Medicine and Health Sciences Commons^™

Quality Improvement Project: Advancing Personalized Depression Care In Outpatient Psychiatry, Jillian K. Benoit

Doctor of Nursing Practice Projects

Depression is a leading cause of disability worldwide, yet inconsistent use of evidence-based assessment and treatment strategies contributes to gaps in the quality of psychiatric care. A needs assessment at a community outpatient psychiatric clinic identified inconsistent documentation of measurement-based care (MBC), shared decision-making (SDM), and patient education during depression treatment. The purpose of this quality improvement project was to evaluate whether implementation of MBC and SDM improved depression treatment documentation among psychiatric providers over a 4-week period. Guided by Lewin’s Change Theory and implemented using the Iowa Model of Evidence-Based Practice as the implementation framework, this quantitative one-group pretest-posttest …

Quality Improvement Project Simulating Ethics: Improving Ethical Decision-Making In Nursing Undergraduates Through Simulation And Faculty Training, Shannon Brown

Doctor of Nursing Practice Projects

Nursing faculty often report limited confidence in teaching ethical principles, despite the essential role ethics plays in preparing students for complex clinical decision-making. This quantitative, quasi-experimental pre/post quality improvement project evaluated whether a structured ethics education module incorporating simulation could impact faculty confidence in teaching ethical principles. Guided by Lewin’s Change Theory and the Jeffries Simulation Framework, the project examined how organizational readiness for change and structured simulation design influence faculty development outcomes. Nursing faculty in a baccalaureate program participated in a single simulation-enhanced ethics session. Data were collected through anonymous pre/post Qualtrics surveys, and faculty confidence was measured using …

Improving Exam Scores: Alternative Next Generation Questions In Curriculum, April Morgan

Doctor of Nursing Practice Projects

Evidence identifies clinical judgment deficits among newly licensed nurses, supporting the integration of the National Council of State Boards of Nursing (NCSBN) Clinical Judgment Measurement Model (NCJMM) and Next Generation NCLEX (NGN) strategies. Inconsistent NGN implementation and Assessment Technologies Institute (ATI) Comprehensive Predictor performance established the local problem. This quality improvement project evaluated the impact of implementing NCJMM-aligned NGN instructional strategies, including unfolding case studies and bow-tie questions, on students’ first-attempt achievement of the ATI Comprehensive Predictor benchmark and faculty outcomes. The primary aim was to increase the percentage of students achieving the ATI Comprehensive Predictor benchmark of 76.2% on …

Hypothermia Management In Adult Trauma Patients: Enhancing Nursing Knowledge And Self-Efficacy In The Emergency Department, Shannon M. Rapert

Doctor of Nursing Practice Projects

Trauma-induced hypothermia is a significant, preventable condition that contributes to increased mortality. Evidence suggests that inconsistent recognition and management of hypothermia persist in the emergency department (ED), highlighting the need to strengthen ED nurses’ knowledge and self-efficacy in evidence-based warming strategies. The purpose of this quality improvement project was to evaluate the impact of an educational intervention on ED nurses’ knowledge and self-efficacy in managing trauma-induced hypothermia. Guided by the Iowa Model of Evidence-Based Practice, the ADKAR Change Model, and the Plan-Do-Study-Act framework, this quantitative, quasi-experimental, pretest–posttest project evaluated the effect of an instructor-led educational intervention in ED nurses at …

Towards The Synthesis Of Dragonamide E And Analogs Thereof, Dante Glover

Chemistry Theses

Leishmaniasis is a disease caused by a parasite spread through the female sand fly. It is categorized as a Neglected Tropical Disease and can cause very severe symptoms, even death, if left untreated. Symptoms include skin lesions that can cause permanent scarring, and mucosal membrane infections that can cause facial deformities. More aggressive forms of leishmaniasis can lead to infections of internal organs like the liver and/or spleen and can lead to death. Drug resistance of these parasites has rendered treatment limited and the side effects of which can be harmful as well.

Scientists looking towards new treatments for tropical …

Standardizing Hypertension Care In An Occupational Medicine Clinic: A Quality Improvement Project, Carolyn Duncan

Doctor of Nursing Practice Projects

Hypertension remains a leading modifiable risk factor for cardiovascular disease, and inconsistent implementation of evidence-based hypertension management may contribute to variability in patient education, documentation, and follow-up care. This quality improvement project evaluated an evidence-based educational program and a standardized hypertension management workflow, based on the 2025 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines, in an occupational medicine clinic. Guided by the Iowa Model of Evidence-Based Practice, Kotter's 8-Step Change Model, and the Plan-Do-Study-Act framework, the intervention aimed to impact staff self-efficacy, documentation of lifestyle education, and follow-up appointment scheduling. A quantitative quasi-experimental pre-post design was used with …

Assessing The Impact Of Knowledge-Based Planning On Dosimetric Performance In Adaptive Prostate Sbrt Planning, Kayla Kenny

Masters Projects

Daily adaptive prostate stereotactic body radiation therapy (SBRT) is now feasible with advances in adaptive radiotherapy and automated optimization. However, the dosimetric quality of Ethos Intelligent Optimization Engine version 2 (IOE v2) automated plans may vary because optimization is based on user-defined templates rather than patient-specific dose guidance. This retrospective study evaluated whether integrating RapidPlan knowledge-based planning (KBP)–derived optimization objectives into the Ethos IOE v2 adaptive planning workflow improved dosimetric quality for prostate SBRT. Fifteen intact prostate SBRT patient datasets were evaluated. For each patient, three plans were generated: a baseline Ethos IOE v2 reference plan (Ref), a plan incorporating …

Effect Of Hydrogel Rectal Spacers On Bladder Wall And Regional Substructure Dose In Prostate Cancer Patients Undergoing Volumetric Modulated Arc Therapy With Simultaneous Integrated Boost: A Retrospective Planning Study, Geronimo Sosa

Masters Projects

Purpose: Hydrogel rectal spacers reduce rectal dose during prostate radiotherapy, but their effect on bladder wall dose is not well characterized, particularly with volumetric modulated arc therapy with simultaneous integrated boost (VMAT-SIB). This study evaluated the effect of spacer placement on whole and regional bladder wall dose.

Methods: Twenty-nine patients treated with VMAT-SIB (70 Gy in 28 fractions) were analyzed retrospectively: 9 with and 20 without a spacer. The bladder wall was defined as the whole bladder minus a 3-mm inner margin. Primary endpoints were D0.03 cc and D1 cc; secondary endpoints included D2 cc, D3 cc, D10 cc, volume-based …

Responsivity Education Reflection Packet For Multigenerational Caregivers, Natalie Holsky

Honors Projects

Caregivers play an essential role in supporting their child’s language development. Through everyday routines, caregivers have countless opportunities to foster strong language skills. Extensive research has examined the influence of caregiver input on language development. Comparatively little research has explored how historical trends in parenting advice across generations may shape caregivers’ use of language facilitation practices. The purpose of my honors project was to examine how generational parenting trends could inform the development of a clinic-to-home language facilitation resource. This resource was designed to help caregivers incorporate language facilitation strategies into everyday routines to increase language-rich interactions at home. A …

An Assessment Of The Multidisciplinary Approach To Fetal Echocardiography Education, Riley Allen

Masters Projects

With congenital heart disease (CHD) being the most common birth defect, there is a growing demand for utilization of fetal echocardiography (FE). In clinical practice FE requires an interdisciplinary approach to performance and patient care, and integration of techniques from both the obstetric and pediatric cardiac areas of medicine. While practitioners align on the need for an interdisciplinary approach to practice and the specific methods of performance, there is little consensus on how to comprehensively educate the sonography workforce. Literature has identified gaps in both the obstetric and pediatric cardiac sonographer education bases, predominantly focusing on the lack of specific …

The Impact Of Point Of Care Hepatitis C Virus Rna Testing On Diagnosis, Treatment Initiation, And Linkage To Care In Marginalized Populations, Maria Simpson

Medical Laboratory Science Independent Study Projects

Hepatitis C virus (HCV) remains a major public health concern, particularly among marginalized and high-risk populations who experience barriers to timely diagnosis, treatment initiation, and linkage to care. Traditional laboratory-based HCV testing often requires multistep workflows and follow-up visits, contributing to delayed confirmation of active infection and loss to care. This literature review examines how point-of-care HCV ribonucleic acid (RNA) testing affects time to diagnosis, treatment initiation, and linkage to care compared with standard laboratory-based testing. Evidence from systematic reviews, community-based trials, correctional settings, supervised consumption sites, diagnostic performance studies, and cost-effectiveness analyses indicates that point-of-care RNA testing shortens turnaround …

Standardized Training Methodologies For Medical Laboratory Science Students And Their Importance For Student Success, Maria Simpson

Medical Laboratory Science Independent Study Projects

Clinical education is a critical component of Medical Laboratory Science (MLS) programs, serving as the primary bridge between academic instruction and professional practice. However, traditional clinical rotation training models often struggle to keep pace with rapid advancements in laboratory technology, expanding professional responsibilities, workforce shortages, and heightened patient safety expectations. The purpose of this capstone project is to examine the key factors driving the need to update training methodologies in MLS clinical rotations and to evaluate contemporary educational approaches that better prepare students for entry-level practice. This project addresses systemic challenges faced by clinical laboratories, such as staffing constraints, heavy …

Telling Their Intensive Stories: Black/African American Intensive Care Unit Nurses And Their Perceived Encounters With Icu Workplace Racism, Sharon M. Butler

Theses & Dissertations

The 2022 American Nurses Association (ANA) study on racism and racial inequality within the nursing profession both acknowledges the presence of racism in nursing and provides evidence of the diverse negative social and psychological effects of racism on minority nurses. Although the 2022 ANA study sets a precedent and shows evidence of racism’s effects across the broader professional nursing workforce, there is limited nursing research literature that offers a focused presentation and understanding of the lived experiences of minority nurses and their personal perceptions of workplace racism. There is also limited nursing research on how workplace racism impacts cultural and …

Online Group Neurobehavioral Therapy (Nbt) For Veterans With Epilepsy And Major Depressive Disorder (Mdd), Melissa F. Fadipe

Dissertations and Theses (Open Access)

Background: Veterans with epilepsy experience high rates of psychiatric comorbidity, most commonly major depressive disorder (MDD). Barriers to accessing mental health care—including geographic distance, transportation limitations related to seizure-related driving restrictions, and fragmented care between neurology and psychiatry, contribute to the underdiagnosis and undertreatment of MDD in this population. Neurobehavioral Therapy (NBT), a Cognitive Behavioral Therapy (CBT)-informed psychotherapy developed for individuals with seizures, has demonstrated benefits for psychological distress and quality of life. Internet-based interventions and short message service (SMS) text messaging offer promising strategies to address access barriers; however, limited research has examined the feasibility and acceptability of delivering …

Baseline Nutrition Knowledge And Feasibility Of A Whatsapp-Delivered Nutrition Education Intervention Among California Wildland-Urban Interface Firefighters, Lauren E. Anderson

Master's Theses

Wildland firefighters perform physically demanding work under challenging environmental conditions that place substantial demands on nutritional health and occupational performance. Despite the importance of nutrition in supporting physical performance, recovery, and long-term health, limited research has examined nutrition knowledge and dietary behaviors among California wildland firefighters or evaluated the feasibility of remotely delivered nutrition education interventions within this occupational population. Therefore, the purpose of this pilot study was to assess baseline nutrition knowledge, nutrition self-efficacy, and dietary behaviors while evaluating the feasibility of a 12-week WhatsApp-delivered nutrition education intervention among California wildland firefighters.

Twenty-four firefighters completed the baseline assessment and …

Predictors Of The Mother-Infant Bond: The Role Of Maternal Attachment Style, Parity, Race, And Motherhood Expectations, Samia Qadri

Theses, Dissertations and Culminating Projects

This study examined how maternal attachment style, parity, race, and motherhood expectations, individually and in interaction, predicted the quality of the mother-infant bond during the postpartum period. Grounded in a maternal feminist framework, the study used a quantitative, cross-sectional correlational design. Postpartum mothers aged 20–39 (N = 87) completed validated measures of maternal attachment style, motherhood expectations, mother-infant bonding, and depressive symptoms. Multiple regression compared a Primary Model containing the four focal predictors and planned interaction terms with a Secondary Model that added maternal depressive symptoms as a covariate. Depressive symptoms emerged as the strongest single predictor of bonding, and …

Evaluating The Discus Throw As An Ancient Greek Combat Training Tool Through Modern Performance Metrics, Daniel R. Porter

All Graduate Reports and Creative Projects, Fall 2023 to Present

This study’s purpose was to explore the correlations between peak velocity in a rotational throw with a medicine ball, peak force (PF) and rate of force development (RFD) in an isometric mid-thigh pull, time to failure in a plank test, and peak velocity in a sword thrust task, which was also tested for reliability. Twenty-seven recreationally trained male participants between the ages of 18-35 completed the study. The sword thrust task was significantly correlated with the medicine ball throw (p = 0.012, r = 0.475, r² = 0.226, 95% CI [0.724, 0.116]) and PF (p = 0.045, r …

The Joint Effect Of Bilingualism And Sleep On Executive Functions Among Children And Adolescents With Attention Deficit/Hyperactivity Disorder (Adhd), Yirou Jiang

Doctoral Dissertations

Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that significantly impacts cognitive and behavioral functions, leading challenges for individuals across the lifespan. While extensive research has been conducted to understand the connection between executive functioning (EF) and ADHD, research findings related to the contributing factors of bilingualism and sleep still remains inconsistent (Bialystok et al., 2017). Investigating the joint effect between bilingualism and sleep on EF among children and adolescents with ADHD may help further clarify the connection between EF, language, and sleep, and facilitate the development of interventions from the perspective of these protective factors. EF encompasses cognitive processes …

Analysis Of Terpenes In Cannabis Flowers Using Gas Chromatography Via Headspace-Solid Phase Microextraction (Hs-Spme), Hannah I. Bergner

Forensic Science Master's Projects

As cannabis commercialization grows, rigorous profiling of cannabinoids, terpenes, and chemical contaminants is legally required for industry standardization and consumer safety. Terpenes are highly volatile components that dictate the unique aromatic profiles and therapeutic properties of cannabis via receptor pathways. This project focused on a gas chromatography-flame ionization detector/mass selective detector (GC-FID/MSD) combined with headspace-solid phase microextraction (HS-SPME) sampling to analyze terpenes present in four cannabis samples. Cannabis samples were tightly sealed in vials (10 mL) and heated to vaporize terpenes in the headspace above the samples, followed by the extraction of the vaporized terpenes using a polydimethylsiloxane (PDMS)-coated SPME …

The Difference In Social Media Coverage For Male And Female Athletes, Amanda Thomas

Communications and Digital Media Theses

Pulling back the curtain on the reality women athletes face when it comes to their social media coverage. Sports have been male-dominated since the start, but over the years women have become more and more involved in sports as they have their own teams and even sports. However, this issue lies with the overall support and coverage they are receiving from well-known Sports coverage networks. For this study, I looked at social media posts from ESPN, FOX Sports, and NBC Sports focused on the sports of Basketball, Baseball/Softball, and Tennis. In doing this study, I analyzed how many posts men …

The Effects Of An Educational Intervention To Enhance Knowledge And Awareness Of The Prevention Of Sexually Transmitted Infections Among College Students, Darcy Yates

Doctor of Nursing Practice Projects

Purpose

The DNP student implemented a single group pretest-postest design underpinned by the Health Belief Model to address the PICOT question: Among a purposive sample of college students at a mid-west college (Population) to what degree does participation in an evidence-based intervention providing information about STIs (Intervention), compared with before that intervention (Comparison), result in to an increase in knowledge and awareness regarding STI infections and associated risks and treatment options (Outcomes) over a six-week period (Time)?

Methods

The pretest and postest scores of 15 students for the 27 items in the Sexually Transmitted Diseases Knowledge Questionnaire (STD-KQ) were evaluated. …

Occupational Health Hazard: Silicosis Policy In California's Engineered Stone Industry, Devany G. Rocha

Master's Projects and Capstones

This policy analysis evaluated the effectiveness of current California regulations that were enacted after the STOP Act was passed to address silicosis incidence rates against Australia's complete ban on manufacture, supply, processing and installation of engineered stone with greater than 1% crystalline silica content. Silicosis is a deteriorating fibrotic lung disease caused by the prolonged or massive inhalation of crystalline silica (Dynamed, 2023). To assess the scope of the problem under the STOP Act, we used data from the California Department of Public Health (CDPH) surveillance from 2019 to present. We assessed incidence rates, mortality rates, and patient demographics. We …

Polyphenol Diet And Exercise As Neuroprotection From Effects Of Alzheimer's Disease, Michelle Morgan

Loma Linda University Electronic Theses, Dissertations & Projects

Healthy non-pharmacological lifestyle factors, such as regular physical exercise and a dietary supplementation, have been shown to significantly improve cognitive outcomes over time compared to a more sedentary lifestyle and poor diet. Furthermore, exercise may serve as a potential protective factor in attenuating the effects associated with cognitive decline that are characteristic of neurodegenerative disorders, such as Alzheimer's disease (AD). Further, evidence indicates that certain diet interventions can also attenuate the effects of neurodegeneration and positively impact longevity. Supplementation of polyphenols, such as ellagic acid (EA), which are abundant in pomegranate juice, may help provide neuroprotective benefits and elicit a …

The Acute Effect Of A Single Dose Of Berberine On Blood Glucose Response Following A Standardized Meal And 2-Mile Walk Performance In Healthy Adults, Victor Emmanuel Obaro

Master's Theses

It is clear that exercise improves overall health status, and it is possible that berberine (BR) may work through some similar mechanisms to improve health status as well.  Purpose: The purpose of this study was to explore the acute effects of a single dose of BR on health status following a standardized meal and a 2 mile walk treadmill protocol with outcomes including blood glucose (BG), blood pressure (BP), heart rate (HR), rate of perceived exertion (RPE), and a two-mile walk time trial performance. Methods: This study used a cross-over design where 14 healthy, young adults were given berberine (BBR) …

Facilitating Occupational Participation In Older Adults With Chronic Pain, Emily K. Ruesch

Occupational Therapy Capstone Presentations

This capstone project developed doctoral-level clinical skills in the management of chronic pain. This capstone project also implemented a six‑week chronic pain management program for independent community‑dwelling older adults at Dow Rummel Village. Eleven adults aged 50–95 participated in weekly 45‑minute group sessions addressing adaptive equipment use, graded exercise, energy conservation, nervous system regulation, stress management, and sleep hygiene. Seven participants completed pre‑ and post‑intervention measures using the Brief Pain Inventory–Short Form and the Pain Self‑Efficacy Questionnaire. A paired samples t‑test assessed changes in pain severity, pain interference, and self‑efficacy. Results demonstrated a decrease in pain severity (t(6) = −3.96, …

Association Between Stress Mindset, Psychological Symptoms, And Psychosocial Risk In Liver Transplant Patients, Sarah Kay Brill

Dissertations

Psychosocial functioning is a central component of liver transplant evaluation, yet less is known about how cognitive factors, such as stress mindset, relate to transplant readiness. The present study examined the association between stress mindset and psychosocial risk, as well as its relationship with depressive symptoms, anxiety, and perceived stress among patients undergoing liver transplant evaluation. Patients included 62 adults completing standard pre-transplant assessment measures, including the Stress Mindset Measure–Specific (SMM-S), Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Perceived Stress Scale (PSS). Hierarchical logistic regression analyses indicated that stress mindset was …

Seeing The Unspoken: A Pilot Eye-Tracking Study Of Moral Injury Among Veterans, Eva M. Valdez

Dissertations

This pilot study examined associations between self-reported moral distress, state distress, combat exposure, deployment history, and maximum pupil reactivity among veterans diagnosed with PTSD. Participants viewed neutral and morally relevant images while pupil responses were recorded using eye-tracking technology. Self-report measures included moral distress severity, exposure to potentially morally injurious events, Subjective Units of Distress Scale (SUDS) ratings, total deployments, number of combat deployments, and Combat Exposure Scale scores. Maximum pupil reactivity was calculated by subtracting the mean z-scored maximum pupil response during neutral image presentations from the mean z-scored maximum pupil response during morally relevant image presentations. This variable …

Analysis Of The Cannabinoid Compositions, Byproducts And Heavy Metals In Unregulated Cannabinoid Products By Hplc-Ms/Icp-Ms, Simone K. Melle

All NMU Master's Theses

The rapid expansion of unregulated hemp-derived products has created a need for analytical methods that characterize both cannabinoid composition and contaminant occurrence. This thesis used liquid chromatography-tandem mass spectrometry (LC-MS/MS) to quantify cannabidiol (CBD), Δ8-tetrahydrocannabinol (Δ8-THC), and Δ9-tetrahydrocannabinol (Δ9-THC), and inductively coupled plasma mass spectrometry (ICP-MS) to measure Al, As, Cd, Cr, Cu, Fe, Mg, Ni, Pb, and Zn in commercial hemp-derived products, laboratory-prepared hemp oils, cultivated hemp tissues, extracted material, and post-harvest soil. Commercial products showed wide cannabinoid variability, with several samples containing more than one target cannabinoid, while laboratory-prepared plant oils showed a more consistent profile dominated by …

Recover Well: Reducing Readmissions Through Nurse-Led Follow-Up After Urologic Surgery – A Quality Improvement Project, Candace Brigette Mike

Doctor of Nursing Practice Projects

Hospital readmissions within 30 days following urologic surgeries are often associated with catheter complications, infections, poor pain management, and limited patient understanding of discharge instructions and therefore represent a significant quality and safety concern for patients and institutions alike. The purpose of this quality improvement project was to evaluate whether implementing structured, nurse-led telephone follow-up in conjunction with standard discharge education reduced unplanned 30-day hospital readmissions among adult patients undergoing urologic surgery. Guided by the Logic Model framework, this project used a quasi-experimental, two-group pre- and post-intervention design to compare outcomes at a high-volume outpatient urology clinic in Houston, Texas. …

Utilization Of An On-Site Primary Care Clinic – An Evaluation, Joulvous Jarvis Drake

Doctor of Nursing Practice Projects

Background: Employers incorporate on-site primary care clinics into their workplace health strategies to improve employees’ access to timely care and chronic disease management and reduce absenteeism and healthcare-related costs. Yet despite the demonstrated organizational and health benefits, many worksite clinics experience lower-than-expected utilization. Purpose: This evaluation project aimed to identify the behavioral and structural factors that influenced employee utilization of a corporate on-site primary care clinic. Method: A quantitative, cross-sectional design was used to evaluate the factors contributing to employees’ low utilization of the on-site primary care clinic. Approximately 1,000 eligible full-time employees at a large corporate campus in Texas …