Medicine and Health Sciences Commons^™

Perceptions Of Lumbee Tribe Members On Participating In Diabetes Type Ii Prevention Practices, Jeremy Wesley Lowery

Walden Dissertations and Doctoral Studies

Type II diabetes (DB2) is one of the leading causes of death in the United States, whether directly or as a comorbidity. This is especially alarming for Native Americans, who have the highest DB2 prevalence and death rates when compared to their non-Native American peers. This qualitative phenomenological study explored the lived experiences of Lumbee Tribe members in Robeson County regarding DB2. The health belief model was used as a lens through which to understand and interpret findings. In-person semi-structured audio-recorded interviews were conducted with 12 participants recruited through social media. Data were coded and analyzed using deductive thematic analysis. …

Development Of An Evidence-Based Educational Intervention To Increase Correctional Nurses’ Knowledge Of Mental Health Crisis Management, Jacqueline Parrish

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) educational intervention targeted correctional nurses and aimed to enhance their knowledge of mental health crisis management. Correctional environments often lack training for managing mental health emergencies, which can negatively impact safety. The goal was to increase correctional nurse knowledge of mental health emergency management. The guiding question was whether an educational intervention would increase correctional nurses’ knowledge of mental health crisis management by a minimum of 20% following a structured, evidence-based educational session. A pretest and posttest design was used in the project. A total of 20 participants completed a pretest, posttest and program …

Adapter Changes Of Central Line Patients On Total Parenteral Nutrition, Courtney Erin Schappell

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infections (CLABSIs) remain a significant and preventable patient safety issue, especially among hospitalized patients receiving total parenteral nutrition (TPN). Patients on TPN face a higher risk of infection due to the high glucose content of the solution and the frequent access required for central line therapy. The Centers for Disease Control and Prevention and the Agency for Healthcare Research and Quality have recognized CLABSI prevention as a national priority. In addition, there is emphasis on high-risk groups like patients receiving TPN. The Infusion Therapy Standards of Practice, an evidence-based guideline, recommends catheter care, including timely adapter (i.e., …

Implementing Sbar-Based Staff Education And A Diabetes-Specific Discharge Checklist To Reduce Patient Identification Errors During Handoffs, Maragarate Nesoa

Walden Dissertations and Doctoral Studies

This doctoral project was an organization change initiative using staff education to reduce patient identification errors during handoffs among older adults with Type 2 Diabetes (T2DM). Misidentification during transitions of care contributes to medication errors, unnecessary readmissions, and preventable adverse events

Correlational Study Of Health Checkups And Patient Wellness: Epidemiological Evaluation On Prophylaxis Pathways, Samantha H. Beaubrun

Walden Dissertations and Doctoral Studies

Health checkups and wellness visits are a vital pathway to early detection and diagnosis of disease. It is not known whether young adults, insured or not, are opting into preventive care services to optimize health status via health checkups/wellness visits at primary care academic health centers. The purpose of this quantitative study was to examine the relation of wellness visits to healthcare insurance and health status while adjusting for gender among young adults ages 18–35 years in the United States. A descriptive correlational design was used with the 2023 National Health Interview Survey data set (N = 6,544). The results …

Staff Education For Effective Patient Handoff, Kaylonn Amundson

Walden Dissertations and Doctoral Studies

This staff education project was initiated to address the lack of standardized handoff procedures which was found to have contributed to an adverse outcome for a hospitalized patient. The purpose of this project was to address the question: Will an interactive education program on a standardized handoff tool increase nursing staffs’ knowledge and self-confidence regarding its use? The project involved educating 20 inpatient nurses and care staff about the structure of the SIGNOUT? handoff tool using a PowerPoint presentation with a follow-up practice simulation. Handoff sheets and visuals were distributed to aid in the learning process. Pre- and post-education surveys …

Impact Of Community Health Needs Assessments As Barriers To Chronic Disease Prevention: A Comparative Study, Marissa E. Woelm Ms.

Honors Thesis

Community health needs assessments (CHNAs) are vital tools for identifying population health priorities through monitoring chronic diseases and conditions; however, their effectiveness in preventing chronic diseases remains debated. This comparative study examines CHNAs from sixteen South Dakota hospitals across Avera, Sanford, Monument Health, and independent systems to evaluate their role in preventing chronic diseases. Analysis reveals significant challenges, including biased data sampling, limited community engagement, small survey samples, and inconsistent implementation strategies. While CHNAs effectively identify mental health, cancer, and obesity as the top community concerns alongside several other diseases like diabetes and kidney disease, most reports lack specific timelines …

Building Relationships: Does Perceived Counselor Cultural Humility Improve Client Satisfaction Of Mental Health Services Within Therapeutic Dyads Of Dissimilar Identities?, Noah Schoch

Electronic Theses and Dissertations

A wealth of clinical research has uncovered the presence of mental health treatment disparities and a lack of treatment consistency when working with clients of dissimilar identities. The purpose of this dissertation study was to investigate potential causes for the observed disparities minoritized individuals have experienced and understand if cultural humility was a variable that affected mental health treatment satisfaction when counselor-client had dissimilar cultural identities. This was achieved through the following research questions: (1) What is the relationship between the extent of client perceived racial/ethnic similarity within the therapeutic dyad and client-rated mental health treatment satisfaction? (2) What is …

Sleep Menus: A Personalized Approach To Enhancing Patient Rest And Improving Sleep Quality, Justin W. Dorman

Doctor of Nursing Practice (DNP) Manuscripts

Sleep disruptions among hospitalized patients can negatively impact healing, recovery, and patient satisfaction. Hospital noise remains a persistent barrier to restful sleep, yet previous hospital-based noise reduction strategies have shown limited sustained success. This quality improvement project aimed to enhance patient-perceived sleep quality by implementing a patient-centered Sleep Menu offering patients earplugs or sound machines. A pre-post design was employed, using the Richard-Campbell Sleep Questionnaire (RCSQ) to assess patients' sleep quality before and after the Sleep Menu intervention. Sixty patients were approached; 25 chose earplugs, and 7 selected the sound machine. Despite environmental decibel levels remaining above the WHO recommendations …

Likes For Love: Examining The Relationship Of Sociocultural Factors On Social Media Influences Of Instagram Use For Young Black Women, Cheria S. Jackson

Electronic Theses and Dissertations

In recent years there has been a push toward studying ethnic minority women related to the psychological implications of image and beauty, as historically the focus has been on the experiences of European women (Awad et al., 2015). Black women must process sexual development, attitudes, and behaviors through the lens of the sexual scripts and stereotypes of their ethnic group and must negotiate between mainstream and culture specific norms of sexuality (Daniels and Zurbriggen, 2016; Jerald et al., 2017). The presence of these scripts signifies a difference between Black women and other races about how they may internalize and react …

Peripheral Blood Biomarkers For Rheumatoid Arthritis-Associated Interstitial Lung Disease, Brent A. Luedders

Theses & Dissertations

Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a common extra-articular complication of rheumatoid arthritis (RA). Measuring peripheral blood biomarkers represents an appealing strategy to inform the screening and prediction of RA-ILD. In these studies, I aimed to further characterize the associations of peripheral blood biomarkers with prevalent and incident RA-ILD. First, I evaluated the associations of matrix metalloproteinases (MMPs) with RA-ILD among a multicenter cohort of RA U.S. Veteran patients (n = 2,312). Higher concentrations of MMP-7 and MMP-9 were independently associated with both prevalent and incident RA-ILD, including a nearly four-fold increased odds of prevalent RA-ILD (adjusted odds ratio …

Feasibility And Function Of A Tilt-In-Space Wheelchair Insert For Low Resource Settings (Development Of The Open Tilt Base), Luke Mcauley, Karen Menard

Student Capstone Papers

The ability to move and be mobile is a basic part of human function. For those without the muscle control and/or strength to attain and maintain the posture necessary for basic movement and mobility a device is necessary to support them and provide them with the highest level of independence possible. This type of device comes at a significant cost and need for highly customizable products which are difficult to obtain in most situations, but especially in Low-Middle-Income Countries (LMIC). The product discussed in this paper is designed to provide a cost effective solution for those in need of a …

Public Perception About Covid-19 Vaccine Hesitancy In South Central Nebraska, Rita Nnenne Oparaocha

Biology Theses, Dissertations, and Student Creative Activity

The COVID-19 pandemic created a shift in the trajectory of vaccination hesitancy, altering risk perceptions and vaccination attitudes among individuals in rural communities. The 5C framework highlights confidence, complacency, constraints, calculation, and collective responsibility as influencing factors of vaccine hesitancy. This study assessed the proportion of adults who refused COVID-19 vaccination and identified the individual reasons for hesitancy among those who refused the COVID -19 vaccines in South Central Nebraska. Data was analyzed from a local cross-sectional public health survey administered to 2,034 adult participants over a six-month period (March-August 2024), including 91 respondents who were from outside the seven-county …

Investigate The Role Of Tgfβ3 In Regulating Irf6 And Δnp63 In Periderm Desquamation, Nam Ha

Theses & Dissertations

Introduction: Failure in palatal fusion during palate development results in cleft palate, one of the most common birth defects in the US. During the final phases of palatogenesis, the palatal periderm (a protective cell layer that prevents premature fusion and adhesion with oral epithelium) must be removed, also known as desquamation. This process is a prerequisite for establishing the midline seam in the fused palate. Previous studies have shown that transforming growth factor-β3 (TGFβ3) plays an irreplaceable role in palate development in mice. Our previously published mechanistic models outline the role of TGFβ3 and its downstream signaling cascade involving proteins …

The Next Drug Epidemic Is Legal: The Nation's Kratom Problem Is More Complicated—And More Harmful—Than It Seems, Elizabeth Walsh

Capstones

This two-part health and science investigative piece reports how kratom and its offshoots have quietly fueled a lucrative and legal addiction epidemic for the last decade. While kratom’s derivative alkaloid 7-hyrdoxymitragynine made headlines this year and as the DEA is poised to ban the strong derivative, “natural” kratom and other kratom-derived products will remain. This piece tracks the history of the 'gas‑station opioid' crisis in the U.S. over ten years: what was thought to be an innocuous southeast Asian supplement has become multi-billion dollar industry built on gray‑area laws, marketed falsehoods, and regulatory loophooles.

Part 1: The ‘Gas Station Opioid’ …

Nyc Falls Behind In Climate Resources For Pregnant And Postpartum Moms, Jada Simon

Capstones

The U.S. still holds the highest maternal mortality rate among high-income nations around the world. While national rates have since seen a slight decrease, Black mothers still see high maternal death rates in comparison to white mothers, showing that racial disparities in maternal death rates are still apparent. In NYC, the reason for these disparities are not just unequal access to quality healthcare, but also the poor living conditions of neighborhoods in the city that are made up mainly of minoritized groups. So far, it has gone unconsidered that that the maternal mortality and climate crises are happening concurrently. This …

Two Major Ontario Hospital Labs Bought Research Dogs From U.S. Breeder With Troubled Pastdogs Bred For Scientific And Medical Testing Suffer Abuse As The Scientific Industry Increasingly Turns To Alternatives For Research., Allison Hunter, Mary Beech, Sami Marshak, Kate Morano

Capstones

The purpose-bred dog breeding industry for research is little known. Each year, thousands of dogs are bred for scientific and medical testing, supplied to research facilities by a handful of major commercial breeders. But gaps in enforcement and regulation have allowed abuses to persist, even as the industry increasingly turns to alternatives to animal testing. Animal rights advocates have been decrying the treatment of these dogs. A federal Inspector General report found lax oversight of the industry, raising further concerns about how dogs are treated. This story was reported in collaboration with the Investigative Journalism Bureau, based in Toronto, and …

(Un)Intended Consequences Of Race In Medicine: The Ethics Of Race-Based Medical Practice And The Perpetuation Of Structural Racism, Allegra Merriweather

Electronic Theses and Dissertations

This dissertation proposes that race-based medicine acts as a form of structural racism that is ethically indefensible. While it may be claimed to be a neutral diagnostic tool, the medical use of race as a biological proxy only further enforces the very hierarchies it purports to remediate, reinscribing inequity from conception to death. Building off Jacques Ellul’s work on Technique, we interpret race-based medicine as a self-perpetuating system that values procedural expediency over moral accountability. In nine chapters, the analysis follows the ways this technique is manifested in genetics and assisted reproduction, where commodified racial selection preserves social hierarchies; in …

A Comparison Of Tenecteplase To Alteplase For Treatment Of Acute Ischemic Stroke Using Epic Cosmos Database, Marco Gonzalez Castellon

Theses & Dissertations

Ischemic stroke is highly prevalent and an important cause of morbidity, mortality, and long-term disability in the in the United States. The incidence and prevalence of stroke is expected to increase in the next few years due to several factors including aging of the U. S. population, improved treatment, and socioeconomic factors. In 1996, the FDA approved rtPA for the treatment of ischemic stroke patients. Patients had a greater likelihood of recovering successfully. However, rtPA has significant limitations, such as an elevated risk of intracranial hemorrhage, administration difficulties, and limited effectiveness. In March 2025, the FDA approved the use of …

Posterior Anatomic Limit For Mandibular Molar Distalization In Subjects With Different Growth Patterns, Genders, And Growth Status, Rehana Bashir

Theses & Dissertations

The objective of this study is to identify the anatomical limits for mandibular molar distalization, a technique frequently employed in orthodontics to address various malocclusions. Mandibular molar distalization plays a critical role in the management of crowding, and correction of the molar relationship.

It is imperative to assess the posterior anatomical space (PAS) in the mandibular retromolar area prior to distalization or uprighting the mandibular molars to avoid periodontal issues (dehiscence, orthodontically induced root resorption, and tooth mobility) and achieve successful treatment outcomes.

A clinical question that, however, isn't well understood is whether the amount of mandibular molar distalization is …

Assessment Of Polymeric Chloroquine Formulations For Targeted Therapy Of Ulcerative Colitis And Metastatic Colorectal Cancer, Neha Kumari

Theses & Dissertations

Effective targeted drug delivery is a critical unmet need in the management of both ulcerative colitis and metastatic colorectal cancer, where conventional systemic therapies may be hindered by suboptimal efficacy and significant side effects. This thesis explores the development and preclinical assessment of polymeric chloroquine (PCQ)-based nanotherapeutics, leveraging stimuli-responsive designs for disease-specific delivery and action.

For ulcerative colitis, a reactive oxygen species (ROS)-responsive nanogel system was engineered to release PCQ, a macromolecular derivative of hydroxychloroquine, specifically in the inflamed areas within the colon. Nanogels with well-defined size and positive surface charge were synthesized via reversible fragmentation chain transfer (RAFT) polymerization …

Development And Characterization Of Non-Viral Delivery Systems For Pulmonary Delivery Of Nucleic Acid Therapeutics, Kasturi Siddhanta

Theses & Dissertations

The development of non-viral delivery systems for pulmonary delivery of nucleic acid therapeutics is driven by the need for safer and more accessible approaches to treat lung diseases, while avoiding the systemic side effects and immune responses associated with viral vectors. Such systems encompass both non-invasive inhalation-based platforms, and systemically administered platforms designed to achieve localized lung delivery. These strategies aim to enable high drug concentrations at the site of action, rapid onset of therapeutic effect, and greater therapeutic efficacy than existing treatments. Designing effective pulmonary delivery systems requires precise optimization of particle properties—including size, morphology, surface characteristics, cell-specific targeting, …

Development Of Self-Assembled Polymeric Polyplexes For Microrna Delivery: Toward Treatment Of Alcohol-Associated Liver Disease, Marjina Akter Kalpana

Theses & Dissertations

Self-assembled polymeric polyplexes have the potential to serve as an RNA interference (RNAi) delivery platform for the combined inhibition of CXCR4 and miR-155 in the treatment of alcohol-associated liver disease (AALD). A central challenge in RNA delivery is balancing the extracellular stability of polyplexes, cellular uptake, and intracellular release of RNA cargo. We developed polymeric polyplexes using the CXCR4-antagonist polymer PAMD, designed to target CXCR4 on activated hepatic stellate cells (HSCs) and deliver therapeutic miRNA to activated Kupffer cells (KCs) in fibrotic liver. We improved the polyplexes by cholesterol modification of PAMD and by PEGylation of PAMD-Ch. The cholesterol modification …

Exposures, Protections, And Barriers: Advancing Understanding Of Agricultural Worker Health, Alexandra A. Farfalla

Theses & Dissertations

Farming is a hazardous occupation. Exposures are multifactorial, variable, and shaped by overlapping tasks, environments, and social contexts. This dissertation aimed to illustrate the complexity of agricultural exposures and the barriers to protective practices through three complementary studies.

The first study examined co-exposures to solvents and noise as risk factors for hearing loss (HL) among 7,495 farmers and ranchers in a 7-state region. Results indicated nearly 60% of co-exposed participants reported hearing loss, with an adjusted odds ratio nearly six-fold (OR=6.03, [4.67-7.78]) for moderate/severe HL. This work highlights the importance of recognizing chemical exposures as a modality in HL in …

Staff Education To Improve Patient Medication Adherence For Schizophrenia Using Long-Acting Injectables, Adela Ghogomu

Walden Dissertations and Doctoral Studies

This doctoral project was conducted as a staff education initiative based on a comprehensive literature review that emphasized the importance of staff education in improving healthcare outcomes. The practice problem identified was a lack of staff knowledge and education regarding long-acting injectables (LAIs) in clients with schizophrenia, which contributed to inconsistent support for client medication adherence. It was essential to address this issue because nurses play a crucial role in medication management, patient education, and adherence support. The practice-focused question explored was: Will staff education regarding the use of long-acting injectables in clients with schizophrenia to enhance medication adherence improve …

Reducing The Use Of Erythropoiesis-Stimulating Agents In Hemodialysis Patients, Myriamme Neree

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a quality improvement (QI) initiative. Nephrologists were inconsistent in ordering iron studies and sometimes delayed the initiation of erythropoiesis-stimulating agents (ESAs) on admission to the inpatient site. These delays often led to suboptimal outcomes. The practice-focused question guiding the project asked whether a nurse-driven iron protocol would improve adherence to anemia management guidelines. The project’s purpose was to evaluate the impact of the evidence-based nurse-driven protocol. I used descriptive and inferential statistics for data analysis. Findings demonstrated a statistically significant improvement in the timely completion of iron studies and in intravenous (IV) iron …

Effects Of Pamam Dendrimer Size On Antimicrobial Activity For Acne Treatment, Elise M. Inae

Honors Theses

This study investigated the antimicrobial activity of G1, G2, and G3-Hex-NH2 polyamidoamine (PAMAM) dendrimers with an emphasis on how dendrimer size influenced their efficacy against C. acnes and S. epidermidis. Dendrimers are nano-sized, radially symmetric polymers composed of highly branched units that extend out from a central core. Dendrimers are known to exhibit antimicrobial activity against Gram-negative bacteria by disrupting the lipid bilayer and causing membrane damage. This study explored their effect on a different group of microorganisms–Gram-positive skin flora. Kirby-Bauer disk diffusion tests were performed to evaluate minimum inhibitory concentrations for each dendrimer solution. All generations of PAMAM dendrimers …

Green Synthesis Of And Antimicrobial Susceptibility Testing Of (2z)-2-[(4-Fluorophenyl)Methylidene]-1-Benzofuran-3-One, Rod Albert C. Olofernes

Honors Theses

Antimicrobial resistance is a global health challenge, rendering once-effective antibiotics less potent or entirely ineffective. In response, there is increasing interest in developing antimicrobial agents through environmentally sustainable methods. In this study, a fluorinated aurone derivative, (2Z)-2-[(4-fluorophenyl)methylidene]-1-benzofuran-3-one, was synthesized using a green Knoevenagel condensation approach. Eco-friendly catalysts were employed to minimize environmental impact and avoid hazardous byproducts. Product formation was confirmed to avoid wasting resources. The compound was evaluated for antimicrobial properties using a Kirby-Bauer plate, but did not demonstrate consistent or significant antimicrobial activity, therefore lacking promise as a standalone antibiotic.

Work-Life Conflict, Anxiety, And Depression In Collegiate Athletic Trainers With Children Under 5, Jordan Helton, Glenn R. Penny, Seth Swary

Student Dissertations

The research problem for this study was that collegiate athletic trainers with children under 5 years old experience significant work-life conflict and negative mental health outcomes. The purpose of this study was to explore how collegiate ATs with young children describe their experiences of work-life conflict and to how these experiences relate to symptoms of anxiety and depression. Guided by interrole conflict theory and work-life conflict theory the study posed two research questions: (1) How do collegiate ATs with children under 5 describe their experiences of work-life conflict? (2) What is the relationship work-life conflict experiences on the symptoms …

Staff Education To Improve Knowledge Of Probiotic Use And Benefits For Best Patient Outcomes, Rebecca M. Hoover

Walden Dissertations and Doctoral Studies

Abstract The staff education project to improve knowledge of probiotic use and benefits with antibiotic use, has shown to improve patient recovery and outcome. The post-implementation impact of the project is increased awareness of probiotic use and their benefits to prevent Antibiotic. Associated Diarrhea at the project site organization. I identified no limitations in the project. Staff education can be used worldwide to prevent digestive diseases with the use of probiotics supplements or probiotic food. Probiotics use is to improve patient outcomes by maintaining gut microbiome and digestive health. The evidence-based practice solution of a staff education on probiotic use …