Medicine and Health Sciences Commons^™

Determining Driving Ability Following Traumatic Brain Injury, Shauna M. Corrigan

Occupational Therapy Capstones

Introduction: A traumatic brain injury (TBI) can be a severe injury that causes lasting effects such as visual changes, challenges with concentration and memory, and problems with coordination and balance (Centers for Disease Control, 2024). This can impact an individual’s ability to safely return to the valued occupation of driving. Occupational therapists will commonly assess an individual’s ability to return to drive following a TBI, but they experience challenges in doing so due to a lack of standard method in assessing one’s safety while operating a motor vehicle (Baker et al., 2015; Tamietto et al., 2006; Classen et al., 2009; …

Development Of Feed In Context: A Context-Responsive Pediatric Feeding Guide For Rural Practice Guided By The Ecology Of Human Performance Model, Jatin Lee Cranmore

Occupational Therapy Capstones

Background: Pediatric feeding participation is influenced by complex interactions among sensory processing, motor coordination, emotional regulation, caregiver routines, and environmental conditions. When feeding challenges occur, the impact extends beyond nutrition and may limit participation in family routines, school environments, and community activities (St. John et al., 2026; St. John & Ausderau, 2024). Access to specialized feeding services can be particularly limited in rural communities where healthcare workforce shortages and geographic barriers reduce the availability of pediatric rehabilitation services (Tak et al., 2022). Occupational therapy practitioners are uniquely positioned to address feeding participation because occupational therapy practice examines the interaction among …

Gamifying Occupational Therapy Education: Enhancing Student Engagement And Outcomes, Payton Alise Baumann

Occupational Therapy Capstones

Background: Occupational therapy students face high rates of burnout and attrition during graduate education due to mental health challenges, reliance on passive learning strategies, and non-learner-centered curricula. These barriers limit active learning and reduce practical readiness for independent practice. Gamification has been shown to enhance engagement and application of knowledge; however, its adoption is limited by time constraints, attitudinal barriers, and lack of implementation guidance.

Purpose: The purpose of this project was to develop practical, evidence-based faculty training resources and gamified learning activities to incorporate gamification into occupational therapy curricula for the promotion of student well-being, engagement, and professional readiness. …

Unfolding Recovery: An Occupational Therapy Practice Protocol Manual For Dupuytren’S Disease, Rebecca Valdez

Occupational Therapy Capstones

Introduction: Dupuytren’s disease (DD) is a disease of the fibrous tissue called the fascia of the palm and fingers of the hand (Eckhaus, 2016). It develops over time, thickening the palmar fascia and leading to nodules and cords that flex the fingers (Pineda et al., 2024; Salari et al., 2020). The disease occurs mostly in men, with individuals of Northern European descent having a higher likelihood of disease development, alongside family history increasing the risk. This disease can result in disability for individuals, including difficulty performing certain activities such as picking up objects, donning and wearing gloves, putting hands in …

Family-Centered Programming For A Rural Midwest Emergency Shelter: An Occupational Lens, Ariel Kathryn Tix

Occupational Therapy Capstones

Introduction: After a period of decline in homelessness, a startling trend reversal occurred between 2023 and 2024; there was a 39% increase in families experiencing homelessness in the United States (de Sousa & Henry, 2024). Rural homelessness is less visible and often looks different from urban homelessness, which presents challenges that require a different approach (Brott et al., 2019). Individuals experiencing homelessness have challenges in every area of occupation and could benefit from novel strategies and resources. Challenges include parenting, accessing medical care, obtaining permanent housing, community mobility, and meaningful routine development (American Occupational Therapy Association, 2020; Brott et al., …

Non-Pharmacological Interventions For The Management And Prevention Of Hypertensive Disorders In Pregnancy: A Review Of The Literature, Shenelle K. Smith, Laurena E. Lepp

All Electronic Theses and Dissertations

Hypertensive disorders of pregnancy (HDP), including preeclampsia (PE), are a leading cause of maternal and perinatal morbidity and mortality worldwide. In the United States, rates of HDP continue to rise and are associated with preterm birth, fetal growth restriction, and long-term cardiovascular disease. Current management focuses only on low-dose aspirin for prevention. Surveillance and timely delivery remain the only definitive treatment for preeclampsia. This highlights a critical gap in prevention. Emerging evidence suggests that non-pharmacological interventions–particularly nutrition, physical activity, and lifestyle modification–may reduce the risk and severity of HDP. These approaches align with midwifery models of care emphasizing prevention, education, …

Fear Of Childbirth As A Perinatal Comorbidity: An Integrative Review, Michelle T. Mcmanus, Ashely N. Payne

All Electronic Theses and Dissertations

Fear of childbirth (FOC) and tokophobia have a significant impact on one in every five pregnant women and is associated with enhanced levels of anxiety, depression, pre-traumatic stress, and has led to increased requests for elective cesarean sections. Given the influence that it has on birth mode and perceived birth experience as well as postpartum wellbeing, it stands to reason that FOC represents an often-overlooked aspect of perinatal mental health.
This capstone reviews cohort, cross-sectional, randomized, and quasi-experimental studies examining prevalence, correlations, and consequences of FOC. It evaluates antenatal education, midwife-led support, and cognitive behavioral therapy as potential interventions. Outcomes …

Integrative Approaches And Data Analysis For Single-Cell Rna Sequencing Data, Teng Long

Computer Science and Engineering Dissertations

The rapid growth of single-cell RNA sequencing and transcriptomic datasets has created major computational challenges in causal discovery, representation learning, and biologically faithful data generation. To address these challenges, this dissertation presents three complementary deep learning frameworks for the analysis and modeling of transcriptomic data. Together, these methods form an integrative computational toolkit for understanding complex biological systems from high-dimensional and heterogeneous gene expression data.

First, this dissertation introduces DAG-VAERL, a causal discovery framework that integrates variational autoencoders, graph neural networks, reinforcement learning, and attention mechanisms to infer directed acyclic graphs for gene regulatory network analysis. DAG-VAERL improves causal structure …

Independent Animal Chiropractic Practice: An Evidence-Based Argument For Autonomy Beyond Veterinary Supervision, Montana Adams

Undergraduate Honors Theses

Animal chiropractic is a growing form of conservative care used to improve mobility, reduce pain, and support neuromusculoskeletal function in animals. Despite evidence suggesting it is both effective and low risk, access remains limited due to inconsistent state regulations. Many jurisdictions require chiropractors to obtain veterinary supervision, referral, or licensure, even when they have completed specialized training and certification in animal chiropractic. This paper evaluates the effectiveness and safety of animal chiropractic while analyzing the impact of current regulatory policies. Research indicates that chiropractic care can improve mobility and reduce spinal conditions in animals when performed by trained professionals. However, …

What Does The Quality Of Life For Congenital Heart Defect Patients Look Like Across The Lifespan?, Kaylee F. Maynor

Undergraduate Honors Theses

Throughout history, birth defects have left a mark on patients and families across the world. From an infant's first few breaths to an elderly person's last breath, congenital heart birth defects play a major role in that person's life. There are many different types of birth defects that effect the heart. Each defect is unique and has different outcomes on the body. Some congenital heart diseases have multiple defects causing more than one complication. The treatment options for many of the common congenital heart birth defects have come a long way throughout decades of research. By diving into what heart …

Tele-Psychiatry Adoption And Its Effect On Rural Mental Health Service Availability, Anna Heineman, Kaylee Canterbury, Taylor Carpenter

Theses, Dissertations and Capstones

Purpose of study: This study examined the association between tele-psychiatry implementation and mental health service availability in rural healthcare settings. The analysis compared tele-psychiatry to traditional in-person psychiatric care among rural populations, focusing on access and utilization outcomes, including time to first psychiatric appointment, number of completed visits, and appointment no-show rates.

Methods: A qualitative literature review following a systematic approach was conducted using peer-reviewed articles published between 2016-2026. Databases included PubMed, ProQuest Health, CINAHL, Journal of Medical Internet Research, and the National Library of Medicine, with Google Scholar used as a supplemental source. The review followed PRISMA …

Dental Implantology: A Literature Review, Kylie Taylor

Undergraduate Honors Theses

Dental implant therapy is the process of replacing teeth as a form of treatment to improve quality of life, function, and esthetics. The success of the implant depends on the surgical technique, type of prosthetic, and factors related to individual patients. The most important factor for implant success is osseointegration. Osseointegration is a process in which success is determined by the bone quality, the surface characteristics of the implant and the surgical approach. Some approaches to improve the osseointegration of the implant are low-speed drilling, guided surgery, and reduced surgical trauma at the site. The impact of systemic conditions, health …

Exploring Tonal Focus: Qualitative Perspectives And Acoustic Correlates In Slps And Singers, Lily C. Carpenter

Theses and Dissertations--Communication Sciences and Disorders

Tonal focus is a complex construct that has variable definitions and interpretations across professions and within existing literature. Although tonal focus is widely described both clinically and pedagogically, both fields differ in their perspectives and goals related to the concept. This study aims to understand singers’ and speech language pathologists’ (SLP) conceptual perception and acoustic demonstration of tonal focus. Eleven SLPs and six singers were recruited to participate in the study. Participants completed an interview with the primary investigator and were recorded producing forward, neutral, and backward tonal focus in various contexts. Acoustic and qualitative analysis indicated that tonal focus …

Elevated Bmi And The Effect On Breastfeeding Duration In Postpartum Individuals: An Integrative Review, Abigail E. Mobilia, Kirstin A. Wyly

All Electronic Theses and Dissertations

Introduction: It has been well documented that exclusive breastfeeding provides benefits for infants and postpartum individuals, yet rates remain suboptimal in the United States, particularly among those with elevated pre-pregnancy body mass index (BMI). Evidence suggests that elevated BMI is associated with shorter breastfeeding duration and may be influenced by physiologic, social, and structural factors. This integrative review synthesizes existing literature to clarify the relationship between elevated BMI and exclusive breastfeeding duration among postpartum individuals.
Methods: An integrative review was conducted following Whittemore and Knafl’s (2005) framework and PRISMA 2020 guidelines. A systematic search of PubMed, CINAHL, and Nursing & …

Gestational Diabetes Mellitus And Its Psychological Impacts During Pregnancy And Postpartum, Nehemie B. Hypolite, Charline Fast

All Electronic Theses and Dissertations

Introduction: This review explores the link between gestational diabetes (GDM) and psychological outcomes. GDM affects 8–10% of pregnancies and is typically diagnosed at 24–28 weeks. This burden leads to anxiety, depression, and fear. Postpartum concerns often persist for mother and infant.

Methods: Whittemore and Knafl’s (2005) method was used to synthesize data. The research databases included CINAHL and PubMed. Covidence supported screening and PRISMA diagram development. Key search terms included “anxiety and GDM,” “depression and GDM,” “GDM and postpartum depression,” “gestational diabetes,” and “pregnancy.” Inclusion criteria included full-text articles published after 2010, original studies, patients undergoing diabetic treatment (medication and/or …

The Impact Of Patient-Centered Care On Women With Infertility And Pregnancy Loss: An Integrative Review, Kaidynce R. Sweazy

All Electronic Theses and Dissertations

Introduction: Infertility affects roughly 17.5% of adults worldwide, while pregnancy loss occurs in up to 30% of pregnancies. These reproductive traumas increase the risk of developing a mental health disorder, such as anxiety, depression, or post-traumatic stress disorder (PTSD). The purpose of this review is to identify the influence of patient-centered care on psychological outcomes and experiences of care in women with infertility and pregnancy loss.
Methods: A literature search of the PubMed and Cinahl databases was conducted for original studies published from January 2016 to January 2026 that address the psychological outcomes and/or experiences of women who experienced infertility …

The Placenta & Covid-19: Histological Changes & Clinical Implications, Melissa F. Paul, Allyson J. Zadlo Sensor

All Electronic Theses and Dissertations

Introduction: The COVID-19 pandemic presented the medical community with complex and novel challenges, not the least of which is how to optimize prenatal and postnatal care for pregnant individuals who have been infected. At present, seven years have elapsed, and despite definitive research demonstrating adverse outcomes associated with placental changes, no professional consensus has been reached.
Methods: This integrative review includes studies involving pregnant individuals with confirmed SARS-CoV-2 infection, who recovered during the same pregnancy, and their infants. An examination of the data available reveals a triad of placental pathologies (chronic histiocytic intervillositis, perivillous fibrin deposition, and trophoblast necrosis) that …

Increasing Colorectal Cancer Screening Rates At A Federally Qualified Health Center: A Quality Improvement Project, Kaeli H. Mcphee

DNP Scholarly Projects

Abstract 

Background: Colorectal cancer (CRC) is on the rise and is currently the second leading cause of cancer-related death in the United States (Wender, 2022). CRC screening rates are below national goals, particularly among underserved populations. At Lowell Community Health Center (LCHC), only 41.9% of eligible adults were up to date with CRC screening as of 2024.

Purpose: This quality improvement project aimed to increase CRC screening rates among average-risk adults aged 45 to 75 by implementing a multifaceted, low-burden intervention targeting both provider and patient behaviors.

Methods: Guided by the Plan-Do-Study-Act (PDSA) framework, the intervention included: (1) provider and …

Characteristics Of Pulmonary Vs. Extrapulmonary Tuberculosis Cases In Kentucky From 2020 To 2024, Mariam M. Alkhairat

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective: Tuberculosis (TB) remains an important public health concern in the United States, especially among people experiencing social and clinical vulnerabilities. Extrapulmonary TB, which occurs outside of the lungs, can be harder to detect and diagnose than pulmonary TB. This study aimed to describe the demographic and clinical characteristics of people with active TB in Kentucky and to identify factors associated with extrapulmonary TB.

Methods: Secondary surveillance data were obtained from the Kentucky Department for Public Health (KDPH) using the National Tuberculosis Surveillance System (NTSS). The study sample included 301 confirmed active TB cases reported in Kentucky. Descriptive statistics were …

Emotion Regulation Difficulties And Substance Use: The Role Of Conscientiousness, Caitlyn M. Donnelly

Theses and Dissertations

Difficulties in emotion regulation have been consistently linked to substance use among college students. However, individual differences may influence this relationship. Conscientiousness, a personality trait characterized by self-control, planning, and goal-directed behavior, has been proposed as a potential protective factor. The present study examined associations among difficulties in emotion regulation, conscientiousness, and substance use behaviors, as well as whether conscientiousness moderates the relationship between emotion regulation difficulties and substance use. Using a quantitative, cross-sectional, correlational design, data was collected from college students recruited through a university participant pool. Participants completed self-report measures of emotion regulation difficulties, conscientiousness, and substance use …

Managing Multi-Drug Resistance: An Evolutionary Game Theory And Optimal Control Approach, Shukhrat Nasrulloev

Theses and Dissertations

Multi-drug resistance is an evolutionary process in which treatment eliminates sensitive cells, allowing resistant clones to dominate. This thesis investigates this process using a framework integrating population dynamics, evolutionary game theory, and optimal control theory. We develop a two-population logistic growth model describing competition between drug-sensitive and drug-resistant cells under treatment, construct dose-dependent payoff matrices and replicator dynamics to characterize evolutionary competition, and derive a critical drug level D_crit = (r_S - rR)/(dS - d_R) at which resistant cells gain a fitness advantage. An optimal control problem is formulated via Pontryagin's Maximum Principle to identify schedules …

Between Tradition And Transition: Cultural Negotiations And Contraceptive Perceptions Among Ghanaian Students In The United States, Beatrice Amissah

Theses and Dissertations

As global mobility continues to rise, international students often encounter new cultural norms and health practices that differ from those in their home countries. While some studies have focused on contraception within the context of gender and types, less focus has been placed on diasporic populations, especially how students navigate tensions surrounding contraception within new cultural environments. This study explores how Ghanaian students in the United States interpret, negotiate, and respond to contraceptive messaging while navigating the cultural transition between their heritage and host societies. Drawing on Berry’s (1980)  Acculturation Theory, the study examines the tensions students experience, the strategies …

Sex Differences In Allergic Asthma Responses Of Mice Prenatally Exposed To Wood Smoke, Adelynne Walley

Undergraduate Theses, Professional Papers, and Capstone Artifacts

No abstract provided.

The Impact Of Community-Based Educational Workshops On The Sexual Health Literacy And Sexual Satisfaction Of Lgbtq+ Adults, Meaghan Burns, Kathryn Burke Otd, Otr/L

Occupational Therapy Doctorate Capstones

A large number of adults who were brought up in the United States have limited sexual health literacy because of incomprehensive sexual education in adolescence. Many adults view sexual activity as an important component that contributes to their quality of life. Occupational Therapists can address sex and intimacy to improve literacy and satisfaction for adults with limited knowledge. The proposed study uses a quasi-experimental design with pre/post surveys to assess the efficacy of educational programming surrounding topics on sexual health literacy and satisfaction. The intended setting and population are adult members who attend programming and events at the Taunton location …

The Effect Of Mental Skills Training On Adolescent Gymnast's Sport Performance Satisfaction, Acadia Cass

Occupational Therapy Doctorate Capstones

Introduction: The aim of this study was to investigate the effects of a mental skills training program on mental skill acquisition and sport performance satisfaction in adolescent competitive gymnasts. Mental blocks can have detrimental effects on athlete confidence, motivation, and mental health. Mental skills training has been found to be an effective intervention for addressing sport performance blocks, but the impact on performance satisfaction has not been thoroughly investigated. Methods: A mixed methods quasi-experimental study was completed using convenience sampling methods to select competitive gymnasts who train at one facility in the United States to participate in an eight-week mental …

Preventing Teen Pregnancy Through Expanded Contraceptive Access In Mccreary County, Kentucky, Dacey B. Chitwood

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This capstone project proposes a school-based Condom Availability Program to reduce teen pregnancy risk by expanding discreet contraceptive access for adolescents in McCreary County, Kentucky. Teen pregnancy remains a persistent public health concern in rural communities where stigma, privacy concerns, transportation barriers, and limited healthcare access can prevent adolescents from obtaining reproductive health resources. McCreary County faces elevated teen birth rates, socioeconomic disadvantage, and limited maternal healthcare infrastructure, making teen pregnancy prevention an important local priority. The proposed program would place free latex and non-latex condoms in student restrooms at McCreary Central High School, with QR-code-linked information connecting students to …

The Impact Of Food Insecurity And Associated Variables On Colon Cancer In Kentucky: An Ecologic Study, Claire E. Lynch

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective: Given colorectal cancer incidence rates are increasing, especially in socioeconomic disadvantaged areas, this study aims to determine if there is an association between specific socioeconomic variables, such as food insecurity, and colon cancer at the county-level in Kentucky.

Methods: Colorectal cancer age-adjusted incidence rates at the county-level were collected from the Kentucky Cancer Registry. Conty-level data was collected from County Health Ranking, The U.S Census Bureau, National Institute on Minority Health and Health Disparities and the Behavioral Risk Factor Surveillance System from 2019 to 2023. R was used to run statical analyses such as a linear regression and a …

Development Of An Educational Toolkit For Clinical Staff At Little Rivers Health Care To Guide Shared Decision Making For The Expanded Age Range Of The Hpv Vaccine, Maureen B. Boardman

DNP Scholarly Projects

BACKGROUND: The Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States (CDC, 2024). Unlike other common STI's, persistent infection with HPV increases the risk of cancer. A Human Papillomavirus (HPV) vaccination was approved in the United States in 2006 for girls and women aged 9 to 26 and in 2009 it was approved for boys and men in this same age range. Despite 20 years of data on the efficacy and safety of the HPV vaccine, rates of completed HPV vaccine series remain low. In 2019 the Advisory Committee on Immunization Practices (ACIP) expanded …

Improving Feeding Outcomes: Occupation-Based Feeding Interventions From Nicu To Outpatient Pediatrics, Bailey Ciardelli

OTD Capstones

A researcher from an entry-level doctorate program examined gaps in feeding and sensory-based care for premature infants in the Neonatal Intensive Care Unit (NICU) and outpatient pediatric feeding setting. The Improving Feeding Outcomes project aimed to improve feeding readiness, sensory regulation, and caregiver confidence through the development of occupation-based, family-centered interventions. This report evaluates the implementation of evidence-based resources, including caregiver education handouts, a NICU staff training presentation, a caregiver tummy time group, and a standardized infant feeding assessment tool integrated into outpatient pediatric therapy practice. These interventions were designed to address gaps in OT-led infant feeding and sensory care, …

“Treatment Not Tents:" The Medicalization Of Homelessness In California’S 2022-2025 Legislative Agenda, Elana R. Straus

Yale Medicine Thesis Digital Library

Modern homelessness emerged in the 1980s due to political choices that cut the social safety net and decreased the availability of affordable housing. Medicalized views of homelessness that frame homelessness as driven by individual pathology, particularly mental illness and addiction, emerged in research, media, and politics at this time. Homelessness has persisted since and remains particularly high in regions, including California, where the housing markets are most constrained. In this context, California advanced multiple legislative changes between 2022 and 2025 that increased pathways to involuntary treatment and criminal-legal control over people experiencing homelessness. In this thesis, I demonstrate how legislators …