Adolescent Students’ Adaptability During The Covid-19 Pandemic Impacting Their Academic Preparedness In College: A Qualitative Exploration Of Resilience In Secondary School Disruptions, Nicole Tyanne Jameson

Dissertations

This study, conducted several years after the onset of the COVID-19 pandemic, takes a unique approach to investigating the long-term effects of the pandemic-induced disruptions on adolescents during secondary schooling and their academic preparedness in college. The study combined a descriptive qualitative analysis of academic routine data with quantifiable resilience scores, providing a comprehensive understanding of the challenges students faced, their adaptability and resilience, and the overall impact on their education journey into college. This comprehensive descriptive qualitative study utilizes triangulation of quantitative data and qualitative approaches to understand the subject matter thoroughly. The quantitative scores meticulously analyzed resiliency and …

Establishment Of Neonatal Sepsis Predictors Utilizing Non-Invasive Monitoring Techniques, Dalton Janssen

Dissertations

Neonatal sepsis remains one of the leading causes of global neonatal mortality. Reactionary approaches for diagnosis and treatment have dominated the tactics in addressing neonatal sepsis but clinical intuition is an untapped resource that could lead to earlier prediction of sepsis onset. Nurses and other staff with specialized training and experience who have served as routine caregivers for a specific patient are able to identify when the patient’s status is altered. This clinical intuition may be substantiated by referencing specific patient trends in non-invasive measures over time. This retrospective, exploratory study examined whether variation in non-invasive monitoring variables could serve …

Demographic Characteristics And Selected Personality Traits Of Women In Competitive Bodybuilding, Chloe A. Zeeuw

Master's Theses

This study investigated demographic characteristics and measures of personality (dimensions of performance perfectionism and five-factor model characteristics) in women in competitive bodybuilding between 18-25 years old. A total of 24 women completed an online survey which included a demographic questionnaire, the Five Factor Model Rating Form (FFMRF), and the Performance Perfectionism Scale for Sport (PPSS) inventories. Descriptive results for the FFMRF were Openness (18.17±3.12), Conscientiousness (25.58±3.33), Extraversion (19.96±3.46), Agreeableness (19.88±4.58), and Neuroticism (15.67±4.94), and for the PPS-S were Self-oriented performance perfectionism (20.96±3.53), Socially prescribed performance perfectionism (13.96±4.26), and Other-oriented performance perfectionism (10.54±4.23). Pearson’s correlation coefficients and Shapiro-Wilk tests revealed that …

Take 3 For Me: Coping With Occupational Stress In Pediatric Oncology Nursing: Quality Improvement., Alexys Nadeau

Doctor of Nursing Practice Papers

Background: High acuity oncology patients increase RN emotional demands, worsening RN compassion fatigue. RNs are more prone to occupational stress/burnout. Maximizing coping self-efficacy can help nurses deal with occupational stress and burnout.

Environment: Implemented at a hospital caring for a pediatrics in a medium-sized Southeastern US city on the hematology/oncology unit, which serves bi-state counties.

Purpose: This QI project uses a Plan-Do-Study-Act framework to assess the levels of stress experienced, implement a stress management program, reassess the stress levels, and evaluate the program’s effectiveness in improving coping self-efficacy.

Procedures: Nurses received education flyers and emails regarding Take3forMe. Then asked to …

A Quality Improvement Project To Improve Touch Exposures In The Neonatal Intensive Care Unit., Jeremi Tricia Braga

Doctor of Nursing Practice Papers

Introduction: Premature infants in the NICU are exposed to many noxious stimuli that could cause negative effects on development. The SENSE® program has been developed to provide developmentally appropriate sensory stimulation for neonates. This project will focus on sense of touch primarily with KC or also referred to as skin-to-skin.

Environment: This QI project took place in to a Level III NICU at a tertiary medical center in Louisville, Kentucky. The facility has a total of 421 beds including the NICU that is licensed for 34 beds and caring for infants born prematurely as early as 22 weeks to term …

Enhancing Nurse Competence And Self-Efficacy In Delivery Of Medication Education At Discharge: A Quality Improvement Project Using The Teach-Back Method., Quinesia James

Doctor of Nursing Practice Papers

Medication nonadherence in pediatric psychiatric care contributes to worsening symptoms, delayed developmental progress, and increased hospitalizations. Adherence rates remain as low as 30–60%, accounting for up to $300 billion in avoidable healthcare costs annually. Low health literacy and inconsistent education strategies further complicate adherence. This quality improvement project took place on the child and adolescent psychiatric units at the project site, a large teaching hospital in a metropolitan area in the south-central United States, which serves patients aged 5–17 with complex mental health needs. The initiative aimed to improve nurses’ competence, self-efficacy, and time efficiency in delivering medication discharge education …

Improving Collaboration With Hospital Security And Nursing Staff, When Treating Patients In Acute Crisis, By Implementing A Modified Sbar Card., Yuna Choi

Doctor of Nursing Practice Papers

Inpatient psychiatric units provide assistance to patients experiencing acute mental health crises such as psychosis or suicidal ideation. Patients experiencing acute mental health crises can sometimes become agitated or aggressive towards staff, themselves, or other patients, which can pose a significant risk to everyone’s safety. The purpose of the project is to improve staff satisfaction and collaboration by standardizing the interdisciplinary communication between hospital security and nursing staff. Over a period of two weeks, the facilitator educated security and unit staff on a SBAR card during shift huddle to implement on the unit in the event of an acute mental …

A Program Evaluation Of The Pet Therapy Program At Norton Children’S Hospital’S Ackerly Child Psychiatric Unit., Michael Brockman, Michael Brockman

Doctor of Nursing Practice Papers

Pet therapy is an increasingly utilized intervention in psychiatric care, particularly among adolescents. Within the inpatient adolescent psychiatric setting, pet therapy has been linked to reduced anxiety, enhanced emotional regulation, and improved patient engagement. At Norton Children’s Hospital’s Ackerly Child Psychiatric Unit, pet therapy sessions are offered weekly but had not been formally evaluated. The absence of structured evaluation raised concerns about sustainability, consistency, and the program’s therapeutic impact. This project aimed to take a deeper look at the program by conducting a program evaluation of the existing pet therapy initiative at the Ackerly Unit. The evaluation focused on identifying …

Implementation And Rvaluation Of A Mindfulness-Based Intervention On Compassion Fatigue And Depressive Symptoms In Perioperative Nurses: Quality Improvement, Felicia R. Preston

Doctor of Nursing Practice Papers

Background: Compassion fatigue (CF) and depressive symptoms (DS) impair the well-being of nurses worldwide, contributing to mental health conditions, poor patient care, absenteeism and turnover. Perioperative nurses are vulnerable to developing CF and DS due to demanding working environments, continually managing postsurgical pain, complications, and emotionally intensive procedures. Mindfulness-based interventions (MBI) may enhance a nurse's resourcefulness and offer coping strategies against CF and DS.

Purpose: The purpose of this quality improvement (QI) project was to implement the Three Minute Breathing Space (3MBS), a mindfulness-based intervention (MBI) and to evaluate its effects on CF and DS among perioperative nurses.

Methods: …

Reducing Inpatient Falls On A Cardiac Progressive Care Unit: A Quality Improvement Project., Danielle R. Turner

Doctor of Nursing Practice Papers

Background: Inpatient falls are harmful to patients and to the healthcare organization. Fall prevention interventions and strategies are necessary in the acute setting to reduce the number of falls and increase patient safety.

Environment: This quality improvement project will take place at a Midwest acute care hospital on a cardiac PCU. This is a 38-bed unit where there has been an increased number of patient falls.

Purpose: The John Hopkins Evidence Based Practice Model was used to design, implement, and assess a nurse-driven, bedside, visual tool to reduce the number of inpatient falls on a cardiac progressive care unit.

Methods: …

Administrative Leadership Digital Hub To Expand Access To Occupational Therapy For Underserved Veterans ​, Bianca N. Haddock

Department of Occupational Therapy Entry-Level Capstone Projects

This capstone project aimed to address key administrative leadership functions within the Orlando Veterans Affairs Healthcare System through the development of a digital hub supporting interdisciplinary collaboration among allied health services— occupational therapy (OT), recreational therapy (RT), and whole health (WH). The project aimed to close communication gaps that limit Veteran access to rehabilitative services by enhancing administrative coordination, streamlining pre-service implementation documentation, facilitating therapeutic equipment acquisition and training, and promoting service integration.

Adiponectin-Regulated Macrophage Responses In Aspergillus Fumigatus Infection: Mechanisms Of Uptake And Killing, Sri Harshini Goli

All-Inclusive List of Electronic Theses and Dissertations

Invasive aspergillosis (IA), caused by Aspergillus fumigatus, is a life-threatening infection in immunocompromised individuals, necessitating novel host-directed therapies. Macrophages are pivotal in antifungal defense, yet their function can be dysregulated; the influence of the adipokine adiponectin (APN) on this process is not fully understood. This thesis investigated the role of APN signaling in alveolar macrophage (AM) and bone marrow-derived macrophage (BMDM) responses to A. fumigatus and assessed the therapeutic potential of the APN receptor agonist, AdipoRon. Initial studies revealed that genetic deficiency in APN or its receptors renders AMs intrinsically pro-inflammatory and significantly impaired fungicidal activity against A. fumigatus. Subsequent …

The Influence Of High Iq On Adhd Symptom Presentation And Outcomes In Children, David A. Lee

All-Inclusive List of Electronic Theses and Dissertations

Research suggests that a high intelligence quotient (IQ) may contribute to the underdiagnosis and misdiagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) in children. High IQ may allow children to compensate for executive functioning-related deficits inherent in ADHD and/or may influence behaviors such as high activity level or not following rules that mimic ADHD symptoms. To gain a better understanding of the relationship between IQ and ADHD, the present study aimed to investigate how high IQ impacts symptoms of inattention and hyperactivity as well as outcomes related to academic performance, emotional regulation, and peer relationships in children. The study utilized archival data from …

Dermatoglyphic Fluctuating Asymmetry In Schizotypy, Marcus R. Thomas

All-Inclusive List of Electronic Theses and Dissertations

Schizotypy has been linked with many of the proposed endophenotypes of schizophrenia, but research is limited on the relationship between schizotypy and dermatoglyphic fluctuating asymmetry. The present study sought to examine relationships between schizotypy, dermatoglyphic fluctuating asymmetry, handedness, and season of birth. 146 undergraduate students were identified as schizotypes (n = 52) or controls (n = 94) based on the Multidimensional Schizotypy Scale and had their finger and palm prints collected along with completing additional measures of schizotypy and handedness. Schizotypes did not exhibit a greater degree of dermatoglyphic fluctuating asymmetry, negative schizotypy was associated with increased absolute finger ridge …

Caregiver Perceptions, Knowledge, And Likelihood To Intervene With Suicidal Youth, Amber L. Willwerth

All-Inclusive List of Electronic Theses and Dissertations

This study utilized an online survey to target primary caregivers of a child aged 5-18. The survey highlighted factors regarding caregiver involvement in suicide prevention efforts, such as their knowledge, comfort and confidence intervening with a youth experiencing suicidality, and barriers to doing so. It was found that caregivers who had experienced suicide prevention training reported higher levels of comfort and confidence intervening with their own child and another child than those who had not, as well as lower levels of worry. Higher levels of education were also found to predict lower levels of worry, suggesting that further training and …

Factors Associated With Postpartum Depression Among Women Attending Postnatal Clinics In A Tertiary Care Hospital In Nairobi, Kenya, Cecilia Muthoni Njoga

Master of Medicine in Family Medicine

Background 

Postpartum depression (PPD) is a major mental health disorder affecting women during the postpartum period with a global prevalence of up to 17.22%. This prevalence has been shown to be higher in low and middle-income countries. In Kenya, about a fifth of women are affected. PPD can lead to poor infant growth and interference with maternal-child bonding. Additionally, women with PPD experience a lower quality of life and their children have an increased risk of developing and psychotic disorders later in life. Understanding the factors associated with PPD is crucial for early diagnosis and intervention. The study aimed to …

Factors Informing Referral Of Adult Patients To Palliative Care Services In A Tertiary Facility In Kenya: Physicians' Perspective, Donnah A. Opiyo

Master of Medicine in Family Medicine

Background The growing burden of chronic diseases underscores the urgent need for palliative care integration into healthcare systems worldwide. Despite its benefits, palliative care remains underutilized due to various barriers, including health system limitations, institutional challenges, infrastructure gaps, and individual provider factors. However, limited research has explored the specific factors influencing physicians' decisions to refer patients to palliative care. This study sought to fill that gap by examining the key determinants shaping referral practices in a tertiary facility in Kenya.

Design and Methods This exploratory qualitative study examined 22 physician specialists from five departments at Aga Khan University Hospital, Nairobi. …

Specificity Of Interaction Of Antimicrobial Peptide With Cell Membrane, Srishhti Kumar Jha

Pharmaceutical Sciences (MS) Theses

Antimicrobial resistance (AMR) is an increasing global health threat due to its rising incidence worldwide. Resistant microbial infections have become difficult to treat and pose serious risks to patients. In 2019, AMR was responsible for approximately 1.27 million deaths globally, with numbers continuing to rise. The World Health Organization (WHO) has highlighted the urgent need for new antibiotics with novel mechanisms of action and low toxicity to combat this issue. Antimicrobial peptides (AMPs) represent a promising solution. These peptides exhibit broad-spectrum antimicrobial activity and rapid killing kinetics, reducing the likelihood of resistance development. AMPs primarily target bacterial cell membranes. Their …

Incidence Of Peripheral Intravenous Cannula Complications And Associated Factors Among Paediatric Patients At A Tertiary-Care Referral Hospital, Vanessa Minsari Ogega

Master of Medicine in Paediatrics and Child Health

Introduction: Peripheral intravenous catheters (PIVCs) are widely used in clinical practice and are a major source of procedure-related pain in children. Their use is associated with complications including occlusion, dislodgement, infiltration, extravasation, phlebitis, and, rarely, bloodstream infections.

Objectives: To determine the incidence and risk factors associated with PIVC complications among paediatric patients aged 1 day to 18 years at Aga Khan University Hospital, Nairobi. The study also assessed the average survival time of PIVCs.

Methods: A prospective cohort study was conducted on 320 PIVCs among 192 children admitted between August and October 2024. Data collected included patient demographics, clinical characteristics, …

Assessing Medical Decision-Making Capacity: The Importance Of Patient Values., Emilee M. Ertle

Electronic Theses and Dissertations

A medical decision-making capacity (MDC) assessment is the assessment of an individual to determine whether they can make their own medical decisions or if a proxy decision maker must make care decisions on their behalf. These assessments are necessary when individuals experience cognitive impairments which limit their ability to think through complex medical decisions. Best practice for MDC assessments is a growing area of research, with no standard approach to guide assessment planning. The current study builds upon the field’s knowledge of capacity assessments by investigating 1) what methods and measures clinicians utilize in capacity assessments, 2) what factors influence …

Effects Of Perfluorooctane Sulfonate In A Mouse Model Of Alcohol-Associated Liver Disease., Paxton Michelle Brizendine/Ames

Electronic Theses and Dissertations

Perfluorooctane sulfonate (PFOS), a pervasive environmental pollutant, has been increasingly associated with the development of metabolic dysfunction-associated steatotic liver disease (MASLD); nonetheless, its connections with alcohol-associated liver disease (ALD) have not been well studied. This study investigates the hypothesis that PFOS exposure alters hepatic metabolism, thereby leading to alterations in ALD severity. Male C57BL/6J mice were fed isocaloric control or 5% ethanol (EtOH) diet for 15 days. From day 6 of feeding, mice were concurrently gavaged with 1 mg/kg PFOS or 2% Tween-80 vehicle for 10 days, followed by a 5 g/kg EtOH binge dose. PFOS and ethanol co-exposure significantly …

Cbl Regulation Of C-Met Signaling In Corneal Epithelial Cells., Kate Elise Tarvestad Laise

Electronic Theses and Dissertations

The cornea is the most anterior portion of the eye and permits light passage through to retina, allowing formation of a clear image as long as it remains healthy. If the cornea sustains damage, it creates and entrance for foreign body invasion, infection, and ultimately blindness in the immunocompromised eye. Healing the corneal tissue is critical for vision restoration and pain alleviation, as it is the most densely innervated tissue in the body. Growth factors and their cognate receptors are currently under investigation as tools to restore proper corneal physiology. We hypothesize that manipulating the hepatocyte growth factor (HGF) /c-Met …

Metabolic Regulation Of Cardiac Fibroblast Phenotype And Function., Collin Kleis Wells

Electronic Theses and Dissertations

Cardiac fibroblasts are central effectors of cardiac repair after myocardial infarction (MI). In response to signaling cues, they differentiate to a range of phenotypes with robust capacities to synthesize and secrete extracellular matrix (ECM) and signaling molecules. Although activated fibroblast phenotypes are associated with pronounced changes in metabolism, it remains unclear how the metabolic network upholds the effector functions of fibroblasts in the post-infarcted heart. Here, we identified that critical enzymes in the phosphoenolpyruvate (PEP) cycle, i.e. pyruvate kinase muscle-2 (PKM2) and phosphoenolpyruvate carboxykinase-2 (PCK2), are elevated in the heart after MI and examined their role in regulating post-MI remodeling …

Immunopathogenic Crosstalk Between Cancer And The Kidney: A Central Role For Macrophages As Potential Mediators., Dana Hammouri

Electronic Theses and Dissertations

Cisplatin remains a mainstay in the treatment of solid tumors, yet its therapeutic efficacy is frequently compromised by dose-limiting nephrotoxicity. Approximately 30% of patients receiving cisplatin develop acute kidney injury (AKI), which increases the risk of chronic kidney disease (CKD), a leading cause of morbidity and mortality. Despite extensive preclinical efforts, no FDA-approved therapy currently exists to prevent or treat cisplatin-induced nephrotoxicity (CIN). This in part is due to the reliance of preclinical studies on non-cancer animal models that fail to capture the complex physiological alterations associated with malignancy. To address this limitation, we developed a clinically relevant model in …

Intestinal Stromal Cells Play A Critical Role In Protection Mediated By Male Microbiota-Derived Metabolites And Androgens Against Disease In Lupus-Prone Mice., Jing Ma

Electronic Theses and Dissertations

Systemic lupus erythematosus (SLE) is a complex autoimmune disease involving broad immune dysregulation. Despite decades of research, most lupus treatments still have limited effectiveness and can cause serious side effects. Both genetic and environmental factors contribute to lupus susceptibility, and a better understanding of how environmental factors influence disease could guide future therapeutic strategies. SLE shows a strong female predominance. Growing evidence implicates the gut microbiota and sex hormones as key environmental contributors to some autoimmune diseases, including lupus. The gut microbiota can influence host immune function, and interestingly, recent studies have revealed sex-bias in microbiota composition and function. Moreover, …

Mental Health Service Utilization Among Arab/Middle Eastern In The Us: Structural Disparities, Digital Access, And Stigma-Related Barriers., Fatima M. Aldarweesh

Electronic Theses and Dissertations

Arab Middle Eastern (AME) United States (US) college-attending students are more susceptible to disproportionate mental health problems and underutilization of mental healthcare services due to cultural, structural, and psychosocial barriers. The study examines mental health service utilization and mental health outcomes among AME, particularly focusing on the impact of structural, cultural, and psychosocial determinants grounded in Andersen and Aday’s Health Services research model and Corrigan’s stigma framework. The three interconnected aims use secondary nationally representative data from the Healthy Minds Study (HMS) 2019-2024. The study was analyzed using logistic regression and generalized structural equation modeling across three aims to identify …

Role Of Cardiac Ketone Body Metabolism In Myocardial Perfusion And Exercise Performance., Kara R. Gouwens

Electronic Theses and Dissertations

Cardiorespiratory fitness, a crucial determinant of overall health and a strong predictor of all-cause mortality, is largely dependent on the capacity of the cardiovascular system to deliver oxygen and nutrients. The heart, as the central pump, requires a continuous and adaptable oxygen supply, particularly during increased workload such as occurs with exercise. Impaired myocardial blood flow (MBF) in response to increased demand can lead to ischemia, limiting exercise capacity and potentially causing severe cardiac events. Interestingly, changes in myocardial metabolism and cardiac work correlate with changes in MBF. Therefore, understanding the regulation of MBF, especially the link between local cardiac …

Engaging In Movement At Work: Exploring Engagement And Physical Activity., Spencer A. Cavan

Electronic Theses and Dissertations

High levels of employee engagement provide organizations competitive advantages such as increased customer satisfaction, profits, and employee productivity. Despite potential benefits, the number of engaged employees is declining and organizations need to find innovative ways to enhance engagement. Emerging evidence suggests workplace physical activity may generate organizational benefits extending beyond health improvement. Therefore, the purpose of this study was to investigate perceptions of engagement among employees participating in a physical activity intervention at work. A qualitative design, guided by phenomenology, examined perceptions of workplace physical activity and perceived levels of engagement, as well as constraints related to involvement among university …

Improving Antipsychotic Compliance By Addressing Client Experience Of Metabolic Syndrome, Lurinda N. Paulsen

Doctor of Nursing Practice

Abstract

Purpose: This project was undertaken to increase medication adherence in clients diagnosed with mental illnesses that necessitate the use of antipsychotic (second generation, atypical or first generation, typical) medications.

Background: Medication compliance in the treatment of schizophrenia, schizoaffective disorder, and bipolar disorder is essential to ensure consistent medication levels and symptom stabilization. There are many reasons clients stop taking their medications, and symptoms of metabolic syndrome are often a cause for self-discontinuation. Metabolic syndrome is a cluster of symptoms including obesity, hypertension, hyperglycemia, hypoalphalipoproteinemia, and/or hypertriglyceridemia, which increases risk for cardiovascular disease and diabetes.

Methods: This project was completed …

Exploring The Effect Of Social Determinants Of Health (Sdoh) Factors On The Time To Kidney Transplant Evaluation Completion For African American End Stage Renal Disease (Esrd) Patients, Kesha Levesque

MUSC Theses and Dissertations

Purpose – The purpose of this dissertation is to investigate the relationship between demographics and Social Determinants of Health (SDOH) variables on diagnostic testing time completion in patients being evaluated for kidney transplant waitlisting.

Aims - Compared to White Americans, African Americans who are eligible to receive a kidney transplant are less likely to complete the required testing in order to be placed on the kidney transplant waiting list which puts African Americans at risk for morbidity and mortality due to prolonged exposure to dialysis. The COVID-19 pandemic was directly associated with a decrease in the number of patients placed …