Medicine and Health Sciences Commons^™

Comparative Evaluation Of Translucency, Fluorescence, And Structural Analysis Of 3d-Printed Vs. Conventionally Fabricated 3y, 4y And 5y Zirconia, Surabhi Chhabra

ETDs from 2020-2029

Statement of Problem: Additive manufacturing has emerged as an alternative to conventional milling for zirconia-based dental restorations because of its potential to reduce material waste and increase design flexibility. However, whether 3D-printed zirconia can provide optical and structural properties comparable with those of conventionally milled zirconia for esthetic applications remains unclear. Purpose: The purpose of this in vitro study was to compare the optical properties of 3D-printed zirconia and conventionally milled 3Y, 4Y, and 5Y zirconia, as measured by translucency and fluorescence, and to evaluate their structural characteristics, as measured by density, porosity, phase composition, and surface morphology. Materials and …

An Examination Of Physical Activity And Arterial Stiffness Among Urban And Rural Older Adults, Michael J. Hankes

ETDs from 2020-2029

Rural populations in the United States experience a disproportionate burden of cardiovas-cular disease, yet how rural‑urban context shapes physical activity (PA) and vascular health is not fully understood. Because vascular dysfunction links PA to cardiovascular risk, rural‑urban differences in movement may help explain disparities in cardiovascular health. Rurality is often treated as a static, binary exposure, which may obscure meaning-ful geographic variation and accumulated life course influences. The overarching goal of this dissertation was to examine associations among rural‑urban exposure, objectively measured PA, and vascular health using national cohort data and a pilot study. This dissertation begins with a conceptual …

Cal Poly Rodeo Program, Keith J. Johnson

Agricultural Education: Graduate Internship Reports

The purpose of this project was to evaluate and improve livestock welfare practices within the Cal Poly Rodeo Program while supporting the program's core values of student success, western heritage, and program excellence. Livestock play a critical role in collegiate rodeo by providing educational opportunities, athletic competition, and hands-on learning experiences for students. As public awareness of animal welfare continues to increase, rodeo programs must demonstrate responsible stewardship and ethical animal management practices.

This project assessed current livestock management procedures, identified areas for improvement, and implemented educational and operational strategies designed to enhance animal health and welfare. Key performance indicators …

Music Appreciation In Cochlear Implant Users: A Questionnaire, Hanna Davidson

Dissertations, Theses, and Capstone Projects

Cochlear implants provide significant benefits for speech perception in individuals with severe to profound hearing loss; however, music perception and appreciation remain challenging due to limited spectral and temporal resolution. This study examined music appreciation in post lingually deafened adult cochlear implant users, focusing on changes in enjoyment, listening behaviors, and subjective experiences following implantation. Sixteen adults completed a 36-item questionnaire assessing pre- and post-implant music engagement, perceived sound quality, and emotional responses to music. Quantitative data were analyzed using descriptive statistics and inferential statistics, and qualitative responses were analyzed thematically.

Results indicated a moderate decline in music enjoyment following …

Parkinson’S Disease Phenotype Stratification Using Multiple Correspondence Analysis, Kelly Astudillo

Dissertations, Theses, and Capstone Projects

Parkinson’s disease (PD) is the second most common neurodegenerative disorder, with over 12 million people projected to be affected by 2040 (Dorsey et al., 2018). Deep phenotyping and stratification can provide useful information regarding PD pathogenesis and can aid in the  development of disease modifying therapies that aim to delay the progression or prevent the onset of neurodegeneration (Blandini et al., 2019; Smith & Schapira, 2022). Utilizing multivariate methods such as multiple correspondence analysis (MCA) permits for the simultaneous analysis of distinct data modalities. To the best of our knowledge, MCA has not been previously used to explore phenotype patterns …

Cerebral Palsy Detection In Neonatal Intensive Care Unit Infants, Anais Jeday, Shane Tryon, Bryanna Leary, Oleana Jacobson

Biomedical Engineering

The project is conducted in collaboration with Dr. Eric Espinoza-Wade to develop a secure, accurate wearable sensing system for infants in the Neonatal Intensive Care Unit (NICU) who have experienced asymmetric perinatal brain injury (APBI). Infants with APBI are at increased risk for developing unilateral cerebral palsy; however, clinical diagnosis is often delayed until 12–24 months of age, limiting opportunities for early intervention.

The goal of the project is to design a wearable system that securely attaches small, lightweight accelerometers to an infant’s limbs to quantify bilateral limb movement. Triaxial acceleration data will be used to detect movement asymmetries, which …

Increasing Efficiency And Flow In Primary Care Clinics Using Triage Protocols Based On The Donabedian Model, Verneita Mun

Doctor of Nursing Practice Projects

Purpose

This project evaluated the effectiveness of triage protocols based on the Donabedian model in increasing efficiency and flow in primary care clinics. Patients experienced extended wait times in primary care clinics, resulting in aggravated outcomes and dissatisfaction with care delivery. Healthcare providers also experienced stress and burnout due to workload and operational inadequacies. These inefficiencies mandated a quality improvement approach that addressed patient satisfaction, workflow optimization, and resource management.

Methods

This project used structured triage protocol based on the Donabedian model, which addressed the dimensions of structure, process, and outcomes. The proposed solution was disseminated through a quality improvement …

Independent And Combined Effects Of Early-Life Iron Deficiency And Antibiotic Exposure On Growth And Hematological Outcomes In A Piglet Model, Ginger M. Fitzpatrick

Master's Theses

Iron deficiency (ID) affects over 2 billion individuals globally. Children under 5 are at increased risk of ID due to rapid growth and are especially vulnerable to its negative consequences because of iron’s essential role in cognitive development and immune maturation. ID is the leading cause of iron deficiency anemia (IDA), with IDA affecting approximately 40% of children in this age group. Antibiotic (abx) exposure is also prevalent during early life and may disrupt growth and through gut dysbiosis, with increasing use posing additional risk in younger populations. Geographically, there is overlap in regions with high anemia prevalence and those …

Personal And High-Intensity Gait Factors Associated With Balance And Walking Improvement With Outpatient Stroke Rehabilitation: A Retrospective Study, Heather Staal

Dissertations

Objective: The purpose of this study is to examine the relationships between personal factors and High-Intensity Gait variables and balance and walking improvement in an outpatient stroke population.

Background: Stroke is a leading cause of long-term disability, with persistent gait and balance impairments commonly limiting independence and participation. High-intensity gait training (HIGT) is an evidence-based rehabilitation approach that improves walking outcomes following stroke; however, guidance on how specific training variables are applied in outpatient physical therapy settings remains broad.

Methods: This retrospective observational study analyzes clinical data from outpatient physical therapy episodes in which HIGT is a …

Attachment Style, The Working Alliance, And Client Self-Disclosure In Individual Psychotherapy, Jennifer S. Baar

Dissertations

Client self-disclosure is a core component of the psychotherapy process and increased levels of client self-disclosure have been shown to predict more positive therapeutic outcomes (Pattee & Farber, 2008; Sloan & Kahn, 2005). Similarly, the working alliance and attachment are constructs that have been studied in psychotherapy research and are consistently associated with therapeutic outcomes. Specifically, stronger working alliance ratings and higher levels of secure attachment have been found to predict more positive therapy outcomes (e.g., Flückiger et al., 2018; Mallinckrodt et al., 2005; Sauer et al., 2010). As these three constructs have been found to influence psychotherapy outcomes, the …

Predicting Clinical Outcomes Of Non-Specific Low Back Pain By Studying The Interaction Of Clinical And Demographic Factors Of A Retrospective Data Set, Erica Michelle Fernandes

Dissertations

The purpose of this research is to investigate demographic factors, including age, gender, body mass index (BMI), race, marital status, insurance type, severity of disease (initial pain level), and clinical factors such as number of visits (no. of visits) at physical therapy (PT), length of time at PT and the type of clinician either physical therapist versus physical therapy assistant (PTA), that most predict PT clinical outcomes in patients with nonspecific low back pain (NSLBP) and see if there is an interaction between demographic and clinical variables.

Methods

The current study is a retrospective, cross-sectional, observational study using secondary electronic …

Exploring How Therapist Trainees’ Mentalization, Attachment Styles, And The Working Alliance Impact Treatment Outcomes In Psychotherapy, Hanali Gilbert

Dissertations

A burgeoning area of research within the past 30 years has sought to identify which specific therapist factors contribute to differential treatment outcomes (Barkham et al., 2017). The purpose of the current naturalistic study was to explore how two personal characteristics of therapist trainees, mentalization capacity and attachment styles, impact early treatment outcomes at two Midwestern psychology training clinics. This study also examined whether therapist mentalization and the working alliance interacted to influence client outcomes. Therapists completed the Mentalization Scale (MentS; Dimitrijević et al., 2018) and the Experiences in Close Relationships scale (ECR; Brennan et al., 1998), while the Working …

An Attachment Perspective For Help-Seeking Intentions Among Emerging Adult Women Child Sexual Abuse Survivors, Dominique Giroux

Dissertations

Child sexual abuse (CSA) is an adverse childhood experience and a global health issue. Approximately one in four girls encounter CSA per year. Research evidence suggests approximately 50% of CSA survivors encounter sexual revictimization during adulthood (Walker & Wamser-Nanney, 2023), but formal help and intervention can mitigate further psychosocial harm experienced by CSA survivors (Widom et al., 2008). Attachment theory has provided a theoretical framework for identifying individuals at risk for revictimization and help-seeking patterns, such that individuals who have insecure attachment styles report more revictimization frequency, but the literature is mixed about attachment styles and help-seeking (Brenner et al., …

Viruses Causing Panleukopenia In Domestic Cats: A Review Of Feline And Canine Parvoviruses, Simon Colby

University Honors Theses

Parvoviruses remain among the most important viral pathogens in domestic cats today. Despite this, there is much confusion around which parvoviruses can infect cats, and what extent of disease they can cause. One of the two parvoviruses infecting cats, canine parvovirus type-2 (CPV-2), likely evolved from the other parvovirus infecting cats, feline parvovirus (FPV). These viruses differ at only a few places in their genomes, and share the method of cell entry via the transferrin receptor. The disease caused by FPV has been well characterized in cats, but disease caused by CPV-2 is more obscure. Additionally, current testing methods for …

Birth Satisfaction, As Measured By The Birth Satisfaction Scale–Revised (Bss-R), And Its Role In Predicting Breastfeeding Duration, Maternal-Infant Attachment, And Postpartum Depression, Molly Parker

University Honors Theses

Birth satisfaction has been consistently associated with improved maternal outcomes such as reduced postpartum depression (PPD), stronger maternal-infant attachment, and longer breastfeeding duration. However, the extent to which birth satisfaction independently predicts these outcomes remains unclear. This study examined whether birth satisfaction, as measured by the Birth Satisfaction Scale–Revised (BSS-R), predicts postpartum depression, maternal-infant attachment, and breastfeeding duration in a longitudinal cohort.

Data were drawn from the Prenatal Environmental And Child Health (PEACH) study. Birth satisfaction was assessed at 12 months postpartum using the BSS-R. Postpartum depression was measured using the Edinburgh Postnatal Depression Scale (EPDS), maternal-infant attachment using the …

Social Determinants As A Predictor For Heart Disease Mortality: Oregon Regional Study, Jewel Jones

University Honors Theses

The study examined the association between selected social determinants of health and heart disease mortality across geographic regions in Oregon. Using a regional analysis design, county-level population and mortality data were grouped into nine geographic regions to evaluate patterns of cardiovascular disease burden across the state. Social determinant variables were obtained from publicly available U.S. Census Bureau datasets and included poverty, crowding among households, single-parent households, lack of broadband internet subscription, housing cost burden, high school diploma attainment, and unemployment.

Heart disease mortality counts per 100,000 population were derived from official birth and death certificate records. Statistical analyses were conducted …

Facilitators And Barriers That Exist For Patients Receiving Dental Care In Rural Communities, Monse Sandoval Brumbaugh

University Honors Theses

Rising healthcare costs and limited access to care have exacerbated the shortage of healthcare providers. Although multiple factors contribute to a clinician’s preference for practicing in rural areas, the imbalance created leads to rural communities with significantly reduced access to essential services, particularly dental care. The disparity between urban and rural healthcare is a well-documented global problem, but it remains a pressing issue in the United States, particularly in Oregon. The Full Time Equivalents (FTE) count of full-time practicing dentists in rural regions is significantly lower than in urban areas. Statewide, there are about 0.48 dentists per 1,000 residents. However, …

Geographic And Systemic Disparities In Maternal Health: A Systems Analysis Of Prenatal Care Access Across Rural Oregon, Cecelia Petrik

University Honors Theses

Objectives: In Oregon, 51% of hospitals providing labor and delivery services are located in rural areas. Consolidation of these hospitals and provider shortages has created severe geographic and systemic disparities in maternal healthcare. This thesis explores how geographic isolation and inadequate prenatal care access contribute to widening disparities in severe maternal morbidity (SMM) and mortality across Oregon's rural and frontier counties.

Methods: This study utilizes data from the Oregon Health Authority (OHA) Center for Health Statistics (2024) and analyzes spatial correlations across all 36 Oregon counties. A bivariate choropleth map was constructed to examine the structural intersection between health infrastructure …

Moving Beyond Traditional Cost Containment For Glp-1 Coverage Within Oregon's Proposed Universal Health Plan, Manoj Rajesh

University Honors Theses

In 2022, Oregon voters passed Measure 111, constitutionally mandating access to affordable health care. As the Universal Health Plan Governance Board (UHPGB) designs the state's proposed single-payer system, it faces an unprecedented financial vulnerability: the clinical demand for GLP-1 receptor agonists. These high-cost, indefinite-use medications for obesity and metabolic syndrome threaten to overwhelm fixed public budgets. Historically, both the Oregon Health Plan's Medicaid framework and commercial private insurers have relied on static cost-containment models—categorical exclusions, step therapy, and aggressive utilization management—that achieve short-term fiscal solvency at the expense of comprehensive preventative care. This thesis argues that to fulfill the mandate …

Supporting Nurse Practitioner Autonomy: A Policy Proposal To Advance Hospice Np Scope, Lauren Hochart

Doctor of Nursing Practice Final Manuscripts

The Nurse Practitioner (NP) profession has achieved many advancements in its autonomy and scope of practice in the last 61 years since becoming a recognized advanced practice registered nursing role. However, some areas of healthcare still limit the NPs ability to practice autonomously even though it is within their scope of practice. This is notable in the subspecialty of hospice care with regards to certifying a terminal diagnosis as part of eligibility determination for a Medicare beneficiary to be able to receive covered hospice services. This health policy paper reviews current hospice regulations and provides evidence to support the benefits …

Exercise Prescription For Adults With Prediabetes In The Primary Care Clinic, Katherine W. Hall

Doctor of Nursing Practice Final Manuscripts

Prediabetes affects approximately one in three adults in the United States, with an estimated 10% progressing to Type 2 Diabetes Mellitus (T2DM) annually. Despite strong evidence supporting exercise as a first-line intervention to prevent disease progression, most patients in primary care settings do not receive structured physical activity counseling. This evidence-based project (EBP) aims to address this gap by implementing a standardized protocol to assess baseline physical activity levels and deliver individualized exercise prescriptions to adults with prediabetes in the primary care clinic.

Eligible participants, defined by HbA1c values between 5.70% and 6.49%, were identified during routine primary care visits …

Enhancing Tardive Dyskinesia Screening In An Outpatient Psychiatry Training Clinic: A Quality Improvement Initiative, Ariel Davalos

Doctor of Nursing Practice Final Manuscripts

Background: Tardive Dyskinesia (TD) is a debilitating, often irreversible movement disorder caused by prolonged exposure to dopamine receptor-blocking agents, affecting 15-30% of patients on long-term antipsychotic therapy. Despite endorsement of the Abnormal Involuntary Movement Scale (AIMS) as the gold standard for TD screening, the condition remains significantly under-diagnosed. Purpose: This quality improvement project evaluated whether a 45-minute educational intervention could improve PMHNP trainees’ confidence and competence in TD recognition and AIMS administration. Methods: Guided by the Iowa Model of Evidence-Based Practice, the project used a pre-post survey design with a planned one-month follow-up across two clinical training sessions. Ten PMHNP …

Empowering Healing And Recovery: Adverse Childhood Experiences Screening In A Cognitive Behavioral Therapy Intensive Outpatient Program, Serena C. Lee

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project implemented Adverse Childhood Experiences (ACEs) screening in an adult Cognitive Behavioral Therapy Intensive Outpatient Program (COG IOP) at San Diego's largest behavioral health hospital to identify ACE exposure, deliver supportive interventions, and enhance clinician competency in trauma-informed care.

Background: ACEs are potentially traumatic experiences occurring before age 18 that are associated with toxic stress and worsening health outcomes. Despite evidence linking ACEs to adverse outcomes and substantial healthcare costs, routine ACE screening is not standardized in behavioral health settings.

Methods: Guided by the San Diego 8A's Evidence-Based Practice model, eligible patients were offered ACEs screening …

Reducing Preoperative Anxiety In Patients Undergoing Gynecologic-Oncology-Related Surgeries, Iman Sean Lavine-Richardson

Doctor of Nursing Practice Final Manuscripts

Elevated levels of preoperative anxiety are associated with adverse effects in the postoperative period. Evidence demonstrates the effectiveness of incorporating multimedia into preoperative education to alleviate preoperative anxiety. This project aims to decrease preoperative anxiety levels and increase satisfaction and feelings of preparedness in patients scheduled to undergo gynecologic-oncology-related procedures through the implementation of an evidence-based practice (EBP) informational video. The San Diego 8A’s EBP model was utilized to guide this project. Data was collected, anonymously, through online questionnaires which included the Anxiety Specific to Surgery Questionnaire (ASSQ) to assess anxiety levels and Likert-scale questions to assess satisfaction and feelings …

Implementation Of Comprehensive Checklist For Opioid Use Disorder Treatment In Primary Care, Sophia R. Madden

Doctor of Nursing Practice Final Manuscripts

Background: The escalating opioid crisis demands a comprehensive approach to Opioid Use Disorder (OUD) management. Patients often face comorbid mental illnesses, infectious diseases, concurrent substance use, and social determinants of health (SDOH)—all of which increase the risk of treatment attrition. Standardizing care through evidence-based clinical practice guidelines and tools is essential for improving treatment quality and consistency.

Purpose: This project aimed to increase comorbidity screenings and improve resource access for OUD patients at a San Diego Internal Medicine primary care office by implementing a comprehensive care checklist based on the American Society of Addiction Medicine (ASAM) guideline.

Methods: The ASAM …

Optimizing Lactation Support: Enhancing Patient-Centered Care And Breastfeeding Self Efficacy Through Data-Driven Survey Analysis, Jessica L. Doshay

Doctor of Nursing Practice Final Manuscripts

Objective: The objective of this project was to implement evaluation of an integrated lactation support model within a multi‑site pediatric primary care organization to assess patient experience and breastfeeding confidence associated with a lactation consultation.

Background: Optimizing the patient experience is an indicator of healthcare quality. Improving breastfeeding outcomes remains a national priority. Structured lactation support delivered by International Board-Certified Lactation Consultants (IBCLCs) enhances breastfeeding outcomes, the impact of this is often undocumented in primary care settings.

Methods: This quality improvement project was conducted within the lactation department of a multicenter pediatric clinic in Southern California. Pediatric clinicians who were …

Evaluating The Role Of Ultrasound As A Tool For Airway Assessment And Management For Anesthesia Providers, Alexyss Capestany

Doctor of Nursing Practice Final Manuscripts

Introduction: The ability to predict and manage difficult intubations is a critical component of airway management in clinical practice.

Background: Ultrasound airway assessment has emerged as a valuable tool in predicting difficult intubation, yet its integration into routine clinical practice remains limited. This Doctor of Nursing Practice (DNP) project aimed to educate healthcare providers, specifically nurse anesthetists, on the use of ultrasound to assess airway anatomy and enhance prediction of difficult airways.

Methods: An evidence-based airway assessment, the Difficult Airway Evaluation with Sonography (DARES), was implemented during a single-day skills fair. Participants received both didactic instruction and hands-on training focused …

Enhancing Emergency Department Preparedness For Amniotic Fluid Embolism Through Evidence-Based Simulation Training, Olivia M. Smoak

Doctor of Nursing Practice Final Manuscripts

Maternal mortality in the United States remains a significant and worsening public health concern, with increasing reliance on emergency departments (EDs) as access points for maternal care. Emergency clinicians are therefore more likely to encounter high-acuity obstetric emergencies, including maternal cardiac arrest and amniotic fluid embolism (AFE), yet often receive limited formal training in these conditions. Simulation-based education, interdisciplinary training, and cognitive aids have been identified as effective strategies to improve performance in high-risk, low-frequency events.

The purpose of the evidence-based practice project was to evaluate whether an interdisciplinary simulation with obstetric-led debrief and introduction of the AFE checklist improves …

Innovating Adhd Care: A Doctoral Capstone On A Pilot Adult Adhd Diagnostic Clinic Implementation, Fozia Aman

Doctor of Nursing Practice Final Manuscripts

Objective: To evaluate whether an APRN-led pilot Adult ADHD Diagnostic Clinic within a large academic healthcare system in the San Diego area improves timely access to diagnostic evaluation and optimizes care disposition for adults with suspected ADHD.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by inattention and/or hyperactivity-impulsivity that interferes with functioning in daily life. It often emerges in childhood and persists into adulthood, affecting approximately 360 million adults globally. Despite its prevalence and associated functional and psychiatric burden, adult ADHD remains underdiagnosed and undertreated due to limited primary care training, stigma, and reduced access to psychiatric services, resulting in delayed …

Sleep Tight: A Sleep Hygiene Bundle For Adults To Improve Sleep Quality In A Skilled Nursing Facility, Meaghan Corbin

Doctor of Nursing Practice Final Manuscripts

Abstract

Nearly two thirds of skilled nursing facility (SNF) residents report poor sleep. Negative consequences of poor sleep are depressed mood, anxiety, pain, cognitive impairment, increased risk for dementia, fatigue, decreased concentration, and lower activity participation. A review of literature has shown that implementation of non-pharmacological sleep interventions can significantly improve sleep quality. The aim to screen SNF residents on current self-reported sleep quality and provide non-pharmacological sleep interventions. The evidence-based project utilized the 8 A’s Model. Using the Pittsburg Sleep Quality Index (PSQI), a resident with a score above 0, received the non-pharmacological sleep hygiene bundle: eye mask, earplugs, …