Medicine and Health Sciences Commons^™

Investigation Of Heterosynaptic Long-Term Potentiation Of Non-Nociceptive Synapses, Synaptically Relevant Kinase Discovery, And Virtual Screening For A Pkmz Inhibitor In Hirudo Verbana", Avery Franzen

Dissertations and Theses

There is a considerable lack in efficacy for current chronic pain treatments. One therapy that has gained attention are cannabinoid-based medications. However, preclinical and clinical trials do not produce anti-nociceptive results consistently and occasionally produce pro-nociceptive results. Understanding this ambiguity between anti-nociceptive and pro-nociceptive effects is vital to cannabinoids’ future utilization. One symptom of chronic pain conditions is allodynia in which pain is perceived following non-painful stimuli. This may be due to non-nociceptive afferents activating nociceptive circuitry in an abnormal manner. Using the medicinal leech, Hirudo verbana, we have begun to elucidate mechanisms by which endocannabinoids strengthen non-nociceptive afferent synapses. …

The Impact And Perceptions Of Open Educational Resources And Oer-Enabled Pedagogy On Affordability, Enrollment, And Student Success In Undergraduate Anatomy And Physiology, Justin Burr

Dissertations and Theses

Open educational resources (OER) can help improve the affordability of higher education. While the impacts of OER on student success and cost savings have been studied in some areas, the literature lacks evidence for undergraduate anatomy and physiology. Additionally, the potential impact OER has on student enrollment choices in undergraduate anatomy and physiology remains unstudied. The cost of textbooks has been a notable hurdle to higher education participation and success, particularly among minority and underserved populations. This study aimed to evaluate the impacts of OER on affordability (cost), access (enrollment), and student success. A mixed-methods approach was used to answer …

Predicting Biologic Nonadherence In Inflammatory Bowel Disease Using Machine Learning Models, Christian Rhudy

Theses and Dissertations--Clinical and Translational Science

Inflammatory bowel disease is a chronic relapsing-remitting disease of the intestinal tract affecting approximately 0.5% of the population in the US. Moderate to severe inflammatory bowel disease is managed with biologic therapies to induce and maintain remission, however nonadherence to biologics occurs in and estimated 16.9% and 45% of patients. Nonadherence to biologics can increase the risk of disease flares, emergent healthcare utilization, and surgical intervention. While numerous factors have been associated with biologic nonadherence, there are limited resources for prospectively assessing patient-specific risk of biologic nonadherence. Accordingly, objective of this work is to develop machine learning methods of predicting …

Rural Hospital Closure And Medicaid Expansion, Jason White

Theses, Dissertations and Capstones

Introduction: In the United States, hospitals in rural areas have been under financial pressure and have been closing at an increasing rate.  This reduces access to care for rural citizens.  The Affordable Care Act of 2010 was passed in order to increase access to medical care, partially through an optional expansion of Medicaid coverage to a larger percentage of the population.  As some states adopted the expansion and some states did not, an opportunity was created to examine the policy’s effect on rural hospital stability.

Purpose of the Study:  This study was designed to examine the effect of …

Effect Of Wildfire Smoke Pm2.5 On Preterm Birth Outcomes: A Generalized Synthetic Control Analysis Of Preterm Births In The Contiguous United States From 2006 To 2020, Alexandra Maria Nechaev

Public Health Theses

Wildfire activity has intensified across the United States due to climate change, contributing to rising levels of smoke-attributable fine particulate matter (PM2.5) in ambient air. Wildfire-specific PM2.5 is linked to adverse health outcomes, including increased risk of preterm birth, a leading cause of infant morbidity and mortality. Despite growing concern, few studies have applied quasi-experimental methods to evaluate the causal effects of wildfire-attributable PM2.5 on preterm birth across large, diverse populations and geographical areas. This study estimated the effect of wildfire-specific PM2.5 exposure on preterm birth rates across all counties in the contiguous United States from 2006 to 2020 using …

Social Media Influences On Youth Substance Use, Sexual Health, And Mental Health In Paterson, New Jersey: A Rapid Qualitative Analysis, Nimisha Srikanth

Public Health Theses

Introduction: Social media use among youth has become a topic of concern among public health professionals and policymakers. Youth have grown to rely on social media for communication and entertainment, but are exposed to negative health behaviors with the potential to model them in their lives. In this study, we investigated youth’s perspectives on social media content and the impact it has on their health and lives.Methods: We conducted a rapid qualitative analysis of individual interviews of youth from Paterson, New Jersey. Among the sample (n=20), the mean age was 16 years, 80% identified as male, and 30% were justice-involved. …

The Role Of Climate Change In The Pandemic Agreement Negotiations, Cristina Arnes Sanz

Public Health Theses

Introduction: For over three years, Member States of the World Health Organization (WHO) have been negotiating a treaty to prevent, prepare for, and respond to future pandemics. The Pandemic Agreement is anticipated to be adopted at the World Health Assembly in May 2025. Growing scientific evidence underscores the effects of climate change on infectious diseases, including those that could lead to pandemics. This thesis examines how climate change has been addressed in the drafting and negotiations of the Pandemic Agreement.

Methods: All the references related to climate change in the transcripts of the publicly broadcast Intergovernmental Negotiating Body (INB) meetings …

Nurse's Satisfaction With The Implementation Of A Standardized Physical Assessment Template In Home Based Medical Care, Nicole Silvestri

Doctor of Nursing Practice Scholarly Projects

Background and Literature Review:
Home based medical care (HBMC), part of Optum’s UnitedHealth division, delivers in-home urgent care to medically complex patients at high risk for hospitalization. A nurse is dispatched to the home and a provider connects via telemedicine to conduct the visit. Currently, there is no standardized documentation tool to communicate physical assessment findings between the in-home nurse and the telemedicine provider. A literature review was conducted using PubMed and CINAHL with search terms including nursing satisfaction, physical assessment, EMR, template, standardized tool, and documentation. This revealed challenges in nursing documentation, communication, and physical assessment, particularly regarding …

Nutritional Knowledge And Perceptions Of The Dietetics Field Among Blue-Collar Workers In The Inland Empire, Sabrina Guerrero, Anthony Morales, Isabel Tjajadi, Liang Ji, Kyndra Woosley, Lesley Ann Foster-Nicholas

Loma Linda University Research Reports

Blue-collar workers often encounter significant barriers to healthful eating. This study aimed to assess the nutritional knowledge and perceptions of the dietetics field among blue-collar workers in the Inland Empire. Eighty-four eligible participants completed an anonymous online survey assessing nutrition knowledge and views on Registered Dietitians (RDs). The average nutrition knowledge score among surveyed blue-collar workers was 20 out of 25 (80%). There were no significant differences in nutrition knowledge based on RD visit history, age, gender, or occupation. However, significant disparities in nutrition knowledge were observed across racial/ethnic groups, with Asian participants scoring lower and White participants scoring higher. …

Elementary School-Based Speech-Language Pathologists' Perspectives On The Management Of Pediatric Feeding And Swallowing Disorders, Kelsi L. Szakovits

Senior Honors Theses and Projects

Speech-language pathologists (SLPs) frequently serve autistic students in the school setting. Research reveals a correlation between autism, sensory processing, and pediatric feeding disorder (PFD). As a result, autistic students may have compromised nutritional health and safety, which stands to impact their ability to access the curriculum. PFD is under the scope of the school-based speech-language pathologist’s practice. However, data has shown a perceived lack of confidence and a limited number of support and resources in the educational setting for SLPs to carry out interventions. This qualitative study will seek to understand the perspectives of elementary school-based SLPs regarding the implementation …

Relationship Between Ehealth Literacy And Use Of Patient Portals Among Older Adults: An Integrative Review, Lore Oluwatominiyi

Senior Honors Theses and Projects

The rapid advancement of healthcare technologies, including patient portals, has the potential to improve patient engagement and health outcomes, particularly among older adults. However, the adoption of patient portals among this demographic remains relatively low, primarily due to varying levels of eHealth literacy. The aim of this integrative review, guided by the Whittemore and Knafl’s (2005) framework, was to investigate the experience of eHealth literacy and patient portal use among older adults. The databases of PubMed, CINAHL, and PsycINFO were searched for articles published between 2017 and 2023. Keywords used included: eHealth literacy, patient portals, and older adults. Thirty records …

Enhancing Nursing Education To Improve Care For Patients With Substance Use Disorder: A Literature Review, Allma Swier

Senior Honors Theses and Projects

Background. As nursing students attend undergraduate school and prepare to enter the workforce, clinical experience and classroom training shape who they will become as caregivers. There is a lack of education built into the standard curriculum on how to care for people with substance use disorders empathetically and professionally. Aim. The purpose of this literature review is to determine if nursing students feel adequately prepared to care for patients with substance use disorder, and how implementation of educational curricula can increase students' knowledge of caring for individuals with substance use disorder, leading to an increase in confidence when caring for …

Clinicians Perspective On The Implementation Of Person-Centered Care In Persons With Aphasia, Carmen S. Alderman

Theses and Dissertations--Communication Sciences and Disorders

This paper examines speech-language pathologist perspective on implementing person-centered care for persons with aphasia. Person-centered care is based on the social model, which emphasizes the importance of including the client. The survey addressed clinicians’ use of person-centered care related to collaborative goal setting and treatment planning, as well as facilitators and barriers to implementing person-centered care for individuals with aphasia based on the view of practicing clinicians across a variety of settings. The results indicated most speech-language pathologists have heard of person-centered care, understand the importance of involving clients in goal setting, ask clients about their preferences when setting goals, …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Biomedical Relation Extraction In The Era Of (Large) Language Models, Yuhang Jiang

Theses and Dissertations--Computer Science

Biomedical relation extraction is a key task in information extraction supporting downstream applications such as knowledge discovery, information retrieval, and question answering. As such, improvements in relation extraction (RE) are expected to have major implications for other information needs in biomedicine. In this dis- sertation, we pursue biomedical relation extraction in several advanced settings with recent advances in large language models (LLMs) and retrieval augmented generation (RAG). First, we address an important slot filling task on social media that arose during the Covid-19 pandemic, using the idea of continuous prompts with encoder models. Next, we handle a tricky dynamic n-ary …

Menstrual Cycle Variations In Ultrasound And Biomechanical Risk Factors For Acl Injury In Adolescent Female Athletes, Jessica Garcia

Kinesiology Dissertations - Archive

Anterior cruciate ligament (ACL) injuries are a significant concern in adolescent female athletes, with rates consistently higher than their male peers. This disparity is attributed to a complex combination of anatomical, hormonal, and neuromuscular factors that elevate injury risk while performing dynamic movements common in running and cutting sports such as soccer, basketball, lacrosse, and volleyball. Knee laxity has been identified as a potential risk factor, yet current measurement tools lack the sensitivity, reliability, and validity needed for practical application. Additionally, fluctuating sex hormones throughout the menstrual cycle (MC) have been implicated in changes to ligament properties and neuromuscular control, …

Artificial Intelligence In Radiology, Olivia Sweeney

Theses, Dissertations and Capstones

Introduction: Artificial intelligence (AI) has increasingly transformed radiologic practice by improving diagnostic accuracy, streamlining workflows, and reducing interpretation errors. As AI integration has expanded across imaging modalities, questions have emerged regarding its effectiveness compared to traditional radiologist-only interpretation.

Purpose of Study: The purpose of this study has been to evaluate the impact of AI-assisted radiology on diagnostic accuracy, efficiency, and error reduction, while also assessing clinician perceptions of AI as a collaborative tool in imaging analysis.

Methodology: This qualitative study has used a systematic review of peer-reviewed literature published between 2015 and 2025, following PRISMA guidelines, combined with an interview …

Reducing Colonoscopy Cancellations Saves Lives, A Quality Improvement Project, Jennifer L. Brosnan

West Chester University Doctoral Projects

One of Healthy People 2030’s objectives is to increase the proportion of adults screened for colorectal cancer. To address this objective, a quality improvement project was completed within an Ambulatory Surgical Center (ASC). An evidenced-based committee was formed with the primary goal to decrease the number of cancelled colonoscopies. The committee aimed to answer the PICOT question: For patients who cancel their colonoscopy, how does the development and implementation of an evidence-based practice (EBP) committee’s nursing interventions reduce cancelled colonoscopy rates and increase reschedule rates, compared to no implementation of an EBP committee’s nursing interventions, over three months?

Nursing interventions …

Reducing Unnecessary Antibiotics For The Treatment Of Urinary Tract Infections, Megan A. Carullo

West Chester University Doctoral Projects

Urinary tract infections (UTIs) are among the most common infections in women and are often a reason for prescribing antibiotics. Appropriately treating these infections is vital to prevent significant health concerns such as pyelonephritis or sepsis. Providers commonly prescribe antibiotics as a preventive measure, but incorrect usage can lead to unnecessary use of antibiotics. This is a large concern for the medical community, given the increased rates of antibiotic resistance. This quality improvement project aimed to answer the following research question: In women with recurrent UTIs (rUTIs), does presumptive treatment compared to standard treatment upon confirmed infection increase the number …

Exploring Perceptions Of Accommodations In Ot Fieldwork: A Mixed Methods Study, Courtney A. Gohean, Courtney Gohean

West Chester University Doctoral Projects

This study employed a convergent parallel mixed-methods design to explore the perceptions and experiences of occupational therapy (OT) fieldwork educators, academic fieldwork coordinators (AFWCs), and Level II OT students with disabilities regarding accommodations during fieldwork. Quantitative data were collected through an online Qualtrics questionnaire completed by 45 fieldwork educators. Qualitative data were gathered through semi-structured interviews with seven AFWCs and seven OT students/new graduates who had used Section 504 accommodations during Level II fieldwork. Thematic analysis revealed key themes among students and AFWCs, including barriers to disclosure, variability in support and communication, the need for proactive planning, and concerns regarding …

Assessing The Effect Of Increasing The Frequency Of Copd Assessment Test Utilization On Rehospitalization Rates For Home Health Patients, Rebecca Goldberg

West Chester University Doctoral Projects

Abstract

This evidence-based practice Process Improvement (PI) project involves using the COPD Assessment Test (CAT) to decrease rehospitalization rates for home health patients with a diagnosis of Chronic Obstructive Pulmonary Disease (COPD). The project includes having therapy clinicians complete the CAT during their in-home skilled visits, between home health nursing visits to increase the frequency of completion. The goal is to recognize symptoms of exacerbation early, engage patients in their own care, encourage communication with providers, initiate early intervention at home, and prevent rehospitalization. Patients with COPD experience frequent symptom exacerbations leading to anxiety, poor quality of life, and challenges …

Decreasing Charting Errors On An Antepartum Testing Unit, Morley Mullins

West Chester University Doctoral Projects

Abstract

This evidence-based quality improvement project addresses problematic documentation noted on a Maternal-Fetal Medicine Antepartum Testing Unit. The quality of patient care and billing practices can be impacted by minor “typos” that exist in electronic medical records (EMRs), creating a significant challenge for those who use them. This project evaluates key areas contributing to inaccuracies in medical records using chart audits to identify frequency and types of errors. Educational sessions via PowerPoint were used to discuss charting practices. A designed framework for ongoing training and support emphasizes the importance of accurate documentation and specific areas of concern via audits to …

The Impact Of Health Promotion Home Visits On Loneliness In An Older Adult Population, Jean M. Herb

West Chester University Doctoral Projects

Loneliness among older adults is a significant public health concern associated with adverse physical, emotional, and cognitive outcomes. Despite widespread recognition of the issue, effective interventions remain limited in clinical practice. This Doctor of Nursing Practice (DNP) project implemented and evaluated a Health Promotion Home Visit (HPHV) intervention designed to reduce loneliness in community-dwelling adults aged 65 and older. A quality improvement initiative using a pre-post design was conducted at a community outreach division of a home health agency. Patients received HPHV every other week over an eight-week period. The UCLA Loneliness Scale (Version 3) was used to assess loneliness …

Cus+E: Creating A Culture Of Safety Through Improved Communication Within Perioperative Services, Sunilka Thompson

West Chester University Doctoral Projects

The Department of Perioperative Services identified ongoing communication and cultural challenges that compromised team dynamics, psychological safety, and patient care. A culture of safety survey revealed a significant disconnect: while many staff felt comfortable raising safety concerns, nurses and ancillary support staff reported widespread experiences of disrespectful behavior—perceptions not shared by providers. In response, the department implemented the CUS+E (I’m concerned, I’m uncomfortable, this is a safety issue + Explanation) communication tool to enhance the real-time escalation of safety concerns. Project goals included increasing safety reporting, reducing adverse events, and improving staff confidence in raising concerns. Post-implementation surveys indicated that …

Understanding The Experience Of Survivorship: Self-Efficacy, Emotional Wellbeing, And Post-Traumatic Growth Across A 6-Month Period In Women Diagnosed With Breast Cancer, Shannon N. Hiscock

West Chester University Doctoral Projects

Breast cancer is one of the most common cancers in the world. Diagnosis and treatment can be traumatic, leading to declining physical and psychological health, but also a process of psychological evolution known as post-traumatic growth (PTG). Self-efficacy is a factor that is associated with positive outcomes in breast cancer, including emotional well-being and post-traumatic growth. The purpose of this study was to examine changes across 6-months in biopsychosocial variables (self-efficacy, PTG, and emotional well-being), as well as the relationships between these variables, in an effort to identify areas for intervention early in breast cancer treatment to promote positive mental …

Changing The Narrative For University Students With A History Of Aces: Campus Assets And Student Well-Being, Hailey Ellingson

West Chester University Doctoral Projects

College students often report high levels of adverse childhood experiences (ACEs), which are linked to poor mental and physical health and lower academic success. While some positive experiences in childhood can lessen the risk outcomes associated with ACEs, limited research has explored how this applies to college students. This study examined how assets – specifically, college climate and resources – relate to student well-being and whether these assets buffer the impact of cumulative ACEs, which refers to adverse experiences within the home (e.g., abuse, neglect, and witnessing domestic violence) and community (e.g., bullying and neighborhood violence). Undergraduate students (n …

Pediatric Medical Traumatic Stress: The Effects Of A Medical Trauma On Development, Psychological Well-Being, And Interventions For Prevention, Emilee M. Stevens

Senior Honors Theses and Projects

Background Pediatric medical traumatic stress (PMTS) is a syndrome of physiological and psychological responses that occur in children following exposure to stressful or traumatic medical events. Experiences such as painful procedures, admission to pediatric intensive care units (PICU) or neonatal intensive care units (NICU), and acute injuries may be traumatic to some children. This integrative review aims to identify risk factors associated with PMTS, examine its impact on child development and psychological well-being, and outline nursing interventions for prevention. Methods A search of ProQuest and PubMed was conducted to identify peer-reviewed articles published in English between 2020 and 2025. Inclusion …

Comparison Of Apixaban And Left Atrial Appendage Exclusion Device (Watchman) In Preventing Stroke And Systemic Embolism In Atrial Fibrillation Patients, Sreeja Konatham

Master's Theses and Doctoral Dissertations

Atrial fibrillation is a cardiac arrhythmia associated with increased risk of stroke and systemic embolism. Apixaban, an oral anticoagulant, and the Watchman, a left atrial appendage closure device, are the currently used therapeutic treatments for the prevention of stroke and systemic embolism in atrial fibrillation patients. However, a direct comparison of these two treatments with respect to safety and effectiveness remains limited. This research evaluates Apixaban and the Watchman device by analysing the clinical trial data and full regulatory approval pathways. Apixaban has been approved through New Drug Application process, and the Watchman device is approved via the premarket approval …

Patient-Centric Barriers To Clinical Trial Participation In Developing Countries: A Retrospective Analysis, Kirandeep Kaur

Master's Theses and Doctoral Dissertations

The underrepresentation of developing countries in clinical trials limits the applicability of research findings to a significant portion of the global population. This study addresses this gap by conducting a retrospective analysis of published literature to identify patient-centric barriers to clinical trial participation in developing countries. A comprehensive search of PubMed, Web of Science, and Cochrane Library databases yielded four relevant studies, which were subjected to thematic analysis. The study identified 12 key emerging themes, with safety and efficacy concerns and trust issues being the most prevalent. The thematic analysis partially supported the hypothesis: While trust issues were found in …

Pathogenesis And Pathophysiology Of Celiac Disease, Kendall N. Reece

Undergraduate Honors Theses

Celiac Disease is an allergic response to foods that contain the protein gluten. Celiac Disease is classified as an autoimmune disorder, which specifically deteriorates the villi of the jejunal segment of the small intestine. Specific topics analyzed within this thesis include some physical attributes of Celiac Disease such as weight loss, diarrhea, dermatitis herpetiformis, etc. The basis of classification is discussed and the negative effects Celiac Disease has on the body, such as malabsorption, vitamin deficiencies, and damage to the villi. Diagnostics such as biopsy and blood tests, treatments both experimental and adhering to a gluten-free diet are discussed. Origination …