Medicine and Health Sciences Commons^™

The Impact Of Perceived Discrimination On Mental And Physical Health Among The Hispanic Immigrant Population, Cheyla Tabares Cuesta

Undergraduate Theses

Discrimination has profoundly shaped the lives of individuals within disadvantaged communities, but its impact on mental and physical health has often been overlooked. In this project, I review literature on perceived discrimination based on immigrant status and its effects on psychological and physical health and examine a potential mediator and moderator of these relationships. Specifically, the relationships between immigration-based discrimination and both mental health and physical health may be mediated by perceived stress, meaning that discrimination may lead to higher stress levels, which results in poorer health outcomes. Furthermore, these relationships may be moderated by psychological resilience; individuals with higher …

Development Of End-Of-Life Educational Module For Nurses, Kari Mcclain

Walden Dissertations and Doctoral Studies

End-of-life (EOL) care is given to patients and their families near the end of the patient’s life or when a patient or family member chooses to stop any treatment they are receiving to either cure or control their disease process. Having discussions regarding end-of-life and dying has proven to be difficult and uncomfortable for most healthcare professionals, whether they are providers or nurses at the bedside. Part of the reason for the discomfort in having these discussions is twofold. First, healthcare professionals are trained to do what they can to save a person's life. Therefore, there is a lack of …

Staff Education To Increase Knowledge Of Safe And Effective Prescription Of Opioids For Pain Management For Patients With Illicit Drug Use, Kenny Adeshola Fagbamila Amanze

Walden Dissertations and Doctoral Studies

Opioid misuse and overdose continue to pose a significant public health crisis in the United States, particularly among patients with a history of substance use disorder (SUD). This Doctor of Nursing Practice (DNP) project aimed to improve healthcare staff knowledge regarding the safe and effective prescribing of opioids for pain management in patients with a history of illicit drug use. A staff education program was implemented at an outpatient clinic and evaluated using a pretest/posttest design with ten participants. The average knowledge score improved from 46% pre-intervention to 86% post-intervention, indicating a substantial increase in staff competence. The project supports …

Clinical Practice Guideline For The Improvement Of Care Compliance Of Children Affected By Obesity, Denise Vaz

Walden Dissertations and Doctoral Studies

Childhood obesity is diagnosed in children with a weight that is above the normal levels for their age and height. This diagnosis can be made if the child's body mass index (BMI) percentile is equal to or above 95% for age and sex. Per the Centers for Disease Control and Prevention (CDC; 2024), BMI, an anthropometric index of weight and height, is calculated by dividing a person's weight (in kilograms) by the square of their height (in meters), is used to assess if a child is underweight, overweight, obese or of healthy weight. The Cleveland Clinic (2024) noted that BMI …

Lived Experiences Of Seropositive Msm Who Face Intersectional Stigma Regarding Hiv-Prevention And Care In California, Sagar Bedi

Walden Dissertations and Doctoral Studies

Individuals who are positive for Human Immunodeficiency Virus (HIV) and identify as MSM (men who have sex with men), a population disproportionately affected by this disease, face complex struggles due to interplay between multiple forms of stigma, disclosure, and HIV risk behaviors. This results in delayed testing, poor treatment adherence, and decreased engagement in care. Despite the growing body of research on HIV among MSM, very few studies have explored the complex ways in which multiple forms of stigma intersect and impact the lives of Seropositive MSM. The purpose of this qualitative study was to explore the perception and lived …

Evaluating Wrist Placement And Signal Processing Techniques For Real-World Hrv Monitoring Using Ppg, Andrew Murphy

College of Computing and Digital Media Dissertations

This thesis investigates trade-offs between signal quality and data coverage in photoplethysmographic (PPG) heart rate variability (HRV) monitoring using wrist-worn devices. The goal was to evaluate whether wrist placement and signal processing techniques can improve measurement reliability in real-world conditions. Data was collected from healthy participants wearing smartwatches on both wrists during rest and a structured math task introducing natural wrist movement. Three distinct processing methodologies were compared, including a proposed Rolling-Standardized Derivative (RSD) approach. Results showed that while HRV signals from both wrists were highly correlated at rest, motion caused a measurable drop in signal quality and inter-wrist agreement, …

No Vaccine? Why Not: Causes Of Vaccine Hesitancy And How Governments Can Stop It, Alexander (Alec) Mccarty '25

Honor Scholar Theses

Vaccine hesitancy is a term that has entered the spotlight since the beginning of the COVID-19 pandemic. With concerns about efficacy, safety, and individual choice, many people have developed a hesitancy toward receiving any vaccine, creating concerns for public and global health. Through responses from local and state health departments about their actions during the COVID-19 pandemic, and through analysis of state vaccine rates based on political affiliation, this study suggests that vaccine hesitancy is a current issue that is likely politically motivated. States that are Republican affiliated have lower rates of vaccine uptake, and in turn they have higher …

Blue Chairs And Broken Minds: The Troubled Teen Industry’S Legacy Of Abuse, Macie Barker '25

Honor Scholar Theses

The Troubled Teen Industry (TTI) operates under the veil of rehabilitating adolescents with behavioral challenges. However, evidence reveals a system rife with abuse, manipulation, and inadequate oversight. From the infamous blue chairs of Straight, Inc., to the isolation tactics of WWASP program, this industry has maintained a facade of treatment while subjecting youth to severe abuse. This paper explores the history, recruitment tactics, institutional failures, survivor recovery journeys, and legal battles that define the TTI. Advocacy movements, including Breaking Code Silence and WWASP Survivors, have emerged to combat industry malpractice and push for policy changes to protect vulnerable youth. Additionally, …

The Impact Of Childhood Sexual Abuse On Resilience And Empathy In Adulthood: Exploring Psychological Outcomes And Interrelationships Among Adult Survivors, Helen Dao

NYMC Student Theses and Dissertations

Background: Childhood sexual abuse (CSA) is a traumatic experience that can have lasting psychological impacts on its survivors. Resilience and empathy are crucial for the recovery and social functioning of CSA survivors. However, the relationship between CSA and these constructs remains complex and not fully understood. Purpose: This study aimed to determine whether significant differences exist between individuals who have experienced CSA and those who have not. Additionally, the study also investigated the relationship between empathy and resilience. Methodology: A cross-sectional study was conducted with 36 adult participants, including CSA survivors and non-CSA participants. The Connor-Davidson Resilience Scale was used …

Culturally Appropriate Mental Health Awareness To Reduce Mental Health Stigmatization And Improve Quality Of Life Among People Of African Descent., Nicoline Frinwie

Walden Dissertations and Doctoral Studies

No abstract provided.

Enhancing State-Of-The-Art Motor Imagery Classification With Reinforcement Learning, Anton Shepelev

USF Tampa Graduate Theses and Dissertations

One of the key obstacles to the rapid adoption of non-invasive Brain-Computer Interfaces (BCIs) for Motor Imagery (MI) is the low signal-to-noise ratio, and the substantial data requirements which can be mentally taxing for users. EEGNet, a compact Convolutional Neural Network (CNN), has long been considered the state-of-the-art (SOTA) for MI classification, demonstrating strong performance even with limited data. However, recent studies advocate for integrating Deep Reinforcement Learning (RL) to further enhance classification accuracy by dynamically optimizing feature extraction and decision-making processes. Despite this potential, practical implementations remain scarce due to challenges in stabilizing RL training and adapting it to …

A Long Non-Coding Erna Forms R-Loops To Shape Emotional Experience-Induced Behavioral Adaptations, Rose Marie Akiki

MUSC Theses and Dissertations

Emotional experiences often evoke neural plasticity that supports adaptive changes in behavior, including maladaptive plasticity associated with mood and substance use disorders. These adaptations are supported in part by experience-dependent activation of immediate-early response genes, such as Npas4. We discovered that a conserved, long non-coding enhancer RNA (lnc-eRNA) transcribed from an activity-sensitive enhancer produces DNA-RNA hybrid R-loop structures that support 3D chromatin-looping of the enhancer and proximal promoter and stimulus-induced, rapid Npas4 gene induction. We also show that this Npas4 lnceRNA and its R-loops are required for the development of behavioral adaptations produced by chronic psychosocial stress or cocaine exposure, …

Aprn Transition To Primary Care Practice Program: A Quality Improvement Project, Melissa R. Baker

Graduate Theses, Dissertations, and Capstones

Transitioning to independent practice presents challenges for advanced practice registered nurses (APRNs) new to primary care. This quality improvement project addressed gaps in training and support through a structured Transition to Primary Care Practice (TTPCP) program across multiple primary care clinics in the southeastern United States. Over 12 months, the program provided weekly didactic sessions, monthly specialty rotations, and bi-weekly feedback. Guided by the Plan-Do-Study-Act framework, the initiative tracked structure, process, and outcome measures. Among 20 participants, attendance and schedule ramp-up reached 100%. Knowledge scores improved by 44%, and self-assessments increased by 23%. All assessed participants were rated Proficient or …

Staff Education To Improve Hand Hygiene Among Inpatient Behavioral Health Staff., Folashade Abosede Fadairo

Walden Dissertations and Doctoral Studies

In this staff education project, I addressed the critical need to improve hand hygiene compliance among healthcare workers in behavioral health settings. Poor adherence to hand hygiene protocols is directly linked to increased healthcare-associated infections (HAIs), patient morbidity, and higher healthcare costs in behavioral health environments. The practice-focused question was: How does a hand hygiene intervention program, grounded in the theoretical domains framework, impact hand hygiene compliance among behavioral healthcare workers in inpatient psychiatric units? The purpose of the project was to evaluate the effect of a hand hygiene intervention program on compliance rates among behavioral healthcare workers in inpatient …

Social Support And Treatment Outcomes Among Multi-Drug Resistant Tuberculosis And Persons Living With Hiv In Nigeria, Abiodun Olusegun Hassan

Walden Dissertations and Doctoral Studies

An estimated 40% of people with tuberculosis (TB) are missed due to underdiagnosis, and among those previously treated TB cases, about a quarter develop drug-resistant TB in Nigeria. The emergence of multi-drug-resistant TB (MDR-TB) is stalling the effort towards TB’s control and eradication. Few studies have examined the impact of the psychosocial effect and support systems for TB, particularly for MDR-TB. In this quantitative, cross-sectional study, the predictive relationship between social support given to MDR-TB patients and their treatment outcomes was examined using secondary data of 594 MDR-TB cases enrolled between January 2018 and December 2021. The theoretical framework for …

"I Know Who I Am": Draw-And-Tell Conversations With Gender-Creative Children, Eline Leemans Lenne

Dissertations and Theses

A growing number of children identify in various gender-creative ways, likely due to broader social awareness and affirmation of transgenderism. Gender-creative children face higher risks for adverse social, academic, mental health, and healthcare outcomes compared to non-transgender peers. Support from loved ones along with guidance from pediatric providers can mitigate poor outcomes and ensure that gender-creative children live healthy and happy lives. Young gender-creative children's perspectives about the aforementioned topics are markedly absent from the literature, which instead highlights adolescent and adult proxy perspectives.

In this participatory arts-based study anchored by a constructivist epistemology and informed by post-structuralist, queer, and …

Exploring The Impact Of Social Media And Social Networks On Juvenile Sexual Behavior Problems: A Scoping Review, Shaleen Clay

LSU Master's Theses

The issue of juvenile problematic sexual behavior has become a pervasive problem, and little research exists on the topic. How social media and social networks impact problematic sexual behaviors in juveniles is even less known and understood. The objective of this scoping review was to determine what is known about the impact of social media and social networks on juvenile sexual behavior problems. Four key themes appeared in the literature including the use of adult terminology, rather than juvenile, to describe juvenile relationships; the normalization of abusive behaviors within adolescent relationship; the influence of social networks/peer groups on aggression and …

The Relationship Between Fear Avoidance Beliefs And Low Back Pain In Crossfit Participants, Kyle Flaten

Doctorate in Kinesiology

This study aimed to examine the relationships between fear avoidance, low back pain (LBP), and disability in CrossFit (CF) participants in the greater Twin Cities area in Minnesota with correlations between the Oswestry Disability Index (ODI), the Roland Morris Disability Questionnaire (RMDQ), and Fear Avoidance Belief Questionnaire for physical activity (FABQpa). 151 CF participants voluntarily completed the survey, including demographic information, LBP characteristics, the ODI, the RMDQ, and the FABQpa. Results showed that for CF participants with current LBP, duration had a large effect on fear avoidance (ɲ = .519 and ɲ2 = .269), and for those who reported a …

Growing The Good: A Communal Garden Case Study Among Marginalized, Rural Populations, Claire Barbier

LSU Master's Theses

Community and Communal gardens (CG) have been documented as early as the late 1800s during periods of economic recessions and high food insecurity (The MIT Press Reader, 2022). However, C.G. adoption rates are expanding on a global scale as communities and municipalities see the potential for the tool to bring relief to environments in dire need of additional resources. Utilizing a communal garden can be used to address a surplus of systemic barriers a community faces; it has a significant opportunity to bring forth the interconnected tiers of public health altogether (Twiss et. al, 2003). Modernized C.G projects bring forth …

Staff Education Program On Pressure Ulcer Prevention, Khadijah Y. Ndiaye

Walden Dissertations and Doctoral Studies

This staff education program was aimed at improving pressure ulcer prevention practices in long-term care settings by increasing staff knowledge. Pressure ulcers remain a significant issue in long-term care facilities, leading to adverse patient outcomes and increased healthcare costs. Addressing this problem is critical within nursing practice to ensure patient safety, enhance quality care, and reduce preventable harm. The practice-focused question was: What is the effectiveness of a staff education program on pressure ulcer prevention in increasing staff knowledge in long-term care settings? The purpose of this doctoral project is to design and evaluate a comprehensive staff education intervention, incorporating …

Use Of An Evidence-Based Practice Model When Implementing An Evidence-Based Practice Change, Gretchen M. Roberts Msn, Rn, Ne-Bc

Doctor of Nursing Practice Scholarly Projects

Implementing evidenced-based practice (EBP) changes at large healthcare organizations is often a lengthy and difficult process, and sustainability is even harder. Many organizations continue to implement changes in EBP without using a standard approach or an evidenced-base practice model. One large healthcare organization in the Midwest is implementing a Professional Development and Advancement Program (also known as clinical ladder) for the direct care nurses across the health system. This is a proposed project and the program will be implemented using the Iowa Model for evidence-based practice change as a framework for guiding the implementation. The implementation team will use the …

A Semi-Mechanistic Model Of Immune Tolerance Induction To Support Preclinical Development Of A Human Monoclonal Antibody, Paridhi Gupta

Alternative Theses and Dissertations (AETDs)

Administration of human monoclonal antibodies (mAb) in preclinical species often triggers an immunogenic response, leading to the formation of anti-drug antibodies (ADA). ADA can bind to the mAb and reduce their systemic exposure by enhancing immune-complex mediated clearance. Thus, ADA complicates the accurate assessment of preclinical pharmacokinetics and toxicology studies. To mitigate this effect, we explored short-term immunosuppressive therapy (methotrexate or combination of tacrolimus and sirolimus) to induce prolonged immune tolerance towards a human mAb, erenumab, in rats. The results demonstrated that tacrolimus/sirolimus but not the methotrexate regimens prevented ADA formation in all treated animals relative to the non-immunocompromised control …

Deciphering Genotype-Phenotype Connections: Leveraging Pangenomes And Comprehensive Genome Variation, Flavia Villani

Alternative Theses and Dissertations (AETDs)

My thesis explores the application of advanced techniques for discovery of genetic variation and pangenomic approaches to enhance our understanding of genetic variation and genotype-phenotype relationships in two key model organisms: the HXB/BXH recombinant inbred rat family and the BXD mouse family. Through deep sequencing and innovative computational methods, I constructed com- prehensive pangenome graphs that captured genetic diversity beyond what is accessible through conventional single-reference approaches. In the HXB rat family, I identified approximately 200 million base pairs of sequence absent from the reference genome and discovered novel variants associated with glucose metabolism and chromogranin expression through phenome-wide association …

Palliative Care Education To Heart Failure Patients, Lindsay Thompson, Emily Lydiatt, Madison Thramer

Doctor of Nursing Practice Projects: College of Nursing

Purpose: This project aims to increase heart failure patients' knowledge of the benefits of palliative care for improved quality of life, advance understanding of the difference between palliative and hospice care, promote attendance at heart chat classes, and increase referrals to outpatient palliative care clinics.

Methods: This quality improvement project used a one-group, descriptive, exploratory design with pre-and post-testing. The study was conducted on a cardiac unit at a large urban medical center, involving heart failure patients. A tailored educational pamphlet and heart chat class were provided to promote understanding and attendance, along with pre-and post-tests to measure changes in …

Improving The Rates Of Sexually Transmitted Infection Diagnosis By Increasing Provider Knowledge About Testing, Lauren Cunningham

Student Scholarship & Creative Works

There has been a significant increase in sexually transmitted infection rates since 2021. Though this issue is nationwide, rural providers require education regarding testing, screening, and transmission of disease processes. The infections with the most significant increase being gonorrhea, chlamydia, and syphilis. The purpose of this project was to provide education to providers regarding local statistics, in addition to when to and not to test for sexually transmitted infections. Education was given to three Advance Practice Nurse Practitioners on disease signs and symptoms, transmission, and local STI statistic rates. STI testing rates were observed three months prior to an educational …

Proposed Method For Analyzing Cognitive Effects Of Chiari Malformation Type I And The Progression Following Cerebral Tonsil Reduction, Isabella Gleason

Selected Honors Theses

Chiari Malformation Type I (CM-I) is a neurological condition characterized by the descent of cerebellar structures through the foramen magnum. This malformation can be associated with cognitive implications, including impaired executive functioning, slowed processing speed, memory deficits, difficulties with attention and concentration, irregularities in emotional processing, and challenges in communication and fluency. Research indicates that cognitive dysfunction is prevalent in CM-I patients, affecting their daily lives. There are two surgical treatments commonly recommended for CM-I: posterior fossa decompression (PFD) and cerebral tonsil reduction (CTR). While both interventions are supported in the literature, studies on their long-term effects and effectiveness remain …

Prevalence And Risk Factors Associated With Postpartum Hemorrhage Among Postpartum Women In Selected Health Facilities In Machakos County - A Case-Control Study, Daniel Kyalo Muthiani

MSc in Advanced Practice Midwifery

Background: Postpartum hemorrhage (PPH) refers to blood loss ≥500mls after vaginal birth and ≥1000mls after cesarean section. PPH is of concern in low and middle-income countries and is estimated to cause maternal mortality every 10 minutes, with a prevalence of 25% and 34% in Uganda and Kenya, respectively. Despite efforts to address this issue, the prevalence of PPH remains high and is associated with maternal and fetal risk factors that can present along the continuum of birth. Understanding the risk factors is necessary in designing appropriate interventions for their prevention.

Objective: To determine the prevalence, maternal and fetal risk factors …

Factors Contributing To Meaningful Work And Intention To Stay In Generation Z Healthcare Workers, Jennifer A. Sippel-Tompkins

PhD in Organizational Leadership

The COVID-19 pandemic intensified two growing workforce challenges: (a) the Great Resignation and (b) quiet quitting, characterized by rising turnover and disengagement. Generation Z healthcare workers, now emerging as a significant segment of the workforce, have entered this environment with distinct values, emphasizing meaningful work, flexibility, growth, and organizational integrity. The purpose of this qualitative bounded case study was to explore the factors contributing to meaningful work and intention to stay among Generation Z healthcare workers in a large healthcare system in the United States. Data were collected through focus groups, paired interviews, single interviews, and analysis of anonymous employee …

Improving The Oral Pathology Referral Process In An Academic Dental Institution, Gregory Olson

Translational Projects (Open Access)

Introduction: Inefficiencies in the oral cancer referral process pose serious risks, including delayed diagnoses and poor patient outcomes. This project aimed to improve the reliability and efficiency of referrals between dental students and oral pathology residents for patients with suspected oral cancer. Although early detection is widely acknowledged as critical, significant process breakdowns were identified, including the absence of a standardized workflow, inconsistent follow-up practices, and a lack of accountability and tracking mechanisms. As a result, approximately half of the patients recommended for biopsy did not undergo the procedure, leading to delayed diagnoses and potentially worse prognoses.

Methodology: …

Improving End-Of-Life Care In The Medical Intensive Care Setting Of A Midwest Hospital Through Nursing Practice Analysis And Education, Hannah Myers

Doctor of Nursing Practice Scholarly Project

The acuity of patients within the intensive care setting compounded by comorbidities and illness complications can lead to death in a large percentage of ICU admits annually. Increased mortality rates translate into end-of-life care being a prominent part of the critical care scope. Using a mixed methods approach the project looks to examine barriers, supportive measures, interdisciplinary communication, procedures, and leadership styles that determine quality end-of-life care. A comprehensive literature review revealed a number of barriers reported by nurses including a lack of interdisciplinary communication, disagreements on care plans, and a lack of communication with patients and their families about …