Medicine and Health Sciences Commons^™

Co-Designing Trust: Patient Experience, Relationships, And The Design Of Care, Toni Land

Patient Experience Journal

Trust can have a positive or negative impact on patients, families, and community healthcare experience. Although important, it is often treated as something soft and intangible rather than something intentionally measured and designed. Currently, healthcare organizations collect and report patient experience data related to communication, courtesy, respect, and responsiveness. But these measures do not capture the specific behaviors that influence whether trust builds or whether it stalls. This commentary explores trust as a foundational behavioral and environmental element in healthcare and challenges that improving trust requires more than good intentions; it requires bringing voices to the table through co-design. Starting …

A Modern Playbook For Trust Across The Health Ecosystem, Erin O'Malley

Patient Experience Journal

Public trust in health care delivery, public health, and biomedical innovation is at a historic low. While many place the blame on the COVID-19 pandemic and the proliferation of social media, the reality is that distrust is a deeply rooted structural challenge that has plagued the U.S. for centuries. It is tied to historical movements for medical freedom and centuries of systemic discrimination and earned mistrust among minoritized communities. Today, this crisis is compounded by a lack of shared values and facts and the rising dominance of tribal identity over objective science. The Coalition for Trust in Health & Science …

Healing The Social Covenant: Rebuilding Trust And Re-Humanizing Healthcare, Cynda Hylton Rushton

Patient Experience Journal

Violence against healthcare workers continues to escalate despite substantial investments in security measures, workplace violence prevention programs, and legislative protections. Although these interventions are necessary, they have not produced sustained improvements in workforce safety or retention, suggesting that workplace violence is more than a behavioral or security problem. This commentary argues that it also reflects a deeper erosion of trust within healthcare. Drawing on evidence linking workplace violence to burnout, moral injury, psychological distress, and turnover intention among nurses, we propose that repairing trust is essential to sustaining the workforce and healthcare.Building on our earlier work, Rebuilding a Foundation of …

Trust: Why A Commitment To Human Experience Matters, Jason A. Wolf

Patient Experience Journal

Trust is one of the most essential elements in our overall human existence. It is a critical part of our human experience, one that reaches well beyond the boundaries of healthcare. Trust is the element that holds society together. It emerges in the relationship of one human being connecting with another human being, and it reaches to the engagements people have with organizations, institutions, and systems as well. Trust, while hard to hold, is ever present. It is a powerful force that guides our way of being, our interactions, our choices, even if we ourselves are not directly conscious of …

Descriptive Anatomy Of The Female Reproductive Organs In Thamin Eld’S Deer (Rucervus Eldii Thamin) And Fea’S Muntjac (Muntiacus Feae) With Utilizing Of The Glycerin Impregnation Technique For Specimen Preservation, Paisan Tienthai, Pawana Chuesiri, Itti Boonorrana, Piyaporn Kongmakee, Ampika Thongphakdee

The Thai Journal of Veterinary Medicine

The reproductive anatomy of rare cervid species remains insufficiently documented, limiting comparative studies and preservation efforts. This study describes the anatomical details in the female reproductive organs of Thamin Eld’s deer (Rucervus eldii thamin) and Fea’s muntjac (Muntiacus feae), while the application of a modified glycerin impregnation technique was achieved for specimen preservation. Dissections of female reproductive tracts revealed morphological variations that correlate with the known female reproductive characteristics of domestic and closely related species. In both species, the ovaries were characterized as small, ovoid structures, exhibiting prominent follicles or corpora lutea consistent with the stage …

Enhancing Nutrition Communication Skills Through Community-Based Learning To Create Cooperative Extension Resources, Elizabeth Lucas Combs, Anna Cason, Courtney Luecking, Heather Norman-Burgdolf

Journal of Dietetic Education

Strong communication and transferable skills are essential for future dietitians. This Best Evidence Teaching Strategy describes a community-based approach within an upper-level community nutrition course that partnered with the Cooperative Extension Service. Over six weeks, scaffolded assignments emphasized written, oral, and digital media skills, aligning with current trends in scientific communication. Students created information releases, podcasts, and short videos to translate evidence-based nutrition content into accessible formats for public audiences. Collaboration with Extension provided authentic context and motivation, as high-quality projects could be disseminated statewide.

The Registered Dietitian Nutritionist’S Implementation Of Dysphagia Screening In Clinical Practice: A Commentary, Nicole Wiksten, Holly Estes-Doetsch, Laura C. Boucher, Sarah Rusnak, Kristen M. Roberts

Journal of Dietetic Education

Background: The Accreditation Council for Education in Nutrition and Dietetics (ACEND) amended the competencies for the future education model (FEM) in dietetic education to include competency 3.6 stating that the Registered Dietitian Nutritionist (RDN) must be able to "Initiate and conduct bedside swallow screenings". There is no clear process for RDNs to implement dysphagia screening in practice or academia. The aim of this review is to inform clinicians and educators on current literature discussing current RDN and speech language pathology approaches to dysphagia screening and to provide a proposed curriculum for implementation of competency 3.6 in clinical practice and academia.

Measuring The Empathy Of Nutrition And Dietetics Students With The Jefferson Scale Of Empathy – Health Professions Student Version: A Pilot Study, Sara Tamsukhin, Youn Seon Lim

Journal of Dietetic Education

The purpose of this study was to learn about undergraduate nutrition and dietetics students’ empathy scores. The study was a descriptive quantitative design with a web-based, cross-sectional survey. Participants were undergraduate nutrition and dietetics students from two universities who completed a survey with demographic questions, clinical experience questions, and the Jefferson Scale of Empathy – Health Professions Student version (JSE-HPS©). Seventy-one nutrition and dietetics students completed the survey. Most respondents were female, white, and non-Hispanic. The mean total empathy score was 114.69 (SD=11.09) with a range of 81 to 137. Welch’s t-test did not show significant differences by gender, ethnicity, …

Disability-Related Educational Content In Nutrition And Dietetic Programs: An Exploratory Study, Wendy Medunick, Allison Gomes, Joachim Sackey, Laura Byham-Gray, Jane Ziegler

Journal of Dietetic Education

Background: Health disparities experienced by people with disabilities (PWD) are partly attributed to inadequate knowledge, training, confidence and competence regarding disabilities among health professionals. While registered dietitian nutritionists (RDNs) are key members of the healthcare team, it is unclear how pre-professional nutrition and dietetics (ND) programs prepare future RDNs to care for PWD. This study examined the status of disability-related education within ND programs in the United States. Methods: A descriptive cross-sectional electronic survey was distributed to 570 directors of accredited ND programs. The survey, which adapted questions from a previously validated instrument and published studies, included questions assessing disability-related …

Assessing And Addressing Cultural Competence And Cultural Humility In Dietetic Education, Zoe Duran, Nicholas Slagel, Lisa Caldwell, Katie Kage

Journal of Dietetic Education

Limited theory-informed, dietetic-specific resources are available to guide the development, evaluation, and refinement of culturally competent (CC) curricula. This pilot study used a mixed-methods, theory-informed approach to evaluate CC integration within an undergraduate dietetics curriculum and examine the applicability of existing CC self-assessment tools for dietetic students. A senior-level undergraduate community nutrition curriculum was evaluated using the Tool for Assessing Cultural Competence Training (TACCT), guided by the Campinha-Bacote Model of Cultural Competence in Healthcare Delivery. James Banks’ Model of Multicultural Curriculum Reform was then applied to refine curricular content and learning activities. In addition, 74 students enrolled in a didactic …

Virtual Reality: The Future Of Didactic And Experiential Education For Nutrition And Dietetics, Michael Holik, Dexter Richardson

Journal of Dietetic Education

The integration of virtual reality (VR) into nutrition and dietetics education provides an innovative answer to challenges in accessing experiential learning. This study examined student perceptions of immersive VR experiences designed to simulate hospital foodservice operations and nutrition counseling sessions, guided by the Diffusion of Innovation Theory (DOI). A quasi-experimental design involved 55 participants who engaged with 360° VR modules featuring interactive elements, avatars representing key healthcare roles, and embedded critical-thinking questions. Results demonstrated strong support for VR’s educational value across DOI’s five key attributes: relative advantage, compatibility, complexity, trialability, and observability. Participants reported enhanced understanding of registered dietitian roles, …

Editors' Message, Volume 4, Issue 2, Diana Cuy Castellanos, M Elizabeth (Beth) Miller

Journal of Dietetic Education

In this edition, you will find research on the use of virtual reality in experiential food service learning, instruments to assess cultural competency and humility in dietetic students, and tools for measuring empathy—an area of growing importance in dietetic pedagogy. Additionally, this issue explores the inclusion of disability-related curricula in education programs and features a commentary on RDNs implementing swallow screenings within clinical practice, highlighting how this procedure falls within an RDN’s scope of practice when supported by proper training and demonstrated competency.

Cover, Table Of Contents, About The Journal

Journal of Dietetic Education

No abstract provided.

Assessing And Addressing Financial Risk In Capitated Primary Care Contracts, Michael R. Wieck Dba, Laurence Smith, Steven R. Stout Dba

Engaged Management ReView

We employ multivariate statistical modeling and Monte Carlo simulation to study systematic and unsystematic financial risk faced by physician groups under capitated contracts with Medicare Advantage Organizations (MAOs). We use mixed methods and a standard reimbursement formula for risk-sharing contracts with primary care physicians (PCPs). We find that diversifying risk simply by increasing the size of a practice is insufficient to mitigate risks of large negative cash flows from capitation contracts and can result in financial failure. However, if use of costly medical services by patients is reduced from levels typically experienced under traditional Medicare to the levels of patients …

Fraction-Seq: An Integrated Experimental And Computational Workflow For Determining The Localization And Abundance Of Small Non-Coding Rnas In Subcellular Compartments, Siddhartha Shah, Tess Cherlin, Yi Jing, Stepan Nersisyan, Benjamin E. Leiby, Isidore Rigoutsos

Computational Medicine Center Faculty Papers

Small non-coding RNAs (sncRNAs) have garnered considerable attention in recent years, following accumulating evidence of their critical roles in many cellular processes. Among sncRNAs, microRNAs (miRNAs) and their isoforms (isomiRs), tRNA-derived fragments (tRFs), rRNA-derived fragments (rRFs), and Y RNA-derived fragments (yRFs) account for more than 95% of all sncRNAs found in cells. Despite their critical regulatory roles, most sncRNAs remain uncharacterized because their functionalization is a lengthy and challenging undertaking. Knowing an sncRNA's abundance helps prioritize among the various choices, while knowing where it localizes in the cell greatly limits the number and identity of its potential targets and helps …

Integrating Matrescence Into Birth Worker Practice: A Practice Improvement Project, Kelsey B. Green

Doctor of Nursing Practice (DNP) Projects

Background: Perinatal mood and anxiety disorders (PMADs) affect 20–25% of mothers worldwide and are a leading cause of maternal complications. Stigma, fragmented care, and limited provider training leave families vulnerable, while birth workers offer trusted, continuous support.

Problem: Birth workers' maternal mental health (MMH) training is minimal and often excludes matrescence, the developmental transition to motherhood, limiting their ability to distinguish normal adjustment from clinical PMADs and delaying intervention.

Methods: A single-group, pre-/post-test design evaluated a matrescence-informed workshop at Roots Community Health's 2nd Annual Symposium. Anonymous surveys measured knowledge, attitudes, and confidence, analyzed with Mann–Whitney U, Wilcoxon signed-rank tests, and …

From Overwhelmed To Empowered: An Emotional Regulation Program To Enhance Social Participation In Young Women With Autism And Adhd, Daisy Lee, Angela Labrie Blackwell Phd, Otr, Jessica Hale

Summer 2026 OTD Capstone Symposium

From Overwhelmed to Empowered is a program developed an occupation-based emotional regulation program for young adult women with attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) during the transition to adulthood. The purpose of the project was to address the need for interventions that support emotional regulation as a foundation for meaningful social participation, independence, and successful role engagement.

The project involved the development and pilot implementation of an eight-week program consisting of weekly 60-minute group sessions and individualized coaching sessions. Program content focused on emotional awareness, mood and motivation, cognitive strategies, anxiety management, sensory regulation, communication, healthy boundaries, and …

Endoscopic Versus Catheter-Based Minimally Invasive Evacuation Of Spontaneous Supratentorial Intracerebral Hemorrhage: A Systematic Review And Meta-Analysis, Shaan Patel, Shiva A Nischal, Kush M Kale, Angelette Mendonca, Keenan Piper, Pious D. Patel, Michael R. Gooch, Stavropoula Tjoumakaris, Pascal M. Jabbour

Department of Neurosurgery Faculty Papers

Minimally invasive surgery (MIS) for spontaneous supratentorial intracerebral hemorrhage (sICH) includes endoscopic evacuation and catheter-based evacuation (aspiration or drainage ± thrombolysis), but comparative performance remains uncertain. We performed a systematic review and meta-analysis comparing MIS approaches. PubMed, Embase, and CENTRAL were searched (December 2025) for studies in adults undergoing endoscopic or catheter-based MIS for supratentorial sICH. Random-effects meta-analysis was conducted. Prespecified subgroup analyses stratified catheter-based techniques by thrombolysis use. Risk of bias and certainty of evidence was assessed. Twenty-nine studies (8221 patients; 5041 endoscopic; 3180 catheter-based) were included. Endoscopic evacuation was associated with lower mortality (RR 0.64; 95% CI: 0.47–0.87; …

Staphylococcus Aureus Urease Is Controlled By A Complex Regulatory Network To Promote Dissemination During Cauti, Jana Gomez, Jesus Duran-Ramirez, Maristhela Alvarez, Shane Cristy, Jennifer N Walker

Faculty, Staff and Student Publications

Catheter-associated urinary tract infections (CAUTIs) are one of the most common hospital-associated infections in the United States, accounting for >1 million cases annually. One CAUTI pathogen, Staphylococcus aureus, is commonly found persisting asymptomatically in the bladder of catheterized individuals, increasing these individuals' risk of developing infection. Importantly, S. aureus is not only associated with severe symptoms during CAUTI, including bacteremia and septic shock, but it also produces a common uropathogen-associated virulence factor, urease. Despite its importance, urease has only been well-studied in another uropathogen, Proteus mirabilis. While previous studies identified three S. aureus urease regulators, including CodY, …

An Online Epilepsy Self-Management Tool For Patients With Epilepsy: A Formative Usability Study, Katarzyna Czerniak, Ross Shegog, Refugio Sepulveda, Robert Addy, Youngran Kim, Sahiti Myneni, Alejandra Garcia-Quintana, Kimberly Martin, David M Labiner

Faculty, Staff and Student Publications

Background: Epilepsy is a serious chronic neurological condition with no permanent cure. Continual self-management is important to mitigate seizure frequency and optimize quality of life in people with epilepsy who have greater disparities in accessing epilepsy care. The Management Information & Decision Support Epilepsy Tool (MINDSET [UTHealth, University of Arizona, and Radiant Digital]) was developed to enhance accessibility to epilepsy self-management (ESM) assessment and treatment. The purpose of this formative usability pilot study was to assess the user experience and functionality of MINDSET 2.0, an enhanced cross-platform online version of MINDSET, among a sample of patients with epilepsy prior to …

Differences In Response Rates To A Previsit Electronic Portal Questionnaire In Outpatient Clinics: A Retrospective Observational Study Of The Standard Dermatology Outcome Measures, Rene F. Chen, Udeyvir S. Cheema, Beiyu Liu, Cynthia L. Green, Matilda W. Nicholas, Suephy C. Chen

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Larotrectinib In Trk Fusion Differentiated Thyroid Carcinoma: Updated Trial Data, Steven Waguespack, Marcia Brose, Jessica J Lin, Ray Mcdermott, Mohammed Almubarak, Jessica Bauman, Michela Casanova, Shivaani Kummar, Se-Hoon Lee, Damian Rieke, Do-Youn Oh, Changsong Qi, Natascha Neu, Domnita-Ileana Burcoveanu, Chiara Mussi, Alexander Drilon, David Hong, Maria Cabanillas

Department of Medical Oncology Faculty Papers

Larotrectinib is a first-in-class, highly selective, central nervous system-active tropomyosin receptor kinase (TRK) inhibitor approved for tumour-agnostic use in TRK fusion cancer. It has previously demonstrated rapid and durable disease control and favourable safety in patients with advanced TRK fusion thyroid carcinoma (TC). After an additional 4 years of follow-up with the inclusion of two additional patients, and utilising an independent review committee (IRC) to assess overall response rate (ORR), we report updated pooled analyses from three phase 1-2 larotrectinib clinical trials, focusing only on patients with TRK fusion differentiated TC (DTC). The primary endpoint was the IRC-determined ORR per …

Prescription Opioid Misuse Among High School Athletes During The Opioid Prescribing Limit Law Era: Yrbss 2017-2023, Francine R Vega, Andrea J Yatsco, Audrey Sarah Cohen, James R Langabeer, Tiffany Champagne-Langabeer, Rakshitha Vijendra, Christine Bakos-Block

Faculty, Staff and Student Publications

Background/Objectives: School-age athletes occupy a paradoxical position in the adolescent opioid crisis, combining health-oriented activity with elevated risk of sports-related injury and prescription opioid exposure. In response to the opioid epidemic, states enacted opioid prescribing limit laws (OPLLs) beginning in 2016-2017, yet whether these supply-side policies reached high-risk youth subgroups remains unclear. This study evaluated national temporal trends in prescription opioid misuse among U.S. high school students during the period of OPLL implementation and examined differences across athletic participation, concussion history, sex, grade, race/ethnicity, and substance-use profiles.

Methods: Using four biennial waves of the Youth Risk Behavior Surveillance System with …

Assessing The Impact Dynamics Of Less Lethal Ammunition, Steven Bermejo

Student Theses

Less-lethal ammunition is widely used by law enforcement as an alternative to lethal force during crowd control, on-street confrontations, and other situations requiring force. Although these projectiles are intended to reduce risk of fatal injury, serious injuries and fatalities have been reported, highlighting the need to better understand the factors that influence their impact behavior. This study evaluated the impact dynamics of four types of 12-gauge less-lethal ammunition, including rubber buckshot, single rubber ball, double rubber ball, and Byrna kinetic projectile, using kinetic energy calculations derived from projectile mass and velocity measurements. In addition, Attenuated Total Reflectance Fourier Transform Infrared …

The 2025 Measles Outbreak In Texas, Tamer Oraby, Martial L. Ndeffo-Mbah

School of Mathematical & Statistical Sciences Faculty Publications

Background

In 2025, Texas experienced its largest measles outbreak in decades, reporting 762 cases by mid-August. Measles is a highly contagious but vaccine-preventable infection transmitted mainly among unvaccinated individuals and capable of causing severe outcomes.

Methods

We investigate counterfactual measles control scenarios based on daycare and school closures and reactive vaccination of infants and children, including mixed interventions. We analyze the 2025 Texas outbreak using an age-structured multi-stage SEIR model formulated as a system of ordinary differential equations. The model is fit to case data using Bayesian inference to estimate the effective reproduction number and generate posterior predictive trajectories under …

Same-Day Cancellation Reduction In An Ambulatory Surgery Unit, Anthone Dalit Vengersammy

Master's Projects and Capstones

Problem: Same-day surgical cancellations in the outpatient surgery setting remain a significant operational and patient care challenge. Preventable cancellations negatively affect patient experience, operating room efficiency, staff productivity, and healthcare costs. 

Context: A microsystem and organizational culture assessment identified several factors contributing to same-day cancellations, including unclear preoperative instructions, incomplete medical clearance, inconsistent patient education, lack of standardized workflows, unclear staff responsibilities, and communication gaps among interdisciplinary teams. SWOT and gap analyses were used to identify opportunities for improvement and guide intervention planning.

Interventions: Quality improvement interventions were implemented through iterative Plan-Do-Study-Act (PDSA) cycles. Strategies included revising preoperative patient instructions, …

Sense Of Purpose As The Guiding Light In Nursing Practice: A Grounded Theory Study, Kathleen Casler

Theses & Dissertations

Problem: As a prosocial profession, individuals may enter the practice of nursing because of an interest in helping and caring for others. However, over time, nurses may be challenged with experiences of burnout that can impact both their relationship with the profession and patient outcomes.

Background/Significance: A sense of purpose has been associated with positive physical, behavioral, and psychological outcomes. In a professional context, a sense of purpose may provide support for navigating complex work environments. It is currently not known what nurses’ experience of sense of purpose may be in relation to nursing practice and how their sense of …

Staff Education To Improve Mindfulness Knowledge Among Rns, Nps, And Mas In A Behavioral Health Setting, Barbara Buxton

Walden Dissertations and Doctoral Studies

Burnout is a recurrent problem for healthcare workers and is associated with staff turnover, a decline in the quality of care, emotional fatigue, and risks to patient safety. This Doctor of Nursing Practice (DNP) staff education initiative created a mindfulness-based training program to expand the knowledge of registered nurses, nurse practitioners, and medical assistants on mindfulness practices in a behavioral health setting. Baseline assessment data identified a need for support to address emotional fatigue, absenteeism, and staff disengagement, with a mean pre‑education knowledge score of 66%. A structured, in‑person educational program addressing burnout awareness, stress reactivity, and helpful mindfulness methods …

A Proposal For A Program To Deliver Equitable Nursing Assignments, Laporsha Glover

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was conducted at an inpatient rehabilitation hospital that provides comprehensive interdisciplinary rehabilitation services for adults. Due to the diverse clinical needs of the rehabilitation patient population, nursing workload varies considerably based on patient acuity, functional status, cognitive impairment, medical complexity, and the intensity of nursing interventions required. This creates a practice gap that contributes to inequitable nursing assignments. A comprehensive literature search was conducted using PubMed, CINAHL, Cochrane Library, and Google Scholar. Nine studies were critically appraised using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Evidence Appraisal Tools (Bissett et al., 2025). The …

A Multifaceted Surgical Suite Quality Improvement Initiative, George Tazvitya Mhosira

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project focuses on modernizing an acute care hospital’s surgical suite, enhancing environmental safety, and supporting the growing complexity of surgical care. As surgical procedures become more advanced, the physical environment must evolve to maintain sterile technique and reduce microbial presence. Current operating room configuration, characterized by overcrowding and outdated ventilation systems, introduces environmental risks that compromise patient safety and limit perioperative efficiency. Modernization is essential to align the surgical environment with contemporary safety expectations and organizational performance goals. The proposed initiative includes a comprehensive renovation and expansion of surgical spaces, integrating advanced air decontamination technologies, …