Medicine and Health Sciences Commons^™

Patients’ And Carers’ Experiences Of The Postoperative Care Pathway Following Coronary Artery Bypass Grafting: A Descriptive Qualitative Study, Dima Nasrawi, Sharon Latimer, Debbie Massey, Brigid M. Gillespie

Research outputs 2022 to 2026

Aim: This study aimed to understand patients’ and carers’ experiences of the inpatient postoperative care pathway during Phase 1 cardiac rehabilitation, including patients’ recommendations to improve its delivery, their engagement, and discharge preparation.

Methods: This was a descriptive qualitative study. Recruitment occurred over 1 month (February to March 2023) in a cardiac surgical ward at a large tertiary hospital. Adult patients who had recently undergone coronary artery bypass grafting and their carers were interviewed. Inductive content analysis was used to analyse interviews.

Results: Nine patients and five carers were interviewed. Patients were mainly male (n=8), while carers were mostly female …

Right-Sized Glycolysis In Growing Children: A Muscle Mass-Based Scaling Perspective, Sébastien Ratel, Joffrey Bardin, Anthony J. Blazevich

Research outputs 2022 to 2026

No abstract provided.

Safety And Effectiveness Of Behavioural Activation For Chronic Pain: A Protocol For A Systematic Review And Meta-Analysis Of Randomised Controlled Trials, Fangyuan Zheng, Laura Hynes, Richard J. Gray, Irene Ngune, Jacqueline Sin, Martin Jones

Research outputs 2022 to 2026

Background/Objectives: Chronic pain is a prevalent and complex condition associated with substantial physical, psychological, and social burden. Behavioural activation (BA), a structured psychological intervention originally developed for depression, may be relevant to chronic pain through its focus on reducing behavioural avoidance and increasing engagement in meaningful activities. Although BA has been applied in studies involving people with chronic pain, the safety and effectiveness of BA in this population have not been comprehensively synthesised. This systematic review and meta-analysis will examine the safety and effectiveness of BA for people with chronic pain.

The Reliability And Validity Of Manual Palpation To Assess Lower Limb Arterial Occlusion Pressure In Older Adults, For Application In Blood Flow Restriction Exercise, Michael Beere, Isaac Selva Raj, Jeremiah J. Peiffer, Keith D. Hill, Peter K. Edwards, Belinda Brown, Brendan R. Scott

Research outputs 2022 to 2026

(A) Investigate test-retest reliability of posterior tibial pulse palpation to determine arterial occlusion pressure (AOP) and examine validity against hand-held Doppler ultrasound. (B) Investigate the suitability of using 130% systolic brachial blood pressure for prescribing cuff inflation pressure for blood flow restriction (BFR) exercise. Repeated measures, crossover design. Lower limb AOP was assessed in 20 adults ≥ 60 years using hand-held Doppler ultrasound and posterior tibial pulse palpation. Brachial systolic blood pressure (bSBP) was measured to predict cuff inflation pressures (bSBP130%). On three occasions > 24 hours apart, three AOP measurements were recorded by the same blinded rater to determine intra-rater …

Measuring Health System Readiness In Saint Lucia Using International Health Regulations Capacity Indicators, Melissa Steele

Walden Dissertations and Doctoral Studies

Emerging infectious diseases continue to challenge national health systems, particularly in small island developing states with limited preparedness resources. Limited evidence comparing the International Health Regulations (2005) State Party Self-Assessment Annual Reporting (IHR SPAR) capacities of small island developing states with those of high-income countries limits efforts to identify preparedness gaps and strengthen health systems. The purpose of this quantitative comparative study was to evaluate Saint Lucia's preparedness using IHR SPAR indicators, compare its preparedness with the United States, and assess changes between 2023 and 2024. Guided by the World Health Organization Health System Framework, a quantitative cross-sectional design using …

Impact Of Media Guidelines On Suicide-Related Reporting Quality And Suicides: A Systematic Review And Meta-Analysis, Simone Scotti Requena, Vikas Arya, Thomas Niederkrotenthaler, Mark Sinyor, Michiko Ueda, Matthew J. Spittal, Jane Pirkis

Center for Policy Design and Governance

This brief summarizes "Impact of media guidelines on suicide-related reporting quality and suicides: A systematic review and meta-analysis," co-authored by Simone Scotti Requena, Vikas Arya, Thomas Niederkrotenthaler, Mark Sinyor, Michiko Ueda, Matthew J. Spittal, and Jane Pirkis in Crisis.

In Reply To The Letter To The Editor Regarding "The Effect Of Glp-1 Receptor Agonists On Reoperation Following Anterior Cervical Discectomy And Fusion", Nicholas C. Bank, Daniel Whittingslow, Sam Duggan, Joshua L. Morningstar, Douglas S. Weinberg

Student Papers, Posters & Projects

No abstract available

Addressing Food Pantry Capacity To Offer Medically Tailored Groceries For Food Insecure Individuals With Chronic Disease In Rural South Carolina, Anna G. Taylor

All Theses

This study examines the feasibility of implementing medically tailored grocery (MTG) programs within rural food pantries in South Carolina to better serve food-insecure individuals living with chronic diseases. Using a mixed-methods design, the study aimed to assess current pantry capacity, identify barriers and facilitators to MTG implementation, and evaluate strategies to strengthen MTG delivery.

The intervention was guided by three implementation science frameworks: the Six-Step Knowledge Sharing Model, the Consolidated Framework for Implementation Research (CFIR), and the RE-AIM evaluation framework. Data collection occurred in two phases. In Phase 1, statewide focus groups, capacity surveys, and inventory assessments were conducted to …

An Update On The Role Of Multimodal Analgesia In Perioperative Pain Management, Whitney N. Kuwamoto, Grace C. Eddy, Edward R. Mariano, Eric S. Schwenk

Department of Anesthesiology Faculty Papers

Multimodal analgesia has become a foundational principle of acute perioperative pain management and enhanced recovery and involves the application of nonpharmacologic, pharmacologic, and/or interventional techniques. The overall goal of this approach is to apply a combination of different modalities that target discrete points along the pain pathway and thereby avoid the overreliance on opioids and associated side effects. Since our review in 2018, there have been significant developments that have prompted an updated review of multimodal analgesia. In this article, we identify and summarize important trends that influence the current approach to acute perioperative pain management as well as provide …

Ecmo Use In Infants With Bronchopulmonary Dysplasia: A Literature Review., John Ibrahim, Nicholas Carr, Franscesca Miquel Verges, Natalie Rintoul, Robert Digeronimo, John M. Daniel Iv, Sarah Keene, Burhan Mahmood

Manuscripts, Articles, Book Chapters and Other Papers

Bronchopulmonary dysplasia (BPD) is a leading cause of chronic respiratory failure in infants. Severe BPD is associated with prolonged mechanical ventilation, pulmonary hypertension, and high morbidity and mortality. As disease severity increases, extracorporeal membrane oxygenation (ECMO) is being reconsidered as a potential rescue therapy. Historically, ECMO has been reserved for neonates with reversible respiratory failure and those who required mechanical ventilation for less than 14 days, while infants with BPD were excluded. However, advancements in ECMO technology, anticoagulation strategies, and ventilatory management have led to a reassessment of its role in this population. Emerging reports suggest ECMO may serve as …

Impact Of Trisomy 21 On Post Pull-Through Enterocolitis And Bowel Function In Children With Hirschsprung Disease: A Pcplc Analysis., Marshall W. Wallace, Scott S. Short, Rachel C. Crady, Ron W. Reeder, Hira Ahmad, Kelly Austin, Andrea Badillo, Casey M. Calkins, Megan M. Durham, Julie R. Fuchs, Christopher Gayer, Julia E. Grabowski, Jamie C. Harris, Charles R. Hong, Ankur Rana, Rebecca M. Rentea, Nelson Rosen, Payam Saadai, Caitlin A. Smith, K Elizabeth Speck, Cristine S. Velazco, Richard J. Wood, Michael D. Rollins

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: We evaluated whether Trisomy 21 (T21) affected bowel management use, ability to toilet train for stool, and rates of Hirschsprung-Associated Enterocolitis (HAEC) in children with Hirschsprung disease (HD). We hypothesized that T21 would be associated with increased rates of HAEC, bowel management program (BMP) use, and delayed toilet training for stool.

METHODS: Children with HD in the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) database who underwent primary pull-through were included and stratified by T21 status: HD only versus HD + T21. Children requiring a redo pull-through, initially managed with a stoma, or those who had inadequate follow-up were …

Sez6-Targeting Antibody-Drug Conjugate Abbv-706 In Advanced Small Cell Lung Cancer And Solid Tumors: A Phase 1 Trial, Lauren Averett Byers, Daniel Morgensztern, Et Al.

2020-Current year OA Pubs

Seizure-related homolog 6 (SEZ6) is expressed in small cell lung cancer (SCLC) and neuroendocrine neoplasms. In an open label, phase 1 trial, ABBV-706, an antibody-drug conjugate with a SEZ6-directed antibody linked to topoisomerase-1 inhibitor (Top1i), was administered intravenously every 3 weeks (Q3W) to 288 patients with advanced solid tumors; 240 received monotherapy, including 124 with relapsed/refractory (R/R) SCLC. Primary objectives of dose escalation (part 1, advanced solid tumors), dose optimization and expansion (part 2, R/R SCLC only) and dose expansion (part 4, central nervous system tumors and high-grade neuroendocrine neoplasms only) were to evaluate the safety, tolerability, pharmacokinetics (PK), immunogenicity …

Biological Aging And Generational Shifts In Early-Onset Cancer Risk, Ruiyi Tian, Xiaoyu Zong, Duo Ren, Stefani Tica, Daniel Hong, Oluseye Oduyale, Jason D Buenrostro, Ramaswamy Govindan, Yin Cao

2020-Current year OA Pubs

Incidence of early-onset cancer is rising globally in recent generations, which underscores the need to elucidate the influence of emerging generational risk factors. Systemic and organ-specific aging reflects the cumulative impact of exposures and may provide an integrative and complementary approach to understand early-onset cancer risk. Here among 154,169 young adults from the United Kingdom Biobank, systemic aging measured by PhenoAge increased across birth cohorts, with 23% s.d. increase for those born 1965-1974 versus 1950-1954, and was associated with early-onset solid cancer risk (hazard ratio (HR)

Effects Of Concurrent Neuropathologies With Alzheimer Disease Neuropathologic Change On Cognitive Decline: Minimal Impact Of Vascular Brain Injury Compared With Other Combinations, Sarah M Yasuda, Charles Mock, Kathryn Gauthreaux, Kwun C G Chan, C Dirk Keene, Jessica E Culhane, Yen-Chi Chen, Walter Kukull

2020-Current year OA Pubs

We examined cognitive changes associated with several neuropathologic entities, alone and in combination. We studied 808 participants from the National Alzheimer's Coordinating Center to assess associations between neuropathologic diagnoses (from autopsy) and neuropsychologic test scores (trajectories over time for 5 domains: overall cognition, episodic memory, attention, language, executive function). Neuropathologies included: Alzheimer disease neuropathologic change (ADNC), Lewy body disease (LBD), vascular brain injury (VBI), and limbic-predominant age-related TDP43 encephalopathy neuropathologic change (LATE-NC). Using linear mixed-effects models, we examined trajectories of cognitive decline for ADNC alone compared to ADNC plus LBD, VBI, or LATE-NC. We also examined differences between observed trajectories …

A Multistate Analysis Of Longitudinal Care Outcomes Among People Newly Linked To Human Immunodeficiency Virus Care In Missouri, Aditi Ramakrishnan, Daniel Vo, Ernie-Paul Barrette, Rachel M Presti, William G Powderly, Anne Trolard, Corey Grejtak-Heaps, Elvin H Geng, Aaloke Mody, Lindsey M Filiatreau

2020-Current year OA Pubs

BACKGROUND: Advancing the HIV response in Missouri, an Ending the HIV Epidemic priority state, requires stronger characterization of treatment gaps. Routine cross-sectional reporting may fail to capture important gaps in care that longitudinal methods can reveal.

METHODS: We characterized clinic engagement and viral suppression among people with Human Immunodeficiency Virus (HIV) aged ≥18 years who were newly linked to clinic in St Louis, Missouri, between 1 January 2015 and 15 March 2020. Using multistate analytic methods that capture change over time, we estimated the prevalence of individuals in 9 mutually exclusive and exhaustive states over 3 years following linkage to …

Financial Toxicity And Cost-Related Imaging Nonadherence In Pediatric Outpatient Imaging, Shireen E Hayatghaibi, Gregory L Jordan, Tucker Hansen, Amy E Ensing, Aditi Gupta, Evan A Mihalakakos, Bin Zhang, Pradipta Debnath, Carrie C Coughlin

2020-Current year OA Pubs

RATIONALE AND OBJECTIVES: Financial toxicity, defined as the financial burden and stress experienced due to medical costs, is increasingly recognized as a key patient-reported outcome and has been linked to cost-related non-adherence in adult populations. However, its prevalence and impact in pediatric imaging are unknown. We examined the prevalence and predictors of financial toxicity among families of children undergoing outpatient imaging and its association with imaging non-adherence.

MATERIALS AND METHODS: We conducted a prospective cross-sectional survey of parental caregivers of children (< 18 years of age) undergoing outpatient imaging at two free standing children's hospitals in the U.S. (July 2024-May 2025). Financial toxicity was measured using the adapted FACIT-COST instrument and scores < 26 indicated high financial toxicity. Multivariable logistic regression examined associations between family characteristics and high financial toxicity.

RESULTS: Among 399 caregivers, the mean FACIT-COST score was 24.6 (SD 10.2), and 49% were categorized as having …

Language And Sound Exposure Across Neonatal Intensive Care Hospitalization And Relationships With Early Outcome, R Pineda, L J Woodward, Z A Vesoulis, C D Smyser, T E Inder, A M Mathur, B L Schlaggar

2020-Current year OA Pubs

OBJECTIVES: Examine relationships between quantitative measures of language and sound exposure in the NICU and infant neurobehavior.

STUDY DESIGN: Sixty-four preterm infants (≤28 weeks of gestation) had language and sound exposure measured across four time points: within two weeks of birth and at 30, 34, and 35-41 weeks postmenstrual age (PMA). Neurobehavior was assessed at 35-41 weeks PMA using the NICU Network Neurobehavioral Scales.

RESULTS: Higher average decibel levels in the NICU environment were associated with lower infant orientation scores (p = 0.04, β = -0.33). Higher peak decibel levels were associated with greater hypertonia (p = 0.01, β = …

Molecular Basis For The Regulation Of Membrane Proteins Through Preferential Lipid Solvation, Nathan Bernhardt, Tugba N Ozturk, Shan Zhang, Noah Schwartz, Rahul Chadda, Alejandro Gil-Ley, Janice L Robertson, José D Faraldo-Gómez

2020-Current year OA Pubs

The mechanism by which lipids regulate membrane proteins remains an open question. While many protein structures reveal associated lipids, neither binding nor regulatory mechanisms can be gleaned from frozen static snapshots, as these processes occur in the context of a dynamic membrane at equilibrium. In this study, we combine single-molecule experiments with computational analyses of lipid dynamics and lipid-solvation energetics to understand how changes in the lipid composition of the membrane influence the dimerization of the CLC-ec1 chloride/proton antiporter. We find this influence does not result from long-lived lipid binding at specific sites, but instead from an inherently dynamic effect …

The Resilient Women's Collective: Empowering Women To Recognize Their Worth, Mary Campbell Johnstone

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2026

Mothers experiencing homelessness face challenges related to chronic stress, trauma, disrupted routines, and limited access to supportive resources, all of which negatively impact health, well-being, and occupational participation (Anderson et al., 2024). Occupational therapy is uniquely positioned to address these challenges through occupation-based, trauma-informed interventions that promote resilience, empowerment, and engagement in meaningful activities. This doctoral capstone addressed these complex needs through a multifaceted approach that included a scoping review, program development, advocacy, and educational initiatives. A scoping review examined stress-management interventions supporting single mothers experiencing homelessness in the United States. Although positive outcomes were reported, the literature revealed limited …

The Acute Effect Of A Single Dose Of Berberine On Blood Glucose Response Following A Standardized Meal And 2-Mile Walk Performance In Healthy Adults, Victor Emmanuel Obaro

Master's Theses

It is clear that exercise improves overall health status, and it is possible that berberine (BR) may work through some similar mechanisms to improve health status as well.  Purpose: The purpose of this study was to explore the acute effects of a single dose of BR on health status following a standardized meal and a 2 mile walk treadmill protocol with outcomes including blood glucose (BG), blood pressure (BP), heart rate (HR), rate of perceived exertion (RPE), and a two-mile walk time trial performance. Methods: This study used a cross-over design where 14 healthy, young adults were given berberine (BBR) …

Enhancing Quality Of Care Through Streamlined Pediatric Ot Resources, Mallori Cooper

Occupational Therapy Doctorate Capstone Posters

This capstone project focused on improving the accessibility and organization of evidence-based pediatric occupational therapy resources to support clinical staff and enhance quality of care. In pediatric practice, therapists often experience limited time for preparation outside of treatment sessions due to high workloads and administrative demands, which can make it challenging to consistently develop and access caregiver education and intervention resources. At the same time, caregiver education and coaching are essential components of pediatric occupational therapy, as they support carryover of strategies and improved functional outcomes. Through partnership with an outpatient pediatric therapy clinic, Associates in Pediatric Therapy, a centralized …

Advocating For Pediatric Therapy Services In A Rural Area, Hailee Bowman

Occupational Therapy Doctorate Capstone Posters

This capstone project was completed with Tonya Fish OTR/L at Hopewell Schools in Coshocton, OH. The primary ACOTE focus areas were education and advocacy, focusing on educating individuals in the community on occupational therapy and the importance of integrating it into the community, as well as advocating for changes to be made to current systems to allow for occupational therapy services to be available to children in the area. In Coshocton, the only opportunities for receiving pediatric occupational therapy services are in the school system or through the county board of developmental disabilities programs like Help Me Grow and Early …

Advancing Experiential Learning And Student Participation Through An Adl Suite, Megan E. Craig

Occupational Therapy Doctorate Capstone Posters

This capstone project was completed within the Occupational Science and Occupational Therapy Department at Eastern Kentucky University. The practice setting was the ADL Suite; a simulated home environment located in the Dizney Building at Eastern Kentucky University. The primary ACOTE focus area(s) applied was program development, with an additional focus area on clinical practice skills. The purpose of this capstone project was to support the development and sustainable use of the ADL Suite as a learning environment for students and faculty to practice ADL/IADL skills, clinical reasoning, activity analysis, assessment, competency development, and fieldwork preparation. A needs assessment and literature …

Community-Based Sensory Kits To Support Regulation And Participation In Individuals With Down Syndrome, Kaela Surrett

Occupational Therapy Doctorate Capstone Posters

This capstone project was completed at the Down Syndrome Association of Central Kentucky (DSACK) in Lexington, KY. The primary ACOTE areas of focus were education and program development. The purpose of this project was to identify sensory support needs within DSACK programming, develop age-based sensory kits, and create educational materials for staff and caregivers to support participation and self-regulation during activities. A needs assessment was completed through direct observations, parent surveys, collaboration with staff, and a review of current literature. Findings showed challenges related to attention, sensory seeking, and sensory sensitivity during both structured and unstructured activities. These barriers impacted …

A Mixed-Methods Study Of Patient And Caregiver Experiences With Home Health Occupational Therapy, Peyton A. Mendias, Cassandra Nelson, Gwen Morris

Summer 2026 OTD Capstone Symposium

Home health occupational therapy (HHOT) promotes independence and safety within the home, yet patients and caregivers often experience challenges implementing therapy recommendations after discharge. This mixed-methods study explored the lived experiences of patients and caregivers who participated in HHOT to identify barriers and facilitators to implementing occupational therapy recommendations and inform the development of a caregiver education toolkit. Adults who received HHOT within the previous six months and informal caregivers completed an online survey, with a subset participating in semi-structured interviews. Quantitative data were analyzed using descriptive statistics, and qualitative interview data were analyzed using reflexive thematic analysis. Findings emphasized …

Supporting Mental Health Through Occupation: Education For Women Living With And Beyond Breast Cancer, Rebekah Nicole Trammell, Lakeisa Boykin, Rebekah Jarrar

Summer 2026 OTD Capstone Symposium

Breast cancer is the most commonly diagnosed cancer among women in the United States, and these women experience high rates of anxiety, depression, and disruption to daily routines and meaningful occupations. Evidence shows that education on self-management strategies, mindfulness-based interventions, and targeted occupational therapy interventions can support the mental health of women experiencing breast cancer. Furthermore, remaining engaged in meaningful occupations is essential to improving overall well-being and quality of life. The purpose of this capstone project was to develop and deliver accessible, evidence-based education in digital and print formats that specifically target identifying mental health challenges, self-management strategies, and …

Attrition Of The Midwifery Workforce: Understanding Factors Associated With Leaving The Profession, E. Brie Thumm, Amy H. Goh, Elizabeth G. Phillips, Zachary Giano

College of Health Professions Faculty Papers

OBJECTIVE: To understand why advanced practice midwives (certified nurse-midwives and certified midwives) leave the workforce.

STUDY SETTING AND DESIGN: A multi-method, multi-source investigation included secondary analysis of certification data of advanced practice midwives and a cross-sectional online survey with closed- and open-ended items. Advanced practice midwives' active certification data were used to compare self-reported demographic characteristics of advanced practice midwives who reported working in the discipline of midwifery to those who did not (n = 9704). A survey was conducted in 2022 with individuals who allowed their certification to lapse between 2017 and 2021 (n = 303) and individuals who …

The Effect Of Telehealth Expansion On The Health Equity Of Underserved Populations, Mansi B. Satani

Electronic Theses, Projects, and Dissertations

The rapid expansion of telehealth, during and after the COVID-19 pandemic, has changed healthcare delivery in the United States. The use of telehealth can potentially decrease disparities related to isolation, shortage of providers and barriers to transportation, however, its impact on health equity in underserved populations is unknown. This paper explores how telehealth expansion impacts rural populations' access to healthcare, health outcomes, and equity. It also examines its impact on populations with low income, racial, ethnic minorities, and Medicaid recipients who frequently encounter obstacles to healthcare and digital access (Nouri et al., 2020; Shah et al., 2024). A mixed-method design …

How Recent Medicaid Defunding Has Impacted San Bernardino County Residents Access To Health Care Services, Samantha I. Rios

Electronic Theses, Projects, and Dissertations

Background: Medicaid is a critical source of health insurance for low-income populations in the United States, providing access to essential preventative, primary, and reproductive health care services (Donohue et al., 2022). The Medicaid defunding of 2025 and policy changes that follow have raised concerns regarding increased barriers to care, particularly among low-income and vulnerable populations who rely on safety-net providers such as Planned Parenthood (Planned Parenthood, 2025). The purpose of this study was to examine how the 2025 Medicaid defunding has impacted access to general and reproductive health care services among residents of San Bernardino County, California.

Conclusion: The research …

Navigating Undone Science: The Search For Adequate Endometriosis Care, Heather Welty, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

Endometriosis is an estrogen-dependent disease in which tissue similar to the lining of the uterus grows elsewhere in the body leading to a variety of symptoms including heavy and prolonged menstruation, chronic pain, cysts, infertility, and gastrointestinal issues. Despite being one of the most common gynecologic conditions, much remains unknown about potential risk factors for endometriosis, its etiology, and treatment options. First and second-line biomedical treatment options, complementary and alternative medicine, and lifestyle changes are all treatment options that people living with endometriosis (PLE) leverage to manage their symptoms. This article draws on in-depth interviews with 52 people living with …