Medicine and Health Sciences Commons^™

Final Scholarly Project: Optimal Perioperative Analgesic Management Guidelines For Elective Hip Arthroplasty In Adults, Makyah Dittoe

Doctor of Nursing Practice Scholarly Projects

Hip arthroplasty, a frequently performed orthopedic surgery, is gaining popularity. However, postoperative pain, opioid utilization, nausea, and vomiting are common side effects associated with this procedure. Perioperative analgesic management for hip arthroplasty varies among providers, leading to possible inadequate pain management. The goal of this scholarly project is to provide an optimal perioperative analgesic guideline to decrease postoperative pain, opioid consumption, nausea, and vomiting in adults undergoing elective hip arthroplasty utilizing evidence-based practice. The evidence suggests that a multimodal analgesic approach incorporating multiple drug classes and types of anesthesia is most effective in reducing adverse postoperative outcomes. Using the Johns …

Prescribing Flavor: Proposal For A Longitudinal Culinary Medicine Curriculum In A Family Medicine Residency Program, Mario F. Jacome Jr

Department of Nutrition Student Projects

Culinary medicine is gaining recognition as an essential component of healthcare, aiming to integrate food and nutrition into medical practice for managing chronic diseases. However, there is a significant gap in nutrition education within medical schools and residency programs, leaving healthcare professionals ill-equipped to address patients' dietary concerns. This proposal presents a comprehensive longitudinal curriculum blueprint for culinary medicine tailored to family medicine residents. The curriculum emphasizes hands-on learning, collaborative cooking opportunities, and practical counseling techniques to empower residents in addressing nutrition-related diseases effectively. Through a structured approach and innovative educational strategies, this initiative aims to enhance resident proficiency and …

Home-Based Virtual Culinary Nutrition Education Sessions For Amyotrophic Lateral Sclerosis Patients: Quantitative Experimental Pilot Study, Ciara N. Reistad, Mauricio Lobo

Department of Nutrition Student Projects

Amyotrophic lateral sclerosis (ALS) impairs voluntary muscular activity and often results in malnutrition. The need for specialized dietary therapy for ALS-related illnesses is highlighted by recent research, but it also draws attention to the lack of targeted care and ongoing nutritional status monitoring. Technological developments like telehealth and chatbots hold potential for ALS patients’ nutritional monitoring. The pilot study examined the feasibility and impact of home-based virtual culinary nutrition education sessions on nutritional knowledge, dietary intake of energy (CHO), protein (PRO) and FAT, body mass index (BMI), and functional status assessed by ALSFRS-R scores in patients with Amyotrophic Lateral Sclerosis …

The Anatomical Embodiment Of Morning Routines In The Reduction Of Anxiety: An Intervention, Natalie Wright

Expressive Therapies Capstone Theses

The topic under investigation is whether physically embodying a morning routine that was designed through the lens of Laban Bartenieff Movement Analysis (LBMA) will reduce daily symptoms of individuals diagnosed with Generalized Anxiety Disorder.

Since morning routines play a significant part in one’s preparation for the day, I created an individualized LBMA morning routine for a specific client to embody. In addition to the routine, the client documented the process of their anxiety levels on a weekly basis. This client was a white, female, 19-year-old, lesbian college student who was previously diagnosed with Generalized Anxiety Disorder (GAD). The movement analysis …

Increasing Faculty Knowledge Of Competency-Based Education: A Quality Improvement Project, Lindsay O'Sullivan

DNP Projects

Background: The nursing academic-to-practice knowledge gap creates systems-based and patient outcomes issues. The changing demands of healthcare require the advancement of the discipline of nursing through the improvement of nursing education. The American Association of Colleges of Nursing (AACN) requires all nursing programs to implement Competency-Based Education (CBE) evaluations and assessments into existing nursing curricula to respond to changing healthcare demands. The aim of this project was to improve the knowledge of nursing educators regarding the use of CBE at a mid-sized university in the southeast.

Methods: The Diffusion of Innovation Theory was used as a framework for this project. …

The Impact Of An Educational Video On Physician Confidence And Comfort Level In Discussing Autopsies, Joy N. Owings, Laura Gray, David Phillippi

DNP Projects

Background: Autopsy rates have declined since the 1970s despite the procedure's benefit to families and medical science. Two well-documented reasons for the declining autopsy rate are physicians’ lack of knowledge about autopsies and lack of confidence in offering them. Objective: The primary aim of this study was to evaluate the impact of a brief educational video on physicians' comfort level, confidence, and knowledge regarding autopsy discussions. The objective was to address the declining autopsy rates by enhancing physicians' confidence and comfort level in offering autopsies to families. In addition, this study aimed to investigate physicians’ practices of consenting for an …

Loneliness As A Predictor For Problematic Social Media Use Associated With Sleep Disruption, Kaylee Mercer

Honors Projects

Social media is growing in popularity and with this new phenomenon could come impacts on a cognitive level. Loneliness is a robust predictor of mental and physical health issues. Loneliness is widely defined as discrepancy between actual and desired levels of social connection. Previous research has found that one impact lonely individuals face may be disruptions to sleep. Loneliness increases the likeliness of problematic social media use, both of which occur in college age and adolescent individuals at a disproportionately high rate. Problematic social media use has been previously found to be associated with less sleep. The current study seeks …

The Effect Of Emotional Intelligence On Relationships: Examining The Correlation Between Teique Score And Support System Health, Anna Lowes-Cannizzaro

Honors Theses

Emotional intelligence (EI), or the ability to monitor one’s own and others’ feelings, and the ability to step outside of these feelings in order to use information to guide thinking and actions, has been shown to affect many aspects of a person’s life. Through prior research, EI has been linked to aspects such as marital satisfaction, job performance, and life satisfaction. This study examines how trait emotional intelligence affects the health of one’s support system. The association between trait EI and support system health, including other demographic variables, was measured with two separate questionnaires: one questionnaire measuring trait EI, the …

Evidence-Based Practice Recommendations For The Use Of A Cardiac Optimization Algorithm In Patients Undergoing A Whipple Procedure, Jarrod Genther

Doctor of Nursing Practice Scholarly Projects

A fundamental responsibility of a certified registered nurse anesthetist includes intraoperative fluid and hemodynamic management. While Enhanced Recovery After Surgery protocols advocate goal-directed fluid therapy, the methodology remains controversial. An algorithmic approach systematically optimizes cardiac function and fluid volume status based on stroke volume variation, cardiac index, and mean arterial pressure. This project aims to evaluate the effects of placing intraoperative guidelines for patients undergoing a Whipple procedure when using a cardiac optimization algorithm to guide fluid and vasopressor management. The outcomes evaluated included the amount of fluids delivered intraoperatively, vasoactive medication administration, urine output, amount of blood transfusions, cardiac …

Diagnostic Disclosure Using Script-Driven Imagery In Borderline Personality Disorder, Michelle Rodriguez

Yale School of Medicine Physician Associate Program Theses

Borderline Personality Disorder is a widely underdiagnosed psychiatric disorder associated with stigma and misinformation, both in the general public and clinical settings. Current diagnostic disclosure methods do not consider borderline-specific challenges, such as interpersonal hypersensitivity and emotion dysregulation. This has led to discrepancies in patient-provider communication approaches, perpetuating underdiagnosis and negative diagnostic experiences, impacting recovery outcomes and attitudes toward the condition. We seek to determine the efficacy of using script-driven imagery as a method of diagnostic disclosure and psychoeducation versus current practice for individuals newly diagnosed with Borderline Personality Disorder. Our randomized controlled trial will assess efficacy as the proportion …

Using Near-Infrared Spectroscopy Monitoring To Diagnose Acute Compartment Syndrome, Andres Yanez

Yale School of Medicine Physician Associate Program Theses

Acute compartment syndrome is a condition of increased pressure in injured extremities leading to decreased oxygen delivery and tissue death in the limb. This condition requires prompt diagnosis to avoid complications such as muscle death and amputation. The current diagnostic standards rely on clinical findings, which are subjective, or compartment pressure measurements, which are painful, invasive, and prone to error. Near-infrared spectroscopy has shown promise as a direct, objective, and non-invasive alternative in identifying compartment syndrome. Tibia fractures are the most common predisposing injury to compartment syndrome. We propose a randomized controlled trial evaluating near-infrared spectroscopy to test for compartment …

Targeted Temperature Management Device Initiation Time And Neurologic Outcomes After Cardiac Arrest, Alexandra Liberti

Yale School of Medicine Physician Associate Program Theses

Targeted temperature management has been shown to improve neurologic status after cardiac arrest; however, recommendations for the timing of its initiation are unclear. Clinical trials have not directly studied time to targeted temperature management initiation, causing wide variability in protocol implementation. We propose a randomized, controlled, multi-center clinical trial to study the effect of early initiation of targeted temperature management in patients who achieve return of spontaneous circulation after out-of-hospital cardiac arrest. Data will be compared among patients who received initiation of targeted temperature management within 3 hours to those in whom initiation occurred after 3 hours. The primary outcome …

Photodynamic Therapy For Early Prevention Of Actinic Keratoses And Skin Cancer Post-Organ Transplant, Megan Karoly

Yale School of Medicine Physician Associate Program Theses

Immunosuppressed solid organ transplant recipients are at a significantly increased risk of skin cancer and precursor actinic keratoses. Guidelines to protect against these lesions are not well-established. Existing data suggests that photodynamic therapy could be effective in the prevention of new actinic keratoses and skin cancers in this population. Therefore, we propose early intervention with photodynamic therapy to combat actinic keratoses and skin cancer in transplant recipients. We will conduct an intrapatient randomized clinical trial comparing two treatments of topical five-aminolevulinic acid photodynamic therapy to placebo on the face as adjuvants to standard sunscreen in transplant recipients within the first …

Memantine For Preservation Of Neurocognitive Function During Reirradiation Of Recurrent Glioblastoma, Yeun Hiroi

Yale School of Medicine Physician Associate Program Theses

Glioblastoma is the most common malignant primary brain tumor in adults. This disease has a dismal prognosis with a median overall survival between 12-18 months. Recent analyses of salvage therapies for recurrence suggest that reirradiation may improve survival. A possible adverse effect is radiation-induced neurocognitive decline. There is a dearth of literature investigating neuroprotective strategies, like using memantine. Our aim is to investigate whether memantine protects neurocognitive function in this population, with an additional goal to show that memantine does not reduce overall and progression free survival. Subjects were randomly assigned to reirradiation plus memantine or reirradiation alone, and the …

Prolonged Metformin For Managing Postpartum Weight Retention In Women With Gestational Diabetes, Ashley Manning

Yale School of Medicine Physician Associate Program Theses

Gestational diabetes is one of the most common obstetric complications and causes both intrapartum issues and increased long-term cardiometabolic risk of type 2 diabetes. Overweight and obese populations are more likely to develop gestational diabetes, which manifests as increased gestational weight gain and postpartum weight retention, perpetuating the cycle of obesity and diabetes in future pregnancies leading to further type 2 diabetes risk. Metformin has become more widely accepted for use during pregnancy and has been associated with decreased gestational weight gain; however, its long-term effects in the postpartum period remain poorly understood. This randomized controlled trial seeks to determine …

Evidence-Based Recommendations For The Use Of Neostigmine Versus Sugammadex In Patients Undergoing Thoracic Surgery, Ostap Dvorakevych

Doctor of Nursing Practice Scholarly Projects

Neuromuscular blocking agents play a vital role in the safe delivery of modern anesthetic practice. These medications provide patient paralysis for anesthesia staff to perform tracheal intubation and for surgeons to have a motionless surgical field. At the end of surgery, the effects of these paralytic agents must be fully reversed by reversal agents. Incomplete reversal impairs the patient’s ability to maintain an airway, which can lead to various postoperative pulmonary complications such as respiratory failure, pneumonia, and atelectasis. Patients undergoing thoracic surgery are at high risk for this incomplete reversal due to deep levels of paralysis required to keep …

Evidence-Based Recommendations For The Use Of Neostigmine Versus Sugammadex In Patients Undergoing Thoracic Surgery, Ostap Dvorakevych

Doctor of Nursing Practice Scholarly Projects

Neuromuscular blocking agents play a vital role in the safe delivery of modern anesthetic practice. These medications provide patient paralysis for anesthesia staff to perform tracheal intubation and for surgeons to have a motionless surgical field. At the end of surgery, the effects of these paralytic agents must be fully reversed by reversal agents. Incomplete reversal impairs the patient’s ability to maintain an airway, which can lead to various postoperative pulmonary complications such as respiratory failure, pneumonia, and atelectasis. Patients undergoing thoracic surgery are at high risk for this incomplete reversal due to deep levels of paralysis required to keep …

Development Of Evidence-Based Practice Guidelines For Perioperative Multimodal Analgesia During Spine Surgery, Jonathan Wagner

Doctor of Nursing Practice Scholarly Projects

The most common cause of adult disability is chronic back pain. As medication maintenance therapy becomes ineffective, surgical intervention is the last resort for treatment. Patients with chronic pain often rely on pain medication such as opioids for relief. The exposure and dependency of opioids can create unique challenges for anesthesia providers to deliver safe and adequate anesthesia for surgery. Patient’s dependent on chronic opioids develops many adverse effects including sleep disordered breathing, suppression of the immune system, and higher risk of developing cardiovascular events under stress. There is a lack of consistent perioperative guidelines for patients undergoing spinal surgery …

Implementing Caregiver Resources Handout And Enhancing Parent And Caregiver Appreciation Week, Sidney Coolidge

OTD Capstone Projects

This doctoral capstone project was completed in partnership with MOVE Inclusive Dance, an inclusive dance studio that empowers individuals of all ability levels to learn life skills through dance. The aim of this project was to provide parents and caregivers resources that would introduce them to different businesses and groups around the greater Nashville area. As a result, a parent and caregiver resource document was created to benefit families from early diagnosis in childhood to adulthood and included financial aid opportunities, respite care, support groups, legal planning, and many others. The project culminated with parent and caregiver appreciation week where …

Sexual Health Education Scope And Sequence, Sara Wadsworth

Honors Projects

Based on a significant amount of prior research, comprehensive sexuality education (CSE) has been identified to be the most effective method of teaching sexual health education (SHAPE America, 2021; World Health Organization, 2023). Comprehensive sexual health education improves healthy behaviors and outcomes, provides useful information, and is positively perceived by students (Gardner, 2015; Kirby, 2002; Robinson et al., 2022). However, the United States’ current sexual health education has not implemented this ideal method, which is shown through state laws, students’ experiences, underdeveloped skills and flawed understanding of concepts, and – most importantly – a lack of resources for teachers (Foley, …

Effects Of Postural Position, Eeg Asymmetry, And Temperamental Style On Cognitive Task Performance, Taylor Cops, Christy D. Wolfe

Undergraduate Theses

The literature shows hemispheric asymmetry in individuals corresponding with temperamental style. Those with greater right-frontal activation tend towards withdrawal/inhibition and those with greater left-frontal activation tend towards approach/activation (e.g., Davidson, 1992). Other literature suggests that greater right-parietotemporal activation is associated with increased arousal (Heller, 1993; Wolfe & Bell, 2014). Temperamental style has been linked with cognitive performance with approach-oriented temperaments being associated with both higher and lower performance depending on the task requirements (Khan et al., 2024; Wolfe & Bell, 2007). Literature further suggests that postural position (e.g., sitting, standing, lying down) may influence feelings of approach/withdrawal and cognitive processing. …

Investigation Of The Anticancer Activity Of Phenylbismuthbis(4-Carboxychalcone), Megan Baker

Undergraduate Theses

Cancer is currently the second leading cause of death in the US. While much progress has been made, there is still a significant need for novel therapies. Chalcones are privileged, natural products that have shown cytotoxic activity and potential as chemotherapeutics in multiple cancerous cell lines. Additionally, bismuth complexes of small organic molecules have been shown to have anti-tumor activity. The anti-proliferative activity of phenylbismuthbis(4-carboxychalcone), a bismuth-coordinated chalcone was assessed in multiple cancer cell lines using MTS assays. The compound demonstrated micromolecular inhibition. Additionally, mechanism of action studies were performed to assess if the anti-proliferative activity seen is due to …

Development And Implementation Of A Training Manual For Increased Utilization Of The Universal Exercise Unit (Ueu), Anya Marie Jones

OTD Capstone Projects

This doctoral capstone project was completed in partnership with Rehab Without Walls (RWW) Neuro Solutions in Hendersonville, TN; an outpatient clinic dedicated towards serving adults with various neurological conditions, including stroke, spinal cord injury, traumatic brain injury, cerebral palsy, and more. The focus of this project was to develop a training manual for the therapists at RWW to improve occupation-based utilization of the Universal Exercise Unit (UEU). Through the lens of the Ecology of Human Performance (EHP) model and Albert Bandura’s theory of behavior change, each therapist’s performance range (i.e., ability to perform tasks) depended on both the context (the …

Induction And Modulation Of Apoptosis In Breast Cancer Cells Mda-Mb-157 And 93b By Chinese Medicinal Herbs Oldenlandia Diffusa And Bryophyllum Pinnatum, Sarah Wolf

Honors Theses

Chinese medicinal herbs have been found to contain bioactive phytochemicals with anti-cancer properties. Herbal extracts induce apoptosis in cancer cells by modulating levels of pro- and anti-apoptotic proteins. A previous study showed that a commonly used herb, Scutellaria barbata, significantly induced apoptosis in the breast cancer cell line MDA-MB-157 and the therapy-resistant breast cancer cell line 93B. However, the effects of two different Chinese herbs, Oldenlandia diffusa (OD) and Bryophyllum pinnatum (BP) on these breast cancer cells are not known. This project indicates the influence of the herbs OD and BP on apoptosis of breast cancer cell line MDA-MB-157 in …

Induction And Modulation Of Apoptosis In Breast Cancer Cells 93a And Mda-Mb-157 By Chinese Medicinal Herbs Oldenlandia Diffusa And Bryophyllum Pinnatum, Rekha Isaac

Honors Theses

Chinese medicinal herbs, such as Oldenlandia diffusa, contain phytochemicals that exhibit antitumor, chemopreventive, and antiangiogenic effects in cancer cells. In this study, both Oldenlandia diffusa and Bryophyllum pinnatum (a lesser-studied herb) were tested on breast cancer cell lines MDA-MB-157 and 93A by administering an aqueous extract. The effectiveness between cell lines was also compared. The apoptotic effect both herbs showed was quantified by the levels of pro and anti-apoptotic proteins expressed in each cell line. Both cell lines treated with Oldenlandia diffusa and Bryophyllum pinnatum showed significant differences in their levels of both pro and anti-apoptotic proteins when compared to …

Medication Errors: The Radonda Vaught Case, Nayeli Guandique-Benitez

Honors Theses

We can recognize that to err is human, yet it may cost us great things, such as our jobs, licenses, and peace of mind. In nursing, 40% percent of the time is spent administering medication (Wolters Kluwer, 2022, p.15-17), which puts nurses and nursing students at an increased rate of making medication administration errors (MAE). The National Coordinating Council for Medication Error Reporting and Prevention (NCCERP,2023) says medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer." …

Impact Of Ehr On Security Check And Patient Outcomes, Arun Kumar Marumudi

Harrisburg University Dissertations and Theses

This study aims to explore patient perspectives on how electronic health record (EHR) security protocols influence care quality and outcomes. In the context of methodology, an online survey was conducted in March 2024 with 10 participants from the USA who provided informed consent. Questions assessed experience with EHRs, security concerns, perceptions of authentication impacts, satisfaction with balancing priorities, and open-ended feedback. Descriptive analysis was used to identify key themes.

Most respondents had direct EHR exposure, which validated their viewpoints. Universal concerns co-existed with preferring digital records due to facilitated sharing when regulated appropriately. One-third reported occasional access issues correlating with …

Bone Marrow Donor Recruitment Drive And Registry, Elizabeth R. Dovich

Honors Theses

Bone marrow transplants are vital for those with blood cancers and disorders, but not every ethnic group has an equal chance of finding a match. Some of the human leukocyte antigen (HLA) cell markers used to match donors and recipients are unique to certain ethnic groups, making it harder for members of those groups to find a match. This project worked to address this inequality by organizing a bone marrow registry recruitment drive on the campus of Andrews University in partnership with the NMDP registry. It encompassed the planning, promotion, and execution of the drive which took place March 5-7, …

The King Hygiene Project: Addressing Hygiene Poverty In College Students, Krislynn King

Honors Projects

For my Honors Project, I seek to shine a light on the topic of hygiene insecurity and investigate how it impacts the modern-day college student. In addition, I have taken physical action through a hygiene drive, marketing, and volunteering to better the lives of those who struggle with this issue regardless of whether they are a student at Bowling Green State University.

Perception Of Pediatric Readiness Across A Health System's Emergency Departments, Rebekah L. Sabo

Doctoral Dissertations & Projects

The recent pandemic and pediatric respiratory syncytial virus surge have reinvigorated pediatric care readiness conversations. National strategies and associations exist to guide health systems in improving the quality of emergency care offered to pediatric populations by first assessing readiness for care. These research strategies center on survey implementation and staff engagement in general emergency departments with the goal to improve staff readiness to care for pediatric patients that may present for treatment. What impact would developing a consolidated pediatric readiness program that includes: pediatric emergency care coordinator designation for each emergency department, pediatric readiness education and committee engagement have on …