The Effect Of Fall Prevention Programs With Hourly Rounding On Fall Rates Among Adults Patients In Neurological Unit, Oyinlola A. Ogundeji

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this QI project was to evaluate the effect of a structured hourly rounding program on patient fall rates in an adult neurological inpatient unit.

Background

Patient falls remain a major safety concern in acute care, particularly among hospitalized neurological patients with impairments in mobility, cognition, and balance. In an adult neurological unit within a Magnet-designated hospital, fall rates exceeded national benchmarks, underscoring the need for a targeted quality-improvement

Methodology

A pre–post QI design, guided by the Plan-Do-Study-Act framework, was implemented over 12 weeks in a 28-bed neurological unit. This intervention featured structured hourly rounding using the …

Prefrontal Engagement In Cognitive Flexibility Across Paradigms, Katarina Kalajzic

Honors Scholar Theses

Cognitive flexibility is an executive function that involves dynamically adapting behavior in the face of changing environmental circumstances to achieve a particular goal. Disrupted in numerous psychiatric disorders such as Alzheimer’s disease, schizophrenia, OCD, and depression, the neural correlates of cognitive flexibility are not well understood. However, the prefrontal cortex (PFC) is strongly implicated in executive function and attentional control processes. Thus, we sought to examine the neural circuitry involved in distinct cognitive flexibility tasks – the attentional set-shifting task and the probabilistic 2-armed bandit task. Through optogenetic suppression, we targeted pyramidal neurons of the rodent medial prefrontal cortex, an …

Factors Affecting Pedestrian-Vehicle Conflicts: An Empirical Analysis, Christo D. Jamo

Honors Scholar Theses

The number of pedestrian deaths increased by 78% between 2009 and 2023, while other motor vehicle crash deaths increased by 13% in the same period [1]. To identify potential pedestrian safety measures, this study analyzed the effects of location-based demographics, pedestrian phasing type, and other physical infrastructure and behavior variables on the probability of pedestrian-vehicle conflicts at signalized intersections, which is a surrogate measure of crash risk. Data were collected from 55 intersections in Connecticut, and the pedestrian-vehicle interactions were classified by severity based on the Swedish Traffic Conflict Technique: undisturbed passage, potential conflict, minor conflict, or serious conflict. Because …

From Prescription To Plate: Redefining The Pharmacist’S Role In Food Is Medicine Initiatives, Aleena R. Thomas

Honors Scholar Theses

Produce prescription (PRx) programs are an emerging Food is Medicine intervention designed to address diet-related chronic diseases and food insecurity by integrating healthcare delivery with access to fruits and vegetables. Diet-related conditions such as type 2 diabetes, hypertension, and cardiovascular disease represent a major public health burden in the United States, particularly among populations with limited access to nutritious food. Despite growing evidence supporting PRx programs, pharmacists -- who routinely manage these conditions and monitor outcomes -- are underutilized in program implementation. The objective of this project is to translate the public health aspects of PRx programs into an accessible, …

Diagnostic Ability Of Rate Of Torque Development For Patellofemoral Pain, Arun Loganathan, Neal R. Glaviano Phd, Sungwan Kim Phd

Honors Scholar Theses

Context: Patellofemoral pain (PFP) is a highly prevalent condition (22.7% in general population) that significantly impacts the quality of life of those who suffer from it. However, there is no gold standard test to diagnose it yet, leading to inconsistencies with treatment as well as delayed intervention. Rate of torque development (RTD) is a neuromuscular measure that has shown strong connections to PFP.

Objective: The purpose of this study is to determine the diagnostic ability of RTD for PFP.

Design: Cross-sectional.

Setting: Laboratory.

Participants: Thirty-five individuals with PFP (24 males and 11 females, 22.7 ± 3.7 years, 1.67 ± 0.1 …

Validation Of A Real-Time Pcr Laboratory Developed Test For The Detection Of Pneumocystis Jirovecii In Bronchoalveolar Lavage Samples, Caitlyn Moon

Honors Scholar Theses

Pneumocystis jirovecii is an opportunistic, host-obligate fungal pathogen responsible for causing P. jirovecii pneumonia (PJP) in humans. PJP is treated with trimethoprim-sulfamethoxazole (TMP-SMX), a strong broad-spectrum antibiotic that carries risk of renal and hepatotoxicity. Therefore, rapid diagnosis or exclusion of PJP is crucial to ensure PJP-positive patients receive effective treatment and PJP-negative patients avoid unnecessary antibiotics. Unlike most microorganisms, P. jirovecii cannot be cultured, presenting complications for the typical methods of diagnosing fungal pathogens. Historically, the gold standard for diagnosis was direct microscopic examination with stains such as methenamine silver and calcofluor white, but this diagnostic technique requires highly skilled …

Play To Win: A Randomized Controlled Trial To Assess The Effects Of Play-Based Training On Upper Extremity Function In Children With Hemiplegia, Vivian London

Honors Scholar Theses

Hemiplegia, or paralysis of one side of the body, is the primary symptom of unilateral cerebral palsy, a subtype of cerebral palsy, the most common movement disorder in children. Standard of care is regular physical and occupational therapy to improve performance in bimanual activities, but conventional therapy can be expensive and draining for caregivers and children, so a need exists for a novel intervention that can take place at home and that is economical for families while being engaging for children. This thesis reports data from a subset of ten children seen as part of a randomized controlled clinical trial …

Undergraduate Nursing Students’ Reactions To Germ Exposure Based On The Big 5 Personalities, Elizabeth Macdonald

Honors Scholar Theses

Despite extensive didactic and clinical training, variability in adherence to infection prevention practices in undergraduate nursing students exists. Individual differences, such as personality, may help to explain this inconsistency. The purpose of this study was to examine the extent to which the Big Five personality traits were associated with self-reported pathogen mitigation or avoidance behavior in undergraduate nursing students. An online survey design was used with undergraduate nursing students. Participants were presented with scenarios depicting different pathogen exposures and asked to indicate their likelihood of engaging in pathogen mitigation behaviors. The Big Five personality traits were also assessed, and bivariate …

The Development Of A Crispr-Based Calibrated Functional Assay For Classifying Pathogenicity Of Msh2 And Msh6 Variants In Lynch Syndrome, Olivia N. Amodeo

Honors Scholar Theses

Lynch syndrome is a hereditary disease caused by the inheritance of a mismatch repair gene variant. Individuals with this condition are predisposed to cancer development, most commonly colorectal cancer. Current guidelines for variant classification are based on numerous evidence categories, including functional evidence. However, many novel clinical variants are not well characterized, and evidence is difficult to obtain if functional assays are not calibrated.

To address this, our lab created a calibrated functional assay that calculates an odds of pathogenicity score for MSH2 and MSH6 gene variants that can be used as evidence for classifying variants of uncertain significance. This …

Essays On Ai-Driven Analytics For Enhanced Healthcare Delivery: From Onset To Outcomes In Neurological Diseases Management, Gabriel Owusu

Theses and Dissertations

Chronic neurological diseases, particularly Alzheimer's disease and related dementias (ADRDs), pose mounting global healthcare burdens. Despite advances in AI and health information technologies, early detection, precise diagnosis, and effective caregiver support remain elusive. This dissertation proposes innovative AI-enabled analytical frameworks to address these challenges across the full ADRD continuum.

The first essay designs an explainable AI-enabled clinical decision support system (CDSS) using a graph neural network for early AD identification, evaluated through usability studies demonstrating improved risk awareness and clinical engagement. The second essay introduces MADT-RNN, a multi-level attention-based deep transfer recurrent neural network that fuses convolutional and recurrent architectures …

Recommendations For Sharing Cardiovascular Implantable Electronic Device Data With Patients Based On Clinician Interviews, Carly Daley, Jonathan Shirazi, Tina Allmandinger, Mindy Flanagan, Stephanie Pruitt, Hung-Yeh Lin, Victor P. Cornet, Jeanne Carroll, Yi Rong Tan, Tammy Toscos, Michael Mirro

Health Services and Informatics Research

BACKGROUND Cardiovascular implantable electronic devices (CIEDs) capture an abundance of data that requires specific medical knowledge to interpret. Currently, there are no clear recommenda tions for sharing clinically meaningful CIED data with patients from the abundance of data in CIED remote monitoring reports.

OBJECTIVE The objectives of this study were to explore clinicians’ perceptions of clinical care gaps related to CIED data that could be improved through patient access to data and to generate recom mendations for sharing CIED data with patients.

METHODS In this institutional review board-exempt, 2-phase sequential qualitative study, 42 semi-structured phone interviews were conducted with 32 …

Improving Follow-Up After School-Based Dental Screenings Using Koha Data In Monterey County, Andre N. Edmond

Capstone Projects and Master's Theses

Limited follow-up after school-based oral health screenings is a major issue for young children in Monterey County, especially for those who do not have a regular source of dental care. This project focused on improving how screening data is used to connect students to needed services. The internship was completed with the Monterey County Oral Health Program and aimed to develop a better system for tracking KOHA (Kindergarten Oral Health Assessment) data and improving follow-up care for students identified with dental needs. Key activities included analyzing screening data, entering into a tracking system, and comparing results from different schools. The …

Tips For Health Care Practitioners: A Guide For Adolescent Obesity, Regina Santana

Electronic Theses, Projects, and Dissertations

Adolescent obesity continues to be a significant public health concern that is associated with long term physical consequences. The purpose of this project was to develop an evidence based, user friendly guidebook that supports healthcare professionals in the education of adolescents with obesity and their families. A structured literature review development process was used to inform the current development of the guidebook. The guidebook includes components of obesity management such as nutrition and physical activity recommendations. The validity of the content was established through the evaluation of five healthcare professionals that include registered dietitians and licensed therapists. The guidebook was …

The Effects Of Administration Policies On Patient Care Quality And Healthcare Service Costs, Rajveer Kaur

Electronic Theses, Projects, and Dissertations

This study examines how administrative policies in U.S. healthcare systems affect patient care quality and service costs. It addresses a gap by analyzing the combined effects of policy, leadership, and technology on both clinical outcomes and financial performance. Using a qualitative descriptive approach guided by the PRISMA protocol, the study systematically identified and analyzed eighteen peer-reviewed articles. The findings show that value-based purchasing policies relate to improved patient safety indicators. Standardized clinical protocols and workforce competency initiatives strengthen care consistency and reduce hospital readmissions. The use of digital health technologies, such as telehealth and predictive analytics, helps optimize resources and …

Easy Travel-Friendly Snack Recipes For College Students To Support Mental Well-Being, Lidia Vides

Electronic Theses, Projects, and Dissertations

College is a pivotal period in life of a young adult, marked by newfound independence, increased responsibilities, heightened academic pressure, and significant changes in daily routine. While this transition can often be exciting for a young adult, it also presents many different challenges. As a result, many students experience increased levels of stress, anxiety, and depression. Nutrition plays a powerful yet often overlooked role in supporting mental and physical health. Current research studies show that a balanced diet rich in whole food ingredients can help regulate mood and promote emotional well-being through multiple biological pathways. However, despite this knowledge, convenient, …

Examining Physical Activity Behaviors And Associated Health Indicators In College Students, Elizabeth A. Reyes

Electronic Theses, Projects, and Dissertations

Background: Physical activity (PA) is a critical determinant of both physical and mental health, yet many individuals fail to meet recommended guidelines. College students face increasing challenges related to physical inactivity, elevated stress levels, and poor sleep quality, all of which negatively impact their overall health and academic success. College students who fail to meet recommended PA guidelines are at an increased risk of chronic diseases. This study aimed to examine patterns of PA among college students and explore associations with sleep quality and perceived stress.

Methods: A cross-sectional design was employed using a self-administered questionnaire that included items on …

Glucagon-Like Peptide-1ra As A Public Health Interventions, Briana Sepeda

Electronic Theses, Projects, and Dissertations

Glucagon-like peptide receptor agonist (GLP-1RA) medications have become a prominent topic of interest both in clinical medicine and broader societal discussions. Although the medication are relatively new and expensive, ongoing research continues to explore pharmacologic modifications aimed at improving therapeutic effectiveness and prolonged drug half-life. GLP-1RAs have gained significant traction due to their ability to lower glycosylated hemoglobin (A1c) and blood glucose levels in individuals who have been diagnosed with type 2 diabetes (T2D). In addition to glycemic control, evidence suggests its associations with appetite suppression, weight loss, reducing cardiovascular disease, improved renal dysfunction, neuroprotective effects related to neurodegenerative disease …

What Is Transitional Care And Its Role In Reducing Readmissions, Decia Rodriguez

Electronic Theses, Projects, and Dissertations

Thirty-day readmissions to hospitals creates significant clinical and financial burdens in healthcare systems and worsens patient outcomes. This project reviews transitional care programs as strategic interventions to minimize preventable readmission with a specific focus on pharmacist-led medication reconciliation. Due to the extensive literature review, this work proves that structured transitional care is effective in closing the gaps between acute hospital care and home-based recovery because it coordinates medication management, patient education, and follow-up care. As it has been shown, pharmacists are in a central position to minimize medication errors and enhance compliance, especially in chronic patients such as those with …

Persistent Wheezing In An Adolescent Patient, Matilda Dervisevic, Stephen Cliff

Posters

No abstract provided.

Evaluation And Treatment Of Pediatric Pre-Eruptive Intracoronal Resorption, Sophia Rosen, Robin Onikul, Neena Patel, Jenna Sparks, Amy Burleson

Posters

Pre- eruptive intracoronal resorption (PEIR), also known as “pre-eruptive caries,” is a dental condition characterized by the resorption of dental tissue prior to the eruption of the tooth.1PIER is typically found adjacent to the dentin-enamel junction, within the occlusal dentin of the tooth.2PIER may be referred to as “occult” or hidden caries due to the presence of sound enamel and is often an incidental finding on routine radiographs.3PEIR is often misinterpreted as traditional caries due to its radiographic appearance,3however requires careful evaluation for determination of treatment and long term success. Case report: This case report details a 13 year old …

Stochastic Universal Differential Equations For Epidemiological Modeling: Uncertainty Quantification In Disease Transmission Dynamics, Alice Menaya Armah-Bonney

Electronic Theses and Dissertations

Epidemic forecasting requires not only predictions of expected case counts, but also quantification of uncertainty, although existing surrogate modeling frameworks for agent-based models remain fundamentally deterministic. In this thesis a Stochastic Universal Differential Equation framework is presented that extends the deterministic Universal Differential Equation approach by incorporating a learnable stochastic diffusion term, enabling calibrated probabilistic forecasts while preserving the mechanistic interpretability and computational efficiency of the deterministic baseline. In doing so, a two-phase training algorithm is introduced to ensure stable convergence and the framework is validated against the ensemble output from ExaEpi, an exascale agent-based model of a COVID-19 outbreak …

University Student Mental Health: Service Utilization, Equity Gaps, And Strategies To Improve Access, Richard Mutua Kilonzo

Electronic Theses and Dissertations

Student mental health and access to care are pressing concerns in higher education. This study assesses mental health outcomes and access to campus mental health services at East Tennessee State University. Survey data from the 2023–2024 Healthy Minds Study were analyzed to report the prevalence of depression, anxiety, and suicidal ideation across the student population. The study evaluates disparities in these outcomes and barriers to care across student groups, with particular attention to equity-impacted students, especially sexual and gender minority students.

Findings indicate widespread psychological distress alongside persistent barriers, including long wait times, limited-service availability, and stigma-related concerns. These barriers …

Bergsonian Blend: Subjective Temporality Within Modernist Aesthetics Of Mental Illness, Lydia Victoria Gervais

Electronic Theses and Dissertations

Henri Bergson was a modernist French philosopher who wrote extensively on the topic of the lived experience of time, which he called durée, or duration. His contemporary, Sigmund Freud, was developing psychoanalytic theory in a growing field of psychological study, which serves as a prominent ancestor to modern psychiatry and current psychoanalytical literary studies. Fiction writers of the 1900s absorbed the zeitgeist of melded chronology and consciousness, interweaving themes of time and trauma in their works. Utilizing Henri Bergson’s durée as a philosophical framework, I examine the moralization of time-consciousness in connection with mental illness and investigate representations of …

Malnutrition And Frailty Risk Among Community Dwelling Older Adults In Northeast Tennessee, Shreeyesha Pradhan

Electronic Theses and Dissertations

Frailty and malnutrition are prevalent conditions among community-dwelling older adults, affecting approximately 10% and 25% of this population, respectively. Despite overlapping symptoms such as functional decline, their relationship remains underexplored in community dwelling older adults. This cross-sectional feasibility study examined the association between frailty and nutritional status among 47 older adults in the East Tennessee Tri-Cities area using the Fried’s Frailty Phenotype (FFP) and the Mini Nutritional Assessment-Long Form (MNA-LF®). Results indicated 13% were pre-frail, 24% were frail, 21% were at risk for malnutrition, and 2% were malnourished. Regression analyses revealed that self-perceived nutritional status (37.6%), daily meal frequency (29.0%), …

Addressing Substance Use Disorder In Rural Appalachia: Improving Access And Treatment Outcomes For Justice-Involved Individuals, Jessica Muldowney

Electronic Theses and Dissertations

Background: Opioid use disorder (OUD) represents a critical public health crisis disproportionately affecting justice-involved (JI) populations, with approximately 65% of incarcerated individuals having substance use disorders (James & Beatty, 2006). Rural Appalachian communities face compounded challenges due to limited healthcare access, provider shortages, and cultural stigma surrounding addiction treatment. Despite evidence demonstrating that medication-assisted treatment (MAT) reduces recidivism and overdose deaths, only 20% of correctional facilities offer these services (Klein & Seppala, 2019).

Objective: This mixed-methods study evaluated organizational readiness and infrastructure capacity for implementing evidence-based OUD interventions, specifically MAT programs across three rural counties in northwestern North Carolina.

Methods: …

Feasibility Of Assessing Dietary Patterns And Anxiety In College Students: A Pilot Study Using Nutrition Questionnaires, Gad-7, And Asq, Kylie Ford

Electronic Theses and Dissertations

Anxiety is highly prevalent among college students representing a significant public health concern. Research indicates that dietary patterns may influence mental health outcomes; however, the practicality of collecting comprehensive dietary and psychological data in college populations remains unclear. This pilot study assessed the feasibility of evaluating dietary patterns and anxiety using self-report instruments. Participants completed the Nutrition and Eating Habit questionnaire, the Generalized Anxiety Disorder-7 (GAD-7), and the Anxiety Sensitivity Questionnaire (ASQ). Although twenty-one students were recruited, survey completion rates were low, with only seven participants completing the nutrition questionnaire necessary to calculate the Dietary Inflammatory Index (DII). Descriptive analyses …

Ethical Engagement In Global Missions: A Qualitative Inquiry Into Planner Motivations And Host Experiences, Harrison J. Ihrig

Electronic Theses and Dissertations

Short-term mission (STM) trips are limited duration service experiences, commonly organized by faith-based organizations (FBO), in which volunteers travel domestically or international to provide ministry, community outreach, and/or health-related services. In recent decades, the number of these trips organized by organizations in the United States has increased exponentially, but the phenomenon is difficult to accurately measure due to its decentralized nature and the lack of standardized terminology. Despite their prominence, limited research has been conducted to examine planning, implementation, and evaluation processes of international STMs organized by FBO, particularly through a public health lens. The purpose of this study was …

Participant Recruitment, Baseline Characteristics And Burden Of Cardiometabolic Risk Markers Among Adults With Prediabetes In Kenya: Insights From The Fermented Foods And Prediabetes Study, Rosebella Iseme, Alex Muia, Jacob Shabani, Samuel Mucheru, Catherine Gathu, Eliphas Gitonga, Redempta Mutisya, Peter Kioko, Jalal Safipour, Cornelia Witthöft

Population Health, East Africa

Aims

Methods

Results …

Prevalence And Determinants Of Fully Vaccinated Status For Covid-19 Among Pregnant Women In Brazil, Ghana, Kenya, And Pakistan, Vaishnavi Mathur, Jessica Schue, Berhaun Fesshaye, Prachi Singh, Emily Miller, Caroline Badzi, Emefa Modey, Marleen Temmerman, Ferdinand Okwaro, Renato Souza

Centre of Excellence in Women and Child Health

Maternal immunization provides essential maternal and fetal protection for several infectious diseases. The variability in vaccination guidelines for pregnant women across countries and through the course of the COVID-19 pandemic influenced the perception of both the general public and broader health care systems towards COVID-19 vaccination in pregnancy and moreover shaped the accessibility and decision-making trajectory of pregnant women to become fully vaccinated. As part of a larger multi-country, mixed-methods study, the purpose of this cross-sectional analysis is to assess what factors are associated with pregnant women being fully vaccinated for COVID-19 in Brazil, Ghana, Kenya, and Pakistan. In each …

Metabolic And Replicative Constraints On Pathogen Virulence: Isoleucine Catabolism In Shigella And Comparative Tanapoxvirus Replication In Cell Cultures, Benecia Angelica

Masters Theses

Pathogens survive by balancing metabolic demands with environmental challenges that shape their virulence and adaptability. Shigella flexneri, a highly infectious human pathogen responsible for severe diarrheal disease worldwide, utilizes branched-chain amino acid (BCAA) metabolism to withstand stress conditions encountered within the host environment. In this study, we explored the Shigella isoleucine catabolism pathway by knocking out four genes in the S. flexneri isoleucine catabolic pathway (ilvE, fadA, fadD, and acnB) and examining their metabolism and virulence. We found that the ilvE and acnB mutants displayed reduced metabolic activity and smaller plaque size, while the fadD mutant showed decreased invasion. In …