Medicine and Health Sciences Commons^™

Motherwise In Nicaragua: The Implementation Of Culturally Adapted Relationship Education For Women During Pregnancy And Postpartum, Amanda Key Correa Love

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Intimate partner violence (IPV) is a concerning public health issue of global proportions, particularly within rural and under-resourced settings. Communities in these settings face elevated risk for relationship abuse, further compounded by barriers to access culturally responsive preventive intervention programming. This qualitative study investigated participant experiences, cultural adaptation, and implementation of the MotherWise program, a healthy relationship education intervention in rural Leon, Nicaragua. Semi-structured interviews were conducted with former and current program participants as well as the program facilitator following the initial program implementation. Data were analyzed using thematic analysis to identify patterns related to participant experiences, the types of …

Understanding Whole-Brain Dynamics Through Generative Modeling, Ruiqi Chen

Arts & Sciences Graduate Student Theses and Dissertations

A central goal in cognitive neuroscience is to map mental processes onto their physical substrates. Traditionally, this goal is pursued by associating different mental processes with spatially-based anatomic localization. On the contrary, much less is known about the temporal dynamics of neural activity, particularly at the scale of the whole brain. Research into whole-brain dynamics has been challenging primarily due to the lack of an analytic framework that can summarize such dynamics, expose the underlying mechanisms, and associate the mechanisms with cognitive processes. In this dissertation, I describe my doctorate research aimed at building such a framework and deploying it …

Will Beauty Save The Brain? Exploring The Relationship Between Eudaimonic Reels Exposure And Egyptian Gen Z'S Mind And Motivations, Petra Zaky

Theses and Dissertations

Social media entertaining content includes a mixed bag of the meaningful and the trivial. For Generation Z, whose favorite daily entertainment is shallow yet funny short-form videos (reels), there is often an invisible price paid. The loss of ability to watch long meaningful videos, distractedness from self, “Brain Rot”, glamorizing of hedonism are among the maladies left behind the attractive rabbit hole of their daily media diet. This study explores the relationship between exposure to meaningful reels, in contrast to pleasurable reels, and Gen Z’s reflective thinking, “Brain Rot” symptoms, motivation to watch long meaningful videos and life motivations between …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Mapping The Neuroexposome: Integrative Analysis Of Dementia Risk Factors Through Multi-Omics And Environmental Profiling In The Egyptian Population., Mai Ahmed Saadzaghloul Othman

Theses and Dissertations

Background: Dementia represents one of the most pressing public health challenges of the twenty-first century, with the global burden projected to reach 153 million cases by 2050. Egypt, as the most populous Arab nation, faces a corresponding rise in age-related diseases, yet comprehensive data from low- and middle-income countries remain severely limited. The neuroexposome framework, integrating genetic susceptibility, environmental exposures, and metabolic alterations, offers a powerful strategy to characterize the complex interplay between internal and external risk factors for Alzheimer's disease (AD) and Alzheimer's disease Related Dementias (ADRD).

Objectives: This thesis aimed to: (1) examine the distribution of APOE alleles …

Safe Medication Administration Practices, Kerisha Gooden-Gordon

Walden Dissertations and Doctoral Studies

No abstract provided.

Understanding Moral Injury In Emergency Department Clinicians: Predictors, Outcomes, And Evidence Gaps, Rose Doering Lightspeed

University Honors Theses

Moral injury (MI) is an emerging construct for understanding clinician distress in high-acuity healthcare settings, yet its application to Emergency Department (ED) clinicians remains limited. MI refers to psychological distress resulting from exposure to, or participation in, situations that conflict with deeply held moral or ethical standards, often due to systemic or organizational constraints. Although prior research has examined MI in heterogeneous healthcare samples, the ED remains underexamined despite its unique combination of high patient acuity, throughput pressure, and resource limitations.

This review synthesizes literature on MI among healthcare workers with a focus on ED clinicians, drawing on Industrial-Organizational psychology …

The Gut Microbiome, The Gut-Brain Axis, And College Student Well-Being, Idi Mckay

University Honors Theses

This literature review examines how diet, stress, environmental exposure, and food accessibility may influence college students' mental health and academic performance through the gut microbiome and the Gut-Brain Axis (GBA). Current microbiome research often focuses on early childhood development, clinical disease populations, or older adults, while overlooking college-age students who experience significant social, environmental, and biological transitions. College students frequently face food insecurity, irregular eating patterns, chronic stress, inconsistent sleep schedules, and reduced access to nutrient-dense foods, all of which may influence microbial diversity and overall gut health.

This thesis explores how modern campus environments and lifestyle factors may contribute …

Staff Education To Registered Nurses On Internal Medicine Unit, Sidonie Alethe Brown

Walden Dissertations and Doctoral Studies

No abstract provided.

Advancing Safe Iv Amiodarone Practices In Acute Care Settings, Ariel Lee

Walden Dissertations and Doctoral Studies

No abstract provided.

The Role Of Project Managers And Pmp Principles In Improving Operational Efficiency In Healthcare Organizations, Karan Thakkar

Harrisburg University Dissertations and Theses

Healthcare organizations operate in increasingly complex, regulated, and resource-constrained environments while managing a growing volume of projects tied to digital transformation, process improvement, regulatory compliance, and infrastructure development. Despite the project-intensive nature of healthcare operations, many organizations do not formally employ trained project managers or consistently apply Project Management Professional (PMP) principles; project responsibilities are frequently absorbed by clinical or administrative leaders whose primary expertise lies outside formal project management. This qualitative study examined how the project manager role and PMP principles contribute to operational efficiency in healthcare organizations. The study was conducted as a qualitative document analysis and thematic …

It's (Not) Raining Men: Exploring The Themes Surrounding Low Male Presence In Pediatric Nursing, Marcin Janczak

Honors Projects

Background: Men remain underrepresented in nursing, with an even smaller presence in pediatric nursing. Purpose: To examine pediatric-specific themes that may contribute to the low presence of men in pediatric nursing, and strategies to counteract these potential barriers. Methods: CINAHL Ultimate and Google Scholar were searched for primary research published from 2015 to 2025 related to male nurses, male nursing students, gender bias, pediatric care, and clinical experiences. Findings: Four major themes emerged: gender stereotypes and the feminization of pediatric nursing, sociocultural barriers and gender bias, fear and distrust toward male nurses, and psychological and professional impacts on men in …

Extraction Of Key Themes In Online Health Discourse Using Unsupervised Learning And Large Language Models, Miranda G. Scully

Computer Science Senior Theses

Health online discussion boards are a modern platform that allow patients to interact with each other and the healthcare system as a whole, making them valuable sources of information for clinicians seeking to better anticipate treatment experiences and barriers. This study focuses on one such community, r/suboxone, a subreddit where patients using Suboxone share their experiences and ask questions. Our analysis is motivated by previous work that proposes event-based classification systems for such posts which buckets posts from r/suboxone into one or more of five high-level labels (Access Logistics, Co-Occurring Drug Usage, Medication for Opioid Use Disorder Administration, Psychophysical Effects, …

Rehabvr: A Virtual Reality System For Upper-Body Orthopaedic Physical Therapy Rehabilitation, Winnie Brenda Wanjiru Waiya

Computer Science Senior Theses

Physical therapy is a central component of rehabilitation for musculoskeletal conditions, yet adherence to prescribed treatment remains persistently poor. Jack et al. identified pain, boredom, and insufficient feedback as key barriers to treatment adherence in physiotherapy outpatient settings,¹ and Rucinski et al. confirmed that non-adherence rates in orthopaedic populations remain between 50 and 70%, with patients who disengage facing elevated risk of reoperation, progressive functional decline, and poor clinical outcomes.² According to the World Health Organization, approximately 1.71 billion people globally live with musculoskeletal conditions,³ with shoulder pain specifically carrying a community prevalence ranging from 0.67 to 55.2% worldwide and …

Implementation And Evaluation Of A Nurse-Led Telehealth Protocol To Reduce No-Show Rates Among Chronic Care Patients, Yaneisy Puig

Walden Dissertations and Doctoral Studies

No abstract provided.

The Impact Of The Covid-19 Pandemic On Obstetric Access In Rural And Urban Areas In The United States, Sandali Chandradasa

Walden Dissertations and Doctoral Studies

No abstract provided.

Longitudinal Relationship Between Income Variability And Hypertension Risk Through A Life Course Lens, Mehrnaz Siavoshi

Walden Dissertations and Doctoral Studies

No abstract provided.

Bullying, Early Sexual Debut, And Sexual Health Behaviors Among Adolescents In New York City, Valentina I. Ramirez

Dissertations and Theses

Adolescent sexual and reproductive health remains a critical public health priority in the United States, particularly given the persistent burden of HIV and sexually transmitted infections (STIs) among young people. Adolescents and young adults account for a disproportionate share of STI cases, reflecting ongoing gaps in prevention, early detection, treatment, and equitable access to sexual health care and services. These patterns are shaped not only by individual behaviors but also by broader social, structural, and developmental contexts that influence adolescents’ opportunities to engage in preventive sexual health care.

This dissertation examined associations between early sexual debut, experiences of bullying, and …

Molecular And Histologic Studies Of The Amygdala And Reward Circuits In Rhesus Macaques (Macaca Mulatta) With Self-Injurious Behavior (Sib), Jackie Barua

Doctoral Dissertations

Self-injurious behavior (SIB), also known as non-suicidal self-injury (NSSI), is characterized by deliberate infliction of harming one’s own body tissues without committing suicide, and persists in a group of captive rhesus macaques despite an enhanced enrichment program and pharmacological intervention with diazepam. The aim of this dissertation was to identify the neurobiological underpinnings of SIB by combining RNA-seq guided transcriptomic discovery and targeted candidate gene validation with unbiased histological and imaging analysis. The secondary aim was to employ a complementary mouse model to investigate the endogenous opioid system in response to diazepam. The amygdala transcriptome of primates with SIB (n …

Enhancing Hiv Prevention: Implementation And Evaluation Of A Standardized Hiv Risk Assessment Screening In A Primary Care Setting, William Duckworth

Doctoral Dissertations

Background: HIV remains a persistent public health concern, with 1.3 million people affected worldwide. Although advances in treatment have improved long-term management, early prevention still relies on identifying individuals at elevated risk. In many primary care settings, routine HIV risk assessment is inconsistent or absent, resulting in missed opportunities to screen, educate and initiate prevention strategies such as pre-exposure prophylaxis (PrEP). This gap underscores the need for structured, evidence-based tools to improve early risk identification and strengthen HIV prevention efforts. Purpose: Implement and evaluate an evidence-based standardized screening process for HIV risk assessment to achieve early identification and enhance appropriate …

Enhancing Hpv Vaccination Engagement And Uptake Among Young Adults Aged 17 To 26 Through A Multilevel, Multicomponent Intervention, Sarah Dianne Girlinghouse

Doctoral Dissertations

Background: Human papillomavirus (HPV) remains one of the most common vaccine-preventable infections, with vaccination rates among young adults aged 17 to 26 remaining below Healthy People 2030 targets. University health settings represent a critical opportunity to improve vaccine uptake. Prior to this quality improvement (QI) initiative, student health services (SHS) at a public university in the southern United States did not routinely offer HPV vaccination, resulting in missed opportunities for prevention. Evidence supports provider recommendation, clinical decision support, and improved access as key drivers of HPV vaccination uptake. Purpose: The purpose of this QI project was to increase HPV vaccination …

Activated Dorsomedial Hypothalamic Astrocytes Regulate Feeding Behavior, Bella M. Lisenby

Honors Projects

The dorsomedial hypothalamus (DMH) region of the brain has been shown to be important for anticipatory feeding activity and play a role in restricting excessive food intake. In obese animals that overconsume calories, astrocytes within the DMH exhibit intracellular signaling changes indicative of cellular activation. Because astrocytes are known to influence neuronal function, we hypothesize that activated astrocytes regulate behavior. In the current study, we use chemogenetics combined with stereotaxic surgery to assess the contribution of astrocyte activity in the DMH towards metabolic behaviors.

Fentanyl Mediated Distortions Of Phasic Dopamine Release Dynamics Encoding Natural Reward And Aversive Processing In The Mammalian Mesolimbic Circuit, Oliver P. Culver Iv

MUSC Theses and Dissertations

Mu opioid receptor (MOR) agonists are recognized to disinhibit tonic dopamine (DA) in the ventral striatum (VS), contributing to opioid addiction and euphoria. However, MOR agonists can also inhibit non-drug reward-seeking, and disrupt conditioned responding to aversive stimuli, a phenomenon not readily explained by tonic DA disinhibition. We hypothesized that this effect could be due in part to disruption of phasic DA responses to conditioned stimuli (CS) which critically shape and maintain behaviors during naturalistic reward and aversive processing. Because MOR effects on CS-evoked phasic DA are largely unexamined, we conducted in vivo fiber photometric recordings in water-deprived male and …

A Strategy For Standardizing Stimulant And Benzodiazepine Management For Advanced Nursing Practice And Drug Safety, Michael Iheukwu Agugo

Walden Dissertations and Doctoral Studies

No abstract provided.

Nursing Students Applying Active Teaching And Learning To Develop Clinical Judgment Skills, Charlene Lindsay Jones

Walden Dissertations and Doctoral Studies

No abstract provided.

Motivation And Leadership Development Among Federal Nurse Leaders, Sarah Davis-Arnold

Walden Dissertations and Doctoral Studies

No abstract provided.

Operation Bite Block, Jennifer Aline Robles, Laura Marie Strobbe, William Pearce Graham, Annabelle Katherine Thalken

Mechanical Engineering

Current dental bite blocks, or mouth props, are typically manufactured in fixed sizes, and often result in patient discomfort, reduced procedural efficiency, and the need for dental offices to maintain multiple product sizes. This project sought to design, prototype, and validate an adjustable dental bite block capable of accommodating a wide range of patient mouth openings while maintaining comfort, structural integrity, sterilizability, and operator usability. Working in collaboration with Dr. Alan Latta, a practicing dentist in San Luis Obispo, the design process incorporated stakeholder feedback, patent and market research, engineering analysis, and iterative prototyping to develop a solution that addresses …

Addressing Mental Health Issues And The Effectiveness Of Cognitive Behavioral Therapy And Mindfulness-Based Interventions Among Athletes, Shelby Jones-Stachnik

Dissertations

This literature review identifies mental health concerns among competitive athletes and evaluates psychological interventions to address these challenges. Specifically, the review explores the mental health concerns experienced by athletes engaged in high-level sport. It examines whether cognitive behavioral therapy and mindfulness-based interventions are effective approaches for improving psychological outcomes in this population. A systematic review of peer-reviewed research was conducted, and findings were synthesized to evaluate the effectiveness of cognitive behavioral therapy and mindfulness-based interventions. The review included randomized controlled trials, quasi-experimental studies, and meta-analyses examining psychological interventions in athletic populations. Findings across the literature indicate that both cognitive behavioral …

Advance Care Planning In Metastatic Lung Cancer Patients: A Quality Improvement Initiative, Khanh H. Thai

Student Theses

Background: Advance care planning (ACP) is essential in achieving goal-concordant care for patients with metastatic lung cancer (MLC), yet it remains underutilized.

Local problem: Despite its benefits, ACP has been inconsistently integrated into outpatient oncology settings, and a baseline evaluation at the project site revealed that only 11% of patients with MLC had ACP documented in the outpatient care clinic.

Methods: This Quality Improvement initiative implemented a formal, Nurse Practitioner (NP)-led intervention into routine oncology care. Using a quasi-experimental nonrandomized design, 13 eligible patients diagnosed with MLC without prior ACP documentation were enrolled in a four-week study. These participants were …

Increasing Lead (Pb) Screening Participation Rates In The Pediatric Patient Population At The Philadelphia College Of Osteopathic Medicine Lancaster Avenue Community Healthcare Center, Jacob Varrato

PCOM Biomedical Studies Student Scholarship

Elevated blood lead levels (EBLLs) are an ongoing public health crisis predominantly affecting children under six in low-income communities located in major cities across the United States (Zartarian et al. 2024). Chronic lead exposure due to outdated housing, polluted water, and contaminated soil is especially harmful in early childhood. Frequent hand to mouth contact at this age increases the risk of ingesting particulate matter containing lead (CDC). EBLLs can predispose children to neurocognitive deficits, cardiovascular disease, and epigenetic modifications to gene expression patterns (Collin et al. 2022). While precautionary measures and timely screening protocols greatly reduce the risk of developing …