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Identifying And Addressing Barriers To Long Term Follow Up Care Of Patients With Hepatitis C In A Rural Southern Appalachian Clinic, Sarah M. Brown

Doctoral Projects

This project addressed the issue of loss to follow-up (LTFU) among patients infected with hepatitis C virus (HCV), a significant barrier to achieving sustained virologic response (SVR) and improving outcomes. LTFU is particularly critical among marginalized and rural populations who face socioeconomic barriers, stigma, and other social determinants of health (SDOH) that affect treatment adherence. Grounded in the Social Ecological Model (SEM), this project examined systemic, community, interpersonal, and individual factors influencing LTFU (Ahmed et al., 2022; Al-Khazraji et al., 2019; Kilanowski, 2017).

This Doctor of Nursing Practice (DNP) quality improvement initiative sought to improve patient retention in HCV care …

Reducing Falls In Medical-Surgical Patients, Braelyn Bailey Bsn, Rn, Haylee Paione Bsn, Rn, Elizabeth Young Bsn, Rn

Nurse Residency

PICO: In adult patients at risk for falls on Med Surg units, how does the implementation of fall-reducing interventions compare to standard fall precautions impact inpatient fall rates?

Education And Advocacy For People With Disabilities: Adaptive Clothing Awareness, Mansi Patel, Zeida Gutierrez

Fall 2025 OTD Capstone Symposium

The purpose of this educational capstone project is to develop and implement educational sessions that provide resources, raise awareness, and support individuals with disabilities in accessing adaptive clothing. The aim was to bridge the knowledge and awareness gap and provide hands-on learning opportunities to promote dressing independence.

Inclusive Education And Autism Spectrum Disorder: Preparing University Students To Support Secondary Learners, Kristen M. Lucke, Cynthia Haynes

Fall 2025 OTD Capstone Symposium

Autism spectrum disorder (ASD) affects approximately 1 in 31 children in the United States, highlighting the need for future teachers and occupational therapists (OTs) to support students with ASD in inclusive educational settings. This mixed-methods capstone examined how an OT-informed professional learning session influenced university students’ knowledge, confidence, and readiness to support learners with ASD. Fifteen graduate students participated in a 75-minute instructional session addressing six ASD learning domains. Pre- and post-session measures included demographic information, the investigator-developed Knowledge and Perceptions of Autism Spectrum Disorder (KPASD) assessment, Likert-scale ratings, and qualitative reflections. Participants demonstrated significant increases in total KPASD scores …

A Guidebook For Occupational Therapy Practitioners To Promote Adaptive Sports, Ivy M. Shimkus, Heather Rennerfeldt, Angela Blackwell

Fall 2025 OTD Capstone Symposium

Adaptive sports offer meaningful physical, social, and emotional benefits for adolescents with disabilities; however, many occupational therapy (OT) practitioners report limited training and resources to support these activities within practice. This capstone project aimed to address this gap by developing Sports for All, an educational guidebook designed to help OT practitioners promote engagement in adaptive sports among adolescents with disabilities. Guided by the Canadian Model of Occupational Performance and Engagement and the PERMA well-being framework, the project emphasized the importance of person, environment, occupation, and positive psychological factors that support meaningful engagement in activities that promote overall well-being in …

Structural Determinants Of Pay-For-Performance: Cross-System Analyses And Implications For Switzerland's Bismarckian Model, Joyce Zhang

Switzerland: Global Health and Development Policy

Rising healthcare costs in Switzerland—driven in part by incentives that reward service volume over value—have sparked interest in alternative payment models such as Pay-for-Performance (P4P). Yet Switzerland remains in the early stages of experimenting with P4P, making this a timely moment to examine how the country’s health system structure shapes the design, implementation, and feasibility of such reforms. This study investigates two gaps in the existing literature: the largely unexamined role of health system typology in conditioning P4P outcomes, and the limited understanding of how Switzerland’s Bismarckian model influences P4P adoption. Using a mixed-methods qualitative design, the study combines a …

Access In Context: A Comparative Study Of Refugee And Asylum-Seeking Child Immunization In Uganda’S National System And Chad’S Humanitarian System, Maya Lunt

Switzerland: Global Health and Development Policy

Vaccinations and child immunizations are widely recognized as a safe and effective public health tool to stop preventable deaths of children and eliminate disease. Refugees and asylum-seeking children are often more vulnerable and have a greater risk of having incomplete immunization. This is due to a wide variety of barriers that refugees can face, which can be unique to different health system designs or country policies. Chad and Uganda are two lower-middle-income countries that have different refugee health system designs. Chad has a health system design where a parallel system is run for refugees, which heavily involves humanitarian aid from …

Beyond The Needle: Microarray Patches And The Pursuit Of Measles Vaccination Equity In Sub-Saharan Africa, Paige Littlefield

Switzerland: Global Health and Development Policy

Persistent inequities in measles vaccination systems across Sub-Saharan Africa leave millions unreached by both routine services and outbreak campaigns. Microarray patches for measles-rubella vaccination (MR-MAPs) are widely promoted as a solution to logistical and workforce barriers, yet little empirical work examines how their benefits align with real operational constraints. This study analyzes the potential role of MR-MAPs in advancing immunization equity through expert interviews and targeted document analysis. Findings reveal a tension between the technological promise of MR-MAPs and the structural limitations of current health systems. While thermostability, simplified application, and task-shifting opportunities could expand reach among zero-dose, mobile, and …

The Rise Of E-Patients In Tanzania: Reflections On The Unregulated Growth Of Digital Health Consultations, Kahabi Isangula

School of Nursing & Midwifery, East Africa

Background: Digital technologies have significantly transformed healthcare delivery globally, enabling patients to access healthcare services through electronic and mobile platforms. In Tanzania, this transformation has manifested in the rise of “e-patients” — individuals who actively seek health advice, consultation, or treatment through unregulated digital platforms. This paper examines the drivers, patterns, and implications of this trend in Tanzania.

Methods: A descriptive approach was employed, synthesising peer-reviewed and grey literature from global and sub-Saharan African sources, with a particular focus on Tanzania. Insights were also drawn from expert discussions, public digital platforms, and the author’s experiential reflections to contextualize …

Planning Ahead: A Holistic Approach To End-Of-Life Planning, Kristin Litzelman, Ashley Berghoff, Jennifer Abel, Carol Bralich, Jackie Carattini, Selena Freimark, Jenna Kink, Sara Richie

Journal of Human Sciences and Extension

End-of-life planning can be an intimidating, confusing, and emotional process, which may explain why only 37% of Americans have completed advance care directives. To address this need, we developed the Planning AHEAD (Advance directives, Handling financial changes, Estate planning, and Arriving at Decisions for the end of this life) curriculum. Planning AHEAD is a seven-session course designed to help participants make important decisions that reflect their end-of-life wishes and document this information to relieve stress for their loved ones. In the first two years of the program, Extension educators facilitated 45 Planning AHEAD series across Wisconsin, reaching over 600 participants. …

What Do Rural Caregivers Need? Implications Of Formal Service Usage And The Role Of Cooperative Extension Systems, Naomi R. Meinertz, Jeong Eun Lee, Erin L. Martinez, Leacey Brown, Chelsey Byers, Sara Richie, Kathy Tutt

Journal of Human Sciences and Extension

The well-being of caregivers in the U.S. is a public health crisis. Caregivers experience greater rates of depression, chronic disease, and social isolation; however, the context of rural and urban living experiences creates different caregiving realities. Using two representative datasets of caregivers in the North Central and Northeast regions of the U.S., this paper examined the experiences of rural and urban caregivers in using formal support services. Rurality was negatively related to formal support service usage. Results from a multiple regression revealed a positive association between formal service utilization and caregiver well-being. These findings suggested that formal services can play …

The Impact Of Cooperative Extension Programs On Late Life Mental Health Outcomes: A Systematic Review, Naomi R. Meinertz, Kate Perepezko, Jeong Eun Lee, Mary E. Dozier Phd

Journal of Human Sciences and Extension

Rural-dwelling older adults have greater mental health disparities with higher rates of depression and anxiety compared to their urban counterparts; however, reaching these communities to understand and address the specific psychological needs of rural-dwelling older adults remains a barrier for gerontologists. Due to the extensive reach of the Cooperative Extension System, university Extension systems are primed to facilitate connections between researchers and rural communities to improve mental health outcomes for older adults. Despite the potential benefits of such partnerships, Extension is largely unknown and underutilized by gerontological researchers, leaving many older adults disconnected from resources available through land-grant universities that …

A Comprehensive Nutrition Education Program Promotes Behavior Change And Perception Of Food Access Across The Older Adult Age Span, Sarah Misyak, Camille Mcguire, Victor Olayemi, Maria Denunzio, Paige Harrigan, Elena Serrano

Journal of Human Sciences and Extension

Strategies to promote healthy behaviors among older adults are needed to mitigate vulnerabilities to negative health outcomes, especially for those with low income. Healthy Eating and Staying Active as We Age (HESA), a nine-lesson educational series for Supplemental Nutrition Assistance Program-eligible older adults, was created to promote health among aging audiences. The purpose of this study was to evaluate the behavior change of older adults following participation in HESA, which covers food resource management, nutrition, food safety, and physical activity behaviors, as well as perceived food affordability and accessibility, and to determine if HESA is appropriate across the age span …

Intergenerational Creative Movement Program: A Social Connection Intervention To Foster Health And Well-Being, Claire M. Reardon, Mohammad Khalilian, Amy F. Kostelic, Susan Thiel, Anthony R. Bardo

Journal of Human Sciences and Extension

A sense of connection and belonging is widely recognized to be essential for mental health. Yet, since the COVID-19 pandemic, loneliness, social isolation, and mental health problems have remained elevated across America. Transitions into young adulthood and older age, while distinct, similarly challenge social connectedness, especially among women. Our multi-lesson education program connected first-generation female college students with college-educated forty-plus women to foster belonging and improve mental health. The program integrated dance as a creative physical activity, promoted intergenerational engagement through a humanistic focus on generativity, and used a social network approach to gauge the development of connections among participants …

Empowering Public Employees For Retirement Security: Evidence From A Pre-Retirement Financial Education Program, Suzanne Bartholomae, Mengya Wang

Journal of Human Sciences and Extension

The United States is facing a retirement crisis, with eight in ten older adult households experiencing or at risk of financial insecurity (Tavares et al., 2024). National data shows 60% of Americans regularly contribute to retirement accounts, and just 40% have estimated their retirement savings needs (Lin et al., 2022). With approximately 5,900 Baby Boomers retiring daily (Fry, 2019), there is considerable interest in identifying effective strategies and policies to address retirement preparedness. This paper presents evaluation findings from a retirement planning financial education program delivered to 750 public employees by Iowa’s public employee retirement system and Cooperative Extension educators. …

You’Re Only Old Once: And Other Truths About The Extension Work We Do In Aging, James S. Bates, Erin L. Martinez

Journal of Human Sciences and Extension

No abstract provided.

Assessing Cultural Competence Before And After Online Teaching Modules On Social Determinants Of Health, Charlie Wright Pharmd, Bcps, Barrett Carter Pharmd, Bcps, Ellen Jones Pharmd, Bcacp

Faculty Research ​and Publications

Introduction:

Cultural competence is essential to provide care to diverse populations and is required in pharmacy curriculum (ACPE Standard 2.1). As pharmacists increasingly serve diverse patient populations, understanding social determinants of health (SDOH) becomes critical in clinical decision-making. Given the emphasis on competency-based education, there is a need to evaluate innovative teaching methods ensuring pharmacy students are prepared to deliver culturally-sensitive care.

Research Question or Hypothesis:

What is the effectiveness of interactive online modules focused on SDOH in improving knowledge, awareness, and attitudes of first-year pharmacy students?

Study Design:

A quantitative pre/post-survey design was used to assess changes in cultural …

Bridging Education And Practice: The Role Of Academic Ehrs In Developing Nursing Workforce Readiness, Ann Varghese

2025 Fall Honors Capstones Projects - Archive

Charting plays a vital role in nursing practice, yet many new graduate nurses find it challenging to master as they learn to document accurately while managing multiple patient care responsibilities. The integration of electronic health record (EHR) training into nursing curricula aims to bridge the gap between education and clinical practice. This study explores whether the use of an academic EHR named "EHR Go" helps prepare nursing students for documenting in real-world clinical settings. A thematic analysis of student feedback on EHR Go was conducted using the Delphi technique and Microsoft Copilot 365. IBM SPSS was then used to compare …

Impact Of Covid-19 Pandemic On Quality Of Life, Anxiety, Connections To Friends, And Access To Resources Among People With Hiv: Using The Social Ecological Model, Carol Dawson-Rose, Christine Davey, Emily Huang, Laura Cox, Phillips Craig, Motshedisi Sabone, Lufuno Makhado, Emilia Iwu, Kathleen Fitch, Sheila Shaibu

School of Nursing & Midwifery, East Africa

The purpose of this study was to understand the impact of the coronavirus disease 2019 (COVID-19) pandemic and mitigation efforts on health and social outcomes for people with HIV at the individual, social, and structural levels of the Social Ecological Model. The International Nursing Network for HIV collected data for a cross-sectional survey of people with HIV in Botswana, Canada, Colombia, Hong Kong, Kenya, Nigeria, South Africa, Thailand, and the United States from August 2021 through June 2023. Among 1,400 participants, 47.5% experienced decreased quality of life, 40.9% experienced increased anxiety, 33.0% had reduced connection with friends, and 38.8% had …

Understanding Strategies To Translate Knowledge On Hookah Smoking: A Mixed Methods Study, Rabia Mir

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: One tobacco trend of the 21 st century is smoking hookah or waterpipes. Hookah smoking is thriving on a false widespread belief that it is a safe alternate to smoking cigarettes when in fact it has adverse effects on health and is not safer. Hookah use has especially become popular for young adults and college students.

Study Objectives: The purpose of this study is to generate knowledge to inform university administration (health education personnel and campus policy makers) on what the psychosocial profile of a hookah smoker is, including risk factors, and how they can use messaging to reduce …

Management Of Recurrent Metastasis Of Renal Cell Carcinoma To The Parotid Gland After Nephrectomy., Kathryn Collins, Emily Cushing, Alex Ellerhorst, Christopher Selinsky

Oncology Articles

Renal cell carcinoma accounts for 90% of malignant renal tumors, with common metastases to the lungs, bones, and brain. Head and neck metastases are uncommon, and the parotid gland is an exceedingly rare site (0.5%). Recurrent metastasis to bilateral parotid glands has been reported in the literature, but recurrent metastasis to the ipsilateral gland has not. This is a case about a 69-year-old female who presented to our clinic with the chief complaint of a slowly enlarging left neck mass. She had a history of clear cell renal cell carcinoma treated with nephrectomy 15 years prior. An MRI reviewed from …

Alumni Journal - Volume 96, Number 3, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Editorials
2 | From the Editor
4 | From the President
6 | From the Dean

News
8 | APC 2026 Preview
10 | Alumni News
14 | School of Medicine News
16 | This & That
20 | Students: Street Medicine
22 | AIMS Report: The Living Body of Christ

Features
24 | Transforming Loss: A Family's Journey to Redefine Compassionate Care
28 | Japan Lifetime Experience Trip
32 | Hope is Always Present: Despite Life's Circumstances
34 | Anchored by Faith: A Story of Family, Service, and Spiritual Growth
38 | Answering the Call: To Serve in Guam …

The 10-Year Functional Outcome Of Ponseti Treatment Of Idiopathic And Arthrogrypotic Clubfeet With An Age-Matched Control, Chris Church, Nicole Wang, Stephanie Butler, Jose J Salazar-Torres, John Henley, Freeman Miller, Nancy Carlin, Maureen Donohoe, L Reid Nichols

Faculty and Staff Publications

Background: The Ponseti method is accepted as an effective primary conservative treatment for idiopathic clubfoot (IC) using serial casting, percutaneous Achilles tenotomy, and prolonged bracing. The outcomes of its use in treating rigid clubfoot in arthrogryposis are unclear. This study assesses the outcomes of the Ponseti method in children with IC and arthrogrypotic clubfoot at an average age of 10 years.

Methods: Outcomes of the Ponseti method were retrospectively studied in ambulatory children ages 8.0 to 12.9 years in the gait lab between 2004 and 2024. Children were excluded due to the presence of nonidiopathic or nonarthrogryposis-related clubfoot and history …

Accreditation Standards Must Protect Trainees: Creating Ethical Fellowship Programs, Anna D Goff, Ryan J Dougherty, Joelle Robertson-Preidler

Faculty and Staff Publications

No abstract provided.

Monitoring The Laboratory Frequency For Musculoskeletal Infections At A Tertiary Care Children's Hospital: A Diagnostic Stewardship Qi Project, Kedar Tilak, Douglas Swanson, Christine Symes, Alaina N. Burns, Ann L. Wirtz, Rana El Feghaly

Posters

Patients with musculoskeletal infections (MSKI) undergo several laboratory tests. To promote laboratory stewardship, our Infectious diseases (ID) division recommended the following frequencies for labs: 1) C-reactive protein (CRP) every 2-3 days until >50% reduction while >3mg/dL, otherwise weekly until normal, 2) Sedimentation rate (ESR) at the start of therapy and end if > 20mm/hr initially, 3) Complete blood cell count (CBC) at the start of therapy and when transitioning to oral therapy if WBC is initially elevated. Baseline data showed that of 42 children evaluated between July 2023-May 2024, only 15 (35.7%) had a CBC and 13 (30.95%) had a CRP …

Two-Staged Lateral Based Thenar Flap For Fingertip Injuries Of Index And Middle Fingers –A Functional Outcome, Srinivas Pamarthi, Pooja Mannela, Saiphanindra Malladhi

Digital Journal of Clinical Medicine

Introduction:

Fingertip injuries, particularly of the index and middle fingers, account for major accidents which occur in industrial regions due to machinery usage, causing sharp cuts or crush injuries of the tips. The treatment of these fingertip injuries previously was amputation and stump closure. As the advancement of flaps occurred, there came many flaps mentioned to treat these tip injuries. Many of these flaps had failed to provide the same functional and aesthetic outcome following surgery. This study aims at assessing laterally-based thenar flap for tip injuries of index and middle fingers for its aesthetic and functional outcome.

Methods:

This …

Growing South Dakota (Fall 2025), College Of Agriculture, Food And Environmental Sciences

Growing South Dakota (Publication of the College of Agriculture, Food and Environmental Sciences)

[Page] 2 Mesonet at SDState: A benefit to every South Dakotan
[Page] 6 Governor’s Ag Ambassador — Glenn Muller
[Page] 8 Precision agriculture cooperative agreement signed with University of Debrecen
[Page] 10 Students experience international agriculture, culture in Vietnam, New Zealand
[Page] 12 Legen-dairy! SDSU students claim national judging awards
[Page] 13 SDSU Rodeo Team continues storied rodeo tradition at nationals
[Page] 14 SDSU wheat breeders helping feed the world
[Page] 20 SDSU drone holds promise for soil, leaf sampling
[Page] 22 Don't be a fish out of water
[Page] 24 A passion for academic advising
[Page] 25 One takeaway …

Sleep Hygiene, Paige Howland, Taylor Jones, Mckenzie Shaffer - Kay, Natasha Rossi

Goal 2: Life Skills Narrative

The purpose of this presentation was to educate students on sleep hygiene and the importance of getting proper sleep each night.

Bio 310: The Organ System, Makenna Franks

Student

Created as a study guide for BIO 310 Comparative Vertebrate Anatomy. Provides parts of the body with labels.