Medicine and Health Sciences Commons^™

Burden Of Neurodevelopmental Disorders In Kenyan Children, Symon Kariuki, Patricia Kipkemoi, Martha Kombe, Mary Bitta, Jacqueline Phillips Owen, Amina Abubakar, Charles Newton

Institute for Human Development, East Africa

Importance: Neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and intellectual disability contribute to one-tenth of the global burden of mental and neurologic disorders. The burden of NDDs is not well documented in Africa.

Objective:To assess the prevalence, risk factors, and comorbidities of NDDs in young Kenyan children.

Design, setting and participants: This cross-sectional study was conducted among children aged 6 to 9 years residing in the Kilifi Health and Demographic Surveillance System in Kenya. In stage I of the study, children were screened for NDDs from March 16, 2015, to September 14, 2016; those …

Care Starts Before Entering The Clinic – A Holistic Approach To Assessing Primary Care Access At Walter Reed National Military Medical Center, Cory E. Hauptman

All Theses

Walter Reed National Military Medical Center is the world’s largest military treatment facility and the primary provider of healthcare to the military, their families, and military retirees in the Washington DC area. The federal government is legally bound to provide access to primary healthcare services to Tricare enrollees within a 30-minute travel time of their residences. This time constraint has only been applied to the transit period from a patient’s residence to the base where the care is provided and has not accounted for the time it takes a patient to get to the clinic once they arrive at the …

Optimizing Endothelial Cell Specific Polymersome-Based Atheroprotective Therapies, Ally C. Brawner

All Theses

Atherosclerotic cardiovascular disease is the number one cause of death in the United States and the world. Every year, billions of dollars are spent in the US alone for direct treatments of this disease, especially on prescription medicines like statins. However, these medications have been unable to curtail global mortality rates, partially because they do not target the entirety of atherosclerotic pathophysiology. A key area of this pathophysiology is that atheroprone arteries typically include pro-inflammatory endothelial cells that exhibit decreased levels of apoAI-mediated cholesterol efflux and an increased release of adhesion molecules, such as VCAM-1. The objective of my project …

Awareness And Usability Of Community And Facility-Based Health Sector Client Feedback Mechanism In Tanzania Public Health System. A Mixed Methods Study, James Kengia, Pius Kagoma, Ally Kinyaga, Helga Mutasingwa, Simon Debere, Robert Smith, Marcos Mzeru, Rashid Mbunda, Claud Kumalija, Paschal Ruggajo

Internal Medicine, East Africa

Background Client feedback systems are increasingly becoming important in person-centered health care. The systems provide opportunities to the public to interact with the health care providers and policymakers, present their concerns related to the performance of the health care system in order to improve the quality, equity, and responsiveness in the provision of services, hence increase social accountability. This study aimed to assess the situation of client feedback systems in Tanzania, focusing on the awareness and usability of existing facility- and community-based feedback platforms from the client’s perspective.

Methods The study employed a concurrent mixed-method design using both quantitative and …

Impact Of Multimodal Analgesia In Comparison To Conventional Analgesia In Coronary Artery Bypass Graft Patient With Implementation Of An Enhanced Recovery After Surgery Order-Set, Rhoda Musyoka, Radhan Gopalani, Maura Falli, Maria Ruiz, Cathleen Charles, Yanija Zhang, Esty Trimino, Laura Dominguez Vasquez, Tom Nguyen

Nursing & Health Sciences Research Journal

Background: An Enhanced Recovery After Surgery (ERAS) pilot program was implemented for coronary artery bypass graft (CABG) procedures under a single cardiothoracic surgeon in May 2024 across two community hospitals. We assessed the impact of multimodal analgesia facilitated through the ERAS CABG order-set compared to the non-ERAS (conventional) CABG order-set.

Methods: This study was an Institutional Review Board-approved, multi-site, retrospective chart review of participants admitted to two community hospitals for a CABG procedure from June 2024 to January 2025. Participants who utilized the preand post-ERAS or the pre- and post-conventional CABG order-sets were included. The primary outcome was the opioid …

Addressing Nursing Student Burnout Through Mindfulness And Zen Den At University Of The Pacific, Jeremy Seaton, Tanairi Ingram, Natalia Zelayandia

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background:

Burnout among nursing students is a critical issue that negatively impacts academic performance, mental well-being, and long-term professional retention. Entry-Level Master of Science in Nursing students at University of the Pacific experience heightened stress due to rigorous coursework, clinical demands, and underdeveloped institutional mental health support.

Aim:

This Quality Improvement project aimed to reduce stress and strengthen emotional resilience among nursing students through Mindfulness-Based Stress Reduction education and the creation of a peer-supported wellness space, the “Zen Den.”

Methods:

A pre- and post-intervention design was implemented, utilizing surveys to measure mindfulness knowledge, attitudes toward self-care, and stress awareness. Zen …

Enhancing Pediatric Sun Safety: A Parent-Focused Intervention In El Dorado County, Ashley Riley, Calvin Nauer, Alaina Godwin

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background:

Childhood ultraviolet (UV) exposure is the most significant modifiable risk factor for skin cancer, yet proper sun protection remains inconsistently practiced by parents. In El Dorado County, California, where high altitude and intense sun exposure amplify UV risk, knowledge gaps and misinformation persist despite resource availability. This quality improvement (QI) project aimed to strengthen parental knowledge, confidence, and modeling of sun-safe behaviors for their children through an evidence-based community education program.

Aim:
The goal of this QI initiative was to improve parental attitudes, self-efficacy, and photoprotective behaviors by implementing a three-part, nursing-led educational intervention focused on UV risk awareness, …

Utilizing An Artificial Intelligence And Machine Learning Model To Predict Colorectal Cancer Risk In American Samoa: A Pilot Study, Va’Atausili Tofaeono, Tulimalefoi Va’Ofanua, Ana Jane M. Bontjia, Siumukuka Fa’Aiuaso – Galea’I, Robert Gayapa, Eran Choman, Shawnda Schroeder

Indigenous Health Faculty Publications

Objective: This pilot study aimed to assess the feasibility of using an artificial Intelligence and machine learning (AI/ML) model to predict colorectal cancer (CRC) risk in American Samoa, where resource limitations and cultural barriers significantly hinder screening efforts. Methods: The AI/ML model used complete blood count (CBC) results, along with age and gender, to predict CRC risk. A retrospective analysis was conducted on data from 6,025 individuals aged 50 and above from the Lyndon Baines Johnson Tropical Medical Center’s electronic health records. Of these, 62 participants were identified as high-risk for CRC based on the AI/ML model. The study also …

The Fascia Iliaca Regional Nerve Block Using Ultrasound And Landmark Technique: An Objective Structured Clinical Examination For Nurse Anesthetists, Braxton T. Beech, Parker F. Rigby

Doctoral Projects

The fascia iliaca block (FIB) is an effective regional anesthesia technique used in various clinical settings, including operating rooms, emergency departments, and pain management clinics. Despite its advantages in reducing postoperative complications and minimizing opioid use, FIB remains underutilized among Certified Registered Nurse Anesthetists (CRNAs), primarily due to limited exposure and training. This doctoral project examines the implementation of an Objective Structured Clinical Examination (OSCE) as an educational intervention to enhance CRNA proficiency in performing FIB using both ultrasound-guided and landmark techniques.

A pre- and post-test study design was conducted with 18 CRNA participants attending a continuing education workshop. Demographic …

Point-Of-Care Ultrasound (Pocus): Measuring Inferior Vena Cava (Ivc) Diameter And Collapsibility In The Preoperative Setting, Jordan Parker, Dakota Kilpatrick

Doctoral Projects

Among the many aspects of preparation required for patients undergoing general anesthesia, preoperative optimization is key. One goal of preoperative optimization is the establishment of adequate preoperative intravascular fluid volume. Inadequate fluid volume can increase surgical risks and lead to adverse patient outcomes. Evidence has demonstrated that using point-of-care ultrasound (POCUS) to assess preoperative surgical patients can diminish the consequences associated with altered fluid status and increase the likelihood of hemodynamic stability. One of the varying methods of POCUS is the point-of-care focused cardiac ultrasound (FOCUS). Using FOCUS, the practitioner can measure the IVC diameter and collapsibility index to determine …

Breastfeeding Safety Following Maternal Anesthesia: A Guideline Development, Megan Honea, Mary Johnson

Doctoral Projects

Recommendations regarding breastfeeding following maternal anesthesia are inconsistent and often not up to date with current best practice guidelines. Previous recommendations have led to mothers unnecessarily “pumping and dumping” breast milk has benefits for both mother and baby. These benefits include (a) increasing the infant’s access to colostrum, (b) encouraging mother-baby bonding, (c) improving the mother’s breastfeeding experience, (d) and providing significant health benefits to the infant. The purpose of this scholarly project was to develop a set of evidence-based recommendations that focus on mothers who desire to breastfeed following general anesthesia. These recommendations will highlight maternal- fetal transfer of …

Bias And Disparities In Neonatal End-Of-Life Care, Tamiko Younge, Daria Murosko, Simranjeet S Sran, Terri Major-Kincade

Faculty, Staff and Student Publications

No abstract provided.

Help-Seeking Among Early Adolescents Who Use Physical Peer Violence, Kelli Franco, Elizabeth Baumler, Leila Wood, Heidi Adams Rueda, Jeffrey R Temple

Faculty, Staff and Student Publications

Despite accumulating research on help-seeking among violence victims, little is known about help-seeking among youth who use violence. In a racially and ethnically diverse sample of early adolescents (N=2,676; 50.3% female; Mage=12.67), participants self-reported physical bullying, physical fighting, physical dating violence perpetration, and help-seeking intentions over the past year. T-tests and one-way ANOVAs examined help-seeking by sex and race, respectively. Prevalence and comparisons of help-seeking across youth with and without any violence were examined. Youth who used any physical peer violence (n=965) reported lower help-seeking intentions than their peers, and among violent youth, males reported …

Presenting The Inner Triangle Outer Diamond (Itod) Framework Of Educational Ecosystems And Its Applications To The Integration Of Educational Technologies And Innovations., Joshua Owolabi

PCOM Scholarly Works

Educators are leveraging technologies and innovations, including artificial intelligence (AI), to support learners and deliver quality medical education. Many of these initiatives have reportedly yielded positive impacts. There have also been publications and reports highlighting the success of educational technologies (EdTech) and innovations, as well as their potential to not only enhance the outcomes of educational programs but also define the future of medical education and practice. Proponents of EdTech and innovations argue that the significant introduction of EdTech and innovations into programs can enhance learners' experiences, improve programme outcomes, and prepare learners for a future of work and practice …

Expanding Access To School-Based Oral Health Services In North Dakota: Revisiting Seal!Nd Eligibility Criteria, Nishat Sultana, Shawnda Schroeder

Indigenous Health Faculty Publications

The North Dakota Department of Health and Human Services Oral Health Program (OHP) implements the SEAL!ND school-based sealant initiative to provide preventive oral health services such as dental sealants, fluoride varnish, and dental screenings in schools across the state. Federal funding guidelines currently require programs to target schools where 50% or more of students participate in the Free or Reduced-Price Lunch (FRPL) program. While this criterion identifies high-need schools, it inadvertently excludes larger schools with substantial absolute numbers of low-income children. This brief examines the potential impact of two policy recommendations.

The Effect Of Exercise On The Development Of Gestational Diabetes Mellitus In Pregnancy: A Systematic Review Of Literature, Abigail Reiche

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this systematic review is to synthesize literature examining the relationship between using exercise as a preventative method for gestational diabetes development during pregnancy, and the effect it may have on lowering glycemic levels. Health Source: CINAHL and PubMed were systematically searched for peer-reviewed journal articles that studied pregnant women (P), and the relationship of consistent exercise (I), compared to no physical exercise (C), on lowering glycemic levels resulting in positive pregnancy outcomes (O), throughout gestation (T). Twenty articles were retrieved in accordance with the PICOT objectives. Additional criteria included only articles from 2019-2024 and articles that were …

Bridging The Language Gap: The Impact Of In-Person Versus Remote Interpreter Services On Medication Adherence And Patient Safety In Adult Spanish-Speaking Patients, Ashley E. Alarcon Martinez, Jocelyn N. Lopez Maradiaga

Nursing | Student Research Posters

Background: Significant health inequities are caused by language barriers between patients and health care staff, resulting in miscommunication among adult Hispanic patients with low English proficiency, reducing medication adherence, impairing patient safety, and raising the possibility of medical errors. To address this issue, interpreter services, both in-person and remote translation, have been introduced in healthcare settings to enhance communication. Objective: The purpose of this study is to investigate the differences in patient safety and medication adherence between in-person and remote translation services for adult Hispanic individuals with limited English proficiency in healthcare settings. Methods: The proposed research involves five local …

The Nature Of Nasal Discharge In Chronic Rhinosinusitis: A Systematic Review And Meta-Analysis Using Patient-Reported Outcomes, Ethan M. Kallenberger, Asher T. Ripp, Shaun A. Nguyen, Erin Briggs, Alexander N. Duffy, Isabella V. Schafer, Jess C. Mace, Timothy L. Smith, Zachary M. Soler, Rodney J. Schlosser

SKMC Student Presentations and Publications

OBJECTIVE: The objective of this study is to answer the question "What is the most common and severe type of nasal discharge in patients with chronic rhinosinusitis (CRS) at baseline as measured by patient-reported outcomes?".

METHODOLOGY: Two independent reviewers evaluated studies for inclusion, extracted data from included studies, and performed critical appraisal of studies. Data on the four Sino-Nasal Outcome Test 22 (SNOT22) discharge questions, demographic, and comorbidity data was collected. Meta-analysis of single means and proportions was performed for demographic, comorbidity, severity, and prevalence data.

RESULTS: A total of 53 studies (n = 6584) were included for analysis. Postnasal …

Exploring The Relationship Between Exercise, Social Support, And Mental Health, Emma Anderson

Honors Theses

This study explored the relationship between exercise, social support, and mental health in college students. Mental health issues such as depression, anxiety, and stress are prevalent among college students. The two components that are experimented with for their potential in decreasing the effects of negative mental health are exercise and social support. This project executed a cross-sectional design by surveying three groups of college students: cycle class participants, independent exercisers, and non-active students. The recruitment process for the three groups of participants were key in measuring the physical activity levels. The participants were individually asked if they completed a specific …

Hand Injuries In Boulderers Across Various Settings, Experience And Skill Levels., Cole E. Olinger

Honors Theses

Survey-based research was performed to identify risk factors and prevention tactics for finger injuries in boulderers. An IRB-approved survey was distributed and taken by 228 respondents, whose data was analyzed. Risk factors for finger injury were found to include years of experience and skill level. Results indicated stronger, more experienced boulderers were more likely to report history of finger injury than weaker, less experienced boulderers. Findings suggest boulderers may avoid injury by manipulating their grip type in specific ways.

The Impact Of Minor Amputation On Occurrence Of Major Amputation In Patients With Diabetic Foot Ulcers, Nivan Wadhawan, Naohiro Shibuya, Daniel C. Jupiter

School of Podiatric Medicine Publications

Diabetic foot ulcers (DFU) may lead to lower extremity amputation (LEA). Although minor LEAs (at or distal to the ankle) can carry a higher risk of perioperative complications compared to major LEAs (proximal to the ankle), they can increase patient independence and quality of life. This study aims to elucidate the impact of minor LEA on the time between DFU occurrence and major LEA to help determine the safer and more efficacious LEA choice for a given clinical situation. Data from 4,199 DFU patients from the TriNetX research platform were utilized. Kaplan-Meier curves and Cox regression were conducted to evaluate …

Acute Dislocations Of The Sternoclavicular Joint: Treatment And Outcomes, Elsa B. Rodriguez-Baron, Fidel Moreno-Diaz, Daniel E. Pereira, Kathy Mcgurk, Langdon Hartsock, Lucy Bowers, Paul Matuszewski, Kevin Murr, John Sharpe, Michael Tucker, Nathan Redlich, Peter Krause, Clay Spitler, Bradley Foulke, Grant Quilling, Abbey Debruin, Richard Behlmer, Paul Whiting, Stephanie Tanner, Kyle Jeray, Joseph Brock Walker, Sarah Obudzinski, Julie Titter, Andrew Chen, Aseel Dib, Christine Churchill, Benjamin Averkamp, Joseph Hsu, Kimberly Tann, Et Al

School of Medicine Faculty Publications

OBJECTIVES: Identify treatment and describe outcomes and complications of acute anterior and posterior sternoclavicular joint dislocation. DESIGN: Retrospective case series. SETTING: Twelve level-one trauma centers. PATIENT/PARTICIPANTS: One hundred twenty-five patients with acute sternoclavicular joint dislocation, most were male (67%), White (61%), 18-29 years old (57%), involved in a motorized collision (60%), with anterior (35%) or posterior (65%) sternoclavicular joint dislocation treated by operative or nonoperative technique. MAIN OUTCOME MEASUREMENTS: Outcomes and complications of joint instability, post-traumatic arthritis, neurovascular injury, chronic pain, and cosmetic deformities after operative and nonoperative treatment of anterior and posterior acute sternoclavicular joint dislocation are reported. RESULTS: …

Relations Between Ethnic-Racial Identity Statuses And Critical Consciousness Among Latine Adolescents, Kristia A. Wantchekon, Esther Burson, Olga Kornienko, Norma J. Perez-­ Brena, Maciel M. Hernández, M. Dalal Safa, Thao Ha

Psychology: Faculty Publications

Ethnic-­racial identity (ERI) development reflects the processes through which adolescents learn about their ethnic-­ racial background (i.e., exploration) and develop clarity about what it means to them (i.e., resolution). Research on ERI has been critiqued for not examining connections between ERI and broader social beliefs, such as critical consciousness (i.e., individuals' level of reflection about social oppression, motivation to take action against it, and the extent to which they take such action). When examining connections to ERI, research underscores the importance of considering individuals' patterns of exploration and resolution in tandem (i.e., ERI status) rather than analyzing them in isolation. …

Balancing Act: Examining The Relationship Between Organizational Culture And Burnout Within Graduate Medical Education Program Coordinators, Michael Conrad

Graduate Theses and Dissertations

This phenomenological study examined the lived experience of working as a graduate medical education (GME) program coordinator to determine how organizational culture impacts their burnout. The study was guided by the Job Demand-Resource Theory and the Conservation of Resources theory. When job demands outweigh job resources for an individual for a long period of time, it can result in burnout. Job resources can be used to buffer against demands and promote job growth, engagement, and learning. It is this concept which leads individuals to protect their resources when needed and to strive to develop new resources. Data was collected through …

Evaluating Psychosocial Stressors And Mental Well-Being Of Construction Professionals From The Management Standpoint: An Exploratory Study, Md Tauhidul Karim

Masters Theses

Construction professionals face persistent workplace stressors that undermine their mental well-being outcomes. Despite progress in general job-related stressors, social and interpersonal aspects of psychosocial stressors traditionally remain underexplored in the construction management research. The present study examines how social and interpersonal factors influence construction workers’ mental well-being and how management’s awareness, responsiveness, and strategic roles evolved in the transition of the COVID-19 pandemic at the organizational level. An integrative mixed-methods approach was employed, combining a systematic literature review, a bibliometric analysis, and an exploratory case study to capture the current landscape of mental well-being and management standpoints in the US …

A Faith-Based Approach To Mental Health Challenges, Patrick Leblanc

Doctor of Ministry Theses and Dissertations

ABSTRACT

This project sheds light on mental health issues within the Black community and the need for faith communities to intentionally address mental health issues in communities of color. Black men are oppressed by an interplay of cultural, historical, societal, and economic factors that impact their well-being. Racial discrimination and oppression are non-medical drivers exacerbating mental health disorders among Black men. The influences of culture and faith fabricate barriers to help-seeking behavior, and mistaken perceptions of masculinity cause many men to suffer in silence. To begin erasing derogatory perceptions of mental health disorders, faith communities need to increase mental health …

December 2025, Swosu Rural Health Center

RURAL ROCKS

• FDA MedWatch - 20 mEq Potassium Chloride Injection by Otsuka ICU Medical
• Plan to expand Medicare Coverage of GLP-1s
• Pharmacist Interventions in The US Oncology Network Cut Cancer Care Costs by Nearly $9 Million

Enhancing End-Of-Life Quality In Hospice Care, Gerson Orellana Prudencio

Capstone Projects and Master's Theses

The‍‌‍‍‌ increasing demand for hospice care in Monterey County is a clear indicator of the rapid growth in the need for end-of-life services driven by the aging population. The project was developed at the Department of Hospice of the Central Coast, which is under the Montage Health Foundation, a non-profit organization. The community served consists of elderly people receiving hospice and end-of-life care, as well as volunteers who provide administrative and indirect support. The Volunteer Handbook aims to create a comprehensive procedural manual for hospice volunteers to improve administrative efficiency and ensure the quality of care. Interviews were conducted with …

Evaluating Parent Workshops To Reduce Sexual Health Misinformation, Marshall Farrior

Capstone Projects and Master's Theses

This capstone project addressed the problem of sexual health misinformation among youth in Santa Cruz County, which stems from cultural factors, limited parental communication, and inadequate comprehensive sexual health education. Implemented through the Santa Cruz County Public Health Department’s Teen Health Outreach (THO) program, the project evaluated the effectiveness of parent workshops designed to build the capacity of adults’ knowledge and confidence to discuss sexual and reproductive health topics with youth. Serving primarily Hispanic/Latino communities in Watsonville and Freedom, THO collaborates with local schools and organizations to deliver workshops. The intervention aimed to reduce misinformation by empowering parents as trusted …

Engaging Independence, Anthony Cazares

Capstone Projects and Master's Theses

This capstone project was completed in partnership with Gateway Center of Monterey County through the Collaborative Health and Human Services (CHHS) program at California State University, Monterey Bay. Gateway Center is a nonprofit organization that provides services for adults with developmental, cognitive, and physical disabilities. The organization identified a need to improve client engagement and staff support, as existing activities had become outdated and inconsistent. This project implemented an evidence-based, activity-based curriculum aligned with the Community Integration Model, a framework that emphasizes participation, inclusion, and independence for individuals with disabilities. Staff received physical binders and digital resources to guide activity …