Medicine and Health Sciences Commons^™

Active Learning And Nclex-Rn Pass Rate On First Attempt In Bsn And Adn Programs, Janette Tingson

Walden Dissertations and Doctoral Studies

Failing the NCLEX-RN on the first attempt affects not only the students and their families but also nursing programs. To increase NCLEX-RN pass rates, nursing programs are shifting from traditional teaching to active learning in their aim to produce nursing graduates who will pass the NCLEX-RN exams on the first attempt. The purpose of this descriptive, correlational study, guided by theory of constructivism, was to determine if there is a relationship between faculty’s use of active learning strategies (ALS) and nursing students’ NCLEX-RN pass rates on the first attempt in bachelor of science in nursing (BSN) and associate degree in …

Quality Improvement Project Supporting The Novice Nurse Educator Through Onboarding Orientation Practices, Samantha Fouts

Doctor of Nursing Practice Projects

There is a growing concern about a nursing faculty shortage. Many reasons exist, but one primary reason is a lack of support. Literature supports the argument that there is a lack of support for novice nursing faculty during their transition from expert clinician to novice educator. Literature also supports the need for formalized mentor programs, but gaps exist in determining successful models. This quality improvement project aimed to measure the impact on novice nursing faculty skill acquisition in a revised mentor program. The previous mentor program was outdated and lacked consistency. The program was updated using Benner’s novice-to-expert theory and …

Quality Improvement Project Enhancing Nursing Faculty Competency In Dimensional Analysis: A Quality Improvement Initiative, Kimberly Mcdonald

Doctor of Nursing Practice Projects

Medication dosage calculation errors remain a persistent concern in nursing education and practice, often tied to inconsistent teaching methods that leave students unsure and underprepared. Dimensional analysis (DA) has been shown to improve accuracy and confidence in solving dosage problems, yet many faculty have not received structured training in this method. To address that gap, a quality improvement (QI) project introduced a six-week DA training program for nursing faculty in a pre-licensure program. The initiative was guided by the Roy Adaptation Model and Bandura’s Self-Efficacy Theory, with change supported through Kotter’s 8-Step Model and the Plan-Do-Study-Act framework. Using a quasi-experimental, …

Quality Improvement Project Integration Of Mentoring Into A Registered Nurse Transition To Practice Program, Sherry L. Roberson

Doctor of Nursing Practice Projects

New graduate nurses (NGNs), who constitute the majority of the nursing workforce, face significant challenges due to high patient acuity, staffing shortages, and long shifts, resulting in risks of burnout, turnover, and impaired patient care. Transition to practice programs, or nurse residency programs (NRPs), are evidence-based solutions designed to support NGNs effectively in their transition to the profession. A key component of NRPs is mentoring, which provides longitudinal support to ease this transition. Research shows that mentorship is associated with increased feelings of support, self-confidence, resilience, and competence among NGNs, while also reducing stress. A needs assessment at the project …

Quality Improvement Project Diabetes Self-Management Education Training Program, Guylene Lucien

Doctor of Nursing Practice Projects

Diabetes is among the leading causes of morbidity and mortality in the United States; therefore, effective Diabetes Self-Management Education (DSME) is vital in improving patient outcomes. A needs assessment of the Practice site identified gaps in provider confidence and frequency and consistency of delivering DSME that correlated with poor patient adherence and readmissions. The purpose of this quality improvement (QI) project was to implement a structured, evidence-based DSME training program to improve healthcare provider self-efficacy to provide DSME. The project utilized Bandura's Social Cognitive Theory and the ADKAR change model and employed a quasi-experimental, one-group pretest–posttest design. Ten providers (six …

Interleukin-6 (Il-6) Mediated Pathways In Nonalcoholic Fatty Liver Disease (Nafld) And Its Implications On Magnesium And Zinc Mineral Deficiencies: A Scoping Review, Marianne Koleng, Leann Nguyen

Department of Nutrition Student Projects

The prevalence and incidence of Non-Alcoholic Fatty Liver Disease (NAFLD) is rising. In the United States alone, the prevalence of NAFLD is currently 38% and there has been a 50% increase over the last three decades. The present study investigated the role of ultratrace mineral deficiencies, specifically magnesium (Mg) and zinc (Zn), and if so, what nutritional interventions could be made to ameliorate or protect against the development of NAFLD. The role of trace and ultratrace minerals in pro-inflammatory cytokine pathways contributing to NAFLD, specifically Interleukin-6 (IL-6), were investigated. IL-6 is produced by hepatocytes and plays a crucial role in …

Quality Improvement Project Optimizing Opioid Screening: The Impact Of Staff Education In A Pain Management Clinic., Khairunnisa Khan

Doctor of Nursing Practice Projects

Chronic pain is a complex condition that often requires long-term opioid therapy, creating challenges for safe prescribing and patient monitoring. Inadequate screening for opioid misuse risk can contribute to unsafe practices, regulatory noncompliance, and patient harm. Validated instruments such as the Opioid Risk Tool (ORT) and the Current Opioid Misuse Measure (COMM) are available to guide risk assessment, yet their use in everyday practice remains inconsistent. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to evaluate whether targeted staff education improved compliance with opioid risk assessment documentation in a rural pain management clinic. A pre-/post-intervention design was …

Ethnic Disparities In Thoracic Aortic Dissection And Rupture: A Retrospective Analysis Of Hispanic And Non-Hispanic White Populations, Manuel Gutierrez

Yale School of Medicine Physician Associate Program Theses

Background: Aortic dissections and ruptures are even more strongly life-threatening events for patients who are unable to access care promptly. A dissection can reach 50% mortality rate within 24 hours, and a rupture may exceed 90%. Risk factors such as hypertension, genetics, and age play a role in the development of these events; however, few studies have explored whether marginalized groups, such as Hispanics, experience aortic events more frequently. The primary objective of this investigation is to determine whether there is a difference in the frequency of thoracic aortic dissections or ruptures driven by ethnicity in patients from the Yale …

Identifying Factors Linked To A Higher Prevalence Of Posttraumatic Stress Disorder Among Younger Us Military Veterans, Jordan Hathorn

Yale School of Medicine Physician Associate Program Theses

Objectives: Posttraumatic stress disorder is a significant public health concern in the U.S., with military veterans disproportionately affected. Although younger veterans exhibit a higher prevalence of PTSD compared to their older counterparts, the mechanisms driving this age-related difference remain unclear. This study examined sociodemographic, trauma-specific, and psychosocial factors that may contribute to the elevated prevalence of PTSD in younger (age < 50) vs. older (age 50 and older) veterans.

Methods: Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative sample of US military veterans (n=4,069).

Results: Younger veterans were three times more likely to screen positive for PTSD compared to …

Simulation Strategies For Safer Student Medication Administration: A Quality Improvement Project, Rochelle D. Beaver

Doctor of Nursing Practice Projects

Medication administration is an essential skill for nurses, but there are few opportunities for students to practice this skill to prepare for clinical practice. Literature shows that best practice to bridge the gap is simulation. The purpose of this quality improvement project is to implement an evidence-based simulation activity for students. The problem is that not all faculty are trained to teach via simulation. The aim of the project is to increase the nursing faculty’s competence in facilitating a medication administration simulation activity focusing on pre-briefing and debriefing utilizing evidence-based standards from International Nursing Association for Clinical Simulation and Learning. …

Two Essays On Health And Health Behavior In China, Jiamin Tan

Lingnan Theses (MPhil & PhD)

This thesis consists of two empirical studies on elderly mental health and on health behaviors. The first study investigates the long-term impact of childhood hunger on mental health in later life, using data from two nationally representative surveys in China. The study finds that childhood hunger exposure significantly increases the risks of depression and anxiety in later life. These effects are most pronounced among individuals exposed after age 5, suggesting that autobiographical memory formation plays an important role beyond socioeconomic and health pathways. The findings further indicate these impacts can be mitigated through economic interventions, such as welfare programs, and …

Reducing Stigma And Enhancing Outcomes: An Antistigma Education Program For Mental Healthcare Professionals, Chidi Oriaku

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education project that addressed the stigmatization of patients with mental illness (PMI) within psychiatric contexts. The project site healthcare organization’s mental health professionals had a high rate of stigmatization of PMI. Stigma is linked to poor medication adherence rates, delays in accessing healthcare, lower healthcare utilization among PMI, psychiatric morbidity and mortality, and poor quality of life. Despite recognizing this problem, the healthcare organization had no targeted antistigma interventions. I developed an antistigma education to improve outcomes. The practice-focused question was: In mental health staff, will an educational program on …

Staff Education To Improve Knowledge On Facilitation Of Psychoeducational Groups, Kenyett Moody

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Kenyett Moody has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Margaret Harvey, Committee Chairperson, Nursing Faculty Dr. Robert McWhirt, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2025 Background and Purpose: Nurse-led psychoeducation groups are essential for improving patient outcomes by educating individuals about health conditions and coping strategies. In a dual-diagnosed inpatient psychiatric unit, a quality improvement (QI) project …

Experiences With Social Media Social Comparison In Women Ages 18-28: A Qualitative Study, Olivia Oakley Dr.

Dissertations

This qualitative study aimed to understand young women’s experience using social media and their reported mental health connections, such as self-esteem and comparison. As inferred in recent research, a wide range of social media content is being produced and consumed, from promoting the “thin ideal” to newer campaigns advocating for body positivity (Cohen et al., 2019, Grabe et al., 2008; Groesz et al., 2002). In a time where there is so much online content to consume, it is important to continue to evaluate the lived experiences of those using social media. This phenomenological qualitative research captured the lived experiences of …

Staff Education To Increase Knowledge About The Workflow Process, Mwikali Mutia-Lamin

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was conducted to address staff’s lack of knowledge about the workflow process in an outpatient mental health setting. Evidence has shown that staff’s lack of knowledge about workflow processes creates ineffective communication and collaboration in care as well as reduces patient outreach. The practice-focused question was focused on determining whether training staff in an outpatient mental health setting about the organization’s workflow process increased their knowledge on how to use the workflow process in an effort to improve patient care and care outcomes. Thirteen of the 20 staff members participated in this educational …

Postpartum Conversion Type 2 Diabetes In African American Women With Gestational Diabetes, Guerino Tondreau

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) remains a significant public health concern in the United States, with non-Hispanic Black women bearing a disproportionately high burden of the disease. Although this group has a lower overall prevalence of gestational diabetes mellitus (GDM), those who develop GDM face an increased risk of progressing to T2DM. The purpose of this quantitative, correlational study was to explore the relationship between GDM, physical activity, weight status, and T2DM development among non-Hispanic Black women. Secondary data from the National Health and Nutrition Examination Survey, collected from 2017 through March 2020, were analyzed. The health belief model served …

The Relationship Between Language And Musical Skill Development In Individuals With Complex Communication Needs: Implications For Interprofessional Pedagogical And Research Practice, Lisa Pierce-Goldstein

Educational Studies Dissertations

The relationship between music and language has long fascinated scholars and educators. Observational and experimental research has yielded evidence of music’s positive impact on language development. However, research has largely focused on individuals who primarily use speech to communicate. Individuals with complex communication needs (CCNs), who use augmentative and alternative communication (AAC) to communicate, are underrepresented in the literature.

Purpose: The primary purpose of this study is to gain a deeper understanding of the relationship between language development and musical skill development in individuals with complex communication needs using alternative assessment tools: the Communication Matrix (CM; i.e., language) and the …

Will Anyone Play With Me? Building Resilience Through Community Play With Transgender And Gender Diverse Young Adults, Lee Lebeda

Expressive Therapies Theses

The recent increase in anti-trans legislature in the United States has negatively impacted the mental health of transgender young adults nationwide. Current research suggests that creative expression in a group setting may be uniquely suited to help transgender people combat the negative mental health effects of internalized anti-trans messaging. Based on this research, a community engagement project was designed for transgender young adult participants to explore resilience building through drama therapy-informed community play. Three play-based support groups, facilitated by a drama therapy graduate student who identified as a peer to the participants, were offered to transgender young adults in their …

Quality Improvement Project Optimization Of Bed Capacity Management At A Tertiary Pediatric Facility, Barbara M. Stewart

Doctor of Nursing Practice Projects

Emergency department (ED) overcrowding can be defined as a circumstance in which the number of patients seeking care has exceeded the resources available. ED overcrowding can have significant negative impacts on patient safety, quality of care, and hospital finances. The use of an ED saturation measurement is supported by research and widely used in adult emergency departments. The quality improvement project evaluated the correlation between a modified National Emergency Department Crowding Scale (mNEDOCS) and established ED metrics- length of stay (LOS) and left-without-being-seen (LWBS) rates. The intervention was guided by the revised Iowa Model and the Model for Improvement, both …

Staff Education About Cultural Awareness In A Healthcare Setting, Phylis Titty Tarawally

Walden Dissertations and Doctoral Studies

Summary This quality improvement project was carried out to address a practice gap in culturally responsive care among nursing staff working in a skilled nursing facility. African-American residents often face disparities in healthcare due to staff’s limited knowledge of cultural health beliefs and confidence in engaging with diverse populations. To improve this, an educational intervention was designed using the ADDIE instructional model and evaluated to see if it could enhance staff knowledge and confidence related to African-American cultural practices. The project was guided by the practice-focused question: Will a structured African-American cultural awareness program improve staff knowledge and confidence to …

Staff Education To Pediatric Healthcare Providers On How To Prevent Unintentional Childhood Injuries., Peter Cleveland Collins

Walden Dissertations and Doctoral Studies

This staff education quality improvement Doctor of Nursing Practice (DNP) project was focused on teaching pediatric healthcare providers how to provide education during wellness visits to prevent unintentional childhood injury. The practice problem at the clinic was that pediatric providers lacked knowledge about injury prevention. A literature review showed that unintentional childhood injuries are the leading cause of death in this population. The practice-focused question determined was to determine if, after educating providers, they have improved knowledge and intent to educate their patients. I used the analysis, design, development, implementation and evaluation (ADDIE) model to guide this project. The participants …

Radio And Television Media And Health-Seeking Behavior Among Women In Rural Northern Nigeria, Olufolake Akeju

Walden Dissertations and Doctoral Studies

Poor maternal health-seeking behavior (MHSB) has contributed to persistently high maternal mortality in rural northern Nigeria. Despite increasing access to health information via media platforms, little is known about the association between media exposure and MHSB in this region. In this study, the association between mass media exposure (radio and television) and MHSB was investigated using institutional delivery as a proxy. The health belief model was applied as the theoretical framework for this study and sought to answer two key questions focused on whether there is an association between media exposure and MHSB in rural northern Nigeria and what the …

Effects Of Probiotic Lactobacilli On Streptococcus Mutans: Implications For Early Childhood Caries, Walaa Al-Turki

All ETDs from UAB

Effects of Probiotic Lactobacilli on Streptococcus mutans: Implications for Early Childhood Caries WALAA MOHIEDEN AL TURKI DENTISTRY ABSTRACT Purpose: Probiotic Lactobacillus species have been shown to have beneficial effects against early childhood caries (ECC) by inhibiting the growth of cariogenic bacteria. However, the acidogenicity of Lactobacillus spp. could have potential carcinogenic effect. The objective of this study was to investigate the effects of probiotic lactobacilli and cariogenic lactobacilli on the growth, biofilm formation, and acid production of Streptococcus mutans (S. mutans). Methods: Growth competition between probiotic L. rhamnosus GG (L-GG) or caries-associated L. rhamnosus M72-26 (L-M72) and S. mutans UA159 …

Access To Care, Structural Barriers, And Recovery Identity In Mental Health And Substance Use Disorder Treatment, Yahya Alnashri

All ETDs from UAB

Substance use disorders (SUDs) remain one of the most pressing public health and economic challenges in the United States, with growing recognition that recovery is a multidimensional process shaped by clinical, social, and structural factors. This dissertation explores recovery at the levels of health policy, population, and experiential levels to assess gaps in access to recovery support services, identify patterns and predictors of recovery identity, and highlight the lived experiences of individuals with opioid use disorder. First, we evaluated whether state Medicaid expansion under the ACA (2010–2019) was associated with changes in the availability of consumer-run peer support services in …

Identifying Functional Regional Changes In Patients With Parkinson’S Disease And Freezing Of Gait, Taylor Robin Davis

All ETDs from UAB

Freezing of gait (FOG) affects anywhere from 20-80% of those with Parkinson’s Disease (PD) with the prevalence increasing with disease severity and length. This detrimental symptom is unpredictable and poorly characterized, which adds to the negative experience of FOG as it is difficult to treat. Using resting-state fMRI (rs-fMRI), we set out to determine the functional changes in those with PD-FOG and map onto regions of the brain where signal power, measured using fractional amplitude of low-frequency fluctuations (fALFF), synchronicity, as measured by regional homogeneity (ReHo), and strength and direction of intra-network connections as measured by static effective connectivity, are …

Understanding Visual Memory Encoding And The Effects Of Endurance Exercise In Healthy Adults And People With Temporal Lobe Epilepsy, Brandon Steve Mitchell

All ETDs from UAB

The visual memory encoding (VME) of indoor and outdoor scenes is a complex cognitive process that primarily utilizes the bilateral hippocampi and medial temporal lobe (MTL) structures along the parahippocampal gyrus. Alpha and theta frequency band oscillations are important in the processing of visual information and memory formation, respectively. We completed hree studies investigating the cognitive process of VME in healthy adults and people with temporal lobe epilepsy (pwTLE). The first study was cross-sectional and utilized a functional magnetic resonance imaging (fMRI)-constrained magnetoencephalography (MEG) analysis in healthy adults to explore VME. The fMRI results were used as spatial priors to …

Water Absorption, Surface Roughness And Flexural Strength Assessment Of Peek With And Without Aging., Pranjal Ramchandra Daundakr

All ETDs from UAB

Polymethyl methacrylate (PMMA) has been the primary material for complete denture bases since its introduction in 1936 due to its esthetics, affordability, and ease of processing. However, PMMA demonstrates well-documented shortcomings, including relatively low flexural strength, high water absorption, and susceptibility to surface wear. These limitations lead to fractures, loss of occlusal vertical dimension (OVD), frequent relines, and compromised esthetics. Even advanced formats such as CAD-CAM milled and 3D printed PMMA remain prone to dimensional instability, microbial colonization, and long-term degradation. Polyetheretherketone (PEEK), a high-performance thermoplastic originally used in orthopedic and spinal implants, has recently been introduced into dentistry as …

In-Vitro Antimicrobial Activity, Demineralization Inhibition Potential, And Staining Effects Of Three Silver Fluoride Materials, Quiesly Torres

All ETDs from UAB

Background: Dental caries is a worldwide preventable public health problem. It affects any individuals regardless of their gender, age, ethnicity, and socioeconomic status. Silver diamine fluoride (SDF) has been extensively used for preventing cavities, but it has side effects; therefore, some other biocompatible antimicrobial and remineralization-inducing alternative materials have been developed. Purpose: This study aims to assess the in vitro antimicrobial activity, demineralization inhibition potential, and staining effect of SDF, Nano Silver Fluoride (NSF), and silver fluoride + potassium iodide (SF/KI). Methods: Three silver diamine fluoride-based materials were tested: SDF 38% (Advantage Arrest®, Elevate Oral Care, USA), 1500 ppm NSF …

Understanding The Functional Consequence Of Cul3 Deletion In The Mammalian Brain, Prathibha Sekar

All ETDs from UAB

Polyubiquitination is a post-translational modification which often results in degradation of the ubiquitin-tagged protein. E3 ubiquitin ligases are multi-subunit protein complexes that assist in this ubiquitination process. Multiple genes that play a role in ubiquitination are implicated in autism spectrum disorder, a highly heterogeneous neurodevelopmental disorder. CULLIN3 (CUL3), a scaffolding protein part of the E3 ubiquitin ligase complex, is the product of a high-risk autism gene implicated across multiple large scale sequencing studies of autism patients. Additionally, CUL3 haploinsufficiency is associated with a syndromic disorder called NEDAUS (Neurodevelopmental disorder with or without autism or seizures) characterized by intellectual disability (ID), …

An Analysis Of Gamma-Aminobutyric Acid Levels With Structural And Functional Connectivity In Antipsychotic Medication-Naïve First Episode Psychosis Patients, Genelle Dano Samson

All ETDs from UAB

Schizophrenia is a complex psychiatric disorder characterized by hallucinations, delusions, disorganized thinking, and abnormalities in emotional expression, social interaction, and motivation. Cognitive deficits and alterations in perception are core features of psychosis spectrum disorders, though the neurobiological bases of these impairments are not thoroughly understood. Examination of the structures responsible for cognition, along with how their connectivity and neurochemistry are altered in psychosis, is crucial to understanding and treating schizophrenia. Gamma-aminobutyric acid (GABA) is the primary inhibitory neurotransmitter in the central nervous system and plays a crucial role in the regulation of neuronal activity. Evidence from animal models and postmortem …