Medicine and Health Sciences Commons^™

Registered Nurses’ Knowledge, Self-Efficacy, And Willingness To Assess Near-Fatal Strangulation: Development Of The Near-Fatal Strangulation Self-Efficacy Scale, Morgan Kenady Mcmahon

Walden Dissertations and Doctoral Studies

Near-fatal strangulation (NFS) is a time-critical clinical presentation associated with elevated risk of stroke, delayed airway compromise, and future intimate partner homicide, yet no validated instrument existed to assess nurses' NFS-specific knowledge or self-efficacy. The purpose of this cross-sectional study, guided by Bandura's social cognitive theory and Benner's novice to expert theory, was to develop and pilot test the Nurses' Near-Fatal Strangulation Self-Efficacy Scale (NFS-SES) and to examine whether knowledge and self-efficacy predicted nurses' willingness to conduct an NFS assessment. A convenience sample of 150 registered nurses in emergency, labor and delivery, and obstetric emergency departments completed the NFS-SES, a …

Characterization Of Zdhhc Palmitoyltransferase Expression During Retinoic Acid-Induced Differentiation Of Sh-Sy5y Neuroblastoma Cells, Mohammad Abdallah Matari

Seton Hall University Dissertations and Theses (ETDs)

Protein S-Palmitoylation is a reversible post-translational modification that regulates protein trafficking, membrane localization, and neuronal function through the activity of the zinc finger Asp-His-His-Cys (zDHHC) family of palmitoyl acyltransferases. Although SH-SY5Y neuroblastoma cells are widely used as an in vitro model of neuronal differentiation, the expression profile of the complete zDHHC family during retinoic acid (RA)-induced differentiation has not been systematically characterized. The objective of this study was to characterize the expression of all 23 human zDHHC genes during RA induced differentiation of SH-SY5Y cells. SH-SY5Y cells were differentiated using 10 µM all-trans retinoic acid for up to seven days. …

The Role Of Reassurance Messages In Pediatric Oncology, Isabelle Faller

Doctoral Dissertations

Despite decreasing mortality rates, the high prevalence and incidence of pediatric cancer necessitate the need for advancements in the treatment of psychological concerns, specifically the reduction of patient distress and anxiety. A more comprehensive understanding of current reassurance messages in clinical practice can aid in developing a standardized framework for providing reassurance in pediatric oncology. Qualitative Content Analysis was employed to examine the types of messages nurses use to reassure patients (to reduce their anxiety about a future health-related event) and how effective nurses perceive these messages to be in relieving patients' anxiety. The adult participants, located at hospitals throughout …

Cultivating Participation: Developing An Evidence-Based Farm-Based Sensory Integration Protocol For A Pediatric Occupational Therapy Clinic, Katelyn Childers

Occupational Therapy Doctoral Capstones

The purpose of this doctoral capstone project was to develop a comprehensive, evidence-informed farm-based sensory integration framework that translates current evidence into practical clinical resources to support therapist education, caregiver engagement, and consistent implementation of occupation centered intervention at Zion Therapy Services.

Sibstars: Empowering Siblings Through Support, Education, And Advocacy, Abbey Edrington

Occupational Therapy Doctoral Capstones

A primary needs assessment conducted through parent and sibling surveys supports these findings and identifies concerns related to anxiety, peer difficulties, uncertainty regarding future caregiving roles, and limited access to sibling-specific support services. Findings additionally reveal discrepancies between parent perceptions and sibling-reported experiences, highlighting the need for increased family awareness and sibling-focused interventions. Therefore, the purpose of the Doctoral Capstone Project was to develop and implement SibStars, a community based sibling support and education program designed to promote peer connection, coping skills, self-advocacy, emotional wellness, and occupational participation among siblings of individuals with IDD through family-centered, occupation based approaches.

Beyond The Birth: An Occupational Therapy Approach To Postpartum Support And Advocacy, Ashlei Aweis

Occupational Therapy Doctoral Capstones

The purpose of this capstone was to address identified gaps in maternal healthcare through the development of three occupational therapy resources: a postpartum wellness workshop, the Occupational Balance Screening Tool, and the “It’s Beyond Birth” educational podcast series. Together, these deliverables were designed to promote maternal health education, support occupational balance, and provide practical strategies that help mothers successfully navigate the transition into motherhood.

Hiking For All: An Adaptive Hiking Program For Disabled Individuals, Anna Grigg

Occupational Therapy Doctoral Capstones

Hiking is a valued activity in the lives of many people. Possessing or acquiring a disability should not prevent or limit someone from participating in hiking; however, many disabled individuals will avoid hiking due to the lack of hiking trails that are accessible to them or the lack of adaptive hiking skills that they have. The purpose of the Doctoral Capstone project was to promote occupational engagement in hiking for disabled individuals, advocate for increased access to hiking resources and information, and facilitate safety during adaptive hiking.

Addressing Pediatric Executive Function Through Nature-Based Occupational Therapy In Central Ohio, Morgan Mahan

Occupational Therapy Doctoral Capstones

Outdoor settings present unpredictable challenges that require children to simultaneously use inhibitory control, working memory, and cognitive flexibility in ways that mirror real-world contexts. This continuous adaptation to changing environmental demands supports the generalization of skills across settings. Despite this potential, no nature-based pediatric occupational therapy program previously existed to effectively address executive function deficits. To address this gap, the Nature Explorers Program was developed, consisting of a theoretical foundation and practical application. The Nature-Based Executive Function Frame of Reference (NBEF) was developed to guide the assessment and treatment of executive function within a nature-based setting, and the Nature Explorers …

Advocating For Access: Empowering Children With Disabilities Through Meaningful Connections To Durable Medical Equipment (Dme), Maddyson Lamb

Occupational Therapy Doctoral Capstones

Access to appropriate DME is vital; without it, children face severe occupational deprivation – the prolonged restriction from participating in meaningful daily activities. Furthermore, when families struggle to secure equipment due to high costs, it deepens the occupational deprivation across the entire family. Ultimately, managing these ongoing needs along a continuum is crucial to long-term health. However, families frequently face severe funding delays and systemic barriers when trying to acquire these vital resources. The purpose of the doctoral capstone was to utilize the PEO model to identify environmental restrictions and advocate for the necessary DME by having developed a multifaceted …

Meeting The Needs Of Individuals With Avoidant/Restrictive Food Intake Disorder Through Occupational Therapy, Tianna Matthews

Occupational Therapy Doctoral Capstones

Avoidant/Restrictive Food Intake Disorder (ARFID) is a relatively new and complex disorder that results in a significant impact on one’s overall health, well-being, and quality of life. The research study was designed to address practitioner knowledge and confidence gaps as they relate to ARFID care by assessing whether an educational in-service could increase pediatric healthcare practitioners’ knowledge of ARFID, confidence with treating ARFID, and their understanding of OT’s role on an interdisciplinary ARFID team.

Building Bridges: A Culturally Inclusive, Education-Based Program For A Pediatric Outpatient Therapy Clinic, Sarah Morgan

Occupational Therapy Doctoral Capstones

The purpose of the Doctoral Capstone Project is to develop and implement a culturally inclusive, education-based program, to address current gaps in pediatric outpatient occupational therapy and to allow the population to overcome challenges inhibiting their occupational adaptation and occupational fulfillment.

Epilepsy Simulation: Educating Occupational Therapy Students On Epilepsy And Community Resources, Cambria Grissom Tolar

Occupational Therapy Doctoral Capstones

Epilepsy is the fourth most common neurological disorder, affecting every 1 in 26 individuals during their lifetime. Individuals with epilepsy frequently experience barriers to employment, transportation, healthcare access, social participation, and more that influences occupational participation and quality of life. Despite the fact these factors fall under occupational therapy’s role and scope, many OT students do not receive adequate education about epilepsy, how to treat someone with epilepsy, and how to navigate community resources. The purpose of this doctoral capstone project was to develop and implement an epilepsy simulation that allows OT students to experience the everyday challenges faced by …

Empowering Middle School Students Through A Life Skills Enrichment Program, Kaitlyn Peavy

Occupational Therapy Doctoral Capstones

Occupational therapy practitioners are uniquely positioned to support this development through occupation-based opportunities that foster meaningful participation and functional independence. The purpose of the doctoral capstone project was to develop an evidence-informed, occupation-based life skills enrichment program that promotes independence, occupational participation, and future readiness for middle school students through structured, hands-on learning experiences.

Occupational Therapy's Role In Burn Rehabilitation, Hallie Poff

Occupational Therapy Doctoral Capstones

Current literature identifies the need for enhanced burn-specific competencies and standardized, patient-friendly discharge resources to improve long-term functional outcomes and occupational participation beyond the hospital setting. Together, these findings highlight the need to advance burn-specific clinical skills while improving the consistency and accessibility of patient resources and education.

Melodies & Memories: An Occupational Therapy-Based Music Program For Individuals With Dementia, Adrianna Mcentire

Occupational Therapy Doctoral Capstones

The purpose of the doctoral capstone experience was to develop and implement Melodies & Memories to use music interventions to improve quality of life, social participation, cognitive functioning, emotional and behavioral regulation, and physical functioning while providing personalized, client centered care through the use of music.

Sipping With A Purpose: Empowering Adults Of All Abilities Through Job Training And Work Skills While Enhancing Social Participation, Shelby Russell

Occupational Therapy Doctoral Capstones

The "Sipping with a Purpose" doctoral capstone project addresses an urgent societal need by bridging the employment gap for adults with IDD, a demographic experiencing an over 80% unemployment rate. Out of 41 local day center participants at The Learning Center (TLC) in Northeast Arkansas, only four are currently employed. This reveals a critical deficit in opportunities for local adults to build the work skills, independence, and self esteem that they desire far beyond a paycheck. To address primary employment barriers such as a lack of vocational skills and fears about disability benefit loss, this functional business provides simulated and …

Mindful Music Lessons: Exploring Emotions Through The Creation Of Music, Shelton Jones

Occupational Therapy Doctoral Capstones

Despite research categorizing mental health and occupational therapy as emerging, many intervention techniques from CBT principles remain applicable and fall within the scope of OT. The purpose of the Doctoral Capstone Project was to develop a healthy coping strategy by implementing a music-based therapeutic program that promotes symptom management, emotional regulation, social participation, and overall health and wellness among military service members

Development Of An Ergonomic Education Program At The Nestlé Usa Production Facility In Nea, Virginia Smith

Occupational Therapy Doctoral Capstones

A review of the literature, needs assessment findings, and collaboration with site stakeholders identified opportunities to strengthen ergonomics education, improve occupational health literacy, and support a more comprehensive approach to workplace ergonomics through the development of evidence-based resources. The purpose of the doctoral capstone project was to develop the Nestlé Ergonomics Program by applying the Person-Environment-Occupation (PEO) Model to create evidence-based ergonomic resources that increase workplace ergonomics education, promote occupational health literacy, and reduce the risk of work-related musculoskeletal disorders among employees at the Nestlé USA Production Facility in Jonesboro, Arkansas.

Fostering Development Through Participation In A Gymnastics-Based Occupational Therapy Program, Alex Theisen

Occupational Therapy Doctoral Capstones

The purpose of implementing a gymnastics-based OT program is to incorporate gymnastics-based movement into interventions that support and enhance each client’s progress toward their unique OT goals, address deficits affecting occupational performance, and increase participation through play-based interventions. The purpose of the doctoral capstone project is to expand knowledge of population needs to develop and facilitate the implementation of a gymnastics-based pediatric occupational therapy program that will promote participation and safety while meeting the individual needs of clients.

Enhancing A Trauma-Informed Reintegration Framework Through Occupation-Based Program Development For Adolescent Survivors Of Human Trafficking In Northeast Arkansas, Faith Welch

Occupational Therapy Doctoral Capstones

The purpose of the doctoral capstone was to enhance Hope Found's existing trauma informed reintegration framework through the development of an occupation-based framework. The enhanced framework focused on integrating developmentally responsive intervention planning, educational programming, implementation guidance, resource organization, documentation recommendations, and outcome measurement strategies to strengthen trauma-informed service delivery and support community reintegration for adolescent survivors of human trafficking and exploitation.

“Something Else To Focus On”: Perinatal Havening And Stress Coping In Pregnant Black Women, Brittany L. Ferrell Young

WUSM Theses and Dissertations – All Programs

Black women in the United States experience maternal mortality at more than three times the rate of white women, a disparity driven by chronic stress rooted in structural racism rather than individual behavior or biology. Accessible, culturally responsive tools for managing stress during pregnancy remain scarce. This mixed-methods pilot feasibility study examined Perinatal Havening, a self-administered psychosensory technique, as a stress management intervention for pregnant Black women. Guided by Lazarus and Folkman's Transactional Theory of Stress and Coping, the study addressed three questions: how Black women experience acute and chronic stress during pregnancy, the acceptability and preliminary influence of Perinatal …

Cortical Plasticity Following Peripheral Nerve Injury In The Upper Extremity, Samah Gassass

WUSM Theses and Dissertations – All Programs

Peripheral nerve injury (PNI) in the upper extremity results in significant sensorimotor impairment. Nearly 40-50% of patients affected by PNI fail to restore normal hand and arm function and recovery remains variable. Recovery related cortical plasticity is recognized as an important factor, though its relationship to meaningful outcomes remains unclear. This dissertation examined how cortical activity patterns relate to functional recovery after PNI through a systematic review and three subsequent cross-sectional studies.

The systematic review of multimodal neuroimaging studies on cortical plasticity after upper extremity nerve transfer found that good recovery is generally linked to restoration of contralateral or typical …

Advancing Maternal Health Equity In Nebraska: Examining Prenatal Care Access Disparities, Policy Context, And Doula Integration As A Complementary Solution, Marlette Grace Dulcinee Mabiala-Maye

Theses & Dissertations

Maternal health inequities persist across the United States, with Black, Native American, and immigrant-origin women facing disproportionate barriers to timely prenatal care. This dissertation examined access to prenatal care in Nebraska, a mixed rural and urban state with extensive maternity care deserts, through three interrelated aims. Aim 1 analyzed PRAMS data using survey-weighted regression with race-by-socioeconomic-status interactions to characterize disparities in the timing and barriers to care. Aim 2 evaluated the state’s October 2020 Medicaid expansion across pre-pandemic, acute pandemic, and post-expansion periods. Aim 3 applied qualitative description and the Consolidated Framework for Implementation Research to interviews withtwenty-three maternity care …

Fireready Oc: Developing A Public Health Protocol For Wildland-Urban Interface (Wui) Fire Events In Orange County, Christian Andre O. Gequillo, Allyson Hayakawa, Selin Erdogan, Natalie Albarran

Master's Projects and Capstones

Objective/Problem: Wildland-Urban Interface (WUI) fires expose communities to a greater number of hazardous pollutants than traditional wildfires and can pose significant health risks; however, Orange County does not have a standardized public health protocol to address WUI fires. A review of the literature identified the need for standardized WUI fire guidance that is focused on improved preparedness and response. Aim: The FireReady OC quality improvement project aimed to develop an evidence-based public health protocol to improve Orange County’s public health preparedness and response for WUI fire events from 0% to 10% during the 12-week period from May 27, 2026, to …

Food For Thought: Building Confidence In Healthy Food Choices Among Seniors In A Residential Facility Through Nutrition Education, Amy Rodríguez

Master's Projects and Capstones

This quality improvement project evaluated the effectiveness of a 10-week nutrition education program designed to improve nutrition knowledge and confidence among independently living older adults residing in a low-income senior housing community. Aim By August 10, 2026, this project aimed to increase average nutrition knowledge and confidence scores related to selecting nutritious foods and preparing healthy meals by 20% among senior housing facility residents. Methods A microsystem assessment, literature review, SWOT analysis, fishbone diagram, and GANTT chart were completed to guide project development and implementation. Weekly nutrition education workshops were conducted over a 10-week period and included presentations, group discussions, …

The Efficacy Of Transversus Abdominis Plane Block As An Adjunct To Spinal Anesthesia For Cesarean Delivery: An Evidence Synthesis And Implementation Toolkit, Alyssa Hebert, Alex Potts, Gabriela Robertson

Graduate Theses, Dissertations, and Capstones

Postoperative pain hinders cesarean delivery recovery and overall patient experience. Although spinal anesthesia with intrathecal opioids remains the standard of practice, associated side effects and concerns regarding opioid exposure highlight the need for effective opioid-sparing strategies. Anesthesia providers play a critical role in advancing postoperative pain management through evidence-based protocol development, provider education, and interdisciplinary collaboration to optimize maternal outcomes. The transversus abdominis plane (TAP) block provides somatic analgesia to the anterior abdominal wall by targeting the thoracolumbar nerves (T6–L1) and has increasingly been incorporated into multimodal postoperative pain management strategies for abdominal surgery. Nevertheless, a gap remains in obstetric …

Standardizing Gestational Diabetes Group Education In An Outpatient Maternal-Fetal Medicine Clinic: A Quality Improvement Project, Nina Prieto

Master's Projects and Capstones

Gestational diabetes mellitus (GDM) requires timely and consistent education to support effective self-management and reduce maternal and fetal complications. Baseline assessment of an outpatient maternal-fetal medicine clinic identified variation in educational materials, teaching approaches, referral processes, scheduling, and workflows across English- and Spanish-language GDM group visits. This quality improvement project aimed to standardize the group visit process and increase staff compliance with standardized materials and workflows from 0% to 50% over a 12-week period. Data were collected through direct observation of group and individual education sessions, stakeholder feedback, review of existing materials, referral and attendance patterns, and workflow analysis. These …

Improving Nursing Adherence To Chg Bathing And Pivc Maintenance Practices To Reduce Hospital-Onset Bacteremia In An Adult Medical-Surgical Unit, Mohabat Barikzai, Dinazar Altamirano, Edward Rivas, Sarah Trilles

Master's Projects and Capstones

Preventing hospital-onset bacteremia (HOB) is a healthcare priority given its association with increased morbidity, mortality, prolonged hospitalization, and healthcare costs. Literature identifies inconsistent adherence to evidence-based practices for chlorhexidine gluconate (CHG) bathing and peripheral intravenous catheter (PIVC) maintenance as a modifiable risk factor for HOB. This quality improvement (QI) project evaluated whether implementing standardized nurse education, routine compliance audits, and performance feedback would improve adherence to evidence-based CHG bathing and PIVC maintenance practices. The project aimed to achieve at least 90% nursing compliance with HOB prevention practices over an intended 8-week implementation period. A pre-post quality improvement design was implemented …

Improving Pressure Injury Prevention Through Braden Scale Compliance And Education In The Emergency Department, Joycelyn Lee, Kira Simone Faerstain, Alyssa Kristine Ortiz, Ashley Briseida Cruz

Master's Projects and Capstones

Pressure injuries are a major burden in healthcare, particularly in the Emergency Department (ED). Patients can be sedentary for prolonged periods of time and don't always get their skin checked promptly. Patients visiting the ED often have comorbidities and patient-specific medical needs, such as seniors with fragile skin, malnourishment, immobility, etc. At a Southern Los Angeles Hospital, leadership found that there was a need for improvement in this area. Implementing standardized risk assessment methods can help to improve the consistent use of the Braden Scale as a predictive and preventive tool for identifying patients' risk for pressure injuries and promoting …

A Dosimetric Comparison Of Halcyon 6x-Fff And Truebeam 6x In Prone Left Whole Breast Radiation Therapy, Maritza Soto, Kelly Labant, M.S., Cmd, Rt(T), Kristen Vu, M.S., Cmd, Rt(T)

Masters Projects

Purpose:

This retrospective study compared dosimetric differences between prone left whole breast radiation (WBRT) treatment plans originally generated for Halcyon using 6X flattening- filter-free (FFF) beams and replanned for a conventional TrueBeam using 6X beams.

Methods:

Ten prone whole left breast treatment plans were paired and retrospectively analyzed. Clinically treated Halcyon 6X flattening filter free plans were replanned on TrueBeam using flattened 6X beams in Eclipse v16.1. Contours for all plans were generated using artificial intelligence-based autosegmentation, reviewed by a medical dosimetrist and radiation oncologist, and forward planned with a tangent technique in EZFluence to achieve identical planning objectives. Dose …