Medicine and Health Sciences Commons^™

Blenderized Tube Feeding Formulas: Attitudes, Barriers, And Clinical Benefits As Perceived By Registered Dietitians In Pediatric Care, Savannah Smiley Keeler

Master's Theses

Blenderized tube feeding formulas (BTFF) are increasingly recognized as a viable alternative to conventional commercial tube feeding formulas (CTFF) for pediatric patients requiring enteral nutrition. This cross-sectional, exploratory study aimed to assess the experiences, attitudes, and perceived clinical benefits of BTFF use among Registered Dietitian Nutritionists (RDNs) working with gastrostomy-tube-dependent pediatric populations in the United States. A total of 146 RDNs completed a 45-item online survey, which gathered quantitative and qualitative data on BTFF familiarity, feasibility, clinical outcomes, caregiver factors, and institutional barriers. Findings revealed that while BTFF use remains variable across clinical settings, 55.8% of RDNs reported increased utilization …

Eating Habits, Eating Behavior Mediators, Body Composition And Physical Fitness Among Rotc Cadets, Kaitlin Renee Hanks

Master's Theses

The physical and mental demands of the military and the requirement to maintain body composition standards make healthful eating essential to military service. Reserve Officer Training Corps (ROTC) cadets are a unique subgroup of the United States military, and the combined demands of their military training and educational pursuits may increase their susceptibility to unhealthy eating patterns. The purpose of this study is to describe the relationship between eating habits, eating behavior mediators, body composition, and physical fitness among ROTC cadets. This study used a cross-sectional design that included an online survey, an inperson body composition assessment, and carotenoid measurements …

Analyzing The Relationship Between Diabetes Duration And Self-Management In Adults With Diabetes, Caroline Noel Stroo

Master's Theses

Diabetes mellitus (DM) is a metabolic disease that affects 14.7% of adults in the United States (Centers for Disease Control and Prevention, 2023). Prevalence of diabetes increases with age, with rates for adults aged 65 and older reaching 29.2% (Centers for Disease Control and Prevention, 2023). Factors such as age, race, obesity, physical activity level, and genetics strongly increase the risk of developing type 2 diabetes (T2DM) (National Institute of Diabetes and Digestive and Kidney Disease, 2016). Diabetes requires complex and comprehensive management to reduce the risk of developing comorbidities (Al-Shabeeb et al., 2021). Factors such as education, familial support, …

Lactation Management Training In Graduate Nutrition And Dietetics Programs: A Preliminary Report, Laura Ashton Gillin

Master's Theses

The American Academy of Pediatrics recommends exclusive breastfeeding (BF) for the first six months and continued breastfeeding for at least two years with complementary food. Despite this recommendation, only 24.9% of infants in the United States are exclusively breastfed at six months (Breastfeeding Report Card 2022). Breastfeeding support and lactation management are critical to promoting a successful breastfeeding experience. Specifically, qualified support from a Registered Dietitian Nutritionist (RDN) is recommended, yet graduate students in Nutrition and Dietetics do not receive adequate training regarding breastfeeding intervention. This study aimed to evaluate graduate Nutrition and Dietetic programs to determine the amount of …

Sleep, Emotion Regulation, And Relationship Satisfaction: A Moderation Analysis, Lakyn Boone

Doctoral Dissertations

Sleep plays a pivotal role in overall health and well-being, influencing mental health, cognitive abilities, memory, emotional balance, and physical well-being (Luyster et al., 2012; Mukherjee et al., 2015). Emotions constitute a natural and indispensable element of human existence but necessitate proper regulation, as any disruption in emotion control has been associated with various mental health disorders (Gross & Jazaieri, 2014; Kring & Gordon, 1998; Phelps, 2006). Furthermore, human connections and relationships are fundamental aspects of the human experience, contributing to emotional support, personal growth, a sense of belonging, and even influencing one's physical health outcomes (Baumeister & Leary, 1995; …

Advancing Rfid Systems: From Head Orientation To Robotic Localization Using Passive Tags, Guilherme Ricardo Mendes Da Silva Barreto De Figueiredo

Doctoral Dissertations

No abstract provided.

Hardiness, Coping, And Well-Being In Trauma-Exposed College Student-Athletes, Kiara Scott

Doctoral Dissertations

College student-athletes (CS-As) face many stressors, such as adjusting to a university setting, academic pressures, and the demands of an elite athlete (e.g., battling at a high level during training and competition and managing mental struggles in their sport) (Barbayannis et al., 2022; Barnard, 2016). Some individuals are exposed to events that may be classified as traumatic, such as physical and sexual assault, natural disasters, and other related forms of human suffering (American Psychiatric Association, 2013). Around 50%-80% of college students have been exposed to at least one traumatic event throughout their lifetime (Frazier et al., 2009; Read et al., …

Vitamin B12 Deficiency: Confidence, Perspectives, And Practices Among Registered Dietitian Nutritionists, Avery Miller Adams

Master's Theses

Vitamin B12 deficiency is common in the United States, occurring in 20% of adults aged 60 and above (Andres et al., 2004). Veterans are susceptible to B12 deficiency due to tobacco product usage, alcohol consumption, and poor diet quality. Megaloblastic anemia is the second most prevalent vitamin deficiency disorder recorded in military personnel from 1997 to 2015 (Knapik et al., 2021). This exploratory, analytic research aims to assess registered dietitian RDN nutritionists’ (RDN) knowledge, perceptions, and intentions regarding treating vitamin B12 deficiency in a clinical setting. Due to population prevalence differences, responses from VA and non-VA practicing registered dietitian-nutritionists (RDNs) …

Is There An Association Between Food Literacy And Diet Quality In Young Adult College Men?, Morgan Claire Mayeux

Master's Theses

Food literacy skills can improve dietary intake in young adults as it provides them with the tools they need to make healthier food-related decisions. The benefits of improving food literacy includes the reduction in the risk of prevalent, preventable dietrelated diseases such as obesity, T2DM, heart disease, and other chronic diseases that plague the Unites States today. Previous literature reports primarily on college female samples. Because a large proportion of the samples in the available studies are female, the current literature may not reflect young adult men’s food literacy and its comparison to their overall diet quality. The purpose of …

Socio-Cultural Correlates Of Breastfeeding Behavior Among Latina Mothers And Its Implications For Child Health, Liliana Davalos, Brisa Rodriguez Alcantar, Marissa Martinez, Christopher Johansen

Social and Behavioral Health Faculty Research

Background: Latina mothers in the United States report lower rates of breastfeeding initiation and exclusivity than their non-Hispanic counterparts. Lower rates of breastfeeding in infancy may lead to a higher rate of excess weight in childhood and adverse health conditions. Breastfeeding disparities in Latina women have been previously correlated with socio-cultural factors such as acculturation, education, income, nativity, and marital status. This study examines whether socio-cultural factors are associated with breastfeeding behaviors in Latina mothers in Nevada. Methods: Participants were Latina mothers [n = 214] over 18 years of age, with a child 2–5 years old. A logistic regression was …

The Safety Of Abiraterone Acetate In Patients With Metastatic Castration-Resistant Prostate Cancer: An Individual-Participant Data Meta-Analysis Based On 14 Randomized Clinical Trials, Amy L Shaver, Nikita Nikita, Swapnil Sharma, Scott W. Keith, Kevin K. Zarrabi, Wm. Kevin Kelly, Grace Lu-Yao

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

Background/objectives: Multiple systemic treatments are available for metastatic castration-resistant prostate cancer (mCRPC), with unclear safety profiles. This study seeks to describe the safety determined in randomized clinical trials of a systemic treatment for mCRPC and whether safety differs by age. Methods: We utilized individual patient data from industry-funded phase 2/3 trials in mCRPC on abiraterone acetate (AA). Vivli, a clinical trial repository site, was used. One investigator independently performed screening. Relative effects of treatment were assessed with frequencies and odds of serious adverse events (SAEs). The Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was used. Subgroup analysis measured …

The Multicultural Orientation Framework In Couple Therapy, Jasmine R. Davis

Electronic Theses and Dissertations

Couples’ cultural values and beliefs are important to their relational connection. Cultural values and beliefs can be sources of strength in relationships, but they can also lead to impasses. As such, clinicians and researchers could benefit from a cultural framework to inform conceptualization and treatment when working with couples. The Multicultural Orientation (MCO) framework has three pillars: cultural humility, cultural comfort, and cultural opportunities. The MCO framework is empirically supported for use in individual and group psychotherapy but has not been applied to couple therapy. This dissertation includes two parts. First, we outline a conceptual framework for the application of …

A Developmental Evaluation Of A Dental Hygiene Program And A Community Health Partnership, Laura Jacob

Higher Education: Doctoral Research Projects

Today, dental hygiene education commonly occurs in community college settings which are removed from dental schools thus dental hygiene students graduate with relatively little to no exposure to dentistry or directly with a clinically practicing dentist. With dental hygiene workforce shortages at an extremely high level, locally and nationally, it is imperative to matriculate students who are poised to be successful in the changing landscape of healthcare.

The purpose of this program evaluation was to investigate via the developmental program evaluation model, the perceived benefits of a potential collaboration between the Colorado Mountain College (CMC) dental hygiene program and a …

A Systematic Review Of Technology-Infused Physical Activity Interventions In K-12 School Settings: Effectiveness, Roles, And Implementation Strategies, Taemin Ha, Jongho Moon, Hyeonho Yu, Xiaoping Fan, Lisa Paulson

Department of Kinesiology Scholarship and Creative Works

Background

Rapid technological advancements have rendered many prior reviews of technology-integrated physical activity (PA) interventions in K–12 schools obsolete. A comprehensive analysis examining both the effects of these interventions and the specific roles that technology plays has been notably lacking. This review aimed to systematically examine the effects of technology-infused PA interventions and identify the specific types, roles, and contextual applications of technology within K–12 schools.

Methods

This systematic review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A thorough search across seven electronic databases (CINAHL, ERIC/EBSCOhost, PsycINFO, PubMed/MEDLINE, Scopus, SPORTDiscus, and Web of Science) …

Temporary Intravascular Shunting Using A Carotid Shunt For Traumatic Femoral Artery And Vein Injury In A Hemodynamically Unstable Patient, Nicola Habash, Fari Fall, Jin Park, Babak Abai, Michael Nooromid

Department of Surgery Faculty Papers

Vascular trauma involving the peripheral arteries of the extremities can lead to limb loss and, in severe cases, death. The use of intravascular shunts can help to temporarily perfuse the limb, while allowing for resuscitation of a critically injured patient. Here we present a case of a concomitant complex injury of the common femoral artery and common femoral vein, and the complementary vascular strategies used to achieve limb salvage.

A Phenomenological Study Of Caregivers For Sexual Minority Hospice Patients, Catherine H. Bianchi

Electronic Theses and Dissertations

Lesbian, gay, and bisexual (LGB) individuals face disproportionate barriers in healthcare across the lifespan that persist and often intensify at the end of life. Despite hospice’s mission to provide comfort, dignity, and patient-centered support, it remains unclear whether these services equitably meet the needs of sexual minority patients. Seeking hospice care presents a unique conundrum for many LGB individuals: it necessitates inviting representatives of a historically exclusionary healthcare system into the privacy of their homes - spaces that often serve as sanctuaries of identity, safety, and autonomy. The already vulnerable experience of seeking care in one’s final days can be …

Phase 1 Clinical Trial Of ¡Iniciando! La Adultez: A Culturally Tailored Intervention For Transitioning Latino Young Adults With Autism, Antonio F Pagán, Ana Esparza, Ana Ramirez, Miriam Ortiz, Linda Hernandez, Mary Beth Morgan, Geohanna Noel, Alejandro L Pagán, Jada Salas, Katherine Maurano, Grace Sattem, Leela Sydow, Noor Ahmed, Katherine A Loveland, Cecilia Montiel-Nava, Ron Acierno

Faculty, Staff and Student Publications

This Phase 1 clinical trial evaluated ¡Iniciando! la Adultez, a culturally adapted intervention for Latino autistic young adults (n = 56) and their parents (n = 63). Young adults showed significant post-treatment improvements on measures of social responsiveness (SRS-2), adaptive behavior (ABAS-3), executive functioning (BRIEF-A), quality of life (WHOQOL-BREF), transition readiness (TRS-A), coping self-efficacy (CSES), and emotion regulation (DERS-SF). Parents reported significant improvements in their perceptions of their child’s social responsiveness, adaptive behavior, and executive functioning, as well as increased transition readiness ratings. Notably, parents evinced a significant decrease in acculturative stress (RASI) and depressive symptoms (PHQ-9), however, …

Placental Polycyclic Aromatic Hydrocarbon (Pah) Levels Are Associated With Spontaneous Preterm Birth, Gwendolynn Hummel, Sohini Banerjee, Vasanta Putluri, Inaara Malick, Grace Johnson, Abu Hena Mostafa Kamal, Chandra Shekar R Ambati, Nagireddy Putluri, Lori Showalter, Cynthia D Shope, Joseph Hagan, Kjersti M Aagaard, Bhagavatula Moorthy, Melissa A Suter

Faculty, Staff and Students Publications

While the cause of preterm birth (PTB) (i.e., delivery before 37 weeks of gestation) is likely multifactorial, ambient exposure to environmental chemicals has been postulated to play a role in its etiology. Our prior studies of exposure to polycyclic aromatic hydrocarbons (PAHs) in pregnancy have shown an increased level of placental PAH-induced bulky DNA adducts with increasing levels of PAH exposures. In this investigation, we hypothesized that higher levels of placental PAHs would be associated with an increased risk of PTB. Using gas chromatography and mass spectrometry (GC-MS/MS), we measured levels of benzo(a)pyrene (BaP), benzo(b)fluoranthene (BbF) and dibenz(a,h)anthracene (DBA) from …

Surgeon Ergonomics While Performing Total Knee Arthroplasty, Cameron Dahman

Electronic Theses and Dissertations

One of the most prevalent hazards to orthopedic surgeons are musculoskeletal disorders with 97% of arthroplasty surgeons reporting procedural-related musculoskeletal pain and 66% of orthopedic surgeons reporting procedural-related musculoskeletal injury [1], [2], [3]. With the annual number of total knee arthroplasties (TKA) on the rise, orthopedic surgeons are taking on larger annual caseloads and retiring later in life [4], [5]. The goal of this study was to quantify postural demand for 11 discrete surgical steps of TKA to identify ergonomically unfavorable positions surgeons experience while operating. Four orthopedic surgeons performed TKA while their motions were recorded using marker-based motion capture. …

Developing Deep Learning Methods For Cognitive Impairment Detection Based On Non-Invasive Data, Muath Alsuhaibani

Electronic Theses and Dissertations

Cognitive impairment detection is on the rise to help reduce the burden of healthcare costs on institutions and individuals. Mild Cognitive Impairment (MCI) is an early stage of cognitive decline progressing to Alzheimer’s disease (AD) or AD-related Dementia (ADRD). Detecting the early stages of AD/ADRD is crucial for early interventions among older adults to mitigate cognitive decline over time. However, the current diagnostic methods are often costly and/or invasive, such as MRI and PET scans. Thus, the search for non-invasive and cost-effective screening tools for the early detection of cognitive impairment using speech, language, visual, and motor data is growing. …

Transgender Individuals’ Experiences Of Ruptures And Repairs In Group Psychotherapy, Gabrielle W. Kaufman

Electronic Theses and Dissertations

As the political climate across the United States worsens for transgender and gender diverse (TGD) individuals (Harmon, 2025), it has become increasingly important to attend to the mental health needs of this population (James et al., 2016). Group therapy is a widely used treatment modality that is often more accessible than individual therapy (Burlingame & Strauss, 2021) and provides unique interpersonal opportunities (Burlingame et al., 2016). While it is expected that TGD individuals face unique challenges in group therapy due to their gender identities (Chen et al., 2020), very little is actually known about the experiences of TGD individuals participating …

Food Insecurity, Diet And Health Outcomes In Pediatric Inflammatory Bowel Disease: A Pilot Study, Nicole Zeky, Alysse Baudier, Colleen Leblanc, Elizabeth Mcdonough, Sarah A. Dumas, Dedrick Moulton

School of Medicine Faculty Publications

Background/Objectives: Food insecurity (FI) is a well-defined factor in pediatric health outcomes and has been associated with lower diet quality. While poor diet quality has been linked to the rising prevalence of inflammatory bowel disease (IBD), little is known about the impact of FI on pediatric IBD. This pilot study explores the feasibility and potential impact of FI on dietary intake and clinical outcomes in children with newly diagnosed IBD. Methods: This pilot study included newly diagnosed IBD patients aged 5 to 18. FI screening was completed using the USDA 6-item and AAP 2-item screeners at diagnosis and 6 months. …

Using The R = Mc2 Heuristic To Assess Whole-Of-School Physical Activity Implementation In Elementary Schools: A Cross-Sectional Study, Derek W Craig, Kevin Lanza, Christopher D Pfledderer, Andjelka Pavlovic, Kempson Onadeko, Natalia I Heredia, Jizyah Injil, Laura F Defina, Timothy J Walker

Faculty, Staff and Student Publications

Background: Schools are recommended to use a whole-of-school (WOS) approach to promote physical activity opportunities before, during, and after school. Yet, the barriers and facilitators to implementing a WOS approach successfully are not well understood. The R = MC2 heuristic, which defines readiness for implementation as a combination of an organization's motivation and capacity to implement, can enhance our understanding of implementation in the school setting. This study examines associations between constructs from the R = MC2 heuristic and schools' implementation of a WOS approach.

Methods: We conducted a secondary analysis of cross-sectional data from U.S. elementary schools participating in …

Blood And Neuronal Extracellular Vesicle Mitochondrial Disruptions In Schizophrenia, A Ankeeta, Ashutosh Tripathi, Bindu Pillai, Yizhou Ma, Joshua J Chiappelli, Jessica N Jernberg, Keiko Kunitoki, Xiaoming Du, Si Gao, Bhim M Adhikari, Consuelo Walss-Bass, Giselli Scaini, Peter Kochunov, Anilkumar Pillai, L Elliot Hong

Faculty, Staff and Student Publications

The high energy demand of the human brain obligates robust mitochondrial energy metabolism, while mitochondrial dysfunctions have been linked to neuropsychiatric disorders, including schizophrenia spectrum disorders (SSD). However, in vivo assessments that can directly inform brain mitochondrial functioning and its etiopathophysiological path to SSD remain difficult to obtain. We hypothesized that system and brain mitochondrial dysfunctions in SSD may be indexed by elevated cell-free mitochondrial DNA (cf-mtDNA) levels in the blood and in neuronal extracellular vesicles (nEVs). We also explored if these mtDNA marker elevations were associated with brain metabolites as measured by magnetic resonance spectroscopy (MRS). We examined blood …

Predicting Regional Cerebral Blood Flow Using Voxel-Wise Resting-State Functional Mri, Hongjie Ke, Bhim M Adhikari, Yezhi Pan, David B Keator, Daniel Amen, Si Gao, Yizhou Ma, Paul M Thompson, Neda Jahanshad, Jessica A Turner, Theo G M Van Erp, Mohammed R Milad, Jair C Soares, Vince D Calhoun, Juergen Dukart, L Elliot Hong, Tianzhou Ma, Peter Kochunov

Faculty, Staff and Student Publications

Background: Regional cerebral blood flow (rCBF) is a putative biomarker for neuropsychiatric disorders, including major depressive disorder (MDD).

Methods: Here, we show that rCBF can be predicted from resting-state functional MRI (rsfMRI) at the voxel level while correcting for partial volume averaging (PVA) artifacts. Cortical patterns of MDD-related CBF differences decoded from rsfMRI using a PVA-corrected approach showed excellent agreement with CBF measured using single-photon emission computed tomography (SPECT) and arterial spin labeling (ASL). A support vector machine algorithm was trained to decode cortical voxel-wise CBF from temporal and power-spectral features of voxel-level rsfMRI time series while accounting for PVA. …

The Journey Of Psychotherapy: Understanding Therapeutic Technique Through Ultralight Thru Hiking, Emma Bossier

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper explores several principles of ultralight backpacking as metaphors for developing one’s therapeutic technique. The tenets of ultralight thru hiking, when interpreted through a clinical lens, offer early clinicians insight into the importance of moving through fear and leaning into exploration, discomfort, and authenticity while on the journey of becoming a therapist. The experiences of numerous thru hikers are synthesized into five principles: Don’t Pack Your Fears, Be Present for the Journey, Slow Simplicity, Embrace the Suck (and The Stink), and Trail Legs. These principles do not define ultralight as carefreeness but rather offer a metaphor for the careful …

A Clinical Pathway For Differential Diagnosis Of Adhd Vs Trauma: Early Childhood Recognition And Intervention, Maria Neiers

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Distinguishing Attention-Deficit/Hyperactivity Disorder (ADHD) from Complex Posttraumatic Stress Disorder (C-PTSD) presents significant diagnostic challenges due to overlapping symptom presentations, shared neurobiological impacts, and frequent comorbidities. This paper explores the nuanced clinical differentiation between ADHD and C-PTSD, and other trauma disorders, in pediatric populations, emphasizing the importance of trauma-informed assessment, early identification, and integrative clinical reasoning. The discussion highlights how structured diagnostic reasoning can reduce uncertainty, enhance diagnostic clarity, and support effective treatment planning. As a central contribution, this paper introduces an original clinical reasoning flowchart and a case conceptualization to illustrate its practical application in real-world diagnostic dilemmas. The need …

Applying Contextual Behavioral Science To Address Addictions In Monsters, Chase Hollander

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The dominant essentialist paradigm in addiction treatment often conceptualizes addiction as a curse or plague which seizes the individual afflicted by it. Such views are reinforced by neurobiological interventions like Medication-Assisted Treatment (MAT). While MAT can reduce cravings and withdrawal symptoms, its long-term efficacy is mixed, and its emphasis on abstinence as a primary outcome limits its scope. Addiction is a multifaceted phenomenon shaped by physiological, psychological, social, and systemic factors—including stigma, moral judgment, and structural oppression. Essentialist approaches frequently pathologize individuals and obscure these broader influences. In contrast, contextual behavioral sciences and therapies aligned with functional contextualism such as …

Proposed Theoretical Model Of Pediatric Onset Multiple Sclerosis And Restrictive Eating Behaviors, Anna L. Smith

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Multiple Sclerosis (MS), a chronic, demyelinating, autoimmune disease that causes an array of physical and cognitive symptomatology, is commonly diagnosed in adulthood. Pediatric Onset Multiple Sclerosis (POMS) is characterized by diagnosis of the disease before age 18 and accounts for about 5% of MS cases. While there is a growing body of literature examining the impact of adult-onset multiple sclerosis on psychosocial functioning, research specifically addressing POMS remains limited. Moreover, there is a notable gap in the literature regarding the risk of eating disorders among individuals with POMS. This paper will explore a constellation of potential risk factors that may …

Supporting Healthy Siblings In Pediatric Cancer: Advancing Relational Interventions To Heal Invisible Wounds, Kristen K. Wederski

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Healthy siblings of children diagnosed with cancer occupy a uniquely vulnerable position within the pediatric oncology landscape. Individuals within this population often demonstrate significant emotional distress and can experience long-term psychological challenges. Despite their risk, healthy siblings remain under-researched and under-supported compared to pediatric patients and caregivers. Existing interventions tend to prioritize individual coping skills and psychoeducation and often overlook the critical relational dynamics that shape healthy siblings' psychological adjustment. Grounded in systematic and relational theories, this paper proposes a paradigm shift toward relationally focused interventions that strengthen the caregiver-sibling bond as a core mechanism of change to foster resilience …