Medicine and Health Sciences Commons^™

Beyond The Genome: The Racialized Exposome, Flourishing, And Stress Biology In African Americans, A Non-Exhaustive Review, Enye Washington

University Honors Theses

Racial health disparities remain an enduring challenge in the United States, disproportionately impacting African American communities through higher rates of chronic disease and premature mortality. This non-exhaustive literature explores how the racialized exposome - a term denoting the totality of social, environmental, and structural stressors rooted in systemic racism - biologically embeds itself via stress-responsive pathways. Specifically, it examines the interaction between racial stress, flourishing, and key biological markers, including allostatic load and telomere length, considering the gut-brain axis. The review highlights robust evidence that chronic exposure to racial discrimination and structural adversity contributes to multisystem dysregulation and accelerated cellular …

The Role Of Neuroscience In Mental Health Management Within The Adhd Population, Kadi Rae Smith

University Honors Theses

Neuroscience-based educational interventions play a role in the management of Attention Deficit Hyperactive Disorder (ADHD), including the regulation of ADHD-correlated depression and anxiety. Existing research shows that elevated rates of depression correspond to anxiety within the ADHD community; approximately 8.83% of the global population. Social ostracization and isolation are established contributors to depression and anxiety which are commonly comorbid with ADHD. The need exists for further investigation of the beneficial impact that an accurate, biological understanding of how the brain works has on the mental health of the ADHD population, and by extension their families, education systems, and medical industries. …

Trauma In The Middle Ages: The Viking Experience Of Trauma Through Saga, Kagan L. Vogt

University Honors Theses

Trauma is a fundamental part of human experience and the ways in which human beings experience trauma differs drastically depending on the time and culture represented. Research on trauma in the Middle Ages does exist, however, often offers windows into very narrow intersections within the study of historical trauma. Other cultures and particularly oral traditions lack the same attention from scholars in trauma. The specific experience of Vikings as referenced in the oral tradition of sagas offers a unique window into the traumatic experience of Vikings as well as how they responded to trauma. This unique response to trauma is …

Advancing Novel Contrast Agents For Applications In Fluorescence-Guided Neurosurgery Using Fluorescence Cryotomography, Augustino Vittorio Scorzo

Dartmouth College Ph.D Dissertations

Fluorescence guided surgery (FGS) is an emerging surgical technique that aims to help surgeons identify tissue types to assist in surgical decision making - ideally providing “cut-by-color” guidance. A primary application for this approach is the identification of tumor tissue to achieve more accurate and complete tumor removal while simultaneously minimizing damage to surrounding normal tissue. The cornerstone of tumor visualization for FGS is the administration of fluorescent contrast agents, or in some cases metabolic precursors, designed to accumulate specifically in tumor tissue, and a wide range of agents that use different targeting mechanisms are currently under investigation. Although these …

Humanizing The Icu: Implementation Of Personalized Communication Boards In The Sicu Drives Enhanced Patient And Family Experience, Stephen D. Hoefler

Master's Theses

Objective: Research has established the importance of personalized communication in critical care settings, where standardized tools like whiteboards can improve patient and family engagement.

Aim: This project aims to develop a personalized communication board in the surgical intensive care unit (SICU) at a Bay Area academic quaternary care facility that, once implemented, will achieve at least 75% utilization in patient rooms by May 2025, enhancing communication and patient experiences.

Methods: Surveys were conducted with patients, families, and staff to gather stakeholder input and guide the design of a new standardized whiteboard model with personalized elements. Results: Based on stakeholder feedback, …

Mechanistic Insights Into The Flash Effect: The Role Of Oxygen And Radiation Chemistry In Ultra-High Dose Rate Radiation Therapy, Jacob Pierce Sunnerberg

Dartmouth College Ph.D Dissertations

The development of new cancer therapies focuses on widening the therapeutic ratio between tumor control and normal tissue toxicity. Over the last decade, ultra-high dose rate (UHDR) radiation therapy, commonly known as FLASH radiotherapy (FLASH-RT), has shown promising potential to reduce normal tissue toxicity while maintaining tumor control. However, the underlying mechanisms of the FLASH effect remain poorly understood. This thesis explores the radiation-chemical basis of FLASH-RT, focusing on the role of oxygen and reactive oxygen species in modulating biological outcomes.

A comprehensive set of in vitro studies demonstrated that UHDR delivery significantly alters radiation chemistry compared to conventional dose …

The Potential For Improv As A Therapeutic Tool In The Context Of Dialectical Behavior Therapy: Suggestions For Dbt Clinicians, Jocelyn Borden

University Honors Theses

This thesis explores the theoretical and practical intersections between improvisational theater and Dialectical Behavior Therapy (DBT), proposing that the core tenets of improv closely align with the philosophical foundation and therapeutic goals of DBT. Aimed at mental health professionals, this work provides a conceptual framework and praxis for incorporating improv-based activities into DBT skills training to enhance client engagement, experiential learning, and emotional resilience. Through an examination of improv theory, parallels with DBT principles, and practical suggestions for integration, the thesis outlines how applied improvisation can be used as a supplemental tool in traditional DBT treatment. The final section includes …

How Do Montessori-Based Activities Affect Behaviors For Older People With Dementia: A Literature Review, Isabel Quigley

University Honors Theses

Objectives: This literature review is meant to analyze the development on the research on Montessori-based activities for adults with dementia.

Introduction: Baby Boomers are the largest generation to enter senior age (65+) in history due to the advancement in medicine to increase life expectancy. Dementia is a neurocognitive disease that affects parts of the brain related to memory and signs typically surface around 65 years old. Dementia is not considered healthy aging. Montessori-based activities have been recently developed as an intervention to encourage a feeling of accomplishment and success for adults with dementia.

Methods: Two electronic databases …

Development Of Preventive Dental Guidelines In The Primary Healthcare Setting In Egypt: A Delphi Method, Basant Mehriz

Theses and Dissertations

This study addresses the critical need for standardized preventive dental care guidelines within Egypt's primary healthcare system amid the rising burden of oral diseases. Through a systematic two-phase methodology combining a comprehensive literature review and a Delphi consensus-building process engaging 35 dental professionals, the research established priorities for contextually appropriate preventive measures. The consensus framework revealed strong support for clinical interventions (mean of 83% agreement), particularly fluoride-based prevention; community initiatives (mean of 83%), especially school-based programs; policy measures (mean of 77%) such as workforce and educational development, though with variable support for taxation and social determinants approaches. Statistical analysis demonstrated …

The Dubr/Mir-210-5p/Retsat Axis In Cholesterol-Associated Steatohepatitis: Clinical Signatures And Molecular Mechanisms, Hana Mahmoud Abdelzaher

Theses and Dissertations

Metabolic-associated fatty liver disease (MAFLD) represents an increasing global health challenge, with cholesterol-associated steatohepatitis (CASH) emerging as a distinct pathological entity warranting investigation. While CASH demonstrates unique features compared to traditional triglyceride-driven steatohepatitis, its underlying molecular mechanisms remain poorly understood. This study investigates a novel regulatory axis involving DPPA2 Upstream Binding RNA (DUBR), miR-210-5p, and retinol saturase (RETSAT). 170 patient samples revealed progressive axis dysregulation in disease states, with RETSAT emerging as a highly accurate diagnostic marker (AUC=1.000). Using novel in vitro models of MASH and CASH, we demonstrated that miR-210-5p modulation significantly affects lipid accumulation and cellular phenotype, with …

Urban-Rural Divide In Inequality’S Impact On Substance Abuse, Jonathan E. Flores

Undergraduate Theses, Capstones, and Recitals

This thesis focuses on investigating the relationship between income inequality, measured through the Gini coefficient, and drug addiction, proxied through substance-related mortality. Specifically, this thesis focuses on how these dynamics vary across rural and urban counties in the United States, using population size as a proxy. County-level data from 2016 to 2020 were collected through both the CDC and the Census Bureau and subsequently analyzed using Stata, with crude death rates from drug and alcohol causes serving as a function of the Gini coefficient, labor force participation, racial composition, and other socioeconomic indicators. Through a quadratic version of the model, …

Together We Thrive: A Co-Production Toolkit For People With Ms And Care Providers, E. Chandlee Bryan

Dartmouth College Master’s Theses

Nearly a million people in the U.S. have Multiple Sclerosis (MS), a progressive neurological disease. People with MS (PwMS), are more likely to have a decreased quality of life (QoL) and are at greater risk for unemployment, loneliness, and depression than people without MS. As MS symptoms can include fatigue, balance issues, mobility problems, and changes to bladder and bowel function, managing MS requires patient engagement that includes coordination of care between neurology, primary care, and specialists. This thesis was researched and written by a PwMS who has worked in collaboration with her neurologist, Dr. Andrew D. Smith III, and …

Intrapersonal And Interpersonal Factors Of Participation In Physical Activity And Resistance Training In Adolescent Girls: A Narrative Review, Ben Banse-Fay

University Honors Theses

Low rates of participation in physical activity and resistance training among adolescent girls are a concern due to increased health and injury risks. Adolescent girls participate in physical activity and resistance training at a lower rate than boys, which may explain higher rates of injury. Research examining physical activity of adolescent girls often utilizes an ecological framework, identifying intrapersonal, interpersonal, and environmental factors. Of these ecological levels, intrapersonal and interpersonal factors are modifiable without large costs.

Therefore, this review aimed to identify and summarize recent research that explores the intrapersonal and interpersonal factors associated with participation in physical activity and …

How Different Forms Of Exercise Affect Bone Mineral Density In Postmenopausal Women, Jonathan Mccanless

University Honors Theses

This paper analyzed 20 studies to understand how bone health in postmenopausal women is impacted by different forms of exercise. The primary aspect of bone health examined in this paper is bone mineral density (BMD). Resistance and impact training demonstrated clear signs of maintenance and increases in BMD, particularly in the lumbar spine and femoral neck. Aquatic exercise demonstrated mixed results in positively impacting BMD in a significant way, but it’s worth noting that there were still some signs of increased BMD. Impact exercise on its own can maintain BMD, and these effects can be seen in total hip BMD. …

The Role Of Adolescent Depression Heterogeneity And Resilience Resources In Adulthood Cardiometabolic Health And Depressive Symptoms, Samantha R. Scott

Electronic Theses and Dissertations

Depression in adolescence is a major public health problem and is a risk factor for early-onset cardiometabolic disease. Although adolescent depression is a risk factor for poor cardiometabolic health, depression is heterogeneous and associations may differ by sex. Additionally, if risk factors such as depression can predict adulthood cardiometabolic health, resilience factors (e.g., social, school, neighborhood) that are protective for depression may also be protective for physical health, but this is an ongoing area of research. The goals of the current dissertation were to gain a better understanding of what depressive symptom presentations in adolescents are most concerning for adulthood …

Representation Of Diseases And Health Care In Selected African Gyno-Texts, Rachael K. Aderoju

Electronic Theses and Dissertations

This study explores the interdisciplinary field of literature and medicine through a feminist psychoanalytic lens, focusing on how Nigerian female writers represent illness, healthcare, and medical ethics in post-independence gyno-texts. Traditionally, scholarship in this field has centered on andro-texts (literary works authored by men), leaving a critical gap in the exploration of women’s perspectives. This research addresses that gap by analyzing nine prose works authored by Nigerian women, including texts by Chimamanda Ngozi Adichie, Ayobami Adebayo, Lola Shoneyin, and Samira Haruna Sanusi. These texts are examined for their portrayal of diseases such as infertility, cancer, bipolar disorder, and renal failure, …

A Clinical Practice Guideline For Enhanced Rehabilitation Assessment In Poststroke Patients, Chanda Honeywood

Walden Dissertations and Doctoral Studies

This doctoral project aimed to develop clinical practice guidelines (CPG) to strengthen the assessment of poststroke patients for rehabilitation. The project sought to adopt an evidence-based approach to develop standardized recommendations that can help in the timely and appropriate rehabilitation of stroke survivors, thereby reducing the risk of long-term disability and readmissions. Stroke is a significant cause of disability and poor functional recovery, increased healthcare costs, and lower quality of life for patients occur because of poor rehabilitation assessment. While rehabilitation protocols already exist, discrepancies in patient evaluations result in intervention delays and ineffective uptake of rehabilitation programs, limiting the …

Review: The Impact Of Insurance Policy On Glp-1 Agonist Treatment, Sunsik Chang

Harrisburg University Dissertations and Theses

This study examines how healthcare system design influences access, adherence, and financial burden associated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in high-income countries. Through a literature review of peer-reviewed articles published between 2020 and 2025, it compares outcomes across universal and multi-payer systems. Findings reveal significant disparities. For example, the 12-month persistence reaches 68% in centralized systems like Denmark, but falls to 32–46% in the U.S., largely due to financial burdens, insurance denials, and administrative barriers. Among uninsured U.S. patients, 45% report significant financial hardship while using GLP-1 RA therapy. However, only 20% of patients enrolled in high-deductible health …

Using The Token Economy To Improve Show Rates In An Outpatient/Community Mental Health Clinic, Gertrude Nabila Ndansi

Walden Dissertations and Doctoral Studies

The type of project was a quality improvement intervention. The identified practice problem was limited appointment shows among patients with appointments. Outpatient clinics often struggle with patients not showing up for appointments. Addressing this gap was critical for improving patient outcomes and resource efficiency. The practice problem must be addressed within the context of nursing practice by enhancing access to consistent mental health care and giving patients more timely support, leading to better outcomes and overall wellbeing.

Carbon Monoxide Releasing Polymeric Micelles, Riya Joshi

Electronic Theses and Dissertations

Carbon monoxide (CO), traditionally known as a toxic gas, has emerged as a potential therapeutic agent due to its cytoprotective, anti-inflammatory, and vasodilatory properties. This study explores the development of CO-releasing polymeric micelles as a controlled delivery system for biomedical applications. Using ring-opening metathesis polymerization (ROMP), we synthesized diblock copolymers incorporating CO-releasing moiety diphenylcyclopropenone (DPCP) with hydrophilic polyethylene glycol (PEG) to enhance solubility and stability of the overall CO releasing system. Dynamic light scattering (DLS) and electron microscopy (EM) confirmed the formation of well-defined micelles, while fluorescence assays demonstrated efficient CO release with the use of Iridium photocatalyst under 470 …

Staff Education Program On Care Transitions For The Elderly, Emmanoela Mugha

Walden Dissertations and Doctoral Studies

This project was developed as a staff education program using the analyze, design, develop, implement, and evaluate (ADDIE) model with a focus on discharge planning in a medical clinic in northern Maryland. There is a gap in discharge planning for older adults due to shortage of providers and inadequate education related to care transitions among the elderly. The care transition process can be improved through education. The practice focused question was: “Does an educational project for nurses on care transitions for the elderly increase knowledge as compared pre-to post education?” The Johns Hopkins evidence-based practice model (Appendix A) was the …

Early Diagnosis And Detection Of Skin Cancer Using Deep Neural Network Models And Feature Extraction From Pre-Trained Cnns, Sahil Khanna

Harrisburg University Dissertations and Theses

Skin cancer is one of the most common and lethal cancer types. While accurate diagnosis at an early stage is essential for skin cancer treatment it remains difficult to achieve in many regions due to lack of sufficient dermatologists and proper diagnostic equipment. Prior studies show Convolutional Neural Network (CNN) models excel at skin lesion classification and consistently achieve better results than standard diagnostic practices. However, the focus of many studies remains confined to image-based learning while neglecting useful patient metadata that could improve prediction accuracy. This research project created a specialized CNN model to classify skin lesions and evaluated …

Building Media Literacy In Adolescence: A Cognitive Behavioral Clinician's Manual To Combat Misinformation And Misdiagnosis During Sessions, Patricia Sacchetti

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper examines the role of Cognitive Behavioral Therapy (CBT) in countering misinformation that youth encounter on social media and other informal sources, with the goal of creating a manual for mental health clinicians. The use of CBT by clinicians working with adolescents to combat the issue of misinformation and misdiagnosis has received little attention in the literature. Mental health clinicians’ knowledge of media literacy as a psychological construct can foster an effective treatment style by building upon the foundation of well-established theory and practice, such as CBT. CBT is a multifaceted treatment that can help guide mental health clinicians …

Overcoming Barriers To Connection Between People With Schizophrenia And Their Caregivers, Sarah G. Fernandez

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The purpose of this doctoral project is to bring together existing literature on relational barriers between patients and caregivers, and strategies for overcoming them, for one reason: to help clinicians facilitate connection within families and households where one person has schizophrenia. It is therefore comprised of two parts: this paper containing a three-part literature review on barriers to connection including social skill deficits characteristic of the disease of schizophrenia, environmental factors, and caregiver burden and expressed emotion within families, as well as protective factors and strategies for overcoming them. The second component of this project is a psychoeducational module geared …

Survival Guide For Queer Families In Heteronormative Healthcare: Liberatory Consciousness And The Paradox Of Dependent Healthcare, A Critical Policy Discourse Analysis, Dwenna A. Holden

Electronic Theses and Dissertations

In this study I explored and analyzed how the queer experiences of an anonymous higher education institution in the western United States’ self-identified queer faculty and staff intersected with the discursive framing of the college’s dependent healthcare structure and documents. Within a critical paradigm I designed research around a high-density theoretical approach to weaving various branches of queer theory together with critical theory around policy and law in relation to queer bodies and hostile heteronormative policy environments. I arrived at solutions based in complaint, survival, and transformation. I used critical policy discourse analyses to interrogate the college’s dependent healthcare documents …

Preoperative Clinical Practice Guidelines For Patients Undergoing Coronary Artery Bypass Graft Surgery, Marjorie Badong Yumul

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Marjorie B. Yumul 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. Patricia Schweickert, Committee Chairperson, Nursing Faculty Dr. Diane Whitehead, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2025 Executive Summary: Clinical Practice Guideline Preoperative Clinical Practice Guidelines for Patients Undergoing Coronary Artery Bypass Graft Surgery by Marjorie B. Yumul MS, University of the Philippines Manila, 2003 BS, La Concordia, …

Loss Of Neuropeptide F (Npf) Signaling Reduces The Strength Of Circadian Rest-Activity Rhythms But Not Feeding-Fasting Rhythms, Katelyn Ann Wendt

Master's Theses

The circadian system governs crucial physiological and behavioral processes, dictating activities like movement, hormone release, and sleep patterns over a 24-hour cycle. Disruptions to these rhythms can lead to various health problems, including cardiometabolic dysfunction. Research has demonstrated the presence of circadian rhythms of feeding behavior in diverse organisms, but the specific molecules involved are not yet identified. Neuropeptide Y (NPY) influences metabolic activity in mammals, and its counterpart, NPF, affects locomotor activity and feeding in Drosophila melanogaster. Our study aims to investigate whether NPF, its receptor (NPFR), and NPF-expressing cells play a role in regulating circadian rest-activity and feeding-fasting …

Effects Of Intensity During Wingate Anaerobic Testing On Pedal Power Asymmetry In Recreationally Active Individuals, Balqees Mraiyan

Student Theses and Dissertations

This study examined the differences between three different intensity levels during a Wingate Anaerobic test (WAT) on the pedal power asymmetry and descriptive variables in recreationally active individuals. Six recreationally active volunteers completed a counterbalanced design of three separate WAT at different intensities. Test intensities consisted of a low resistance (5%), traditional resistance (7.5%), and a high resistance (8.7%) of each individual’s body mass in kilograms (kg). Descriptive data (age, weight, height, blood pressure, and heart rate) were also collected. A two-way repeated measures analysis of variance (ANOVA) examined the differences between each intensity level across all four sprints with …

Nurses’ Role In Reducing Mental Health Stigma In Healthcare, Olufunmilayo Elizabeth Adeloye

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project implemented a targeted educational intervention to reduce mental health stigma among healthcare providers. Mental health stigma, often resulting in misdiagnosis, delayed treatment, and decreased patient engagement, represents a significant barrier to effective nursing practice. The project’s practice-focused question examined whether an educational program could improve provider knowledge and attitudes toward mental illness. Using the ADDIE model (analysis, design, development, implementation, and evaluation), a needs assessment at a family practice and behavioral healthcare clinic identified gaps such as judgmental perceptions, avoidance behaviors, and lack of empathy among providers. An extensive literature review supported the …

Revising And Consolidating The Dsm-5 And Icd-11 Post-Traumatic Stress Disorders Into A Dimensional Spectrum-Based Disorder: A Literature Review, Samuel Milton Shatsky

University Honors Theses

This thesis investigates the clinical, cultural, and theoretical implications of replacing the current DSM-5 and ICD-11 categorical diagnoses of posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD) with a unified dimensional framework: trauma spectrum disorder (TSD). The proposed TSD model addresses ongoing concerns around diagnostic inflation, treatment misalignment, and clinical confusion stemming from binary trauma categorizations. This thesis explores whether adopting a dimensional diagnostic model to replace DSM-5 and ICD-11's current PTSD and CPTSD designations could lead to improved treatment outcomes and diagnostic clarity.

Methodology consisted of an extensive literature review of the field's current research. Using the …