Medicine and Health Sciences Commons^™

Supporting An Inclusive Summer Camp For Children With Developmental Disabilities Who Use Aac And Their Neurotypical Peers: A Practice-Based Report, Jessica Hicks

Communication Disorders and Occupational Therapy Undergraduate Honors Theses

For my honors research, I completed an internship in an augmentative and alternative communication (AAC) lab at the University of Arkansas. For most of my internship work, I helped support an inclusive AAC summer camp for children with and without developmental disabilities, such as autism, for whom speech does not fully meet their communication needs. AAC includes high-tech tools such as communication apps on tablets that serve as speech-generating devices (SGDs). SGDs were used by many of the AAC summer camp participants with developmental disabilities. In this report, I will provide background information on AAC and developmental disabilities. I will …

Investigating Speech-Language Pathologists’ Perceptions On Bilingual/Multilingual Aac Intervention And Quality Of Care, Lillian D. Griffith

Communication Disorders and Occupational Therapy Undergraduate Honors Theses

This study examined U.S.-based speech-language pathologists' (SLPs) perceptions of bilingual/multilingual AAC service provision and the barriers SLPs encounter to determine if SLP beliefs align with practices. An anonymous survey was distributed to 307 ASHA-certified SLPs, resulting in 21 completed responses. The survey consisted of questions that gathered information on participant demographics, caseload, perceptions/beliefs, and practices, with optional open-ended questions for additional context. SLPs in the participant sample strongly believed that AAC intervention should occur in all the languages spoken by the client. Despite this belief, they struggled to implement it due to barriers. Key barriers identified included SLP language limitations, …

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 …

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 …

Identifying And Addressing Burnout Among Nurses In Cache Valley And The Surrounding Salt Lake Metropolitan Area, Teegan Alma Martinez

Undergraduate Honors Capstone Projects

Background: Nursing burnout has emerged as a critical issue within modern healthcare systems, with widespread implications for nurse well-being, patient safety, and organizational performance. Characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, burnout affects an estimated 30% to 60% of nurses, particularly in high-acuity settings. The persistence of burnout highlights the need to better understand its contributing factors, consequences, and effective strategies for mitigation.

Purpose: The purpose of this study was to examine the prevalence and contributing factors of nursing burnout, evaluate its impact on nurses and patient care, and identify effective interventions. Additionally, this study aimed …

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 …

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 …

Understanding Vaccine Hesitancy In Veterinary Medicine: A Review Of Client Attitudes, Grace Moore

Undergraduate Honors Capstone Projects

Uncertainty toward vaccination, long recognized as a public health concern in human medicine, is increasingly recognized within veterinary contexts, posing risks to both animal and community health. This literature review examines the development, causes, and implications of reduced vaccine confidence in veterinary medicine, with emphasis on small animal and some large animal practices. The review combines historical and current research to explore how vaccination perceptions have evolved among veterinarians and clients, and how factors such as the COVID-19 pandemic have shaped current attitudes.

The literature highlights recurring themes surrounding vaccine reluctance in veterinary settings. Client perceptions of safety, efficacy, and …

Towards Dementia-Inclusive Digital Text-Based Health Information: A Multi-Method Investigation Of Cognitive And Affective Accessibility, Margi Engineer

All Dissertations

This dissertation examines the accessibility, readability, emotional tone, and trustworthiness of digital, text‑based dementia information and investigates how older adults with and without dementia cognitively and affectively engage with such content. It further explores the potential of generative AI to improve dementia information delivery through the development of a domain‑specific retrieval‑augmented generation (RAG) large language model (LLM) chatbot designed to deliver accessible, stigma‑free information. The dissertation comprises four studies using complementary quantitative and qualitative methods. Study I conducts a large‑scale content analysis of 300 medical articles, 35 websites, and 50 blogs, applying readability metrics, LIWC‑based linguistic and sentiment analysis, and …

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 …

Caregiver Self-Reflection: Does It Matter? A Study Of The Relationship Between Caregiver Self-Reflection And Participation In Home Programs In Outpatient Pediatric Physical Therapy Settings, Andrea Myane

Graduate Theses and Dissertations

Despite evidence that caregiver coaching can improve patient outcomes and caregiver participation, little information exists on the effects of its individual components. Additionally, previous research has highlighted the importance of home programs in improving pediatric physical therapy outcomes. The aim of this study is to explore the role that caregiver self-reflection, a component of caregiver coaching, plays in facilitating outcomes in the pediatric physical therapy outpatient setting. Caregivers will be asked to complete a series of self-reflection questions based on Gibbs’ Reflective Cycle, while also recording the number of minutes they spend facilitating a prescribed home program. All study participants …

Developmental Assets And Risk-Related Restraint And Resistance Orientations Among Emerging Adult College Students: Examining Protective Associations, Summer N. Beck

Graduate Theses and Dissertations

Abstract Background: Although developmental assets are well established as protective factors during childhood and adolescence, less is known about their role during emerging adulthood, a period when the prevalence of several types of risk behaviors peak. For the U.S. college student, campus can provide ideal conditions for supporting the extended transition to adulthood. However, that same environment may increase exposure to health risk behaviors. This study examined associations between developmental assets and the risk-related restraint and resistance orientations involving sexual activity, alcohol, and illicit drugs among emerging adult college students. Methods: A cross-sectional correlational design was employed with a sample …

Investigating The Influence Of Dietary Phytogenics And Postbiotics On Horizontal Transmission Of Histomonas Meleagridis In Commercial Turkey Poult Hens, Diego Fernando Cortes Velez

Graduate Theses and Dissertations

Histomonas meleagridis is a parabasalid protozoan and the causative agent of histomonosis, or blackhead disease, in turkeys. Withdrawal of the last remaining in-feed arsenical from the market in 2015 led to the re-emergence of the disease. As a result, there is a need to investigate alternatives, such as dietary inclusion of postbiotic and phytogenic compounds, to reduce H. meleagridis transmission and disease severity in commercial turkey flocks. The purpose of this project was to evaluate the influence of dietary inclusion of three different combinations of postbiotic and phytogenic compounds on H. meleagridis transmission in turkey poult hens. A thesis introduction …

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 …

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 …

A Pilot Project On Improving Icu Nurses’ Confidence In Early Defibrillation, Adetutu Obadina

Doctoral Projects

Early recognition of shockable cardiac rhythms and timely defibrillation are critical components of effective resuscitation during in-hospital cardiac arrest. Despite established guidelines from the American Heart Association (AHA), nurses may experience uncertainty or reduced confidence when identifying shockable rhythms and delivering timely defibrillation during cardiac arrest events. The purpose of this project was to examine whether a structured educational intervention incorporating simulation-based training could improve intensive care unit (ICU) nurses’ confidence and knowledge in recognizing shockable rhythms and performing timely defibrillation. A pre-and post-intervention design was implemented among ICU nurses at a large academic medical center between September and October …

Understanding The Role Of Toxs As A Bile Sensing Component Of The Toxrs Virulence Regulatory System In Vibrio Spp., Minje Kim

Dartmouth College Ph.D Dissertations

Pathogenic Vibrio bacteria, such as V. cholerae and V. parahaemolyticus, colonize in the human small intestine to cause severe gastrointestinal disease. During the infection, these bacteria encounter bile salts, antimicrobial cholesterol metabolites secreted into the intestine. Pathogenic Vibrio species have evolved to utilize bile salts as signals to regulate virulence. The signaling depends in part on ToxRS, a conserved co-component transmembrane transcription regulator. ToxRS consists of the transcription factor ToxR and its membrane-tethered binding partner ToxS. ToxS is required for ToxR stability and full transcriptional activity. Although bile salts are known to influence ToxRS-dependent virulence gene expression, the molecular …

Clawing Our Way To Inclusion: Identifying Minority Students’ Barriers To Entering The Veterinary Medicine Profession, Danielle Reeves

Animal Science Undergraduate Honors Theses

Veterinary services are being utilized more each year as pet owners are increasingly viewing and treating their pets like family members. Due to this changing perspective, the veterinary profession has grown significantly. Yet, despite this change, there is a lack of ethnic/racial diversity within the veterinary field. The purpose of this study was to determine the factors and/or barriers associated with minority students' desire or lack of desire to pursue a career in veterinary medicine. This study used an online survey tool to collect qualitative and quantitative data from 423 undergraduate students at the University of Arkansas during the spring …

Treatment And Interventions For Sexual Assault In Humanitarian Contexts: Addressing Gaps In Refugee And Idp Camp Care In Myanmar, Erin Nash

Capstone Experience: Master of Public Health

Sexual and gender-based violence (SGBV) remains a pervasive yet under-addressed issue in humanitarian settings. Refugee and internally displaced person (IDP) camps along the Thai– Myanmar border represent a complex nexus of protracted displacement, ethnic conflict, and limited access to medical and psychosocial care. Although the prevalence of sexual assault in these contexts is well-documented, there is a critical gap in the literature regarding effective, context-specific treatment and intervention strategies. This capstone project conducts a comprehensive review of existing research on sexual assault care in humanitarian crises worldwide and assesses its applicability to displaced ethnic minorities from Myanmar. The analysis considers …

Plan To Develop A Theory-Based Diabetes Social Media Campaign For Spanish-Speaking Adults In Finney County, Ks: Integration Of A Promotora, Focused Discussion Groups, And Community Feedback To Ensure Cultural Appropriateness, Julevi P. Bernido

Capstone Experience: Master of Public Health

The 2025 Community Health Needs Assessment (CHNA) shows that over 11% of adults in Finney County, Kansas, have diabetes, which surpasses both state and national averages. Census data from 2016-2020 indicate that 42.6% of residents ages five and older speak a language other than English at home, and 36.1% speak Spanish (United States Census Bureau, n.d.). The CHNA further highlights concerns about language and cultural barriers to care, especially among the Spanish-speaking population. Notably, 21.74% of residents have limited English proficiency—much higher than the state’s 12.1% (CHNA, 2025).

This capstone will develop a theory-based social media campaign plan to support …

Gestational Diabetes And Social Determinants Of Health In Black Women, Darianne Greenwood

Capstone Experience: Master of Public Health

Gestational Diabetes Mellitus (GDM) poses significant health risks, specifically increasing the risk of developing Type 2 Diabetes post-delivery, as well as increasing the risk of adverse neonatal and maternal outcomes. Black women, in particular, experience disproportionately higher rates of GDM incidence, severity, and complications in comparison to White women. Biological factors alone do not account for these disparities, necessitating a deeper examination into how systemic factors, particularly the social environment, influence these inequitable health outcomes. The purpose of this comprehensive literature review is to answer the question: “How do the Social Determinants of Health (SDoH), such as residential segregation, food …

A Literature Review Of Estrogen Synthesis And Metabolizing Enzymes Produced By The Human Gut Microbiome And Their Correlation With Cancer, Rebecca Cederberg

Capstone Experience: Master of Public Health

The link between estrogen and cancer initiation or progression has been well established; such that the World Health Organization’s International Agency for Research on Cancer (WHO IARC) has classified several estrogen therapies and estrogenic compounds as group 1 carcinogens. Estrogen and/or its receptors have been associated with reproductive cancers such as breast, ovarian, endometrial, and prostate, as well as lymphomas, lung, and colon cancers. Additionally, elevated levels of estrogen and altered gut microbiomes are also associated with increased rates of breast cancer. More recently, microbial genes that are capable of synthesizing estrogen and deconjugating estrogen metabolites have been identified, and …

In-Vitro Testing Of Light Wavelength To Detect Clots In Neonatal Extracorporeal Membrane Oxygenation Circuitry, Amanda Holmes

Dissertations and Theses (Open Access)

Background: Neonates requiring extracorporeal membrane oxygenation (ECMO) are at high risk for thrombotic complications, which contribute substantially to morbidity and mortality. Current circuit surveillance methods rely on intermittent visual inspection and indirect laboratory markers, both of which often detect thrombosis only after clinically significant progression. Optical approaches offer a non-invasive alternative for earlier clot visualization, yet the influence of illumination wavelength on detection performance under realistic ECMO conditions remains incompletely characterized.

Methods: This study evaluated wavelength-dependent clot detection performance in a controlled in-vitro neonatal ECMO circuit model using a portable imaging prototype designed to emulate bedside workflow. Twelve independent ECMO …

An Investigation Of Data Granularity In Rag Pipelines For Personalized Medicine, Paritosh Pandey

Master's Theses

Generative AI, exemplified by large language models like the OpenAI GPT and Meta LLaMA families, can produce diverse content in response to prompts. This capability offers a promising solution to challenges in precision medicine, which seeks to tailor treatments to individual clinical profiles but often struggles with data collection, cost, and privacy concerns. By generating realistic, privacy-preserving patient data, generative AI has the potential to transform patient-centric healthcare. With such motivation, this research develops a comprehensive Generative AI pipeline emphasizing data granularity for accurate prediction of personalized treatments. The pipeline features a central Large Language Model interacting with a Machine …

Discharge Process Improvement Initiative Using An N-By-T Strategy In A Progressive Care Unit In An Acute Care Setting, Sukhvir Walia

Doctor of Nursing Practice Projects

Background

Timely and efficient patient discharge processes are crucial for enhancing hospital throughput, reducing emergency department boarding, optimizing inpatient bed utilization, and ensuring safe transitions of care. Delayed hospital discharges contribute to prolonged hospitalizations, operational inefficiencies, increased healthcare expenditures, and decreased patient satisfaction. Progressive care units (PCU) are particularly vulnerable to discharge delays because patients frequently require multidisciplinary coordination before safe discharge can occur.

Purpose

The purpose of this quality improvement project was to evaluate the effectiveness of implementing a structured discharge readiness checklist combined with an n-by-T discharge planning strategy during multidisciplinary patient progressive rounds (PPRs) to improve discharge …

The Role Of Occupational Therapy In Community-Based Nonprofit Durable Medical Equipment Programs, Coral Mcfern

Capstone Projects

This 14 week doctoral capstone project focused on improving education within a nonprofit durable medical equipment program, Renew Mobility, to enhance safety and independence for individuals using mobility devices. This work is relevant to occupational therapy as it applies OT principles of client-centered care, health literacy, and adaptive equipment training in a community-based setting. A key gap in the literature was identified as the lack of structured educational resources, leading to inconsistent training and reliance on verbal instructions.

The objective of this project was to develop accessible educational materials to support proper equipment use and safety. This resulted in a …

The Intersection Of Occupational Therapy And Optometry In The Treatment Of Visual Impairments: Addressing An Unmet Need, Grace Bannon

Capstone Projects

The prevalence of visual impairments in the United States is substantial and anticipated to increase in severity over the coming decades. These impairments have wide-reaching consequences on an individual’s occupational performance in daily living. While both occupational therapists and optometrists focus on the relationship between visual function and engagement in meaningful and purposeful occupations across the lifespan, only a limited number of optometrists offer specialized vision therapy services. This gap emphasizes a growing demand for vision services to manage the needs of individuals with visual deficits. Therefore, this Doctoral Capstone Experience (DCE) sought to bridge this gap by exploring the …

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 …