Medicine and Health Sciences Commons^™

Staff Education On Vital Sign Assessment And Electronic Health Record Documentation For Acute And Critical Care Nurses And Patient Care Technicians, Natalie Brock

Walden Dissertations and Doctoral Studies

A staff educational quality improvement initiative aimed at enhancing the knowledge and accuracy of acute care nurses and patient care technicians (PCTs) in vital sign documentation was the focus of the doctoral project. Gaps in vital sign obtainment and electronic health record (EHR) documentation were identified through organizational serious safety event reviews, highlighting risks to patient safety and clinical decision-making. The project addressed the question of whether, in the inpatient hospital setting, a staff educational training program for acute and critical care nurses improves their knowledge of accurate vital sign documentation in the EHR. I analyzed pre- and posttest assessments …

Staff Education Project To Improve Hypertension Medication Adherence In An Underserved Clinic, Margaret Mboe Etukeni

Walden Dissertations and Doctoral Studies

Hypertension is one of the most common chronic conditions managed in primary care. The identified practice problem for this staff education project was the lack of structured staff training and inconsistent provider knowledge regarding evidence-based strategies to improve medication adherence among patients with hypertension. Poor medication contributes to preventable complications such as stroke, heart failure, and kidney disease. The purpose was to evaluate if an educational intervention could improve provider knowledge related to medication adherence strategies in an underserved clinical setting. The practice question guiding the project was: In clinical staff working in an underserved clinic, does a staff education …

Cellular Therapy For The Treatment Of Ischemic Limb Disease, Akazha Nicole Green

ETDs from 2020-2029

Ischemic limb disease continues to pose major clinical challenges. The effect of this disease causes restricted blood flow, which is followed by a limited ability to regenerate in the vascular tissues. The purpose of this study is to address the current limitations in producing large-scale generation of Smooth Muscle Cells (SMCs) derived from human induced pluripotent stem cells (hiPSCs) and then assessing their potential therapeutic efficiency individually and in combination with endothelial cells (ECs) for vascular repair. A dynamic three-dimensional (3D) culture system was integrated with a two- dimensional (2D) expansion to enhance cell culture yield while maintaining contractile marker …

Engineering Enac Constructs To Examine Pip2 And Ubiquitin Competition On Enac Regulation And Stability, Lacie Johnson

Chemistry & Biochemistry Undergraduate Honors Theses

The epithelial sodium channel (ENaC) plays a critical role in sodium homeostasis, fluid balance, and blood pressure regulation. ENaC activity is tightly controlled by post-translational mechanisms, including ubiquitination-mediated degradation and phosphatidylinositol 4,5-bisphosphate (PIP2) dependent channel activation. PIP2 is a phospholipid necessary to facilitate the maximal channel opening. Previous studies suggest that intracellular PIP2 binding sites are located in proximity to ubiquitination sites on ENaC subunits, raising the possibility of PIP2 binding to influence channel stability and function. This thesis aimed to engineer and validate molecular tools capable of examining the interplay between PIP2 binding and ubiquitination in ENaC regulation. A …

Quality Improvement Project: Improving Transitional Care Management (Tcm) Follow-Up Through Medical Assistant Education, Oben Assick

Doctor of Nursing Practice Projects

The underutilization of Transitional Care Management (TCM) services in primary care significantly contributes to preventable hospital readmissions and revenue loss. Despite established Centers for Medicare & Medicaid Services (CMS) guidelines, execution often fails due to knowledge gaps among frontline staff. This quality improvement project addressed low TCM task completion rates by implementing a structured educational intervention for medical assistants (MAs). The purpose was to evaluate whether targeted training improves timely patient follow-up, visit scheduling, and billing accuracy. The project utilized Kotter’s 8-Step Change Model to guide organizational change and the Health Belief Model to address behavioral barriers. A quantitative, quasi-experimental …

Does Hormone Replacement Therapy Reduce Bone Resorption In Postmenopausal Women With An Intact Uterus?, Ashley Harding

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not hormone replacement therapy reduces bone resorption in postmenopausal women with an intact uterus.

STUDY DESIGN: A systematic review of three double blind randomized control trials (RCTs) published from 2016 to 2022.

DATA SOURCES: All RCTs were published in peer reviewed journals in English and were found on PubMed and Google Scholar. Articles were chosen based on relevance to the clinical question.

OUTCOME MEASURED: Level of bone resorption was measured via assessment of bone turnover markers at baseline and after use of hormone replacement therapy in all …

In Adults With Elevated Or Borderline-High Ldl Cholesterol Levels, Does Daily Consumption Of Oat-Derived Products Providing Approximately 3 G Of Β-Glucan Reduce Ldl Cholesterol?, Marilyn K. Enderson

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence-based medicine review is to determine whether daily consumption of approximately 3 g of oat-derived β-glucan reduces low-density lipoprotein cholesterol (LDL-C) in adults with elevated or borderline-high LDL-C when compared with a β-glucan–free control.

STUDY DESIGN: Review of three double-blind randomized controlled trials (RCTs) published from 2020 to 2021.

DATA SOURCES: All RCTs were published in English in peer-reviewed journals and identified using PubMed. Articles were selected based on relevance to the clinical question, inclusion of adult populations with elevated LDL-C, and evaluation of oat-derived β-glucan as an intervention.

OUTCOMES MEASURED: The primary outcome …

Are Berberine-Based Treatments Effective In Reducing Hemoglobin A1c (Hba1c%) In Adults With Type Ii Diabetes?, Queenie Douangpraseuth

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Are berberine-based treatments effective in reducing Hemoglobin A1c (HbA1c%) in adults with type 2 diabetes?”

STUDY DESIGN: A review of 3 randomized control trials (RCTs) published between 2015 to 2020 DATA SOURCES: Articles were found on PubMed and Google scholar. Selected articles were published in peer-reviewed journals in English and were chosen based on applicability to clinical questions posed in the objective and meeting inclusion criteria.

OUTCOMES MEASURED: All three RCTs measured the mean HbA1c% over time. A blood sample is taken and laboratory tests are …

Does A Single Dose Of Intravenous Ketamine Reduce Suicidal Ideation In Adults With Major Depressive Disorder?, Rylee Schieman

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not a “single dose of intravenous (IV) ketamine can decrease suicidal ideation in adults with major depressive disorder (MDD)?”

STUDY DESIGN: A systematic review of 3 double-blind, randomized controlled trials (RCTs) published from 2018 to 2024.

DATA SOURCES: All RCTs were found using PubMed and Google Scholar. The articles were published in peer-reviewed journals and in English. The articles were selected based on their relevance to the clinical question posed in the objective.

OUTCOMES MEASURED: All 3 studies focused on reducing suicidal ideation. The outcome was measured …

Monosaccharide Binding To Synthetic Carbohydrate Receptor Microarrays, Milan A. Shlain

Dissertations, Theses, and Capstone Projects

Chapter 1: A glycan detection platform comprised of synthetic carbohydrate receptors (SCRs) immobilized onto polymer brushes was prepared. SCR043, an alkene-containing SCR, was incorporated into grafted-from polymer brushes using hypersurface photolithography, resulting in microarrays of SCR043-functionalized polymer brushes, where brush height (h) and SCR grafting density (Γ) is controlled precisely at each feature in the array. The influence of h and Γ on the binding to five fluorescently labelled monosaccharides – α-glucose (α-Gluc-FL), α-galactose (α-Gal-FL), α-mannose (α-Man-FL), β-glucose (β-Gluc-FL), and β-galactose (β-Gal-FL) – in aqueous buffer …

Protein Allostery Probed By Ligands Across Sites, Virgil A. Woods

Dissertations, Theses, and Capstone Projects

Allostery is a pervasive regulatory principle throughout biology, yet the structural pathways by which distal inputs alter active‑site chemistry within protein structures remain incompletely defined and exploited. This dissertation uses protein tyrosine phosphatase 1B (PTP1B) as a tractable model to map those pathways with complementary experimental and computational tools. I integrate high‑resolution hydrogen-deuterium exchange mass spectrometry (HDX-MS), room-temperature crystallography, NMR, steady-state kinetics, crystallographic pseudo-ensembles, and machine-learning-guided ligand discovery. The working premise is that regulation reflects redistribution within a conformational ensemble rather than a binary switch. That orthogonal perturbations by small molecules, mutations, and protein partners can be used to both …

Sit, Stay, And Teach: Exploring Teachers' Perceptions Of Facility Dogs' Impact On Stress And Retention, Dennis Powers

Graduate Student Dissertations, Theses, Capstones, and Portfolios

The teaching profession remains at a high level of workplace stress, a factor contributing to teacher burnout and turnover. The study examines how teachers in K-12 public education perceived that facility dogs might reduce stress, increase job satisfaction, and aid in teacher retention in public schools of a southeastern state. The study employed a qualitative, cross-sectional survey that was emailed to 112,546 educators from a LISTSERV request. A total of 1,242 individuals provided informed consent and completed the survey, which consisted of Likert-scale measurement items, open-ended questions, and an informational video inserted to achieve a common understanding of the facility …

Essays On Public Policy And Health Outcomes: Unintended Consequences And The Cost Of Influence, Wenhan Yan

Dissertations and Theses Collection (Open Access)

This dissertation investigates the complex behavioral responses to public policy shifts and institutional cues, quantifying their intended and unintended societal impacts. Across two distinct empirical contexts, this research examines how individuals adapt their risk profiles when signals from political or legal authorities change and how these adaptations generate measurable externalities.

The first chapter, "From Punishment to Treatment: Unintended Social Impacts of Changing Drug Policies," shifts the focus to the intersection of health policy and criminal justice. This chapter evaluates the sudden transition from punitive drug enforcement to health-oriented decriminalization, utilizing the 2021 State v. Blake decision in Washington as a …

Leader Rounding For Outcomes To Improve Employee Retention, Laura R. Escobar

Electronic Theses and Dissertations

Intention to leave a nursing staff position, if not addressed, may lead to an increased rate of nursing turnover. High turnover rates can negatively affect staffing patterns, increase organizational costs, and disrupt the continuity of patient care. A quantitative quasi-experimental pre-/posttest design was used to evaluate the impact of the High Reliability Organization Leader Rounding for Outcomes tool to reduce the intent-to-leave scores, as measured by the Turnover Intention Scale (TIS-6), compared to current practice over 12 weeks. Implementation of the tool provided a structured leader rounding process designed to strengthen communication, recognize staff contributions, and proactively identify workplace concerns. …

Patient Wait Time And Throughput Interventions In The Cardiology Outpatient Setting, Chioma Ohiri Tawose

Electronic Theses and Dissertations

Healthcare collaboration and patient care require effective communication. Poor communication impacts wait time. Inadequate communication in the outpatient cardiology clinic can lead to disruptive patient throughput, or workflow, and extend patient length of visit. The purpose of this project was to implement a means of communication for clinicians and healthcare assistants to improve patient flow and cut down idleness, ultimately reducing patient wait time. The project established the incorporation of a built-in electronic health record communication notification system, the Event Button, for asynchronous communication between staff. A quantitative quality improvement design was used to conduct this project. Inferential and descriptive …

Assessing The Effectiveness Of A Habit Recording Tool To Improve Mental Health Of University (Auc) Students, Noran Nounou

Theses and Dissertations

Introduction: According to previous research, the mental health of university students has become an alarming public health concern worldwide. Most of the mental disorders begin among young adults, attributed to the transition to university and increased financial and societal pressure. Despite the important effect of daily habits on mental health, there still remain research gaps in Egypt in exploring their effect among university students and exploring the potential opportunities to support their well-being. Objectives: To assess depression rates among AUC students and to evaluate the effectiveness of a newly designed habit recording board, Make an Impact (MAI) to improve depression …

An Impact Assessment Of The Effectiveness Of Utilizing Informal Health Communication Interventions To Spread Health Recommendations And Change Public Perception, Lina Mohamed Ezzat Ahmed Abdel Mawgoud

Theses and Dissertations

Brain health is an increasingly urgent but critically under-addressed public health priority in Egypt and the wider MENA region. Despite its centrality to aging, productivity, and overall quality of life, public understanding of brain health remains limited, and stigma continues to shape responses to dementia and cognitive decline. This study evaluates the effectiveness of informal, culturally adapted health communication as a tool to shift perception, increase awareness, and promote behavior change among non-medically trained adults in Egypt.

Grounded in global evidence on cognitive reserve, neuroplasticity, and the life-course approach to brain health, the intervention translated expert-informed brain health recommendations into …

A Virtual-Reality-Based Dental Simulator For Endodontics With Automated Formative Feedback, Yousef Salah Abo El Ela

Theses and Dissertations

Advancements in virtual reality (VR) and haptic technology are transforming the landscape of medical and dental education, offering new avenues for safe, immersive, and repeatable training experiences. Within dentistry, endodontics presents unique challenges for preclinical education due to anatomical complexity, limited access to extracted teeth, ethical concerns, and the shortcomings of conventional plastic models. Despite endodontics specific plastic teeth being available, they fall short of replicating the hardness of real extracted teeth, are relatively costly compared to generic plastic teeth, and are ultimately a disposable item which makes them inadequate as a sustainable long-term solution. Extracted teeth do a much …

Investigating The Risk Factors Affecting The Control Of Diabetes And Hypertension In The Refugees Living In Egypt, Noura Seada

Theses and Dissertations

Introduction: Non-Communicable Diseases (NCDs) account for 74% of global deaths, with high prevalence of Diabetes and Hypertension worldwide. Egypt hosts over 1 million registered refugees and asylum seekers, often lacking inclusion in social protection or insurance schemes. This study aimed to assess the factors affecting the control of Type 2 Diabetes (T2D) and Hypertension (HTN) among Syrian and Sudanese refugees in Egypt, focusing on healthcare access, sociodemographic characteristics, lifestyle, and health behaviours.

Methods: This study employed a cross-sectional design using a self-administered questionnaire and BMI measurement. Data were collected from 246 refugees diagnosed with type T2D and/or HTN in the …

Mechanical Characterization And Modeling Of Rat Myocardia Under The Influence Of Epirubicin, Abdallah Mahmoud Alkhaiyat

Theses and Dissertations

Cancer remains a predominant health challenge that is responsible for a significant portion of global morbidity and mortality. Epirubicin (EPI), a chemotherapeutic anti-cancer drug, has shown remarkable efficacy in combating various malignancies. However, it is known to have undesirable side effects on the heart, collectively referred to as cardiotoxicity. This research investigates the adverse effects of chemotherapy on cardiac contractility through an in vitro examination of the mechanics of healthy and infarcted animal heart tissues. Electrically stimulated slices of rat ventricular tissue were tested using an isometric force measurement tissue bath. The tissue slices were subjected to uniaxial stretching, allowing …

Targeting The Cd47/Calreticulin Axis In Triple Negative Breast Cancer Using Ha Grafted Chitosan Nanoparticles Loaded With Doxorubicin And Polygodial, Hadir M. Emara

Theses and Dissertations

Background: Triple-negative breast cancer (TNBC) is considered the most aggressive subtype of breast cancer. Although progress in cancer treatment has led to better results for different types of breast cancer, TNBC remains particularly challenging due to persistent resistance to both chemotherapy and immunotherapy. This resistance ultimately renders chemotherapy less effective and is frequently associated with substantial side effects. Immunosurveillance significantly impacts the onset of cancer, the rise of resistance to therapies, and the likelihood of tumor recurrence. In this immunomodulatory process, Cluster of Differentiation 47 (CD47) and Calreticulin (CALR) are two key regulators. CD47 expression is strongly linked to anti-phagocytic …

Enhancing Rn Confidence In Early Recognition And Treatment Of Sepsis, Tiffany Lee Gossai

Walden Dissertations and Doctoral Studies

Background: Sepsis is a leading cause of mortality in U.S. hospitals, with delays in recognition and treatment significantly contributing to poor patient outcomes. Nurses are essential to early identification and timely intervention; however, gaps in confidence and preparedness persist, particularly among newly hired staff. Traditional educational approaches may be insufficient to support rapid clinical recognition and evidence-based management. Purpose: This staff education project evaluated whether participation in a virtual sepsis escape room during general nursing orientation improved newly hired nurses’ confidence in early identification and treatment of sepsis. Methods: A virtual escape room was integrated into an existing general nursing …

Clinical Practice Guidelines For Suicide Risk Assessment, Jelitta Cleatus

Walden Dissertations and Doctoral Studies

In this doctoral project, I developed a clinical practice guideline (CPG) to address the lack of a standardized suicide risk assessment protocol at a Texas mental health clinic. At project initiation, suicide risk assessment at the facility was inconsistent due to the absence of a CPG. The guideline incorporated the Columbia-Suicide Severity Rating Scale (C-SSRS), a validated instrument that improved early detection of suicidal ideation and behaviors, which were often under recognized in older adults. This inconsistency led to the following clinical question, Does the evidence support the development of a CPG for assessing suicide risk among high-risk patients using …

Staff Education On Medication Adherence, Jerome Obiagba

Walden Dissertations and Doctoral Studies

Summary The Doctor of Nursing Practice (DNP) project focuses on improving medication adherence in mental health settings, where many patients do not take medications as prescribed, leading to worsening symptoms, relapse, frequent hospitalizations, higher healthcare costs, and reduced quality of life. This problem mainly affects individuals with anxiety, bipolar disorder, major depressive disorder, and schizophrenia, and is often related to poor understanding of treatment, cultural beliefs, or limited access to care. Because nurses play a key role in medication monitoring, education, and patient support, the project examined whether staff education improves nurses’ knowledge, confidence, and effectiveness compared to standard practice …

Staff Education To Streamline Congestive Heart Failure Education, Shannon Hunter

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a progressive disease that affects a diverse population. Patient-centered education is key to lowering rehospitalizations and mortality rates. Although nurses are essential providers of patient-centered education, those in acute care settings often have unclear directions for implementing and documenting CHF education. Multiple educational materials within electronic health record (EHR) systems further complicate the process and highlight the practice gap. The aim of this Doctor of Nursing Practice (DNP) project was to streamline CHF education by clarifying the role of nurses in education delivery and documentation, potentially enhancing nurse confidence and improving patient health outcomes, with …

Staff Education To Improve Nurse Use Of Teach-Back In Outpatient Diabetes Care, Latoya Hodge-Curtis

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus is a prevalent chronic condition in the United States, with ineffective patient education and low health literacy linked to poor glycemic control, preventable complications, and increased health care utilization. At the project site, a practice gap was identified related to a lack of knowledge among nurses regarding the use of teach-back strategy for use with Type 2 diabetes education. The practice-focused question was: Does educating nurses on the teach back strategy for Type 2 diabetes improve knowledge as evidenced by pre- to post-survey? This project was implemented using the ADDIE (analysis, design, development, implementation, and evaluation) …

Enhancing Medication Adherence In Home-Based Hypertension Care Through Targeted Staff Education, Marie Lunie Bazile

Walden Dissertations and Doctoral Studies

Summary In this practice-based, quality improvement project, I incorporated a one-group, pre-/posttest design with the aim to evaluate a staff education intervention, reflecting on key principles in improving practice, including continuous evaluation and informing locally based change. This Doctor of Nursing Practice (DNP) project addressed the issue of inconsistent adherence to medication and the lack of staff skills in home-based hypertension management. Notably, the nurse plays an important role in medication adherence to care and in the consistent, evidence-based care with chronic diseases. The practice-focused question was: For home health staff, how does participation in an evidence-based medication adherence education …

Nilotinib-Mediated Reprogramming Of Bone Marrow Macrophages Alters Hematopoietic Stem Cell Fate In Chronic Myeloid Leukemia, Tiffany Davia Ricketts

ETDs from 2020-2029

Tyrosine kinase inhibition (TKI) is highly effective and promotes favorable long-term outcomes for many patients with chronic myeloid leukemia (CML). However, many patients experience treatment resistance or recurrence after TKI cessation due to leukemic stem cell (LSC) persistence within the hematopoietic stem cell (HSC) niche. Within the niche, macrophages adopt different activation states to alter HSC function, however, CML disrupts niche signals to selectively support LSCs and macrophages may contribute to this process. We hypothesize that macrophages contribute to pro-inflammatory activation within the niche to promote LSC development and nilotinib will reprogram macrophages to selectively support non-leukemic stem cells. To …

Conserved Chromatin Programs Orchestrate Cardiac Cell States In Health And Disease And Drive Cardiomyocyte Proliferation After Injury, Xiaoxiao Geng

ETDs from 2020-2029

Chromatin structure is a central regulator of gene expression and cellular identity, yet the chromatin structural factors driving cardiac disease and regeneration remain incompletely defined. This dissertation investigates how modulation of chromatin architecture shapes pathological and regenerative cardiac phenotypes through integrated single-cell transcriptomic, epigenomic, and functional analyses. To determine whether chromatin structural regulators distinguish healthy from diseased cardiac states, we curated a comprehensive list of chromatin structural genes and applied it to single-nuclei RNA sequencing datasets from human hearts with and without dilated cardiomyopathy (DCM). Chromatin structural gene expression effectively stratified cardiomyocyte and fibroblast populations by disease status. Diseased cardiomyocytes …

Structural Empowerment And The Work Environment Of Nursing Home Care Workers In China, Yawen Ou

Lingnan Theses (MPhil & PhD)

China is experiencing a profound demographic transformation as its population ages rapidly, driven by declining fertility, increased longevity, and long-term effects of the One- Child policy. Traditional family-based elderly care has become increasingly unsustainable due to the pressures of the “4-2-1” family structure and the rising prevalence of empty-nest households. In this context, there is an increasing trend in institutionalized elderly care, accompanied by a growing demand for Nursing Home Care Workers (NHCWs). In spite of their vital importance, NHCWs often face heavy workloads, poor compensation, low recognition, and limited professional autonomy. This study explores the work environment and structural …