Medicine and Health Sciences Commons^™

Epinephrine In Cardiac Arrest: Is It Enough?, Zachary Gusler

The PA Department Journal of Medical Science

Introduction: Epinephrine has long been the clinical mainstay of pharmacologic treatment for cardiac arrest management. It provides both α- and β-adrenergic receptor activation. However, at higher dosages, it may lead to sympathetic overload, oxidative stress, and cardiac myocyte apoptosis. The purpose of this paper is to evaluate the rates of ROSC (return of spontaneous circulation) with in-hospital cardiac arrest between epinephrine monotherapy and VSE (vasopressin, steroid, and epinephrine).

Methods: A search via PubMed database using the keywords “Cardiac arrest” AND “VSE” AND “Vasopressor monotherapy” with additional specifiers resulted in 30 articles. 26 articles were removed due to study type and …

Efficacy Of Catheter Ablation Compared To Antiarrhythmic Drug Therapy In Atrial Fibrillation, Sarah Mckinney

The PA Department Journal of Medical Science

Introduction: A-fib occurs when the electrical signals in the heart become unorganized and unsynchronized, resulting in an irregularly irregular heart rate. This can increase the risk of blood clots and stroke. The purpose of this paper is to explore two of the most common treatment options, comparing the efficacy of catheter ablation to AAD (antiarrhythmic drug) therapy in adults diagnosed with atrial fibrillation.

Methods: PubMed was searched using the keywords “atrial fibrillation,” “catheter ablation,” and “antiarrhythmic.” Operators and filters yielded a final result of 159 articles; four articles that most closely aligned with the focus of this research were reviewed. …

Hyaluronic Acid Versus Corticosteroids In Osteoarthritis Of The Knee, Victoria B. Short

The PA Department Journal of Medical Science

Introduction: Osteoarthritis is a very common degenerative disease seen in older adults that is typically due to repetitive movements of the joints over time. Without treatment, osteoarthritis can progress and cause individuals to have decreased function and quality of life. The purpose of this review is to evaluate the effectiveness of hyaluronic acid injections compared to corticosteroid injections in treating osteoarthritis of the knee.

Methods: PubMed was searched with a specific search strategy using key terms “knee osteoarthritis”, “hyaluronic acid”, and “corticosteroids”. Operators and filters were applied to narrow 572 results down to 40. 15 articles were reviewed and 4 …

Injection Or Ingestion: A Comparative Review Of Antipsychotic Delivery Methods And Patient Outcomes In Schizophrenia, Jeffrey K. Fear

The PA Department Journal of Medical Science

Introduction: Schizophrenia is a chronic psychiatric disorder that causes significant functional impairment and decreased quality of life for those who suffer from it. The purpose of this review is to compare the use of long-acting injectable (LAIs) antipsychotics with oral antipsychotic medications and to evaluate which treatment modality provides more favorable outcomes in terms of symptom control, adherence, and relapse prevention.

Methods: PubMed was searched to find articles examining the efficacy of both long-acting injectables and oral antipsychotics, and why long-acting injectables are becoming the preferred method of delivering treatment to patients suffering from schizophrenia. Four articles were selected for …

Glp-1 Agonists For Pediatric Obesity: A Clinical Review, Grace Burgin

The PA Department Journal of Medical Science

Introduction: Pediatric obesity is a chronic disease with multiple complex causes and many potential consequences if carried into adulthood. Lifestyle modifications alone have not been effective for all patients in the treatment of pediatric obesity. GLP-1 RAs already being prescribed in the adult population were also recently approved for pediatric patients. The purpose of this clinical review is to analyze the efficacy of GLP-1 RAs in decreasing markers associated with obesity, such as BMI, cholesterol, etc. in pediatric patients diagnosed with obesity.

Methods: PubMed was first searched using synonyms of the keywords “pediatric obesity,” “GLP-1 agonists,” “lifestyle modifications,” and “biomarkers …

The Gut Microbiome’S Effect On Metabolic Syndrome, Kayla Turner

The PA Department Journal of Medical Science

Introduction: Metabolic Syndrome (MetS) is a chronic condition characterized by insulin resistance and low-grade inflammation. The purpose of this review is to focus on pre-/pro/symbiotic supplementation as a means of improving MetS parameters in place of pharmacological intervention.

Methods: PubMed was searched with the terms “metabolic syndrome”, “obese”, “obesity”, “overweight”, “insulin resistance”, “insulin sensitivity”, “probiotic”, “symbiotic”, and “bifidobacter*”. Operators and filters narrowed the results down to 55 results, 4 of which were picked due to their relevance and quality.

Results: The 4 articles chosen were RCT and a systematic review that explored the Bifidobacterium genus in relationship to the MetS …

Pharmacological Management Of A Spinal Cord Injury: A Review, Victoria A. Sumner

The PA Department Journal of Medical Science

Introduction

A spinal cord injury results from damage to the cord itself. People who experience such an injury often live with pain for the rest of their lives. This review aims to compare the effectiveness of gabapentin versus tramadol in managing post-spinal cord injury pain.

Methods

A search using the key terms “spinal cord injury,” “gabapentin,” and “tramadol” was conducted on PubMed. Five relevant results were identified after applying operators and filters to narrow down the articles. Of those five articles, four were reviewed in this analysis.

Results

All four articles directly compare gabapentin to a test substance. Three of …

Understanding The Efficacy Of Photodynamic Therapy In Comparison To Topical Therapies In Treating Actinic Keratosis In Those At Increased Sun Exposure Risk, Tatum R. Mcbride

The PA Department Journal of Medical Science

Introduction: Actinic keratoses are precancerous skin lesions that arise secondary to increased sun exposure. These lesions have a propensity to transform into non-melanoma skin cancers, mainly squamous cell carcinoma, if left untreated. There are a multitude of different treatment options for the prevention and clearance of these lesions. Among these options is photodynamic therapy (PDT). The purpose of this paper is to investigate the effectiveness of PDT when compared to other options for AK treatment.

Methods: A search was conducted using PubMed for studies to analyze the efficacy of PDT when compared to other treatment options. 3 articles were selected …

Psilocybin Treatment For Refractory Depression: A Clinical Review, Hailey A. Jensen

The PA Department Journal of Medical Science

Introduction:

Depression is a widespread mental illness that affects a large portion of the world population and many of those who suffer from depression are resistant to treatment currently available. The purpose of this review is to compare the efficacy of psilocybin to the current available methods for the treatment of refractory depression.

Methods:

PubMed was searched with the key search terms: resistant depression, psilocybin therapy, and adults. Operators and filters narrowed down the search to 43 results. Four articles were then chosen based on quality and specificity with this review.

Results:

The articles included in this review compare the …

Hyaluronic Acid For The Treatment Of Knee Osteoarthritis: A Clinical Review, Victoria G. Morrison Cerda

The PA Department Journal of Medical Science

Introduction: Osteoarthritis of the knee (KOA) is a progressive degenerative disease of the knee joint characterized by knee pain and limited knee function which negatively impacts activities of daily living. Effective and safe IA treatments are needed to meet the needs of an ever-increasing population of those living with KOA. This clinical review aims to assess the effectiveness of IA hyaluronic acid compared to corticosteroids for pain management in KOA.

Methods: PubMed was searched using the key terms “hyaluronic acid injection”, “knee osteoarthritis”, “corticosteroid injection”, and “pain relief”. Modifiers and operators were applied, and results were narrowed to four relevant …

Beyond Steroids: A Head-To-Head Review Of Hyaluronic Acid And Prp In Knee Osteoarthritis, Phillip A. Sekander

The PA Department Journal of Medical Science

Introduction: Osteoarthritis of the knee is one of the most common primary complaints in the US. Newer injectable therapies that target specific cartilage degeneration are being developed. The purpose of this review is to compare the efficacy of PRP and HA injections for the management of knee osteoarthritis.

Methods: PubMed was searched using the key terms “osteoarthritis of the knee,” “hyaluronic acid,” “platelet-rich plasma,” and “management of pain.” This search was refined using MeSH terms, Boolean operators, and applied filters (English, free full-text, publication date between 2020-2025). Four articles were selected for in-depth review of the efficacy of platelet-rich plasma …

Physiologically Based Pharmacokinetic Modeling Of Acetaminophen In A Preterm Neonate Population, Sonia Sharma

Selected Full-Text Dissertations 2020-

Extremely preterm neonates are a pharmacologically vulnerable group due to their immature organ function and rapid developmental changes, which complicate optimal drug dosing. This thesis introduces a comprehensive physiologically based pharmacokinetic (PBPK) model for acetaminophen (APAP) tailored to this population, incorporating mechanistic ontogeny equations for key sulfotransferase (SULT) enzymes SULT1A1, SULT1A3, SULT1B1, and SULT2A1 developed from a unique dataset of pediatric liver samples. The PBPK model was calibrated and validated using observed pharmacokinetic data from neonates, infants, and children, demonstrating high predictive accuracy across developmental stages. By applying virtual twin simulations, the model was used on a nationwide children's hospital …

Enhancing Resilience And Reducing Burnout In Oncology Nurse Practitioners Through The “Three Good Things” Intervention, Ernestine A. Muanya

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Burnout among oncology nurse practitioners (NPs) threatens clinician well-being, care quality, and workforce retention. The World Health Organization (2019) defines burnout as a workplace condition caused by chronic unmanaged stress. Nationally, over half of healthcare professionals report burnout symptoms, with high rates in oncology (Deriglazov et al., 2025). In Texas, nearly 48% of advanced practice providers report emotional exhaustion and job-related stress (Patel et al., 2024). Objective: This single-group pre–post quality improvement project evaluated an eight-week, app-based Three Good Things (3GT) intervention to reduce burnout and enhance resilience among 19 breast medical oncology nurse practitioners at a comprehensive …

A Structured Discharge Bundle To Reduce Heart Failure Readmissions, Carolyn Hudson

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Heart failure (HF) remains a major contributor to 30-day hospital readmissions, placing strain on patients, healthcare systems, and reimbursement structures tied to quality metrics. Inconsistent discharge practices and gaps in transitional care coordination increase the likelihood of preventable rehospitalizations.

Purpose: This project examined whether implementing a standardized, nurse-driven discharge bundle would improve transitional care outcomes and decrease 30-day readmissions among adults hospitalized with HF.

Methods: A practice-based quality improvement initiative was conducted in a 465-bed regional hospital over a 8-week period. Using iterative Plan-Do-Study-Act cycles, a structured discharge bundle was introduced for eligible HF patients discharged from medical-surgical and …

Nurse-Led Interventions To Reduce Occupational Hand Injuries In Manufacturing, Patti Harter

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Occupational hand injuries cause preventable morbidity, lost productivity, and workers’ compensation costs in manufacturing. Although safety policies and personal protective equipment (PPE) are in place, inconsistent glove use, slow hazard identification, and delayed response still cause injuries. This quality improvement (QI) project evaluated an eight-week, nurse-led injury-prevention bundle at a Texas heavy-vehicle manufacturing facility. The intervention required daily glove inspections, Safety Champion participation, real-time electronic hazard reporting, and corrective action within the shift. Injury outcomes were measured using Occupational Safety and Administration (OSHA) rates per 200,000 work hours and percentage change from baseline. After implementation, hand injury rates fell from …

Sexually Transmitted Infections And Screening: An Educational, Evidence-Based, Quality Improvement Bundle, Misty D. White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: With sexually transmitted diseases on the rise in central Texas, advance practice providers were not following evidence-based practice recommendations for sexually transmitted infection screening, treatment, and follow-up. Screening for sexually transmitted diseases occurred at a rate of less than one patient every 7.75 days.

Objective: The objective of this project was to develop and implement an advanced practice provider training tool to educate the clinic providers on sexually transmitted infections, collect pre- and post-data for the educational sexually transmitted infection bundle, and collect sexually transmitted infection screening, identification, treatment, and follow-up data generated by the clinic advanced practice providers …

Improving Colorectal Cancer Screening Adherence, Albin Abraham

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background

As the second leading cause of cancer-related deaths in the United States, colorectal cancer (CRC) is a prevalent but highly preventable form of cancer (American Cancer Society National Colorectal Cancer Roundtable [ACSNCCR], 2026; Maratt et al., 2024). Screening for CRC is fundamental to prevention and early detection. Despite advances in screening measures, CRC screenings remain suboptimal (Tonini & Zanni, 2024). In the US, more than one in three adults 45 years or older are not screened as recommended (ACSNCCR, 2026).

Purpose

As a safety-net county health network primarily serving the under-resourced population, the organization is uniquely positioned to impact …

Implementing A Nurse-Led Multimodal Pain Management Toolkit To Enhance Recovery After Outpatient Urologic Surgery, Danielle Cirlos-Valles

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Purpose To evaluate the impact of a nurse-led multimodal postoperative pain management toolkit on recovery outcomes among adults undergoing same-day urologic surgery.

Design Quality improvement project using a pre–post implementation design in an outpatient perioperative setting.

Methods An evidence-based toolkit grounded in Enhanced Recovery After Surgery (ERAS) principles was implemented over eight weeks, incorporating scheduled non-opioid analgesics, nonpharmacologic strategies (thermal therapy, guided breathing, early mobilization), standardized patient education, and 24-hour follow-up calls. Outcomes included Visual Analog Scale (VAS) pain scores at discharge and 24 hours, escalation pathway utilization, and nurse knowledge competency. Descriptive statistics and paired t tests were used. …

Implementing An Anxiety Management Bundle In Long-Term Nursing Facilities, Sundan G. Bryson

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

There is currently a gap in accurate screening and treatment of anxiety in Long-Term Care (LTC) nursing facilities. The question for this quality improvement project was: Will implementing interventions for long-term care residents aged 65 and older improve anxiety screening, non-pharmacological interventions, and mental health referrals by 10% compared to current practices? Interventions to enhance anxiety screening included the Geriatric Anxiety Scale-Long Term Care (GAS-LTC) tool to assess and score anxiety. In addition, a Non-Pharmacological Intervention (Non-PI) tool was created to evaluate interventions performed by facility staff. Referrals to the mental health care provider were submitted if a resident scored …

Tiny Heart Bundle Qi Project: 3d Modeling To Improve Care Of Cardiac Nicu Patients, Stacy Ranee Harris

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background—Infants with congenital heart disease (CHD) are being care for in the neonatal intensive care unit (NICU) by increasing numbers of novice nurses. Understanding complex cardiac anatomy is imperative to novice nurses’ readiness to care. Parents of infants with CHD may not understand their child’s anatomy, which impacts many facets of their care.

Purpose— The purpose of this quality improvement (QI) project was to determine if education, including 3D heart models improved novice nurse readiness to care for NICU patients with CHD and if parental understanding improves after receiving education with 3D heart models.

Methods— This was a plan-do-study-act (PDSA) …

Programming Macrophage Phenotypes And Promoting Ischemic Heart Repair With Precision Immunomodulatory Therapy, Jing Zhang

Dissertations and Theses

Despite significant advances in reperfusion and pharmacological therapies, effective strategies to modulate the post-infarction inflammatory response remain limited, leaving a critical gap in improving cardiac repair and long-term outcomes. Excessive or prolonged inflammation after myocardial infarction (MI) drives cardiac remodeling and fibrosis, impairing myocardial recovery and increasing the risk of heart failure (HF) or recurrent ischemic events. I hypothesize that appropriate immunomodulation after MI may reduce unwanted inflammation and improve heart function. Interleukin‑10 (IL‑10) is a pleiotropic immunomodulatory cytokine with therapeutic promise for limiting excessive inflammation and improving tissue repair in ischemic hearts. However, two translational barriers remain for applying …

The Impact Of Nurse-Led Distraction Techniques On Pain And Anxiety During Cancer Treatment In Pediatric Oncology Patients: Examining Virtual Reality And Play Therapy, Alexis Abalos

Nursing | Senior Theses

Children undergoing cancer treatment often experience pain and anxiety during cancer treatment, including chemotherapeutic invasive procedures such as frequent port access or peripheral catheterization. Nurse-led distraction techniques, including virtual reality and play therapy, have emerged as promising non-pharmacologic interventions to reduce levels of pain and anxiety in pediatric oncology patients. This thesis analyzes existing data through a close examination of primary and secondary research articles that prove the effectiveness of virtual reality and play therapy on reducing pain, anxiety, and psychosocial distress in pediatric oncology patients receiving cancer treatment. Using the University of California, San Francisco (UCSF) Symptom Management Theory, …

Advancing Screening For Intimate Partner Violence In Pregnant Individuals Throughout The Perinatal Period To Prevent Adverse Pregnancy And Maternal Outcomes, Emilia R. Valdez

Nursing | Senior Theses

Background: Intimate Partner Violence experienced by pregnant individuals contributes to adverse pregnancy outcomes and maternal health. A mother’s exposure to Intimate Partner Violence (IPV) can affect their ability to carry a healthy pregnancy to term (38 – 40 weeks gestational age) and places them at risk for comorbidities including; Preterm birth, Intrauterine Growth Restriction, Low Birth Weight/ Small for Gestational Age, Premature Rupture of Membranes and Miscarriage. The incidence of IPV screening is not accessible to all pregnant individuals due to healthcare providers lack of education, time constraints in the workplace, bias and discomfort towards IPV. The implementation of IPV …

How Instructor Engagement Shapes Nursing Students’ Perceptions And Specialty Preference, Marissa M. Sigel

Nursing | Senior Theses

Background: As nursing students approach graduation, choosing a specialty becomes a key decision. Although clinical rotations offer exposure to different practice areas, the role of the clinical instructor is equally influential. Instructor engagement extends beyond teaching skills and may shape how students perceive clinical environments. Objective: This study examines how clinical instructor engagement influences senior nursing students’ specialty preferences. Method: A longitudinal cohort design will be used with pre-licensure BSN students at a small private university in Northern California. Students will complete the same survey twice during their program, and paired t-tests will be used to assess changes in specialty …

The Relationship Between Registered Nurse Burnout, Organizational Engagement, And Quality Outcomes In Acute Care Hospitals, James E. Parsons

Theses, Dissertations and Capstones

Registered Nurse (RN) burnout remains a significant challenge in acute care hospitals, with far-reaching consequences for staff well-being, organizational performance, and patient care outcomes. Characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, burnout among RNs contributes to decreased job satisfaction, increased turnover, and compromised care quality. Despite extensive research on burnout, few studies have integrated theoretical frameworks such as the Theory of Reasoned Action (TRA) with large-scale, nationally representative data to empirically test how burnout influences organizational engagement and healthcare quality outcomes.

This quantitative, non-experimental study examined relationships among RN burnout, organizational engagement, and patient care …

Low Energy Availability (Lea) And Its Relationship To Nutritional Status And Bone Health In Collegiate Athletes, Anthony Dempsey

UNH URC Open (2026 and after)

This project aims to identify low energy availability in a sample of collegiate athletes and explore the relationship with bone mineral density and nutrient deficiencies. Participants (n=3,407) were recruited from a northeast university and self-reported athlete status and physical activity via online questionnaire. Food records were used to calculate energy and nutrient intake. Anthropometrics including height, weight, body composition and bone mineral status were measured in duplicate. Energy availability (EA) was calculated as (Energy Intake (EI) -Exercising Energy Expenditure) (EEE)) /Fat Free Mass (FFM) (kg) and categorized as optimal (>45 kcal/kg FFM), subclinical, or clinically low (< 30 kcal/kg FFM). Fifteen percent of participants were characterized as athletes (club or division I varsity); mean EA was lower among athletes vs. nonathletes (17.90.7vs.21.90.3, p< .001). Males were more likely to have optimal EA status vs. females (8.8vs4.7%, p< .001). Most females (75.1%) were categorized as clinically LEA; 20.3% had subclinical LEA. Among men, athletes’ EA was similar to nonathletes (21.11.2vs22.20.5, p=.4); among females, athletes had lower EA vs. nonathletes (16.220.9vs21.70.3, p< .001). Males with clinically low EA were most likely to consume inadequate intakes of potassium, fiber, iron, and vitamin D (77.1,94.0,10.4 and 97.3%, respectively); similarly, females with clinically low EA, were most likely to consume inadequate intakes (81.9,87.6,88.3, and 99.5%, respectively). Bone z-scores were higher among athletes vs. non athletes (-.27±.06vs-.67±.02, p< .001) but were not different by EA status. Given the prevalence of LEA within the college athlete and nonathlete populations, further research and tailored nutritional education is needed for this at-risk population.

Enhancing Stroke Recovery: A Proposal To Implement Self-Efficacy Strategies In Rehabilitation, Ariana M. Allen, Elliott P. Mcneely

Williams Honors College, Honors Research Projects

Self-efficacy is a critical predictor of rehabilitation success in stroke survivors, influencing motivation, therapy adherence, and functional recovery. This study will investigate the current use of structured self-efficacy enhancement programs (SEEPs) by healthcare professionals in post-stroke rehabilitation settings. Guided by Bandura's Self-Efficacy Theory, this proposal outlines a study that will include a comprehensive literature review and suggestions for further research. It will explore the frequency and methods of SEEP use, including goal setting, motivational feedback, and graded task planning. Data would be analyzed through descriptive statistics and thematic analysis. Findings are expected to identify usage patterns, barriers, and opportunities to …

Evaluation Of Peptides And Peptide–Doxorubicin Conjugates Designed And Synthesized For Targeting Triple-Negative Breast Cancer Via Cell-Surface Receptors, Shih-Jing (Jane) Yao

Pharmaceutical Sciences (PhD) Dissertations

A significant problem faced in oncology is the lack of chemotherapeutic agents that are tumor site-specific, resulting in reduced therapeutic efficacy and unintended infliction of harm to surrounding healthy tissues and cells that often lead to serious side effects. Current strategies being explored to circumvent this issue aim to refine delivery of  chemotherapeutic agents specifically to tumor sites, which may be achieved via conjugation of these agents to biomarker-specific ligands. This forms the foundation of ligand-targeted drug delivery. Among different breast cancers, treatment of the triple-negative breast cancer (TNBC) subtype has been particularly challenging, largely due to the absence of …

In Vitro Dihalobenzene Nephrotoxicity In Isolated Kidney Cells, Jana Ahmed Sherif

Theses, Dissertations and Capstones

Brominated and chlorinated benzenes are common industrial chemicals linked to kidney injury. This study evaluated the nephrotoxicity of several mono- and dihalogenated derivatives using isolated kidney cells from male Fischer 344 rats. LDH release and trypan blue exclusion were measured after 30- and 60-minute exposures to 0.25–1.0 mM to test compounds. Toxicity increased with increased concentration and longer times. Mixed-halogen bromobenzenes, particularly 1-bromo-4-chlorobenzene, showed one of the highest toxicity levels, while 1,4dichlorobenzene was the most toxic chlorobenzene. Antioxidants (glutathione, ascorbate, and αtocopherol) markedly reduced injury, indicating oxidative mechanisms play a role in toxicity. cytochromes P450 (CYP) inhibitors (piperonyl butoxide and …

Examining The Association Between Ddt Exposure And Parkinson’S Disease, Hodges Mccathern

Undergraduate Honors Theses

Dichlorodiphenyltrichloroethane, commonly known as DDT, was an organochlorine pesticide widely used in the mid-20th century. It is highly stable and resistant to degradation, leading to its long-term presence in the environment. This chemical bioaccumulates in ecosystems and in human tissue, particularly adipose tissue, raising concerns about chronic exposure. Emerging research links DDT exposure to adverse neurological outcomes, including increased risk for neurodegenerative disorders such as Parkinson’s Disease. Mechanistically, DDT and its metabolites may disrupt dopaminergic neurons, induce oxidative stress, and interfere with mitochondrial function, contributing to neurotoxicity. Understanding the environmental fate of DDT and its bioaccumulative properties is essential for …