A Quality Improvement Project To Improve Touch Exposures In The Neonatal Intensive Care Unit., Jeremi Tricia Braga

Doctor of Nursing Practice Papers

Introduction: Premature infants in the NICU are exposed to many noxious stimuli that could cause negative effects on development. The SENSE® program has been developed to provide developmentally appropriate sensory stimulation for neonates. This project will focus on sense of touch primarily with KC or also referred to as skin-to-skin.

Environment: This QI project took place in to a Level III NICU at a tertiary medical center in Louisville, Kentucky. The facility has a total of 421 beds including the NICU that is licensed for 34 beds and caring for infants born prematurely as early as 22 weeks to term …

Enhancing Nurse Competence And Self-Efficacy In Delivery Of Medication Education At Discharge: A Quality Improvement Project Using The Teach-Back Method., Quinesia James

Doctor of Nursing Practice Papers

Medication nonadherence in pediatric psychiatric care contributes to worsening symptoms, delayed developmental progress, and increased hospitalizations. Adherence rates remain as low as 30–60%, accounting for up to $300 billion in avoidable healthcare costs annually. Low health literacy and inconsistent education strategies further complicate adherence. This quality improvement project took place on the child and adolescent psychiatric units at the project site, a large teaching hospital in a metropolitan area in the south-central United States, which serves patients aged 5–17 with complex mental health needs. The initiative aimed to improve nurses’ competence, self-efficacy, and time efficiency in delivering medication discharge education …

Improving Collaboration With Hospital Security And Nursing Staff, When Treating Patients In Acute Crisis, By Implementing A Modified Sbar Card., Yuna Choi

Doctor of Nursing Practice Papers

Inpatient psychiatric units provide assistance to patients experiencing acute mental health crises such as psychosis or suicidal ideation. Patients experiencing acute mental health crises can sometimes become agitated or aggressive towards staff, themselves, or other patients, which can pose a significant risk to everyone’s safety. The purpose of the project is to improve staff satisfaction and collaboration by standardizing the interdisciplinary communication between hospital security and nursing staff. Over a period of two weeks, the facilitator educated security and unit staff on a SBAR card during shift huddle to implement on the unit in the event of an acute mental …

A Program Evaluation Of The Pet Therapy Program At Norton Children’S Hospital’S Ackerly Child Psychiatric Unit., Michael Brockman, Michael Brockman

Doctor of Nursing Practice Papers

Pet therapy is an increasingly utilized intervention in psychiatric care, particularly among adolescents. Within the inpatient adolescent psychiatric setting, pet therapy has been linked to reduced anxiety, enhanced emotional regulation, and improved patient engagement. At Norton Children’s Hospital’s Ackerly Child Psychiatric Unit, pet therapy sessions are offered weekly but had not been formally evaluated. The absence of structured evaluation raised concerns about sustainability, consistency, and the program’s therapeutic impact. This project aimed to take a deeper look at the program by conducting a program evaluation of the existing pet therapy initiative at the Ackerly Unit. The evaluation focused on identifying …

Implementation And Rvaluation Of A Mindfulness-Based Intervention On Compassion Fatigue And Depressive Symptoms In Perioperative Nurses: Quality Improvement, Felicia R. Preston

Doctor of Nursing Practice Papers

Background: Compassion fatigue (CF) and depressive symptoms (DS) impair the well-being of nurses worldwide, contributing to mental health conditions, poor patient care, absenteeism and turnover. Perioperative nurses are vulnerable to developing CF and DS due to demanding working environments, continually managing postsurgical pain, complications, and emotionally intensive procedures. Mindfulness-based interventions (MBI) may enhance a nurse's resourcefulness and offer coping strategies against CF and DS.

Purpose: The purpose of this quality improvement (QI) project was to implement the Three Minute Breathing Space (3MBS), a mindfulness-based intervention (MBI) and to evaluate its effects on CF and DS among perioperative nurses.

Methods: …

Reducing Inpatient Falls On A Cardiac Progressive Care Unit: A Quality Improvement Project., Danielle R. Turner

Doctor of Nursing Practice Papers

Background: Inpatient falls are harmful to patients and to the healthcare organization. Fall prevention interventions and strategies are necessary in the acute setting to reduce the number of falls and increase patient safety.

Environment: This quality improvement project will take place at a Midwest acute care hospital on a cardiac PCU. This is a 38-bed unit where there has been an increased number of patient falls.

Purpose: The John Hopkins Evidence Based Practice Model was used to design, implement, and assess a nurse-driven, bedside, visual tool to reduce the number of inpatient falls on a cardiac progressive care unit.

Methods: …

Time Reduction Or Waste Production?, Katryna Smith, Brittany Grannell, Cheri Geurtin

Nurse Residency

PICOT Question: In adult patients arriving at the Emergency Department, does proactively conducting standard laboratory tests prior to provider assessment, as opposed to waiting for provider instructions, lead to a reduction in the overall length of stay during a single visit?

From Harm To Healing: Centering Towards Black And Ethnic Minority In Birth Equality, Jodiann Coleman, Ikesha Green

Nurse Residency

PICOT Question: In ethnic minority pregnant individuals, does anti racism training for healthcare providers improve the birthing experience compared to standard care?

Fractal Analysis In Different Regions Of A Fracture Surface In A Dental Glass-Ceramic, Kartikeya S. Jodha, Susana Salazar Marocho, John J. Mecholsky, Seth T. Lirette, Yuanyuan Duan, Jason A. Griggs

Biomedical Materials Science Publications

Objectives: Previous studies have reported the fractal dimension of dental ceramic fracture surfaces from mist and hackle regions. The aim of this study was to determine and compare the fractal dimensional increment between the mirror, mist, and hackle regions of lithium disilicate fracture surfaces. Methods: Nine bar-shaped specimens were prepared from lithium disilicate glass-ceramic. One face of each specimen was indented using a Knoop diamond at 10 N followed by loading in 4-point flexure until failure at a loading rate of 12.6 MPa/s to avoid environmental slow crack growth. Fracture surfaces were replicated in epoxy, and an atomic force microscope …

Himmelfarb Library Liaison Letter - August 2025, The George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

Administrative Leadership Digital Hub To Expand Access To Occupational Therapy For Underserved Veterans ​, Bianca N. Haddock

Department of Occupational Therapy Entry-Level Capstone Projects

This capstone project aimed to address key administrative leadership functions within the Orlando Veterans Affairs Healthcare System through the development of a digital hub supporting interdisciplinary collaboration among allied health services— occupational therapy (OT), recreational therapy (RT), and whole health (WH). The project aimed to close communication gaps that limit Veteran access to rehabilitative services by enhancing administrative coordination, streamlining pre-service implementation documentation, facilitating therapeutic equipment acquisition and training, and promoting service integration.

Adiponectin-Regulated Macrophage Responses In Aspergillus Fumigatus Infection: Mechanisms Of Uptake And Killing, Sri Harshini Goli

All-Inclusive List of Electronic Theses and Dissertations

Invasive aspergillosis (IA), caused by Aspergillus fumigatus, is a life-threatening infection in immunocompromised individuals, necessitating novel host-directed therapies. Macrophages are pivotal in antifungal defense, yet their function can be dysregulated; the influence of the adipokine adiponectin (APN) on this process is not fully understood. This thesis investigated the role of APN signaling in alveolar macrophage (AM) and bone marrow-derived macrophage (BMDM) responses to A. fumigatus and assessed the therapeutic potential of the APN receptor agonist, AdipoRon. Initial studies revealed that genetic deficiency in APN or its receptors renders AMs intrinsically pro-inflammatory and significantly impaired fungicidal activity against A. fumigatus. Subsequent …

The Influence Of High Iq On Adhd Symptom Presentation And Outcomes In Children, David A. Lee

All-Inclusive List of Electronic Theses and Dissertations

Research suggests that a high intelligence quotient (IQ) may contribute to the underdiagnosis and misdiagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) in children. High IQ may allow children to compensate for executive functioning-related deficits inherent in ADHD and/or may influence behaviors such as high activity level or not following rules that mimic ADHD symptoms. To gain a better understanding of the relationship between IQ and ADHD, the present study aimed to investigate how high IQ impacts symptoms of inattention and hyperactivity as well as outcomes related to academic performance, emotional regulation, and peer relationships in children. The study utilized archival data from …

Dermatoglyphic Fluctuating Asymmetry In Schizotypy, Marcus R. Thomas

All-Inclusive List of Electronic Theses and Dissertations

Schizotypy has been linked with many of the proposed endophenotypes of schizophrenia, but research is limited on the relationship between schizotypy and dermatoglyphic fluctuating asymmetry. The present study sought to examine relationships between schizotypy, dermatoglyphic fluctuating asymmetry, handedness, and season of birth. 146 undergraduate students were identified as schizotypes (n = 52) or controls (n = 94) based on the Multidimensional Schizotypy Scale and had their finger and palm prints collected along with completing additional measures of schizotypy and handedness. Schizotypes did not exhibit a greater degree of dermatoglyphic fluctuating asymmetry, negative schizotypy was associated with increased absolute finger ridge …

A Word From The Writing Team (August 2025), Pam Walter, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Publications Spotlight
• Join the Last Summer Writing Warriors Session Tomorrow
• Check out our Fall Workshops
• Two Ways to Fund Open Access Fees

A Phase 2 Trial Of Niraparib Plus Bevacizumab Maintenance Therapy Following First-Line Platinum-Based Chemotherapy With Bevacizumab In Advanced Ovarian Cancer: Final Analysis And Overall Survival Results From Ovario., Melissa M Hardesty, Thomas C Krivak, Gail S Wright, Erika Hamilton, Evelyn L Fleming, Jimmy Belotte, Shelby Gorman, Natalie Compton, Aine Clements, Heidi J Gray, Gottfried E Konecny, Richard G Moore, Debra L Richardson

Oncology Articles

OBJECTIVE: To report long-term outcomes from the OVARIO trial of niraparib plus bevacizumab maintenance following first-line platinum-based chemotherapy with bevacizumab in advanced ovarian cancer.

METHODS: The phase 2, single-arm, open-label trial enrolled adult patients with stage IIIB-IV epithelial ovarian, fallopian tube, or primary peritoneal cancer (NCT03326193). Patients were required to have attempted debulking surgery and have a complete or partial response or no evidence of disease following first-line, platinum-based chemotherapy with ≥3 cycles of bevacizumab. The primary endpoint was 18-month progression-free survival (PFS) rate, per RECIST. Secondary endpoints included PFS, overall survival (OS), safety, and health-related quality of life (HRQOL) …

Dementia- Friendly Interventions In The Hospital Setting And Positive Patient Outcomes, Breanna Wenger

Nurse Residency

PICOT Question: In patients with dementia, what impact does a “dementia-friendly” hospital have on their outcomes in comparison to hospitals that do not employ dementia-friendly practices during their stay?

Caregiver Perceptions, Knowledge, And Likelihood To Intervene With Suicidal Youth, Amber L. Willwerth

All-Inclusive List of Electronic Theses and Dissertations

This study utilized an online survey to target primary caregivers of a child aged 5-18. The survey highlighted factors regarding caregiver involvement in suicide prevention efforts, such as their knowledge, comfort and confidence intervening with a youth experiencing suicidality, and barriers to doing so. It was found that caregivers who had experienced suicide prevention training reported higher levels of comfort and confidence intervening with their own child and another child than those who had not, as well as lower levels of worry. Higher levels of education were also found to predict lower levels of worry, suggesting that further training and …

Factors Associated With Postpartum Depression Among Women Attending Postnatal Clinics In A Tertiary Care Hospital In Nairobi, Kenya, Cecilia Muthoni Njoga

Master of Medicine in Family Medicine

Background 

Postpartum depression (PPD) is a major mental health disorder affecting women during the postpartum period with a global prevalence of up to 17.22%. This prevalence has been shown to be higher in low and middle-income countries. In Kenya, about a fifth of women are affected. PPD can lead to poor infant growth and interference with maternal-child bonding. Additionally, women with PPD experience a lower quality of life and their children have an increased risk of developing and psychotic disorders later in life. Understanding the factors associated with PPD is crucial for early diagnosis and intervention. The study aimed to …

Factors Informing Referral Of Adult Patients To Palliative Care Services In A Tertiary Facility In Kenya: Physicians' Perspective, Donnah A. Opiyo

Master of Medicine in Family Medicine

Background The growing burden of chronic diseases underscores the urgent need for palliative care integration into healthcare systems worldwide. Despite its benefits, palliative care remains underutilized due to various barriers, including health system limitations, institutional challenges, infrastructure gaps, and individual provider factors. However, limited research has explored the specific factors influencing physicians' decisions to refer patients to palliative care. This study sought to fill that gap by examining the key determinants shaping referral practices in a tertiary facility in Kenya.

Design and Methods This exploratory qualitative study examined 22 physician specialists from five departments at Aga Khan University Hospital, Nairobi. …

Specificity Of Interaction Of Antimicrobial Peptide With Cell Membrane, Srishhti Kumar Jha

Pharmaceutical Sciences (MS) Theses

Antimicrobial resistance (AMR) is an increasing global health threat due to its rising incidence worldwide. Resistant microbial infections have become difficult to treat and pose serious risks to patients. In 2019, AMR was responsible for approximately 1.27 million deaths globally, with numbers continuing to rise. The World Health Organization (WHO) has highlighted the urgent need for new antibiotics with novel mechanisms of action and low toxicity to combat this issue. Antimicrobial peptides (AMPs) represent a promising solution. These peptides exhibit broad-spectrum antimicrobial activity and rapid killing kinetics, reducing the likelihood of resistance development. AMPs primarily target bacterial cell membranes. Their …

Incidence Of Peripheral Intravenous Cannula Complications And Associated Factors Among Paediatric Patients At A Tertiary-Care Referral Hospital, Vanessa Minsari Ogega

Master of Medicine in Paediatrics and Child Health

Introduction: Peripheral intravenous catheters (PIVCs) are widely used in clinical practice and are a major source of procedure-related pain in children. Their use is associated with complications including occlusion, dislodgement, infiltration, extravasation, phlebitis, and, rarely, bloodstream infections.

Objectives: To determine the incidence and risk factors associated with PIVC complications among paediatric patients aged 1 day to 18 years at Aga Khan University Hospital, Nairobi. The study also assessed the average survival time of PIVCs.

Methods: A prospective cohort study was conducted on 320 PIVCs among 192 children admitted between August and October 2024. Data collected included patient demographics, clinical characteristics, …

Kenyan Dietitians’ Knowledge Of Ketogenic Dietary Therapies For Drug-Resistant Epilepsy, Pauline Samia, Violet Naanyu, Perry Ndila, Helen Cross, Richard Idro, Paul Boon, Jo Wilmshurst, Stanley Luchters

Paediatrics and Child Health, East Africa

Background: Ketogenic dietary therapy (KDT) has been proven to be efficacious for people with drug-resistant epilepsy. However, it is rarely utilized in low-resource settings. Due to the complexity of implementation, dietitians play a crucial role in managing KDT.

Methods: We conducted a cross-sectional survey of 253 out of the 1,000 registered dietitians. We assessed their knowledge of and interest in further training in KDT.

Results: Most participants were female (78%), with a median age of 33 years (IQR=28–38). A total of 171 (67.6%) reported knowledge of KDT. However, only 13 respondents (7.6%) answered all five knowledge-specific questions correctly. A …

Interview With Former Chairman Of Cardiology E. Berry Hey, Jr. Md, Caitlin Moss

Historic Narratives

No abstract provided.

Polyphenols For The Mitigation Of Vascular Calcification; In Vitro And In Vivo Studies, Abdullah Altuhami

All Theses

Globally, cardiovascular diseases, in most cases associated with calcification, are the main cause of death. However, currently, the only effective cure is to undergo surgery to augment or receive a healthy donor heart, which could be very difficult due to the long waiting list and the associated risks. The possibility of body rejection of the foreign organs is attributed to immunoreaction or the risk of infection, since the donor must be on immunosuppressant drugs that lower the body's immunity and facilitate the body's acceptance of the new organ as one of its own. Taking that into consideration, using tissue-engineered vascular …

Improving Antipsychotic Compliance By Addressing Client Experience Of Metabolic Syndrome, Lurinda N. Paulsen

Doctor of Nursing Practice

Abstract

Purpose: This project was undertaken to increase medication adherence in clients diagnosed with mental illnesses that necessitate the use of antipsychotic (second generation, atypical or first generation, typical) medications.

Background: Medication compliance in the treatment of schizophrenia, schizoaffective disorder, and bipolar disorder is essential to ensure consistent medication levels and symptom stabilization. There are many reasons clients stop taking their medications, and symptoms of metabolic syndrome are often a cause for self-discontinuation. Metabolic syndrome is a cluster of symptoms including obesity, hypertension, hyperglycemia, hypoalphalipoproteinemia, and/or hypertriglyceridemia, which increases risk for cardiovascular disease and diabetes.

Methods: This project was completed …

Exploring The Effect Of Social Determinants Of Health (Sdoh) Factors On The Time To Kidney Transplant Evaluation Completion For African American End Stage Renal Disease (Esrd) Patients, Kesha Levesque

MUSC Theses and Dissertations

Purpose – The purpose of this dissertation is to investigate the relationship between demographics and Social Determinants of Health (SDOH) variables on diagnostic testing time completion in patients being evaluated for kidney transplant waitlisting.

Aims - Compared to White Americans, African Americans who are eligible to receive a kidney transplant are less likely to complete the required testing in order to be placed on the kidney transplant waiting list which puts African Americans at risk for morbidity and mortality due to prolonged exposure to dialysis. The COVID-19 pandemic was directly associated with a decrease in the number of patients placed …

Navigating Childhood Asthma Care In Kenya: Barriers Identified By Children And Their Caregivers, Joan Ahimbisibwe, Roselyter Riang’A, Angela Migowa, Samuel Otido

Paediatrics and Child Health, East Africa

Background: Asthma is one of the most common chronic conditions in children, with significant morbidity and mortality, especially in Africa. Achieving adequate asthma control in children remains challenging because of gaps between standard recommended management strategies and actual treatment practices. This study explored barriers to asthma management as perceived by children and their caregivers in a private tertiary care setting in Kenya.

Methods: An exploratory phenomenological qualitative study was conducted at Aga Khan University Hospital (AKUH), Nairobi. Children aged 6–18 years with a confirmed diagnosis of asthma and their caregivers were recruited. The participants had been receiving treatment for at …

Dissecting The Heterogeneous Effects Of Opioid Prescribing Limit Laws On Pediatric Mortality: A Multidimensional And Negative Binomial Modeling Approach, Francine R. Vega

Dissertations and Theses (Open Access)

Opioid prescribing for children and adolescents continues to be a significant health crisis in the United States. Early naïve exposure to opioid prescriptions has been linked to later misuse, opioid use disorder, and death. In response to the crisis, many states have implemented opioid prescribing limit laws (OPLLs) aimed at reducing exposure to opioids. These laws vary widely in their approach, including differences in dosage restrictions, prescription duration limits, informed consent requirements, educational provisions, and whether they offer explicit protections specifically for minors. Despite their widespread adoption, there is limited understanding of how heterogeneity in legal regulations affects outcomes for …

Rethinking Health Systems Responsiveness In Low–And Middle-Income Countries, Meesha Iqbal

Dissertations and Theses (Open Access)

Health systems responsiveness (HSR) refers to a health system’s ability to meet legitimate non-health expectations of the population. Traditionally, HSR has been conceptualized across eight domains: respect for dignity, autonomy, confidentiality, prompt attention to health needs, availability of basic amenities, choice of provider, access to social support networks, and clarity of communication. However, as the expectations of populations in high-income countries (HICs) and low- and middle-income countries (L&MICs) differ significantly due to diverse social and cultural contexts, the conceptualization of HSR also varies. We conducted a systematic review of literature to adapt and contextualize the HSR framework for L&MICs based …