while participants were invited to describe their experiences based on their own lived understandings of the phenomenon. A qualitative thematic analysis was conducted using data collected through an anonymous online survey featuring open-ended prompts. Participants included 32 licensed counselors who graduated from CACREP-accredited programs and reported previously experiencing burnout and no longer identifying as currently burned out. Thematic analysis yielded nine interrelated themes encompassing contributors, …

Predicting Counseling Student Well-Being: The Role Of Faculty And Stress, Kendall G. Woods, Elizabeth K. N. Harper, Michell L. Temple

Journal of Counselor Preparation and Supervision

Approximately one-third of Americans live in areas with limited access to mental health services, with only one mental health provider for every 350 people (Health Resources and Services Administration [HRSA], 2024; Reinert & Nguyen, 2022). The shortage of mental health providers persists as the need for services grows, a challenge compounded by the 40-60% attrition rate among counseling trainees (Chrzanowski, 2018). Improving counseling program completion is essential to address the mental health workforce shortage. While previous research has emphasized the importance of faculty support for graduate students (Estrada et al, 2019), little research has examined how faculty-student interactions and academic …

Counseling Supervision In Vocational Rehabilitation: An Integration And Extension Of The Discrimination Model And Critical Disability Theory, Nichole Tichy, Harvey C. Peters

Journal of Counselor Preparation and Supervision

As a specialized counseling discipline, vocational rehabilitation aims to support individuals with disabilities in obtaining integrated and competitive employment within their communities. Within the rehabilitation counseling profession, the practice of clinical supervision is considered an essential function of the job; however, most professionals report inadequate or nonexistent supervision within their professional settings. Research on this topic is scarce, and few clinical supervision models exist specific to the needs of rehabilitation counselors. In this manuscript, we present an adaptation of the discrimination model for counselors that incorporates vocational rehabilitation and critical disability theory to encourage the challenging and dismantling of ableism. …

Enacting Leadership And Transforming The World: Hannah Arendt, The Private, The Public, And Transfigurations In Between, Xochitl Mendez

Educational Studies Dissertations

In this dissertation I propose a framework that emphasizes transitions between Private and Public. I argue that individuals can consciously reshape and reformulate these transitions to assert themselves in the world. How can the individual’s own internal realities, ventures, projects and selfhood assert themselves in a fraught world as an act of self-affirmation, leadership, and transformation? New approaches to this question can all be revealed by using transitions between Private and Public as actionable strategies. I re-interpret Hannah Arendt’s Private and Public as she presented them in The Human Condition (1958). I turn these into multivalent and multilayered spaces of …

Influence Of The Discipline Of Authentic Movement Practice On Interpersonal Relationships, Joy Ruben Welts

Educational Studies Dissertations

This mixed methods study explored how practicing the Discipline of Authentic Movement impacts relationships. This research was conducted to fill in the gaps around attunement and use of the Discipline of Authentic Movement as an intervention to support healthy relationships. Five self-selected adults met on Saturday afternoons for eight weeks to practice the Discipline of Authentic Movement. They completed a pre and post Revised Adult Attachment Scale and reflected weekly on their experience through journaling. Participants reported that it was the structure of the Discipline of Authentic Movement that allowed them to feel more comfortable being themselves with others. The …

Harnessing Mechanobiology Of Resident Stem Cells To Refine Cell Based Therapeutics, Dakota R. Kamm

WUSM Theses and Dissertations – All Programs

Mesenchymal stem cells (MSCs) are resident cells residing with many adult tissues such as adipose tissue and bone marrow that have the potency for multiple lineage differentiation as well as the capacity to secrete a litany of beneficial factors to maintain homeostasis and promote tissue repair. Since 1995, MSCs have been used therapeutically to treat a variety of conditions from osteoarthritis to heart disease to muscle pathologies. Great leaps have been made in improving MSC-based therapies through optimization of culture methods and select enrichment of cellular subpopulations. More recently, the physical microenvironment of tissue in vivo and culture conditions in …

Improving The Assessment And Treatment Of People With Low Back Pain, Kayla Krueger

WUSM Theses and Dissertations – All Programs

Low back pain (LBP) is a significant and continually growing public health problem. While some people recover from an initial episode, a proportion will develop chronic or recurrent LBP that limits their ability to perform daily functional activities. The variable and often function-limiting course of LBP underscores the clear need for improved methods of assessment and treatment. One way to improve the assessment and treatment of LBP is to develop a more comprehensive understanding of factors that contribute to LBP. In this dissertation, we investigated two categories of factors that may contribute to a person’s LBP: (1) spinal movement impairments …

Examining The Association Of Nurse Staffing Levels With Delayed Antibiotic And Insulin Administration: A Mixed Methods Study, Mikie Desyana Rachman

WUSM Theses and Dissertations – All Programs

Background: Recent reports indicated that medication errors contributed to 10% of preventable harm among hospitalized patients with over half occurring during the administration stage. Despite emerging research using EHR data to examine care processes and clinical outcomes, limited studies have integrated objective and subjective nursing staffing measures to evaluate how nursing staffing levels could be associated with delays in care delivery.

Method: A parallel convergent mixed-methods study was conducted in four adult medical-surgical units at a Midwestern Academic Medical Center from January 1 – March 31, 2025. Quantitative data of insulin and IV antibiotic administration records, laboratory results, and nurse …