Medicine and Health Sciences Commons^™

The Role Of Sexual Assault Nurse Examiners: Addressing The Shortage And Its Implications For Healthcare, Isabel Mary Mccarthy

Nursing | Senior Theses

Background: Sexual Assault Nurse Examiners (SANE) are registered nurses specifically trained to perform forensic examinations and provide medical and emotional support to sexual assault victims. Many nursing programs lack formal education on SANE practices, which can hinder students' preparedness to address such cases in their future careers.

Method: A mixed-methods, three-phase approach to evaluate the effectiveness of a Sexual Assault Nurse Examiner (SANE) training module within the Dominican University of California Nursing Program. 40- 60 nursing students will be separated into two separate community health classes with one given module in SANEs nursing and the other not. Both classes …

Exploring The Adoption, Perceptions, And Opportunities Of Artificial Intelligence Among Registered Dietitians In The United States, Hong Liu, Mariana Tadros, Edward Bitok, Liang Ji

Loma Linda University Research Reports

Artificial Intelligence (AI) is reshaping healthcare, yet its integration into nutrition and dietetics remains underexplored. This study investigates the adoption, perceptions, and opportunities related to AI technologies among Registered Dietitian Nutritionists (RDNs) in the United States. Our survey was opened in April 2025 and is still ongoing, having gathered responses from over 70 RDNs. Findings reveal that while 58% of RDNs report some familiarity with AI, only 13% consider themselves very or extremely familiar. Attitudes toward AI are generally positive, with 56% viewing AI’s impact on dietetics as positive and 70% believing it could at least moderately improve patient outcomes. …

Cultivating Quality Of Life: Assessing Diet, Physical Activity, And Mental Health Among Arab-American Breast Cancer Survivors - Uncovering Barriers And Facilitators For Holistic Well-Being, Nouf Ali Alhomaidhi

CGU Theses & Dissertations

This dissertation examines the quality of life among Arab-American breast cancer survivors, with a particular emphasis on dietary practices, physical activity, and mental health. Despite increasing survivorship rates in this population, there remains a significant gap in the literature addressing their unique post-treatment experiences and needs. Employing a convergent parallel mixed-methods design, this study integrates quantitative survey data and qualitative narrative interviews to assess adherence to health behavior guidelines and to identify culturally specific barriers and facilitators to well-being. Quantitative findings indicated suboptimal adherence to recommended dietary and physical activity guidelines and highlighted prevalent psychological distress among participants. Thematic analysis …

The Way Work Should Be™ Fostering A Stigma-Free Workplace For Mainers, Samuel Joseph Leo Fernald

CGU Theses & Dissertations

The proposed program, The Way Work Should Be ™, aims to enhance Mental Health & Illness education and establish a Stigma-Free Workplace. NAMI Maine, a leader in mental health advocacy, will partner with organizations throughout Maine to provide essential resources, including mental health toolkits, training for recognizing and addressing mental health issues, and strategies to create supportive work environments. The urgency for mental health training in Maine's business community is clear. Employers and employees require resources to effectively manage mental health issues, which can lead to immediate and lasting positive outcomes. This project includes a comprehensive "Program Evaluation" to establish …

Exploring Factors Associated With Adverse Childhood Experiences And The Development Of Posttraumatic Stress Symptoms Among Children And Adolescents, Ayesha Qureshi, Sarah Delahanty Phd, Sima Sharghi Phd, Lisa Shauver Ms, Ayla Mapes Phd

Williams Honors College, Honors Research Projects

Adverse Childhood Experiences (ACEs) have a significant influence on long term mental and physical health risks, including the development of Posttraumatic Stress Symptoms (PTSS). The current study examined the association between demographic and geo-coded environmental factors and ACE exposure and PTSS development among pediatric patients seen in a behavioral health department at a children’s hospital. Geo-coded factors included Child Opportunity Index (COI scores) and Rural Urban Area Commuting Codes (RUCA). ACE-related factors (type of ACE, ACE overall score) were also included when examining PTSS. Machine learning results indicated that models incorporating environmental data and ACE-related factors performed better than models …

Do Patients Who Receive Dexmedetomidine As An Adjunct To Spinal Anesthesia For Cesarean Delivery Achieve Longer Block Duration Compared To Those Who Receive Spinal Anesthesia With Local Anesthetic Alone?, Liana S. Garrison

Theses, Dissertations and Capstones

Problem Statement: Cesarean delivery is associated with significant postoperative pain, typically managed with spinal anesthesia using a local anesthetic. While opioids are often added as adjuncts, the addition of dexmedetomidine, an alpha-2 agonist, has emerged as a potential alternative that may enhance the efficacy of the spinal block in terms of pain management, potentially improving block duration and quality compared to local anesthetic alone.

Methodology: A literature review was conducted on the use of dexmedetomidine as an adjunct to spinal anesthesia for patients undergoing cesarean sections. Databases used for the search included PubMed, CINAHL Complete, and MEDLINE. The keywords used …

The Use Of Therapeutic Communication To De-Escalate Aggression And Violence In Clients Living In A Homeless Shelter, Tionna S. Felder

Doctor of Nursing Practice Projects

Individuals working at homeless shelters have the daunting task of managing violent/aggressive behaviors with the population they serve. This project focused on educating homeless shelter staff on the use of therapeutic communication to decrease the escalation of aggression and violence when caring for their guests. The DNP Project Leader taught 23 homeless shelter staff members, and the project included three 2-hour educational sessions. The first class focused on understanding what regions in the brain are responsible for aggressive, violent, and emotional behaviors; the second class focused on what the literature says about aggressive behavior in homelessness; and the last class …

Addressing Physical Inactivity In Cabarrus County, Amy S. Hicks

Doctor of Nursing Practice Projects

Background: 21% of Cabarrus County, North Carolina, residents report complete physical inactivity during their leisure time, contributing to various health problems affecting 29% to 33% of Cabarrus County residents aged 40 to 84.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to implement and evaluate a 3-week community walking challenge (Trim Before the Turkey Walking Challenge) to increase physical activity and social connectedness among Cabarrus County residents aged 50 and older.

Methods: A pre- and post-program survey design was used to evaluate participant-reported physical activity levels and sense of social engagement. Participants were recruited through the …

Exploring Approaches To Address Racial Discrimination, Stigma, And Provider Communication In Sickle Cell Disease Pain Management Through Interprofessional Education And Collaboration, Ronisha Edwards-Elliott

Graduate Research Theses & Dissertations

This dissertation presents research across three publishable manuscripts that investigate why structural and systemic racism persist among patients with sickle cell disease (SCD) seeking pain management, and how interprofessional collaboration and education can help reduce disparities through shared learning, accountability, and standardized care (Chapters Two through Four). A scoping review identifies current interventions and strategies aimed at sharing the pain experiences and feelings of being unheard by SCD patients (Chapter Two). Findings of the scoping review revealed that although interventions and strategies exist and have been tested, the lack of implementation or buy-in from healthcare professionals has allowed racial discrimination …

A Phenomenological Study: Implicit Bias In The Hiring Practices Of Health Care Organizations (Perception, Impact On Workforce Diversity, Mitigation Methods, And Implementation Assessment), Mohamed Boubrik

Dissertations

Purpose: The purpose of this phenomenological study was to explore how implicit bias influences hiring practices within health care organizations. Specifically, it investigated the perceptions of hiring professionals regarding implicit bias, its impact on workforce diversity, the strategies used to mitigate it, and the effectiveness of those strategies in real-world implementation.

Methodology: This qualitative study employed a phenomenological approach to capture the lived experiences of hiring professionals in Southern California health care organizations. A random sampling method was used to select participants across various health care facilities. Data collection was conducted through semistructured interviews, using a validated interview protocol as …

Quality Improvement Project: Improving Tardive Dyskinesia Detection And Management Through Aims Scale Utilization In Outpatient Psychiatry Clinic, Judeline Docteur

Doctor of Nursing Practice Projects

Tardive dyskinesia (TD) is a debilitating movement disorder commonly associated with prolonged antipsychotic medication use. The disorder results in functional impairment and reduced quality of life for those affected. Frequent TD screening using scales such as the Abnormal Involuntary Movement Scale (AIMS) for those on antipsychotic medication is recommended. However, its underutilization due to a lack of awareness, confidence, and knowledge of its applicability contributes to delayed detection and management, resulting in poor patient outcomes. The purpose of this quality improvement project was to improve TD detection and management through healthcare provider training to affect their self-efficacy and knowledge and …

Quality Improvement Project - Test Anxiety In Nursing Students: Reducing Stress And Anxiety In The Testing Environment, Aaron Gann

Doctor of Nursing Practice Projects

Nursing student retention is a critical issue due to limited clinical placements and faculty shortages, with many students citing test anxiety as a barrier to success in high-stakes National Council Licensure Examination (NCLEX) testing. The problem the Doctor of Nursing Practice (DNP) project identified is the lack of targeted interventions for test anxiety at the project site, a two-year community college’s associate degree nursing (ADN) program. The DNP project aimed to evaluate the efficacy of an Assessment Technologies Institute (ATI) test anxiety module on students’ course quiz scores and self-reporting of emotional barriers as measured by the depression, anxiety, and …

Building Confidence In Critical Thinking Through Faculty Implementation Of Simulation, Melissa Morris

Doctor of Nursing Practice Projects

Simulation provides nursing students with experiences that are as effective as clinical experiences in a non-threatening environment. Clinical experiences such as obstetrics, pediatrics, and mental health have been observation only at the project site. With observation-only clinicals, students do not have opportunities to master skills specific to nursing, which bridge theory to practice. The purpose of this Quality Improvement (QI) project focuses on educating nursing faculty who may not be simulation experts to learn the skills to build and implement simulations that align with the International Nursing Association Clinical and Simulation Learning (INACSL) simulation standards. The Primary Investigator (PI) utilized …

Enhancing Faculty Confidence And Candidate Selection: Evaluation Of A Standardized Holistic Interview Rubric In Nursing Program Admission, Jennifer M. Bray

Doctor of Nursing Practice Projects

Nursing programs continue to struggle with high attrition rates, which impact student success, program outcomes, and the development of a competent nursing workforce. National data show that associate degree nursing programs report attrition rates as high as 50% in the first year, highlighting the urgency for more effective admission strategies. The problem addressed in this quality improvement project was the use of traditional academic metrics, such as grade point average (GPA) and standardized test scores, as primary admission criteria, which often overlook essential non-cognitive attributes linked to student persistence and success. The purpose of the project was to improve faculty …

The Impact Of Staff Education On Menopausal Care, Oluwatoyosi Olumide

Doctor of Nursing Practice Projects

Natural menopause typically occurs around the age of 51. During this transition, many women experience a variety of vasomotor symptoms, with hot flashes and night sweats being the most common. As women age, diminishing levels of estrogen, progesterone, and testosterone can lead to various health complications. Without proper assessment, diagnosis, and treatment, many may suffer in silence. This quality improvement project sought to evaluate the impact of staff education on menopausal care. The symptom checklist, or the Menopause Rating Scale (MRS), is a standardized, evidence-based tool for assessing menopause symptoms and serves as an essential component of the admission process …

Environmental Health Priorities In Rural Public Health Departments: Perspectives From Health Agency Directors, Michelle Rastegar

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Rural communities are staffed by environmental health practitioners with less formal public health training and fewer years of public health experience. The literature on environmental health program implementation in rural communities is incomplete and specifically misses the perspectives of those charged with developing and fielding such programs. The purpose of this paper is to gather and report the insights of three rural local public health department leaders regarding the challenges, opportunities and stakeholders for implementing environmental health programs. Using purposive sampling of faculty community partners, three rural Kentucky local health department directors were recruited to participate in the study. After …

Promoting Physical Activity (Pa) Among Latinas In Fayette County, Ky, Vanessa Diaz Mph

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In the United States, the prevalence of overweight and obesity continues to rise at a disproportionate rate that is greatly affecting Latinas. This paper outlines the implementation of an adapted version of Fe en Acción, a faith-based evidence-based physical activity (PA) intervention that was initially implemented in San Diego, CA. The program targets Latinas in Fayette County, KY through culturally tailored, faith-based PA classes held at local Catholic churches. By using promotoras– health promoters– the program works to increase self-efficacy and social support while promoting sustainable behavior change. Key adaptations include a reduction in class frequency (four times a week), …

Pathways To Green River District Health Department, Gracelyn P. Bush

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In an effort to decrease Neonatal Abstinence Syndrome (NAS) in the Green River District of Western Kentucky, this grant proposes the expansion of the evidence-based University of Kentucky PATHways program to the Green River District Health Department (GRDHD). To protect the health of both women and children, this program will specifically target pregnant women with substance use disorder (SUD). This program will deliver a group-based prenatal and postpartum curriculum with the integration of Peer Recovery Support Specialists, specifically modeled on Social Cognitive Theory and the adoption of whole-person care. The proposed program spans a three-year time frame, beginning with program …

A Case Study In Program Evaluation: Evaluation Of A Community Program To Increase Rates Of Physical Activity, Emma Hughes

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Bourbon County faces rates of obesity and levels of physical inactivity that are at, or worse, than the Kentucky state average. The Bourbon County Health Department (BCHD) has prioritized addressing these issues and received funding from a private foundation to do so. Collaboration with the University of Kentucky and additional funding from UK Healthcare (UKHC) will support these efforts to improve the rates of regular physical activity, raise awareness of the negative health impacts of inactivity, and increase access to safe places to exercise. The BCHD developed a 6-month program that involves several interventions aimed at increasing the percent of …

Understanding The Intersection Between Alaska Native And Military Cultural Identities: Using Arts-Based Narrative Inquiry With Mixed Methods, Leslie M. Robertson

Art Therapy | Doctoral Dissertations

American Indian and Alaska Native (AI/AN) peoples have contributed significant efforts towards involvement in the military and have served in the Armed Forces at five times the national average. AI/AN peoples have served with distinction in every major conflict for over 200 years. There has been a pervasive and historical lack of recognition for their service and a lack of awareness of the intersection between Indigenous and military cultures (Ault, 2020; Bennett, 2009; Department of Veterans Affairs, 2020; Harris & Hirsch, 2020; Holm, 2010; Krouse, 2007; Marston, 1972; Nalewicki, 2021; NICOA, 2019; Viola, 2008; Wooda et al., 2021).

This study …

Increasing Pediatric Asthma Follow-Up Visits And Decreasing Emergency Department Visits In A Primary Care Setting, Rima M. Basal

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The implementation of the asthma follow-up visits bundle in the pediatric primary care setting is an evidence-based practice project aimed at improving pediatric asthma management. This manuscript discusses the deployment of the bundle, which includes pre- and post- knowledge assessment for parents/caregivers, asthma education through a short video and handout, administration of the asthma control test (ACT), completion of a written asthma action plan (WAAP), and education about the patient portal and telehealth. The goal is to improve parent/caregiver knowledge, treatment adherence, follow-up visit compliance (in-person or virtual) and reduce emergency department (ED) utilization. Parent/caregiver knowledge increased by 23%, ACT …

Investigating Sex-Specific Role Of The Kynurenine Pathway In Opioid Withdrawal, Blake Brady

Psychology Theses - Archive

The opioid epidemic has led to a surge in opioid use disorder (OUD) and overdose deaths, making opioid withdrawal a critical area of study. Opioid withdrawal is characterized by both somatic and affective symptoms, including anxiety-like behaviors and physical withdrawal signs, yet the underlying neurobiological mechanisms remain insufficiently understood. The kynurenine pathway (KP), a primary metabolic route for tryptophan (TRP), is increasingly implicated in neuroinflammatory responses and neuropsychiatric disorders, yet its involvement in opioid use and withdrawal remains poorly studied, with even less known about potential sex-specific differences. Historically, the predominant use of male subjects in preclinical research has compounded …

Burnout Among Nurses In The United States, Faheem Ohri

Social Work Dissertations - Archive

Burnout is an exhausted state of the body, mind, and emotions, characterized by feelings of “depersonalization and reduced personal accomplishment” resulting from prolonged and continuous occupational stress. Burnout among nurses in the United States (U.S.) is a growing concern with significant implications for healthcare professionals and patient outcomes. Nurse burnout compromises patient safety and workforce stability, but pre-pandemic national correlates remain understudied. This dissertation examined employment settings and demographic correlates of burnout among U.S. nurses using the National Sample Survey of Registered Nurses (NSSRN) secondary datasets. Compared inpatient burnout odds pre-/post-pandemic using national twin surveys. Jackknife complex survey logistic regression …

Perioperative Surgical Site Infection Reduction Bundle In Colorectal Patients, Flatasha A. Roland

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Surgical site infections (SSIs) are a common and preventable complication after colorectal procedures, significantly impacting patient morbidity and increasing healthcare costs. This quality improvement (QI) project aimed to lower SSIs in adult colorectal surgery patients by implementing a perioperative SSI reduction bundle at a large acute care facility in North Texas. The intervention targeted three modifiable risk factors: perioperative hypothermia, hyperglycemia, and incorrect antibiotic timing. Despite established protocols, institutional data revealed subpar compliance with active warming (46%), blood glucose control (52%), and antibiotic stewardship (75%), all of which fell below national benchmarks. A gap analysis and literature review guided the …

Regionality In Heart Failure Self-Care Behaviors Using The Medical Expenditure Panel Survey, Gretchen K. Wendt

Nursing Dissertations - Archive

Heart failure (HF) risks increase as patients age, with most of the HF patients having at least one chronic condition and 40% having two or more. Further confounding the HF morbidity and chronic medical conditions are psychiatric conditions like depression and anxiety. For most Americans with HF, managing the diagnosis and chronic conditions can be overwhelming. To formalize the definitions of HF disease management, the concepts of self-care from the situation-specific theory of HF self-care (SST-HFSC) were applied.

The medical complexity of HF self-care during the pandemic was shown to vary based on the US region where the individual resided. …

Reframing Recovery: Comparing Music Interventions And Traditional Rehabilitation Methods For Cognitive Function In Traumatic Brain Injury Patients, Laura Velez

Honors Undergraduate Theses

Traumatic brain injury (TBI) affects millions annually, often resulting in long-term cognitive deficits that hinder independence and quality of life. While traditional rehabilitation methods address many physical and functional limitations, cognitive impairments—such as deficits in attention, memory, and executive function—often persist. Emerging evidence highlights music-based interventions as a promising complement to standard therapies, yet comparative research remains limited. This integrative literature review examined the effects of music interventions versus traditional rehabilitation methods on cognitive function in adults with TBI. Using a systematic search of databases including MEDLINE, CINAHL Ultimate, APA PsycInfo, and Music Index, eight peer-reviewed studies were selected for …

Consequences Of Artificial Intelligence In Health Insurance: Lawsuits, Policy, And Ethics, Alyssa N. Roberts

Honors Undergraduate Theses

In recent years, the healthcare system has been burdened by a multitude of obstacles that hinder the ability to provide effective, affordable, and timely care. Among these, one of the most significant challenges is the role that health insurance plays in shaping the quality of care. Health insurance companies are designed to decrease financial strain on patients, but they have introduced inefficiencies through delayed coverage approvals, increased denials, and administrative costs. Artificial intelligence (AI) has started to play an integral role in resolving these issues for the health insurance industry. Through its quick automated claim processing, fraud screening, and reduced …

Nf-Κb-Mediated Oxidative Stress Drives Cigarette Smoke-Induced Emt In Human Bronchial Cells, Sarah M. Alqithami

Theses and Dissertations--Toxicology and Cancer Biology

Cigarette smoke contains over 7,000 chemicals, many being carcinogens and proinflammatory agents contributing to chronic respiratory diseases like COPD and lung cancer. This study investigated responses of human bronchial epithelial cells (HBECs) to cigarette smoke condensate (CSC), focusing on oxidative stress and NF-κB signaling. Three HBEC lines were exposed to non-cytotoxic CSC doses for 48 hours, inducing morphological changes consistent with epithelial-to-mesenchymal transition (EMT). RNA sequencing revealed transcriptomic shifts in all cell lines, particularly affecting genes related to oxidative stress, inflammation, hypoxia, and metabolism. Enrichment analyses confirmed activation of NRF2 antioxidant, NF-κB and IL-17 inflammatory, and hypoxiainducible factor pathways, indicating …

Elucidating The Adverse Effects Of Chronic Pfos Exposure On Gastrointestinal Pathology And Colorectal Cancer, Jerika Durham

Theses and Dissertations--Toxicology and Cancer Biology

Commonly referred to as "forever chemicals," per- and polyfluoroalkyl substances (PFAS) have been linked to a number of detrimental health effects, including an elevated risk of cancer. One "long-chain" subtype of PFAS, perfluorooctanesulfonic acid (PFOS), has a long elimination half-life and a significant propensity for bioaccumulation. Because PFOS is commonly found in drinking water, the gastrointestinal system absorbs it at a high rate. Recent studies demonstrate that PFAS exposures promote intestinal inflammation and gut barrier dysfunction. However, how a long-term PFOS exposure affects colorectal cancer (CRC) progression is not known. Therefore, the purpose of this research is to understand how …

Investigating Plk1 In Pulmonary Fibrosis, Tempany Arbogast

Theses and Dissertations--Toxicology and Cancer Biology

Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease, with a median survival of only 2–3 years following diagnosis. In the United States, the disease contributes to more than 40,000 deaths annually, underscoring its severe clinical burden. Alveolar type II (AT2) lung epithelial cells serve as progenitors that maintain alveolar integrity by replenishing epithelial populations and producing surfactants, while fibroblasts and myofibroblasts regulate the extracellular matrix and structural support. In pulmonary fibrosis (PF) injury to AT2 cells promotes cytokine and growth factor release, driving inflammation, fibroblast proliferation, myofibroblast accumulation, and excessive extracellular matrix deposition. Aberrant AT2 cell …