Medicine and Health Sciences Commons^™

Registered Nurses’ Perceptions Of Patient Safety In Critical Care Units, Martha Benghie Hyacinthe

Walden Dissertations and Doctoral Studies

Patient safety is a cornerstone of effective healthcare delivery, particularly in critical care units (CCUs) where patients are at heightened risk of complications due to their complex medical conditions. The purpose of this study, guided by Watson’s theory of human caring, was to explore RNs’ perceptions of patient safety in CCUs. Data on eight RNs working in CCUs were collected through semi-structured interviews, allowing for an in-depth exploration of nurses’ perspectives. Data were collected through semi-structured interviews, allowing for an in-depth exploration of nurses’ perspectives. Using Saldana’s method of thematic analysis, three overarching themes emerged: patient safety, resource allocation, and …

Nafld Surveillance In The Alaska Native/American Indian Population, Wileina Saumara Rhodes

Walden Dissertations and Doctoral Studies

In the United States, the prevalence of NAFLD is estimated at 24% of the population, and by 2030, the incidence of NAFLD will increase to 100.9 million cases. This study aimed to determine the prevalence and rate of non-alcoholic fatty liver disease (NAFLD) progression in the Alaska Native/ American Indian population (AN/AI) with and without elevated liver function tests. Two research questions guided the study: Do outcomes (abnormal/normal) of LFTs, A1C, lipids, BMI, and inflammatory markers predict or have a relationship with NAFLD progression? Does NAFLD surveillance have a relationship with the patient’s outcome as measured by the NAFLD Fibrosis …

Exploring The Connection Between Mental Health Stigma, Social-Emotional Risk, And Help-Seeking Behaviors Among High School Students, Dorie Ross

USF Tampa Graduate Theses and Dissertations

Throughout the United States, the rate of adolescents experiencing mental health-related challenges continues to rise, impacting their social-emotional well-being. Despite increasing concerns, the majority of adolescents do not seek treatment for mental health problems. One barrier contributing to a lack of help-seeking behaviors is mental health stigma. Furthermore, for students who have sought help for such concerns, there is a lack of consensus on whom high school students turn to for support when seeking help. The current study utilized quantitative methodology in the form of Structural Equation Modeling to examine the complex relationship between social-emotional risk, perceptions of mental health …

Maternal Access For Depression In Rural Environments, Simone Parlier

Dissertations

Significance –As many as 25% of birthing persons experience postpartum depression (PPD) within the first year after childbirth making this one of the most common postpartum disorders. PPD is prevalent, incapacitating, and treatable. The first step is identifying those at risk. Rural birthing persons are understudied, and may have unique predisposing characteristics as well as geographic challenges for optimal detection and treatment of PPD. Purpose -The long-term goal is to improve the health of rural families. Using The Theory of Unpleasant Symptoms, the purpose of this descriptive, cross-sectional research was to describe the prevalence of PPD in rural birthing persons …

Assessment Of Relationships Between Quality And Staffing In The Ambulatory Care Environment, Rachel E. Start

Dissertations

ABSTRACT Background The United States healthcare system underperforms compared to other industrialized countries where cost and quality are concerned. Nursing is accountable, as a profession recognized by society, to ensure health and livelihood in the patients and populations served. Advancing the role of the ambulatory care nurse and providing valid strategies to measure the contribution of the nursing profession in this setting is a tactic that many organizations are pursuing to achieve this paradigm shift. The assessment of relationships between measures of structure, process, and outcome within the ambulatory care setting across a variety of organizations may have the potential …

Food Environments And Mental Health: Analyzing The Impact Of Fast-Food Availability On U.S. Adults (2011-2016), Nicole Tenner

NYMC Student Theses and Dissertations

This study investigates the relationship between the availability of fast food in US territories and mental health outcomes. Utilizing a cross-sectional design, the study examines data from the 2011 and 2016 Behavioral Risk Factor Surveillance System (BRFSS) from the CDC, along with data from the U.S. Department of Agriculture’s Food Environment Atlas. The analysis included a nationally representative sample of 351,823 participants across all 50 US states. Multiple regression models examined the association between fast food availability and two primary mental health outcomes: the number of self-reported poor mental health days and the likelihood of being diagnosed with a depressive …

Staff Education On Uti Screening, Antimicrobial And Antibiotic Resistance, And Poor Regimen Adherence, Shereen Robinson

Walden Dissertations and Doctoral Studies

This staff education project focused on enhancing nurses’ knowledge of urinary tract infections (UTIs) and antibiotic and antimicrobial resistance intended to promote screening for UTIs. The practice problem addressed was lack nurses’ knowledge of UTI screening and antibiotic resistance. Inadequate screening contributed to increased UTI rates, re-occurrences, and complications such as delirium. It was essential to address the issue because nurses are at the frontline regarding educating, screening, and providing care to patients with UTIs. Knowledgeable nurses can implement standard practices to ensure adequate screening for UTIs. Effective screening would enhance early treatment and minimize misuse and unnecessary antibiotic prescriptions. …

Adolescent Preventive Care Outcomes Before And After Covid-19 Onset: What Is The Role Of Telehealth?, Sarah Hayden Knipper

Dissertations and Theses

Adolescents are a developmentally distinctive population with unique primary health care needs; they comprise about 10% of Oregon's population and more than half are covered by the Oregon Health Plan (OHP). This dissertation investigated significant declines in preventive care utilization (well visits and HPV immunizations) among adolescents enrolled in OHP during the COVID-19 pandemic and the relationship between the decline in utilization and the rise in telehealth availability. The study focused specifically on the role of race/ethnicity, geography, and access to health systems in mitigating or exacerbating decreases in preventive care. A mixed methods approach was employed to understand not …

Bereavement Needs Of Parent-Child Dyads Following Sibling Death, Shannon V. D'Alton

MUSC Theses and Dissertations

In the United States, nearly 62,000 children and adolescents experience the death of a sibling each year and sibling bereavement is one of the most distressing life events during childhood; however, it has received less attention in research compared to other forms of childhood loss. Bereaved siblings and parents are at increased risk for negative physical and psychological outcomes, yet little is known about their support and resource needs during the early years following the death. A limitation in understanding sibling bereavement is the methodological and ethical challenges of researching this vulnerable population. Consequently, the bereavement needs of surviving siblings …

Mechanisms Underlying Estrous Cycle-Dependent Changes In Incubated Cocaine Craving, Erin Elizabeth Wannen

Theses and Dissertations

Cues associated with cocaine use are one of the most common relapse triggers and understanding what promotes cue-induced cocaine craving and relapse is a critical question in the field. Human studies have shown that these measures are impacted by fluctuations in ovarian hormone levels, as higher levels of estradiol promote cue-induced cocaine craving in women while higher levels of progesterone reduce craving in both sexes. Enhanced or incubated cue-induced cocaine seeking or craving also changes across the rodent reproductive (estrous) cycle as levels of estradiol and progesterone fluctuate, with enhanced seeking behavior observed during the estrus stage of the cycle. …

Support Beyond Services: Examining The Role Of Neighbor Relationships, Housing Staff, And Place In Mental Health Recovery, Kenna Estell Dickard

Dissertations and Theses

This dissertation explores the role of non-clinical support for individuals with serious mental illness (SMI). Through three interconnected manuscripts, this dissertation highlights the importance of housing staff support, places in the community, and neighbor relationships in fostering recovery for individuals with SMI. The first manuscript analyzes how housing staff support influences residents' well-being through an ecological lens. This study found that staff support is associated with reduced loneliness, higher residential satisfaction, and increased sense of community. This study also considers the role of self-determination as a moderator, demonstrating the importance of resident agency in maximizing well-being outcomes. The second manuscript …

Effect Of Olympic Weightlifting Training On Power Output And Landing Forces In Adolescent Female Athletes: A Quasi-Experimental Study, Emily Neff

Doctorate in Kinesiology

To examine whether a periodized, eight-week strength and conditioning (S&C) program incorporating Olympic Weightlifting (OWL) improves vertical jump height and reduces peak landing forces in adolescent female athletes. Despite the proven benefits of neuromuscular training (NMT), (Nessler et al., 2017; Mattu et al., 2022), access to high-skill S&C remains limited for this population (Sommi et al., 2018; Parsons et al., 2021). Twenty-four adolescent female athletes were divided into a training group (n = 15) and a control group (n = 9). The training group completed two one-hour sessions weekly for eight weeks. Pre- and post- intervention testing assessed vertical jump …

Temporal Modeling And Forecasting Of Blood Glucose Dynamics In Individuals With Diabetes Mellitus, Mj Ruff

University Honors Theses

People living with Diabetes Mellitus face significant health risks, including an increased likelihood of heart disease, stroke, and fluctuations in blood glucose levels. The unpredictable nature of glucose levels can lead to dangerous conditions such as ketoacidosis and hypoglycemia. This study employs advanced time series analysis tools to forecast the glucose levels for an individual diagnosed with Type 1 Diabetes Mellitus.

Evaluating Depression In Adults Undergoing Substance Abuse Treatment: A Program Evaluation Of Intensive Outpatient Program, Chidochomoyo E. Zvirawa

Dissertations

Problem: Depression and substance use disorders (SUDs) frequently co-occur, complicating recovery outcomes. Despite screening recommendations, depression remains underdiagnosed in many SUD treatment settings.

Methods: This mixed-methods program evaluation examined depressive symptoms among adults in an Intensive Outpatient Program (IOP) using the Patient Health Questionnaire (PHQ-8). Depression screenings were conducted at intake, four weeks, and eight weeks. Eight participants meeting inclusion criteria were assessed. Data included demographics, treatment engagement, and PHQ-8 scores.

Results: PHQ-8 scores significantly declined from baseline (M = 11.75, SD = 6.52) to eight weeks (M = 5.13, SD = 5.05), t(7) = 2.76, p = .028, indicating …

Persistent Activation Of Cardiac Fibroblasts Contributes To Myocardial Interstitial Fibrosis And Left Ventricular Dysfunction In Heart Failure, Rachel Biggs

MUSC Theses and Dissertations

Heart Failure (HF) is a complex clinical syndrome that is defined by an inability of the heart to meet the oxygen demands of the body. Myocardial interstitial fibrosis (MIF), the diffuse overaccumulation of extracellular matrix (ECM) proteins within the cardiac interstitium, contributes to ventricular dysfunction in HF. Mechanical devices designed to alleviate left ventricular deficiencies, termed left ventricular assist devices (LVADs), provide a pump that delivers oxygenated blood to the aorta thereby decreasing hemodynamic load on the ventricle. This end-stage HF therapy alleviates symptomatic burden for HF patients, however, LVAD support does not reduce MIF in the LV, and myocardial …

Policy Paper Assessing The Risk Of Obstructive Sleep Apnea In The College Football Player, Joseph C. Archer

Doctor of Nursing Practice Projects

Sleep is a vital yet often overlooked component of athletic performance, particularly in collision sports such as football. Despite growing evidence connecting obstructive sleep apnea (OSA) with cognitive impairment, cardiovascular risk, and injury, standardized screening is rarely implemented in collegiate athletics. This project aimed to assess the risk of obstructive sleep apnea (OSA) in college football players aged 18–25 using the STOP-BANG screening tool and to evaluate the impact of an educational intervention on the knowledge of athletic trainers. The purpose was to identify at-risk athletes early, promote timely intervention, and improve athletic trainers' understanding of OSA. The project addressed …

The Mechanisms Of Heterogenic Necrotic And Apoptotic Cell Death Fates In Human Epidermal Keratinocytes Following Uvb Exposure, Madeline Zoe Tara

Master's Theses

UVB radiation is a carcinogen that triggers inflammation and contributes to skin carcinogenesis. Although UVB exposure can induce apoptosis, this form of cell death is non-inflammatory and thus cannot explain the inflammatory response observed following UVB. Necrotic regulated cell death (RCD) pathways, namely necroptosis, pyroptosis, and PANoptosis, are inherently pro-inflammatory, and thus this study focused on characterizing these in irradiated human epidermal keratinocytes. Keratinocytes were irradiated, treated with cell death inhibitors, and analyzed for apoptotic and necrotic RCD markers using immunofluorescence (IF). Despite uniform UVB exposure, keratinocytes displayed heterogeneous cell death responses, and these findings were validated in ex vivo …

Exploring Muslim American Attitudes Toward Genetic Testing: Perceptions, Barriers, And Ethical Considerations, Hannah Mahmoud

University Honors Theses

This thesis explores perceptions and attitudes toward genetic testing within the Muslim American community, a group often underrepresented in genomic research and public health discourse. Using a community-distributed digital survey, data was collected from 50 self-identified Muslim Americans on their familiarity with genetic testing, reproductive and ethical considerations, and the influence of religious factors. While only 18% had undergone genetic testing themselves, many were familiar through family or friends, and most expressed cautious interest—especially when results could influence future family planning. Education level, age, and religious values shaped both comfort and understanding.

A key theme was the desire for culturally …

Forecasting Influenza Rates Using Machine Learning: A Study Of Chatgpt's Predictive Accuracy, Sara Saleh

University Honors Theses

This study evaluates ChatGPT's ability to forecast influenza rates, such as the number of flu cases, hospitalizations, and death during peak season periods using CDC data, and comparing forecasts against actual results to calculate statistical accuracy and consistency. Influenza forecasting is essential for public health planning, but traditional methods may not always provide timely or accurate predictions. In this research study, ChatGPT was utilized to predict the influenza rates for the following week based on the previous week's data obtained from the FluView surveillance system. The predicted rates were compared to the actual influenza rates to assess the model's overall …

Clinical Practice Guideline For Systemic Lupus Erythromatosus And Lupus Nephritis, Seleaina A. Thomas

Walden Dissertations and Doctoral Studies

Summary This project addressed the critical practice problem of delayed and inaccurate diagnosis of systemic lupus erythematosus (SLE), which has been linked to increased morbidity and mortality, particularly among marginalized populations. These diagnostic challenges have been recognized globally, with international research highlighting inconsistencies in care and the absence of standardized guidelines. Implementing inclusive and equitable clinical practice guidelines (CPGs) that consider social determinants of health, political determinants of health and actively involve diverse populations in research can play a crucial role in reducing racial disparities and improve outcomes for all lupus patients. Thus, the development of a CPG focused on …

Development Of Recommendations For The Future Of Telehealth Use Among Sexual And Gender Minorities (Sgm), Jeffrey A. Wilhite

Dissertations and Theses

It is now well-documented that sexual and gender minoritized individuals (SGMs) face consistent stigmatization from not just the health care system, but also from overarching community, federal, and societal entities. Subsections of the SGM community, like gay men for example, face higher rates of eating disorders, certain cancers, alcoholism, mental illness and even obesity, when compared to heterosexual counterparts. Many of these challenges could be exacerbated by current political administration efforts to silence the community. Ensuring access to clinical care is one way of preserving the health and livelihood of the community. Telehealth, or synchronous, remote based clinical care, can …

Staff Education To Registered Nurses On An Inpatient Pediatric Unit Regarding Pediatric Burn Principles, Qwinnetta Janae Stokes

Walden Dissertations and Doctoral Studies

The purpose of this staff education project was to improve nurses’ knowledge on burn care using an educational intervention. The project site became the children's hospital designated burn unit. Children with burns were a new patient population that the project unit had never cared for, and there was no formal training or competencies for nurses caring for these patients. Nurses requested formal education before being expected to care for these patients. This project utilized a single group, pre-post design comparing knowledge of bedside surgical nurses about pediatric burn care management principles before and after the educational intervention. The intervention was …

A Literature-Informed Nutrition Patient Communication Toolkit For Hashimoto’S Thyroiditis, Kieren Ritter

Department of Nutrition Student Projects

This project is intended to help bridge the gap in nutrition education and treatment for the autoimmune disease Hashimoto’s thyroiditis (HT). Current research was synthesized and converted into a communication tool for adults diagnosed with HT. The toolkit was based on 33 articles, from three databases, that passed the inclusion and exclusion criteria for analysis. The education toolkit was intended to be practical and valuable for below a high school reading level. The aforementioned articles reviewed the effects of dietary changes on HT with vitamin D, selenium, gluten removal, dietary patterns such as the Mediterranean diet and Autoimmune Protocol, and …

Staff Education On Substance Use Screening In An Outpatient Mental Health Clinic, Kelvin Okwudiogor

Walden Dissertations and Doctoral Studies

This DNP project aimed to enhance the quality of care by improving healthcare providers’ knowledge and fostering confidence in the utilization of screening, brief intervention, and referral to treatment (SBIRT). At the practice site, patients were not screened for substance use due to the lack of provider knowledge on evidence-based screening tools. The practice-focused question for this project was, Among healthcare providers in outpatient mental health clinics, does education on the use of the SBIRT screening tool increase their knowledge and skill after educational intervention? The project used a sample of 12 healthcare professionals, including four mental health practitioners and …

The Ecology Of Gender-Based Violence For Syrian Refugee Women In Tripoli And Akkar, Dima Masoud

Dissertations and Theses

Lebanon is a country that suffers from multiple economic, political, and health crises. Additionally, the mass displacement of Syrian refugees to Lebanon after the war in Syria over a decade ago has left Syrian refugees vulnerable, including the vulnerability of Syrian refugee women to gender-based violence (GBV). While these conditions have affected all of Lebanon, this dissertation focuses on the regions of Tripoli and Akkar in northern Lebanon. Tripoli and Akkar are regions that border Syria, which means that an influx of Syrian refugees, mostly unregistered, comes in. While other regions in Lebanon also border Syria, Tripoli and Akkar are …

Standardizing Discharge Planning To Reduce Readmission Rates In Outpatient Mental Health Clinics, Navasha Martin

Walden Dissertations and Doctoral Studies

Psychiatric readmission rates remain a major concern in outpatient mental health clinics, often resulting from inconsistent discharge practices and limited patient education. This Doctor of Nursing Practice (DNP) project aimed to develop and evaluate a clinical practice guideline (CPG) to standardize discharge planning and reduce psychiatric readmission rates. Guided by the question: Does evidence support the quality of an evidence-based standardized discharge planning protocol to reduce readmissions?, this project integrated findings from a structured literature review and expert panel evaluation. The CPG was developed using evidence-based strategies and evaluated using the AGREE II instrument, a validated tool for assessing the …

The Relationship Between Food Label Comprehension And Consumer Dietary Choices, Marline Denis

Walden Dissertations and Doctoral Studies

Poor dietary choices and limited understanding of nutritional information are ongoing public health concerns that contribute to the rise of chronic illnesses such as obesity, diabetes, and heart disease. This quantitative, cross-sectional, correlational study investigated the associations between health literacy and food label comprehension with consumer dietary choices and adherence to dietary guidelines among individuals aged 16 and older in the United States. Guided by the Nutrition Label Literacy (NLL) framework, this study explored whether components such as basic nutritional knowledge, numeracy skills, health motivation, and label usage predict healthier food choices. Age, education, and gender were included as covariates. …

Translucency And Stain Resistance Of A Light Cured Pontic Paste, Ahmed Abumustafa

All ETDs from UAB

Objectives: Light-cured pontic pastes can be applied to the internal aspect of clear retainer/aligner trays at sites of missing teeth. Ideally, the pontic tooth should appear visually opaque and resist staining. The aim of this study was to determine if the number of coats of the paste will affect its translucency and stain resistance. Materials and Methods: 12mm diameter discs of a biocryl clear retainer material (Clear Splint) (n=10) were punch-cut. Light-cure pontic paste (Perfect-A-Smile Pontic) was applied to one side of the biocryl discs in 1, 2, 3 or 4 coats (200-400g /coat). The paste was light cured between …

Race, Resources, And American Adolescents’ Mental Health During The Covid-19 Pandemic, Chineze Nkemeh

Walden Dissertations and Doctoral Studies

During the COVID-19 pandemic, African American adolescents experienced reduced access to needed resources and may have suffered poorer mental health outcomes as a result. The purpose of this quantitative study was to examine the association between race and the availability of mental health resources, food, medical health resources and mental health outcomes among African American adolescents in the United States during the COVID-19 pandemic compared to their White counterparts. The theoretical framework that grounded this study was the Socio Ecological Model. Secondary data from the Centers for Disease Control and Prevention’s Adolescent Behaviors and Experiences Survey database were analyzed. These …

Effects Of Cerebral Tumor Necrosis Factor Alpha On Systemic Glucose Homeostasis In Obese Mice, Gabriela Griepp

Honors Projects

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by impaired blood glucose regulation and persistent hyperglycemia. The central nervous system functions as a key regulator in the maintenance of peripheral normoglycemia. Obesity, commonly associated with T2DM, often leads to chronic inflammation in the hypothalamus, a critical brain center for integrating metabolic feedback and controlling outputs to peripheral organs. However, the physiological mechanisms through which obesity-induced brain inflammation affects glucose regulation remain somewhat unclear. Previous studies have linked one key pro-inflammatory cytokine, tumor necrosis factor alpha (TNF-α), to metabolic function and glycemic control; however, the exact nature of its …