Medicine and Health Sciences Commons^™

Barriers To Healthcare Faced By Individuals With Autism Spectrum Disorder And Their Families, Jennifer Lu

Theses and Graduate Projects

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that is characterized by impairments in social interaction and communication as well as repetitive behaviors or interests that can affect daily functioning. ASD individuals are also more likely to experience poor physical and mental health along with reduced life expectancy compared to non-autistic people. Thus, it is crucial that those with ASD are able to obtain adequate healthcare. However, there is limited research on the barriers to medical care access faced by those with ASD and their families.

Purpose: Due to the lack of autism awareness in the general population and …

Efficacy Of Probiotics In Decreasing Rates Of Necrotizing Enterocolitis And Sepsis In Preterm Neonates, Valisa K. Teekadharry

Theses and Graduate Projects

Background: The incidence of preterm infants developing serious infections is a common finding in many neonatal intensive care units. Probiotics have been a supplement that has been used by numerous people to improve the microbiota of the intestine for prevention of infection.

Purpose: The purpose of this literature review is to explore the efficacy of using probiotics in preterm infants for prevention of serious infections such as necrotizing enterocolitis (NEC) and sepsis.

Methods: A comprehensive literature review was conducted using Lindell Library, Pub Med, Science Direct and Google Scholar. Using the search terms probiotics, probiotics in premature infants, probiotics and …

Awareness Of Nutrition's Impact On Mental Health And Ketogenic Diet’S Therapeutic Potential For Mental Illness And Other Chronic Disorders, Innocent Nsengiyumva

Theses and Graduate Projects

Mental health affects millions of people worldwide, and current pharmaceutical treatment approaches often lead to worse outcomes, weight gain, and increased cardiovascular risk. The ketogenic diet offers hope in the treatment of schizophrenia and other neurological and psychiatric disorders. The aim of this project is to explore public awareness of nutritional psychiatry and the ketogenic diet’s clinical utility for various conditions including schizophrenia, mood disorders, Parkinson’s, and multiple sclerosis. Study participants (n=108) completed a 12-question survey about individual nutritional habits and current knowledge of KD. Responses were obtained from medical students, practicing healthcare professionals, college undergraduate students, and members of …

Evaluation Of An Advanced Practice Clinician Onboarding Program, Sophia Robinson

Student Scholarly Projects

Practice Problem: This project aimed to evaluate the effectiveness of a mentorship-based onboarding program versus a standard program without mentorship.

PICOT: The PICOT question that guided this project was (P), In newly hired APCs did the inclusion of mentorship in the onboarding process (I) lead to higher levels of general self-efficacy compared to standard orientation practices lacking mentorship (C), within an 8-week timeframe (T)?

Evidence: Nine articles were reviewed, revealing that standardized mentorship, structured orientation, and tailored support for professional development are critical strategies to boost confidence and retention among healthcare professionals.

Intervention: A standardized onboarding program that incorporated …

Neural Control Of Swallowing In Infants: White Matter Tracts Associated With Swallow Function, Heather Christine Mcghee

MUSC Theses and Dissertations

This dissertation investigates innovative approaches to improve feeding and swallowing outcomes in infants, particularly those born prematurely or with brain injury. It focuses on understanding the neural networks involved in sucking and swallowing by utilizing diffusion kurtosis imaging (DKI), a more sensitive neuroimaging technique than traditional MRI, and the BaByVFSSImP, a standardized tool for assessing swallow function. Additionally, the research explores the use of transcutaneous auricular vagus nerve stimulation (taVNS) as a neuromodulation technique to enhance oral feeding skills. The study found no adverse effects from taVNS on airway protection or swallowing physiology. Furthermore, there were some possible associations between …

Discovery And Development Of Epigenetic Inhibitors Targeting Kdm4b To Alleviate Chronic Inflammatory Response In Periodontal Disease, Kathleen Abigail Garrabrant

MUSC Theses and Dissertations

This study describes the synthesis and biological evaluation of small molecule KDM4B inhibitors for use in modulating immune responses in periodontal disease (PD). Periodontal disease begins with the accumulation of bacterial plaque in the oral cavity, triggering an inflammatory response that damages host tissues. Despite standard treatments such as scaling and root planing (SRP) to remove biofilm, the host immune response can remain hyperactive, leading to ongoing tissue destruction and bacterial-driven inflammatory bone loss.

Research suggests that the microenvironment of periodontal disease induces epigenetic alterations, particularly through increased activity of lysine-specific demethylase 4B (KDM4B). Previous studies using a murine macrophage …

Staff Education To Enhance Healthcare Providers' Use Of The Phq-9 Assessment Tool, Priscilia Nguh

Walden Dissertations and Doctoral Studies

Depression is a common mental health issue that has a substantial impact on people’s well-being and healthcare results. While there is ample evidence of depression’s harmful impact, the difficulty of accurate diagnosis remains. Inadequate screening of depression in primary health clinics results in treatment delays. The PHQ-9 is a tool to diagnose depression, however many clinicians are unfamiliar with its use. As a result, individuals susceptible to depression may not receive timely appropriate management, leading to poor health outcomes and higher healthcare utilization. This practice focused project aimed to understand if staff education would improve healthcare providers’ knowledge regarding use …

Socioeconomic Determinants And Maternal Mortality In Liberia, Monee Sherman

Walden Dissertations and Doctoral Studies

High rates of pregnancies and childbirth contribute to a heightened risk of maternal mortality among women between 15 and 49 in Liberia. Most women are uninformed about their maternal risk behaviors, symptom severity, and delayed care-seeking. The mortality rate for women between 25 and 34 during pregnancy and childbirth is unacceptably high. The highest increase in maternal mortality rates is seen among women between 40 and 44 who choose to delay motherhood. In Liberia, the deaths of 4.5 women a day are caused by complications during pregnancy and childbirth. We examined the influence of participant background characteristics, socioeconomic factors, and …

The Status Of Abortion Care Training For Medical Providers Amidst The Current Abortion Access Crisis: A Literature Review, Leah Johnson

Theses and Graduate Projects

Background: While a common, safe, and essential aspect of reproductive healthcare, abortions have been subject to countless legal restrictions and bans in the United States, especially after the overturn of Roe v. Wade. This has also exacerbated the current shortage of abortion providers. Within this crisis of worsening abortion access, it is imperative to appropriately train future clinicians to provide abortion care. Purpose: This literature review will investigate the status of abortion training in medical schooling. It will explore physician-specific education in abortion and look specifically at the impact of recent legal threats on the availability of this training. Finally, …

Caffeine Trends And Optimal Intake Systematic Review, Mark Byaliy

Theses and Graduate Projects

Background: Caffeine is the world’s most consumed psychoactive stimulant, with many different sources. Many individuals drink caffeine for the wakefulness effect, but there are many secondary effects that might be unknown to most consumers.

Purpose: This review explores the trends in caffeine consumption, how our bodies process caffeine, the potential benefits and adverse effects of caffeine, and the health benefits associated with natural sources. It also examines the ingredients found in energy drinks, such as vitamin B complexes and taurine.

Methods: A literature review was conducted using Augsburg Lindell Library, NIH National Library of Medicine, and Google Scholar. Using the …

Building A More Resilient Physician Assistant Student: Suggestions For Implementing Mindfulness-Based Training Into Didactic Education, Sarah Cornell

Theses and Graduate Projects

Background: Burnout affects a high number of healthcare providers and compromises both provider and patient wellbeing. In addition to high turnover rates, burnout costs healthcare systems through errors, poor care outcomes, and decreased patient satisfaction. Mindfulness-based therapy delivered by phone apps has been successful in improving stress levels and burnout measures. Based on similar research with medical students, physician assistant students may benefit from early stress-reduction interventions, although the research surrounding implementation and long-term follow up is lacking.

Objective: This cross-sectional study looks at burnout rates across three cohorts at a single Master of Science in Physician Assistant Studies program …

Maternal Mortality In American Indian And Alaska Native Women: It Is Time To Prevent The Preventable, Brynn Cusack

Theses and Graduate Projects

Background: A concerning disparity exists between maternal mortality rates of American Indian and Alaska Native (AIAN) women and White women. Contributing factors include historical trauma, systemic inequities, inadequate funding, and deprioritization of the health of AIAN people.

Purpose: This literature review aims to address the research question: “Why were American Indian and Alaska Native women two times more likely to die of pregnancy-related causes than White women in the US during the period of 2017 through 2019?” The review explores historical context, current evidence, potential causes and interventions that can address AIAN maternal mortality.

Methods: A comprehensive literature review was …

Stargardt’S: Trends In Treatment Modalities, Dallas Myers

Theses and Graduate Projects

Background: This review is aimed at furthering understanding of Stargardt’s, including disease pathophysiology, treatment methods, and the future of vision restoration.

Purpose: Stargardt’s (STGD) was initially discovered in 1909, but it was not fully understood until 1997. It is the most common form of inherited macular degeneration. There are few resources for patients and providers regarding treatment options and lifestyle recommendations.

Methods: A comprehensive literature review was conducted using NIH, UpToDate, and Google Scholar. Specific terms are further detailed in the review. Inclusion criteria were studies focused on STGD patients. Exclusion criteria for were those that only …

An Evidence-Based Bundle To Decrease Pressure Injuries (Pis) In Homecare, Esther Owookade

Student Scholarly Projects

Practice Problem: Pressure injuries are a significant problem in healthcare settings. The older adult patients in this home health agency have experienced an increased in incidences of pressure injuries which necessitates intervention.

PICOT: The PICOT question that guided this project was" In older adults 65years and above with pressure injuries in the home healthcare setting(P), does a pressure injury care bundle(I), compared to the current practices of standard care of repositioning alone( C),reduce the incidence of pressure injuries( O ) in 10 weeks (T)?"

Evidence: The evidence used to guide this evidence-based change project was from relevant health …

Sailing Is For Everyone: Developing An Adaptive Sailing Program For Seattle's Community Boating Center, Karoline J. Ashpole

OTD Capstone Projects

This doctoral capstone project was in partnership with Seattle’s community boating center, Sail Sand Point (SSP). SSP’s mission is “to bring the joy and life-enhancing benefits of sailing and small boats to people of all ages, abilities, and backgrounds”. This project aimed to develop adaptive sailing programming to increase sailing access to individuals with disabilities. This included expanding the partnership with Outdoors For All, an adaptive outdoor recreation organization in Seattle. Through this partnership we hosted their summer camp for five sailing days with five additional days planned for after the completion of this project, demonstrating program sustainability and longevity. …

A Systematic Review: Longevity And Quality Of Life In Blue Zones, Salmaan Mulla

Theses and Graduate Projects

Ikaria, Loma Linda, Sardinia, Okinawa, and Nikoya. These 5 cities around the world are famed for their increased longevity and quality of life and are termed “Blue Zones”. Blue zones are areas around the world noted for their population of centenarians, overall long life expectancy and high quality of life compared to the average population. Studying these communities offer insights into the commonalities they share to better understand the unique aspects of living a healthy, fulfilling and long life. A comprehensive literature review was conducted using Google Scholar, with the search terms “Ikaria, Greece longevity; Loma Linda, California longevity; Sardinia, …

Antibiotic Resistance In Livestock: A Literature Review Of Its Consequences And International Effort On Human Antimicrobial Agents Resistant Crisis, Ha Nguyen

Theses and Graduate Projects

Background: Despite their benefits, the overuse of antibiotics in livestock has resulted in negative consequences to human health and the augmenting of an antibiotic-resistant crisis. Countries worldwide have conducted analyses and confirmed the growth of bacterial strains immune to most antibiotics. The widespread use of antibiotics is shown in various sectors, including human medicine and agriculture, leading to the emergence of antibiotic-resistant bacterial strains.

Purpose: This comprehensive literature review focuses on finding the connection between the usage of antibiotics in livestock, the transfer of antibiotic resistance to humans through consumption and exposure, and international efforts to find solutions to antimicrobial …

Injectable Formulations For Localized Delivery Of Immunomodulators, Ketki Velankar

Electronic Theses and Dissertations

Dysregulation of immune homeostasis is fundamental to the development of autoimmune disorders. Fibroblastic reticular cells (FRCs) within lymph nodes play crucial roles in forming a microenvironment conducive to immune cell interactions and regulating autoreactive T cells driving autoimmune diseases. Studies have shown the potential of FRCs as a form of personalized cell therapy to correct dysregulated immune responses. Successful translational efforts, however, require the cells to be formulated as injectable suspensions while retaining their native architecture, which is essential for their regulatory functions. The main challenge resides in retaining the native reticular organization of FRCs lost in conventional monolayer cultures …

The Ethical Duty Of Care For Suicide Ideation, Tah Ngijoi Yogo

Electronic Theses and Dissertations

With suicide being a leading global cause of death, there is a need to explore the ethical complexities surrounding suicide and preventive measures. This dissertation questions the morality of suicide by examining the historical and philosophical dimensions across cultures and religions. The text argues for an approach that acknowledges rational suicide while developing the ethics of paternalistic measures for suicide prevention of vulnerable populations.

Considering the ethics of autonomy, the dissertation discusses the practice of nudging in healthcare to highlight the role of paternalism in supporting informed consent. The text proposes an enhanced autonomy model that balances trust, influence, and …

Uptake Of Extracellular Vesicles Into Brain Endothelial Cells And Development Of Motor Neuron-Derived Extracellular Vesicles For Amyotrophic Lateral Sclerosis, Jhanvi Rajan Jhaveri

Electronic Theses and Dissertations

Extracellular vehicles (EVs) are an emerging class of drug carriers and are primarily reported to be internalized into recipient cells via a combination of endocytic routes such as clathrin-mediated, caveolae-mediated and macropinocytosis pathways. In part one of this thesis, (1) we investigated potential effects of homotypic vs. heterotypic interactions by studying the cellular uptake of homologous EVs (EV donor cells and recipient cells of the same type) vs. heterologous EVs (EV donor cells and recipient cells of different types) and (2) determined the route of EV internalization into low pinocytic/hard-to-deliver cell models such as brain endothelial cells ( …

Delivery Of Mitochondria-Containing Engineered Extracellular Vesicles To The Blood-Brain Barrier For Ischemic Stroke Therapy, Kandarp Dave

Electronic Theses and Dissertations

Ischemic stroke is the second leading cause of death worldwide, and the lack of effective treatment options is an unmet clinical need for stroke survivors. Ischemic stroke-induced oxygen-glucose deprivation (OGD) in the affected brain tissue leads to mitochondrial dysfunction and adenosine triphosphate (ATP) depletion in the brain endothelial cells (BECs) lining the blood-brain barrier (BBB). ATP deprivation in the BECs dysregulates actin cytoskeleton dynamics, resulting in BBB breakdown. Restoration of blood flow (i.e., reperfusion) upon the first-line stroke treatment further leads to BBB breakdown and widens the paracellular spaces between BECs. …

Reducing Compassion Fatigue On A Cardiac Telemetry Unit, Nicole Rocio Garzon

Master's Projects and Capstones

Abstract

Background: Compassion fatigue (CF) among nurses is a significant concern affecting both individual well-being and patient care outcomes. Findings from a 2020 national survey found two-thirds of nurses (62%) struggle with CF and even a high rate for those nurses under the age of 25 years. Through a review of current literature and case studies, the effectiveness of these interventions in reducing stress, enhancing resilience, and improving overall job satisfaction among healthcare professional is examined. Practical implications for implementing these interventions in healthcare organizations are discussed, emphasizing the potential for creating supportive environments that foster emotional and mental well-being …

A Nursing Education Intervention For Delirium Prevention, Sarah Eckles

Doctor of Nursing Practice Projects: College of Nursing

Background

At a large, tertiary care hospital in the Midwest, it had been anecdotally noted that delirium or acute encephalopathy cases were increasing. Specifically, inpatient neurology consultations for delirium were on the rise. This data had been confirmed by hospital administration. Delirium has been identified as a well-known problem in elderly, hospitalized adults—most notably in elderly, postoperative adults. It can cause a cascade of additional complications for elderly patients. Delirium prevention is known to be the best method to combat delirium incidence. Prevention has been proven to occur by way of non-pharmacologic, early interventions by nursing. Bedside nursing staff must …

Education And Training On Naloxone Administration For Healthcare Professionals: An Integrative Literature Review, Remigus C. Nwaokoro

DNP Qualifying Manuscripts

Abstract

Background: Healthcare professionals’ lack of knowledge and confidence in administering naloxone affects their willingness to inform at-risk patients about its use in the event of an overdose. The lack of understanding and confidence in using naloxone delays efforts to inform at-risk patients about this life-saving treatment for opioid overdose. This integrative literature review aimed to answer the following question: Do increased education and training enhance healthcare professionals' knowledge and confidence in administering naloxone and decrease the rate of opioid overdose fatalities?

Methodology: A comprehensive search of the literature (2019 and 2024) was conducted to identify studies of education …

A Glance Into The Roles Of Higher-Level Academia, Camye White

Department of Occupational Therapy Entry-Level Capstone Projects

This Capstone Project looks at the multiple roles of a full-time faculty member in higher-level academia while looking at implications for best practices to pass the NBCOT certification exam.

Cycle Syncing: Optimizing Women's Quality Of Life, Megan Francois

Theses and Graduate Projects

A woman’s hormones are in constant fluctuation throughout the menstrual cycle. This 28-day, on average, fluctuation can cause major shifts in mood, cognition, exercise tolerance, and nutrition needs. Because of this, there is potential to optimize quality of life if each phase is synced with diet, exercise, and complementary medicine utilizing holistic methods. Implications for further research include a need for additional longitudinal and prospective studies. Factors that need to be addressed include further analysis of the windows of vulnerability over the menstrual cycle according to female hormone fluctuations, effects of hormonal contraceptives, and effects of pathology on the cycle.

Preserving Pediatric Wellness: Enhanced Recovery After Surgery Protocols And Pain Management In Pediatric Surgery, Kimberly Kim

Theses and Graduate Projects

Background: Enhanced recovery after Surgery (ERAS) protocols and multimodal pain management strategies have revolutionized perioperative care in adult surgical practice by leading to improved postoperative outcomes and better pain management. However, the adoption of these protocols to pediatric surgical care remains underexplored.

Purpose: This systematic review aims to examine recent randomized clinical trials on the implementation of ERAS protocols and multimodal pain management strategies in pediatric surgical patients.

Methods: A computer-based literature search of databases through Google Scholar and PubMed with manual reference searches was used to identify eligible studies. The review includes randomized controlled trials focusing on multimodal pain …

Digital Scribes: A Possible Solution For Provider Burnout By Reducing Provider Workload, Shannon Storley

Theses and Graduate Projects

Background: Provider burnout is continuing to be a massive problem for our healthcare industry. One major contributor to provider burnout is burdensome administrative tasks associated with documentation of electronic medical records (EMR). This review aims to uncover the applications for artificially intelligent digital scribes as a solution to reduce EMR documentation burden. Purpose: Provider burnout has shown to increase the incidence of major mistakes and decreased patient safety grades. Digital scribes could be a solution in reducing provider burnout by reducing the administrative burden of EMR documentation. Methods: A comprehensive literature review was conducted using articles from PubMed using search …

Queering Pa School: An Audit Of Augsburg University’S Physician Assistant Program Regarding Lgbtq+ Related Health Topics, Annika Kuchar

Theses and Graduate Projects

Background: Historically LGBTQ+ people have encountered discrimination in the world of medicine, and often providers are sometimes unaware of how to manage medical issues of these patients. In order to best serve queer and trans patients, a more coherent, consistent curriculum needs to be established so that all medical professions are capable of giving high quality treatment to these patients. Physician assistants (PAs) are advanced practice providers who take care of LGBTQ+ patients on a daily basis and are trained under a similar model as physicians. PA programs must also be up to date on the most culturally sensitive ways …

Barriers Primary Care Physician Assistants Face In Referring Patients To Palliative Care Services Early In The Disease Process, Claire Petersen

Theses and Graduate Projects

Background: Medical specialties such as hospice and palliative care have been proven to improve quality of life for patients facing end-of-life and chronic illness. Though increasing awareness of these specialties has resulted in greater availability, it is essential to investigate the barriers clinicians, such as Physician Assistants, face in making these referrals in order to provide quality healthcare to those who need it. Physician Assistants specifically are an essential clinician group to evaluate, as they continue to become more prevalent in the healthcare system.

Purpose: To determine barriers primary care Physician Assistants face when identifying candidates for and referring to …