Medicine and Health Sciences Commons^™

Interprofessional Palliative Care: Implementation Of What Matters Most, Nicole Moran, Madeleine A. Keppel, Madison E. Markey, Alicia Naccarato, Kristen Cumming, Lori Boright

Oncology Rehabilitation in Practice

Palliative care (PC) is defined as specialized care plans for people with serious, life-limiting illnesses, emphasizing comfort care and management of complex symptoms. Rehabilitation professionals such as physical and occupational therapists have unique skills and perspectives towards managing and contributing to this population though are often under-represented on interprofessional palliative care teams. The Guide to What Matters (The Guide) was created upon recognition of the need for an increased presence of rehabilitation services in PC.

Severe Chemotherapy-Induced Peripheral Neuropathy Presenting With Paraplegic Symptoms: A Rehabilitation Case Report, Cecilia Hammond, Elizabeth Campione

Oncology Rehabilitation in Practice

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is characterized by sensory and/or motor symptoms in distal extremities starting within 24 hours of receiving chemotherapy and can potentially last for years. Management of CIPN may include medication (i.e. Duloxetine) and physical therapy (PT). The purpose of this case report is to describe the rehabilitation process and adjustments to the plan of care for a patient with severe CIPN. This case underscores the importance of a proper diagnosis and the need for research to develop evidence-based guidelines for PT interventions for non-ambulatory patients with severe CIPN.

Case description: The patient was a 53-year-old female …

Clinical Management Of A Patient With Lipo-Lymphedema Using Adjustable Compression Wraps: A Case Report, Candace Alexander, Claire Davies, Martha Monroe

Oncology Rehabilitation in Practice

Background: Lipo-lymphedema indicates the presence of lipedema and lymphedema. Compression is used to achieve volume reduction and assist with long-term management. Adjustable compression wraps (ACWs) have been used in lymphedema care to replace traditional compression bandaging and facilitate patient self-care.

Case Description: This patient reported issues with bilateral leg edema for more than 35 years. She reported poor experiences with compression garments and had tried self-management with a compression pump only. She was referred for lymphedema care when her malfunctioning compression pump enabled her edema to worsen.

Assessment and Treatment: Lipedema may have been present for many years …

Recurring Axillary Web Syndrome (Aws) Following A Strenuous Increase In Upper Extremity Strengthening Exercise: A Case Report, David Locke, Linda Koehler

Oncology Rehabilitation in Practice

Background: Axillary web syndrome (AWS) refers to cords presenting in the axilla, upper extremity, and lateral chest wall after breast cancer surgery with axillary lymph node dissection. This unique case demonstrates the onset of AWS 2 weeks post-operatively with recurrence at 4 and 21 months, following rapid progression in upper extremity strengthening exercise.

Case Description: A 33-year-old athletic woman with invasive ductal carcinoma underwent a left mastectomy with sentinel node biopsy (6 nodes removed). Cord development occurred at 2 weeks after surgery. She sought physiotherapy consisting of AWS education, myofascial pin-and-stretch techniques applied to the cord in end-range abduction, a …

Physical Therapy Management Of An Adult Patient Diagnosed With Spindle Cell Rhabdomyosarcoma: A Case Report, Jennifer Carrano

Oncology Rehabilitation in Practice

Background: Rhabdomyosarcoma (RMS) is a rare soft tissue sarcoma that primarily affects children and adolescents. Adult RMS is uncommon and associated with poorer prognosis and limited evidence to guide rehabilitation.

Case Description: A 29-year-old male presented with right facial pain, hearing loss, tinnitus, and right facial and tongue paresthesia. Imaging and biopsy revealed spindle cell RMS of the right masticator space. He had no cancer-related family history, did not smoke, and used alcohol occasionally. Treatment included neoadjuvant chemotherapy, major oncologic resection with scapular free flap reconstruction, and adjuvant radiation. He was referred to outpatient physical therapy with trismus, restricted …

Navigating Care In Cancer: Aligning Rehabilitation And Exercise To Support Patients, Christopher M. Wilson

Oncology Rehabilitation in Practice

The growing evidence base supporting both exercise oncology and cancer rehabilitation highlights their complementary roles across the cancer continuum. Research consistently demonstrates that physical activity improves physical function, fatigue, quality of life, and survival, while rehabilitation addresses impairments and restores participation in meaningful activities. Despite these advances, current care models often lack coordination, resulting in fragmented services, inappropriate referrals, and missed opportunities for optimal patient outcomes. Some individuals are directed to exercise programs without adequate screening for underlying impairments, while others may receive rehabilitation services when supervised, independent or community-based activity would suffice.

To address these gaps, there is a …

Editorial Board Message: About This Issue, Bryan A. Spinelli

Oncology Rehabilitation in Practice

Bryan Spinelli provides a summary of the contents of the issue.

Cover And Front Matter, Volume 3, Issue 1

Oncology Rehabilitation in Practice

Cover and front matter, Volume 3, Issue 1

Dementia Detection In Low-Resource Languages: Evaluating Translation-Assisted Transfer Learning For Multilingual Clinical Assessment, Kylar A. Deloach

Honors Theses

Alzheimer's disease (AD) is a growing global health concern, with millions of people affected worldwide and cases expected to rise significantly in the coming decades. Early detection is critical for patient treatment and care, and recent advances in natural language processing (NLP) have shown promise in identifying linguistic markers associated with AD. However, most existing work has focused on English, leaving speakers of other languages with limited access to such tools. This study investigates how effective AD detection models trained on English data are at transferring to Greek, a low-resource language with limited dementia-related speech data available. We propose a …

The Role Of Dollar Store Proliferation In Influencing Diabetes And Obesity Rates In West Virginia, Kelli L. Keith

Walden Dissertations and Doctoral Studies

Dollar stores are the fastest growing food retail format and are highly concentrated in rural, low-income communities including West Virginia, where diabetes and obesity prevalence rank among the highest in the United States. Although these retailers increase physical access to food, concerns remain about their limited healthier food options and potential contribution to chronic disease disparities. Guided by the socioecological model, this three-manuscript dissertation examined how dollar store density and healthier food availability related to county-level diabetes and obesity prevalence in West Virginia. Manuscript 1 used a cross-sectional ecological design with all 55 West Virginia counties, using data from USDA, …

Ai- Ready Assignments: Using Infographics To Translate Pedagogy Into, Kim Nehls

UNLV Best Teaching Practices Expo

I developed an AI teaching infographic assignment in a doctoral-level Seminar in College Teaching (EDH 780) that requires students to design their own original course assignment for any course that meaningfully integrates AI, and then they communicate the assignment visually through an infographic.

Perceptions Of Instructional Accommodations Among Nursing Students With Information Processing Disorder, Imaobong Aliyu

Walden Dissertations and Doctoral Studies

Instructional accommodations in nursing education often emphasize testing adjustments, while classroom-based instructional support for students with information processing challenges remains underexamined. This descriptive qualitative study explored pre-licensure nursing students’ perceptions of instructional accommodations for students with information processing disorders in Southern California. Guided by humanistic learning theory, the study addressed the research question: What are the perceptions of instructional accommodations in the classroom setting among pre-licensure nursing students with information processing disorders? Seven pre-licensure nursing students participated in semistructured Zoom interviews. Data were analyzed using an inductive process consistent with Saldaña’s analytic approach. Analysis revealed one overarching theme- Instructional accommodations …

Optimizing The Charge Nurse Role To Improve Workflow And Communication In A Community Living Center, Ndidi Kalu Ibe

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project evaluated the impact of optimizing the charge nurse role on workflow efficiency and communication within a Community Living Center. Identified practice gaps included role ambiguity, inconsistent delegation, and communication breakdowns, which contributed to delays in care and decreased staff satisfaction. An evidence-based approach was used to standardize charge nurse responsibilities, strengthen leadership practices, and introduce structured communication processes. The project demonstrated that improving role clarity and leadership consistency supports more effective delegation, enhances team communication, and improves care coordination. Outcome included increased staff engagement, improved workflow efficiency, and enhanced patient safety. This initiative …

The Correlation Of Beer, Wine, And Liquor Excise Tax With Alcohol-Impaired Traffic-Related Deaths In All 50 U.S. States, Paul R. Amigh Ii

Walden Dissertations and Doctoral Studies

Alcohol-impaired driving remains a persistent public health and safety problem in the United States, resulting in thousands of preventable deaths each year and substantial societal costs. Policymakers frequently rely on alcohol excise taxes as a deterrence strategy; however, evidence regarding the effectiveness of taxation alone in reducing alcohol-impaired traffic fatalities remains mixed. The purpose of this quantitative, correlational study, grounded in economic deterrence theory, was to assess relationships between state-level beer, wine, and liquor excise tax rates and alcohol-impaired traffic fatality rates per 100,000 population in 2019. A cross-sectional design used secondary data from all 50 U.S. states and the …

Staff Education On Structured Phq-9 Administration To Enhance Depression Screening In Outpatient Mental Health Care, Zekarias F. Abessa

Walden Dissertations and Doctoral Studies

In outpatient mental health settings, inconsistent use of the Patient Health Questionnaire-9 (PHQ-9) due to gaps in knowledge and lack of standardized training can lead to missed opportunities for early identification of depression and delayed treatment. Mental health nurses play a key role in screening and early intervention, underscoring the criticality of this role in practice. The Doctor of Nursing Practice (DNP) project explored whether a structured PHQ-9 staff education program could improve staff knowledge compared to baseline practice. The project involved using an intervention-based quality improvement design to enhance staff knowledge of administering and interpreting the PHQ-9 screening tool. …

Predicting Epileptic Seizures From Eeg Signals Using Machine Learning, Hamzah Luqman, Galal M Binmakhashen, Hanan Alali, Marwa Alsleebi, Hamdi A. Al-Jamimi, Motaz Alfarraj, Shahid Bashir, Brent Hedgcock, Ali Mir, Raidah Albaradie

Neurosciences

Objective: To develop a machine learning-based model for predicting epileptic seizures by analyzing electroencephalogram (EEG) signals and classifying the interictal and preictal phases.

Methods: The EEG signals were analyzed in both the time and frequency domains using advanced feature extraction techniques. Three different machine learning approaches were employed, with special focus on long short-term memory (LSTM) networks. Features were extracted and classified to differentiate between seizure and non-seizure phases. The proposed models were evaluated using the publicly available CHB-MIT EEG dataset. The study was conducted between September 2022 and September 2024.

Results: Among the tested models, the LSTM-based approach using …

Epilepsy And Cluster C Personality Disorders: A Saudi Cross-Sectional Study, Mohammed A. Aljaffer, Ahmad H. Almadani, Ayedh H. Alghamdi, Mohammad N. Aljarba, Azzam A. Alotaibi, Mohammed A. Alorayyidh, Abdulaziz M. Alawwad, Rakan S. Alromayan, Faisal M. Alkhunein, Sohaila A. Alshimemeri, Bandar N. Aljafen

Neurosciences

Objective: Epilepsy is a neurological disorder with profound impacts on various aspects of life. It may lead to significant medical and psychiatric comorbidities, one of which is personality disorders (PDs). This study aims to assess the prevalence of Cluster C PDs among adult patients with epilepsy (PWE) at a tertiary care hospital in Riyadh, Saudi Arabia. Method: This cross-sectional study, conducted between January 2024 and April 2025, enroled 360 adult PWE using convenience sampling. The study tool included the Structured Clinical Interview for DSM Disorders criteria, along with additional demographic and epilepsy-related questions developed by the research team. Results: Cluster …

Quality Improvement Project: Impact Of An Escape Room Simulation Tool On Nursing Confidence, Farren M. Moore

Doctor of Nursing Practice Projects

This quality improvement project aims to address the need for innovative teaching strategies to meet the demands of licensure exams and the increasing complexity of patient care. Evidence supports simulation-based learning as an effective method to enhance critical thinking and clinical judgment; however, faculty members lack confidence in implementing innovative strategies in their courses. The purpose of this project is to determine whether a standardized escape room simulation tool would impact faculty’s self-confidence in developing and implementing simulation-based activities. Guided by the National League for Nursing (NLN) Jeffries Simulation Theory and Lewin’s Change Theory, the project evaluates the change in …

Current Landscape Of Mental Health Conversational Agents From A Trauma-Informed Care Lens: Scoping Review., Faye Kollig, Kira Voelker, Emily Ryan, Rachel Pfafman, Fayika Farhat Nova

Health Services and Informatics Research

BACKGROUND: Conversational agents (CAs) are increasingly used in mental health care to enhance access and engagement. However, their safe, ethical, and user-sensitive design remains a challenge. Despite growing attention to trauma-informed approaches in human-computer interaction, there is limited work on how the trauma-informed care (TIC) framework could be applied in the design of mental health CAs and no comprehensive synthesis to date.

OBJECTIVE: Guided by the Substance Abuse and Mental Health Services Administration's TIC framework, this scoping review explored how TIC principles (safety; trustworthiness and transparency; collaboration and mutuality; empowerment, voice, and choice; peer support; and cultural, historical, and gender …

Motivational Interviewing Vs. Educational Handouts For Caregiver Smoking Cessation In Pediatric Asthma Patients: A Scoping Review, Michael Stefano, Hannah Marsh, Tracy Mcclinton, Dnp, Aprn, Ag-Acnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Secondhand smoke exposure can significantly worsen asthma outcomes in pediatric patients, leading to increased exacerbations and healthcare utilization. Caregivers can play a critical role in reducing secondhand smoke exposure, however sustained smoking cessation can be challenging to achieve. Two powerful healthcare interventions to assist in caregiver smoking cessation include motivational interviewing and educational handouts, however their compared effectiveness has not yet been fully reviewed. This scoping review compared the effectiveness of motivational interviewing and educational handouts in promoting smoking cessation among caregivers of children hospitalized for asthma exacerbations over the course of 90 days.

Vo: The Vaccine Ontology, Jie Zheng, Asiyah Yu Lin, Anthony Huffman, Anna Maria Masci, Rebecca Racz, Guanming Wu, Kallan Roan, Edison Ong, Sirarat Sarntivijai, Joy Hu, Eliyas Asfaw, Hayleigh Kahn, Xingxian Li, Xumeng Zhang, Joshua Monickaraj, Nilufer Kosar, Jianfu Li, Warren Manuel, Rashmie Abeysinghe, Hasin Rehana, Benu Bansal, Yuanyi Pan, Jinjing Guo, Virginia He, Justin Song, Andrey I Seleznev, Katelyn Hur, Anna He, Alexander Davydov, Qi Yang, Anna Ostropolets, Randi Vita, Bjoern Peters, Alan Ruttenberg, Alexander D Diehl, Charles Tapley Hoyt, Paola Roncaglia, Rachael P Huntley, Richard H Scheuermann, Melanie Courtot, Thomas Todd, Samantha Sayers, Fang Chen, Xinna Li, Feng-Yu Yeh, Zuoshuang Xiang, Arzucan Ozgur, Patricia L Whetzel, Mark A Musen, Christopher J Mungall, Wolfgang W Leitner, Licong Cui, Lesley A Colby, Harry L T Mobley, Brian D Athey, Gilbert S Omenn, Lindsay G Cowell, Cui Tao, Junguk Hur, Barry Smith, Yongqun He

Faculty, Staff and Student Publications

Vaccines are widely used in both research and clinical settings. To facilitate FAIR data practices, we urgently need to standardize vaccine representation, integrate information across diverse vaccine types, and support computer-assisted reasoning. Accordingly, we have since 2007 developed the community-based Vaccine Ontology (VO), which aligns with the Basic Formal Ontology and adheres to OBO Foundry principles. VO ontologically models vaccines, vaccine components, vaccine immune responses, vaccine investigation studies and other vaccine-related topics. VO represents more than 10,000 vaccines targeting 289 infectious pathogens and cancers in humans and over 30 nonhuman animal species. VO provides mappings to external resources such as …

The Pressure Is On For Pediatric Primary Lymphedema (Ple): Guiding Future Occupational Therapy Clinicians To Address The Unmet Needs And Enhance Care At An Academic Health Center, Ginger A. Kohler

Post-Professional Occupational Therapy Doctorate - Innovations in OT Symposium: Transforming Possibilities into Practice

Objective: Pediatric primary lymphedema (PLE) in adolescents is a rare, chronic condition frequently associated with delayed diagnosis and limited healthcare provider awareness. The purpose of this capstone project was to enhance Entry‑Level Doctor of Occupational Therapy (OTD) Students’ knowledge of the characteristics, management strategies, and available resources for PLE in adolescents, while increasing awareness of the critical role of occupational therapists certified in lymphedema therapy.

Methods: A hybrid educational module consisting of two one‑hour sessions, one asynchronous and one in‑person, was developed and delivered to Residential Entry-Level OTD Students at the Medical University of South Carolina (MUSC). Module content included …

Cuidarte También Es Trabajar: Hábitos Saludables Para Una Vida Laboral Plena, Lady Carolina Díaz Jurado, Francisco Javier Laguna Polanía

Ciencias de la Salud

El sedentarismo se ha convertido en un problema recurrente en la salud, especialmente en el ámbito laboral donde predomina la ausencia de actividad física prolongada. Diversos estudios indican que pasar mucho tiempo sentado aumenta notablemente las probabilidades de desarrollar enfermedades cardíacas, metabólicas y del sistema musculoesquelético. Ante esta problemática, surge esta publicación a modo de guía práctica y educativa sobre cómo implementar, de forma segura y progresiva, rutinas de HIIT y MISS, basada en el macroproyecto de investigación “Entrenamiento HIIT vs MISS, una mirada desde la salud ocupacional y los efectos cardiovasculares dirigido al personal administrativo de la Universidad de …

Applying Lean Six Sigma To Optimize Pediatric Liver Transplant Workflows: An Investigational Quality Improvement Initiative And Process Improvement Framework, Sarah E. Auletta

Online/Hybrid MPH Integrative Learning Experience (capstone projects)

For children with end-stage liver disease, liver transplantation is the only cure. While organ scarcity is a national challenge, internal pre-listing processes remain within an institution's control. This quality improvement initiative applied Lean Six Sigma and mixed-methods process mapping to the pediatric deceased donor liver transplant pathway at Boston Children's Hospital. By integrating five years of electronic health record data with multidisciplinary interviews, the project developed a comprehensive process map and performance dashboard.

The study revealed a median of 65 days elapsed between referral and waitlist activation—a timeline entirely within internal operational control. This delay was concentrated in two specific …

Knowledge Gaps In High-Energy Sacral Fracture Treatment And Management, Ashraf N. El Naga, Marko H. Neva, Ahmed Abdelazim Hassan, Gregory D. Schroeder, Mohammad El-Sharkawi, Sebastian F. Bigdon, Andrei F. Joaquim, Klaus Schnake, Richard Bransford, Emre Yilmaz

Rothman Institute Papers

High-energy sacral fractures (HESF) are often challenging injuries due to the location of the sacrum at the junction of the spine and pelvis, the complex biomechanics of the pelvic ring and the wide spectrum of injury patterns, which make treatment standardization challenging. Despite advances in classification systems - particularly the AOSpine Sacral Injury Classification - significant gaps remain in understanding optimal management. To review and discuss the management and identify knowledge gaps related to HESF. A narrative review of the literature was conducted, focusing on five domains: 1. Relative instability and biomechanics affected in different injury patterns; 2. The significance …

Cyanosis-Associated Coagulopathy In Neonates Undergoing Cardiopulmonary Bypass: A Scoping Review, Lily Crickmar

Student Works

2. Structured summary:

A. Background: Patients with cyanotic congenital heart disease exhibit coagulation abnormalities related to chronic hypoxemia, which may increase the risk of bleeding and thrombosis, particularly during cardiopulmonary bypass.

B. Objective: This scoping review mapped the existing literature on coagulation disturbances and perioperative hemostatic outcomes in pediatric patients with cyanotic congenital heart disease.

C. Methods: 14 studies meeting the inclusion criteria were identified through structured database searching. The data were collected and synthesized descriptively due to heterogeneity in study design, patient populations, and coagulation assessment methods.

D. Results: Across studies, cyanotic patient physiology was associated with platelet dysfunction, …

Intraoperative Aspiration Risk Reduction Of Diabetic Patients Through Gastric Ultrasound: A Scoping Review, Dakota Sellers Bsn, Rn, Kristy Speight Bsn, Rn, Ginger Chastain Bsn, Rn, Tyler Stone Bsn, Rn, Claudia Bursi Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap, Margaret Harvey Phd, Acnp-Bc, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

Patients with diabetes mellitus are significantly more prone to delayed gastric emptying, which can increase their risk for aspiration events in the operating room despite following standard fasting guidelines set by the American Society of Anesthesiologists (ASA). Using point-of-care gastric ultrasound, trained providers can quickly and accurately evaluate gastric volumes and risk-stratify patients based on these findings. However, these methods have not been clearly assessed in the diabetic population. The purpose of this scoping review is to map the existing evidence on the use of gastric ultrasound findings among adult patients with diabetes undergoing anesthesia.

Methods

A scoping review …

Dexmedetomidine As An Adjuvant In Intrathecal Anesthesia Vs. Opioids - Evaluating Adverse Events: A Scoping Review, Autumn Holloman Bsn, Rn, Paige Blackstock Bsn, Rn, Rasmia Ibrahim Bsn, Rn, Chase Logan Bsn, Rn, Hunter Turner Bsn, Rn, Dwayna Accardo Dnp. Crna, Faana, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Purpose/Background 

Spinal anesthesia is widely used in surgical practice because it provides effective anesthesia and analgesia while reducing the need for intravenous anesthesia. Opioids are commonly used as intrathecal adjuvants; however, their use is associated with adverse effects such as pruritus, postoperative nausea and vomiting (PONV), urinary retention, and respiratory depression. Dexmedetomidine, a selective α2-adrenergic agonist, has gained attention as an alternative to opioids due to its sedative and analgesic properties without the opioid side effect profile. This scoping review evaluates current evidence comparing intrathecal Dexmedetomidine and opioids as adjuvants to spinal anesthesia in adult surgical patients.

Methods

A scoping …

Evaluation Of A Wearable Wireless Respiratory Monitoring System (Rms) For Detecting And Predicting Clinical Deterioration, Shreya Kolipaka, Jeffrey I. Joseph, Do

Student Papers, Posters & Projects

Introduction & Objectives

- Mortality within 30 days after major surgery is the third leading cause of death worldwide.¹

- Post-operative adverse events leading to mortality include pneumonia, respiratory failure, sepsis, kidney failure, pulmonary embolism, and major cardiac events.^2,3

- Early warning signs of clinical deterioration are commonly missed due to infrequent clinical assessments, delaying timely diagnosis and intervention.^2,4

- On the general hospital floors, vital signs are monitored every 4 to 8 hours, suggesting patients could be unmonitored 96% of their hospital stay.¹

- Changes in respiratory rate (RR) are the earliest and most sensitive …

Inconsistent Post-Fall Follow-Up And Documentation In A Skilled Nursing Facility, Brooke Beier

Celebrating Scholarship and Creativity Day (2018-)

Falls remain a significant safety concern in skilled nursing facilities and are associated with increased morbidity, hospitalization, and loss of independence among older adults. While fall prevention strategies are widely implemented, inconsistent post-fall follow up and incomplete documentation can negatively impact residents and the facility. At a moderate-sized skilled nursing facility in central Minnesota, a review of recent fall reports identified inconsistencies in post-fall follow-up documentation, as well as gaps in staff education and the absence of a clearly defined post-fall documentation policy. The facility experienced 44 resident falls in the month of January alone, highlighting the urgency of addressing …