Medicine and Health Sciences Commons^™

Effect Of The Sava Syndemic On Hiv Viral Suppression Among People Living With Hiv In The United States: A Scoping Review And Meta-Analysis, Jacquelyn Rodriguez

UNLV Theses, Dissertations, Professional Papers, and Capstones

The SAVA syndemic highlights the interconnected and mutually reinforcing nature of substance use, violence victimization, and HIV/AIDS. The synergistic interaction of these conditions creates structural and behavioral barriers that disrupt the HIV care continuum and contribute to significant health inequities. Achieving a suppressed viral load is a critical clinical outcome for people living with HIV, while viral non-suppression can be an indicator of poor health, elevated transmission risk, and disease progression. Still, the association between SAVA factors and viral suppression/non-suppression outcomes within U.S. populations remains inconsistently characterized due to heterogeneous methodologies and variable inclusion of high-risk groups. This mixed-methods study …

Evaluating An Educational Intervention On Screen-Time And Behavior Change: A Pilot Study, Kayla L. Sweeney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Excessive screen time among adolescents has been associated with negative health outcomes, including sleep disturbances, anxiety, and depression. Despite growing awareness, many parents lack sufficient understanding of these risks and their impact on adolescent well-being. This project evaluated whether a brief educational intervention improved parents’ knowledge of the health effects of excessive screen time. Methods: A pre-and post-survey design was used to assess changes in parents’ understanding following an educational video intervention. The educational intervention consisted of evidence-based content highlighting the impact of screen time on mental health and sleep. The survey measured knowledge, beliefs, behavioral intentions, and strategies …

Addressing Sexual Health For Older Veterans By Healthcare Providers: A Mixed Method Study, Andrew James White

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Older adults remain sexually active, yet sexual health is frequently under-discussed in healthcare settings, particularly within veteran populations. Sexual health is essential to overall quality of life, and prior studies have shown that older patients value these conversations. However, veterans often face unique factors such as military-related trauma, including military combat exposure and post-traumatic stress disorder, in addition to compounded stigma from these topics in regards to open discussions about sensitive health issues to their healthcare providers. This study is significant in its potential to uncover systemic, cultural, and interpersonal influences that shape these dynamics, with a particular emphasis …

Effects Of A Basketball Match On Heart Rate Variability In Collegiate Intramural Players, Unobatsha Mbaiwa

Master's Theses

Heart rate variability (HRV) is a standard non-invasive physiological marker used to asses the autonomic nervous system (ANS) function and cardiovascular adaptability. HRV reflects the natural variations in time between successive heartbeats (R-R intervals), which come as a result of the interaction between sympathetic and parasympathetic branches of the ANS (Shaffer & Ginsberg, 2017). Higher HRV compared to an individual's baseline is normally considered an indicator of greater parasympathetic (rest/digest) influence and more effective physiological recovery, whereas lower HRV relative to baseline is associated with sympathetic (fight/flight) dominance, fatigue, and increased physiological strain. Since the standardized HRV measurement criteria were …

Barriers And Bridges: Exploring Factors That Shape Mental Health Service Utilization In Rural America, Margaret Wiwuga

Educational Specialist, 2020-current

Despite disproportionately higher suicide mortality rates and comparable prevalence of mental illness across urban and rural communities in the United States, rural populations across the nation experience significantly lower access to and utilization of mental health services, naturally leading to worse comprehensive outcomes. This literature review examines multifaceted factors shaping mental health service use in rural America, taking note of both barrier and enabling factors that impede or enable these unique populations’ willingness and ability to access and use mental health services. Ten articles published prior to September 9, 2025, were selected from the James Madison University Libraries’ Psychology and …

Black Maternal Mental Health: Counseling Considerations For Prenatal Depression And Anxiety, Morgan Renee Williams

Educational Specialist, 2020-current

The maternal mortality rate of Black women in the United States is four times higher than white women (Centers for Disease Control and Prevention, 2020). The CDC defines a maternal death as “the death of a woman while pregnant or within 42 days of termination of pregnancy… but not from accidental or incidental causes” (Centers for Disease Control and Prevention, 2024, para. 1). This statistic is a consequence of the inequality within and outside of the American healthcare system (National Academies of Sciences, Engineering, and Medicine, 2020). For the purposes of this research, Black women are defined as any women …

What’S Behind The Mask: The Diagnostic Divide In The Female Autism Phenotype, Shelley Gies Alston

Educational Specialist, 2020-current

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by differences in social communication and restrictive, repetitive behaviors; however, women are diagnosed at significantly lower rates than men. This study examined whether DSM-5-TR diagnostic practices may contribute to the underdiagnosis and delayed identification of ASD in individuals assigned female at birth (AFAB), with attention to masking behaviors, gendered social expectations, and clinician interpretation of symptoms. Grounded in the Female Autism Phenotype (FAP), a retrospective mixed-methods study surveyed 12 AFAB individuals aged 18–24 who self-identified or were formally diagnosed with ASD. Participants completed a 44-item online survey including Likert-scale and open-ended …

Thrombin-Induced Myofibroblast Differentiation Is Regulated By Myocardin And Novel Effector Genes In Ipf Fibroblasts, Christiana Okeke

Biotechnology Theses

Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease characterized by fibroblast activation, excessive extracellular matrix (ECM) deposition, and irreversible respiratory decline. In this study, we investigated the role of myocardin and its downstream effectors, RGS5, DLGAP5, and TAGLN, in thrombin-induced myofibroblast differentiation and ECM remodeling using primary human IPF fibroblasts. Myocardin knockdown significantly attenuated thrombin-induced expression of profibrotic genes, including FN1, COL1A1, PAI-1, ACTA2, and CNN1, as well as the novel effectors RGS5, DLGAP5, and TAGLN, confirming myocardin as a central regulator of fibrotic signaling. Silencing RGS5 produced minimal effects on gene and protein expression despite minor downward …

Identification Of Proteins With Immune Stimulatory Activities From The Culture Filtrates Of Nontuberculous Mycobacteria, Christian Albert Agyei Acheampong

Biotechnology Theses

Nontuberculous mycobacteria (NTM) are the mycobacterial species other than Mycobacterium tuberculosis, which causes tuberculosis, and Mycobacterium leprae, which causes leprosy. Diseases caused by NTM are on the rise in the United States and are steadily becoming a significant public health problem globally, particularly in developed countries. Despite the ability of NTM pathogens to interact with the host immune system, the proteins responsible for eliciting host immune responses remain unidentified, making the accurate and timely diagnosis of the disease a challenge. In this study, we tested the hypothesis that NTM strains secrete proteins that stimulate immune responses. Our study …

From Evidence To Practice: Improving Diabetic Patient Outcomes By Increasing Statin Utilization, Elizabeth Mcfalls

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) prevention in patients with diabetes is essential, as heart disease remains the leading cause of death within this population (American Diabetes Association, n.d.). The purpose of this evidence-based project is to improve patient outcomes by enhancing adherence to statin therapy. A thorough literature review yielded 246 pieces of moderate-to-high-quality evidence; of these, eight articles were appraised in detail and selected for project inclusion. The strongest evidence identified four meaningful interventions. Thus, a multimodal approach was indicated for this project. This included addressing barriers to therapy, creating practice nudges, implementing a shared decision-making (SDM) tool, and utilizing clinical …

Reducing Catheter-Associated Urinary Tract Infections Through Staff Education In A Nursing Home Setting, Aderonke Abimbola Abatan

Walden Dissertations and Doctoral Studies

No abstract provided.

Pre-Chiropractic Student Organization At The University Of Mississippi: Education Of Future Chiropractic Students And Empowerment Of The Public With Chiropractic Knowledge, Avery E. Lirette

Honors Theses

The chiropractic profession continues to grow within the allied health community, yet public understanding of its scope remains limited. Prior to the creation of the Pre-Chiropractic Student Organization (PCSO) at The University of Mississippi, students interested in pursuing chiropractic education lacked a structured support system in comparison to those available for other health professions on campus. This thesis documents the foundation, development, and impact of the PCSO as a registered student organization that was designed to educate undergraduate students about the chiropractic profession, connect them with mentors and graduate programs, and promote public awareness of chiropractic care.

This project builds …

Staff Education To Improve Mental Health Prescribers’ Knowledge On Polypharmacy And Deprescribing Strategies For Older Adults, Mercy Oluchi Eke

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education To Improve Staff Knowledge And Confidence In Delivering Sleep Education And Administering Sleep Quality Assessment Tools, Beverly Britton

Walden Dissertations and Doctoral Studies

No abstract provided.

Overweight And Obesity Among Southeastern Nigerian Lecturers And Its Association With Absenteeism And Presenteeism, Ezenwa Victor Ejikem

Walden Dissertations and Doctoral Studies

No abstract provided.

Family Quality Of Life And Infant Language Development: A Pilot Study Of Infants Without A History Of Chronic Otitis Media, Aubreigh Cartwright

Dissertations, 2020-current

Chronic otitis media (COM) is a condition associated with hearing fluctuations, recurrent medical interventions, and speech-language concerns. While the audiological impacts for children are well documented, there is less research pertaining to parents’ and caregivers’ experiences. The goal of the overall line of inquiry was to examine the impact of chronic otitis media on parent and caregiver quality of life. Parents and caregivers of ten typically developing infants from six to twelve months of age without COM were administered parent-proxy instruments to determine quality of life, as well as expressive and receptive lexicon. The parents were administered a family intake …

A Measure Of Spatial Orientation In Healthy Adults, Lauren Maloney

Dissertations, 2020-current

Spatial orientation is essential for effective navigation and movement, relying on the integration of sensory inputs from systems such as proprioception, vision, audition, and the vestibular system. The vestibular system, responsible for detecting rotational and linear movements, plays a crucial role in maintaining balance and spatial awareness. However, its specific influence on spatial orientation remains underexplored. This study investigates how vestibular input influences spatial orientation accuracy by examining participants' ability to estimate angular displacement during rotational stimuli. Twenty participants underwent testing using a rotational chair, with stimuli at varying rotational amplitudes (5-400 degrees). Along with their perceived angular displacement (i.e. …

The Effect Of Head Coverings On Directional Microphone Performance, Mariam Mohamed

Dissertations, 2020-current

Background: Directional microphones in hearing aids are a well-established strategy for enhancing speech intelligibility in background noise. While previous studies have examined the effects of hair, spectacles, and earmold venting, no systematic research has addressed whether head coverings, commonly worn for cultural, religious, or personal reasons, affect directional performance.

Objective: This study aimed to determine whether a thin cotton head covering alters the directivity index (DI) of premium receiver-in-canal hearing aids from four leading manufacturers, using laboratory-controlled conditions. 

Methods: A Knowles Electronics Manikin for Acoustic Research (KEMAR) was positioned within a sound-treated room to measure DI for both omnidirectional and …

How Audiologists Are Using Adapted Cognitive Behavioral Therapy For Tinnitus Management: A Preliminary Study, Katherine M. Mueller

Dissertations, 2020-current

Audiologists interact with patients reporting bothersome tinnitus frequently, however there is no standardized protocol to follow when treating/counseling these patients. Cognitive Behavioral Therapy (CBT) is highly researched and has been proven to alleviate bothersome tinnitus symptoms, yet audiologists are not clinically trained in this tinnitus management. Specific forms of CBT that were analyzed in this study include Attention Shifting, Neurophysiological Education, and Progressive Muscle Relaxations. This study surveyed current audiologists to determine how they are using adapted CBT techniques (aCBTt) for tinnitus management. This questionnaire aimed to investigate a) the effect of audiologists’ practice duration on their frequency to recommend …

Stigma Predicts Participation And Autonomy In Chronic Vestibulopathy: An Explanatory Mixed Methods Study, Brandy L. Hollins

Dissertations, 2020-current

Many vestibular disorders are “invisible”, not widely recognized, and challenging for patients to describe. However, its impact is visible and leads to significant challenges. Research has shown that stigma associated with other chronic health conditions can detrimentally affect patient outcomes, suggesting a greater need in this area. The World Health Organization’s (WHO) International Classification of Functioning, Disability, and Health (ICF) elucidates the role of physical, social, and cultural factors in the manifestation of health conditions within a universal framework. A critical aspect of the ICF’s contextual factors for individuals with vestibular loss is societal perception. Few studies have reported stigmatization …

Enhancing Access Through Integrated Behavioral Healthcare: Expanding Counselor Identity And Social Determinants Of Health Competency, Tiffany N. Snow

Dissertations, 2020-current

Abstract

The counseling profession has historically differentiated its identity by emphasizing a wellness-oriented approach. However, this has often led to the exclusion of counselors from integrated behavioral healthcare (IBH). With the 2024 enactment of the Mental Health Access Improvement Act, counselors now have unprecedented opportunities to serve as behavioral health providers in federal medical settings. This three-manuscript dissertation explores the intersection of counselor professional identity, social determinants of health (SDoH) competency, and interprofessional collaboration within IBH.

Manuscript 1 presents a conceptual framework for reconciling traditional counselor identity with the "medical model" of Primary Care Behavioral Health (PCBH), arguing that this …

Novel Paradigm For Assessing Vestibular Perception In Children, Nicole Kirk

Dissertations, 2020-current

While objective vestibular reflexive testing has been heavily researched, there are few studies analyzing subjective vestibular perception and to date no progress has been reported on motion perception in children. It is unknown if children perceive motion like adults creating a need for research comparing these age groups for thorough clinical profiles. This study adapted an adult psychophysics protocol for school-aged children and collected data on ten typically developing children and ten healthy adults. Participants rotated at various peak velocities and frequencies in a rotary chair and were asked to report their spatial orientation (i.e., how far around they rotated) …

Building A Road To Mitigate Ambulance Patient Offload Time (Apot), William J. Manguil

Doctoral Projects

Emergency departments (EDs) worldwide are experiencing increased utilization resulting in care delays for patients seeking urgent treatment. Despite critical circumstances that warrant emergency medical services (EMS) response, patients arriving to the ED via ambulance remain vulnerable to delays in care due to prolonged ambulance patient offload times (APOTs). The amount of health care providers and treatment space necessary to initiate care are both limited and often strained resources which dictate the need for innovative interventions to prevent patient harm. The following project outlines the interventions implemented at the project site to improve APOT as a means to enhance patient safety …

Staff Education Project To Assess The Use Of Telehealth In The Care Of Adult Psychiatric Patients, Edith Nwosu

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education To Enhance Sepsis Knowledge And Clinical Self-Efficacy Among Registered Nurses In An Adult Intensive Care Unit, Jessica Shantel Moses

Walden Dissertations and Doctoral Studies

No abstract provided.

Evaluating Clinical Practice Guidelines For Managing Missed Appointments And Patient Re-Engagement In An Outpatient Mental Health Clinic, Agnes Limunga Jackai

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education To Enhance Telepsychiatry Use Among Nurses, Shaundelle Mitchell

Walden Dissertations and Doctoral Studies

No abstract provided.

Predictors Of New Vaccine Introduction In Nigeria, Omotayo Giwa

Walden Dissertations and Doctoral Studies

No abstract provided.

Reducing Unnecessary Cancellations In Interventional Radiology Procedures, Rose Tarantino

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving Medication Literacy In Older Adults With Chronic Kidney Disease Through Nurse-Led Education, Markesia R. Forward

Walden Dissertations and Doctoral Studies

No abstract provided.