Medicine and Health Sciences Commons^™

Staff Education To Improve End-Of- Life Pain Management Confidence Among Long-Term Care Nurses, Andrea Osuji

Walden Dissertations and Doctoral Studies

No abstract provided.

Applying User-Centered Design To Develop A Culturally Sensitive, Low-Calorie Meal Plan For Enhancing Dietary Behavioral Control In Masld, Maya Balakrishnan, Paola Martinez, Brett Deng, Ivonne Arguelles, Crystal Arguelles, Terri L Fletcher, Natalia I Heredia, Myriam Ibarra, Anna Christine Rome

Faculty, Staff and Students Publications

Background: Dietary changes are essential for managing metabolic dysfunction-associated steatotic liver disease (MASLD), yet patients often face barriers related to knowledge, skills, cost, time, and cultural fit.

Aims: The purpose of this paper is to report a process for culturally tailoring a dietary intervention and its application to create a calorie-restricted meal plan for Mexican and Central American patients with MASLD. Guided by the Theory of Planned Behavior and user-centered design, we produced a culturally tailored seven-day structured meal plan aligned with dietary guidelines for MASLD and weight loss.

Methods: We conducted a three-phase, mixed-methods process among Mexican/Central American patients …

Neurodevelopmental Effects Associated With In Utero Exposure To Bpa, Maximilian A. Nilsen, Grace A. Carlucci, Cody V. Thompson, Berfin Gul

Student Work

No abstract provided.

Seasonal Variation And Size Distribution Of Particulate Matter In The Mississippi Delta: Implications For Source Attribution, Abigail E. Barnett

Honors Theses

This study examines seasonal patterns of particulate matter in the Mississippi Delta using data from PurpleAir sensors, with a focus on particle size distributions across PM₁.₀, PM₂.₅, and PM₁₀. The purpose of this research is to evaluate whether particulate trends in the region reflect signatures consistent with wildfire smoke or are better explained by local environmental and agricultural factors.

Daily average concentrations were analyzed and grouped by season to compare spring and summer conditions. Results show that all particle size fractions increased from spring to summer. However, PM₁₀ concentrations remained consistently higher than PM₂.₅ in both seasons. The PM₂.₅/PM₁₀ ratio …

Building Nurse Managers’ Knowledge And Confidence To Lead Clinical Ladder Success: A Theoretically Informed Educational Framework, Michelle Joann Chlebinski

Doctoral Projects

Background: Clinical Ladder Programs (CLPs) offer a structured pathway for nursing professional growth, fostering clinical excellence while improving nurse satisfaction and longterm retention. Although nurse managers play a pivotal role in facilitating the CLP, there is currently no comprehensive educational framework to enhance their knowledge and confidence in supporting clinical ladder advancement. Purpose: The aim of this DNP project is to develop implement, and evaluate an educational framework grounded in Benner’s Novice-to-Expert framework and Watson Caring Science® to enhance nurse managers' knowledge and confidence in leading nurses towards clinical ladder success. Methods: In a quasi-experimental study using a single-group, pre-post …

Cd8+ T Cell Differentiation Into Nk-Like Effector Cells Drives Transplant Rejection, Dawei Zou, Stephanie G Yi, Yulin Dai, Luan Truong, Lillian W Gaber, Richard J Knight, Xiang Xiao, Rafik M Ghobrial, Xian C Li, Zhongming Zhao, Wenhao Chen, A Osama Gaber

Faculty, Staff and Student Publications

T cells are central drivers of transplant rejection, yet the differentiation fates underlying this process remain unclear. Using single-cell transcriptomic profiling of human kidney allograft biopsies, we identified a predominant infiltrating CD8+ T cell subset exhibiting killer cell lectin-like receptor (KLR)+ NK-like features. Mechanistic studies in mice showed that the KLR+ subset emerged de novo post-transplantation and dominated the CD8+ T cell infiltrate in rejecting allografts. These NK-like CD8+ T cells expressed high levels of interferon regulatory factor 4 (IRF4), and Irf4 deletion disrupted their differentiation and induced transplant acceptance. Therapeutically, either costimulation blockade or mTOR inhibition substantially reduced the …

Immediate Nerve And Tendon Transfers After Wide Resection Of A Radial Nerve Malignant Peripheral Nerve Sheath Tumor: A Case Report And Surgical Technique, Joanne Zhou, Sai Shreya Kambham, Andrew Fang, Christopher Frey, Michael Macavoy

Faculty, Staff and Student Publications

The authors have reported on immediate nerve and tendon transfers postresection of a radial nerve-based malignant peripheral nerve sheath tumor in a 15-year-old female with neurofibromatosis. The median nerve branch to flexor carpi radialis was transferred to the posterior interosseous nerve, the median nerve branch to flexor digitorum superficialis was transferred to the nerve to extensor carpi radialis brevis, and the pronator teres tendon was transferred to the extensor carpi radialis brevis tendon, with 3-year outcomes reported. Tumor excision, tendon, and nerve transfer yielded negative margins and remission. Functional wrist/finger extension appeared at 6 months and increased until 3 years …

Computational Ligand-Receptor Simulations Of Fluorinated Morphine Derivatives Using Pymol, Mirabella Romano, Emily Chen

Student Scholar Symposium Abstracts and Posters

The opioid epidemic impacts 60 million people worldwide every year. Morphine, a commonly prescribed opioid, binds to the μ-opioid receptor (MOR) in the body via protonation of its tertiary amino group and the MOR. An unfortunate side effect of this binding process is its non-selectivity in both peripheral and central tissues. While activation within inflamed peripheral tissues results in pain relief, activation within central tissues results in the unwanted and addictive side effects of opioids. Because there is a pH discrepancy between healthy (central) and inflamed (peripheral) tissues, selective binding in the inflamed tissues could provide pain relief without addictive …

Freshman 15? Freshman 50?? The Reality Of Daily Life Habits Of A First Year College Student, Gregorio R. Salgado

Student Scholar Symposium Abstracts and Posters

This project presents a personal data tracking study in which I collected daily self-reported metrics over the course of the Spring semester using Excel. The variables tracked include sleep duration, caloric intake, screen time, social media usage, phone checks per day, family communication, and personal spending. The goal of this project is to identify meaningful patterns and correlations between daily habits and personal well-being.

Data was collected through a combination of manual logging and smartphone-generated daily reports. This study explores potential relationships between variables such as sleep duration and social media usage, as well as the association between family communication …

Discrepancies In Pediatric Oral Health, Tyler B. Truong

Student Scholar Symposium Abstracts and Posters

In 2024, data was collected by the CDC on untreated tooth decay. From that data, children living in low-income households had an estimated 18.8% of tooth decay untreated, almost triple the amount when compared to children from middle to high income households (6.6%). As the income disparity continues to grow in the US, it is critical that we implement strategies to aid lower income communities in providing their children with proper oral hygiene tactics. In order to understand how communities can help promote healthy oral hygiene for their children, a survey of dentists from various areas was conducted to see …

El Papel Del Bilingüismo En La Atención Médica A Pacientes Hispanohablantes, Ariela Deleon

Student Scholar Symposium Abstracts and Posters

Spanish-speaking patients in the United States frequently face significant barriers to quality healthcare due to language differences between themselves and their providers. This project examines how English-Spanish bilingualism among healthcare professionals meaningfully improves the quality of care delivered to Spanish-speaking patients. To analyze this, the project draws on a review of academic literature on bilingualism, language concordance, medical interpretation, and health outcomes, as well as interviews with healthcare professionals across various fields who possess different levels of Spanish fluency and regularly work with Spanish-speaking patients. This project argues that bilingualism among healthcare providers is not merely a supplementary skill but …

Staff Education To Use Best Practices For Implementing And Utilizing The Digital Depression Screening Tool In An Outpatient Psychiatric Clinic, Robert James

Walden Dissertations and Doctoral Studies

No abstract provided.

Underdiagnosis Of Bipolar Disorder And Under Utilization Of The Mood Disorder Questionnaire, Sandeep Grewal

Walden Dissertations and Doctoral Studies

No abstract provided.

Characterizing Core Outcomes Of Responsible Stewardship For Human Genomic Data In The Cloud, Vasiliki Rahimzadeh, Bronwyn Walsh, Heidi L Rehm, Mildred Cho, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

We present findings from a scoping review of the genomic data sharing literature used to inform a core outcomes set for responsible data stewardship in the cloud. Genomic and related health data stemming from government funded research have undergone mass migration to the cloud where they can be more securely stored, accessed, and analyzed within shared computing environments. While this migration reflects a shift in privacy and security infrastructure for cloud-based repositories as oversight becomes more globalized, it also necessitates new data stewardship responsibilities to align authorized data access with ethical data use. Responsible data stewardship refers to the ethical …

Early-Life Wnt4 Expressing Colon Stromal Cells Orchestrate Lifelong Mucosal Homeostasis Via Bmp-Driven Inkt Cell Imprinting, Xi Lin, Chloe Hyun-Jung Lee, Ting Zhang, Agne Antanaviciute, Thomas Hanley, Jonathan N Glickman, Nikhila S Bharadwaj, Vicki Rosen, Jenny E Gumperz, Matthew K Waldor, Alison Simmons, Thomas Gensollen, Richard S Blumberg

2020-Current year OA Pubs

The early-life intestinal microenvironment plays a pivotal role in shaping immune cell development. Here, we identify a colonic Wnt4-expressing stromal cell, enriched during early-life, that promotes iNKT cell proliferation via BMP-MAPK signaling. These stromal cells are spatially associated with iNKT cells and macrophages and exhibit high Bmp2 expression during the neonatal period. Depletion of BMP2 in Wnt4

+Cd49a+Cd103+ Cytotoxic Tissue-Resident Natural Killer Cells Infiltrate And Control Solid Epithelial Tumor Growth In Mice, Nina B Horowitz, Jennifer A Foltz, Et Al.

2020-Current year OA Pubs

Human tissue-resident natural killer (NK) cells (trNK cells), broadly defined by markers of tissue residency, such as CD49a [

Genealogy-Based Trait Association With Locater Boosts Power At Loci With Allelic Heterogeneity, Xinxin Wang, Ryan Christ, Erica Young, Chul Joo Kang, Indraniel Das, Edward A Belter, Markku Laakso, Louis J M Aslett, David Steinsaltz, Nathan O Stitziel, Ira M Hall

2020-Current year OA Pubs

A key methodological challenge for genome-wide association studies is how to leverage haplotype diversity and allelic heterogeneity to improve trait association power, especially in noncoding regions where it is difficult to predict variant impacts and define functional units for variant aggregation. Genealogy-based association methods have the potential to bridge this gap by testing combinations of common and rare haplotypes based purely on their ancestral relationships. In parallel work, we have developed an efficient local ancestry inference engine and a novel statistical method (LOCATER) for combining signals present on different branches of a locus-specific haplotype tree. Here, we develop a genome-wide …

The Picture Exchange Communication System (Pecs) As A Functional Form Of Low-Technology Aided Augmentative And Alternative Communication (Aac): A Systematic Review, Faith K. Curran

Pacific Journal of Health

This systematic literature review was completed with the aim of investigating the functionality of the low-technology aided Augmentative and Alternative Communication (AAC), Picture Exchange Communication System (PECS). In this review, functionality was defined by how successful AAC users used PECS. Fifteen peer reviewed primary sources which were published between 2020 and 2025 were selected to provide a current and relevant analysis. There was not enough current research to support the use of PECS across various functions of language. However, PECS is mainly used for one to two language functions, object requesting and commenting. Further research studying the success rates of …

The Use Of Video Laryngoscopy In Pregnant Women Undergoing Non-Obstetric Surgery, Samantha Gastaldo

Doctor of Nursing Practice Scholarly Projects

This quality improvement project looks at the proposed implementation of endotracheal intubation guidelines regarding pregnant patients undergoing non-obstetric surgery and how the use of video laryngoscopy versus the traditional practice will affect the first pass rate of the endotracheal tube intraoperatively. Statistics show that 2% of women undergo non-obstetric related surgery during pregnancy. Physiological changes during pregnancy, including increased laryngeal mucosa swelling and higher metabolic oxygen consumption, result in a heightened risk of apnea and hypoxemia during intubation. Pregnant women experience an eightfold higher incidence of failed intubation compared to non-pregnant populations. The number of patients classified as Mallampati 4 …

Comparison Of Ecg Features, Cardiac Biomarkers, And Clinical Outcomes In Three Waves Of Hospitalized Covid-19 Pneumonia Patients With Cardiovascular Events, Yuchen Han, Jahnavi Sunkara, Tshura S Ali, Harideep Samanapally, Vidyulata Salunkhe, Fnu Deepti, Emma C. Huang, Justin J. Huang, Maiying Kong, Jiapeng Huang

The University of Louisville Journal of Respiratory Infections

Background

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a rapidly evolving virus that can severely impact the cardiovascular system. With new variants, it is important to characterize wave-specific (defined by dominant circulating variants) clinical changes.

Methods

A multi-center retrospective cohort study of patients hospitalized with SARS-CoV-2 community acquired pneumonia at eight adult acute-care hospitals in the city of Louisville, KY was conducted. Patients hospitalized with Coronavirus Disease 2019 (COVID-19) community acquired pneumonia who experienced a cardiovascular event between March 2020 and July 2022 were included in this analysis. Variant assignment was based on temporal prevalence rather than genomic confirmation, and …

Nurse-Driven Infusion Protocols In Diabetic Ketoacidosis: A Scoping Review, Nicholas Morrell Pierce Msn, Rn, Cen, Ccrn, Mary Cassandra Scott Bsn, Rn, Ccrn, Cen, Alvertis Demetreis Warren Bsn, Rn, Ccrn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Diabetic ketoacidosis (DKA) is a high-risk acute emergency requiring timely insulin titration, intensive monitoring, and coordinated interdisciplinary care. Traditionally, management relies on provider-driven insulin infusion adjustments, which may introduce delays and workflow inefficiencies. Emerging nurse-driven insulin infusion protocols aim to standardize care, improve safety, and enhance clinical efficiency. The purpose of this scoping review was to evaluate existing evidence comparing nurse-driven versus provider-driven insulin infusion protocols in the management of adult patients with DKA.

Methods

A scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From August 2023 through November 2025, …

Herbularyo (Folk Healer): An Herbal Medicine Card Game, Maryjane T. Magsino, Inah Marie Q. Rivera, Armando M. Guidote, Genejane M. Adarlo

Chemistry Faculty Publications

Herbularyo, a card game teaching about herbal plants (HPs), was created and evaluated as a viable educational card game based on Tuomisto and Aksela’s criteria. A quasi-experiment was performed on 81 Grade 8 students from a private high school and 50 Grade 11 from a public high school. Independent t-test revealed that the control group (CG) and experimental group (EG) (p=0.386), and EG1 (played ≤5) and EG2 (played >5) (p=0.681) are not comparable with each other. Paired t-test showed EG performed better (p=0.001) than CG (p=0.901) whereas ANCOVA showed that playing Herbularyo improved students’ information retention (p=0.006). EG1 and EG2 …

Staff Education Intervention To Improve Staff Knowledge And Competency In Supporting Patients With Type 2 Diabetes Mellitus Self-Management, Dorothy Chudi-Agbaku

Walden Dissertations and Doctoral Studies

No abstract provided.

Increasing Safe Driving Among Adults With Neurological Impairments In A Rural Setting, Melissa V. Burt

Occupational Therapy Capstone Presentations

This capstone project examined challenges related to safe driving for adults living in rural communities with neurological impairments. Guided by the Person-Environment-Occupation Model and Toglia's Dynamic Interactional Approach, the project focused on increasing awareness, accessibility, and utilization of occupational therapy (OT) led assessments, community-based services, and educational outreach on driving safety. Clinical skill development was demonstrated through standardized and informal assessments and evidence-based interventions with adults with neurological conditions. Program implementation included driving risk assessments, one-on-one CarFit sessions, the creation of educational pamphlets, and educational presentations to increase community and provider awareness of OT's role in driving rehabilitation. CarFit surveys …

Co-Active Therapeutic Filmmaking: A Methodology Pilot Project, Blair Webber

Expressive Therapies Theses

This pilot project examined the intersection of drama therapy and filmmaking. Drawing on the Co-Active Therapeutic Theater model from drama therapy and digital storytelling and participatory video methods from social work research, this methodology designed and delivered a co-created filmmaking intervention at a residential treatment center for adult men with co-occurring mental health and substance use disorder. Four participants made a seven-minute-long short fictional film based on their definition of active recovery and a theme of recovery they wished to share with an audience. It was screened at the treatment center for staff and their fellow residents. Data collection was …

Improving Restraint Care Plan Documentation Among Nursing Staff, Samson E. Okotie

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement project aimed to improve nursing compliance with restraint care plan documentation standards using bundled interventions, including targeted education, electronic health record (EHR) prompts, and unit-based audit and feedback processes. The goal was to achieve at least a 70% improvement in documentation compliance within 12 weeks.

Background: Accurate restraint documentation is essential for patient safety, ethical practice, interdisciplinary communication, and regulatory compliance. Despite existing policies and education, institutional audits revealed compliance rates of 50% or less, demonstrating a persistent gap in practice and the need for structured interventions.

Methodology: The project used the Plan-Do-Study-Act (PDSA) framework across …

Staff Education To Improve Phq-9 Knowledge, Confidence, And Competency In An Outpatient Mental Health Clinic, Zainab Lawal

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving Emergency Department Throughput: Implementation Of A Nurse-Driven Protocol In Pediatric Fast-Track Patients Presenting With Fever, Kerrigan A. Teeple

Evidence-Based Practice Project Reports

Overcrowding in the emergency department presents significant operational challenges and is associated with adverse patient outcomes (Gottlieb et al., 2020). Despite throughput initiatives, increasing patient acuity and rising census levels continue to strain emergency department efficiency. This quality improvement project evaluated whether implementing a fever-reduction standing order protocol could reduce door-to-provider and door-to-disposition times for pediatric fast-track patients presenting to the emergency department. A review of evidence across 6 databases identified nurse-initiated standing orders as a best-practice strategy to expedite care, improve throughput, and reduce delays in disposition. Guided by this evidence, a standing order protocol for acetaminophen administration was …

Barriers To Palliative Care Access In Rural South Dakota: A Policy And System-Level Analysis, Harshavardhan Kadarkaraisamy

Honors Thesis

Palliative care improves the quality of life for people living with serious illness. It helps by addressing symptoms, improving communication, and providing mental, physical, and spiritual support. However, in South Dakota access to palliative care is limited in rural areas. These challenges include geographic isolation, workforce shortages, healthcare infrastructure, reimbursement, and misunderstandings about palliative care. This thesis examines the key policy barriers that limit access to palliative care in rural South Dakota. This work involves engaging with South Dakota-specific literature, rural health research, policy sources, community education, telehealth expansion, and policy reform. By focusing on the rural context of South …

Falling Star Program: A Visual Cue Intervention To Reduce Falls In Long-Term Care, Maggie Shanahan

Evidence-Based Practice Project Reports

Falls among older adults in skilled nursing and long-term care settings remain a leading cause of injury, functional decline, and increased healthcare utilization, contributing significantly to morbidity and mortality in this population (Centers for Disease Control and Prevention [CDC], 2023; Agency for Healthcare Research and Quality [AHRQ], 2022). The primary purpose of this project aimed to implement and evaluate a structured visual cue–based fall prevention intervention to reduce fall rates among high-risk residents in a long-term care facility in Northwest Indiana. The project included 23 participants aged 65 years and older who were identified as high risk for falls. Using …