Dissecting The Heterogeneous Effects Of Opioid Prescribing Limit Laws On Pediatric Mortality: A Multidimensional And Negative Binomial Modeling Approach, Francine R. Vega

Dissertations and Theses (Open Access)

Opioid prescribing for children and adolescents continues to be a significant health crisis in the United States. Early naïve exposure to opioid prescriptions has been linked to later misuse, opioid use disorder, and death. In response to the crisis, many states have implemented opioid prescribing limit laws (OPLLs) aimed at reducing exposure to opioids. These laws vary widely in their approach, including differences in dosage restrictions, prescription duration limits, informed consent requirements, educational provisions, and whether they offer explicit protections specifically for minors. Despite their widespread adoption, there is limited understanding of how heterogeneity in legal regulations affects outcomes for …

Rethinking Health Systems Responsiveness In Low–And Middle-Income Countries, Meesha Iqbal

Dissertations and Theses (Open Access)

Health systems responsiveness (HSR) refers to a health system’s ability to meet legitimate non-health expectations of the population. Traditionally, HSR has been conceptualized across eight domains: respect for dignity, autonomy, confidentiality, prompt attention to health needs, availability of basic amenities, choice of provider, access to social support networks, and clarity of communication. However, as the expectations of populations in high-income countries (HICs) and low- and middle-income countries (L&MICs) differ significantly due to diverse social and cultural contexts, the conceptualization of HSR also varies. We conducted a systematic review of literature to adapt and contextualize the HSR framework for L&MICs based …

Evaluating Quadrupedal Locomotion In Bats: A Geometric Morphometric Comparison Of Vertebral Adaptations Across Mammals, Jessica Upham

Electronic Theses and Dissertations

Flight is the primary locomotion of bats, while quadrupedal locomotion is not often observed and is widely variable among bats. Frugivorous bats in Pteropodidae are more efficient climbers than frugivorous bats in Phyllostomidae and insectivorous bats in Vespertilionidae, while phyllostomids and vespertilionids are better at walking on horizontal surfaces. The aim of this study is to investigate whether bats with differing modes of nonflight locomotion also exhibit disparity in thoracolumbar vertebral morphology. Using geometric morphometrics, we compared the thoracolumbar vertebral shapes of these bat families with other terrestrial and arboreal mammals. The results revealed distinct vertebral shapes among bat families …

Strength Beyond Cancer: An Occupational Therapy Guidebook For African American Breast Cancer Survivors, Taihia A. Wilson

Student Capstone Papers

This capstone project aims to explore the nuanced and often underrepresented experiences of African American women (AAW) who have survived breast cancer (BC), with a specific focus on the recovery phase. By examining the physical, cognitive, and psychosocial obstacles encountered during survivorship, the project seeks to highlight significant gaps in care and support. The primary goal of this project is to develop an accessible and culturally responsive guidebook that provides healthy strategies to enhance quality of life (QoL), promote occupational wellbeing, and empower AAW to manage their overall health beyond treatment. This paper will begin by presenting the background and …

Reentry For Formerly Incarcerated Individuals: A Focus On Workforce Reentry And Recidivism In Appalachia, Margaret E. Francisco

Electronic Theses and Dissertations

Formerly incarcerated individuals face challenges to successful reentry, a critical component of reducing recidivism and improving public health outcomes. These challenges are particularly acute in rural Appalachia, where structural disadvantages such as limited economic opportunities, healthcare access, and public transportation intersect with stigma and systemic barriers related to prior incarceration. This dissertation addresses these gaps through a mixed-methods examination of reentry and recidivism, grounded in public health frameworks and focused on the unique context of rural Appalachia.

This work includes three studies. First, a PRISMA-guided systematic review synthesized qualitative research on barriers and facilitators to employment following incarceration. Findings highlighted …

Rebounds Reconsidered: Exploring Perceived Causes And Consequences Of People's Beliefs About Rebound Relationships, Hunter Krampe

All-Inclusive List of Electronic Theses and Dissertations

Romantic breakups are common and can significantly impact emotional well-being. Many individuals enter rebound relationships despite the prevailing belief that these relationships are disingenuous or unhealthy. While limited empirical research exists, some studies suggest rebound relationships may have positive effects, contradicting common advice. This study examined perceptions of rebound relationships, assessing whether individuals who entered a new relationship shortly after a breakup (3 weeks) were perceived more negatively than those who waited longer (3 months). Using a 2x2 experimental design, participants rated targets on emotional state, personality traits, and expected relationship stability. Results indicated that rebounders were not perceived as …

Sad Music Listening: What Is It Good For? An Exploratory Study Of Motivations For Listening To Sad Music, Ariel Gelfand

All-Inclusive List of Electronic Theses and Dissertations

This study sought to bolster research related to the function of sad music listening. Music listening is a common coping strategy for individuals attempting to cope with and manage different emotional states, including negative or sad moods and emotions. Research surrounding self-reported reasons or motivations for listening to sad music outlines several factors that appear to serve as mood-management strategies. However, there are discrepancies among these motivations across research, which thus far has consisted of qualitative interviews of participants. (Garrido & Schubert, 2011; Saarikallio & Ekkila, 2007; Van den Tol & Edwards, 2013). Additionally, it is unclear whether listening to …

Advanced Interactions Of Directed Energy With Retinal Pigment Epithelial Cells And Their Photochemical And Photothermal Responses, Jin B. Ha

Theses & Dissertations

Excess optical radiation can injure the retina through either rapid heat deposition (photothermal damage) or cumulative photo‑oxidative stress (photochemical damage), yet current laser‑safety limits treat these mechanisms as independent. To test that assumption, this dissertation integrated systematic wavelength, duration and temperature‑controlled laser exposures with live/dead fluorescence imaging in a melanin‑loaded hTERT‑RPE1 monolayer model. First, concurrent 447 nm (blue) and 2 µm (infra‑red) beams delivered for 200 s demonstrated a strong thermal–photochemical synergy: each beam alone was sub‑threshold (≤25 % lethality) but together produced 100 % RPE death without exceeding 50 °C, proving that modest heating markedly lowers the photon dose …

Improving The Screening And Management Process For Mental Health Disorders And Health Risk Behaviors In College-Age Students: A Quality Improvement Project, Brooke L. Styslinger

Doctor of Nursing Practice (DNP) Manuscripts

Establishing a standardized electronic screening process for mental health disorders and health risk behaviors is crucial for early identification and intervention before poor outcomes occur. This quality improvement project addresses a gap in care relating to screening practices in a college health services office which primarily relied on a provider-based interview screening processes in students reporting for care. Pre-implementation data showed providers most often screened for Major Depressive Disorder (MDD), alcohol use, and drug use, with inconsistent screening for Generalized Anxiety Disorder (GAD) or tobacco/vaping use. Follow-up screening form administration was also inconsistent, only given 3.3% of the time for …

Analyzing The Impact Of Interactive Home Monitoring On Congestive Heart Failure Readmissions: A Program Evaluation, Josh C. Riggs

Doctor of Nursing Practice (DNP) Manuscripts

Hospital readmissions are described as a situation in which a patient is admitted to a hospital within 30-days of being discharged from an earlier inpatient stay and is a critical indicator of care, contributing heavily to the rising healthcare costs in the United States. Heart failure is one of the leading contributors to 30-day hospital readmissions, prompting healthcare organizations to develop and implement policies aimed at reducing these occurrences. This program evaluation examined the effectiveness of the University of Virginia’s (UVA) Interactive Home Monitoring (IHM) program at reducing 30-day hospital readmission rates among patients diagnosed with heart failure (HF). Utilizing …

Associations Between Mental Health Outcomes And Discrimination And Victimization Among Adult Lgbtq+ Community Members Or Guardians Of Lgbtq+ Children, 2023-2024, Perla Gisel Mercado

Open Access Theses & Dissertations

BACKGROUND: LGBTQ youth face unique challenges and experiences that can significantly impact their mental well-being. Discrimination, stigma, prejudice, and struggle for self-acceptance contribute to increased rates of mental health issues within this population. Almost one in 8 people, or 970 million individuals worldwide, were living with a mental disorder. PURPOSE: Assess the relationship between discrimination and victimization and mental health outcomes among sexual and gender minorities (SGMs) in the Paso del Norte Region. METHODS: Data was collected through a cross-sectional needs assessment survey among adult LGBTQ+ community members or parents/guardians of LGBTQ+ children/youth living in New Mexico or Texas in …

Regulation Of Icer Degradation And Its Role In Melanoma, Justin Wheelan

Theses, Dissertations and Culminating Projects

Melanoma is the deadliest form of skin cancer, with 100,640 new cases and 8,290 deaths estimated in the United States in 2024. While targeted therapies and immunotherapy have improved patient outcomes, resistance remains a major challenge, necessitating new therapeutic approaches. Approximately 50% of melanomas harbor BRAFⱽ⁶⁰⁰ᴱ mutations, leading to constitutive MAPK pathway activation. Targeted small molecule therapies such as BRAF and MEK inhibitors are available and initially reduce tumor burden, however resistance frequently occurs, likely through many pathways including compensatory activation of cAMP signaling. ICER (Inducible cAMP Early Repressor), a transcriptional repressor of CREB-mediated gene expression, is absent in melanoma …

Machine Learning Based Medical Ultrasound Image Classification And Grad-Cam Interpretation, Victoria C. Hemphill

All Theses

This work takes a step in creating a diagnostic tool for the classification decision process of Achilles tendinopathy using ultrasound images. An attention-based multiple instance learning model is developed to classify the images. Typically, doctors capture multiple ultrasound images of the Achilles tendon during a study to determine a complete diagnosis. Multiple instance models adopt this behavior by providing a single label for a set of instances (images). The images are grouped into ”bags” at the study level and passed into the model. The MIL model then uses its attention property to assign an importance score to each image to …

Polyphenols For The Mitigation Of Vascular Calcification; In Vitro And In Vivo Studies, Abdullah Altuhami

All Theses

Globally, cardiovascular diseases, in most cases associated with calcification, are the main cause of death. However, currently, the only effective cure is to undergo surgery to augment or receive a healthy donor heart, which could be very difficult due to the long waiting list and the associated risks. The possibility of body rejection of the foreign organs is attributed to immunoreaction or the risk of infection, since the donor must be on immunosuppressant drugs that lower the body's immunity and facilitate the body's acceptance of the new organ as one of its own. Taking that into consideration, using tissue-engineered vascular …

Markerless Clinical Gait Identification Using Computer Vision Techniques And Artificial Intelligence, Katelyn Conroy

Open Access Theses & Dissertations

Pose estimation algorithms could provide an unbiased examination for diagnosis, progression, and rehabilitation. PURPOSE: The purpose of this study was 1) to critically identify and appraise literature investigating spatiotemporal and kinematic gait characteristics in individuals with idiopathic Parkinson's Disease and spastic diplegic Cerebral Palsy compared to healthy controls; 2) to examine the validity and reliability of spatiotemporal gait characteristics and upper- and lower-body joint kinematics of OpenPose and the agreement with marker-based motion capture in healthy individuals; and 3) to examine the sensitivity, specificity and predictive values of a proposed clinical diagnostic tool using OpenPose in the diagnosis of idiopathic …

Quality Improvement Project Advancing Success In Nursing Education: An Evidence-Based Approach To Remediation, Jessica Wilson

Doctor of Nursing Practice Projects

Nursing education requires intense academic work, which creates specific obstacles for learner achievement. The improvement of academic results in BSN 346 and similar high-stakes courses remains essential for maintaining learner retention, graduation success, and practice readiness. This quality improvement project assessed how evidence-based remediation with structured implementation compared to traditional voluntary remediation methods. The research investigated whether faculty-led evidence-based remediation meetings would enhance BSN 346 learner success through concept map score assessment. A retrospective pre-/post-intervention study analyzed concept map performance between two learner groups from Spring 2025, who received standard remediation, and Summer 2025, who received structured remediation. The researchers …

Anxiety During Perimenopause: A Narrative Qualitative Study Of The Women’S Lived Experiences, Kayla Mcelhany

Dissertations and Theses (Open Access)

Abstract

Objectives: Perimenopause has been associated with increased anxiety symptoms. However, data is lacking regarding the experiences of women with perimenopausal anxiety and the contributing factors to worsening anxiety symptoms. We explored the experiences of women with self-reported new onset or worsening of anxiety symptoms during perimenopause to better understand contributing factors.

Study design: Twenty women participated in one-on-one interviews to explore experiences of perimenopausal anxiety in the context of their daily lives and perimenopausal physical changes. Inductive thematic analysis was used to develop codes and themes from the transcribed interview data. Analysis was done using MAXQDA software.

Main …

How Was Rehab? A Follow-Up To A Randomized Effectiveness Control Trial Of A Brief Acceptance And Commitment Therapy Protocol For Inpatient Detoxification Patients, Alexander J. Twohy

Dissertations

Residential treatment for Substance Use Disorders (SUD) is a common treatment modality. However, the literature is sparse on modifiable predictors that affect change during the residential treatment stay. Acceptance and Commitment Therapy (ACT) has been shown to be an effective treatment for SUDs. Weststrate et al. (2023), in a randomized controlled effectiveness trial, compared ACT plus medication management to medication management during detoxification. The addition of ACT increased consumer satisfaction and ACT skills use, while decreasing psychological inflexibility and reducing withdrawal symptoms.

This study explored whether the brief ACT intervention had impacts during participants' subsequent residential stay. Forty out of …

Exploring Adverse Childhood Experiences And Bullying Of Children Who Are Deaf Or Hard Of Hearing, Alyson Connelly Ward

All Graduate Theses and Dissertations, Fall 2023 to Present

Adverse childhood experiences (ACEs) and bullying can lead to psychological distress, causing both short- and long-term health and mental health problems. Children with special healthcare needs (CSHCN), including those who are deaf or hard of hearing (DHH), face a higher risk of ACEs and bullying, which can affect their well-being.

This study builds on existing literature by (a) reviewing ACEs and bullying in CSHCN, especially those who are DHH, and (b) using data from the 2016-2022 National Survey of Children's Health to analyze ACEs and bullying in children who are DHH, DHH+CSHCN, and CSHCN. The literature review found that disability …

Diagnostic Accuracy Of The Stopbang Questionnaire Against Polysomnography For The Screening Of Obstructive Sleep Apnea In A Tertiary Hospital In Kenya., Sandra Obaje Maseno

Master of Medicine in Internal Medicine

BACKGROUND: Obstructive sleep apnea is a syndrome of upper airway and neuromuscular dysfunction during sleep that subsequently causes interruption of normal breathing. Polysomnography is the reference test for the diagnosis of obstructive sleep apnea. Obstructive sleep apnea can be categorised as mild, moderate or severe based on an apnea-hypopnea index (AHI) on polysomnography. The recommended treatment using Continuous Positive Airway Pressure lowers morbidity and mortality rates. The STOPBANG questionnaire has been used as a screening tool for obstructive sleep apnea due to its easy and concise approach. However, even with the increasing prevalence of obstructive sleep apnea and its risk …

Perception And Experiences With Telemedicine Among Caregivers Of Children Requiring Outpatient Chronic Care, Maureen Wambui Kigara

Master of Medicine in Paediatrics and Child Health

Introduction Telemedicine is an expanding healthcare modality with potential to enhance access to paediatric specialist care, reduce healthcare costs, and minimize school and work disruptions. However, little is known about caregiver perceptions and experiences with telemedicine in low- and middle-income countries, especially in the context of chronic paediatric care.

Objectives This study explored how caregivers of children with chronic health conditions perceive and experience telemedicine, and what factors influence its adoption. The findings aim to inform the design of patient-centered paediatric telemedicine services.

Methodology A cross-sectional qualitative study was conducted at the Paediatric Specialist Clinics of Aga Khan University Hospital. …

Reducing Suicide Ideation Through Healthcare Provider Training In The Use Of The Columbia Suicide Severity Rating Scale (C-Ssrs) In A Rural Community Mental Health Clinic, Lashunda R. Lewis

Doctoral Projects

This doctoral project aimed to address the inconsistent and inadequate assessment of suicide risk by healthcare professionals in a Rural Community Clinic. Staff members do not comprehensively understand the Columbia-Suicide Severity Rating Scale and vary in how they screen patients before the intervention. When we looked at the baseline, we found that only 45% of charts contained suicide risk screening, and C-SSRS was used in only 5% of cases. Some of the main obstacles reported were not properly training staff and keeping patients from sharing their thoughts on this subject.

The main objective of the doctoral project was to test …

An Evaluation Of Training Strategies Among Healthcare Professionals During The Covid-19 Pandemic: A Cross-Sectional Survey Study, Darshani D. Singh

Theses & Dissertations

Background: During Spring 2020, the COVID-19 pandemic temporarily displaced healthcare workers from suspended clinical work areas to inpatient critical care areas. Nurses were rapidly uptrained for unfamiliar roles in critical care using a variety of instructional formats.

Purpose: The purpose of this survey study was to evaluate the effectiveness of eight training strategies on healthcare workers' perceived competence, confidence, and satisfaction during the first wave of the COVID-19 pandemic.

Methods: This cross-sectional, retrospective, investigator-developed survey study examined the effectiveness of eight training strategies used during the COVID-19 pandemic on three outcomes for professional registered nurses. The three outcomes were self-reports …

A Tale Of Two Toxicants: Investigating The Interaction Between Hexavalent Chromium And Perfluorooctane Sulfonic Acid., Morgan Elizabeth Delnicki

Electronic Theses and Dissertations

Hexavalent chromium [Cr(VI)] and per- and polyfluoroalkyl substances (PFAS) are environmental contaminants of major public health concern. Despite commonly being found together in contaminated drinking water, no studies have considered the concomitant health effects of Cr(VI) and PFAS, specifically perfluorooctane sulfonic acid (PFOS). In vitro studies using CHO cells assessed the cytotoxicity and genotoxicity of Cr(VI) and PFAS both individually and in combination. Intracellular and extracellular Cr levels were measured with Atomic Absorption Spectrometry. PFOS was found to exacerbate Cr(VI) induced cytotoxicity and genotoxicity. Additionally, a novel in vivo model of studying the hepatotoxicity of Cr(VI) was established. Adult Hartley …

Exploring Hexavalent Chromium Exposure And Lipid Accumulation In Liver Disease., Gabrielle Celine Griffin

Electronic Theses and Dissertations

The prevalence of MASLD has doubled over the past 20 years and continues to rise. Hexavalent chromium [Cr(VI)], a top chemical hazard in U.S. drinking water, is emerging as potential risk factor for liver disease. To study the impact of Cr(VI) and high-fat diet on MASLD, we developed an in vivo model using Sprague-Dawley rats exposed to Cr(VI) in drinking water (0, 0.05, or 0.1 mg/L) and fed normal or high-fat diet for 90 days. High-fat diet significantly increased body mass, plasma lipoproteins, cholesterol, liver injury, and hepatic triglycerides, which were exacerbated by Cr(VI) exposure. Cr(VI) alone increased hepatic chromium …

Integrating Bulk And Single-Cell Transcriptomics To Investigate Intratumor Heterogeneity, Shuai Guo

Dissertations and Theses (Open Access)

Cancers are heterogeneous mixtures of tumor and surrounding cells, where each component comprises multiple distinct sub-types and/or states. Understanding the cell-type-specific contributions is critical for advancing cancer biology, yet high-throughput expression profiles from tumor tissues only represent combined signals from all diverse cellular sources. Bulk deconvolution with single-cell/nucleus (sc/sn) RNA-seq data has emerged as a powerful approach to dissect both cellular composition and cell-type-specific expression patterns, yet the technological discrepancy across sequencing platforms limits accuracy.

To systematically evaluate the impact of platform discrepancies on bulk deconvolution, we first generated a benchmark dataset of 24 healthy retinas with paired bulk and …

College Students And Wearable Health Technology: A Study On Digital Health Literacy, Gavin Wright

Undergraduate Honors Thesis Collection

The market for wearable devices has seen significant growth in the last decade and is only expected to increase as the world enters a new age of health literacy known as digital health literacy. Digital health literacy, or eHealth literacy, is defined as “the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem.” The issue with this new age is that most consumers have access, but lack the ability to apply the knowledge that they must improve their health. The goal of this study is …

Therapeutic Potential Of Sglt2 Inhibitors In A Repeated Love Dose Cisplatin Model., Dianet C. Sanchez

Electronic Theses and Dissertations

Cisplatin is a potent chemotherapeutic, thirty percent of patients develop Acute Kidney Injury (AKI). These patients are ten times more likely to develop chronic kidney disease (CKD). Sodium-glucose-cotransporter-2-inhibitors (SGLT2i), FDA approved for diabetes, has shown protection in multiple mouse models of AKI-CKD. We hypothesize SGLT2i can protect the kidney in a model of repeated low dose cisplatin with/without cancer. B6:129 mice with/without lung adenocarcinoma (Lung-adeno) were treated daily with SGLT2i dapagliflozin (10mg/kg)/vehicle control. After seven days, weekly cisplatin (7mg/kg)/vehicle control was initiated for 3-4 weeks. Following final cisplatin dose, kidney function, injury, fibrosis, inflammation was assessed. SGLT2i treatment attenuated alterations …

Effects Of Training With Different Set-Repetition Configurations On High-Intensity Exercise Endurance And Acute Recoverability, Wesley Gawel

Electronic Theses and Dissertations

This study aimed to evaluate how high- (3x10) versus low-repetition (3x2) resistance training affects (1) muscular strength-endurance and (2) immediate recovery after a high-intensity exercise effort (HIEE). Fourteen college-aged participants (10 males: 24.5 ± 4.9 yrs, 1.76 ± 0.05 m, 86.56 ± 6.90 kg; 4 females: 23.0 ± 2.8 yrs, 1.58 ± 0.09 m, 62.19 ± 5.96 kg) completed a 4-week training program and were divided into two groups: G2 (3x2; 5 males, 2 females) and G10 (3x10; 5 males, 2 females). All subjects performed back squats to failure at 67.5% of baseline 1RM. Repetitions (REPS) and volume load with …

The Effect Of An Acute Bout Of Rock Climbing On Cognitive Functioning And Cortisol Levels, Vanessa Steigauf

All NMU Master's Theses

Rock climbing is an understudied physical activity (PA) that demands active decision-making, integration of sensory and visual input, and continuous regulation of nervous system activity to produce complex motor outputs. The unique psychological demands of climbing warrant studying its effect on cognition and brain health. I recruited 26 generally healthy adults for a randomized-controlled study. Climbing experience, PA and perceived stress were self-reported. Each participant was randomly assigned to a climbing (10x2 minutes climb, moderate intensity) or control group (seated, watching climbing-related video). The primary outcomes, cognitive performance and salivary cortisol levels were assessed by the Stroop test. A linear …