Medicine and Health Sciences Commons^™

The Impact Of Structured Family Meetings In The Intensive Care Unit, Loyce T. Mofor

Doctor of Nursing Practice Final Project Abstract

The Impact of Structured Family Meetings in the Intensive Care Unit (ICU)

Purpose

Train providers at an academic institution in a large metropolitan area to conduct family meetings using a structured approach and evaluate this intervention's impact on family satisfaction with communication in the ICU.

Background

Inadequate communication between families and healthcare teams leads to lower family satisfaction, heightened feelings of guilt, and diminished capacity for making clinical decisions.

Methodology

VitalTalk training was utilized to improve providers’ communication skills. Structured family meetings were conducted for Surgical and Thoracic ICU patients with an ICU length of stay of > 5 days or …

Improving The Quality Of Bone Marrow Specimen Collection Through Powered Bone Marrow Device Simulation And Supervised Procedures, Ethel C. Estrada

Doctor of Nursing Practice Final Project Abstract

Improving the Quality of Bone Marrow Specimen Collection Through Powered Bone Marrow Device Simulation and Supervised Procedures

Purpose

This quality improvement (QI) project aimed to implement powered bone marrow simulation training and supervised procedures for the Advanced Practice Provider (APP) proceduralists to increase proceduralists' use of powered bone marrow devices and reduce poor bone marrow sampling.

Background

This project was implemented within the Bone Marrow Aspiration Clinic (BMAC) of an academic cancer center in Houston, Texas.

Methodology

Five APP proceduralists completed powered bone marrow device simulation training on the Bone Marrow (BM) Skills Simulator, followed by supervised procedures. Data were …

Gme As A Healthcare And Economic Driver In Southern Nevada, Tripp Umbach

Policy Briefs and Reports

In early 2025, the Nevada Health and Bioscience Corporation (NHBC) commissioned Tripp Umbach to conduct a comprehensive study examining the current state and future expansion of physician training and retention in Southern Nevada. The approach recommended in this report is rooted in strategic partnerships among medical institutions, proven funding approaches, and needed policy changes. Tripp Umbach, a nationally renowned private consultancy specializing in medical education expansion strategies, reviewed data, conducted interviews, and developed recommendations to expand GME, highlighting its profound economic impact in Southern Nevada.

Clinical Pathway For Rhogam Administration In The Emergency Department, Lauren Kyzar, Amy Bigham

Appalachian Student Healthcare Research Review

Background: Clinical pathways in emergency departments (ED) are designed to standardize patient care and reduce variability in clinical practice. In a rural hospital setting, the ED management of RhoGAM administration in pregnant patients with vaginal bleeding varied by provider with no standard of care achieved. This approach raised concerns about potential patient safety issues.

Methods: In response, the local emergency department medical director, in conjunction with local perinatal providers developed a clinical pathway to standardize care and optimize RhoGAM administration. The clinical pathway was implemented to the local ED providers over a three-month period. Retrospective chart review for Type and …

A Narrative Of The Plague Doctor And How Its Historical Context Translates To The Modern View Of The Plague Doctor, Callie P. Johnston

Honors Theses

The Plague Doctor was once a historical figure who practiced medicine primarily on those infected with the bubonic plague. The plague doctor, as a historical figure and physician, has been transformed in modern culture and media. Originally perceived as a harbinger of both hope and death, the Plague Doctor has undergone a historical transformation from a masked physician to a more stylized character that appears in modern media, digital art, toys, costumes, video games, and popular culture. This thesis examines the evolution of the Plague Doctor from its historical role as a plague physician to its current iconography as a …

A Meta-Analysis Of Endometrial Cancer Metabolites As Potential Non-Invasive Biomarkers, Makenna K. Johnson

Honors Theses

Endometrial Cancer (EC) is the most prevalent gynecological cancer in the United States and causes tens of thousands of deaths. Despite its massive negative impact in developed countries, there currently is no reliable screening tool used to diagnose women. Due to this urgent need for minimally invasive and precise techniques to diagnose this malignancy, the metabolomics field has been at the forefront of current research. An untargeted mass-spectrometry approach is used by many researchers to form an initial hypothesis as to which metabolites are key in identifying EC cases. However, there are sometimes inconsistencies between studies. A meta-analysis approach examines …

Domain-Specific Concussion Knowledge And Reporting In United States Major League Rugby Players, Julie Stamm, Katherine Hunzinger, Owen Sheehy, Christine Baugh

Department of Exercise Science Faculty Papers

Previous research indicates high concussion knowledge is not associated with better concussion reporting, with research examining the relationship between reporting and global concussion knowledge. Concussion knowledge has not yet been investigated in United States Major League Rugby (MLR) players. This study evaluated domain-specific concussion knowledge, concussion history, and reporting behaviors among active MLR players. In a cross-sectional design, 207 MLR athletes (age 26.6 ± 3.4 years) completed a survey assessing concussion history, knowledge, and nondisclosure reasons. While in the MLR, 24% reported an undisclosed concussion, with nondisclosure reasons related to a lack of concussion knowledge, a desire to continue playing, …

Systemic Barriers To Educational And Employment Attainment Among Individuals With Substance Use Disorders, Mollie B. Mccann Poblocki

Creativity and Change Leadership Graduate Student Master's Projects

Substance use disorders (SUDs) and opioid use disorder (OUD) represent one of the most pressing yet poorly understood public health crises in the United States. Despite decades of clinical intervention, recovery outcomes remain deeply unequal, not because individuals lack motivation, but because the structural systems surrounding them are fundamentally broken. This project explored that reality through a comprehensive literature review examining how systemic barriers across educational systems, labor markets, poverty dynamics, and healthcare infrastructure shape vulnerability, treatment access, and recovery outcomes for individuals with SUDs. Major findings revealed a consistent socioeconomic gradient of harm: individuals with lower educational attainment, unstable …

An Investigation Of The Roles Aging, Gender And Age-Related Hearing Loss Play In Emotional Prosody Recognition, Giavanna Yowell

Undergraduate Honors Thesis Collection

Emotional prosody recognition is crucial for social interactions but is influenced by aging, gender, and age-related hearing loss (Lambrecht et al., 2012; Oerlemans et al., 2014; Palermo et al., 2013). No past studies have looked at all of these factors collectively. To address this shortcoming, the current study explored the relationships between aging, hearing loss and gender differences in emotional prosody recognition. The ability to recognize emotions through facial expressions was also included as a comparative measure. One hundred fifteen individuals (42 men and 73 women), ages 50 and older (M = 60.39, SD = 8.12), completed a hearing handicap …

Acute Effects Of Tempering On Biomechanical Tissue Characteristics In The Lower Back, Danielle Rae Marie Alley

Undergraduate Honors Thesis Collection

Body tempering (BT) is a novel, myofascial release technique that is growing in popularity among sports medicine and performance practitioners. No studies have explored its effects on biomechanical tissue characteristics or its influence on perceived disablement within the thoracolumbar spine region. The aim of this study was to examine the acute effects of BT on soft-tissue characteristics and perceived disablement in the thoracolumbar spine region. A randomized controlled trial was used to study 22 young adults (10 males, 12 females, age=21.1±0.68 years, height=170.6±11.8 cm, mass=65.2±14.2 kg). Treatment group participants received a 1-minute BT treatment to the soft tissues of their …

The Effects Of Private Equity Ownership Of Acute Care Hospitals On Patient Experience, Abigail M. Huffman

Theses and Dissertations

In 10 years, private-equity firms' share of hospitals has grown from 2-3% to 8%.  Using data from two sources: the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient surveys and the Private Equity Stakeholder Project (PESP), I demonstrate a causal effect of private-equity ownership on patient satisfaction using difference-in-difference methods.

Synthetic Explorations Towards Phenyl Benzazepine-Inspired Scaffolds And Synthesis Of Minor Cannabinoid Derivatives, Vishwashiv Kumar Emogaje

Theses and Dissertations

D1R is a compelling therapeutic target for correcting dopaminergic imbalances. However, existing ligands exhibit suboptimal pharmacokinetic properties. As such, we synthetically explored untouched structural modifications to the phenyl benzazepine scaffold. Cannabinoid-based molecules also display potential to treat neurological maladies and cancer. We synthesized Cannabichromene derivatives and uncovered enhanced anticancer activities.

Neuroprotective Effects Of Prophylactic Brivaracetam On Memory And Anxiety Following Traumatic Brain Injury, Sofia Dumic

Theses and Dissertations

Prophylactic brivaracetam (BRV) was evaluated in a rat TBI model for effects on behavior and serum tau. BRV reduced anxiety-like behavior with optimal dose-dependent effects at 2.1mg/kg, but did not affect working memory. Serum tau was detectable early post-injury, supporting its use as a biomarker.

Enhancing Healthcare Communication With Artificial Intelligence Translation Methods For Improved Patient Healthcare Satisfaction, Mireille Signe

Doctor of Nursing Practice Final Project Abstract

Purpose:

To evaluate whether artificial intelligence (AI) verbal translation improved communication-related satisfaction during routine nurse–patient interactions.

Background:

In the ICU, brief, frequent conversations with patients with Limited English Proficiency (LEP) often occur without timely access to professional interpreters, contributing to delays, improvised communication, and lower satisfaction. AI tools offer immediate access for low‑complexity exchanges but require evaluation for feasibility and effectiveness as a supplement to certified interpreter services.

Methodology:

Twelve nurse-LEP proxy patient dyads were evaluated using a mixed-methods design (8/2025-12/2025) in a 16-bed ICU during QI PDSA cycles. Standardized care communication scenarios were completed using the AI tool. Process …

Measuring School Anxiety In Pediatric Chronic Pain: Initial Investigation Of The Psychometric Properties Of The School Anxiety Inventory For Chronic Pain (Sai-Cp), Caitlyn Maye, Robert C. Gibler, Kristen E. Jastrowski, Dustin Wallace Phd, Cara M. Hoffart, Jenny Scheurich Phd

Posters

Introduction: School anxiety is common among adolescents with chronic pain and often impacts academic and social functioning. Existing anxiety measures lack specificity for capturing the unique sources and symptoms of school-related anxiety in this population. To address this gap, a bank of new potential measure items (the School Anxiety Inventory for Chronic Pain [SAI-CP]), was developed based on the original School Anxiety Inventory (SAI), qualitative interviews with adolescents with chronic pain, and expert clinician input. The objective of this study was to evaluate the construct validity and internal consistency of the SAI-CP and identify avenues for future measure refinement. Method: …

Recognizing What Matters Most: Using Safety-Critical Tasks To Strengthen Central Line-Associated Bloodstream Infection (Clabsi) Prevention Rounds, Lacey Bergerhofer, Christian Anthony Schneider, Emily Evans

Posters

Background: Our CLABSI improvement team developed high-risk rounding processes on the Hematology/Oncology unit. Expanding this model to additional Med/Surg units was challenging due to limited staffing and time-intensive tasks required during rounds. Concurrently, CLABSI rates across other Med/Surg units increased, necessitating a scalable approach. Objectives: Apparent Cause Analysis (ACA) review in Med/Surg units identified an opportunity to strengthen surveillance by engaging Vascular Access subject-matter experts. Our proactive high-risk rounds pilot led to CLABSI rate reduction. The objective was to expand service coverage without compromising established high-risk rounding quality standards. Our goal is to assess > 90% of central lines in Med/Surg …

Newly Registered Nurses With Neurodiversities: A Qualitative Study Of Their Experiences During Transition To Professional Practice, Heather Wallace

Dissertations and Theses (Open Access)

Abstract Introduction: Transition-to-practice (TTP) programs play a crucial role in bridging the academic-to-practice gap for newly licensed Registered Nurses (NLRNs) and improving first-year retention rates. However, these programs may fall short in addressing the specific needs of NLRNs with neurodiversities (NLRN-ND). Neurodiversity (ND) encompasses Autistic Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Tourette Syndrome, and the 3 Ds – Dyslexia, Dyscalculia, and Dysgraphia. Unsupportive environments for disclosing neurodiversity and requesting accommodations may contribute to the 10-25% NLRNs leaving their jobs within the first year, with 1-3% exiting the nursing profession altogether. Objectives: This study aimed to (1) explore NLRN-ND …

Exploring Teamwork Between Virtual And Bedside Nurses, Caitlin Weinheimer

Dissertations and Theses (Open Access)

Background: Advancing technologies and the use of telehealth have expanded in hospitals to include telenursing. Telenursing introduces a unique dynamic where virtual and bedside nurses work together as a remote team to provide patient care. Published literature reports that teamwork among nurses and healthcare professionals impacts patient and workforce outcomes. However, there is a gap in exploring teamwork between virtual and bedside nurses. Addressing this knowledge gap is critical to ensure positive patient and nursing workforce outcomes in hospital-based telenursing settings.

Objective: To generate a grounded theory that explains teamwork between virtual and bedside nurses in the hospital setting. A …

Breastfeeding Education Preferences Of Pregnant People With Low Incomes, Megan Kindred

Dissertations and Theses (Open Access)

Background: The proportion of infants breastfed at 1 year in the United States remains below the Healthy People 2030 goal. Longer breastfeeding durations are important due to dose-response benefits, but disparities are greater among those with low incomes. Prenatal breastfeeding education (PBE) interventions can increase breastfeeding duration. Additionally, incentivization and gamification can be used to increase use of educational technology but are underexplored in this domain. Prior studies examining PBE format preferences do not reflect currently available technology. PBE format preferences of childbearing people should be reexamined.

Purpose: This purpose of this study is to: (1) identify PBE format preference …

Ethnic And Sex Differences In Salt Sensitivity Amongst Normotensive Young Adult Nigerians: Implications For Hypertension Prevention, Ahmed Oloyo, Abdullahi Adejare, Oluwakemi Odukoya, Simiat Elias, Oyewole Kushimo, Olusoga Sofola

Biomedical Sciences, East Africa

Background: High dietary salt intake is a well-established modifiable risk factor for hypertension and cardiovascular disease. Salt sensitivity – a blood pressure (BP) phenotype defined by exaggerated BP response to salt loading, remains underrecognised in normotensive populations despite its strong link to adverse cardiovascular outcomes. The burden and determinants of salt sensitivity amongst young Nigerians remain poorly understood.

Aims: This study aimed to identify demographic and behavioral risk factors associated with salt sensitivity, explore potential ethnic and sex-related differences, and determine the independent predictors of salt-sensitive (SS) BP response amongst normotensive young adult Nigerians.

Subjects and Methods: An …

A Planetary Health Approach To Address Food Insecurities In New Mexico, Mariah Kennell

Doctor of Nursing Practice Scholarly Projects

Food insecurity remains a persistent public health concern throughout New Mexico, impacting both rural and urban populations and contributing to significant health disparities. Limited access to affordable, locally sourced fresh foods exacerbates chronic disease burden and undermines community health. The purpose of this Doctor of Nursing Practice project was to conduct a comprehensive policy analysis to identify feasible state-level strategies to improve food access through strengthening local food systems. Using the Centers for Disease Control and Prevention POLARIS policy analysis framework, a structured evaluation of existing and potential state and community-level policies was conducted. The analysis incorporated stakeholder interviews with …

Ambient Air Pollution In New Mexico: Nurse Practitioner Awareness, Mckenzie Hemmes, Grayson Kemp

Doctor of Nursing Practice Scholarly Projects

Ambient air pollution is a significant public health concern in New Mexico and contributes to respiratory disease, cardiovascular illness, and adverse pregnancy outcomes (Dominski et al., 2021; Di et al., 2022). Despite well-established evidence linking environmental exposures to health outcomes, environmental exposure screening is not routinely incorporated into clinical practice. The purpose of this Doctor of Nursing Practice (DNP) project was to improve environmental health literacy (EHL) among advanced practice registered nurses (APRNs) in New Mexico and to increase their intention to integrate ambient air pollution exposure screening and mitigation counseling into routine clinical practice. A virtual educational intervention guided …

A Rare Convergence: Malignant Thymoma With Pericardial Invasion In A Brca2 Mutation Carrier With A Synchronous Breast Mass, Mahmoud Yacout, Mohammad Chisti

Conference Presentation Abstracts

Introduction Thymomas are rare epithelial tumors of the anterior mediastinum, accounting for < 1% of adult malignancies, with an estimated annual incidence of approximately 0.15 cases per 100,000 persons. Although often indolent, thymomas are malignant by definition and may invade locally, recur, and, less commonly, disseminate. They are classically associated with autoimmune conditions, most notably myasthenia gravis, yet their relationship with hereditary cancer syndromes remains poorly defined. Germline BRCA2 mutations are well established in the pathogenesis of breast, ovarian, pancreatic, prostate, and other malignancies through impaired homologous recombination DNA repair. However, an association between BRCA2 mutations and thymic epithelial tumors has rarely been reported. We describe an unusual case of invasive malignant thymoma with pericardial invasion in a BRCA2 mutation carrier, discovered concurrently with a synchronous FDG-avid breast mass suspicious for malignancy. Case Presentation An 85-year-old man with a history of CAD, hypertension, GERD, and prior radical prostatectomy presented with several months of unintentional weight loss and chronic diarrhea. During evaluation for recurrent appendicitis, imaging incidentally revealed a large anterior mediastinal mass measuring up to 7.9 cm with irregular margins. FDG-PET demonstrated moderate metabolic activity within the mass (SUVmax 3.8). CT-guided biopsy revealed a thymic epithelial neoplasm consistent with thymoma. There was no clinical evidence of myasthenia gravis. He subsequently underwent partial sternotomy with thymectomy. Pathology demonstrated a 6-cm type B2 thymoma with direct pericardial invasion, positive surgical margins (R1), and no regional lymph node involvement (pN0), consistent with pT2 stage III disease by the Masaoka–Koga system. Given high-risk features, adjuvant radiation therapy was initiated, with planned surveillance using PET imaging and circulating tumor DNA monitoring. Concurrent PET imaging identified a palpable FDG-avid right breast mass. Genetic testing revealed a pathogenic germline BRCA2 mutation. The breast lesion is currently undergoing diagnostic biopsy and surgical evaluation. Discussion Thymomas are malignant neoplasms with a predilection for local invasion. Type B2 thymomas carry a higher risk of recurrence, particularly in the presence of pericardial invasion or incomplete resection. Complete surgical excision remains the cornerstone of management, while postoperative radiotherapy is recommended in invasive or R1 disease to reduce locoregional recurrence. The coexistence of invasive thymoma and a germline BRCA2 mutation is exceedingly rare and raises questions regarding shared oncogenic mechanisms. While thymic epithelial tumors are not classically associated with BRCA mutations, DNA repair defects may contribute to tumorigenesis in rare malignancies. The presence of a synchronous FDG-avid breast mass in a male BRCA2 carrier further underscores the importance of comprehensive oncologic and genetic evaluation and highlights the need for multidisciplinary management in complex hereditary cancer presentations. Conclusion We report a rare case of malignant type B2 thymoma with pericardial invasion in a BRCA2 mutation carrier, identified alongside a synchronous breast mass suspicious for malignancy. This case highlights the potential intersection between thymic epithelial tumors and hereditary cancer syndromes, reinforces the importance of genetic evaluation in patients with multiple malignancies, and underscores the need for long‑term multidisciplinary surveillance. Further investigation is warranted to elucidate any causal relationship between BRCA‑mediated DNA repair dysfunction and thymoma development.

Eptinezumab In Treatment-Resistant Chronic Migraine: Four-Year Real-World Effectiveness And Treatment Persistence, Wan-Jen Hsieh, Kelly Nicol, Chai Ching Ng, Tsung-Wei Hou, Phillip Phan, Scott W. Keith, Brittany Heckel, Michael J. Marmura, Hsiangkuo Yuan

Department of Neurology Faculty Papers

AimTo evaluate 48-month real-world outcomes of eptinezumab users in chronic migraine (CM), including longitudinal effectiveness, treatment persistence, reasons for discontinuation, and post-discontinuation anti-calcitonin gene-related peptide (CGRP) treatment patterns.MethodsWe conducted a retrospective cohort study of 112 CM subjects initiating eptinezumab at a tertiary headache center between 2019 and 2021. Monthly headache days (MHD), migraine disability assessment (MIDAS), and average pain intensity (API) were extracted at baseline and every 6 months for up to 48 months using a predefined outcome form at each visit. Longitudinal changes were analyzed using generalized estimating equations (GEE) with an unstructured correlation matrix, adjusting for age, sex, …

Navigating Recovery: A Qualtitive Study Of Harm Reduction And Sobriety Among African American In Redlined Chicago Neighborhoods, Erica N. Tate

Dissertations

This qualitative study examines the lived experiences of African American individuals residing in historically redlined communities in Chicago who are maintaining sobriety using harm reduction strategies. Grounded in the context of structural inequities, the study explores how social determinants of health, including limited healthcare access, transportation barriers, and community disinvestment, shape recovery pathways. Semi-structured interviews were conducted with individuals in sustained recovery and providers, and the data were analyzed using inductive and deductive thematic approaches. Findings indicate that recovery is an ongoing process influenced by environmental exposure, trauma, and access to support systems.

Participants identified harm reduction strategies, such as …

Agnikarma Therapy In Management Of Plantar Fasciitis (Vatakantaka): A Systematic Review Of Ayurvedic Case Reports, Karishma Sebastian, Nidhin John, Amanda Killeen

School of Podiatric Medicine - Student Research

Plantar fasciitis is a leading cause of heel pain, commonly affecting adults aged 40–60, characterized by microtears and inflammation of the plantar fascia.

Conventional treatments (NSAIDs, corticosteroids, orthotics, surgery) often provide incomplete relief or cause adverse effects.

In Ayurveda, plantar fasciitis corresponds to Vatakantaka, a Vata-dominant condition of the heel region (Khudukapradesha).

Agnikarma, a para-surgical Ayurvedic technique involving therapeutic thermal cauterization using heated metallic rods (Shalaka), is described for disorders involving ligaments, bones, and joints with chronic pain and stiffness.

This review synthesizes clinical case reports evaluating Agnikarma as a treatment for plantar fasciitis to determine its efficacy, safety, and …

The Impact Of Palm Cooling On The Physiological And Cognitive Function Of Aerobically Trained Individuals, Katherine L. Tibbs

Honors Theses

Background: Cooling strategies have been shown to combat the harmful effects that an increase in body temperature can potentially cause, and palm cooling in particular has been adopted due to its effectiveness in mitigating muscle fatigue during exercise. While there is clear support that this improves muscular strength and endurance, there is a lack of research on the impact palm cooling has on the mental aspect of physical activity. The purpose of this study was to investigate the cognitive and physiological effects of palm cooling on aerobic exercise performance. Methods: Ten aerobically trained participants between the ages of 18-35 were …

Navigating The Gray Area: The Unregulated Surge Of Unique Glp-1 And Glp-1/Gip Products, Jordyn Belcourt, Amy Sapowadia, Charles Michael White

Honors Scholar Theses

Purpose: To identify unique compounded semaglutide and tirzepatide products that existed after the shortage grace period ended and to assess their characteristics.

Methods: Researchers searched for compounding pharmacies using specific terms on Google. They collected the formulation, ingredients, dosage, and monthly cost of products. Researchers also contacted compounding company websites with available information to ascertain further information about products.

Results: Researchers identified 26 sites selling a total of 86 semaglutide or tirzepatide products. Of the included products, 33 were unique, and 41 products were essentially copies of FDA-approved products. Unique formulations included sublingual solution (n=9), sublingual tablets (n=5), and orally …

Investigating The Role Of The Fascia In The Development Of Fibrodysplasia Ossificans Progressiva (Fop), Liv Nevo

Honors Scholar Theses

Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder that primarily affects connective and muscle tissues. It is characterized by heterotopic ossification (HO), which is the formation of bone tissue where it does not normally form. HO can be triggered by physical trauma, infection, inflammation, or stress. The formation of HO leads to impaired muscle function and reduced patient quality of life. Concurrently, the loss of muscle function indicates there is an impairment in the ability of the muscle to regenerate effectively. The most common genetic cause of FOP is an arginine-to-histidine substitution within the type I bone morphogenic protein …

A Comparative Analysis Of Two Play-Based Upper Extremity Training Programs In Improving Arm Motor Function In Children With Hemiplegia, Kara Borkowski

Honors Scholar Theses

Cerebral Palsy is one of the most common causes of childhood motor disability. Children with cerebral palsy often experience impaired movement, posture, and balance (Vitrikas et al., 2020). A key factor in the success of upper extremity training for children with cerebral palsy is the frequency and intensity of therapy sessions (Jackman et al., 2020). However, these sessions can be expensive, time consuming, and often difficult to fit into home routines. These limitations have led to an increasing exploration of the effects of caregiver-led programs, bridging many of the gaps these barriers create. The efficacy of a play-based training program …