Medicine and Health Sciences Commons^™

Improved Child Participation And Performance At Saddle Up!, Maya Pakulski

OTD Capstone Projects

This capstone project was created in partnership with the staff at Saddle Up! in Franklin, TN. Saddle Up! is a PATH accredited non profit organization that offers hippotherapy, adaptive riding and various horsemanship lessons and opportunities for children and youth with various disabilities to learn and engage with horses. The primary goal of this project was to address a need for improved child and family participation in various aspects of lessons and therapy sessions. The focus was to develop a functional communication and visual schedule system that was accessible and easily understood by all staff. This system included a wide …

The Effect Of Low And High-Carbohydrate Diets On Memory Performance In College Students, Samia Baugh, Zoe Zajko, Jamie Analuisa, Ivanna Jacome

Department of Nutrition Student Projects

Carbohydrates are the primary source of energy for the brain and play an important role in processes related to memory performance. The purpose of this study is to examine the impact of a low-carbohydrate diet compared to a high-carbohydrate diet on memory performance in college students aged 18–22 years. For the purposes of this study, a low-carbohydrate diet is defined as a diet providing fewer than 130 grams of carbohydrates per day, while a high-carbohydrate diet provides approximately 325 grams of carbohydrates. This population is particularly important to study because college students experience high academic demands that require strong memory …

Mental Health Rates Across Ethnic Groups In A Small Midwestern Christian University, Arianna Torres

Honors Theses

This study aims to find if there is a significant difference in depression, anxiety, trauma, and suicidality among students of different ethnic backgrounds at Andrews University. By focusing on ethnic disparities, this research aims to target the mental health issues rising among college students and bring to light the importance of cultural competency in relation to mental health. Results from this study may aid Andrews University in developing more inclusive and culturally responsive mental health services and inform broader discussions about mental health equity in higher education. It can also add insight into how mental health rates may vary by …

Opium Of The Masses: An Analysis Of Archeobotanical Research In The City Of Tábor, Czechia And How It Potentially Influenced Forms Of Radical Hussism, Sasha Gladding

Undergraduate University Honors Capstones

Opium of the Masses performs in depth analysis of the Hussite Wars–a time period lasting from 1419 to 1436, Jan Hus, Hussite factionalism, and archeobotany. This analysis proposes that there are numerous possible contributing factors to the development of the radical Hussite teachings and ways of life. The instability of the Catholic hierarchy and the dissenting teachings of Jan Hus also likely were contributors to the development of the unique sociopolitical and spiritual practices of the radical Hussites. It is also possible that the Hussite factions residing in the Czech (then Bohemian) town of Tábor utilized opium as an entheogen …

Patient-Provider Communication Among Deaf English Users: Disparities And Implications For Cancer Screening, Ciara Luttrell

Undergraduate University Honors Capstones

Early detection is one of medicine's powerful tools; routine cancer screenings can help diagnose cancer early and enable immediate treatment. Cancer screening and prevention efforts have accounted for 4.75 million (80%) cancer deaths averted between 1975 and 2020 for five major cancer types (NIH, 2025). Nevertheless, this powerful tool is not shared equally. Many deaf adults who use English still experience barriers and disparities. Accordingly, the purpose of this study is to investigate how deaf English-using individuals in the United States interact with their healthcare providers and whether these interactions are associated with cancer screening interest among these populations. The …

Nurse Driven Intervention To Address Cesarean Section Rates, Cavetta Tulloch-Lewis

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

Cesarean sections (C-sections) account for approximately one-third of births in the United States and remain the most common inpatient surgical procedure. Primary cesarean sections are a major contributor to rising rates, often leading to repeat cesareans in subsequent pregnancies. While medically necessary C-sections are lifesaving, their overuse in low-risk pregnancies is associated with increased maternal morbidity. Labor dystocia is one of the leading indications for primary cesarean delivery and may be mitigated through evidence-based, nurse-driven interventions such as maternal positioning and peanut ball utilization. Registered nurses are uniquely positioned to influence labor progression and promote vaginal birth through continuous …

Improving Medication And Lifestyle Adherence Through A Standardized Clinical Practice Guideline, Chazemba Shamaila

Walden Dissertations and Doctoral Studies

Medication and lifestyle nonadherence remains a persistent and costly problem within healthcare systems and represents a critical gap in nursing practice. Approximately half of adults prescribed long-term medications do not adhere to recommended regimens, contributing to poor disease control, preventable hospitalizations, increased mortality risk, and substantial healthcare expenditures. These challenges are particularly pronounced in outpatient mental health settings, where symptom burden, cognitive impairment, treatment complexity, and social determinants of health further compromise adherence. Addressing medication and lifestyle nonadherence aligns with nursing priorities related to patient safety, quality improvement, and health equity. This Doctor of Nursing Practice (DNP) project focused on …

Breaking Barriers: Advancement Toward Practical Nursing Licensure For Certified Medication Assistants In Long-Term Care--A Descriptive Study, Aleshia L. Maxwell

ATU Theses and Dissertations 2021 - Present

The persistent nursing shortage across the United States, particularly in Long-Term Care (LTC) settings, has complicated the healthcare system’s ability to meet the needs of an aging population. While existing research often examines progression from Licensed Practical Nurse (LPN) to Registered Nurse (RN), limited research explores factors influencing progression from entry-level LTC healthcare workers to Practical Nursing (PN) licensure. This quantitative descriptive study examined the barriers and supporting factors influencing advancement toward PN licensure for Medication Assistants-Certified (MA-Cs) in Arkansas LTC facilities. A convenience sample of N=100 participated in the study. Results indicated that financial and structural barriers often …

Lived Experiences Of Shingles Vaccine-Hesitant Adults Over Age 50 In Riverside County, California, Michelle Beatrice Loomis

Walden Dissertations and Doctoral Studies

Shingles (herpes zoster) causes substantial morbidity, especially among adults over age 50 in the United States. There is a need to better understand the reasons behind low vaccination rates among adults over age 50 given the associated risks for infection and adverse health outcomes that can reduce their quality of life. This qualitative interpretative phenomenological study explored how individuals’ perceptions of the benefits, barriers, susceptibility, and severity of shingles influence vaccine intentions and identified what factors influence vaccine uptake. The health belief model was used to guide the study. Data were collected from one-on-one semistructured virtual interviews with eight adults …

Evaluating The Relationship Between Vitamin D Supplementation, Lifestyle, Social Determinants Of Health, Asthma, And Respiratory Tract Infections, Yun O'Donnell

Walden Dissertations and Doctoral Studies

Hypovitaminosis D is a significant public health concern in the United States associated with inadequate sunlight exposure and insufficient dietary intake. Asthma is a chronic respiratory condition that progressively worsens over time. While asthma is typically managed through individual-level treatment approaches, population-level strategies such as vitamin D supplementation and food fortification policies have not been implemented. A five-tier Public Health Impact Pyramid theoretical foundation guided this nonexperimental quantitative cross-sectional study. Data from 2013-2014 and 2017-2018 NHANES (n = 1,456) was evaluated for relationships between vitamin D supplementation, duration of sunlight exposure, and food security index, with asthma, asthma exacerbation severity, …

Effects Of Static Ankle Stretching On Balance And Gait: The Roles Of Age And Parkinson's Disease, Taylor M. Gauss

LSU Doctoral Dissertations

The focus of this dissertation involves the effects of static ankle stretching on balance and gait in adults of different ages and with Parkinson’s disease (PD). A brief introduction in Chapter 1 precedes a detailed literature review in Chapter 2, in which we identify gaps in research on balance and gait following ankle stretching and explain why ankle stretching may serve as a predominant strategy for improving motor performance in aging and PD populations. In Chapter 3, we present the first study identifying whether muscle group selection or stretch duration influences balance in young adults. Results showed that longer durations …

Hypothermia Prevention In Major Trauma Patients, Alaina Hostetler

Doctor of Nursing Practice Scholarly Projects

Traumatic injuries present a significant health challenge for providers, often resulting in hypothermia, coagulopathy, and acidosis, referred to as the trauma triad of death. Hypothermia significantly impacts trauma patients' outcomes and exacerbates morbidity and mortality rates, particularly in trauma cases with high injury severity scores who require immediate surgical intervention. Despite the detrimental effects of hypothermia, evidence-based approaches to treating hypothermia in this population are lacking. Traditional warming methods heavily rely on provider preference and can lead to inconsistent care. Rapid, reliable, and effective resuscitation interventions are essential in the immediate care of major trauma patients. The proposed project will …

A Mixed-Methods Research Study: Nc Health Department Directors’ Perspective On Local Impact Of Early Medicaid Expansion, Asma Warrich

MUSC Theses and Dissertations

North Carolina became the 41^st state to expand Medicaid under the Affordable Care Act. The bipartisan expansion addressed longstanding challenges; however, little is known about how Local Health Departments (LHDs) adapted to this policy change, especially in the 24 months following expansion. This study sought to fill that gap by documenting the perspectives of LHD Directors in North Carolina utilizing a ten-question REDCap survey with closed- and open-ended questions. Purposeful sampling targeted all 86 LHD Directors. Data was collected anonymously between November 2025 and January 2026. Descriptive and thematic analyses were conducted. Thirty LHD Directors completed the survey, which …

Exploring The Impact Of Cat Nutrition On Consumer Purchases: An Examination On Feline Microbiome, Health, And Owner Responses, Cassidy Curry

Honors College Theses

The gastrointestinal (GI) microbiome plays a critical role in feline health, influencing conditions such as inflammatory bowel disease (IBD), kidney disease, and other digestive disorders. Diet is a major factor affecting microbial balance, yet many cat owners lack sufficient knowledge of feline nutrition. This may lead to suboptimal feeding practices that negatively impact microbiome stability. This study aimed to evaluate the relationship between an owner’s nutritional knowledge and their pet food purchasing decisions. Specifically, it examined feeding schedule, food type and consistency, supplement use, and veterinary engagement. A 13- question survey was administered to 84 Murray State University Honors College …

Supporting School-Based Adaptive Movement: Developing Resources For The Flip For Function Program, Isabel C. Creasey

OTD Capstone Projects

This doctoral capstone project was conducted in collaboration with Flip for Function, an adaptive gymnastics program that incorporates occupational therapy principles to serve children with and without disabilities. The primary aim of this project was to facilitate the expansion of adaptive movement programming into school-based settings through the development of structured resources, evaluation tools, and educational materials. A comprehensive literature review was completed to examine the relationship between physical activity, executive functioning, self-regulation, and school-related outcomes in children with disabilities. Guided by these findings, key deliverables were developed, including a school-based implementation guide, outreach materials for school personnel, a teacher-reported …

The Significance Of Vaccine Education In Vaccination Status, Emma Webb

Honors College Theses

In recent years, more of the general population of the United States has become skeptical about vaccines and overall vaccination numbers have declined. Since the Covid-19 pandemic, vaccines have become somewhat of a controversial topic due to varying opinions about the adverse reactions and effectiveness of vaccines. The purpose of this study was to determine if there is a correlation between a person’s overall knowledge of vaccinations and a person’s vaccination status by asking a series of questions about the science used in vaccines and identifying the participant’s vaccination status in regards to influenza and Covid-19. This study also asked …

Empathy, Compassion Fatigue, And Resilience In Central Florida Firefighters And Ems Personnel, Lisa M. Correll

PhD in Education

The purpose of this nonexperimental quantitative study was to determine the relationship between empathy, compassion fatigue (CF), and resilience in firefighters and EMS personnel. Career firefighters and EMS personnel (N = 76) in Central Florida participated in an online survey that included demographic information, the Empathy Assessment Index, Professional Quality of Life Scale, and the Connor-Davidson Resilience Scale-10. Participants reported high perceptions of empathy (M = 4.11), resilience (M = 3.98), and quality of life (M = 3.28), but CF was perceived at low levels (M = 2.97). Empathy was not predictive of CF, indicating that overall empathy alone does …

Standardized Home Blood Pressure Log Implementation For Patients With Hypertension To Increase Patient Awareness And Clinical Action, Ashley Alcala

Doctoral Dissertations & Projects

Background: Home blood pressure monitoring (HBPM) is recommended for hypertension management, yet primary care clinics often lack standardized workflows for distributing, collecting, and using home blood pressure (BP) data. Inconsistent reporting and limited patient understanding of their own BP trends, such as whether readings are stable, elevated, or unchanged, reduce providers ability to make timely clinical decisions.

Problem: Despite evidence supporting HBPM, patients rarely brought usable BP logs to follow‑up visits, limiting providers ability to assess BP control, identify trends, and make timely medication or care plan adjustments.

Approach: This project used a Plan‑Do‑Study‑Act (PDSA) model to implement a standardized …

Comparison Of Levels Of Bmi, Stress, And Depression Of Women During The Prenatal Period Relative To Their Activity Levels, Kalayna King

Honors Theses

This study aimed to analyze the relationships between activity levels, Body Mass Index (BMI), stress levels, and depression symptoms in obese pregnant women in Arkansas. Two separate exercise intervention studies were combined in this analysis to ultimately give a sample size of 293 pregnant women who were randomized into standard of care group (control) and an exercise group (treatment/experimental) (n = 115 and n = 178, respectively). Women in the control groups were instructed to independently continue to follow the physical activity guidelines recommended by their gynecologist, whereas the experimental groups participated in a combination of aerobic and resistance exercise …

"On The Same Rope": An Exploratory Study Of Staff Experiences At The Mountain Seed Foundation's Healing Base Camp Program, Jill C. Kivikoski

Counseling & Human Services Theses & Dissertations

Since the escalation of Russia’s invasion of Ukraine in 2022, Ukrainians have faced significant social and public health challenges, particularly among Service Members, Veterans, and their Families (SMVF), including disability, traumatic stress, and barriers to mental health care (Kostenko et al., 2024; Krasnodemska et al., 2023; O’Grady & Galouchka, 2023). Retreat based programs grounded in shared military identity may offer an accessible form of support (Barrett & Currin, 2024). Mountain Seed Foundation’s (MSF) Healing Base Camp (HBC) was developed to promote healing and resilience among Ukrainian SMVF (Mountain Seed Foundation, n.d.).

This qualitative dissertation used a single-case study design (Yin, …

Education And Training In Water Operator Certification And Its Role In Water Utility System Performance, Heath A. Edelman

Educational Leadership & Workforce Development Theses & Dissertations

Access to safe and reliable drinking water is a foundational component of public health and environmental protection. The United States drinking water sector is highly regulated and increasingly challenged by workforce shortages, aging infrastructure, and variability in operator training requirements across states. Despite the federal mandate for operator certification under the Safe Drinking Water Act Amendments of 1996, empirical evidence on the effectiveness of certification policies in improving regulatory compliance outcomes remains limited.

This study examined the relationship between operator certification policies and drinking water compliance outcomes under the Safe Drinking Water Act, with particular attention to differences across violation …

Electromyography, Prosthetic Properties, And Running Biomechanics In Recreationally Active Persons With Lower Extremity Amputation, Paige M. Agnew

Rehabilitation Sciences Theses & Dissertations

Lower extremity loss affects nearly 150,000 individuals in the United States yearly yielding extreme health care costs annually. Typically, prosthetic devices are prescribed for 5-8 years despite known changes to an individual’s gait as time progresses. Patients can expect to undergo approximately 8-12 weeks of gait retraining to improve their comfort and efficiency. Biomechanical changes occur when running with a specific running prosthetic including considerable biomechanical and neuromuscular interlimb asymmetries and alterations in loading patterns. The purpose of this dissertation was to investigate the biomechanical demands for lower extremity prosthesis users during running. The first study synthesized peer reviewed evidence …

Exploring The Perceptions Of United States Dentists And Dental Hygienists Towards Implementation Of New Workforce Shortage Policies, Hite N. Jones

Dental Hygiene Theses & Dissertations

Background: There is a perceived national dental hygiene shortage causing delays in receiving preventive treatment and potentially increasing oral disease risk. States are proposing alternative pathways to allow less-trained individuals to provide dental hygiene care to fill this perceived gap. There is no research to support whether such measures would mitigate the shortage issue. Purpose: Therefore, the purpose of this study was to examine the perceptions of United States (U.S.) dentists and dental hygienists (DH) towards the implementation of new workforce shortage policies and contributing factors and solutions to the workforce shortage. Methods: This descriptive, cross-sectional study included a convenience …

“Recollecting The Told Story”: Storytelling, Activism, And The Black Maternal Health Emergency, Lamaya C. Williams

English Theses & Dissertations

Storytelling is a foundational component of Black knowledge creation and transmission. This dissertation centers Black women’s stories of birth and mothering—drawing on both primary source birth stories and fictional narratives—to examine the United States’ Black Maternal Health Emergency (BMHE). The BMHE is a complex and urgent issue wherein structural racism, medical bias, and intersecting social determinants disproportionately endanger the health of Black mothers. As such, Black mothers in the United States are three times more likely to die from a pregnancy-related condition compared to their white counterparts.

This study examines the birth stories of women who survived the BMHE and …

The Effects Of Covid 19 Job Demands On Public Sector Employees’ Organizational Commitment: The Mediating Roles Of Work Engagement And Job Burnout, And The Moderating Role Of Supervisor Support, Benjamin R. Kaufman

Psychology Theses & Dissertations

United States citizens rely on state government employees to provide essential public services. During the COVID-19 pandemic, these employees responded by administering both routine and novel procedures to protect public health, often placing them on the frontlines and at increased risk of contagion. Concurrently, the pandemic-driven economic downturn created budget shortfalls that threatened the job and financial security of the state workforce. Together, these conditions substantially increased job demands for state government employees.

Guided by the Job Demands–Resources (JDR) Model, this study examined how COVID‑19-related job demands influenced state employees’ work engagement, job burnout, and organizational commitment, and whether supervisor …

An Evidence-Based Educational Intervention To Enhance Nurses' Knowledge Of Metabolic Syndrome In Residential Care Facilities, Marie Tanyi

Doctor of Nursing Practice Scholarly Projects

The project addresses a critical gap in nursing education by implementing a structured, evidencebased educational intervention led by an Advanced Practice Registered Nurse (APRN) to improve nurses’ knowledge of metabolic syndrome in residential care facilities. The purpose was to determine whether this intervention could significantly enhance nurses’ understanding and management of metabolic syndrome, a complex cluster of disorders present in adult populations. Nine nurses participated in targeted educational sessions focusing on definition, diagnosis, complications, and evidence-based prevention and management strategies. Each participant completed the Metabolic Syndrome Knowledge Scale (MSKS) questionnaire before and after the intervention to assess changes in knowledge. …

Navigating End-Of-Life Decisions: Cultural Considerations For Latine Patients, Michelle Carbajal Hernandez

Honors Capstones

Healthcare professionals face many challenges when communicating terminal illness prognoses for individuals. This responsibility to address a terminal prognosis is further complicated when communicating with Latine patients who may face multiple barriers within the healthcare system and whose cultural preferences influence end-of-life care planning (Carrion, 2010). For example, Latines are less likely to enroll in end-of-life (EOL) care services (e.g., hospice) (Barragan-Carrillo et al., 2022). As well as engage in end-of-life care planning than White Non-Latines (Shen et al., 2016). To understand this hesitancy towards EOL care options, this literature review aims to explore how terminally ill Latine and …

Human Osteosarcoma Cell Line That Overexpresses Cd4/Ccr5 Or Cd4/Cxcr4 To Study Hiv-Host Interactions, Harry Baffour Awuah

Biotechnology Theses

Human immunodeficiency virus type 1 (HIV-1) entry into host cells occurs through interactions between the viral surface envelope glycoprotein (Env) and the host receptor CD4, and co-receptors CCR5 or CXCR4. However, understanding these interactions in membrane contexts remains limited due to low receptor and coreceptor densities in commonly used cell models. To address this, we developed cellular systems with elevated CD4 expression and either CCR5 or CXCR4. Human osteosarcoma cells (HOS), which lack endogenous surface expression of HIV receptor (CD4) and co-receptors (CCR5 or CXCR4), were engineered via lentiviral transduction to overexpress CD4 and either CCR5 or CXCR4. Cells were …

Pastoral Listening Skills Training In The Black Baptist Church: Equipping Clergy To Better Support Congregants, Regina Pair Allen

Doctor of Ministry Projects and Theses

This study engages a historical survey of qualitative studies of perspectives of Black pastors regarding pastoral care, examining various avenues for training in pastoral listening and the role of ministers as theological clinicians in supporting church ministries and community needs. The findings highlight the ongoing need for professional development among pastors as primary educators and theological clinicians. The study underscores the importance of equipping Black Baptist pastors to address the clinical pastoral needs of African American congregants. The significance to this field of study is providing Black Baptist clergy with practical skills and tools, grounded in theological principles, to better …

Occupational Therapy’S Role In Supporting Caregivers Of Children And Adolescents With Type 1 Diabetes, Ania G. Millan

Student Capstone Papers

Caregivers of children and adolescents with Type 1 Diabetes (T1D) often experience increased stress, occupational imbalance, and challenges related to maintaining their own health and wellness while managing their child’s complex daily care needs. Despite the significant impact caregiving responsibilities may have on daily routines, self-care, and overall quality of life, occupational therapy’s (OT) role in supporting caregivers within endocrinology settings remains underrecognized. The purpose of this capstone project was to explore caregivers’ perceptions of their health and wellness and examine the differences and similarities between caregivers’ and occupational therapy practitioners’ (OTPs) perspectives regarding OT’s role in supporting caregivers of …