Medicine and Health Sciences Commons^™

Quality Improvement Project Nursing Student Retention Strategies: A Focus On Peer Mentoring, Anh Vittoria

Doctor of Nursing Practice Projects

The nursing shortage remains a concern in healthcare. Increasing the number of students who complete nursing programs and enter the profession can help with the demand for nurses in the workforce. Nursing programs face challenges with student retention, which limits the number of nurses entering the profession. The quality improvement project aimed to examine the effects of a peer mentorship program on first-year associate degree nursing students’ perception of support and course completion rates. The purpose is to impact student retention and sense of support in an Associate Degree Nursing Program (ADN) through peer mentorship. The project was guided by …

Quality Improvement Project Enhancing Documentation Practices In Community Mental Health Clinics, Carol Parker

Doctor of Nursing Practice Projects

Accurate and timely documentation are essential for safe, high-quality care in community mental health settings. This quality improvement (QI) project addressed inconsistent documentation practices among licensed, unlicensed, and Qualified Mental Health Specialist (QMHS) staff at an outpatient clinic. The purpose of the QI project was to implement and assess a structured in-service training program using the Accountable Health Communities–Health-Related Social Needs (AHC-HRSN) screening and documentation tool to improve staff knowledge, enhance documentation accuracy, and facilitate care coordination. Guided by the Iowa Model of Evidence-Based Practice and Lewin’s Change Management Model, a pre- and post-intervention design was used. Fifteen staff members …

Enhancing Mental Health Providers' Approach To Medication Adherence In Schizophrenia Patients Using Motivational Interviewing Techniques., Jacinta Madu

Doctor of Nursing Practice Projects

Medication non-adherence among individuals with schizophrenia remains a persistent challenge that undermines symptom management and increases relapse and hospitalization rates. This quality improvement (QI) project aimed to evaluate the effect of Motivational Interviewing (MI) training on provider knowledge and confidence in promoting medication adherence within an outpatient mental health clinic. Guided by Lewin’s Change Theory and the Plan-Do-Study-Act (PDSA) framework, a quasi-experimental pre–post design was used. Six providers, including psychiatric nurse practitioners, therapists, a psychiatrist, and a registered nurse, participated in a structured MI training session incorporating didactic instruction and role-play exercises. Data were collected using pre- and post-intervention surveys …

Quality Improvement Project: Effect Of Multi-Level Student Collaboration On Clinical Judgment In High-Fidelity Simulation, Jillian Carroll

Doctor of Nursing Practice Projects

There is a gap in undergraduate nursing curriculum on incorporating collaboration and communication into patient care, leading to a lack of competence and confidence in novice practice. Using collaboration in high-fidelity simulation, students gain real-world exposure and opportunities to communicate and make independent decisions. Using Kotter’s eight-step change theory, this project addresses the limited exposure to collaboration by implementing purposeful interdisciplinary collaboration within high-fidelity simulation to improve undergraduate nursing students’ confidence and competence in nursing practice. This will build on Patricia Benner’s novice-to-expert theory and help advance Associate Degree Nursing (ADN) students into a safe and effective novice year of …

Quality Improvement Project: Impact Of A Brief Mindfulness-Based Stress Reduction Program For Healthcare Providers Who Evaluate Veterans, Peng Anderson

Doctor of Nursing Practice Projects

Long-term stress can lead to healthcare provider burnout. Mindfulness-based interventions, even when shortened, may provide a promising and innovative method to reduce stress and prevent burnout. Research on mindfulness programs has demonstrated significant benefits for both providers and patients. This quality improvement project aims to evaluate the effect of a brief mindfulness-based stress reduction program (MBSR) for providers who evaluate veterans on the variable of mindfulness awareness compared to current site practice. Lewin’s change management model and Peplau’s Interpersonal Relations Theory were used. Plan-Do-Study-Act was the implementation framework applied. The design was pretest-posttest using the Mindful Attention Awareness Scale (MAAS). …

Environmental Sanitation In Long-Term Care Facilities: A Focus On Regulations And Implementations, Ruwan Dissanayake Dissanayake Mudiyanselage

All Theses

Environmental sanitation is a fundamental component of infection prevention in long-term care facilities (LTCFs), where residents are at increased risk due to advanced age, underlying health conditions, and communal living arrangements. Despite its critical role, significant gaps remain in implementing environmental sanitation procedures and the regulatory frameworks that guide them.

This study combines two components: (1) an across-state regulatory review of environmental sanitation in LTCF regulations and (2) a cross-sectional survey assessing environmental sanitation characteristics of nursing homes (NHs) and assisted living facilities (ALFs) and Rural and Urban LTCF observation study in South Carolina (SC) . For the regulatory review …

Parental Experiences With Financial Toxicity In The Pediatric Intensive Care Unit: A Phenomenological Research, Sohrab Alexander Sardual

Dissertations and Theses (Open Access)

Background: Parents of children admitted to the pediatric intensive care unit (PICU) encounter multiple stressors; however, there is a need to further understand their experiences with financial toxicity. Understanding parents’ experiences and perspectives on how they can be assisted is a critical first step to formulating interventions to help parents deal with financial toxicity.

Aims: The aims of this study are (a) to describe the experiences with financial toxicity of parents with critically ill children admitted to the PICU and (b) to explore parents’ perspectives on how they can be assisted in dealing with financial toxicity.

Methods: A phenomenological qualitative …

Editorial – Dec 2025, Edwin Van Teijlingen, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Effect Of Focussing On Anastatica Hierochuntica Flower On Labour Pain, Duration Of Labour And Perceived Fatigue During Labour: Randomized Controlled Study, Emine Koç, Şükran Başgöl, Sümeyye Bal, Sabire Kirtiloğlu

Journal of Asian Midwives (JAM)

Background: Maternal fatigue and pain during labour can adversely affect the health of the mother, fetus, and newborn. Anastatica hierochuntica is a plant traditionally used in some cultures during childbirth rituals. When placed in water, the dried flower gradually unfolds and symbolically represents the opening of the uterus and birth canal. This study aimed to investigate the effect of focusing on the Anastatica hierochuntica flower during labour on labour pain, duration, and perceived fatigue.
Methods: This randomized controlled trial was conducted in the delivery unit of a mother-friendly hospital with 119 participants 60 in control group and 59 in intervention …

Factors Associated With Preterm Premature Rupture Of Membranes: A Case-Control Study In A Tertiary Hospital In Kabul, Afghanistan, Atia Sharif Nadi, Freshta Sharif Tawakkuli, Zainab Sharif Ezadi, Sayed Murtaza Sadat Hofiani, Shoaib Murtaza Sadat Naeemi, Ahmad Komail Frogh

Journal of Asian Midwives (JAM)

Background: It is essential to identify preterm premature rupture of membranes (PPROM) and its associated risk factors to reduce its impact. This study aims to find the demographic, reproductive, and obstetric factors associated with PPROM among women in Kabul, Afghanistan.
Methods: This case-control study was conducted over six months in 2023 at a tertiary hospital in Kabul, Afghanistan. We included 40 cases of PPROM and 80 controls without PPROM in this study. We used structured questionnaires to collect demographic, reproductive, and obstetric characteristics of the participants. To find the factors associated with PPROM, Logistic regression was performed using IBM SPSS …

A Scoping Review Of Maternal Active Smoking During Pregnancy And Low-Birth Weight, Naomi Sondang, Nindi Oktavia, Qorinah Estiningtyas Sakilah Adnani, Lani Gumilang, Hadi Susiarno, Victor Abiola Adepoju

Journal of Asian Midwives (JAM)

Background: Low-birth weight (LBW; < 2.5 kg) infants are at increased risk of early mortality, impaired growth, neuro-developmental delay and chronic disease later in life. Maternal behavior, especially cigarette smoking, remains one of the most modifiable determinants of birth weight. We therefore synthesized recent evidence on the association between active maternal smoking during pregnancy and LBW.
Methods: Following PRISMA guidance, we systematically searched PubMed, Scopus and ScienceDirect for the period January 2020 to 31 January 2025 for English-language observational studies that quantified the relationship between active prenatal smoking and LBW. Risk of bias was appraised, and findings were summarized narratively.
Results: In total 26,650 papers were found and eight eligible studies (four cohort, three cross-sectional, one case-control) from Asia, Europe and the Middle East were included. Across all designs and exposure metrics—self-report, exhaled carbon-monoxide, urinary cotinine, and cord-blood DNA-methylation, active smoking was consistently associated with …

Neurology Residency Training In Pakistan: Current Status And Future, Bashir Soomro

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Alarming Rate Of Hemorrhagic Stroke Showing An Urgent Need For Hypertension Control: A Retrospective Study From A Major Stroke Center In Sindh, Sana Ghous, Muhammad Hashim Kalwar, Muhammad Hassan Butt, Irfan Ali Vighio, Mehfooz Ali Shah, Javed Khurshed Shaikh, Mansoor Hassan

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Hemorrhagic stroke accounts for approximately 18–20% of the global stroke burden and is associated with high mortality and disability. It poses a significant challenge in low- and middle-income countries, where delayed presentation and inadequate risk factor control worsen outcomes. Hypertension remains the most important modifiable risk factor, particularly when poorly controlled. The objective of this study was to investigate the incidence of hemorrhagic stroke at a major stroke center and its association with uncontrolled hypertension.

Methods:

This retrospective study was conducted at Sindh institute of cardiovascular diseases (SICVD) Sukkur over three months, from May to July 2024. …

Prevalence And Characterization Of Post-Acute Sequelae Of Sars-Cov-2 Infection (Pasc) In Rwanda, Fernand Rwamwejo, Vivianne Umuhire Niyonkuru, Gilbert Rukundo, Eric Remera, Edson Rwagasore, Les Sztandera, Ruranga Charles, Elizabeth Krebs

School of Business Faculty Papers

Objectives

Reliable, population-level estimates of post-acute sequelae of SARS-CoV-2 infection (PASC) remain scarce for sub-Saharan Africa. We aimed to quantify PASC prevalence and identify associated factors among adult COVID-19 survivors in Rwanda.

Methods

A nationally representative cross-sectional telephone survey (August-October 2024) sampled 3143 adults from the national COVID-19 registry. PASC was defined as new or persisting symptoms ≥3 months after acute illness and lasting ≥2 months. The prevalence was calculated, and multivariable logistic regression identified factors independently associated with PASC.

Results

Overall, PASC prevalence was 34%. Leading symptoms were back pain, headache, dizziness, fatigue, and reduced sexual desire. Higher odds …

Integrating Spot-Scanning Proton Arc Therapy With Functional Avoidance Strategies To Reduce Pulmonary Toxicity, Yingxuan Chen, Peilin Liu, Xiaoda Cong, Edward Castillo, Richard Castillo, Inga Grills, Craig Stevens, Xiangkun Xu, Xiaoqiang Li, Yevgeniy Vinogradskiy, Xuanfeng Ding

Department of Radiation Oncology Faculty Papers

Background and purpose: Functional avoidance radiotherapy has emerged as a promising technique using functional imaging to minimize pulmonary toxicity by reducing doses to functional lung. This study aims to investigate the potential dose-volume advantages of a novel spot-scanning proton arc (SPArc) therapy for functional avoidance radiotherapy with four-dimensional computed tomography (4DCT)-based ventilation imaging.

Material and methods: Twenty-five patients from a prospective functional avoidance clinical trial treated with intensity-modulated photon radiotherapy were included. Robustly optimized intensity modulated proton therapy (IMPT) and SPArc plans were generated in RayStation. Functional lung contour was derived from the 4DCT-based ventilation imaging and utilized as an …

Benefits Of Animal Assisted Therapy In Pediatric Inpatient Units: A Literature Review, Logan M. Shiflett

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this systematic review of literature was to establish if animal assisted therapy (AAT) is helpful in the reduction of stress for patients on pediatric inpatient floors. The PICOT question that led this review was: In pediatric patients, how does animal assisted therapy affect patient outcomes related to increased hospitalizations? The EBSCOhost database, as well as the Web of Science and CINAHL Complete information sources, were used to find relevant studies for this review that assessed the benefits and contraindications for AAT. Key terms such as “animal assisted therapy,” “pediatrics,” and “inpatient” were used to narrow down the …

A Comparison Of Cultural Aspects Of Breastfeeding In The United States Vs Italy, Madison P. Wallace

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Healthcare systems internationally differ from policies, funding and resources available, and it is evident when comparing the United States and Italy. Participation in the Nursing Across the Lifespan study abroad program at the University of Arkansas Rome Center and Tiny Tusk Breastfeeding and Infant Support internship inspired a comparative exploration of breastfeeding practices in the United States versus. Italy. The United States has a mixed public- private insurance system, workplace policies and government assistance, while Italy has a universal healthcare system with a mandated maternal work paid leave to support breastfeeding mothers. Italy's program supports education and physical care needed …

Exercise As A Treatment For Depression And Anxiety Symptoms In College Students, Ashley J. Fountain

ATU Honors Projects

Anxiety and depression have become increasingly prevalent among college students, with rates rising to levels that demand urgent and accessible treatment alternatives. Traditional interventions such as psychotherapy and pharmacological treatments, while effective for many, present limitations including high cost, side effects, and barriers to access. This paper examines exercise as a holistic, evidence-based treatment modality for reducing symptoms of depression and anxiety in college students. Recent research demonstrates that aerobic exercise, resistance training, and yoga each produce meaningful physiological and psychological benefits through mechanisms involving neurotransmitter regulation, reduced cortisol levels, and enhanced self-esteem. Studies comparing exercise with antidepressant medications show …

Incidence And Management Of Adverse Events Associated With Tebentafusp Treatment In Metastatic Uveal Melanoma: Pooled Safety Analysis Of 410 Patients, Takami Sato, Marcus O. Butler, Sophie Piperno-Neumann, Jessica C. Hassel, Paul Nathan, Alexander N. Shoushtari, Piotr Rutkowski, Richard D. Carvajal, Jean-Francois Baurain, Max Schlaak, Josep M. Piulats, Ryan J. Sullivan, Sebastian Ochsenreither, Reinhard Dummer, John M. Kirkwood, Alexandra Ikeguchi, Anthony M. Joshua, Mark R. Middleton, Ramakrishna Edukulla, Constance Pfeiffer, Joseph J. Sacco

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

PURPOSE: We conducted an integrated safety analysis from three clinical studies of tebentafusp, a first-in-class ImmTAC bispecific T-cell engager, which can redirect T cells to target glycoprotein 100-positive cells, in metastatic uveal melanoma.

EXPERIMENTAL DESIGN: HLA-A*02:01-positive patients with unresectable or metastatic uveal melanoma enrolled in three clinical trials (IMCgp100-01, IMCgp100-102, and IMCgp100-202) who received ≥1 dose of tebentafusp were included. Safety data were pooled to evaluate the profile, onset, and management of treatment-related adverse events (TRAE). Adverse events of special interest included cytokine release syndrome (CRS), acute skin reactions (ASR), and liver function test elevations. Primary prophylaxis with medications was …

Navigating Upstream: How Medical Educators Strategize The Unfamiliar During Their Transition Into A Leadership Role, Sarah Williams

LSU New Orleans Theses and Dissertations

As the medical field grows more complex, the need for medical educator leaders has increased, driving the integration of leadership training into medical education to help manage an increase in administrative challenges. In U.S. medical schools, the Liaison Committee on Medical Education (LCME) standards require faculty to fill high-ranking leadership roles who must balance academic and administrative duties. Medical educators in these leadership roles must manage the tensions between teaching, research, patient care, and administrative responsibilities. Although leadership programs designed for medical educators exist, as well as faculty development opportunities, educators consistently express a lack of training as they transitioned …

A Quantitative Exploration Of Risk And Protective Factors Affecting The Mental Health Of Chitimacha Tribal Youth, Daphnie Vilcan-Tanner

LSU New Orleans Theses and Dissertations

This study examines the relationships between demographics, risk factors, and protective factors with mental distress among Chitimacha Tribal adolescents aged 12 to 18. Using a Positive Youth Development framework, the research aimed to identify the prevalence of mental distress, trauma, discrimination, and protective factors, as well as their collective and individual impacts on mental health. Data were collected through online surveys completed by 73 participants residing on or near the Chitimacha Tribal Reservation. Descriptive statistics and multiple linear regression analyses were conducted to analyze the data. Results revealed that while trauma and discrimination collectively predicted mental distress, family and community …

Gender Differences In Psychological Strengths Among Rural Adolescents, Angela Preston, Jodi Bullard, Rachel Smith, Ashlyn Peppler

Nursing Faculty Publications and Presentations

Purpose: Rural adolescents often lack access to mental health care along with increased rates of depression and suicide completion. While psychological strengths have been associated with positive outcomes globally, little is known regarding the prevalence of these indicators (hope, self‐efficacy, resilience, optimism, and gratitude) among adolescents living in rural Texas. The purpose of this study was to describe how rural adolescents report their psychological strengths and examine the data for potential gender differences.

Design and Methods: A secondary analysis of cross‐sectional data was performed on the RStudio platform using tests of central tendency and inferential statistics. Results: There were 425 …

Injury Prevention And Care Training Website, Samantha E. Myers

Theses/Capstones/Creative Projects

Injury Prevention and Care is a University of Nebraska Omaha (UNO) resource within Campus Recreation and Wellness. It serves a variety of students, staff, , and other membership holders with a variety of resources and treatments in caring for injuries and in seeking to prevent new or worsening of injuries. In facilitating the health and growth of this department and their staff, updating the current training resources, and making them more accessible was necessary. Moving forward, discussions of the importance of accessibility and providing various resources, both in IPC and across the UNO campus, were pivotal in the formation and …

Comparative Analysis Of The Effects Of Peppermint Oil On Colorectal Cancer Cells And Human Fibroblasts, Allen W. Mccumbers

Theses/Capstones/Creative Projects

This study contrasted the effects of Peppermint Oil on two cell lines, HT29s (colorectal adenocarcinoma cells) and HFFs (Human Foreskin Fibroblasts). Cytotoxic as well as genomic effects were compared between the cell lines. Trypan Blue, Alamar Blue, and qPCR assays were used to study these effects. Both cell lines were treated with a range of Peppermint Oil concentrations, and it was determined that there is a dose-dependent factor associated with cytotoxicity. To confirm results, Alamar and Trypan Blue assays were repeated at 300 and 500 cells/mL respectively. Effects were confirmed, and results were averaged and plotted. Alamar Blue revealed that …

Factors Associated With Stillbirth In Four Selected Hospital Maternity Units: An Unmatched Case-Control Study In Eswatini, Phetsile Thwala, Abednego Ongeso, Rose Maina, Benard Mutwiri

School of Nursing & Midwifery, East Africa

Background: Stillbirth is a substantially under-recognized adverse pregnancy outcome that predominantly occurs in low-middle-income countries. In 2019, Eswatini’s stillbirth rate was 13.2 per 1,000 births, higher than global targets. However, there is limited research on stillbirths in Eswatini. This study analyzed factors associated with stillbirths among women giving birth in four selected hospitals.

Methods: A multi-center unmatched case-control study was conducted using secondary data sources from July 1 to December 31, 2021. Birth records of 268 stillbirths (cases) and 1,151 live births (controls) were selected using consecutive and systematic random sampling, respectively. A piloted data extraction tool was used to …

A Scoping Review Of Human Digital Twins In Healthcare Applications And Usage Patterns, Brant H. Tudor, Robert Burton, Joyce T. Johnson, Ryan Shargo, Geoffrey M. Gray, Jamie L. Fierstein, Frederick H. Kuo, Brandi B. Scully, Alfred Asante-Korang, Mohamed A. Rehman, Luis M. Ahumada

Student Publications [Scholarly]

Digital twins have become increasingly popular across various industries as dynamic virtual models of physical systems. In healthcare, Human Digital Twins (HDTs) serve as virtual counterparts to patients. According to the National Academies of Sciences, Engineering, and Medicine (NASEM), a digital twin must be personalized, dynamically updated, and have predictive capabilities to—in the context of health care—inform clinical decision-making. This scoping review aims to assess the current state of HDTs in healthcare, examining whether the literature aligns with the NASEM definition and identifying trends. A systematic literature search was conducted, covering articles published from January 2017 to July 2024. Only …

Identifying Barriers For Community Pharmacies As Vaccines For Children (Vfc) Providers In Rural Alabama: Opportunities For Solutions, Myra Bajwa

Honors Theses

Significant Human papillomavirus (HPV) vaccination disparities exist between rural and urban areas in the US. A primary contributor is low access to preventive care in rural areas. Among the most promising strategies to overcome this is increasing access through offering HPV vaccination in non-traditional, convenient health settings such as pharmacies. In rural areas, community pharmacies are trusted, convenient pillars of the community. In Alabama, community pharmacies are eligible for enrollment in the Vaccines for Children (VFC) Program, a federally-funded program that provides free vaccines to children and adolescents under 18 years old who are uninsured, underinsured, American Indian, or Alaska …

Best Practice Recommendations For Anesthesia Providers In Preventing Postoperative Delirium In The Geriatric Population Undergoing Non-Cardiac Surgery, Ana Primeaux, Ashanti Reed

Doctoral Projects

Postoperative delirium (POD) is a significant and preventable complication in geriatric patients undergoing non-cardiac surgery. Such complication is associated with foreseeable consequences, such as prolonged hospitalization, long-term cognitive decline, increased morbidity and mortality, and increased costs. Despite the emerging awareness of evidence-based nonpharmacologic and pharmacologic interventional strategies, POD still represents a clinical challenge for anesthesia providers.

Currently, there is a lack of clinical guidelines to guide formalized education and evidence-based interventions on POD prevention across anesthesia practice settings. Consequently, there is a critical need to raise awareness that the lack of clinical guidelines and the high incidence of POD may …

Advancing Anesthesia Provider Proficiency In Airway Assessment Using Point-Of-Care Ultrasound: An Osce-Based Educational Initiative, Austin Fike, Trevor Jordan, Sam Sherrill Iii

Doctoral Projects

Airway management is one of the fundamental pillars of anesthesia. Traditionally, tools such as the Mallampati classification and the thyromental distance are used for airway assessment in the perioperative area. However, often, these methods fail to reliably predict difficult intubations. The use of point-of-care ultrasound (POCUS) has emerged as a valuable adjunct in airway assessment. However, a knowledge deficit exists among anesthesia providers regarding its application in airway assessments for perioperative adult patients. This doctoral project addressed the knowledge deficit in POCUS airway assessment among Certified Registered Nurse Anesthetists (CRNAs) and Student Registered Nurse Anesthetists (SRNAs) through the development and …

High Test-Retest Reliability Of Nucleus Accumbens Activity During Reward Anticipation, Nathaniel Bouton

Graduate Theses and Dissertations

Recent research has questioned the reliability of Functional Magnetic Resonance Imaging (FMRI). The findings suggest poor test-retest reliability of FMRI measures across brain areas and tasks, and specifically in subcortical brain areas during reward-related tasks. Further, data from the Adolescent Brain Cognitive Development (ABCD) study showed low reliability and low stability of the fitted coefficients from whole-brain regression analyses of the Monetary Incentive Delay (MID) task. However, optimizing methods might improve reliability, for example: (1) acquiring single-band rather than multi-band FMRI sequences, (2) extracting raw activity rather than fitted coefficients, and (3) honing analyses to target brain areas during specific …