Medicine and Health Sciences Commons^™

Feasibility Testing Of A Web-Based Phq-9 Test For Student Depression, Israel Oluwagbenga Odugboye

Graduate Theses, Dissertations, and Problem Reports (ETD)

Feasibility Testing of a Web-Based PHQ-9 Test for Student Depression

Israel Odugboye

Student depression stands as a critical public health issue because it affects numerous young adults who experience academic decline, disability, absenteeism, productivity reduction, and suicidal thoughts. The general population shows a 10% to 15% lifetime risk of developing depression which leads to a twentyfold elevation in suicide risk for depressed individuals [3]. The Patient Health Questionnaire-9 (PHQ-9) serves as a popular tool for detecting depressive symptoms and determining severity levels among students from different cultural backgrounds. The assessment contains 27 possible scores which follow DSM depressive symptom criteria …

Ciliary Arl14b In Vision, Alexis Breann Crockett

Graduate Theses, Dissertations, and Problem Reports (ETD)

Primary cilia are highly specialized organelles that regulate signaling, trafficking, and sensory perception across multiple tissues, including the retina. The small GTPase ADP Ribosylation Factor-Like Protein 13B (ARL13B) is an atypical ARF-family protein enriched in cilia. ARL13B acts as a guanine exchange factor (GEF) for another small GTPase ARF-like Protein 3 (ARL3). Mutations in ARL13B cause Joubert syndrome, a ciliopathy characterized by brain malformation, developmental delays, and retinal degeneration. Despite ARL13B’s known ciliary localization and clinical relevance, ARL13B’s precise functions in cilia remain poorly defined. This dissertation investigates the cilia-specific roles and GEF-specific roles of ARL13B in photoreceptors using two …

The Association Of Vitamin D Status In Us Adults With Depression: Nhanes 2011 - 2018, Joshua A. Yearout

All Master's Theses

ABSTRACT

Background: Vitamin D (VD), essential for bone health and various physiological processes, has been increasingly associated with mental health, particularly depression. Depression is the most common and prevalent of disorders regarding mental health. It is influenced by biological, psychological, and socioeconomic factors. This study examines association and the interplay of both vitamin D deficiency (VDD) and depression among adults 18- 70+ residing in the U.S, focusing on disparities across demographic and socioeconomic groups.

Methods: Data was taken from the National Health and Nutrition Examination Survey (NHANES) 2011–2018. The present study utilized a cross-sectional analysis included 7,981 participants aged 18 …

Relative Energy Deficiency In Sport: Risk Assessment In Collegiate Female Athletes Using The Reds Cat2 Tool, Kelsea Elizabeth Nunes

All Master's Theses

Context: Alterations in energy intake (EI) and high exercise energy expenditure (EEE) may increase the risk of low energy availability (LEA) in Division II female collegiate ball sport athletes. Furthermore, chronic LEA can transition to problematic LEA, leading to Relative Energy Deficiency in Sport (REDs).

Objective: The purpose of this study was to assess the current severity and prevalence of REDs using the REDs CAT2 Tool and the Female Athlete Triad using the FAT CRA in Division II collegiate female volleyball, basketball, soccer, and rugby athletes.

Design: Cross-sectional design.

Setting: Research laboratory.

Patients or Other Participants …

Characteristics Contributing To The Risk Of Diabulimia In Adults Living In The United States, Danielle L. Van Hout

All Master's Theses

The purpose of this study was to determine the prevalence and factors that contribute to the risk of diabulimia by using the validated Diabetes Eating Problem Survey-Revised (DEPS-R) (Markowitz et al., 2009) screening tool in adults living in the U.S., as well as to examine differences in individuals at-risk and not-at-risk for diabulimia. This observational study involved a 30-question Qualtrics survey containing the DEPS-R distributed via various social media outlets and flyers on the CWU Ellensburg campus. Participants were required to be 18 years or older, diagnosed with T1DM for more than one year, and live in the U.S to …

Focus Group Interview: Perspectives Of Virtual Dietary Counseling Methods Post Covid-19 Pandemic, Maria R. Mendoza

All Master's Theses

In response to the prevalence of morbidity and mortality, studies to avert these conditions in a cost-effective and accessible manner are also increasing. Developing new methods to provide nutrition education that are more accessible is critical to reaching individuals who may experience socioeconomic barriers impacting their ability to access healthcare. The purpose of this study is to examine the perceptions related to different delivery methods of dietary counseling. This qualitative research study will examine the perceptions related to different methods of dietary counseling (telephone calls, video calls, or face-to-face visits). Focus group one contained provider participants (N = 7), which …

The Effect Of The Ketogenic Diet On The Circadian Rhythmicity Of Glymphatic Function In Mice, Tanner Metcalfe

Yale Medicine Thesis Digital Library

The glymphatic system is a network of perivascular spaces that coordinates removal of waste products from brain parenchyma. It is known that the glymphatic system is under control of the circadian rhythm, however little is known about factors that influence this control. Data has shown that the expression of specific circadian rhythm genes is altered when exposed to the ketogenic diet. In this experiment, we show that the day-night rhythmicity of glymphatic function is extinguished in mice exposed to the ketogenic diet through the up-regulation of influx of cerebrospinal fluid to brain parenchyma and the reduction in cervical lymph node …

Clinical Predictors Of Fluid-Responsive Acute Kidney Injury, Cindy Khanh Nguyen

Yale Medicine Thesis Digital Library

CLINICAL PREDICTORS OF FLUID-RESPONSIVE ACUTE KIDNEY INJURY

Cindy Khanh Nguyen, Abinet M. Aklilu, Yu Yamamoto, Bashar A. Kadhim, Claudia Coronel-Moreno, Francis P. Wilson. Section of Nephrology, Department of Internal Medicine, Yale University, School of Medicine, New Haven, CT.

Specific Aims: We aimed to explore and identify common clinical variables that may be helpful in selecting patients who will benefit from volume challenge when the fluid-responsiveness of AKI is unclear.

Methods: Our study is a retrospective secondary analysis of a clinical trial that prospectively enrolled adult patients at Yale-New Haven Hospital with AKI defined by the 2012 Kidney Disease: Improving Global …

Development Of Cerium Oxide Based Polymer Composites With Enhanced Cytocompatability For Biomedical Applications, Roshna Cherugail

Honors Undergraduate Theses

This thesis presents the synthesis and characterization of cerium oxide nanoparticles (CNPs), and silver-doped cerium oxide nanoparticles (AgCNPs) loaded in alginate beads that were designed to be applied in biomedical settings. Cerium oxide was chosen for its antioxidant and anti-inflammatory capabilities, and silver oxide was selected to enhance antimicrobial functionality, both of which are pivotal in expedited wound closure and promoting cellular proliferation. Through the use of an advance electrospray encapsulation apparatus, alginate-based polymer beads were created by incorporating either CNPs or AgCNPs into the matrix. These beads were later characterized using a range of microscopic and FTIR analyses, in …

Implementing A Routine Patient Health Questionnaire-9 (Phq-9) Screening Bundle For Adults (18-65 Years) Scheduled For A Psychiatric Evaluation, Olivier Bertrand Djoumessi

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Depression affects 21 million American adults (8.4%), yet only 28% receive appropriate screening. In Texas, where 20.8% of adults experience depression, systematic screening remains inconsistent. This quality improvement project addressed a critical gap at an outpatient mental health clinic in the Dallas-Fort Worth metroplex, where Patient Health Questionnaire-9 (PHQ-9) screening occurred in only 40% of psychiatric evaluations, resulting in missed diagnoses and inconsistent treatment. Using the Plan-Do-Study-Act framework, the project implemented a comprehensive PHQ-9 screening bundle consisting of staff training, electronic health record integration, and a treatment algorithm based on severity thresholds. The intervention targeted adults, aged 18-65, scheduled for …

Sex-Specific Roles Of The Adipocyte Mineralocorticoid Receptor In Obesity And Early Life Stress, Meghan B. Turner

Theses and Dissertations--Pharmacology and Nutritional Sciences

Obesity is a burgeoning health epidemic caused by chronic overnutrition and exacerbated by genetic, environmental and developmental factors. The adipocyte mineralocorticoid receptor (MR), a transcriptionally active nuclear receptor, is speculated to contribute to metabolic dysfunction in the obese state. MR expression is increased in obese adipose tissue, and MR modulates the expression of fat-derived hormones such as leptin and adiponectin. In women, obesity can be exacerbated by early life stress, such as adverse childhood experiences (ACEs). Studies show that women display a positive association between cumulative ACE exposures and increased body mass index. Previously, we demonstrated that maternal separation and …

Mechanistic Insights Into The Antimicrobial Action Of Fungus-Derived Xanthoquinodins Against Clostridioides Difficile, Erika A. Serravalle

Graduate Thesis and Dissertation post-2024

The bacterial pathogen Clostridioides difficile is the leading cause of antibiotic- and healthcare-associated diarrhea, imposing significant clinical and economic impacts. The emergence of hypervirulent strains, such as PCR ribotype 027 (RT027), has exacerbated disease severity, recurrence rates, antibiotic resistance, and epidemiological spread. Expanding resistance profiles among C. difficile strains continue to limit the effectiveness of current IDSA-SHEA recommended therapies, which are already compromised by high recurrence rates due to antibiotic-induced disruption of the gut microbiota. These challenges highlight the urgent clinical need to identify and characterize antimicrobial compounds targeting alternative pathways in C. difficile physiology. We report the discovery and …

Synthesis And Evaluation Of Chalcones As Treatment For Negative Sense Single Stranded Rna Viruses And Applications As Broad-Spectrum Antivirals, Lorael Kirton

Graduate Thesis and Dissertation post-2024

Chalcones are a class of compounds naturally found in plants and are predicated upon a 1,3-diphenylprop-2-en-1-one scaffold. Chalcones possess many biological activities ranging from anticancer to antiviral activities. This thesis investigates the broad-spectrum antiviral properties of chalcones. Some chalcones have been reported to affect host cell mechanisms such as mammalian target of rapamycin (mTOR) signaling cascade or the cell cycle to reduce viral replication. Previously, a series of chalcones 8 were synthesized and investigated in human cytomegalovirus virus (HCMV) and human immunodeficiency virus (HIV). In this study, ten new chalcones predicated upon the design of 8 were synthesized and a …

Fgf19 Facilitates Metastatic Phenotypes In Colorectal Cancer, Joseph W. Nolff

Graduate Thesis and Dissertation post-2024

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. With 154,000 new cases estimated in 2025, there is an increased need for early screening to detect CRC prior to metastasis. Our laboratory has focused on enteroendocrine hormone Fibroblast Growth Factor-19 (FGF19) as it is overexpressed in a subset of CRC tumors. FGF19 is an intestinal-derived hormone involved with lipid homeostasis when bound to its receptor, Fibroblast Growth Factor Receptor-4 (FGFR4). Our objective focuses on FGF19 contribution towards an epithelial-to-mesenchymal transition (EMT) and overall metastatic properties including rapid proliferation and/or increased cell motility. Immunofluorescence was …

Fructose Induces Metabolic Changes Distinctly Different From Glucose In A N2a Cell Line., Catherine A. Ghigleri

All Master's Theses

Over the last 50 years, there has been a rise in diagnoses of Alzheimer’s Disease and other dementias associated with metabolic stress. This parallels an increase in fructose consumption and has led to research on the effects of fructose on the hippocampus, a brain structure responsible for learning and long-term memory formation. The hippocampus is also a region of the brain that metabolizes fructose. Experiments using animals fed diets containing fructose have shown a correlation between fructose consumption, learning impairment, and structural changes to the hippocampus in animals’ brains. However, the effects of fructose on hippocampal neurons have not been …

Facilitating Engagement In Meaningful Occupations Through Nature-Based Experiences, Sydney Johnson

Occupational Therapy Capstones

Background: Many children, especially those living in urban areas, are spending less time in nature than ever before which is decreasing their engagement in meaningful occupations such as sleep, play, education, social participation, and activities of daily living. Interacting with nature can improve children’s emotional regulation, development, attention span, mental health, and overall well-being. It is important that children have access to nature and its benefits to ensure they are reaching their full potential in life. One method to improve children’s access to nature is providing them with nature-based activities that can be modified or adapted for those living in …

A Path Analysis Of Predictive Factors Affecting Kangaroo Mother Care Practice Among Mothers In Communities In Upper East Region, Ghana, Francis Anaba Agana

Chulalongkorn University Theses and Dissertations (Chula ETD)

This cross-sectional descriptive correlational study aimed to explore the level of KMC practice among the mothers in communities in Upper East Region, Ghana, and to explore the direct and indirect effects of socioeconomic status, social support, maternal autonomy, self -efficacy and sociocultural norms on the practice of KMC in communities in Upper East Region, Ghana. The sample were 300 mothers of preterm and/low birth weight babies recruited by using stratified random sampling technique. This study applied the Socio-Ecological Model as a theoretical framework. Data were collected using questionnaires including socioeconomic status, social support, maternal autonomy, self-efficacy, sociocultural norms and KMC …

The Effects Of An Integrated Application Supported Mindfulness-Based Cognitive Therapy Program On Depression Among Adolescents With Non Suicidal Self-Injury, Russunan Jantarapakdee

Chulalongkorn University Theses and Dissertations (Chula ETD)

This randomized controlled trial with repeated measures aimed to evaluate the effectiveness of an integrated application supported MBCT program in reducing depression among adolescents with NSSI. The sample consisted of 96 participants who met the inclusion criteria and were randomly assigned to either the experimental group or control group, with 48 participants in each group. The experimental group received the program, was developed based on the MBCT framework proposed by Segal et al. (2013) once a week for 60 minutes over eight weeks. Sessions were delivered through both on-site activities at schools and online meetings via the LINE application, supplemented …

Molecular Investigation Of Clade Classification, Knockdown Resistance And Pathogen Detection Of The Head Louse (Pediculus Humanus Capitis) Collected From Children In Ang Thong, Thailand, Urooj Gul

Chulalongkorn University Theses and Dissertations (Chula ETD)

Human head lice (Pediculus humanus capitis) are medically significant ectoparasites due to their capacity to harbor pathogenic bacteria and the increasing prevalence of insecticide resistance. A total of 112 head lice specimens were collected from children in Ang Thong, central Thailand. Phylogenetic analysis of the mitochondrial cytb gene identified two well-supported clades, with clade A (69.2%) predominating over clade C (30.8%) in the studied population. Molecular screening revealed a high incidence of bacterial associations, with Staphylococcus aureus detected in 96.4% of specimens and Acinetobacter spp. in 2.7%. Furthermore, genotypic analysis of the voltage-sensitive sodium channel (VSSC) gene demonstrated a strikingly …

Recommendations For The Novel Assessment System In The Doctor Of Medicine Program From The Medical Students’ And The Educators’ Perspectives, Tanat Tabtieang

Chulalongkorn University Theses and Dissertations (Chula ETD)

The 2024 Doctor of Medicine curriculum at Chulalongkorn University introduced a new assessment system comprising outcome-based assessment system with milestones, a non-tiered grading model with recognition of excellence, a professional development dashboard (PDD), remediation with re-examination, and a faculty-level student profile (FLSP). This study employed a quantitative cross-sectional survey design, complemented by a sequential exploratory element, to compare student and faculty perspectives using a questionnaire across five themes, analyzed with descriptive statistics, Mann-Whitney U tests, and effect sizes (ES). A total of 490 students and 285 faculty responded. When analyzed by theme, students showed greater confidence than faculty in the …

Antimicrobial Activity Of Silver Nanoparticles Synthesized Using Thai Herbal Extracts, Charuwan Pradabsang

Chulalongkorn University Theses and Dissertations (Chula ETD)

Synthesis of silver nanoparticles (SNP) using Thai herbal plants, namely Garcinia cowa Roxb. ex Choisy (S1), Boesenbergia rotunda (L.) Mansf. (S2), Curcuma mangga Valeton & Zijp (S3), Momordica charantia L. forma abbreviata (Ser.) W. J. de Wilde & Duyfjes (S4), Persicaria odorata (Lour.) Soják (S5), Litsea elliptica Blume (S6), Gnetum gnemon Linn. var. tenerum Markgr (S7), Phaleria macrocarpa (Scheff.) Boerl. (S8), Salacia chinensis Linn. (S9) and Brachypterum scandens (Roxb.) Miq. (S10), is considerably economical and safe. Plants and preparation methods can affect properties and bioactivity such as controlled temperature of SNP. This study aimed to assess the ability of aqueous …

The Development Of Surveillance And Monitoring Tools For Pharmaceutical Supply Chain Management System For Public Health Emergencies, Kakanang Tosanguan

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Thailand frequently experiences public health emergencies (PHEs) that severely disrupt pharmaceutical supply chain (PSC) management. This study addresses the urgent need for a specialized assessment tool to identify system weaknesses, support timely risk management, and enhance national preparedness planning.Methods: Utilizing a sequential exploratory mixed-methods design (July 2022–July 2024), the study began with a scoping review to identify existing frameworks. Following this, in-depth interviews with 36 key stakeholders synthesized conceptual domains. The draft tool underwent rigorous content validity assessment by 63 experts and was then pilot tested with 62 participants to confirm reliability (Cronbach’s alpha).Results: The evidence synthesis resulted in …

Optimization And Efficacy Of Car T Cells Derived From Newly Generated Anti-Cd22 Monoclonal Antibody For Blood Cancer Treatment, Wipawadee Ruengdej

Chulalongkorn University Theses and Dissertations (Chula ETD)

Chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment of B-cell malignancies. Nevertheless, relapse due to loss of CD19 expression remains a major clinical challenge. CD22 serves as an alternative target because of its consistent expression on malignant B cells, even in CD19-negative disease. Optimization of CD22-directed CAR design is therefore critical to enhance antitumor potency and persistence. Two novel anti-CD22 CAR constructs were generated from monoclonal antibody clones 24A7G6 and 29H9C8, each incorporating either a 4-1BB or CD28 costimulatory domain. The resulting CAR T cells were evaluated for proliferation, phenotype, and cytotoxicity against CD22-positive (Raji, Nalm-6) and CD22-negative …

The Role Of Advocacy And Occupational Justice In Increasing The Accessibility Of Parks For Parents With Disabilities, Nathan Burke-Tan

Doctoral Projects

The purpose of this doctoral capstone project was to address ongoing accessibility barriers experienced by adults with disabilities, particularly those in caregiving roles, in public parks and playgrounds in the greater San Diego region. Although many parks meet the minimum requirements of the Americans with Disabilities Act (1990), research shows that caregivers with disabilities continue to encounter obstacles that limit safe, meaningful participation in community spaces (Dalpra, 2022; Fernelius, 2017; Firkin et al., 2024; Movahed et al., 2023; Ogletree et al., 2020; Prellwitz & Skar, 2007). These persistent gaps indicate a need for stronger advocacy and clearer public awareness of …

Grounded In Experience: A Collaborative Approach To Resource Development For Adults With Ehlers-Danlos Syndrome, Morgan Kam

Doctoral Projects

Background: Ehlers-Danlos syndrome (EDS) is a complex connective tissue disorder that significantly affects daily occupations, participation, and quality of life, yet early support for individuals pursuing or newly receiving a diagnosis remains limited. Occupational therapy (OT) is uniquely positioned to address these challenges through interventions that promote self-management and functional engagement.

Purpose: This project aimed to develop an experience- and evidence-informed educational resource for individuals undergoing or newly receiving an EDS diagnosis, while increasing awareness of OT’s role in managing this chronic, multisystemic condition.

Methods: A mixed-methods approach integrated qualitative insights from interviews, online support groups, and practitioner feedback. A …

Family-Level Impacts Of Equine-Assisted Occupational Therapy For Children With Disabilities: An Exploratory Mixed-Methods Pilot Study, Emily Canigiula

Doctoral Projects

Equine-assisted occupational therapy (EAOT) has been shown to enhance functional, social, and quality-of-life outcomes for children with disabilities (McDaniel Peters & Wood, 2017; Prieto et al., 2022). While child-focused outcomes are well documented, significantly less is known about how EAOT participation may influence caregivers and the broader family unit, as existing research largely prioritizes individual outcomes over family experiences (Peters et al., 2017; Tan & Simmonds, 2018; Trzmiel et al., 2019; Xiao et al., 2023). Emerging qualitative studies suggest potential family-level impacts including family engagement, reduced parental stress, and enhanced feelings of pride, empowerment, and connection (Kalmback et al., 2020; …

Bridging Gaps With Occupational Therapy: The Unique Role Of Occupational Therapy In Women’S Day Shelters, Alex Sato

Doctoral Projects

Homelessness is a multifaceted, complex issue that we face as a society. Mainstream services provided to homeless or vulnerable populations tend to focus on housing and basic services. While these are essential and meaningful, literature suggests there is a lack in trauma and self-care support (Marzana et al., 2023; Milaney et al., 2020). Looking through an Occupational Therapy (OT) lens, there are a multitude of ways the profession can provide holistic care. Current OT service provision within this population most commonly focuses on obtaining and maintaining housing and addressing the survival occupations these individuals may be engaging in (Cunningham & …

Applying Occupational Empowerment Principles In A Life Skills Program For Unhoused Transitional-Aged Youth: Feasibility And Early Outcomes, Eriza Navarro

Doctoral Projects

The purpose of this occupational therapy doctoral capstone project was to address a gap in community-based services for unhoused transitional-aged youth (TAY) by promoting life skill acquisition and supporting participation in meaningful activities in order to enhance self-efficacy. This project aimed to design, implement, and evaluate a structured occupation-based life skills program that builds upon existing services at a local drop-in center. The program incorporated life skill education and activity-based, experiential interventions tailored to meet the needs and learning styles of the population. Methods included conducting a needs assessment, developing the program curriculum, and piloting the 6-week program consisting of …

Promoting Participation And Self-Efficacy Among Youth With Disabilities In Community-Based Vocational Education, Allison Hollender

Doctoral Projects

Occupational therapy, with its focus on participation, contextual adaptation, and strength-based practice, is uniquely suited to support the growth and inclusion of youth in transition (Angell et al., 2018; Cahill et al., 2020; Carroll et al., 2025). Research indicates that transitional-aged youth (TAY) with disabilities, ages 14-24, are less likely to graduate from high school, pursue postsecondary education, or live independently (BLS, 2024; Cheng & Shaewitz, 2022; Cook et al., 2015). These disparities are compounded by occupational deprivation, or limited opportunities for meaningful participation, which can negatively impact long-term self-efficacy and belonging (Arbesman & Logsdon, 2011; Cahill et al., 2020). …

From Silos To Synergies: How To Enhance Interdisciplinary Collaboration Among Graduate Students, Jennifer Jimenez

Doctoral Projects

Interprofessional education (IPE) is essential for preparing collaborative healthcare practitioners, yet opportunities at San José State University (SJSU) have been limited, inconsistent, and largely dependent on individual faculty initiative. This capstone project aimed to strengthen IPE at SJSU by assessing institutional capacity and developing feasible, sustainable strategies to enhance exposure and participation across health-related programs. Guided by the Person–Environment–Occupation–Performance (PEOP) model and adult learning theory, the project combined a needs assessment, literature review, and partnership with the Healthy Development Community Clinic (HDCC) to create an instructor implementation guide and student introductory modules for HDCC service-learning onboarding. An IRB-approved mixed-methods faculty …