Medicine and Health Sciences Commons^™

The Exploration Of Self-Management Support Programs For African American Adults Ages 18 To 75 In Harnett County, North Carolina, Moya Camille Henny

Doctoral Dissertations and Projects

This phenomenological study explored the health needs and self-management experiences of African American adults ages 18 to 75 living with type 2 diabetes and hypertension in Harnett County, North Carolina. The study aimed to understand how self-management support programs could be better tailored to meet the cultural, social, and behavioral needs of this population, who face a disproportionate burden of these chronic conditions. Guided by Critical Care Theory, Chronic Care Model, and Social Cognitive Theory, the research examined how systemic inequalities, community resources, and personal beliefs shaped participants’ ability to manage their health. Data were collected through in-depth, semi-structured interviews …

Development Of A Physiologically Based Pharmacokinetic (Pbpk) Model And Evaluation Of Antioxidant Capacity For Polypodium Leucotomos Extract, Christopher L. Basel

Doctoral Dissertations and Projects

The purpose of this study was to develop an equation to calculate the approximate concentration of active components in orally administered Polypodium leucotomos fern extract (PLE) and to develop physiologically based pharmacokinetic (PBPK) models for an active component of PLE or its metabolite to address the need for human pharmacokinetics (PK). Model differences based on ethnic groups were also investigated. This was a quantitative study using secondary data. It has been estimated that skin cancers account for approximately 40% of all human cancers and that approximately 13,000 people will die of skin cancer in 2024. People with darker skin experience …

Exploring The Impact Of Foot Overpronation On Gluteus Medius Activation In Recreational Runners: A Biomechanical Analysis, Austin D. Stroeh

Doctoral Dissertations and Projects

Pes planus foot type and gluteus medius (GMed) dysfunction are independently considered risk factors in developing several overuse running-related injuries because they propagate kinematic and kinetic changes in the leg during the gait cycle. While both produce similar kinesiological actions, research on the relationship between foot type and GMed activation in running is limited. The purpose of this study was to investigate the relationship between pes planus and pes rectus foot types and their association with GMed activity during running gait in recreational endurance runners. 47 recreational endurance-based runners running approximately 5-15 miles weekly for at least 6 months with …

Biomarkers In Renal Cell Carcinoma: A Systematic Review And Immunohistochemical Validation Study, Brett Berezowski, Robert Boothe, Billy Chaplin, Sharon J Del Vecchio, Zakariya Fares, Tyrone L R Humphries, Keng Lim Ng, Taylor Noonan, Hemamali Samaratunga, Aaron Urquhart, David A Vesey, Simon T Wood, Glenda C Gobe, Robert J Ellis

Faculty, Staff and Student Publications

The worldwide incidence of renal cell carcinoma (RCC) rose by 22% between 2012 and 2022. In Australia, RCC accounted for 2.8% of all cancer diagnoses and contributing to 1.8% of cancer-related deaths. Identification of RCC biomarkers may aid in diagnosis and management. Methods: A systematic review of immunohistochemical markers of RCC studies published between 1990 and 2019 was undertaken to select candidate biomarkers of RCC. Immunohistochemical staining of 73 clear cell RCC tumors and paired normal tissue was undertaken using selected markers. Semi-quantitative and quantitative analysis of staining intensity between paired samples was undertaken to evaluate utility as potential …

Implementation Of A Pre-Discharge Screening Program For Fracture Prevention, Sarah J. Russell

Master's Projects and Capstones

Problem Osteoporotic fractures are a major public health concern in the United States; 1 in 2 women and 1 in 4 -5 men will experience a fracture due to low bone density. Despite established clinical guidelines, many patients in this managed care health system do not receive timely osteoporosis screening or treatment, placing them at increased risk for costly readmissions averaging $50,000 per hospitalization especially among those discharged to skilled nursing facilities.

Context The improvement project targeted patients admitted with fractures and integrated DEXA scanning during the acute care stay to avoid delays in diagnosis and bisphosphonate therapy. Barriers included …

Red Room Redesign: Improving Operating Room Workflow For Urgent And Emergency Procedures, Hipolito Jamilan

Master's Projects and Capstones

Problem: Limited operating room (OR) availability is a significant challenge in many healthcare facilities. Overbooked or understaffed ORs can lead to delays in surgical procedures, which are particularly detrimental in urgent and emergency situations (Cholewa et al., 2024). The OR is among the costliest areas in a hospital; it is essential to improve efficiency in surgical throughput to deliver timely care for urgent and emergent cases, enhance patient outcomes, and manage healthcare costs effectively.

Context: The microsystem for this project is a Northern California OR that handles a high volume of surgical procedures. There is a dedicated red room for …

Preventing Hospital-Acquired Pneumonia In Non-Ventilated Oncology Patients, Carmi Villanueva

Master's Projects and Capstones

Problem - Hospital Acquired Pneumonia (HAP) remains the leading cause of death among hospital-acquired infections, underscoring the need for effective prevention strategies. Between October 2023-2024, six HAP infections occurred in non-ventilated oncology patients. A routine audit revealed zero adherence to the existing evidenced based ROUTE “bundle” to prevent HAP. ROUTE indicates Respiratory care (R), Oral Care (O), Up in bed (U), Tube care (T), Education (E).

Context – In a 325-bed hospital in Northern California, a 26-bed telemetry/oncology microsystem serves a mixed population including immunocompromised, non-ventilated oncology patients at higher risk for developing HAP. A quality improvement project was initiated …

Does The Addition Of Digital Care Along With Standard Chemotherapy Teaching That Is Provided At City Of Hope Increase Patient Satisfaction And Confidence?, Sheridan Wendy Lomeli, Brooklin Mize, Tatyana Franco, Daniela Naemi

Master's Projects and Capstones

Chemotherapy education is critical when it comes to improving patient confidence, reducing anxiety, and enhancing symptom management. However, there is still a variety of patients who begin their infusion therapy with a limited understanding of what to expect. This quality improvement project was conducted at an outpatient infusion center, exploring whether combining traditional nurse-led chemotherapy education calls with a digital care platform would enhance patient satisfaction and confidence compared to standard care alone. A total of forty-one adult oncology patients participated in an educational survey at the end of each follow-up phone call, which was completed three days after their …

Drug Development Studies Supporting Zileuton As A Parenteral Adjuvant To Attenuate Antibiotic-Associated Nephrotoxicity, Cole S Hudson, James E Smith, Linh T Vuong, Nicholas S Teran, Nazanin Pouya, David Sheikh-Hamad, Xinli Liu, Shama Kajiji, Vincent H Tam

Faculty, Staff and Students Publications

Glycopeptide, polymyxin, and aminoglycoside antibiotics are among the most commonly used agents to treat drug-resistant bacterial infections; however, their clinical use is hindered by nephrotoxicity. We previously reported that zileuton has the potential to attenuate antibiotic-associated nephrotoxicity in an animal model. Here, we further report the development of a parenteral formulation and exploration of dosing strategies for zileuton. The solubility, stability, and multi-dose safety of two zileuton formulations were evaluated. Zileuton serum and renal tissue pharmacokinetics were evaluated after a single dose and compared to steady state after 10 days. Different dosing strategies of zileuton to attenuate vancomycin-, polymyxin B-, …

Mri-Based Radiomics For Outcome Stratification In Pediatric Osteosarcoma, Esther Ngan, Dolores Mullikin, Ashok J Theruvath, Ananth V Annapragada, Ketan B Ghaghada, Andras A Heczey, Zbigniew A Starosolski

Faculty, Staff and Students Publications

Background/Objectives: Osteosarcoma (OS) is the most common malignant bone tumor in children and adolescents; the survival rate is as low as 24%. Accurate prediction of clinical outcomes remains a challenge due to tumor heterogeneity and the complexity of pediatric cases. This study aims to improve predictions of progressive disease, therapy response, relapse, and survival in pediatric OS using MRI-based radiomics and machine learning methods. \

Methods: Pre-treatment contrast-enhanced coronal T1-weighted MR scans were collected from 63 pediatric OS patients, with an additional nine external cases used for validation. Three strategies were considered for target region segmentation (whole-tumor, tumor …

Iodine-Promoted Oxidative Cross-Coupling For The Synthesis Of (E)-2-(3-Oxo-3-Phenylprop-1-En-1-Yl)-3-Phenylquinazolin-4(3 H)-One Via C-H Activation: Development Of Synthetic Tlx Agonists, Lingaiah Maram, Puhan Zhao, Thomas Koelblen, Lamees Hegazy, Thomas P Burris, Bahaa Elgendy

2020-Current year OA Pubs

We report the development of an efficient iodine-promoted oxidative cross-coupling reaction for the synthesis of (

Applying The Practical, Robust, Implementation And Sustainability Model (Prism) To A Community-Based Youth Participatory Action Research Program, Nicholas Szoko, Tyia K Wilson, Ebonie Slade, Ti'yanna Risher, Marquise Wheeler, Elizabeth Miller, Alison J Culyba

2020-Current year OA Pubs

BACKGROUND: Youth participatory action research (YPAR) represents an empowerment-based process in which youth identify and address issues in their schools and communities. YPAR has been applied in diverse settings, but evaluations of YPAR implementations using an implementation and dissemination science (IDS) framework are limited. Our goal was to use the Practical, Robust, Implementation & Sustainability Model (PRISM) to evaluate a multisite community-based YPAR program.

METHODS: We identified three community sites to implement Youth Leadership in Action (YLIA+), an eight session YPAR intervention. Any youth aged 13 and older was eligible to participate. Guided by PRISM, we collected data using: (1) …

Review Of Alcohol Use Among Aboriginal And Torres Strait Islander Peoples: Patterns, Impacts And Community-Led Responses, Teagan J. Weatherall, Ks Kylie Lee, Annalee Stearne, Monika Dzidowska, Nicole Hewlett, Lynette Bullen, Taleah Reynolds, Summer Loggins, James H. Conigrave

Journal of the Australian Indigenous HealthInfoNet

This review provides an overview of alcohol use among Aboriginal and Torres Strait Islander peoples using the latest research available. It has been designed to update the evidence published since the previous review conducted in 2018 on this topic (Review of the harmful use of alcohol among Aboriginal and Torres Strait Islander people by Prof Dennis Gray, Dr Annalee Stearne and colleagues) (Gray et al., 2018).

In this updated review, we discuss the historical context and scope of alcohol use among Aboriginal and Torres Strait Islander peoples, impacts on individuals and whole communities, relevant national policies and strategies, present …

Saudi Heart Association Position Statement On Troponin Use For Cardiovascular Risk Screening In Asymptomatic Populations, Waleed Alhabeeb, Abdulhalim Jamal Kinsara, Fahad Alnouri, Hussein Alamri, Owayed Alshammeri, Turki Albacker, Khalid Al Faraidy, Wail , Alkashkari, Shukri Alsaif, Mohammed Balghith, Anwar Abdullah Borai

Journal of the Saudi Heart Association

Background: Cardiovascular disease (CVD) remains the leading cause of death and disability globally. In Saudi Arabia, the burden of CVD is exceptionally high, with age-standardized mortality and prevalence rates that far exceed global averages. The current CVD risk prediction tools have several limitations, and those classified as low to intermediate risk still experience cardiovascular events, underscoring the urgent need to address CVD through effective screening and prevention strategies.

Methods: A panel of Saudi experts reviewed evidence on the use of high-sensitivity cardiac troponin (hs-cTn) to enhance cardiovascular risk assessment among seemingly healthy individuals. Consensus recommendations tailored to the Saudi context …

Reframing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (Me/Cfs): Biological Basis Of Disease And Recommendations For Supporting Patients., Priya Agarwal, Kenneth J Friedman

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a worldwide challenge. There are an estimated 17-24 million patients worldwide, with an estimated 60 percent or more who have not been diagnosed. Without a known cure, no specific curative medication, disability lasting years to being life-long, and disagreement among healthcare providers as to how to most appropriately treat these patients, ME/CFS patients are in need of assistance. Appropriate healthcare provider education would increase the percentage of patients diagnosed and treated; however, in-school healthcare provider education is limited. To address the latter issue, the New Jersey Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Association (NJME/CFSA) has developed …

Effect Of Gait Retraining In Minimalist Footwear Or Barefoot On Running Footstrike And Cadence: A Systematic Review, John Desrochers, Alexis Chow, David Rubin, Altamash Raja

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Gait retraining programs take a structured approach to altering a runner's gait, often with the goal of decreasing footstrike angle and increasing cadence, as these outcomes have been correlated to a reduced rate of injury and optimal performance. Minimalist footwear, or running barefoot entirely, has been explored as a tool for gait adjustment in runners, largely due to the increased feedback from ground forces experienced by the runner. This systematic review aims to decipher the effect of gait retraining with minimalist footwear or barefoot running on footstrike angle and cadence. The comparison group included runners that underwent gait retraining in …

Enhancing Caregiver Support: Tailored Education For Families Of Veterans With Polytrauma, Riley J. Pullen

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Addressing The Occupational Therapy Faculty Shortage: A Capstone Experience In Academic Administration At Nova Southeastern University, Tiesha N. Henley

Department of Occupational Therapy Entry-Level Capstone Projects

The project aimed to address the critical shortage of occupational therapy faculty by understanding and mitigating factors that contribute to this shortage, ultimately strengthening recruitment pipelines and supporting long-term faculty development within a graduate-level occupational therapy program. I developed a pamphlet outlining concrete resources and strategies to attract and retain qualified educators. Additionally, I engaged in the daily responsibilities of a full-time OT faculty member by contributing to course instruction and creating graduate-level learning materials.

Occupational Therapy’S Impact On Heart Failure Readmission Rates In The Acute Care Setting, Morgan Breen

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

The Role Of Posture And Balance In Fall Prevention For Older Adults: Implications For Daily Living Activities, Julia L. Otoski

Department of Occupational Therapy Entry-Level Capstone Projects

The purpose of this doctoral capstone project was to develop and implement a falls prevention program within a community-based organization to help reduce fall risk and maintain independence in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), among older adults. The project focused on assessing fall risk using evidence-based tools, including the Timed Up and Go (TUG) and 4-Stage Balance Test, which identified all participants as being at risk for falls. Individualized treatment sessions were then implemented, emphasizing balance, posture, and the safe performance of ADLs and IADLs. The Otago Exercise Program was adopted and integrated …

Occupation-Based Foster Caregiver Toolkit, Jane L. Donat

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

The Impact Of Socio-Emotional And Provider Support On Hiv Testing In Southern United States, Ijeoma Onyinyechi Nwazuruokeh

Walden Dissertations and Doctoral Studies

HIV was first diagnosed over 40 years ago in the United States; however, HIV remains an epidemic. An understanding of how socio-emotional support, social isolation, and support from an individual's provider influence HIV testing in the Southern United States can be a key to increasing testing rates and ultimately reducing the incidence and prevalence of HIV in the Southern United States. The purpose of this non-experimental quantitative study was to examine the relationship between HIV testing, socio-emotional support, and social isolation, and how these variables are further moderated by an individual having provider support in the Southern United States. The …

Establishing Operational Foundations In A Faculty-Led Clinic: Workflow Design, Role Development, And Service Planning, Rebecca Wensmann

DNP Projects

A Central Minnesota College, in collaboration with local community partners, sought to provide access to medical care for an underserved population while offering opportunities for graduate and undergraduate nursing education. They achieved this by establishing a faculty-led clinic in a high-poverty level area in Central Minnesota, where nearly 7% of the population under the age of 65 lacked health insurance (U.S. Census Bureau, 2024). Research was completed on clinic workflows and processes, as well as many interviews with clinics and community members throughout Minnesota. With this data, a clinic workflow, job description list, and services offered were created. This information …

A Dosimetric Comparison Of 6 Mv And 10 Mv Beam Energies For Adrenal Sbrt, Mariel A. Lewis

Masters Projects

Purpose This study aims to compare the dosimetric performance of 6 MV and 10 MV photon beam energies in stereotactic body radiation therapy (SBRT) for adrenal tumors. Given the anatomical complexity of the adrenal region and its proximity to critical organs, optimizing beam energy selection is essential to maximize tumor control while minimizing normal tissue toxicity. Methods and Materials A retrospective study analysis was conducted using treatment plans from ten patients with adrenal metastases. Each case was planned with volumetric modulated arc therapy (VMAT) using both 6 MV and 10 MV beam energies. Dosimetric metrics assessed included target coverage, conformity …

Staff Education To Improve Staff Knowledge On Preeclampsia, Doris Wanmban Fombo

Walden Dissertations and Doctoral Studies

Preeclampsia is a disorder that usually develops after 20 weeks of pregnancy and can lead to serious adverse outcomes or death for the mother and fetus if not promptly diagnosed and managed. Hence, a staff education project was designed and implemented to enhance staff knowledge of preeclampsia. The practice problem was limited staff knowledge of preeclampsia a pregnancy complication that can affect both the mother and fetus. The practice-focused question explored whether a staff education project on preeclampsia affected office staff knowledge. The purpose of the project was to develop and implement a staff education program to improve staff knowledge …

Comparison Of 10 Mv Flattening Filter And Flattening Filter-Free Volumetric Modulated Art Therapy (Vmat) Radiation Plans In Partial Breast Irradiation: Evaluating Dose Sparing To The Left Anterior Descending Coronary Artery, Jillian Beliew

Masters Projects

Importance Minimizing radiation dose to the heart, particularly the left anterior descending coronary artery (LAD), is essential in left-sided partial breast irradiation (PBI). Flattening filter-free (FFF) beam configurations may improve organ-at-risk (OAR) sparing and treatment efficiency.

Objective To compare dosimetric outcomes between 10 MV flattening filter (FF) and 10 MV flattening filter-free (FFF) VMAT plans in patients receiving accelerated partial breast irradiation (APBI), focusing on LAD dose sparing.

Design, Setting, and Participants This retrospective dosimetric study included 10 patients with early-stage, left-sided breast cancer. Each patient had two VMAT plans generated using identical geometry and constraints in Eclipse v16.01: one …

Implementation Of A Standardized Onboarding Program, Sarah J. Wall

Doctor of Nursing Practice Final Project Abstract

Purpose: To evaluate the impact of a standardized onboarding program on Advanced Practice Provider (APP) retention and productivity within an academic department.

Background: High APP turnover in specialized settings disrupts care and leads to financial losses. Previously, onboarding lacked structure, leading to early attrition and delayed productivity. A 24-week phased, competency-based orientation program was developed to improve retention, job satisfaction, and clinical performance.

Methods: The program, implemented in April 2024, included clinical precepting, didactic modules, and mentorship. Retention and Relative Value Units (RVUs) were measured before and after implementation. Qualitative data was collected through mentorship surveys and APP focus groups. …

Nuak Kinases: Signaling Mechanisms And Therapeutic Applications, Nicole M. Cullen, Peter Rosston, Bakhtawar Tufail, Anne E. D'Armond, Ayushi Patel, Dara H. Khosravi, Bridgette M. Collins-Burow, Van T. Hoang, Elizabeth C. Martin, David H. Drewry, Matthew E. Burow, Suresh K. Alahari

School of Medicine Faculty Publications

The novel (nua) kinases 1 and 2 are two of 12 AMP-activated protein–related kinases whose signaling pathways are involved in cancer progression, as well as neurologic, fibrotic, and inflammatory diseases. Currently, there are 80 Food and Drug Administration-approved kinase inhibitors which target roughly 24 of the 500+ known human kinases, leaving most kinases underexplored, including NUAK1 and NUAK2. Thus, there is a critical need for selective inhibition of NUAK1 and NUAK2 signaling. Here, we review the protein structure, known upstream regulators and downstream targets, and expression profiles of NUAK1 and NUAK2 in cancerous compared to noncancerous tissue. We also delineate …

Cone Vs. Vmat Srs Planning For Dual Targets: Effects Of Target Size, Separation, And Isocenter Displacement, Hannah Angeli

Masters Projects

Objective: This study compares cone-based and volumetric modulated arc therapy (VMAT) stereotactic radiosurgery (SRS) planning for dual intracranial targets, examining the effects of target size, inter-target separation, and isocenter displacement on dosimetric outcomes. Methods: Plans were generated for spherical targets of 8.0 mm, 10.0 mm, and 12.0 mm diameters using both VMAT and cone-based techniques with single-isocenter configurations. Key metrics including maximum dose, volumes of normal brain receiving 12 Gy and 50% of the prescription dose (V12Gy, V50%), high-dose volume (V100%), gradient index, and target coverage were evaluated. Results: Cone-based plans demonstrated superior dose conformity and reduced normal tissue exposure …

Increased Fungal Burden In The Gastrointestinal Tract Of Brain-Dead Organ Donors, Erika J Nachman, Colleen K Ardis, A Kyle B Ardis, Javier Nieto, Madeline M Bresson, Clare M Robertson, Maggie N Seale, Nora M Villafuerte, Zhe Lyu, Eva C Preisner, Heather A Danhof, Sara C Di Rienzi, Yolanda T Becker, Robert A Britton

Faculty, Staff and Students Publications

Approximately 3% of organ transplant recipients will be diagnosed with an invasive fungal infection (IFI), with 10%-47% being fatal. The source of IFI is typically not known, but Candida spp. cause the majority of IFI cases. We obtained intestines from two types of organ donors, brain-dead (BD) (n = 7) and donation after circulatory death (DCD) (n = 5), to sample microbes from the mucosal surface and the lumen. BD donors were parenterally fed and treated with corticosteroids in the days before procurement, whereas DCD donors were enterally fed and not given corticosteroids. We found fungi present in …