Medicine and Health Sciences Commons^™

Bridging Data Gaps In Retinal Imaging: From Structural Domain Adaptation To Topology-Aware Synthesis, Gözde Merve Demirci

Dissertations, Theses, and Capstone Projects

Comprehensive visualization of the retina is essential for diagnosing and monitoring blinding diseases such as Diabetic Retinopathy and Retinopathy of Prematurity (ROP), where pathological changes often extend beyond a single field of view. Despite significant advances in automated retinal image analysis, clinical deployment remains limited by two fundamental data gaps: a structural learning gap, arising from scarce expert annotations and poor generalization across imaging domains, and a spatial coverage gap, caused by the difficulty of acquiring multi-view retinal images in fragile populations. Although these challenges are often addressed independently, this dissertation argues that they are tightly coupled: accurate, …

Optimizing Nanoparticle Quality And Function In Applied Research, Angela M. Fried

Dissertations, Theses, and Capstone Projects

Radiology tests are among the fastest-growing categories of diagnostic analysis, and the gold standard of radiology tests is MRI.  MRI can be more informative if a contrast agent is used, and the standard of care contrasting agents (CA) are gadolinium-based.  Gadolinium is a heavy metal, toxic, and contraindicated for renal-compromised patients and the critically ill.  We propose a nanogel (NG) vehicle for an alternative organic CA.  CNs like 4-hydroxy-2,2,6,6-tetramethylpiperidin-1-oxyl (TEMPOL) and its derivatives have a variety of medical and industrial uses.  These cyclic CNs are stable, synthetic radicals with distinctive EPR/ESR signals and are helpful for various experimental applications, from …

Parenthood And Re-Appraisal Of Childhood Maltreatment, Gayathri Cheran

Dissertations, Theses, and Capstone Projects

Background: Child maltreatment is associated with poorer physical and mental health outcomes across the lifespan.  Individuals’ appraisals of childhood maltreatment have important implications for these outcomes.  Appraisal is shaped by biological, psychological, and social-cultural factors, each of which undergoes change in parenthood.  Parenthood may prompt re-appraisal of childhood maltreatment in that being a parent evokes one’s experience of being parented.

Hypotheses: (1) Re-appraisal will be more likely in parents than non-parents.  In parents, re-appraisal will be more likely among: (2) primiparous parents, (3) parents with offspring of the same sex, and (4) parents who experienced maltreatment older in childhood (at …

New York City Women’S Experiences With Perinatal Depression Inquiries, Diagnosis, And Treatment Initiation, Caterina Pisciotta

Dissertations, Theses, and Capstone Projects

Perinatal depression represents a significant public health concern, yet many women who experience depression symptoms during the perinatal period (either during pregnancy and/or after birth) do not receive treatment. Initiatives, such as ThriveNYC, were designed to address these gaps by screening and treating perinatal women for maternal depression, integrating screening into routine perinatal care and strengthening pathways to treatment. Using representative survey data collected between 2016 and 2021 via the Center for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System (PRAMS), this study examined trends in perinatal depression inquiries (a proxy for “screening”) and postpartum diagnosis, as well as …

Beyond The Binary: Strengthening Nursing Students’ Proficiency Of Equitable Health Promotion, Martha K. Findley

Theses

Background: Sexual and gender diverse (SGD) populations continue to experience significant health inequities, yet prelicensure nursing curricula often lack structured, evidence‑based training to prepare students for equitable care.

Purpose: This study evaluated whether a targeted, transgender‑focused simulation could improve nursing students’ clinical knowledge and preparedness for providing equitable health promotion to SGD populations.

Methods: A pre‑/post‑intervention design was used with senior‑level nursing students who completed a transgender patient simulation emphasizing communication, assessment, and equitable health promotion. Students completed a validated survey measuring knowledge and preparedness in caring for SGD patients.

Results: Significant improvements across most survey items demonstrated that the …

Staff Education On Standardized Suicide Risk Assessment In An Outpatient Clinic For Behavioral Health, Fanta Haja Cabah

Walden Dissertations and Doctoral Studies

Suicide risk assessment is a high-priority nursing safety responsibility in outpatient behavioral health. The practice gap was a variation in nurses’ knowledge of validated suicide screening, direct inquiry, risk escalation, referral, and related documentation expectations working in an outpatient behavioral health clinic located on the Eastern Atlantic Coast. To address this problem, I developed, implemented, and evaluated a staff education program on a standardized suicide risk assessment. The practice question focused on whether staff knowledge increased following participation in the education program. Ten nursing staff members participated in a 60-minute education program. Pretest and posttest questionnaires included 20 multiple-choice questions. …

Implementing A Routine Fall Risk Assessment In Older Adults In An Inpatient Psychiatric Setting, Amaka Obi

Walden Dissertations and Doctoral Studies

The purpose of the project was to implement and evaluate a structured fall risk assessment process that promoted the early identification of patients at increased risk for falls and supported interventions designed to prevent fall-related events. A pre- and post-implementation evaluation design was used to assess the intervention's effectiveness by comparing fall rates before and after implementation of the standardized assessment protocol. De-identified data obtained from the electronic health record (EHR) were analyzed using descriptive statistics to evaluate changes in fall incidence and protocol adherence. The project findings demonstrated that provider-led, standardized fall-risk assessments improved screening compliance, provider adherence, and …

Staff Education To Increase Knowledge And Awareness Of Sexually Transmitted Diseases, Alie Sholola Sahid

Walden Dissertations and Doctoral Studies

Background STIs or sexually transmitted diseases (STDs) are consequential public health emergencies that affect millions of people globally and have long-term health implications (Garcia et al., 2024). STIs are infections that are passed from one person to another through sexual contact with the most common types of STIs include chlamydia, trichomoniasis, general herpes, and human papillomavirus (HPV). It is estimated that each year, more than 20% of the U.S. population has had an STI, with around 26.2 million cases per year (Centers for Disease Control and Prevention [CDC], 2024a). The common types of STIs include chlamydia, trichomoniasis, general herpes, and …

Development Of Ultrafast Protein Digestion And Standards Free Quantitation Methods For Mass Spectrometric Analysis, Praneeth Ivan Joel Fnu

Dissertations

A wide variety of biologically important molecules, such as enzymes, antibodies, hormones, transporters and receptors are proteins by composition and they play key roles in biological functions such as cellular regulation, communication, metabolism and physiological function. Protein dysfunctions and abnormalities are associated with numerous diseases, making proteins critical targets for understanding disease mechanisms and developing therapeutic interventions. Protein-based therapeutics such as monoclonal antibodies, hormones and vaccines gained popularity due to their high specificity, efficacy, and ability to treat complex diseases that are often difficult to address with small-molecule drugs.

Given the important role of proteins in a variety of biological …

Tracking Toward Zero: Implementing A Picc Team Tracker To Prevent Clabsis, Christian Justin Carreon

Master's Projects and Capstones

Problem: Central line-associated bloodstream infections (CLABSIs) remain a significant and preventable patient safety concern in acute care settings, contributing to increased morbidity, mortality, prolonged hospitalization, and substantial healthcare costs.

Context: At Hospital A, a tertiary referral center in Northern California, six adult CLABSIs were identified between June and December 2025 following an eight-month CLABSI-free period. Four events occurred in adult medical surgical telemetry. All peripherally inserted central catheter (PICC) line CLABSIs were attributed to gaps in maintenance bundle adherence and the lack of a standardized, real-time tracking mechanism for the PICC Team.

Interventions: A PICC Team Tracker was implemented as …

Tracking Towards Zero: Implementing A Picc Team Tracker To Prevent Clabsis, Carolina Maria Gerodias Cayetano

Master's Projects and Capstones

Background: Central line-associated bloodstream infections (CLABSIs) remain among the most serious and costly healthcare-associated infections in acute care settings, with each event associated with significant excess mortality, prolonged hospital stays, and avoidable healthcare costs. At Hospital A, a 239-bed acute care facility, two of six total CLABSI events over a 12-month period were associated with peripherally inserted central catheters (PICCs), representing 33% of all facility CLABSIs and exposing a critical gap in standardized PICC line surveillance and maintenance bundle monitoring.

Problem: The PICC team lacked a systematic, real-time tracking mechanism to monitor central line maintenance bundle adherence across seven adult …

Effect Of Partial Ablation Of Skeletal Dynamin Related Protein 1 On Mitochondrial Health, Inflammation, And Fibrosis In A Mouse Model Of Duchenne Muscular Dystrophy, Tessa L. Duzz

Graduate Masters Theses

Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disorder characterized by muscle weakness, degeneration, fibrosis, and impaired muscle regeneration. Mitochondrial dysfunction is an early pathological feature of DMD and has been linked to excessive mitochondrial fission. Dynamin-related protein 1 (Drp1) is a central regulator of mitochondrial fission, a key process in regulating mitochondrial quality and function. Inhibition of Drp1-mediated mitochondrial fission has shown promise as a potential therapeutic target for alleviating pathology and dysfunction in dystrophic muscle. The objective of this study was to determine whether partial skeletal muscle-specific ablation of Drp1 could improve muscle pathology and mitochondrial health in …

Cultural Responsiveness: Examining Assessments Of Therapists For Ethical And Clinical Outcomes (Create Clout), Tsotso T. Ablorh

Graduate Doctoral Dissertations

The Multicultural Counseling Competencies (MCC) and Multicultural and Social Justice Counseling Competencies (MSJCC) are well-researched and supported counseling practices for decreasing microaggressions in therapy and consequent attrition, lack of satisfaction, and maltreatment (Ratts et al., 2016; Sue et al., 1982). However, scholars critique existing methods for measuring therapists’ cultural responsiveness for being disconnected from therapeutic process and outcomes (Hays, 2020; Wilcox et al., 2020). This study examined which MSJCC measures associated with variables clinically and ethically relevant to better treatment outcomes and lower microaggressive, neglectful, and stereotypical treatment for hypothetical Black, female clients by White therapists. 62 White psychologists in …

Understanding Factors Influencing Multiple Tobacco Product Use Among Adolescents In Thailand: A Structural Equation Modeling Approach, Chaowalit Srisoem

Graduate Doctoral Dissertations

Tobacco use among Thai adolescents is shaped by personal, environmental, and product-related factors. However, the pathways linking these influences to actual behavior remain unclear. This study examined how personal, environmental, and product-related factors, along with intentions to use, relate to tobacco use among Thai adolescents. A cross-sectional secondary analysis was conducted using data from the 2022 Thailand Global Youth Tobacco Survey of 6,235 students aged 13–15 years. Survey weights methods were applied to produce nationally representative estimates. Confirmatory factor analysis and structural equation modeling assessed latent constructs, and multinomial logistic regression examined predictors of single, dual, and multiple product use. …

“When I’M Not Heard, I Feel Like I Don’T Matter”: Advancing Equity In Disability Policy Through Critical Participatory Action Research With People With Intellectual Disability, Cris Marchionne

Student Theses

People with intellectual disability deserve a system that offers flexible, timely, and person-centered support — one that is innovative, sustainable, and holistic in enabling them to live fulfilling lives. This qualitative study, grounded in Critical Participatory Action Research (CPAR), examines how people with intellectual disability experience participation in decision-making within New York State's disability service system. By centering lived experience, the study identifies factors that facilitate or hinder participation in decision-making and examines structural, social, and policy-related barriers that limit agency. Through six focus groups and a Photovoice project with self-advocates receiving OPWDD services, participants described systemic barriers that limited …

Staff Education To Strengthen Patient Counseling For Recurrent Uti Prevention In Middle-Aged And Older Women In A Low-Income Community Clinic, Linda Osamede Isidienu

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project was a practice-focused quality improvement (QI) staff education initiative designed to address recurrent urinary tract infections (UTIs) among middle-aged and older women receiving care in a low-income community clinic. Recurrent UTIs are associated with increased antibiotic use, antimicrobial resistance, and reduced quality of life. The purpose of this project was to evaluate whether a structured staff education program could improve provider knowledge related to patient counseling on UTI prevention. Twenty nurses and medical assistants participated in the intervention, which included education on evidence-based prevention strategies, counseling techniques for low health literacy populations, and …

Reducing Inpatient Falls Through Staff Education, Courage Duin Chiangeh

Walden Dissertations and Doctoral Studies

Patient falls remain a major patient safety concern, particularly among hospitalized stroke patients who are at increased risk because of impaired mobility, neurological deficits, and cognitive changes. The inpatient stroke unit selected for this quality improvement project consistently reported the highest fall rates within the hospital system, highlighting the need for evidence-based interventions. The purpose of this project was to determine whether a structured fall-prevention education program incorporating evidence-based practices and the 4Ps of purposeful rounding (pain, potty, position, and possessions) would improve staff knowledge, increase compliance with fallprevention practices, and reduce patient falls over a 2-month period. Guided by …

Breaking The Cycle: From Victimization To Offending Through The Lens Of Human Services, Colette R. Penalosa

Master of Arts in Human Services

The victim-offender overlap challenges the common view that victims and offenders are separately labeled by recognizing that both groups have experienced significant childhood trauma, physical, emotional, and psychological abuse, neglect, and other adverse childhood experiences (ACEs). Current research implies these experiences can increase the risk of offending as they all influence cognitive and behavioral development while leaving criminal behavior undetermined. The purpose of this capstone is to analyze the relationship between childhood victimization and offending from a human service perspective; analyzing the pathways a victim takes on the road to offending. Research conducted will focus on exploring the victim-offender overlap, …

Staff Education To Improve Staff Knowledge Regarding Candida Auris, Nkechinyere Ejelonu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a staff education project regarding Candida auris, a multidrug-resistant fungus recognized by the Centers for Disease Control and Prevention (CDC) as an urgent global health threat due to its high mortality, environmental persistence, and resistance to common disinfectants. Staff play a crucial role in infection prevention; however, limited awareness and inconsistent knowledge of Candida auris contribute to potential transmission in skilled nursing home settings. The project question was as follows: Among staff members in a skilled nursing facility, does an evidence-based educational intervention improve knowledge of Candida auris infection prevention as compared pre- …

Understanding Familicide: Psychosocial, Behavioral, And Mental Health Risk Factors And Implications For Forensic Behavioral Health Professionals, Molly M. Vogl

Master of Arts in Human Services

Familicide is a rare but devastating form of family violence involving the killing of multiple family members by another family member. Although research examining domestic violence, homicide, and homicide-suicide has expanded, familicide remains less understood due to its low occurrence and complex nature. This capstone examined the psychosocial, behavioral, and mental health risk factors commonly associated with familicide perpetrators and explored how forensic behavioral health professionals may use this information to improve violence risk assessment, prevention, and intervention efforts. A review of peer-reviewed research from academic databases and scholarly search engines identified common themes associated with familicide, including relationship conflict, …

Registered Nurses’ Perceptions Of Relational Service Behaviors In Nursing Practice, Dadakpoye Tina Johnson

Walden Dissertations and Doctoral Studies

Nurses play a central role in shaping patient experiences through clinical care and relational service behaviors. However, little is known about registered nurses’ perceptions and experiences of relational service behaviors in contemporary health care settings. The purpose of this interpretive description qualitative study was to explore registered nurses’ perceptions and experiences of relational service behaviors and their role in promoting patient-centered care. Herzberg’s two-factor theory provided the conceptual framework for examining how intrinsic motivators and extrinsic workplace factors influence relational engagement. Semistructured interviews were conducted with 11 registered nurses from diverse clinical practice settings. Interview data were analyzed using Braun …

Staff Education To Improve Healthcare Staff Knowledge Of An Electronic Scheduling System In An Intensive Outpatient Program (Iop), Catherine Kinyili

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice staff education project aimed to improve staff knowledge of the newly implemented electronic scheduling and booking kiosk system. A transition from a paper-based to an electronic scheduling system led to reduced staff efficiency, communication challenges, scheduling errors, and delays in patient care. An evaluation identified inconsistent staff knowledge of the newly implemented electronic scheduling system. The practice-focused question for the project was: Among healthcare staff in an intensive outpatient program, how does a one-time structured education and training session affect staff knowledge of a new electronic scheduling system? The purpose of this project was to …

Trauma Processing And Sleep Inconsistencies In Firefighters: A Proposed Program To Bridge Gaps And Set Heroes Up For Success, Megan Griffin

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This doctoral paper presents a comprehensive review of the literature supporting the need for an integrated training program addressing sleep disruption, trauma exposure and processing, and substance use as a self-medication strategy among firefighter populations. Drawing on empirical research, the paper examines the prevalence and interaction of posttraumatic stress disorder (PTSD), moral injury, sleep disturbances, and substance use within this occupational group. The introduction provides operational definitions of PTSD and moral injury and synthesizes existing research on trauma exposure, sleep impairment, and substance use functions among firefighters. The literature review also highlights evidence-based, exposure informed interventions to facilitate adaptive trauma …

Diagnosis And Treatment Of Trauma In Adolescents: A Doctoral-Level Clinical Psychology Course, Jasmine M. Cervantes

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Adolescent trauma is a significant mental health concern that can profoundly disrupt emotional, cognitive, social, and developmental functioning. Although evidence-based interventions for adolescent trauma are well established, doctoral-level psychology training programs may provide limited instruction focused specifically on the unique developmental, cultural, and clinical considerations required when treating traumatized adolescents. This paper presents the development of a ten-week doctoral-level elective course designed to address this gap in clinical training. The curriculum provides foundational knowledge regarding the prevalence, developmental impact, diagnosis, and treatment of adolescent trauma, with an emphasis on posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD). Students …

Sober Curious: A Treatment Manual For A Semi-Structured Interpersonal Process Group Targeting Substance Misuse In Emerging Adults, Annalise G. Floody

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper presents Sober Curious, an original treatment manual for an eight-session, semi-structured interpersonal process group for emerging adults ages 18–25 with mild-to-moderate substance misuse concerns. This group is designed for university counseling centers and outpatient treatment settings, particularly for individuals who experience substance-related distress, impairment, risk, or ambivalence but may not identify with abstinence-based recovery or formal diagnostic substance use disorder (SUD) language. The manual is grounded in epidemiological data, established substance use treatment guidelines, meta-analytic findings on group psychotherapy and substance use interventions, and the developmental theory of emerging adulthood. Key intervention elements include motivational interviewing (MI) to …

Act And Posttraumatic Growth In Military Veterans: Growth Through Flexibility After Adversity, Andrew J. Moller

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Military veterans are disproportionately exposed to potentially traumatic events across service eras. While much of the clinical and research literature has focused on posttraumatic stress disorder (PTSD) and symptom reduction, a growing body of work highlights the possibility of posttraumatic growth (PTG) following adversity. PTG refers to positive psychological changes that may emerge through engagement with traumatic experiences, including enhanced appreciation for life, renewed purpose, personal strength, deepened relationships, and reintegration into community roles. Importantly, PTG does not imply the absence of distress but may coexist alongside ongoing trauma-related symptoms. Understanding processes that facilitate growth alongside suffering may support more …

A Brief Self-Help Intervention For Anxiety And Depressive Symptoms Utilizing Cognitive Behavioral Therapy And Dialectical Behavior Therapy Within Correctional Settings, Genevieve L. Ray

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Individuals within incarcerated settings are far more likely to experience symptoms that meet criteria for a mental health disorder compared to the general population. This population is often underserved due to various financial and resource constraints. Self-help interventions have grown in popularity due to their proven effectiveness and accessibility for consumers, particularly for anxiety and depression symptoms. A self-help intervention for those in a correctional setting would not require extensive additional personnel amid financial constraints and would increase access to care. Many self-help interventions that are currently published apply to the community population, but readily accessible resources that reside in …

Clinical Considerations For Black Student Athlete Development, Jahnia Margarita Green

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Black student athletes exemplify the complexity of navigating intersecting identities at pivotal points in their development. They are also more likely to make premature commitments to their athletic identity and in turn suffer from psychological distress during times of transition (Beamon, 2012). The focus on Black collegiate athletes is informed by persistent mental health challenges associated with higher levels of competition or transitions (e.g., injury or retirement) within collegiate athletics (Brewer & Petitpas, 2017; Menke & Germany, 2019). This paper aims to develop culturally informed clinical considerations through the analysis of the Black student athlete experience and structural aspects of …

The Evaluation Of The Epic Epidural Assessment Event And The Effects Of The Conversion Of Epidural To General Anesthesia For Cesarean Sections, Rebecca Turney, Bridget Shinnick

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Unplanned conversion from labor epidural analgesia to general anesthesia (GA) for cesarean delivery is associated with increased maternal and neonatal risk and may occur when inadequate epidural function is not recognized before operative delivery. This Doctor of Nursing Anesthesia Practice quality improvement project evaluated implementation of the Epic Epidural Assessment Event, a structured electronic medical record documentation tool designed to standardize epidural assessment during labor at a high-acuity obstetric referral center in Western Pennsylvania. Using a Plan-Do-Study-Act framework, the project compared pre- and post-implementation epidural-to-GA conversion trends, reviewed Epic audit data for documented tool utilization, and collected anonymous anesthesia provider …

A Quality Improvement Project On Maternal Hemorrhage Protocol Adherence, Cyrus Masih, Richard Zapata

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postpartum hemorrhage is a leading cause of preventable maternal morbidity and mortality and requires rapid, coordinated response among obstetric, anesthesia, nursing, and blood-bank teams. This quality improvement project implemented and evaluated a California Maternal Quality Care Collaborative (CMQCC)-based Code OB maternal hemorrhage intervention at a western Pennsylvania hospital. The project aimed to improve anesthesia provider knowledge, confidence, and readiness to recognize, stage, and respond to maternal hemorrhage using standardized guidance, quantitative blood loss (QBL) measurement, and point-of-care cognitive support. Guided by the Institute for Healthcare Improvement Model for Improvement and a Plan-Do-Study-Act cycle, the intervention included a focused educational presentation …