Medicine and Health Sciences Commons^™

Promoting Mental Health And Wellness For Adults With Developmental And Intellectual Disabilities, Tristen Six Caceres

OTD Capstone Projects

This doctoral capstone project was completed in partnership with the Metro Parks disABILITIES Program. This community-based program provides recreational, social, and wellness opportunities for adults with intellectual and developmental disabilities (IDD) in the Nashville area. The purpose of this capstone project was to address a need for increased mental health support, education, and accessible resources for adults with IDD participating in the day programs, as well as for the staff who support these participants. Adults with IDD often experience barriers to receiving mental health care, including limited access to providers with appropriate training and confidence in working with this population. …

Interventions For Geriatric Patients With Dementia In Inpatient Psychiatric Settings, Kenya Raybon

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Geriatric patients with dementia in inpatient psychiatric units are admitted with cognitive and behavioral challenges that often lead to increased agitation and greater reliance on 1:1 support, limiting participation in group therapy. While evidence supports structured, activity-based and sensory-informed interventions to promote regulation and engagement, implementation is often inconsistent due to workflow barriers, staffing limitations, and lack of structured guidance for staff, especially if cognitive impairment is not immediately recognizable.

This quality improvement capstone project aimed to develop and implement an evidence-informed staff training program, along with a structured activity binder system with adaptable, unit-specific interventions to support consistent activity-based …

The Integrated 31-Gene Expression Profile Test Identifies Low-Risk Patients With Cutaneous Melanoma Who Can Forego The Slnb Procedure: Results From A Prospective, Multicenter Trial., Timothy Beard, J Michael Guenther, Stanley P Leong, Maki Yamamoto, Samuel Dierks, Brenda Sickle-Santanello, Andrew Ward, Mark Cripe, Parth Shah, Shawn Young

Oncology Articles

AIMS: Prospectively confirm use of the integrated 31-gene expression profile test (i31-SLNB) in patients with cutaneous melanoma to predict sentinel lymph node biopsy (SLNB) positivity and assess recurrence rates in those considered low risk by i31-SLNB who did not have an SLNB.

METHODS: Patients with T1-T4 tumors being considered for SLNB who received 31-gene expression profile (31-GEP) testing in the multi-center, prospective DECIDE study were included (n = 912). Kaplan-Meier analysis was used to estimate recurrence-free survival (RFS).

RESULTS: Among 430 patients with T1-T4 tumors who had an SLNB, the positivity rate was 2.6% (3/114) in those with < 5% i31-SLNB-predicted risk versus 21.4% (28/131) in those with >10% predicted …

Improving Patient Satisfaction In The Emergency Department Waiting Room Through Enhanced Communication Strategies: A Quality Improvement Initiative, Wael P. Karaki

Doctor of Nursing Practice Final Project Abstract

Purpose: This QI project aimed to improve ED waiting room experience by standardizing communication to increase transparency and expectation management, targeting an increase in Net Promoter Score (NPS) from 33.5 to ≥35.4 within three months.

Background: ED waiting room dissatisfaction is driven by uncertainty (unclear wait times, inconsistent updates, and limited understanding of triage and ED flow), supporting structured communication over individual clinician delivery.

Methodology: A 3-month, single-site QI project in an urban ED used iterative PDSA cycles and included all ED encounters (n=17,444). The bilingual intervention included orientation pamphlets (print/QR-based), standardized triage verbalization of …

Co-Designing An Adolescent Perinatal Mental Health Intervention In Kenya And Mozambique: The Inspire Project, Tatiana Salisbury, Fernando Chissale, Margrette Hanselmann, Evaline Langat, Sarah Kinja, Violet Naanyu, Mark Nyalumbe, Mellan Lilumbi, Lucy Nyaga, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background Interventions to support adolescent perinatal mental health are limited and largely developed for delivery in high-income countries. This study aimed to co-design an intervention to improve mental health outcomes among pregnant and post-partum adolescent girls in Mozambique and Kenya.

Methods 159 adolescent girls (aged 15–19 years) and young women (aged 20–24 years) with experience of a pregnancy during adolescence, their partners and family members, service providers and community influencers were recruited in Kilifi County, Kenya and Moatize District, Mozambique. Those who consented took part in individual interviews, focus group discussions, observations, and workshops to identify key priorities for supporting …

Effects Of Ndbi With Just-In-Time Programming Of Vsds On Communication Of Children With Asd, Jenna M. Rogers

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Autism Spectrum Disorder (ASD) is a prominent neurological and developmental disability that often requires communication support, such as Augmentative and Alternative Communication (AAC). Visual Scene Displays (VSDs) are an AAC support that directly immerses in the user’s life, using images from real environments the user has or may experience. Naturalistic Developmental Behavioral Intervention (NDBI) is an evidence-based approach to early intervention that targets social communication during naturalistic routines, including those who rely on AAC support to communicate. Despite recent research indicating that combining NDBI and AAC is a promising approach (Pope et al., 2024), no studies to date have examined …

Dean's Update, April 2026, Neil W. Schluger

SOM Dean's Research Newsletter

No abstract provided.

The Influence Of Older Age On Rbc Transfusion Decisions In Icu Patients, Caroline Schaap, Jorinde Raasveld, Florian Reizine, Boillot Corentin, Jimmy Schenk, Sanne De Bruin, Merijn Reuland, Claudia Van Den Oord,, Andrew Flint, Marcus Lance

Anaesthesiology, East Africa

Objectives: RBC transfusions are common in the ICU. Recent studies suggest that a restrictive transfusion policy is noninferior or superior to a liberal policy. However, few studies focus on the influence of age in transfusion. In elderly ICU patients, reduced physiologic reserves may shift the perceived risk-benefit balance of transfusion, potentially leading to different transfusion practices. This study examines whether transfusion practices in ICU patients differ across patient age.

Design: This is a substudy of the International Point Prevalence Study of ICU Transfusion Practices (InPUT), a global, multicenter, prospective observational cohort study.

Setting: ICUs from 233 centers …

Something In The Air? Uncovering The Air Quality Of St. Mary's University, Isaiah Charles, Keagan Farrell, Antonio Martinez, Andrea Realyvasquez, Kelly Swyers

Presentations - 2026

What is air quality?

Measurement of how clean or polluted the air is in a certain area. The Environmental Protection Agency uses Air Quality Index (AQI), a scale that describes the quality of air. The six major pollutants measured are: •ground- level ozone •particulate matter •carbon monoxide •sulfur dioxide •nitrogen dioxide •lead   Impacts of air pollution
•Acid rain •Climate change •Damage to plants and crops •Loss of biodiversity
•Respiratory illnesses •Cardiovascular damage •Premature death •Coughing and asthma

Cure Sound Project: Study In Silence?, Quezia Abrao, Deeya Bhadresa, Elisa Castro, Fiona Coulbourne, Carlos Flores, Lizzeth Holguin, Lazarus Maldonado, Jeremy Mares, Andrew Martini, Nicole Matthews, Katherine Montero, Mariana Reyes, Jacob Rodriguez, Julieta Ruiz, Eliana Sanchez, Gabriela Varela

Posters - 2026

Difference in sound levels in study areas across campus can affect students’ ability to work and learn efficiently 1.

According to the WHO, safe sound levels are measured to be around 70dB 2. Some study areas on campus experience sound levels exceeding the safe threshold. Unsafe sound levels are considered to be at or above 85dB 3. These unsafe and excessive noise levels negatively affect a student’s ability to concentrate and work efficiently which correlates to a decrease in class performance, attention deficits, and stress 4.

This study aims to get a base-line measurement of dB levels in common study …

Neurophenomenology: A Research Method Combining Neuroscience And Philosophy, Jonas Lokensgard

Posters - 2026

Neurophenomenology – Cognitive Sciences + Phenomenology Phenomenology – the study of consciousness (basically just how you experience things) Cognitive Sciences – The study of the functional processes of the mind, and the operations of the brain that enable these processes to be performed. (“Cognitive Science” 2004)

Analyzing The Effect Of Melatonin On B Cells' Expression Of Cd36, Caitlyn Pinaga, Gabriella Galdeano, Nayi Gonzalez, Emma Welsch

Posters - 2026

• B cells specifically target pathogens and proliferate to make a plasma cell and secrete antibodies when stimulated. They use glucose as a main energy source but can also use fatty acids. • CD36 is a glycoprotein involved in the transportation and metabolism of fatty acids. • B cells express CD36 in unusually high levels in autoimmune patients. It is unknown as to how this occurs. • Melatonin is a hormone produced in the pineal gland, commonly known for its function in regulating the circadian rhythm. • Melatonin is also known as a master cell regulator and is believed to …

Obesity In The Rio Grande Valley: Applying An Evidence-Based Public Health Approach, Erika Pineda-Horta

Posters - 2026

What structural and social determinants drive elevated adult obesity rates in the Rio Grande Valley, and what evidence-based interventions can reduce adult obesity prevalence in Hidalgo County by 5% by 2030?

Objective: This study applies an EBPH framework to (1) characterize the burden and structural determinants of adult obesity in the RGV, and (2) propose a culturally responsive, evidence-based intervention targeting adults aged 18+ in Hidalgo County.

Adult obesity is clinically defined as a Body Mass Index (BMI) ≥30 kg/m² in adults aged 18 and older (CDC, 2022). It is a chronic, multifactorial non-communicable disease shaped by structural, social, and …

Comparison Of Three Coordination Methods To Increase Outpatient Follow Up Among Older Adults Discharged From The Emergency Department: A Pilot Study, Michelle Simpson, Suzanne Ryer, Christopher Rubach, Joseph Chase

Journal of Patient-Centered Research and Reviews

Purpose: Older adults are among the highest users of the emergency department (ED), comprising over 50% of those discharged home from the ED. The Geriatric Emergency Department (GED) guidelines recommend addressing transitions of care that connect older adults with timely outpatient services to decrease adverse events. The purpose of outpatient follow up is to evaluate and adjust patient treatment, if necessary, following an ED visit to prevent adverse events.

Methods: A prospective, descriptive pilot study was conducted to gather preliminary data on the potential impact of follow-up outpatient appointment coordination types (standard care, point-of-care scheduling, and portal reminder message). Older …

Efficacy, Acceptability, And Feasibility Of Stayquit For Sustaining Smoking Abstinence After Psychiatric Hospitalization: A Pilot Study, Corinne N. Kacmarek, Hannah C. Smith, Alicia Lucksted, Lan Li, Laché Wilkins, Gabriella Coakley, Peter Phalen, Deborah Medoff, Faith Dickerson, Julie Kreyenbuhl, Melanie E. Bennett

Journal of Patient-Centered Research and Reviews

Purpose: Veterans with mental illness have high rates of tobacco use and psychiatric hospitalization in the Veterans Health Administration (VA). VA is smoke-free, and guidelines recommend that smoking cessation medication and counseling be delivered during and one month after hospitalization to sustain abstinence. Little is known about how patients experience this intervention. This pilot study evaluated the acceptability, feasibility, and efficacy of an evidence-informed, novel smoking intervention, StayQuit, for psychiatric inpatients.

Methods: Participants were recruited from an inpatient VA psychiatric unit. Changes in self-reported cigarettes smoked per day, nicotine dependence, and abstinence self-efficacy were evaluated between baseline and 12-week follow …

Associations Of Cortisol With Alzheimer's Disease Fluid And Neuroimaging Biomarkers: A Systematic Review, Jasper Holleman, Sima Toopchiani, Oliver Robinson, Ingemar Kåreholt, Miia Kivipelto, Lefkos Middleton, Alina Solomon, Chinedu Momoh, Shireen Sindi

Brain and Mind Institute

Background Chronic stress triggers the dysregulation of hypothalamic–pituitary–adrenal (HPA) axis which is characterized by altered diurnal cortisol patterns and increased basal cortisol levels. This dysregulation has been found in Alzheimer’s Disease (AD), but its link with AD-related biomarkers remains underexplored. This systematic review aims to synthesize the current knowledge regarding the association between cortisol and biomarkers related to AD.

Methods Keywords and phrases related to cortisol and AD-related biomarkers were used to search the MEDLINE database via PubMed and OVID interfaces up to January 2024. Studies focused on the association between cortisol levels and genetic, neuroimaging, and fluid biomarkers related …

Patient Views On Blood-Based Biomarker Tests For Alzheimer's Disease In Primary Care, Andrea Russell, Abigail Vogeley, Rebecca Lovett, Rachel O’Conor, Stephanie Batio, Jeimmy Hurtado, Morgan Bonham, Julia Benavente, Adam Brickman, Chinedu Momoh

Brain and Mind Institute

INTRODUCTION Blood-based biomarkers could offer accessible, cost-effective detection of Alzheimer's disease (AD) in primary care. This study examined patient attitudes toward AD biomarker testing.

METHODS Crosssectional surveys were conducted with 572 adults from Chicago-area clinics. Participants received brief education on biomarker tests before completing the survey.

RESULTS Most participants (83.8%) were unfamiliar with biomarker tests; 1.8% previously completed testing. After brief education, most (94.5%) supported offering tests to patients with memory complaints, and 85% were willing to complete testing if recommended by their clinician. Facilitators included tests informing clinical care, coverage by insurance, and education in advance. Barriers included cost …

Improving First Time Iv Success Rates In The Emergency Department Through The Implementation Of An Ultrasound-Guided Iv Training Program, Tram Dinh

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement (QI) project was conducted at a Level III trauma emergency department (ED) in Fort Worth, TX. The aim was to improve first-attempt intravenous (IV) success rates for patients with difficult IV access (DIVA) to at least 50% and reduce average disposition times.

Background

Patients with DIVA frequently experience delays in care, including prolonged time to establish IV access, obtain laboratory studies, perform contrast-enhanced imaging, and administer IV medications. Ultrasound-guided IV (USGIV) access is an evidence-based technique shown to reduce these delays and improve timely care for patients with DIVA.

Methodology

The Plan-Do-Study-Act (PDSA) model guided development …

Reducing The Incidence Of Acute Care Falls In Medical-Surgical Psychiatric Adult Patients, Ijeoma Nwosu

Doctor of Nursing Practice Final Project Abstract

The purpose of this scholarly project was to implement a multifactorial fall prevention program within a medical-surgical psychiatric unit. The program was intended to reduce the incidence of falls, strengthen staff compliance, and bridge the gap of fall education. The interventions were developed based on evidence-based fall prevention strategies. The project was implemented within a large healthcare organization in the Texas Medical Center (TMC) located in Houston, Texas. The project utilized the Plan-Do-Study-Act (PDSA) framework. Staff were given education prior to implementation and reeducation during the project cycle. Visual guides were created to guide staff and assist with documentation expectations. …

Improving Throughput: A Quality Improvement Initiative To Expedite Inpatient Psychiatric Placement From The Emergency Room, Candice J. Battle

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement project was to evaluate the effectiveness of a standardized psychiatric transfer workflow designed to reduce emergency room (ER) boarding time for psychiatric patients in a 30-bed acute care hospital from an average of 3-5 days to an average of 2-3 days.

Background

Psychiatric patients often experience prolonged ER boarding while awaiting inpatient psychiatric placement. These delays contribute to delayed treatment, worsening psychiatric symptoms, ER overcrowding, and increased healthcare costs.

Methodology

This four-week quality improvement project utilized the Plan-Do-Study-Act (PDSA) framework. Interventions included a standardized psychiatric transfer protocol, simplified transfer checklist and staff education. …

The Benefits Of Glucagon-Like Peptide 1 Agonists In Adult Women With Polycystic Ovary Syndrome, Bethany A. Johnson

Nursing Capstones

Background: PCOS is the most common endocrinopathy in women of reproductive age, affecting 5-6 million women in the United States. Symptoms include hirsutism, acne, hormone imbalances, menstrual irregularity, obesity, infertility, hypertension, and hyperlipidemia. GLP-1s are being studied for their benefits in women with PCOS.

Purpose: To review the current evidence on the efficacy of GLP-1 receptor agonists in improving symptoms and complications of PCOS.

Methods: This scoping literature review used three databases, including CINAHL Ultimate, PubMed, and ClinicalKey. Inclusion criteria were women 18 and older diagnosed with PCOS and studies that evaluated any type of GLP-1 and their effect on …

2026 Research Day Program, Lincoln Memorial University

Research Day

This program contains abstracts and presentation summaries from LMU's 2026 Annual Research Day conference.

Overcoming Challenges With Rural-Related Health Data: Lessons Learned From Published Studies, Casey P. Balio, Margaret M. Francisco, Nicole Galler, Olivia A. Sullivan, Kate E. Beatty, Michael E. Meit, Chyanne Morrison, Christiana Keinath, Stephanie M. Mathis

ETSU/NORC Rural Health Research Center Policy Briefs

No abstract provided.

Bridging Cultures: Developing A Culturally Responsive Educational Website For Pediatric Service Providers, Aimun Aziz, Wendy Tremaine

Spring 2026 OTD Capstone Symposium

The increasing cultural diversity of the pediatric population in the United States highlights the need for culturally responsive, family-centered care. However, many providers report limited training and practical resources to support the integration of cultural humility into clinical practice. This capstone project aimed to develop and evaluate an evidence-based educational website to support pediatric service providers in delivering culturally responsive care.

A program development framework was used, incorporating family needs assessments, pre- and post-intervention surveys of pediatric therapy staff, and thematic analysis of key factors related to communication, trust, and provider preparedness. Community field visits with diverse populations informed the …

Ready, Set, Play! Empowering Caregivers Through Adaptive Playground Resources, Makenna Thigpen, Angela Blackwell, Brianne Harryman

Spring 2026 OTD Capstone Symposium

This doctoral capstone project addressed the need for accessible, caregiver-friendly education to support inclusive play opportunities for children of diverse abilities. Guided by occupational therapy frameworks emphasizing participation, environmental supports, and family-centered care, this project involved collaboration with the local Parks and Recreation Department to better understand community needs and existing inclusive playground resources. Through this partnership, the project supported efforts to promote awareness and accessibility of inclusive play spaces within the community.

As part of the project, educational video resources were developed to increase caregiver knowledge of inclusive playground equipment, play strategies, and environmental modifications. Content focused on promoting …

Enhancing Student Engagement In Leadership And Advocacy, Rosanoemi A. Mejia, Jazminne Orozco Arteaga

Spring 2026 OTD Capstone Symposium

Occupational therapy has a unique capacity to foster social change and occupational justice. Leadership and advocacy are essential components of the daily academic practice for occupational therapists. However, leadership development within the field is largely socially driven, and students often lack access to structured, mentored pathways that would empower them to speak up and engage in advocacy. This capstone project aimed to fill this gap by addressing the shortage of coordinated mentorship and leadership development opportunities, which hinder advocacy efforts and professional growth. The study employed a mixed-methods approach, involving occupational therapy students in quantitative Likert-scale surveys and qualitative semi-structured …

Analyzing Pressure Injury Trends Among Hospitalized Older Adults From Tarrant County, Oluwafunto M. Olorundare

2026 Spring Honors Capstones Projects

Pressure injuries occur when skin and underlying tissues are damaged due to unrelieved pressure that reduces blood circulation to the affected area. Hospitalized older adults are vulnerable to pressure injuries due to factors such as limited mobility, physiological changes associated with aging, chronic conditions, and longer hospital stays. Despite multiple studies on the prevalence and incidence of pressure injuries at the national and global levels, there is limited research that analyzes trends among hospitalized older adults at the county level, specifically Tarrant County. This research aims to examine pressure injury trends among hospitalized older adults residing in Tarrant County. Using …

Complex Regional Pain Syndrome In A 21-Year-Old Male Patient Following A Gunshot Wound (Gsw), Jonathan Rodriguez, Oyinkansola Mudasiru, Alexandria Armstrong, Hooman Tabatabai-Mir

School of Podiatric Medicine - Student Research

Purpose: Complex Regional Pain Syndrome (CRPS) is a pain disorder that typically follows several forms of trauma, including surgery or fractures. The diagnostic gold standard for CRPS is the Budapest diagnostic criteria. In the general population, CRPS is 3-4 times more common in middle-aged women. Regarding incidence following injury, it most often occurs after a fracture. CRPS secondary to ballistic trauma is rarer, particularly in the case of a young male individual. The purpose of our case study is to follow a 21-year-old male patient who suffered an accidental self-inflicted gunshot wound to the left foot and detail the presentation …

Menstrual Cycle Hormonal Fluctuations And Non-Contact Acl Rupture Risk In Female Athletes: A Literature Review, Alexa K. Larson

Honors Thesis

Anterior cruciate ligament (ACL) injuries are among the most common and debilitating injuries in athletic populations, with female athletes experiencing significantly higher rates of non-contact ACL rupture compared to males, often while participating in the same sports. Hormonal fluctuations associated with the menstrual cycle have been proposed as a potential intrinsic risk factor influencing injury susceptibility. The purpose of this literature review was to examine current research investigating how menstrual cycle-related hormonal fluctuations may influence the risk of non-contact ACL rupture in female athletes. A comprehensive search of PubMed, SPORTDiscus, and CINAHL databases identified fourteen peer-reviewed studies that met the …

Regional Inequalities In Healthcare Access And Capacity In Brazil, Elena Kossler

Posters - 2026

The Brazilian health system is one of the largest and most comprehensive universal public health systems, fully funded by the government.