Medicine and Health Sciences Commons^™

Preserving Life In An Age Of Autonomy: A Critique Of Physician-Assisted Suicide, Adeline Holcombe

Senior Honors Theses

This thesis critiques physician-assisted suicide (PAS) as a reflection of Western thought’s shift from a biblical sanctity-of-life ethic toward autonomy and relativism. Through analysis of biblical and historical foundations, major cases, and state PAS laws, it argues that legalization weakens the state’s interest in preserving life, normalizes suicide, and exposes vulnerable populations to coercion, inadequate safeguards, and legal expansion. The thesis concludes that PAS laws should be repealed and that palliative care, hospice, and mental health treatment provide more compassionate and ethically sound alternatives.

The Effects Of Dietary Interventions On Gut Microbial Balance In Healthy Adults: An Integrative Review, Miranda Demars

Senior Honors Theses

The goal of this review is to answer the question: What dietary changes are most effective in restoring gut dysbiosis in healthy adults? The gut microbiome (GM), a community of microorganisms that colonizes in the gastrointestinal (GI) tract, can become imbalanced, a condition known as dysbiosis, which is associated with an increased risk of dysbiosis-induced disease. Dysbiosis-induced diseases include GI disorders such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), neurological disorders such as Alzheimer’s disease (AD) and Parkinson’s disease (PD), and metabolic disorders such as diabetes and obesity (Shen et al., 2025). Pharmacologic interventions are often not …

Volume 17, Christian O’Neill, Kyara Greene, Savva Sidorov, Laura Bisaillon, Luke Clemmer, Hannah Gordon, Kitt Benson, Taylor Blount, Rachel Danzitz, Nicholas Duellman, Chase Gionis, Hima Fernando, Seth Franzyshen, Onyx Gonzalez, Bryan Lin, Samantha Start, Ysabel Wells, Maggie Duncan

Incite: The Journal of Undergraduate Scholarship

Introduction Dr. Amorette Barber, Director, Office of Student Research

From the Editor Dr. Hannah Dudley-Shotwell

Cover Artist’s Statement Maggie Duncan

On Mentoring Dr. Yulia Uryadova

Ukrainian Resistance in the Face of Russification: Nestor Makhno and Anarchism

by Christian O’Neill

Life Vest by Kyara Greene

Isolation and 16S rRNA Identification of Bacteria from Fire Department Connection Pipe by Savva Sidorov

The Effectiveness of Planned Exercise in Reducing ADHD Symptoms in Children by Laura Bisaillon & Luke Clemmer

Linguistic Analysis on Confidence and Communication Strategies with Disparities Between Sign Fluency and Hearing Impairment by Hannah Gordon

Freedmen in Indian Territory by Kitt …

Understanding Delays In Emergency Department Care: A National Analysis Of Wait Times, Gregory Forsberg

Mathematics, Statistics, and Computer Science Honors Projects

Emergency department (ED) wait times remain a persistent bottleneck in the United States healthcare system, impacting patient outcomes, hospital efficiency, and equitable access to care. This study analyzes nationally representative data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), a complex, multi-stage probability sample. Using survey-weighted analyses and predictive modeling, we examine the effects of patient characteristics, triage acuity, and visit timing. Results indicate that operational and system-level factors, including hospital capacity, geographic region, and temporal variation, are among the most influential predictors of ED wait times

Rare Diseases In Children—Knowledge, Experiences And Challenges Faced By Pediatricians In Tanzania, Mariam Noorani, Mohamedraza Ebrahim, Francis Furia

Paediatrics and Child Health, East Africa

Diagnosing and treating rare diseases in children is a major challenge for pediatricians globally. There is a lack of adequate knowledge of these conditions and diagnostic testing is not easily accessible, which frequently results in delays in care. The knowledge, experiences and challenges faced by pediatricians in Tanzania are not known. This study used a nationwide cross-sectional online survey to describe the knowledge of pediatricians in Tanzania on rare diseases, their experiences, and the challenges they face in treating these children. The survey tool was shared on the Pediatric Association of Tanzania WhatsApp group where most pediatricians are registered. 168 …

Pattern Dynamics And Stochasticity Of Brain Rhythms And Spike Trains In A Tauopathy Mouse Model Of Alzheimer’S Disease, Clarissa M. Hoffman

Dissertations and Theses (Open Access)

Systems neuroscience posits that every aspect of perceived physical reality, every aspect of animal and human behavior, and every cognitive phenomenon emerges from patterns of neuronal activity. While most researchers embrace this idea, there are major difficulties in describing and analyzing these complex neuronal dynamics—spike flows produced by cells ensembles, synchronized extracellular field oscillations, and other patterns—which limits our understanding of how the activity of individual neurons and the whole-animal cognition and behavior might be connected. In particular, we lack the approaches and even the semantics for connecting the individual cell outputs and the integrated results of their activity. Current …

Technical Development, Optimization, And Clinical Implementation Of Quantitative Magnetic Resonance Imaging Methods For Radiation Oncology, Lucas Mccullum

Dissertations and Theses (Open Access)

Magnetic resonance imaging (MRI) has gradually grown more important in the field of radiation oncology. This paradigm shift has grown from initial experiments with MRI of cancerous lesions in the early 1970s, to the integration of MRI images for radiation therapy treatment planning (i.e., MRI-Simulation) in the early 1980s, to the combined MRI linear accelerator (MR-Linac) becoming commercially available in 2018 which can simultaneously image a tumor and treat it with radiation. However, due to its novelty in radiation oncology, its full potential for the integration of quantitative MRI-based biomarkers has yet to be fully realized.

Therefore, this dissertation will …

Screening For Hypertension And Diabetes In Laundromats In The Largest Hispanic-Majority City In The U.S, Nicholas A Mccann, Vanessa Schick, Jack Tsai

Faculty, Staff and Student Publications

Purpose: This study aimed to assess the prevalence of hypertension and diabetes among laundromat users in San Antonio, Texas, and explore laundromats as a novel setting for health interventions regarding these 2 conditions.

Design: This descriptive, cross-sectional study involved demographic, blood pressure and HbA1c screenings to assess the health status of laundromat users.

Setting: The study took place in 7 laundromats in low-income areas of San Antonio.

Subjects: A total of 150 adults aged 18 and older who regularly used the laundromats and spoke either English or Spanish were eligible to participate.

>Measures: Hypertension was defined as a systolic BP …

An Integrated Framework For Early Detection And Transmissibility Assessment Of Emerging Variants In Wastewater, Xingwen Chen, Tin Phan, Wei Lin Lee, Katie Clark, Steven F Rhode, Samantha Brozak, Bruce Pell, Tsultrim Palden, Mats Leifels, Anna Gitter, Yang Kuang, Stefan Wuertz, Janelle Thompson, Kristina D Mena, Eric J Alm, Fuqing Wu

Faculty, Staff and Student Publications

Tracking the emergence of new viral variants is critical for epidemic preparedness, but remains challenging because variants typically circulate at low prevalence during the early phase of outbreaks. Here, we present an integrated framework that combines sensitive variant detection in wastewater with quantitative assessment of transmissibility through dynamic epidemic modeling. Using the SARS-CoV-2 Omicron variant as a proof of concept, we developed a novel nested allele-specific RT-qPCR assay (NAS-PCR) that achieved a thousand-fold increase in sensitivity compared with allele-specific RT-qPCR (limit of detection: 0.5 copies/μl). NAS-PCR detected Omicron in wastewater samples from the Greater Boston area starting in September 2021, …

Learning About The Direct Experiences Of Very Young Children With Hearing Loss: A Feasibility Study, Jenni M. Funk

Undergraduate Honors Capstone Projects

We aimed to explore the feasibility of employing a developmentally appropriate, modified puppet interview method to elicit thoughts and perspectives directly from very young children (ages 3 to 6 years old) who are deaf or hard-of-hearing. Little is known about the direct experiences of children with hearing loss, making it difficult to improve care. In our field of speech and hearing sciences, there is no current method of gathering direct experiences of young children and placing them at the center of care. We proposed that researchers may be able to learn about the direct experiences of very young children who …

Abnormal Trafficking And Processing Of Multiple Matrix Metalloproteinases Drive Cartilage Defects In Congenital Disorders Of Glycosylation, Chia-Lun Wu

All Dissertations

Congenital Disorders of Glycosylation (CDG) are rare metabolic diseases caused by defects in glycosylation. Despite identification of over 200 CDG types, the mechanisms linking glycosylation defects to diverse clinical phenotypes remain unclear. This dissertation uses zebrafish models of PMM2-CDG and STT3-CDG to redefine CDG pathogenesis, shifting from a simple glycan deficiency model to one involving disrupted cellular spatial organization.

We identify a protease-dependent pathway underlying craniofacial cartilage defects. Specifically, defective proteolytic processing of N-cadherin, a key adhesion molecule in chondrogenesis, is a central driver of pathology. We further uncover an unconventional trafficking mechanism in which ER stress and altered secretory …

From Synapse To Circuit: Mechanisms Of Behavioral Flexibility And Its Restoration After Prenatal Alcohol Exposure, Jayapriya Chandrasekaran

Biomedical Sciences ETDs

Behavioral flexibility—the ability to adapt behavior when contingencies change—is a fundamental executive function supported by orbitofrontal–striatal circuitry. This dissertation examined molecular, motivational, and circuit mechanisms underlying flexibility and its restoration after prenatal alcohol exposure (PAE). In healthy mice, GluN2B-containing NMDA receptors in the orbitofrontal cortex increased during outcome updating, while AMPA receptor subunits in the dorsal striatum rose during new learning, defining temporally distinct plasticity processes. PAE impaired reversal learning under low-reward conditions, but not when motivation was high, indicating altered thresholds for circuit engagement rather than permanent loss. Finally, optogenetic stimulation of OFC→dorsal striatum projections rescued flexibility in PAE …

Look, I Finished My Pem Sticker Chart!, Kimberly L. Fugok Do, Sarah Fish Do, Kira Galeano, Kyle S Wilson Md, Dawn M. Yenser, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

A Global Prospective Harmonization Framework For Suicidality, Anhedonia, And Obsessive-Compulsive Symptoms In Psychiatric Genetic Studies: A Cross-Continental Study Within The Ancestral Population Network, Ana Diaz-Zuluaga, Jacey Anderberg, Ana Ramirez-Diaz, Andrea Marques, Catherine Rast, Daniel Bustamante, Deborah Jonker, Johanna Valencia-Echeverry, Stella Gichuru, Lukoye Atwoli

Internal Medicine, East Africa

This study aims to prospectively collect harmonized, quantitative, and dimensional psychiatric phenotypes (suicidality, anhedonia, and obsessive-compulsive symptoms) and information on discrimination, stigma, and unfair treatment in up to 27,500 individuals across diverse ancestries and clinical populations for genetic analysis within the NIMH Ancestral Population Network (APN). Five APN projects are participating in the current study (PUMAS-Paisa, PUMAS-NeuroGAP, KOMOGEN-D, LATINO, and SAX-II), spanning recruitment over 15 countries across the Americas, Africa, and Asia. Participants are being enrolled via the recruitment protocols specific to each participating project. The harmonized clinical battery includes the Columbia-Suicide Severity Scale, Snaith-Hamilton Pleasure Scale, and Florida Obsessive-Compulsive …

Implementation Of A Patient Preference Card (Ppc) To Enhance Nurse–Patient Communication In The Intensive Care Unit, Lashunda S. Hickerson

Doctor of Nursing Practice Final Project Abstract

Purpose

Nurse-patient communication barriers occur when critically ill patients are sedated, mechanically ventilated, or neurologically impaired. The purpose of this quality improvement project was to implement a structured Patient Preference Card (PPC) to improve nurse–patient communication for non-verbal postoperative patients in an intensive care unit (ICU). The primary aim was to improve nurse-patient communication scores on the Nurse-Patient Communication Scale (NPCS) by at least 20% during a 90-day pilot implementation. A secondary aim was to achieve at least 90% compliance with PPC completion and use across nursing shifts to support consistent communication of patient preferences.

Background

Communication breakdowns frequently occur …

Improving Nurse Utilization Of Protocols To Prevent Pressure Injuries And Increase The Detection Of Pressure Injuries On Admission Using Skin Assessments And Education, Karla Vazquez

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This quality improvement project was intended to improve nurses’ use of existing pressure injury (PI) prevention protocols by 20%, ensure 80% of them can adequately stage PIs, 100% report adequate PI prevention knowledge, and 50% of patient admissions receive a comprehensive skin assessment by two nurses. This project took place in the intensive care unit of a hospital in San Antonio, Texas.

BACKGROUND

PIs are sources of pain and infection for patients and financially burden healthcare systems. Nurses are frontline workers with the capability to prevent PIs by being knowledgeable of prevention practices. Additionally, the two-nurse skin assessment is …

Exploring Clinical Reasoning In Occupational Therapy Students Using Think Aloud During Computerized Patient Simulation, Candra Selene Talylor

Graduate Theses and Dissertations (2019 - present)

The objective of this research was to explore the effects of the think aloud (TA) method on the development of clinical reasoning in occupational therapy students completing an online simulation assignment. The study aimed to determine if thinking aloud develops clinical reasoning in occupational therapy students as evidenced by a change in clinical reasoning skill scores and investigates the relationship between students' overall clinical simulation competency scores.

This study used a mixed methods design, combining quantitative and qualitative data to explore and measure the use of the TA strategy on the development of clinical reasoning skills. The sample from this …

Big Feelings, Fast Decisions: Emotion Regulation As A Moderator Of Impulsivity In Binge And Emotional Eating, Emma G. Folk

Graduate Theses and Dissertations (2019 - present)

Emotion-driven impulsivity and difficulties with emotion regulation are both associated with maladaptive eating behaviors, including binge eating and emotional eating. However, it remains unclear whether broader emotion regulation difficulties intensify the influence of impulsive responses to emotional states on these behaviors. This study examined whether emotion dysregulation moderates the relationship between emotion-driven impulsivity and maladaptive eating behaviors. Participants were 266 adults (ages 18–65) who completed measures of impulsivity, emotion regulation difficulties, binge eating, and emotional eating. Moderation analyses were conducted using PROCESS in SPSS, controlling for body mass index (BMI) and gender. Negative and positive urgency were significantly associated with …

Associations Of Blood Biomarkers Of Glial Cell Dysfunction And Neuronal Injury With Future Cognitive Decline And Incident Dementia, Srishti Shrestha, Xiaoqian Zhu, B Gwen Windham, Kevin J Sullivan, Priya Palta, Rebecca F Gottesman, Russell P Tracy, Clifford R Jack, Petrice M Cogswell, Prashanthi Vemuri, Sudha Seshadri, Thomas H Mosley, Michael E Griswold, Myriam Fornage

Faculty, Staff and Student Publications

Introduction: Prospective studies of blood-based biomarkers reflecting pathogenic processes, other than Alzheimer-specific pathologies, that contribute to dementia in diverse cohorts are lacking.

Methods: We jointly fitted linear mixed-effect models and proportional hazards models to examine associations of midlife glial fibrillary acidic protein (GFAP), chitinase-3-like protein 1 (YKL-40), soluble cluster of differentiation-14 (sCD14), neurofilament light chain (NfL), total tau (t-tau), and ubiquitin C-terminal hydrolase L1 (UCHL1) levels in serum (collected in 1993 to 1995) with cognitive decline and incident dementia (ascertained over 29 years through 2022) in the community-based Atherosclerosis Risk in Communities Study. sCD14 and YKL-40 were measured in 3082 …

Perceived Neighborhood Environment And Objectively Assessed, Habitual Physical Activity Among Us Adults: An All Of Us Research Program Study, Natalia I Heredia, Michael C Robertson, Christopher D Pfledderer, Ethan T Hunt, Timothy J Walker, Deborah Salvo

Faculty, Staff and Student Publications

Introduction: The purpose of this study was to assess the associations between perceived socioenvironmental neighborhood attributes and objectively assessed habitual physical activity among US adults as well as whether associations vary by sociodemographic characteristics.

Methods: We used data from the All of Us research program, a longitudinal cohort study of a diverse sample of Americans. Perceived neighborhood social cohesion, physical and social disorder, walkability, and sociodemographic characteristics were self-reported. Habitual physical activity was ascertained using Fitbit-derived step counts over ≥24 weeks. Generalized additive mixed-effects models were used to test the associations between perceived socioenvironmental neighborhood attributes and daily step counts. …

Addressing Nonignorable Missing Data And Heterogeneity In Prognostic Biomarker Assessment, Xinran Huang, Ruosha Li, Jing Ning, For The Alzheimer's Disease Neuroimaging Initiative

Faculty, Staff and Student Publications

Covariate-specific and time-dependent area-under-curve (AUC) is often used to evaluate the discriminative performance of biomarkers with time-to-event outcomes, particularly when certain covariates influence biomarkers' accuracy. In biomarker research, despite extensive efforts, missing data remain unavoidable, with nonignorable missingness posing significant challenges. This article focuses on estimating the impact of covariates on time-dependent AUC in the presence of nonignorable missing biomarkers. Assuming a parametric model on the missing probability, we leverage instrumental variables to address the identifiable issue and estimate the unknown parameters. We integrate the inverse probability weighting approach into the score equation of a pseudo partial likelihood for estimation …

A Bilingual Ai-Based Chatbot For Nutrition Education In A Food Is Medicine Intervention For High-Risk Pregnant Women: Design And Development Study, Lorena Macias-Navarro, Nalini Ranjit, Gregory W Bounds, Brendon A Providence, Yesmeena Shmaitelly, Naomi M Tice, Shreela V Sharma

Faculty, Staff and Student Publications

Background: Conversational agents (artificial intelligence [AI]-based chatbots) offer a novel approach to health interventions by providing personalized, adaptive interactions that improve over time based on user engagement. In nutrition education, given the wide variation in knowledge, skills, and abilities across participants, AI-based chatbots have the potential to enhance accessibility, engagement, and behavior change. Food is Medicine (FIM) interventions, which aim to improve food security and diet quality among multicultural, at-risk populations, often face challenges related to sustained engagement and use.

Objective: This paper describes the design, development, and iterative refinement of a bilingual AI-driven nutrition chatbot integrated into an FIM …

The Current Status Of Infant Oral Health Instruction Within Predoctoral Dental Education, Beau D Meyer, Priyanshi Ritwik, Jean Star, Timothy Followell, Mikhail Jones, Leola Royston, Brenda Bohaty, Martina Majstorovic, Adriana Modesto Gomes Da Silva, Katherine Chin, James R Boynton, Chelsea Fosse

Faculty, Staff and Student Publications

A pediatric dental home is a patient-provider relationship that establishes compassionate, comprehensive care that is continually accessible. For more than two decades, professional organizations have recommended children establish a dental home by their first birthday. In 2024, the American Academy of Pediatric Dentistry (AAPD) Council on Pre-Doctoral Education had a governance charge approved by the AAPD Board of Trustees to evaluate the status of infant oral health (IOH) instruction in pre-doctoral dental education. This study was designed to describe the current state of didactic and clinical clock hours dedicated to IOH in U.S. pre-doctoral curricula. Following IRB approval, a 25-item …

May 2026, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

Mental Health Awareness Month

Stress Management Tips for Bulldogs

WELLNESS REMINDER

GET INVOLVED WITH BULLDOG WELLNESS

Bulldog Resources

The Bulldog Wellness Stress Relief Toolkit

Waring Library Society Newsletter, Spring 2026, Waring Library Society, Waring Historical Library, Medical University Of South Caroilna, Jude Arendall, Joann Livingston Zeise, Brooke Fox

The Waring Library Society Newsletters

In this issue, the Waring Library Society welcomes its new President and shares updates on recent and upcoming renovations to Waring Historical Library. Waring Historical Library's staff reflect on insights gained from a recent sabbatical, and highlight several events and engagements the Waring has been part of this season.

Improving Patient Satisfaction Through Enhanced Communication Strategies, Kiranjot Kaur

Electronic Theses, Projects, and Dissertations

Patient satisfaction reflects more than the technical quality of healthcare; it represents patients' perceptions of communication, respect, and emotional trust throughout the care experience. Ineffective communication contributes to poor comprehension, reduced treatment adherence, preventable readmissions, and disparities in patient outcomes. Conversely, clear, culturally responsive communication improves patient engagement, safety, and satisfaction. This project proposes a leadership-driven communication improvement initiative for a mid-sized acute-care hospital located in Southern California serving a culturally and linguistically diverse population, including Hispanic, Asian, and limited-English-proficient patients. The initiative is guided by the Patient-Centered Care Model and Hersey and Blanchard's Situational Leadership Theory. These frameworks position …

Associations Between Water Intake, Dietary Quality, And Beverage Consumption Among University Students, Mohammad A. Qazi

Electronic Theses, Projects, and Dissertations

Title: Associations Between Water Intake, Dietary Quality, and Beverage Consumption Among University Students

Background and Aims: Sugar-sweetened beverage (SSB) and ultra-processed food (UPF) consumption significantly contribute to chronic disease risk and is often more common in underserved and racially/ethnically diverse communities. Drinking water is a low-cost, calorie-free behavior that may support healthier beverage and dietary patterns. Previous studies show that increased daily water consumption positively correlates with better diet quality and is inversely correlated with SSB and UPF consumption. This study aims to examine whether (1) increased daily water intake is associated with self-reported diet quality and (2) self-reported hydration …

Certified Health Education Specialist Exam Toolkit For Undergraduate Public Health Students, Briana C. Villari

Electronic Theses, Projects, and Dissertations

The Certified Health Education Specialists (CHES) is a credentialing exam that is offered by the National Commission for Health Education Credentialing, Inc (NCHEC) for public health professionals and students. With the completion of this exam, individuals can demonstrate their mastery of core health education skills and concepts. With the 2025 testing cycle, roughly 63 to 73 percent of test takers passed. The purpose of this project is to create a CHES exam toolkit for undergraduate public health students in preparation for their exam. The development of this toolkit was guided by the Health Education Specialists Practical Analysis (HESPA II 2020), …

Assessing The Needs Of Public Health Professionals In The Inland Empire, Esteban Silva-Garcia

Electronic Theses, Projects, and Dissertations

An effective public health system relies on the need for highly trained professionals with degrees or certifications within the field of public health. As public health continues to evolve, professionals are required to improve and evolve with the pace of technology and knowledge advancements. This project focuses on reviewing literature on the current ongoing needs of public health professionals and providing them with resources that are available at low to no cost. It surveys the needs of public health professionals in the Inland Empire and the solutions created by organizations and federal agencies to support professional development for current and …

The Quantification Of Fluoride Water Quality And Its Significance On Oral Health, Harleen Kaur Maroak

Electronic Theses, Projects, and Dissertations

Fluoride is a naturally occurring mineral and studies have shown that when added to community water supplies, it effectively reduces dental caries. According to the U.S. Public Health Services (PHS), 0.7mg/L is the optimal fluoride level in drinking water to prevent tooth decay. This study focuses on examining the fluoride levels in water in San Bernardino County (SBC) and Riverside County (RC). Data is collected from recently published articles, databases along with assessing the laboratory water sample (n=45) analysis to determine if the fluoride levels are meeting the optimal standards. In SBC, there are total of 154 water systems with …