Medicine and Health Sciences Commons^™

Quality Improvement Project: Improving Tardive Dyskinesia Detection And Management Through Aims Scale Utilization In Outpatient Psychiatry Clinic, Judeline Docteur

Doctor of Nursing Practice Projects

Tardive dyskinesia (TD) is a debilitating movement disorder commonly associated with prolonged antipsychotic medication use. The disorder results in functional impairment and reduced quality of life for those affected. Frequent TD screening using scales such as the Abnormal Involuntary Movement Scale (AIMS) for those on antipsychotic medication is recommended. However, its underutilization due to a lack of awareness, confidence, and knowledge of its applicability contributes to delayed detection and management, resulting in poor patient outcomes. The purpose of this quality improvement project was to improve TD detection and management through healthcare provider training to affect their self-efficacy and knowledge and …

Quality Improvement Project - Test Anxiety In Nursing Students: Reducing Stress And Anxiety In The Testing Environment, Aaron Gann

Doctor of Nursing Practice Projects

Nursing student retention is a critical issue due to limited clinical placements and faculty shortages, with many students citing test anxiety as a barrier to success in high-stakes National Council Licensure Examination (NCLEX) testing. The problem the Doctor of Nursing Practice (DNP) project identified is the lack of targeted interventions for test anxiety at the project site, a two-year community college’s associate degree nursing (ADN) program. The DNP project aimed to evaluate the efficacy of an Assessment Technologies Institute (ATI) test anxiety module on students’ course quiz scores and self-reporting of emotional barriers as measured by the depression, anxiety, and …

Building Confidence In Critical Thinking Through Faculty Implementation Of Simulation, Melissa Morris

Doctor of Nursing Practice Projects

Simulation provides nursing students with experiences that are as effective as clinical experiences in a non-threatening environment. Clinical experiences such as obstetrics, pediatrics, and mental health have been observation only at the project site. With observation-only clinicals, students do not have opportunities to master skills specific to nursing, which bridge theory to practice. The purpose of this Quality Improvement (QI) project focuses on educating nursing faculty who may not be simulation experts to learn the skills to build and implement simulations that align with the International Nursing Association Clinical and Simulation Learning (INACSL) simulation standards. The Primary Investigator (PI) utilized …

Enhancing Faculty Confidence And Candidate Selection: Evaluation Of A Standardized Holistic Interview Rubric In Nursing Program Admission, Jennifer M. Bray

Doctor of Nursing Practice Projects

Nursing programs continue to struggle with high attrition rates, which impact student success, program outcomes, and the development of a competent nursing workforce. National data show that associate degree nursing programs report attrition rates as high as 50% in the first year, highlighting the urgency for more effective admission strategies. The problem addressed in this quality improvement project was the use of traditional academic metrics, such as grade point average (GPA) and standardized test scores, as primary admission criteria, which often overlook essential non-cognitive attributes linked to student persistence and success. The purpose of the project was to improve faculty …

The Impact Of Staff Education On Menopausal Care, Oluwatoyosi Olumide

Doctor of Nursing Practice Projects

Natural menopause typically occurs around the age of 51. During this transition, many women experience a variety of vasomotor symptoms, with hot flashes and night sweats being the most common. As women age, diminishing levels of estrogen, progesterone, and testosterone can lead to various health complications. Without proper assessment, diagnosis, and treatment, many may suffer in silence. This quality improvement project sought to evaluate the impact of staff education on menopausal care. The symptom checklist, or the Menopause Rating Scale (MRS), is a standardized, evidence-based tool for assessing menopause symptoms and serves as an essential component of the admission process …

The Effect Of Intraoperative Facet Joint Denervation In The Prophylaxis Of Back Pain After Spinal Fixation: A Randomized Prospective Controlled Single-Blind Study, Mohamed Ali Abbas, Ahmed Zaghlol, Ayman M Ismail, Hamdy Nabwi, Mohamed Ismail, Ahmed Sameh Nada, Mona Mokhtar, Ahmed Shaker Elakhras

Mansoura Medical Journal

Background: Failed back surgery syndrome (FBSS) remains a significant challenge after fixation procedures of the spine. The present research assessed the efficacy of intraoperative facet joint denervation in preventing postoperative back pain in individuals undergoing spinal fixation. Methods: A randomized retrospective controlled single-blind study was carried out on 70 patients requiring spinal fixation assigned to two equal groups: Group A: intraoperative facet joint denervation was performed, while Group B was a control group. Pain levels were evaluated utilizing the visual analog scale (VAS) for 7 days following surgery. Follow-up visits occurred at 2 weeks, 1, 3, and 6 months. The …

Lost In Transition: The Need For Research On Immersive Clinical Experiences In Athletic Training Education, Julie M. Cavallario, Stephanie M. Singe

Rehabilitation Sciences Faculty Publications

Context

Immersive clinical experiences (ICEs) were integrated into athletic training education to enhance student learning. However, their structure and effect remain poorly understood.

Objective

To highlight the lack of research on ICEs and the need for data-driven improvements in athletic training education.

Background

Since the transition to graduate-level education, ICEs have been required to provide students with uninterrupted exposure to professional practice. Despite this requirement, little evidence exists regarding their effectiveness or best implementation practices.

Synthesis

Authors of recent studies have revealed inconsistencies in implementation, limited placement diversity, and inadequate preceptor training. Despite widespread adoption, little evidence supports how ICEs …

Exploring The Barriers To The Implementation Of Acute Care Nurse Practitioner Roles, Madeline Wd Mcnulty

2025 Fall Honors Capstones Projects - Archive

Acute care nurse practitioners (ACNPs) are associated with improved patient outcomes and are among the fastest-growing professions in healthcare. However, this growth is accompanied by barriers to the ACNP role. Despite this expansion, limited research has examined these barriers or identified strategies to reduce them in acute care settings. Therefore, this study aimed to identify the obstacles to ACNP practice and to describe approaches to overcoming them. A qualitative descriptive design was employed. Twenty-one pioneering ACNPs participated in semi-structured interviews. Data were analyzed using the “Sort and Sift, Think and Shift” method. We identified nine themes in the study: four …

Environmental Health Priorities In Rural Public Health Departments: Perspectives From Health Agency Directors, Michelle Rastegar

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Rural communities are staffed by environmental health practitioners with less formal public health training and fewer years of public health experience. The literature on environmental health program implementation in rural communities is incomplete and specifically misses the perspectives of those charged with developing and fielding such programs. The purpose of this paper is to gather and report the insights of three rural local public health department leaders regarding the challenges, opportunities and stakeholders for implementing environmental health programs. Using purposive sampling of faculty community partners, three rural Kentucky local health department directors were recruited to participate in the study. After …

Promoting Physical Activity (Pa) Among Latinas In Fayette County, Ky, Vanessa Diaz Mph

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In the United States, the prevalence of overweight and obesity continues to rise at a disproportionate rate that is greatly affecting Latinas. This paper outlines the implementation of an adapted version of Fe en Acción, a faith-based evidence-based physical activity (PA) intervention that was initially implemented in San Diego, CA. The program targets Latinas in Fayette County, KY through culturally tailored, faith-based PA classes held at local Catholic churches. By using promotoras– health promoters– the program works to increase self-efficacy and social support while promoting sustainable behavior change. Key adaptations include a reduction in class frequency (four times a week), …

Pathways To Green River District Health Department, Gracelyn P. Bush

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In an effort to decrease Neonatal Abstinence Syndrome (NAS) in the Green River District of Western Kentucky, this grant proposes the expansion of the evidence-based University of Kentucky PATHways program to the Green River District Health Department (GRDHD). To protect the health of both women and children, this program will specifically target pregnant women with substance use disorder (SUD). This program will deliver a group-based prenatal and postpartum curriculum with the integration of Peer Recovery Support Specialists, specifically modeled on Social Cognitive Theory and the adoption of whole-person care. The proposed program spans a three-year time frame, beginning with program …

A Case Study In Program Evaluation: Evaluation Of A Community Program To Increase Rates Of Physical Activity, Emma Hughes

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Bourbon County faces rates of obesity and levels of physical inactivity that are at, or worse, than the Kentucky state average. The Bourbon County Health Department (BCHD) has prioritized addressing these issues and received funding from a private foundation to do so. Collaboration with the University of Kentucky and additional funding from UK Healthcare (UKHC) will support these efforts to improve the rates of regular physical activity, raise awareness of the negative health impacts of inactivity, and increase access to safe places to exercise. The BCHD developed a 6-month program that involves several interventions aimed at increasing the percent of …

Understanding The Intersection Between Alaska Native And Military Cultural Identities: Using Arts-Based Narrative Inquiry With Mixed Methods, Leslie M. Robertson

Art Therapy | Doctoral Dissertations

American Indian and Alaska Native (AI/AN) peoples have contributed significant efforts towards involvement in the military and have served in the Armed Forces at five times the national average. AI/AN peoples have served with distinction in every major conflict for over 200 years. There has been a pervasive and historical lack of recognition for their service and a lack of awareness of the intersection between Indigenous and military cultures (Ault, 2020; Bennett, 2009; Department of Veterans Affairs, 2020; Harris & Hirsch, 2020; Holm, 2010; Krouse, 2007; Marston, 1972; Nalewicki, 2021; NICOA, 2019; Viola, 2008; Wooda et al., 2021).

This study …

Increasing Pediatric Asthma Follow-Up Visits And Decreasing Emergency Department Visits In A Primary Care Setting, Rima M. Basal

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The implementation of the asthma follow-up visits bundle in the pediatric primary care setting is an evidence-based practice project aimed at improving pediatric asthma management. This manuscript discusses the deployment of the bundle, which includes pre- and post- knowledge assessment for parents/caregivers, asthma education through a short video and handout, administration of the asthma control test (ACT), completion of a written asthma action plan (WAAP), and education about the patient portal and telehealth. The goal is to improve parent/caregiver knowledge, treatment adherence, follow-up visit compliance (in-person or virtual) and reduce emergency department (ED) utilization. Parent/caregiver knowledge increased by 23%, ACT …

Investigating Sex-Specific Role Of The Kynurenine Pathway In Opioid Withdrawal, Blake Brady

Psychology Theses - Archive

The opioid epidemic has led to a surge in opioid use disorder (OUD) and overdose deaths, making opioid withdrawal a critical area of study. Opioid withdrawal is characterized by both somatic and affective symptoms, including anxiety-like behaviors and physical withdrawal signs, yet the underlying neurobiological mechanisms remain insufficiently understood. The kynurenine pathway (KP), a primary metabolic route for tryptophan (TRP), is increasingly implicated in neuroinflammatory responses and neuropsychiatric disorders, yet its involvement in opioid use and withdrawal remains poorly studied, with even less known about potential sex-specific differences. Historically, the predominant use of male subjects in preclinical research has compounded …

The Influence Of Social Support On The Stress Levels Of Pre-Nursing Students, Michelle Chinwendu Nicole Izuwah

2025 Fall Honors Capstones Projects - Archive

Introduction/Background: The nursing shortage in the United States continues to pose a significant challenge due to the widening gap between the supply of and demand for qualified nurses. The COVID-19 pandemic demonstrated the importance and vitality of nurses to society. Thus, it is important to support students throughout their nursing journey, even from the earliest stages. Pre-nursing students are college students who have not yet begun taking upper-division classes and are enrolled in nursing programs, and face a unique set of struggles due to the pressure of prerequisite classes, as well as fears of not being accepted into the nursing …

Burnout Among Nurses In The United States, Faheem Ohri

Social Work Dissertations - Archive

Burnout is an exhausted state of the body, mind, and emotions, characterized by feelings of “depersonalization and reduced personal accomplishment” resulting from prolonged and continuous occupational stress. Burnout among nurses in the United States (U.S.) is a growing concern with significant implications for healthcare professionals and patient outcomes. Nurse burnout compromises patient safety and workforce stability, but pre-pandemic national correlates remain understudied. This dissertation examined employment settings and demographic correlates of burnout among U.S. nurses using the National Sample Survey of Registered Nurses (NSSRN) secondary datasets. Compared inpatient burnout odds pre-/post-pandemic using national twin surveys. Jackknife complex survey logistic regression …

Excitation And Polarization Of Isolated Neurons By High-Frequency Sine Waves For Temporal Interference Stimulation, Iurii Semenov, Vitalii Kim, Giedre Silkuniene, Andrei G. Pakhomov

Bioelectrics Publications

The capacity of temporal interference (TI) stimulation to target deep brain regions without affecting nearby surface electrodes remains uncertain. Using artifact-free optical recording, we compare excitation patterns and thresholds in hippocampal neurons stimulated by “pure” and amplitude-modulated sine waves, representing TI waveforms near electrodes and at the target, respectively. We show that pure 2- and 20-kHz sine waves induce repetitive firing at rates that increase up to 60–90 Hz with stronger electric fields. Beyond this limit, action potentials merge into sustained depolarization, resulting in an excitation block. Modulating the sine waves at 20 Hz aligns firing with amplitude “beats” and …

The Influence Of Adhesive Curing Mode (Light Vs. Dual) On The Microtensile Bond Strength Of Cad/Cam Composite Blocks To Human Dentin : (In-Vitro Study), Mohamed Fouad Haridy, Shadwa Hatem Kabil, Amr Hesham

Dentistry

No abstract provided.

Perioperative Surgical Site Infection Reduction Bundle In Colorectal Patients, Flatasha A. Roland

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Surgical site infections (SSIs) are a common and preventable complication after colorectal procedures, significantly impacting patient morbidity and increasing healthcare costs. This quality improvement (QI) project aimed to lower SSIs in adult colorectal surgery patients by implementing a perioperative SSI reduction bundle at a large acute care facility in North Texas. The intervention targeted three modifiable risk factors: perioperative hypothermia, hyperglycemia, and incorrect antibiotic timing. Despite established protocols, institutional data revealed subpar compliance with active warming (46%), blood glucose control (52%), and antibiotic stewardship (75%), all of which fell below national benchmarks. A gap analysis and literature review guided the …

Regionality In Heart Failure Self-Care Behaviors Using The Medical Expenditure Panel Survey, Gretchen K. Wendt

Nursing Dissertations - Archive

Heart failure (HF) risks increase as patients age, with most of the HF patients having at least one chronic condition and 40% having two or more. Further confounding the HF morbidity and chronic medical conditions are psychiatric conditions like depression and anxiety. For most Americans with HF, managing the diagnosis and chronic conditions can be overwhelming. To formalize the definitions of HF disease management, the concepts of self-care from the situation-specific theory of HF self-care (SST-HFSC) were applied.

The medical complexity of HF self-care during the pandemic was shown to vary based on the US region where the individual resided. …

Lowering The Barrier For Reading Primary Literature In Stem, Sebastian G. Alvarado, Maral Tajerian

Open Educational Resources

Building Bridges of Knowledge (BBK) is a cross‑CUNY initiative that integrates artificial intelligence (AI) and open educational resources to lower the barrier to primary literature and enhance research‑focused pedagogy. Recognizing that scientific papers are often dense and inaccessible to newcomers, we developed a suite of AI‑assisted instructional materials and activities to help students interpret complex data and methodology. A central component is the use of large language models (LLMs) and tools such as Scite.ai to provide citation‑context analytics and personalized research support. These tools allow students to filter literature by supportive, neutral, or contrasting citation statements and to troubleshoot laboratory …

Principles Of Biomedical Research, Faina Linkov, Matthew C. Kostek

Open Education Materials

HLT 430/530

CC BY-NC-SA

Exploring The Impact Of Covid-19 And The Role Of The Church On African Americans’ Mental Well-Being In South Georgia, Adrian D. Lewis

College of Graduate Studies: Theses & Dissertations

The emergence of COVID-19 in 2020 disrupted the social dynamics of communities in the United States. Furthermore, public health mandates led to closures that changed how populations access faith. Historically, African Americans have utilized the church to cope with societal stressors. This study will explore the history of church utilization in the African American community, assess how COVID-19 public health mandates led to church closures for the first time in recent history and impacted this marginalized population, and provide a qualitative perspective on the quality of life during the closures and what changed after the closures for African Americans in …

Expertise Or Experience: Comparing Discussion Of Drought Between Audiences And Agencies In Nebraska, Kansas, Iowa, And Missouri, Cory L. Armstrong, Sharon E. Baldinelli, Kelly Helm Smith, Sharon J. Medcalf

Journal Articles: Epidemiology

Significant portions of the states in FEMA region 7 (Kansas, Nebraska, Missouri, and Iowa) were in drought in 2022–23. Culling data gathered from a prominent social media platform and from focus group discussions, this research examines how drought information was communicated between the public officials and the general public. Through the lens of the two-step flow of communication theory, the central research question explored the differences between public conversations about drought among individuals experiencing it and the viewpoints of experts who work on drought-related issues. Results from social media conversations were examined, along with insights from focus group discussions involving …

Reframing Recovery: Comparing Music Interventions And Traditional Rehabilitation Methods For Cognitive Function In Traumatic Brain Injury Patients, Laura Velez

Honors Undergraduate Theses

Traumatic brain injury (TBI) affects millions annually, often resulting in long-term cognitive deficits that hinder independence and quality of life. While traditional rehabilitation methods address many physical and functional limitations, cognitive impairments—such as deficits in attention, memory, and executive function—often persist. Emerging evidence highlights music-based interventions as a promising complement to standard therapies, yet comparative research remains limited. This integrative literature review examined the effects of music interventions versus traditional rehabilitation methods on cognitive function in adults with TBI. Using a systematic search of databases including MEDLINE, CINAHL Ultimate, APA PsycInfo, and Music Index, eight peer-reviewed studies were selected for …

Consequences Of Artificial Intelligence In Health Insurance: Lawsuits, Policy, And Ethics, Alyssa N. Roberts

Honors Undergraduate Theses

In recent years, the healthcare system has been burdened by a multitude of obstacles that hinder the ability to provide effective, affordable, and timely care. Among these, one of the most significant challenges is the role that health insurance plays in shaping the quality of care. Health insurance companies are designed to decrease financial strain on patients, but they have introduced inefficiencies through delayed coverage approvals, increased denials, and administrative costs. Artificial intelligence (AI) has started to play an integral role in resolving these issues for the health insurance industry. Through its quick automated claim processing, fraud screening, and reduced …

Beyond Involuntary Movements: A Case Of Diabetic Striatopathy Complicated By Cardiac Arrest, Deepa M

Manipal Journal of Nursing and Health Sciences

Abstract

Diabetic striatopathy (DS) is a rare neurological manifestation of poorly controlled diabetes mellitus, typically characterized by hemichorea–hemiballismus and distinctive basal ganglia abnormalities on neuroimaging. We report the case of a 57-year-old woman with type 2 diabetes mellitus who presented with generalized choreiform and ballistic movements and subsequently developed an in-hospital cardiac arrest. Diagnostic evaluation revealed uncontrolled hyperglycemia (random blood glucose 243 mg/dL; HbA1c 8.3%) without ketosis, with neuroimaging findings consistent with DS. The patient was initially managed in the casualty department and subsequently admitted to a neuro stepdown intensive care unit, where she remained for 10 days. Comprehensive medical, …

Enhancing The Accuracy Of Image Classification For Degenerative Brain Diseases With Cnn Ensemble Models Using Mel-Spectrograms, Sang-Ha Sung, Michael Pokojovy, Do-Young Kang, Woo-Yong Bae, Yeon-Jae Hong, Sangjin Kim

Mathematics & Statistics Faculty Publications

Alzheimer’s disease (AD) and Parkinson’s disease (PD) are prevalent neurodegenerative disorders among the elderly, leading to cognitive decline and motor impairments. As the population ages, the prevalence of these neurodegenerative disorders is increasing, providing motivation for active research in this area. However, most studies are conducted using brain imaging, with relatively few studies utilizing voice data. Using voice data offers advantages in accessibility compared to brain imaging analysis. This study introduces a novel ensemble-based classification model that utilizes Mel spectrograms and Convolutional Neural Networks (CNNs) to distinguish between healthy individuals (NM), AD, and PD patients. A total of 700 voice …

Covariate Selection For Rna-Seq Differential Expression Analysis With Hidden Factor Adjustment, Farzana Noorzahan, Hyeongseon Jeon, Yet Nguyen

Mathematics & Statistics Faculty Publications

In RNA-seq data analysis, a primary objective is the identification of differentially expressed genes, which are genes that exhibit varying expression levels across different conditions of interest. It is widely known that hidden factors, such as batch effects, can substantially influence the differential expression analysis. Furthermore, apart from the primary factor of interest and unforeseen artifacts, an RNA-seq experiment typically contains multiple measured covariates, some of which may significantly affect gene expression levels, while others may not. Existing methods either address the covariate selection or the unknown artifacts separately. In this study, we investigate two integrated strategies, FSR_sva and SVAall_FSR, …