Medicine and Health Sciences Commons^™

Identifying The Role And Influence Of Interleukin-27 On The Neonatal Immune Response, Jordan Kane Vance

Graduate Theses, Dissertations, and Problem Reports (ETD)

The first month of life is a critical and vulnerable developmental stage, characterized by a heightened risk of life-threatening infections. Each year, 1.3 million newborns succumb to neonatal bacterial sepsis. The immune system during the neonatal period has unique features that lead to inefficiencies at clearing infection. Early life immunity is characterized by a Th2-biased profile with decreased IL‑12, IFN-γ, and TNF-α, along with increased IL‑6 and IL‑23. Additionally, IL‑27, an immunosuppressive cytokine, is also elevated during this period and further contributes to susceptibility to infection. Early diagnosis and intervention are critical in administering effective care in newborns and there …

Pancreatic Cancer In Appalachia: An Examination Of Detection, Associated Factors, And Provider Experiences With A Focus On West Virginia, Melissa Mae Elder

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Pancreatic Cancer in Appalachia: An Examination of Detection, Associated Factors, and Provider Experiences with a Focus on West Virginia

Melissa M. Elder

Introduction: The Appalachian population accounts for a substantial proportion of the United States and are uniquely susceptible to health care disparities. The Appalachian Regional Commission has reported on the inequities found within the Appalachian region as part of its formal establishment in 1965. When compared to the Non-Appalachian U.S., Appalachia experiences a higher incidence of chronic disease such as diabetes, cancer, lung, and liver disease; mortality from diseases of despair constituting prescription drug, alcohol, illegal drug use, …

Development Of Novel Carbohydrate-Based Nanoparticles For Precision Drug Delivery, Krystal Ann Hughes

Graduate Theses, Dissertations, and Problem Reports (ETD)

Nanoparticle-based drug delivery has made tremendous advancements in the last decade. However, several critical factors, including precision drug delivery at the site of interest, long-term storage stability, and controlling release profiles of drugs in the systemic circulation, need to be addressed for successful clinical translation of nanomedicine. This dissertation presents novel carbohydrate-based nanoparticles that achieve precise intracellular delivery and therapeutic release at the disease site. We present the formulation and optimization of polymeric and polymer-lipid hybrid nanoparticles that enable precision intracellular delivery and passive accumulation of therapeutics in the bone marrow. Intracellular delivery is highly impactful and sought after. One …

The Gut-Brain Axis: Investigating The Effects Of Diet, Physical Activity, And Prior Adversity On Anxiety Via Autonomic Nervous System, Jenna L. Pennella

UNF Graduate Theses and Dissertations

Previous literature has highlighted a bidirectional relationship between the gut and brain called the gut-brain axis (de Punder & Pruimboom, 2015; Hill et al., 2008; Leistner & Menke, 2020). The current study aimed to investigate directional relations between different stressors (e.g. poor diet, vigorous activity, and prior adversity) and anxiety and how interactions with gut issues and autonomic dysfunction may impact these relationships. Based on previous literature, we examined (a) physical activity and diet as moderators of stress and anxiety as well as stress and GI symptoms, (b) GI symptoms as a mediator between various predictors (i.e., diet, stress, physical …

Investigating The Production Challenges Of The P100.1 Phage Endolysin, Jonah O. Frago

EWU Masters Thesis Collection

Acne vulgaris is one of the most common skin diseases globally. One key aspect of acne pathogenesis is the disturbance of healthy strain diversity of the skin bacterium Cutibacterium acnes. Many acne treatments are antimicrobial; however, these treatments are generally nonspecific and carry a variety of side effects in addition to contributing to rising antibiotic resistance. Lytic bacteriophages (or phages) are viruses that infect and kill bacteria. Their lytic lifestyle is facilitated by enzymes called endolysins. Phages have been studied as an alternative to traditional antimicrobials in acne treatment and have shown reduced C. acnes load in acne lesions and …

Food Allergies And Quality Of Life In Older Adults: Development Of A Food Allergy Questionnaire, Avalon F. Mustafa

UNF Graduate Theses and Dissertations

The United States is experiencing a rapid increase in the number of older adults, yet there is a lack of research on food allergies in this demographic. While there are survey instruments available to study food allergies and quality of life, none of these are tailored to the unique needs of elderly individuals. This study aims to create and validate an on-line survey instrument specifically designed for older adults, focusing on their quality of life in the context of food allergies. The survey will be used to establish a food allergy severity score and a quality-of-life score, enabling comparison between …

Factors Influencing Emergency Department Utilization Among Heart Failure Patients In The Home Health Care Setting: A Secondary Data Analysis, Lynette Ramlogan

Theses & Dissertations

Heart failure is a chronic, progressive condition affecting over 6 million adults in the United States and remains a leading cause of morbidity and mortality, contributing to approximately 380,000 deaths annually. Disparities in health outcomes for individuals with heart failure are further exacerbated by social determinants of health (SDoH), including socioeconomic status, healthcare accessibility, and availability of social support, particularly among vulnerable populations. Insurance coverage plays a critical role in influencing access to care, treatment adherence, and overall health outcomes among patients with heart failure. For patients receiving home health care (HHC) services, limited caregiver support and inadequate socioeconomic resources …

A Mixed Methods Study: The Influence Of Educational Preparation, Clinical Experience, And Orientation On Nursing Professional Development Role Transition Experience, Lauren Elizabeth Moran

Theses & Dissertations

This study explored the role transition experiences of novice Nursing Professional Development (NPD) practitioners, examining how educational preparation, clinical experience, and orientation programs influence successful adaptation. NPD practitioners are essential in facilitating learning, mentoring staff, and advancing nursing excellence; however, transitions from clinical nurse to NPD practitioner are often marked by role ambiguity, limited confidence, and insufficient preparation. Despite the importance of this role, research on novice NPD practitioners’ transition experiences remains limited. This mixed-methods explanatory sequential study, guided by the Nurse Educator Transition (NET) model and From Novice to Expert frameworks, explored factors influencing the role transition of novice …

Exploring The Impact: Eating Disorder Treatment And Mortality In The United States, Brittany Tolbert

College of Graduate Studies: Theses & Dissertations

This study explores adolescent eating disorder trends in the United States between 1999-2013, identifies national eating disorder mortality trends, and analyzes data for in-patient adolescent hospital admissions. Additionally, this study uses public-facing data for residential eating disorder treatment centers to explore issues related to insurance coverage, gender inclusivity, and evidence-informed treatment practices. The findings will highlight gaps in data collection and policy, support advocacy, and contribute to the research into eating disorder prevalence, prevention, treatment outcomes, and economic impact, leading to greater visibility to promote change.

Application Of Machine Learning And Large Language Models In Healthcare For Data Prediction And Summarization, Chiazam Chisom Izuchukwu

College of Graduate Studies: Theses & Dissertations

This study aims to examine the use of machine learning (ML) and large language models (LLMs) in healthcare to enhance disease prediction, clinical decision-making, and information management. Five supervised ML models—Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF), Decision Trees (DT), and Naïve Bayes (NB)—on three different computing platforms—Google Colab, Databricks, and Snowflake—were employed for disease classification. Data preprocessing included treating missing values, encoding categorical variables utilizing one-hot-encoding, feature scaling when needed, and tackling class imbalance with Synthetic Minority Over-sampling Technique (SMOTE) before an 80-20 train-test separation. Models were created with Scikit-learn (Google Collab), Spark MLlib (Databricks), and …

Providing Healthcare Access For The African Population Using An International Care Coordination System: A Case Study Of Nigeria And Ghana, Aminat B. Nwaonumah

College of Graduate Studies: Theses & Dissertations

Introduction: Healthcare access is a major population health challenge among underserved populations in many parts of the world, and the situation in Africa is no exception. Foreign aid, a significant component of healthcare financing in Africa, has played a crucial role in mitigating communicable diseases. However, there is a lacuna in care for non-communicable diseases, such as chronic illnesses, especially among the elderly. This study explored an innovative approach to expanding healthcare access in Nigeria and Ghana through care coordination sponsored by migrant family members residing in the United States. Beyond foreign aid, this research elucidates how the International Care …

A Critical Examination Of Scent Avoidance And Olfactory Development After Neonatal Predator Scent Exposure, Cynthia Ware

College of Graduate Studies: Theses & Dissertations

The long-standing assumption that predator odor avoidance in rodents is an innate survival mechanism has shaped decades of behavioral neuroscience research and underpins translational models of post-traumatic stress disorder (PTSD). However, developmental systems theory (DST) posits that behaviors emerge from dynamic interactions across physiological and environmental systems over time, rather than from fixed genetic programs. This study critically evaluates the developmental plasticity of predator scent aversion by examining whether early-life exposure to red fox urine (a natural predator odor) can attenuate avoidance behaviors in Long–Evans rats. Seventy-one rats were bred into three conditions: Control (no exposure), Partial (exposure from birth), …

Barriers To Seeking Medical Care And Their Effects Among Fat Patients With A Fat Liberation Praxis In The United States, Christina Seiko Cook

College of Graduate Studies: Theses & Dissertations

Weight stigma and weight bias have significant effects on the health of individuals (Alberga et al., 2019; Pearl, 2018; Puhl & Heuer, 2010; Schwartz et al., 2003; Udo et al., 2016). These biases can show up in the form of fatphobia or anti-fat bias. Physicians who hold anti-fat bias can affect their relationship with their patients, leading to poorer health outcomes and worse patient experiences for larger-bodied and fat people (Phelan et al., 2015). The purpose of this study is to contribute to the current literature regarding the positive and negative experiences of fat patients with a fat liberation praxis …

Effects Of Perinatal Exposure To Lipopolysaccharide And Acetaminophen On Learning In Adult Long-Evans Rats, Lucy A. Sivils

College of Graduate Studies: Theses & Dissertations

The present study investigated the individual and combined effects of elevated perinatal inflammation, oxidative stress caused by acetaminophen (APAP) exposure, or elevated inflammation and oxidative stress on adult learning behaviors in Long-Evans rats. While prior studies have examined these factors independently, the combined effects of inflammation and oxidative stress via APAP exposure during early development on learning-related behaviors remain unexplored. The present research aimed to address this gap by the analysis of potential long-term neurodevelopmental consequences of lipopolysaccharide (LPS)-induced inflammation and APAP-induced oxidative stress. LPS, APAP, or LPS + APAP was administered during the perinatal period: postnatal days (PD) 9, …

Exploring The Impact Of Covid-19 And The Role Of The Church On African Americans’ Mental Well-Being In South Georgia, Adrian D. Lewis

College of Graduate Studies: Theses & Dissertations

The emergence of COVID-19 in 2020 disrupted the social dynamics of communities in the United States. Furthermore, public health mandates led to closures that changed how populations access faith. Historically, African Americans have utilized the church to cope with societal stressors. This study will explore the history of church utilization in the African American community, assess how COVID-19 public health mandates led to church closures for the first time in recent history and impacted this marginalized population, and provide a qualitative perspective on the quality of life during the closures and what changed after the closures for African Americans in …

Perceptions And Influences On Physical Activity Engagement During Pregnancy Among Rural Southern Black Women, Sandra Ofosuhemaa

College of Graduate Studies: Theses & Dissertations

Black women living in the rural South experience disproportionately high rates of hypertension, gestational diabetes, excessive gestational weight gain, and adverse birth outcomes. Although physical activity during pregnancy is known to improve maternal and fetal health, Black pregnant women remain less likely to meet recommended activity guidelines. This qualitative study examined the perceptions, beliefs, and multilevel factors influencing physical activity during pregnancy and the postpartum period among Black women in rural Southeast Georgia. Guided by the Health Belief Model (HBM) and Social Ecological Model (SEM), the study explored how individual, interpersonal, community, and structural conditions shaped women’s decisions, motivations, and …

Comparing The Patient Shielding Practices For Healthcare Facilities In Southeast Georgia, Genesis Horton

Honors College Theses

Since the discovery of X-rays in 1895, research has consistently been conducted on their capabilities and limitations in healthcare. One primary focus of interest is patient shielding, especially regarding radiation protection and patient safety. Introduced in the mid-1900s, patient shielding has been practiced to protect the gonads, the thyroid, and other radiosensitive body parts. This research project investigated common shielding protocols implemented in healthcare facilities, specifically within Southeast Georgia. This study utilized anonymized in-person interviews with local imaging departments regarding their procedures and protocols for patient shielding. Results from these interviews have been analyzed and compared to shielding best practices …

Ankle Dorsiflexion Range Of Motion And Its Association With Semi-Professional Female Soccer Player's Overall Performance, Lily G. Nolan

Honors College Theses

Lower extremity injury screening is a common tool in soccer due to the changes of direction, jumping, landing, and cutting maneuvers players must exhibit. Talocrural dorsiflexion range of motion (DFROM), vertical jump (VJ) and unilateral hop tests are used to assess ankle and knee injury risk. Further, DFROM asymmetries may present a higher risk than reduced DFROM alone. It is unknown how DFROM asymmetries affect these tests. Thus, the purpose of this study was to examine the relationship between DFROM and hop and VJ performance, and to examine the differences between those with and without DFROM asymmetries. The current results …

Exploring Lgbtq+ Competency In Healthcare, Jordan Whiteman

Honors College Theses

Marginalized groups such as the LGBTQ+ community are known to face healthcare disparities that negatively affect their process of navigating healthcare systems. This project explores the perceived lack of representation and understanding of the LGBTQ+ community within healthcare settings, exposing the deficits in knowledge for unique challenges and inequalities these patients may face. By viewing the literature, a myriad of complications faced by LGBTQ+ people in clinical settings can be identified. They possess a generalized feeling of mistrust towards the healthcare system. Healthcare staff overall describe low confidence with caring for this demographic. Heteronormativity’s presence in the field of healthcare …

Evaluation Of Therapist Modeling To Decrease Latency To Exercise Initiation, Darci L. Davis, Kayla Randall

Honors College Theses

Patients recovering from traumatic brain injury (TBI) or other adverse health events (e.g., hip surgery) often require physical therapy (PT) to restore baseline function. However, individuals with mild cognitive impairment (MCI) or dementia may have difficulty engaging in therapy due to deficits in attention, imitation skills, and motor performance. Enhancing participation in this population is essential for achieving functional recovery and return to baseline status. This study aimed to determine whether systematic model prompting could decrease latency to compliance and increase the level of completion of therapeutic exercises in short-term rehabilitation settings. A multiple-baseline single-case design with time-lagged and staggered …

The Impact Of Professionalism Education And Formative Feedback In Doctor Of Physical Therapy Students Utilizing The Abbreviated Cpi Feedback Form In The On-Campus Clinic Environment, William L. Scott

Dissertations

Problem

The American Physical Therapy Association (APTA) developed the Clinical Performance Instrument (CPI) to assess the professional behaviors required for a Doctor of Physical Therapy (DPT) student to be considered "entry level" in their clinical training. Feedback from our clinical partners has indicated that, historically, students from the Andrews University DPT program have scored lower than students from other programs in several areas of the CPI during their clinical experiences. According to subjective reports from our clinical partners, these areas included safety, professional behavior, accountability, communication, and critical thinking. These five areas have been the focus of our efforts in …

The Relationship Between Mindfulness, Emotion Regulation, And Anxiety Levels Among College Students In Saudi Arabia, Tahani Aljuaid

Dissertations

Problem

Anxiety is one of the most common psychological issues affecting youth globally and is particularly prevalent among Saudi adolescents and college students. Studies in Saudi Arabia have reported anxiety rates ranging from 48.9% to 66.2% among adolescents and high levels of generalized anxiety among university students, especially females (Aldosary et al., 2023; Alhabeeb et al., 2023). Poor emotion regulation has been identified as a key factor associated with anxiety and other mental health difficulties. In recent years, mindfulness has gained attention as a protective factor that promotes better emotion regulation and reduces anxiety symptoms. Despite this growing recognition, there …

Improving The Emotional Wellbeing Of Healthcare Workers In A Homecare Agency, Crystal U. Okafor

Doctor of Nursing Practice Projects

Healthcare workers (HCWs) often have traumatic experiences in the course of care delivery, and these experiences negatively impact their well-being, affecting them emotionally, psychologically, and physically. With the COVID-19 pandemic, healthcare workers have had indelible experiences questioning their choice of profession. This project aimed to teach the factors affecting the emotional well-being of healthcare workers and develop strategies to improve emotional distress in a home care agency. The implementation site was Carolina Homecare Solutions, with 21 participants, including nursing assistants and registered nurses. Sample selection was via a convenient strategy, selecting the most conveniently available participants. The project leader used …

Enhancing Sleep Quality: The Interrelationship Between Sleep Hygiene And Comprehensive Well-Being, Marissa Strenkert

Doctor of Nursing Practice Projects

In North Carolina, many adults face sleep loss, negatively impacting cognitive functioning, mental health, and physical well-being. This project aimed to educate the public about sleep hygiene techniques and their benefits. An informational session was conducted on sleep hygiene. The informational session included 31 participants, who then completed a voluntary survey to assess their likelihood of adopting the techniques and their satisfaction with the session. Out of 31 participants, 18 completed the survey. The survey consisted of 10 questions, scored on a scale from 1 (strongly disagree) to 5 (strongly agree), allowing for total scores between 0 and 50. Higher …

Sleep Promotion In Neonatal Intensive Care Units, Maelyn G. Cranford

Doctor of Nursing Practice Projects

Sleep is a fundamental requirement for the human body to achieve and sustain overall health and well-being. In Neonatal Intensive Care Units (NICU), sleep is a vital step in an infant’s routine to allow for proper neurodevelopment and growth. Parents of infants in the NICU may be unaware of the critical role sleep plays in their child’s health. Without realizing it, they can unintentionally disrupt their infant’s sleep by speaking loudly, using bright lights, or playing loud sounds from their phone. This DNP project was created to increase NICU parent education on the importance of sleep promotion and involve them …

Recognizing Opioid Withdrawal: An Educational Intervention To Increase Nurses' Knowledge And Improve Quality Of Patient Care, Keyannah L. Glover

Doctor of Nursing Practice Projects

Opioid abuse, prescription and illicit use, remain a problem in the United States. Recognizing signs and symptoms is important because lack of recognition can lead to misdiagnosis and mismanagement. The target population for this study was nurses in the emergency department. This quality improvement project was developed to provide education to the nurses in the emergency department to recognize opioid withdrawal signs and symptoms. This project evaluated the baseline knowledge of nurses working in the emergency department. The project was implemented over a 3-week time frame. The pre-test was sent out to participants via email to test their baseline knowledge. …

Pantry To Plate: Using Local Food Pantries To Improve Diabetes Self-Care Deficits, Rachelle Zielazienski

Doctor of Nursing Practice Projects

This project aimed to improve food pantry participants’ diabetes self-management and understanding of diabetes nutrition education through a collaborative approach. Over the course of 2 months, the project provided educational resources on diabetes nutrition at a food pantry. The target population included individuals with diabetes, pre-diabetes, and those responsible for preparing meals for diabetic individuals. A certified diabetes specialist was enlisted to ensure the delivery of culturally sensitive, evidence-based educational support tailored to participants’ diabetes health goals. Orem’s Self-Care Deficit Theory served as a framework for this project. A mixed-methods approach was utilized through pre-and post-test design to gather qualitative …

Complementary And Alternative Therapies To Improve Quality Of Life For People With Chronic Pain And Addictions, Nicole K. Smith

Doctor of Nursing Practice Projects

There is a known opiate crisis prevalent in the United States. There is similarly an addiction crisis in the United States that saw a marked increase during the COVID-19 pandemic. Interestingly, there are many Americans who experience a connection between chronic pain and the onset of addiction. This project sought to introduce the idea of complementary therapies such as square breathing, mindfulness, and essential oil (EO) aromatherapy that could improve the quality of life for people who have chronic pain and/or addiction. The project consisted of a pre-test prior to education about square breathing, mindfulness, and EO aromatherapy, followed by …

Increasing The Knowledge And Access To Naloxone (Narcan) For High-Risk Populations, Jessica E. Jones

Doctor of Nursing Practice Projects

This study investigated the knowledge and access to Naloxone (Narcan) in high-risk populations in Robeson County, NC. In order to mitigate the rate of overdose in tribal members who are part of the Lumbee Tribe of North Carolina. Indigenous populations have had the highest overdose rate of increase since 2019. In collaboration with CORE Pathways, a quality improvement project was implemented at the Harvest Moon Fall Powwow. Opioid overdose education was provided to voluntary participants, free Naloxone was provided to individuals, along with a created video presentation of Naloxone education. Pre- and post-surveys were utilized to gauge participants' knowledge before …

Homelessness: An Emergency For Many, Casey Almond

Doctor of Nursing Practice Projects

This DNP project implemented nursing staff education on the importance of recognizing homeless individuals early during the initial triage process within the emergency department. Nursing staff were educated on community resources available for homeless individuals. This DNP project helped to promote the collaboration of care by nursing staff with the case management team to help provide resources, which can result in a safer and more effective discharge of homeless patients within the emergency department. Participation consisted of 125 nursing staff who reviewed the online training module and attended one of the 15-minute in-person poster educational sessions. About 53 nursing staff …