Medicine and Health Sciences Commons^™

Swimming In Sh*T: Quantifying Lagoon Flushing Impacts On Fecal Indicator Bacteria In Surf Zones Of Three Beaches On The East End Of Long Island, Ny, Brody C. Eggert

Pomona Senior Theses

This thesis investigates how lagoon flushing influences fecal indicator bacteria (FIB) concentrations—specifically enterococcus bacteria—in the surf zones of East Hampton and Southampton, New York. Focusing on the coastal lagoons of Georgica Pond, Sagg Pond, and Mecox Bay, the study analyzes how episodic inlet openings and environmental conditions affect enterococcus levels at adjacent recreational beaches. Using over 700 observations from the Surfrider Foundation’s Blue Water Task Force (BWTF) database, I construct a series of statistical models ranging from ordinary least squares to mixed effects frameworks; this thesis shows my process in developing this model. My analysis reveals that open inlets between …

Rwanda's Natural Remedies: A Fresh Look At The Fight Against Malaria, Leandre Nsabimana Ndisanze

Pomona Senior Theses

Malaria remains one of the most devastating parasitic diseases globally, disproportionately affecting sub-Saharan Africa, where Rwanda continues to face high transmission rates and rising resistance to conventional interventions. Despite decades of control efforts, the emergence of drug-resistant Plasmodium falciparum and insecticide-resistant Anopheles mosquitoes threatens to reverse recent gains. This research responds to the urgent need for sustainable and culturally relevant alternatives by exploring the therapeutic potential of Rwandan traditional medicinal plants. These indigenous remedies, long used by local healers, offer an underexplored reservoir of bioactive compounds that may provide the basis for novel antimalarial drugs.

The central hypothesis of this …

Evaluation Of Lyte’S Pilot Health And Wellness Coach Training Program, Lauren Allyson Von Lawn

CGU Theses & Dissertations

Breast cancer survivorship presents ongoing physical, emotional, and social challenges that often extend beyond clinical treatment. While survival rates continue to improve, many survivors lack adequate post-treatment support, particularly in underserved communities. The Living Your Truth Empowered (LYTE) Foundation developed and piloted a Health and Wellness Coach Training Program to address these gaps by preparing individuals—including survivors, advocates, and community members—to provide evidence-based, holistic support. This 16-week cohort-based program, funded through a City of Hope Healthy Living Community Benefits Grant, integrates the National Board of Health and Wellness Coaching (NBHWC) standards with curriculum content focused on: behavior change, cultural humility, …

Birthing While Black: The Color Of Care And Black Women’S Lived Experiences Giving Birth In The United States, Portia Cowlings

Theses and Dissertations

Black women in the United States face disproportionate maternal health outcomes during pregnancy, childbirth, and postpartum compared to other racial and ethnic groups. Despite advancements in healthcare, the United States continues to report the highest maternal mortality rates among high-income developed nations, with Black women experiencing rates up to three times higher than their White counterparts. This phenomenological study explores the lived experiences of Black women in the United States to understand how they navigate the continuum of maternal healthcare, from preconception through postpartum. Guided by the social determinants of health (SDOH) theoretical framework, childbirth was examined through four interconnected …

Speech-Language Pathologists’ Preparation To Become Clinical Educators, Alivia English

Master's Theses and Doctoral Dissertations

Clinical education is significant in a student clinician’s educational journey to prepare them for their career after graduation. It provides the hands-on component that can only be learned and fully understood through performing. The literature regarding students’ experiences in clinical education is vast, but there is a shortage of literature that explores the perceptions of clinical educators (CEs). This thesis consists of three articles. The first article explores the perceptions speech-language pathologists’ have regarding the preparation they received to become CEs, and then the second article takes a look at how the requirements to becoming CEs differ across similar clinical …

The Impacts Of Dietary And Educational Intervention In Addressing Adult Obesity In The Mexican Population, Matthew C. Servin

CMC Senior Theses

Mexico’s obesity epidemic has been an ongoing issue for the past few decades, with multiple studies attributing this to the disparities in accessing healthy food and health education. Designing a solution to Mexico’s adult obesity crisis will focus on studying the effects of an intervention plan that addresses these obesogenic factors. This proposed study will assess how a token system and health education sessions may impact the risk of obesity in the adult Mexican population. This study also will consider any limitations that arise when only one of the two intervention methods are used. As these interventions are implemented over …

Impact Of Hiv-2 Rod9 Vpx Mutations On Samhd1 Degradation And Vpx Nuclear Trafficking, Tolulope R. Oladimeji

All Graduate Theses, Dissertations, and Other Capstone Projects

Human Immunodeficiency Virus (HIV) is a leading cause of death in many parts of the world. HIV-2, endemic to West Africa, has infected over 2 million people globally. A key difference between HIV-2 and the more widespread HIV-1 is the HIV-2 protein Vpx, which facilitates infection in non-dividing cells by targeting SAMHD1, a host innate immune protein, for proteasomal degradation. This research aims to identify specific amino acid residues in HIV-2 ROD9 Vpx that are essential for mediating SAMHD1 degradation by the proteosome. I hypothesize that amino acid residues located in the C-terminal region of Vpx play a critical role …

Effective Measurement-Based Care For Depression Within Va Health Systems: A Quality Improvement Initiative, Amie L. Doyle

DNP Scholarly Projects

Background: Depression is highly common among U.S. veterans, surpassing civilian rates. Measurement-Based Care (MBC), including the Patient Health Questionnaire-9 (PHQ-9), facilitates systematic symptom monitoring and treatment enhancement. At Manchester VA Medical Center (VAMC), PHQ-9 completion in primary care was low (18.93% in May 2025) due to workflow inefficiencies, provider workload, and dependence on Mental Health Service Line (MHSL) referrals.

Local Problem: Underutilization of the PHQ-9 in primary care hampers early detection and effective treatment of depression among veterans.

Methods: Four primary care teams received training on using the Behavioral Health Laboratory (BHL) software, which facilitates pre-visit electronic completion of the …

Improving Transitions In Care: The Post-Discharge Follow-Up Process For Va Hospitalizations, Kristina Huntoon

DNP Scholarly Projects

BACKGROUND: Transitions in care from hospitalization to home are a high-risk period for patients. Without care coordination during these transitions in care, patients are left trying to manage their care without any support. The VA has a mandated two-day post-discharge contact process that requires a member of the patient’s primary care team to contact the patient within two business days of a VA discharge.

METHODS: The Plan-Do-Study-Act method of quality improvement was used for this project. Baseline assessment included review of patient medical records for 15 months before the intervention, which included 27 discharges from unit 78C. The patient medical …

Adapting A Mobile Health Intervention To Improve Prep Adherence Among Young Black Msm In Fulton County, Georgia, Kassidy Maust

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

Young Black men who have sex with men (YBMSM) in the southern United States, particularly in Fulton County, Georgia, face disproportionately high rates of HIV and unique structural barriers to pre-exposure prophylaxis (PrEP) uptake and adherence. Sustained adherence among YBMSM remains low due to intersecting structural, social, and behavioral barriers. To address these disparities, this paper presents an adapted implementation of the evidence-based M-Cubed (Mobile Messaging for Men) mHealth intervention. Prior studies of M-Cubed and similar mHealth interventions have shown promising outcomes in increasing PrEP adherence among Black MSM populations. The adapted intervention integrates culturally tailored messaging specific to behaviors …

Enhancing Nursing Education: A Quality Improvement Project To Mitigate Incivility Among Faculty, Rebecca Mitschele

Doctor of Nursing Practice Projects

Incivility among nursing faculty poses a significant challenge, adversely affecting job satisfaction, mental health, and communication within academic and clinical settings. This Quality Improvement (QI) project addressed this pervasive issue by identifying faculty incivility as a key contributor to high turnover rates and burnout in faculty and students. A mixed-methods approach assessed the prevalence and types of incivility displayed, including surveys and focus group discussions with faculty. The intervention included conflict resolution training, the establishment of an anonymous reporting mechanism, and the development of a framework to revise the faculty handbook specifically to address incidents of incivility. Post-intervention results indicated …

Promoting Student Retention Through Mandatory Remediation, Randi Mccoy

Doctor of Nursing Practice Projects

This DNP Project seeks to identify and evaluate among associate degree nursing (ADN) faculty, will implementing a pilot remediation policy, compared to the current remediation policy, impact faculty perception regarding exam remediation? Exam remediation is important as it helps students understand why they missed questions, how to improve on their next exam, provides guidance and confidence. It is also essential to determine whether required remediation for students after failing an exam promotes student retention, growth, and expansion at a local university in Oklahoma in the setting of an unprecedented program. Does adding required remediation after a failed exam offer students …

Improving Nursing Faculty's Self-Efficacy For Pre-Brief In High Fidelity Simulation: A Quality Improvement Project, Jamie Herron

Doctor of Nursing Practice Projects

High-fidelity simulation (HFS) effectively allows students to practice nursing care in a safe and controlled environment with fewer chances of error or harm. The Society of Simulation in Healthcare (2021) states that best practice standards include pre-briefing, evaluation during simulation, and debriefing. A standardized pre-briefing for faculty during nursing students' high-fidelity simulation was needed in an Oklahoma associate degree nursing (ADN) program. The Society of Simulation in Healthcare (SSH) evidence-based standards of practice include providing a pre-brief before starting a high-fidelity simulation, which decreases the student's anxiety and improves learning. The PICOT question, “How does education about pre-briefing in high-fidelity …

Quality Improvement Project: Reducing Ventilator Days: Evaluating The Effectiveness Of A Nurse-Led Mechanical Ventilation Liberation Protocol In Critical Care Units, Joseph Duncan

Doctor of Nursing Practice Projects

The present study investigated the effect of intensive care unit (ICU) nurses’ knowledge and confidence in managing mechanically ventilated patients’ weaning trials, and whether innovative education can improve these clinical interventions. Current practice relies on an antiquated provider-led protocol that does not account for the nurses’ skill level or practice autonomy. This oversight consistently leads to ventilator associated complications including prolonged ventilation time, increase sedation infusion use and increase ICU length of stay. This study’s aim was to determine if innovative education could improve nursing knowledge and confidence related to ventilated patient care. Nurse participants (N=100) were randomly selected to …

Quality Improvement Project: Improving Access To Early Intervention For Prediabetic Patients In Primary Care, Jude Abam

Doctor of Nursing Practice Projects

Primary care frequently misdiagnoses prediabetes, which serves as a diabetes type 2 precursor, resulting in failed early treatment opportunities. A structured staff education program was the goal of the quality improvement project during the DNP implementation. The initiative addressed knowledge gaps alongside screening protocol standardization all to enhance early detection as well as intervention efforts. Using both Lewin’s Theory of Change and Kolb’s Theory of Experiential Learning, a pre-post-design was applied across seven weeks. Prediabetes screening and management, along with its risk factors, were taught to the staff. The demographic questionnaires helped in assessing the knowledge and self-efficacy of the …

Quality Improvement Project - Virtual Escape Rooms: A Teaching Strategy For Nurse Educators, Alisha Mcafee

Doctor of Nursing Practice Projects

Virtual escape rooms (VERs) are an active learning activity that engages students with learning materials while applying theory and knowledge to life-like patient scenarios. Nursing faculty at one nursing program required education about VER development. The problem identified for this quality improvement (QI) project was the lack of knowledge of the nursing faculty on the use and development of this active learning strategy. This QI project aimed to enhance nurse faculty knowledge and ability to utilize VERs within their courses. Faculty participated in an educational session about VERs. Completion of a pre-and post-questionnaire took place. Three Likert-scale questions were asked …

Point-Of-Care Lab Testing Reduces Lab Turn Around Times And Decreases Delays In Treatment, Arkayla Beamon

Doctor of Nursing Practice Projects

The purpose of this doctoral project was to explore workflows associated with the preanalytical phase of the lab diagnostic process in a one-hundred-bed long-term acute care hospital, identify the most common errors that occur, and explore the effect of point-of-care lab testing (POCT) education on a reduction in treatment delays. More specifically, the project aims to answer the following question: In nurses, unit clerks, and respiratory therapists what is the impact of POC education on lab diagnostic delays in a long-term acute care hospital over six months?

Enhancing Simulation Debriefing In Nursing Education: A Quality Improvement Project, Rebecca L. Ray

Doctor of Nursing Practice Projects

This quality improvement (QI) project is of utmost importance as it aims to significantly enhance the debriefing process after simulations in an Associate Registered Nursing Program. The project is designed to equip nursing instructors with a comprehensive guide to facilitate debriefing after simulations, thereby improving student learning outcomes, fostering reflection, and enhancing clinical practice. The lack of consistent and practical guidance during the debriefing process after simulation exercises has been identified as a critical challenge in the nursing program. Without proper guidance, the debriefing process may not achieve its intended outcomes, underscoring the necessity of this project. The intervention at …

Nurses Confidence And Knowledge Improvement For Sleep In Sleep Hygiene Education, Rawda Nourain

Doctor of Nursing Practice Projects

The purpose of this DNP project was to increase the knowledge and self-confidence of nurses in relation to sleep hygiene practices for psychiatric patients to improve sleep quality and overall mental health. In this study, a pre- and post-intervention design was used for four nurses in a psychiatric unit. The intervention was comprised of teaching the patients about sleep hygiene practices, altering the environment (light and noise reduction), and using non-drug approaches. Knowledge assessments and self-confidence surveys were used to collect the data. All the participants were able to recall the correct sleep hygiene knowledge after the intervention, and all …

Community Based Psychosocial Wellness Groups For Children And Adolescents With Neurodivergent Conditions, Caitlin Duffy Ot/S, Tania Rose Otd, Otr/L

Occupational Therapy Doctorate Capstones

Aim and Purpose:

Research Question: What is the impact of community based psychosocial wellness groups on the overall mental health and wellness of children and adolescents with neurodivergent conditions?

Aim: To reach more children by creating a Surf-Fit program located within a local community setting.

Purpose: To create and implement effective community-based psychosocial wellness groups in collaboration with Gnome Surf.

Optimizing Compression In Venous Leg Ulcers To Improve Wound Healing Rates Through Wound Care Nurse Support: A Quality Improvement Project, Temilola Obisesan

DNP Scholarly Projects

BACKGROUND: Venous leg ulcers (VLUs) are the most common lower extremity ulcers, accounting for 75% of chronic leg wounds and affect up to 2% of the population in developing countries. Generally, it has a 1-year recurrence rate of 40-70%. VLUs costs about $11B in the USA and other developed countries annually. Patients with VLUs spend about $7,000 more annually. Compression therapy along with local wound care is the best approach for VLU management, with compression therapy as the gold standard. Currently, compression therapy is underutilized in VLU care. The goal of this QI project is to provide wound nurses who …

Feeding With Competence: Empowering Parents In Ng Feeding For Nicu Graduates: A Quality Improvement Project, Karen Marsh

DNP Scholarly Projects

Abstract

Background: Infants who are born prematurely stay in a neonatal intensive care unit (NICU) until they are able to take full enteral nutrition by mouth. While in the NICU a nasogastric tube (NG tube) would be used to supplement the volume needed to be ingested for optimal nutrition. Infants typically feed better with a consistent caregiver and at home in an environment with less stimulation. Allowing infants to be discharged with an NG tube allows the parents to be more involved in their infant's care with a shorter hospital stay. An increased number of infants being discharged home with …

A Quality Improvement Initiative To Improve Nurse Reassessment And Documentation Of Administered Prn Pain Medication, Stacy L. Brady

DNP Scholarly Projects

BACKGROUND: Effective pain management remains a critical challenge both globally and with the United States, where more than 51 million adults suffer from pain. Veterans are particularly vulnerable due to the lasting impact of service-related injuries. “Pro re nata” (PRN or “as needed”) pain medications are frequently used to manage pain, but timely reassessment and documentation following a PRN pain medication administered is often missed or delayed. Reassessing and documenting the results after the administration of the PRN pain medication is required by The Joint Commission and the Veterans Affairs Providence Healthcare System’s (VAPHS) standard operating procedure (SOP) states reassessment …

Implementation Of Outpatient Cervical Ripening In The Community Hospital Setting: A Quality Improvement Process, April St Hilaire

DNP Scholarly Projects

Background: Cervical ripening is a critical component of labor induction. Outpatient cervical ripening using mechanical dilators offers a safe patient- centered alternative to inpatient management, with potential benefits in efficiency and patient satisfaction and cost savings.

Local Problem: At a community hospital setting with increasing induction rates, prolonged admission-to-delivery times and prolonged patient stays were observed in patients undergoing inpatient cervical ripening, prompting a need for more efficient, patient centered approaches.

Methods: Using the Plan-Do-Study-Act (PDSA) framework, an outpatient cervical ripening protocol was implemented over a 15-week period to compare inpatient versus outpatient cervical ripening using mechanical …

The Effect Of Non-Contact Boxing On Occupational Performance Of Individuals With Parkinson's Disease: A Case Series Design, Ruben Blanco Ot/S, Sheridan Ferland Otd, Otr/L

Occupational Therapy Doctorate Capstones

Parkinson’s Disease (PD) is a neurodegenerative disease that negatively impacts occupational performance due to the effect it has on motor and nonmotor skills. Research suggests that forced intense exercise such as noncontact boxing improves these motor and nonmotor symptoms in individuals with PD. Unfortunately, there is no literature that determines a direct link to noncontact boxing and an improvement in occupational performance for individuals with PD. This study aims to make this direct link using the Rock Steady Boxing (RSB) protocol.

The Impact Of A Community-Based Motor Performance Program On Children And Adolescence With Neurodivergent Conditions, Isabella Catarina Ots, Tania Rose Otd, Otr/L, Brooke Tubbs Otd, Otr/L

Occupational Therapy Doctorate Capstones

Site Description:

Gnome Surf

• A non-profit organization committed to inclusive therapy for all children, regardless of ability or financial background.

• Surf Therapy: Uses the therapeutic elements of water and the joy of surfing to improve physical and mental health. Providence Parks and Recreation.

• Includes a gymnasium, indoor pool, play areas, and multipurpose field.

• After-school program offers rotating programming.

Research Question, Aim, and Purpose:

PICO: What is the impact of community-based motor programming on motor performance in children & adolescents with neurodivergent conditions.

Aims: Enhance participants' motor abilities, socialization, and general well-being through a therapeutic Surf-Fit program. …

Teaching And Learning Approaches To Improve Staff Training At Empowersci, Amanda Bastos Ot/S, Monique Dawes Otd, Otr/L, Cpam

Occupational Therapy Doctorate Capstones

Empower SCI: A non-profit organization for individuals with SCI Mission of Empower SCI: “To propel individuals living with spinal cord injuries on their path to a fully actualized, more independent life through immersive programming and community support” (Empower SCI, n.d.)

Purpose: develop an evidence-based orientation program for new staff and to provide EmpowerSCI with a more uniform and effective training protocol that will improve participant safety and experiences, as well as staff caregiver confidence.

Research Question: How will an evidence-based orientation and training program impact knowledge and task performance in personal care staff at EmpowerSCI?

Impact Of Power Tilt Functions On Users Independence, Functional Reach, And Overall Quality Of Life, Jordan Dodge Ots, Andrea Fairman Phd, Otr/L, Atp, Jennith Bernstein Pt, Atp/Sms, Heather Cianciolo Otr/L, Atp/Sms

Occupational Therapy Doctorate Capstones

Background:

• There is significantly limited information regarding the functional benefits of using power tilt functions.

• Insurance, specifically Medicare, will only cover these functions under limited circumstances.

• This project intended to collect further data that highlighted the functional benefits of power tilt functions to further advocate for increased insurance coverage.

Increasing Self-Efficacy Through A Wellness Program For People With Parkinson’S Disease And Their Care Partners, Abby Clark Ot/S, Sheridan Ferland Otd, Otr/L, Carolyn Kosiba-Quiterio Cpt, Crs, Cgx, Sf

Occupational Therapy Doctorate Capstones

Site Description:

Rock Steady Boxing is a nonprofit organization that gives people with Parkinson’s disease the opportunity to improve their quality of life through non-contact boxing, stretching and various exercises (Rock Steady Boxing, 2024). Locally, Rock Steady Boxing East Greenwich (RSBEG) has approximately eighty athletes enrolled.

Aim & Purpose:

Aim: To provide a comprehensive wellness education program on various PD related topics for people who participate in RSB class.

Purpose: To explore the impact of wellness education on self-efficacy to improve physical and mental outcomes for those with PD, thereby addressing a gap in current literature. Question: Does wellness education …

Technology Use By Skilled Nursing Facility Residents To Enhance Leisure Participation And Overall Quality Of Life, Madisyn Frederick Ots, Shannon Strate Otd, Ms, Otr/L

Occupational Therapy Doctorate Capstones

Site Description:

• 120-bed skilled nursing and rehabilitation center located in Providence, RI

• Comprised of 3 units: short-term rehabilitation services, long-term skilled nursing care, and memory care

Research Question: Is technology use an effective form of leisure engagement for improving the quality of life for long-term skilled nursing facility residents?

Project Goals:

•Identify an effective means for enhancing leisure participation amongst residents

•Assess residents’ relationship with technology and identify barriers or oppositions to use

•Provide Steere House with an effective solution to their lack of resident leisure engagement