Medicine and Health Sciences Commons^™

The Impact Of Structured Weekend Group Therapy On Restraints, Seclusion And Length Of Stay On Inpatient Psychiatric Units, Victoria Grau

West Chester University Doctoral Projects

Group therapy is an essential part of inpatient psychiatric treatment, with documented positive effects including better medication compliance, lower readmission rate, and improved self- esteem. Patients who are admitted for an inpatient psychiatric stay have a small window of time in which behavioral health staff can work with them. Group therapy can help patients develop a plan for these issues and provide a foundation for successful discharge and symptom management. The project site is a mid-size teaching hospital in an urban community with higher rates of mental health diagnoses than the national average. Group therapy was conducted initially Monday – …

Screening For Relative Energy Deficiency In Sport (Reds) And The Female Athlete Triad In Female Undergraduate Collegiate Athletes: A Quality Improvement Project, Maria A. Marziano

West Chester University Doctoral Projects

This quality improvement (QI) project investigated female collegiate athletes’ knowledge and prevalence of Relative Energy Deficiency in Sport (REDs) and the Female Athlete Triad (Triad). The increase in female athletics brings a growing concern for performance-related health risks, including low energy availability (LEA), menstrual dysfunction, and low bone mineral density (BMD). This study assessed the effectiveness of education and self-screening in identifying at-risk athletes and encouraging resource application for intervention. A mixed-methods design was employed, utilizing retrospective data along with pre- and post-intervention surveys. The study involved 33 female collegiate athletes from lean endurance sports, assessing knowledge, risk factors, and …

Distinguishing Symptoms Of Racial Trauma From Conventional Trauma, Michelle Yoong

West Chester University Doctoral Projects

Trauma research in psychology has traditionally been shaped by a White-centric framework, leading to the underrepresentation of racial and ethnic minority experiences. This study aims to establish racial discrimination as a distinct traumatic stressor with significant psychological consequences by exploring the distinction between racial and conventionally recognized traumatic stressors and posttraumatic stress symptoms (PTSS). It also aims to address inconsistent and exclusionary assessment methodology involving underrepresented racial minority (URM) populations, including the neglect of racial trauma and discrimination measures in trauma research. Participants consisted of URMs who sought enrollment in a clinical trial for opioid use disorder at a community …

A Question For The Ages: The Relationship Between Nurse Staffing And Quality In Appalachian Skilled Nursing Facilities, Eric Jason Pulice

Theses, Dissertations and Capstones

Nurse staffing levels have been shown to have a critical impact on nursing quality in skilled nursing facilities (SNFs). Sociodemographic disparities in Appalachian areas have the potential to impact SNF nurse staffing levels and quality. This study examined the relationship between nurse staffing levels and quality in Appalachian SNFs, as well as compliance with the Biden Administration’s minimum staffing mandates as set forth in CMS-3442-F enacted on June 24, 2024.

The study applied Resource Dependency Theory (RDT) through Donabedian’s Structure-Process-Outcome (SPO) conceptual framework to assess how external resource constraints and regulatory policies impact nurse staffing levels and quality in Appalachian …

Investigating The Extent To Which Diet-Induced Obesity Alters Gene Expression In Hematopoietic Stem And Progenitor Cells Following Influenza Immunization In Mice, Chaitanya Lahari Chowdary Pathipati

Theses, Dissertations and Capstones

Vaccines are a vital tool in preventing diseases, but their effectiveness varies depending on factors like diet and body weight. Obese individuals often experience reduced vaccine protection, as seen with influenza vaccines, where they have twice the risk of getting the flu compared to healthy-weight individuals after vaccination. This study aims to understand why obesity weakens vaccine effectiveness, focusing on the role of blood-forming stem cells in the bone marrow, known as hematopoietic stem and progenitor cells (HSPCs). These cells are crucial for producing immune cells that defend the body against infections. Previous research has shown that diet-induced obesity alters …

Implementing Gallup 12+ Employee Engagement Survey In A Critical Access Hospital, Catherine R. Hardwick

Honors Theses and Capstones

Objective: To utilize the Gallup Q12+ survey to assess baseline staff engagement among nurses and nursing assistants at a critical access hospital, implement direct education intervention, and evaluate its impact on staff engagement rates, with the goal of identifying micro and macro-problems.

Methods: This quality improved project was conducted at Littleton Regional Hospital, a level Ⅲ trauma center and critical access hospital. The PDSA cycle started on March 1 and ended May 10. The Gallup Q12+ survey was sent to Registered Nurses, Licensed Nursing Assistants, and Nursing Technicians to establish baseline staff engagement levels and areas that need improvement. Directed …

Noise In The Acute Care Patient Setting, Taylor A. Cota, Brynn Roberts

Honors Theses and Capstones

Noise levels in hospital environments can negatively impact patient satisfaction and recovery, particularly in high-acuity units such as Progressive Care Units (PCUs) (Choiniere, D. B., 2010). Patient satisfaction surveys at the PCU at Exeter Hospital have consistently identified noise as a concern, highlighting the need for rigorous quality improvement (QI) planning phase to determine whether a structured intervention, such as white noise implementation, is indicated.

This project focuses on the initial planning phase of the Plan-Do-Study-Act (PDSA) cycle (Institute for Healthcare Improvement, n.d.) to assess the feasibility and necessity of introducing white noise machines to enhance patient experience on the …

18s Metabarcode Analyses Of Eukaryotic Species In The Respiratory Microbiomes Of Wild Canids From New Hampshire, Collin Sinclair Blake

Honors Theses and Capstones

This study is of an exploratory nature and focuses on characterizing the eukaryotic microbiota present in the respiratory tissues of six wild canids and one domestic canine. The contents of this document largely pertain to dry lab analyses of 18S barcodes in bioinformatics programs – primarily QIIME2 running in the GitBash command line, service for which was hosted by the UNH Ron Bioinformatics training server. All procedures listed within the section below were performed by second parties at the UNH Hubbard Center for Genomics Studies (HCGS), the New Hampshire Veterinary Diagnostics Lab (NHVDL), and the UNH Microbial Ecology and Emerging …

Synthesis Of Tu100 Analogs And Biological Assays, Feyisope Tonye Oladapo

College of Graduate Studies: Theses & Dissertations

TU100 (14-methyl-5H-5,12-epiminobenzo[4,5]cyclohepta[1,2-b]naphthalene-6,11,13(12H)-trione) exhibits exceptional chemotherapeutic properties. It operates via a distinct mechanism that triggers cell death to create cytotoxic effects while concurrently inhibiting topoisomerase I and II. Its efficacy rivals that of well-known chemotherapeutic drugs like Daunorubicin. The distinctive characteristics of TU100 have led to initiatives aimed at creating structurally similar compounds to discover even more effective bioactive alternatives.

The analog synthesis incorporated quinoxaline or its derivatives (diphenyl quinoxaline, dipyridinyl quinoxaline, and dibenzophenazine-10,13-dione) that have been shown to have promising chemotherapeutic effects. Synthesizing the hetero naphthoquinones required a multi-step synthetic process, so quinoxaline/ derivatives intermediates are first prepared, then the …

Implementing Noninvasive Capnography Monitoring To Enhance Early Recognition Of Postoperative Respiratory Decline In High-Risk Patients: A Quality Improvement Project, Trevor A. Messenger

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Implementing Noninvasive Capnography Monitoring to Enhance Early Recognition of Postoperative Respiratory Decline in High-Risk Patients: A Quality Improvement Initiative

Trevor Messenger

Background: Those suffering from chronic respiratory disease, obstructive sleep apnea (OSA), obesity, and other serious comorbidities are at an increased risk of respiratory decline after receiving general anesthesia. Respiratory decline leads to adverse outcomes, including increased hospital length of stay, intensive care unit (ICU) admissions, morbidity, and mortality.

Purpose: To improve the safety of postoperative patients at risk for OSA, and to reduce adverse events and airway interventions by enhancing the monitoring capabilities of bedside clinicians with waveform …

All-Terrain Vehicle Injuries Among Youth: A Multidimensional Analysis Of Injury Patterns In West Virginia And Safety Laws Across High-Fatality States, Sabrina Chyann Beal

Graduate Theses, Dissertations, and Problem Reports (ETD)

All-terrain vehicles (ATVs) pose significant injury risks, particularly among youth. These powerful machines are widely used across recreational and rural settings. West Virginia consistently ranks among the top five states for ATV-related deaths and injuries. Safety equipment and requirements are often not followed nor enforced, causing children and adolescents to be the most vulnerable group because they tend to not wear safety equipment such as helmets, ride on roadways, carry passengers, and operate oversized ATVS. This study examined ATV injury patterns from the WVU Medicine Trauma Registry and ATV laws across the five states with the highest reported fatalities. This …

Code Blue Narrator Documentation: An Evidence Based Quality Improvement Initiative, Stefanie A. Benvenuto

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: The code documenter plays a crucial role in ensuring accurate, real-time documentation during Code Blue events, which is critical for patient care and compliance with established guidelines and protocols. However, nurses have reported discomfort with the Code Narrator tool in EPIC, which has hindered effective documentation during these high-pressure situations.

Purpose: The lack of comfort in using the Code Narrator tool has led to inconsistent and inaccurate documentation during Code Blue events, potentially impacting the effectiveness of the response and patient outcomes, such as the achievement of return of spontaneous circulation (ROSC).

Intervention: An educational competency …

Improving Perinatal Outcomes With The Mood Disorder Questionnaire: A Quality Improvement Project To Increase Identification And Referral, Elizabeth R. Bargardo

Master's Theses and Capstones

Abstract

Background: Perinatal mental health is a growing concern, with under identification and lack of access to mental health as contributing factors. Screening tools such as the Mood Disorder Questionnaire are one way to increase identification of patients at risk for bipolar-spectrum disorders and subsequent postpartum psychosis and initiate referrals to appropriate mental health services.

Local Problem: One outpatient women’s health center has a 94% screening rate for the Edinburgh Postnatal Depression Score (EPDS) for anxiety and depression but has not implemented a screening for bipolar disorder. In addition, while approximately one in five perinatal patients struggles with a mental …

Is Laughter The Best Medicine? Analyzing The Role Of Gallows Humor In Nursing Education, Favour Onichabor-Connell

Honors College Theses

Gallows humor is a coping mechanism used by healthcare professionals to manage stress and emotional burden. Understanding its role in nursing education can help educators and students navigate the complexities of the profession. This study examined its significance through a literature review and a survey of nursing students and educators. The literature review included 15 peer-reviewed articles from databases like GALILEO, CINAHL, PubMed, and Scopus, highlighting both its benefits and ethical concerns. Findings suggest gallows humor is commonly used for stress management and is generally viewed as beneficial for learning and emotional resilience. However, concerns were raised about its potential …

The Role Of Horizontal Gene Transfer In Antibiotic Resistance Amidst Prevalent Community And Healthcare-Associated Mrsa Rates, Gabrielle Nascimento

Honors College Theses

In recent decades, cases of community-acquired MRSA (CA-MRSA) and healthcare-associated MRSA (HA-MRSA) have been on the rise. The ability of antibiotic resistance to transfer between microorganisms greatly expands its threat to the effective treatment and containment of bacterial infections. The mecA gene is found on a mobile cassette within the Staphylococcal cell and encodes for PBP2a, an alternate version of penicillin-binding protein (PBP) with less binding affinity for β-lactam antibiotics, increasing resistance to the effects of antibiotics. The goal of this research is to investigate the horizontal transfer of the mecA gene between various Staphylococcus species as well as to …

A Spectroscopy Study Of The Brain: Exploring Sex Differences In Healthy Older Adults, Angela Gushue

CMC Senior Theses

Cognitive decline and aging-related disorders, such as Alzheimer’s, disproportionately affect patients based on sex, but the mechanisms underlying these skewed effects are unknown. This proton magnetic resonance spectroscopy (H-MRS) study seeks to understand if sex disparities in aging exist in neurometabolite concentrations of older adult brains. Sixty-seven participants, ranging from 60 to 85 years of age, underwent the Montreal Cognitive Assessment (MoCA) and H-MRS of the brain. Concentrations of myo-inositol, total creatine, total NAA, and total choline were calculated in the dorsal posterior cingulate cortex, left hippocampal cortex, left medial temporal gyrus, left primary sensorimotor cortex, and right dorsolateral prefrontal …

From Fields To Fast Foods: Food Culture, Identity, And Health In Puerto Rico Under The U.S. Empire, Ivanna Morales Mercado

CMC Senior Theses

Operation Bootstrap, launched in 1947, fundamentally altered Puerto Rico’s economy, just as much as its food culture. Prioritizing manufacturing over agriculture led to the collapse of the island’s farming sector, increasing reliance on food imports and leading to a rise in diet-related diseases such as obesity, type 2 diabetes, and cardiovascular issues. This thesis examines the legacies of Operation Bootstrap on Puerto Rico’s food system, health outcomes, and cultural identity by emphasizing the need to value intergenerational knowledge. The oral history research in this study highlights the importance of intergenerational knowledge in reclaiming sustainable agricultural practices and healthy, culturally significant …

Investigating The Impact Of Phthalate Exposures From Personal Care Products On Uterine Fibroid Incidence And Prevalence In Us-Born Black Women, Ella Brissett

CMC Senior Theses

Uterine fibroids are benign tumors composed of smooth muscle cells and connective tissue that develop within or on the walls of the uterus. Despite being non-cancerous, they can severely affect quality of life by causing heavy bleeding, chronic pain, and reproductive complications. Fibroids are typically found in women of reproductive age, but they disproportionately affect Black women, who experience higher incidence and severity. The underlying causes of this disparity is poorly understood; however, an emerging body of research is highlighting the role of phthalates, endocrine-disrupting chemicals found in many personal care products, in exacerbating fibroid development. Through a critical analysis …

Regulation Of Neuronal Autophagy By Amyotrophic Lateral Sclerosis (Als) - Associated Kinase Tbk1: Evaluating The Role Of Ncoa7, Vikram Chatterjee

CMC Senior Theses

Amyotrophic lateral sclerosis (ALS) is a fatal, neurodegenerative disease characterized by motor neuron loss and the pathological accumulation of misfolded proteins. Autophagy, a lysosome-mediated clearance mechanism, plays a vital role in maintaining cellular homeostasis by removing damaged organelles and protein aggregates. Impairments in autophagy have been increasingly linked to ALS, underscoring its importance in neuronal health. TANK-binding kinase 1 (TBK1) is a key regulator of selective autophagy, facilitating the recognition and sequestration of specific cargo through phosphorylation of autophagy receptors. Notably, mutations in the TBK1 gene have been identified in ALS patients, directly implicating TBK1 dysfunction in disease pathogenesis. Through …

Neural Correlates Of Attentional Biases In Dietary Choice: Role Of Childhood Socioeconomic Status, Justine Jamie N. Gotico

CMC Senior Theses

Childhood poverty has been shown to increase adult risk for obesity above and beyond its direct effects on adult socioeconomic status (SES). One proposed mechanism of these effects is by shifting behavioral patterns of dietary consumption and choice, for example by increasing rapid attention to high-calorie unhealthy foods. Yet, whether such neural mechanisms can explain observed differences in dietary behavior based on childhood SES remains an open question. Here we used event-related potentials (ERPs) to examine early attentional correlates of low childhood SES during a dietary choice task, based on research suggesting that early attentional biases toward high-calorie foods emerge …

Money Matters: Investigating The Emotional, Cognitive, And Biological Pathways Connecting Maternal Early Life Financial Insecurity And Parenting Quality, Elise Power, Stacey N. Doan

CMC Senior Theses

Early life adversity has been shown to have a variety of negative effects on adult functioning, including parenting quality, with implications for child wellbeing. Adverse early life experiences including poverty have been linked to long-term disruptions in emotional, cognitive, and physiological functioning that compromise the ability to provide sensitive, nurturing care. The present study investigated whether emotional regulation difficulties, physiological regulation, and cognitive function mediate the relationship between early life financial insecurity and parenting quality. A sample of 132 mother-child dyads completed self-report measures, biological samples, and cognitive assessments. A multiple mediation model ran in SPSS, revealed a significant indirect …

Nightmare, Phoebe E. Bowen

Honors Theses and Capstones

No abstract provided.

Nh State Parks Outdoor Recreation And Wellbeing, Muriel C. Bennett

Honors Theses and Capstones

This evaluation strives to analyze NH residents’ usage of outdoor spaces (adults 18+) and NH State Park lands. The general purpose of this evaluation is to gain evidence and develop an understanding of participant use of outdoor spaces and whether participant’s mental well-being is a driving factor in outdoor recreation. As children and adults are spending increasingly more time indoors and on phones and computers, it is necessary for further research and advocacy efforts to be developed on the importance of time outdoors. It has be found that “urban lifestyles impose increasing demands on our cognitive resources” (Ohily, 2010) which …

A Program Evaluation Case Study, Madelyne G. Culbertson

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

This case study presents a program evaluation of a physical activity intervention implemented in Bourbon County, Kentucky, guided by the Centers for Disease Control and Prevention’s Framework for Program Evaluation in Public Health.

A Case Study In Program Evaluation, Alexis Strottman

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

This paper presents a comprehensive evaluation plan for the Bourbon County Physical Activity Improvement Program, as prompted in the University of Kentucky's 2025 MPH-Health Management and Policy Capstone Case Study. The case study outlines a program developed in response to high obesity and inactivity rates in Bourbon County, Kentucky. Utilizing the CDC's 6-step program evaluation framework, the plan outlines engagement of a diverse group of stakeholders to assess the program's effectiveness in increasing physical activity among residents. The evaluation focuses on both process and outcome measures, examining the implementation of exercise facilities, community events, and an app designed to track …

A Case Study In Program Evaluation: Evaluation Of A Program Designed To Increase Activity Levels In Bourbon County Residents, Brooke M. Woodburn

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

This paper provides recommendations to eliminate possible barriers in a program developed to reduce inactive levels across Bourbon County.

Increasing Hpv Vaccination Adherence In Floyd County, Ky: Give Teens Vaccines, Taylor M. Stumbo

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

Cervical cancer remains a pressing public health issue, particularly in underserved and rural areas where access to preventive care is limited. This capstone addresses the urgent need to increase human papillomavirus (HPV) vaccination adherence in Floyd County, Kentucky—part of the central Appalachian region that experiences disproportionately high cervical cancer incidence and mortality. Despite the proven effectiveness of HPV vaccines in preventing the virus strains most responsible for cervical cancer, uptake in this region remains below national targets due to socioeconomic barriers, limited healthcare access, and lack of awareness. Give Teens Vaccines is a two component intervention leveraging existing healthcare systems …

A Case Study In Program Evaluation Evaluation Of A Physical Inactivity Program In Bourbon County, Kentucky, Carine N. Malekera

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

This paper evaluates a physical activity program by the Bourbon County Health Department aimed at increasing physical activity among local residents. Using the CDC’s Framework for Program Evaluation, the study includes both process and outcome evaluations to assess program implementation and impact on health outcomes. Key findings indicate success in urban areas but challenges in rural regions due to limited access to resources. Recommendations include improving access to exercise opportunities in rural areas and offering virtual classes. This evaluation emphasizes the importance of continuous assessment for effective public health interventions.

A Case Study In Program Evaluation, Kaitlyn E. Lee

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

This capstone project evaluates a fictious online MRSA education program developed by the Lexington-Fayette County Health Department and Fayette County Public Schools after a suspected outbreak among student athletes. Using the CDC’s 6-Step Framework for Program Evaluation, the project focuses on how stakeholders were engaged, how the program was described and mapped, how the evaluation questions were developed, what evidence was collected, and how conclusions were formed. The goal of the evaluation is to understand whether the program’s structure, delivery, and implementation support clear infection-control education for the different school personnel who use it. This project emphasizes the overall evaluation …

Evaluation Of Blending Ability Of Single-Shade Composite Relating To Different Cavity Depths And Abrasive Wear From Toothbrushing, Nattaporn Verayangkura

Chulalongkorn University Theses and Dissertations (Chula ETD)

Materials and Method: Eighty extracted human premolars were used for the shade‑matching evaluation. The materials tested in this study were Omnichroma (OC), Vittra APS Unique (VU), Charisma Diamond One (CD), and Filtek Z350 XT (FZ, control). The initial tooth shade was determined using a dental spectrophotometer and the reference color parameters (L, C, and H) were recorded with a laboratory spectrophotometer. A 4‑mm‑diameter cylindrical cavity was prepared in each tooth at restoration depths of either 1 mm or 2 mm. The prepared teeth in each restoration depth group were further divided into four subgroups based on the resin composite material …