Medicine and Health Sciences Commons^™

Using Visual Discharge Instructions: How Comics Can Improve Healthcare And Outcomes For Limited English Proficient Patients, Alexandra R. Streeter

Honors Thesis

The purpose of this thesis is to demonstrate how graphic medicine could be a useful tool for communicating medical discharge instructions to populations with Limited English Proficiency (LEP). It is divided into three parts. First, it provides an overview of the biggest struggles LEP patients encounter in healthcare, which often occur around discharge instructions and medication changes. Second, the paper explores what graphic medicine is and how it has been used in healthcare. The last part of this paper consists of original graphic medicine artwork that addresses key issues for LEP populations during discharge with the goal of offering a …

Quality Improvement Project Enhancing Mental Health Clinic Practices: Increasing Healthcare Professionals' Knowledge And Self-Assurance In Opioid Abuse Screening Tools In Healthcare Professionals Treating Adolescents, Festus Obonna

Doctor of Nursing Practice Projects

This study aimed to address the psychiatric mental health nurse practitioner’s unfamiliarity and inadequate confidence in utilizing the CAGE-AID screening tool in detecting opioid use in adolescents undergoing treatment at a psychiatric mental health clinic. The goal was to find out how structured training affected providers' understanding of and confidence in using the screening tool. Eight psychiatric mental health nurse practitioners, participated in a quasi-experimental pre- and post-intervention design. Descriptive statistics, paired t-tests, and Cronbach's alpha reliability analysis were used to look at the data. There was a significant improvement in providers' self-reported familiarity, confidence, and efficacy in using the …

Ensemble Learning With Explainable Ai For Improved Heart Disease Prediction Based On Multiple Datasets, Shahid Mohammad Ganie, Pijush Kanti Dutta Pramanik, Zhongming Zhao

Faculty, Staff and Student Publications

Heart disease is one of the leading causes of death worldwide. Predicting and detecting heart disease early is crucial, as it allows medical professionals to take appropriate and necessary actions at earlier stages. Healthcare professionals can diagnose cardiac conditions more accurately by applying machine learning technology. This study aimed to enhance heart disease prediction using stacking and voting ensemble methods. Fifteen base models were trained on two different heart disease datasets. After evaluating various combinations, six base models were pipelined to develop ensemble models employing a meta-model (stacking) and a majority vote (voting). The performance of the stacking and voting …

Flip For Function Event Development For Increased Effectiveness And Promotion Of Community Engagement, Chloe D. Nedds

OTD Capstone Projects

This doctoral capstone project was completed in partnership with Flip for Function, a therapeutic gymnastics program that promotes self-confidence through adaptive athletics and child-led activities. The aim of this project was to enhance the efficiency of events to promote visibility and awareness of Flip for Function within the community. To reach these goals, research-based sensory activities, graphics, programming, and effective timelines were established to ensure seamless execution of events and promote awareness within the community. Alongside this, a choice board was created and implemented within the gym to promote access to communication resources for all individuals. As a result, events …

Lecture Series Supporting Maternal-Infant Health Population: Educating Parents And Training Occupational Therapy Students, Katherine Henry

OTD Capstone Projects

This capstone project was completed in collaboration with both the Belmont University School of Occupational Therapy and Ella’s House, a nonprofit organization that supports pregnant and parenting college students finishing their education. A needs assessment was completed to identify what type of project would be most beneficial to both organizations, with a final decision to create a series of courses that support infant and maternal health and well-being. Course topics included basic newborn childcare skills; perinatal mental health; and caregiver roles, routines, and supports. With each presentation of a course, students reviewed the course to compare knowledge prior to and …

Heart Attacks Are On The Rise Among Young And Middle-Aged Adults In The United States, Vicente Cuevas

Population Health Research Brief Series

Heart attacks are on the rise among young and middle-aged adults in the United States. This brief describes these increases, the role of behavioral, lifestyle, and societal factors, and provides recommendations for organizations, healthcare providers, and policymakers to combat the increase in early-onset heart disease.

Characterizing Radiation-Related Laryngotracheal Stenosis, Natalia Queenan, Jay Trivedi, Dylan Bertoni, Sana Siddiqui, Austin Yap, Kathleen Tibbetts

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

BACKGROUND: Radiation-related laryngotracheal stenosis (RLTS) develops due to fibrosis of the airway after radiotherapy. We aim to characterize the presentation, management, and outcomes of patients with RLTS and compare these to patients with iatrogenic laryngotracheal stenosis (ILTS).

METHODS: In a single-center retrospective cohort study, patients diagnosed with RLTS between 2017 and 2022 were identified. Demographic data, risk factors, cancer history and treatment, presentation of stenosis, primary stenosis intervention, and outcomes were extracted. Patients were compared to a cohort of patients with ILTS and no history of radiation therapy. Data were analyzed using Fisher's Exact Tests and paired t-tests.

RESULTS: Seven …

Evaluating The Effectiveness Of Selective Serotonin Reuptake Inhibitors In Reducing Migraine Frequency In Adults: A Literature Review, Samantha Tully

Nursing Capstones

This scoping review aims to evaluate current literature on selective serotonin reuptake inhibitors (SSRIs) for migraine prevention and prophylaxis in adults. Key themes and gaps in the research are identified. A systematic review was completed across two databases including PubMed and Cochrane. Fifteen studies have been examined in this review with a range of publication dates from 1999 to 2022. Based on this literature review, the author concludes that SSRIs may reduce migraine frequency and severity in the adult population through their action to increase serotonin availability and stabilize serotonin levels. Further research is needed in this area.

Improving Home Healthcare Interdisciplinary Team Communication, Nishea Andrea Flores

Doctor of Nursing Practice Final Project Abstract

PURPOSE This Quality Improvement (QI) proof-of-concept project aimed to enhance communication within interdisciplinary healthcare teams (IDTs) in home healthcare settings through the creation and implementation of the .ACT tool (Ask, Context, Timeframe), designed to reduce communication barriers and improve team collaboration.

BACKGROUND Fragmented communication in home healthcare leads to inefficiencies in care delivery. The .ACT tool was created to standardize and simplify communication, ensure clarity in task delegation and timelines, improve coordination, and reduce errors.

METHODOLOGY A phased implementation strategy followed the Consolidated Framework for Implementation Research (CFIR) and Iowa Implementation Sustainability Framework (IISF), focusing on staff engagement …

Unveiling The Potential Of Urolithin A In Cancer Therapy: Mechanistic Insights To Future Perspectives Of Nanomedicine, Vinita Karumuru, Anupam Dhasmana, Narsimha Mamidi, Subhash Chauhan, Murali Yallapu

School of Medicine Publications

Cancer remains a leading global health challenge, with high mortality rates persisting despite significant advancements in therapeutic interventions. Major obstacles, including systemic toxicity, therapy resistance, metastasis, and relapses, emphasize the urgent need for safer, more effective, and readily accessible treatment strategies. Among emerging alternatives, natural bioactive compounds have gained considerable attention because of their diverse therapeutic potential and lower toxicity profiles. Urolithin A (UA), a metabolite derived from ellagic acid through gut microbiota metabolism, has emerged as a compelling anticancer agent. UA has multiple mechanisms of action, including the regulation of autophagy, enhancement of mitochondrial function, and inhibition of tumor …

First Endovascular Flow Diversion Treatment For A Supergiant Brain Aneurysm (>110 Mm) In Ethiopia, Wondwossen G. Tekle, Eskedar Kebede Belayneh, Kaleab Tesfaye Eticha, Tariku Assefa Soboka, Michael Yirgalem Teka, Hilina Agonafir Mengistu, Yonatan Wudeneh Mekonnen, Fikru Tsehayneh Kelemu, Bereketeab Ethiopia Bogale, Eden Enyew Zeleke

School of Medicine Publications

In late 2022, a 65‐year‐old woman presented to us with a 3‐day history of ischemic stroke resulting in left facial droop and left‐sided weakness. She had a known giant right internal carotid artery (ICA) aneurysm since 2015 that kept on growing and causing her a myriad of neurologic signs and symptoms including recurrent severe headaches, debilitating tinnitus, right‐sided vision loss (2020), proptosis, ophthalmoplegia, ptosis, and hearing loss. She had allodynia in the right trigeminal nerve distribution, complete right facial palsy, new left lower facial palsy and left hemiparesis (3/5 strength). Unfortunately, local treatment options were unavailable at that time, and …

The Effect Of Patient-Centered Discharge Instructions In Reducing 30-Day Readmission Rates In Heart Failure Patients, Ashley Spiering

Nursing Capstones

Background: Heart failure (HF) is a leading cause of hospital readmissions, with nearly one in four patients experiencing rehospitalization within 30 days of discharge. Readmissions within this timeframe present a significant clinical and economic challenge for patients and healthcare services. Reducing 30-day readmissions has become a central goal for hospitals aiming to improve patient outcomes and minimize financial burdens.

Purpose: To evaluate whether patient-centered discharge instructions are an effective tool in reducing 30-day readmission rates for patients with HF.

Method: A literature review was conducted using PubMed and CINAHL databases. Keywords such as heart failure, readmission, education, discharge, and instructions …

Risk Factors Of Self-Reported Prediabetes Status In New York State, Kari Ann Hunter Thompson

Walden Dissertations and Doctoral Studies

Prediabetes affects over 4 million people in New York State and increases the risk of Type 2 diabetes. Prior research identified risk factors such as poor diet, inactivity, obesity, hypertension, and smoking; but no studies examined these collectively or assessed their interactions. This quantitative, cross-sectional study analyzed a sample of 289 non-institutionalized adults aged 18 or older with landline or cellular phone, from the Behavioral Risk Factor Surveillance System. The study examined relationships between prediabetes and 16 factors in five categories: demographic (age, race, sex, education), socioeconomic (income, employment), behavioral (fruit intake, vegetable intake, physical activity, smoking), physiological (hypertension, BMI), …

Childhood Trauma Affects Romantic Relationships In Adulthood, Rhianna Vranka

D.U.Quark

Childhood trauma is when a child experiences sexual, emotional, or physical abuse or neglect. Trauma’s causes aren’t limited to just those factors and can result from a variety of experiences. Childhood trauma makes children more vulnerable to developing issues in adulthood because they are at a critical point in their development. There is insignificant knowledge on why childhood trauma affects romantic relationships in adulthood. Knowledge of warning signs and accurate diagnosis is essential to prevent violence stemming from the psychological effects exhibited by those with childhood trauma in relationships. More research is required to understand how to treat the psychological …

Improving Admissions Planning In A Specialized Adult Foster Care Program, Jessie Sullivan

Doctoral Dissertations & Projects

Background: Specialized adult foster care (AFC) programs have the unique ability to facilitate and coordinate continuity of care with an interdisciplinary approach internally and with community provider collaboration. The lack of communication in the transition of care admissions process leads to negative patient safety outcomes.

Purpose: The purpose of this quality improvement project was to identify barriers to improve communication, continuity of care, reduce negative health outcomes, and provide a culture of safety.

Methods: The Systems Engineering Initiative for Patient Safety (SEIPS) guided this quality improvement project. Assessment of quality measures and outcomes included the administration of pre- and post-implementation …

Evaluation Of Objective Methods For Analyzing Ipsilateral Motor Evoked Potentials In Stroke Survivors With Chronic Upper Extremity Motor Impairment, Xin Li, Jayme S. Knutson, Xiaofeng Wang, Ken Uchino, Ela B. Plow, David A. Cunningham

Faculty Scholarship

Objective. Ipsilateral motor evoked potentials (iMEPs) are believed to represent cortically evoked excitability of uncrossed brainstem-mediated pathways. In the event of extensive injury to (crossed) corticospinal pathways, which can occur following a stroke, uncrossed ipsilateral pathways may serve as an alternate resource to support the recovery of the paretic limb. However, iMEPs, even in neurally intact people, can be small, infrequent, and noisy, so discerning them in stroke survivors is very challenging. This study aimed to investigate the inter-rater reliability of iMEP features (presence/absence, amplitude, area, onset, and offset) to evaluate the reliability of existing methods for objectively analyzing iMEPs …

Advancing A Patient- And Carer-Centered Approach For The Clinical Development Of New Therapeutics For Aneurysmal Subarachnoid Hemorrhage: Insights From A Qualitative Study, Sonya Abraham, Silvia Amaro, Ellyn Getz, Sylvia Herget, Gregory J. Kato

Journal of Patient-Centered Research and Reviews

Aneurysmal subarachnoid hemorrhage (aSAH) is characterized by a high rate of fatality and high risk of secondary brain injury. More treatment options are needed to improve outcomes. There are very few reports in the medical literature involving patient experience of aSAH, which is known for its unexpected onset and profound medical impact. Improved understanding of this patient experience would help make future clinical research more patient centered. To this end, we convened an advisory board consisting of aSAH patients and care partners in the United States. Participants emphasized the critical role that care partners play during hospitalization and in accessing …

Bridging The Gap Between Knowledge And Practices Pertaining To Naloxone Use: A Single-Institution Experience In North Carolina, Michael S. Argenyi, Gisele Bailey, Christopher J. Mclouth, Erin Barnes, Candice J. Mcneil

Journal of Patient-Centered Research and Reviews

Naloxone is a life-saving medication for opioid overdose, which claims many lives annually. This study investigated provider attitudes about, beliefs about, and barriers to naloxone use to inform an increase in provider prescription of naloxone. The survey took place at a large Southern tertiary health center. An adapted REDCap survey utilizing validated questions was distributed via institutional e-mail listservs. The results (N = 181) were analyzed using descriptive and chi-square statistics. While 90.9% of the providers had heard of the strategy of prescribing naloxone to prevent overdose, only 72.1% of providers would have considered prescribing naloxone. Providers reported implementing treatment …

The Use Of Person-Centered Language In Scientific Research Articles Focused On Psychosis, Zach Monahan, Tanner Stone, Vinay Swami, Kelly Dunn, Micah Hartwell

Journal of Patient-Centered Research and Reviews

Purpose: Societal stigma of psychosis leads to delayed treatment for individuals experiencing early symptoms, for fear of being labeled “crazy” or “psychotic.” Delayed treatment can worsen the prognosis of individuals with psychosis. Proper adherence to person-centered language (PCL) guidelines can curb the widely held stigmatized preconceptions about psychotic conditions.

Methods: Our meta-epidemiological analysis began with a systematic search of literature in PubMed discussing psychosis from 2020-2022. From the 14,522 results, we randomly selected 500 articles in journals with at least 20 articles on psychosis (n = 9,775), of which 241 articles met the inclusion criteria. These papers were screened for …

Molecular Changes, Histopathology, And Ultrasonic Vocalization Acoustic Profiles Of Systemically Dehydrated Rats, Brooke Rodgers, Naila Cannes Do Nascimento, Abigail Cox, Taylor W. Bailey, M. Preeti Sivasankar, Allison J. Schaser

Department of Speech, Language, and Hearing Sciences Faculty Publications

Systemic hydration is known to promote optimal functioning of bodily systems—including the vocal folds. The impact of systemic dehydration on the biology of the vocal folds and the downstream effects of dehydration on voice output are not well understood. An in vivo rat model of systemic dehydration was employed to investigate vocal fold gene expression, histological changes, and acoustic changes in vocalization. Ultrasonic vocalizations (USVs) were recorded every day for 5 days (baseline), in male and female Long-Evans rats (N = 36, ages: 3–4 months) using an anticipatory reward paradigm. Next, rats were dehydrated (N = 18) using a published …

Biallelic Fgf4 Variants Linked To Thoracic Dystrophy And Respiratory Insufficiency, Laura M. Watts, Esther Kinning, Donald R. Latner, Marla Johnston, Jessica Patrick-Esteve, Gregory M. Cooper, Stephen R.F. Twigg, Alistair T. Pagnamenta, Jenny C. Taylor

School of Medicine Faculty Publications

The thoracic dystrophies are inherited skeletal conditions where abnormal embryonic development of the thoracic skeleton results in a narrow chest, pulmonary hypoplasia, and respiratory insufficiency, which can be severe or lethal. The majority of thoracic dystrophies are due to biallelic alterations in genes needed for normal ciliary function. However, despite the identification of over 20 genes as causal for the thoracic dystrophy phenotype, around 20% of patients remain without a molecular diagnosis. We present two unrelated families with a clinical diagnosis of thoracic dystrophy with associated respiratory insufficiency without a molecular diagnosis on previous genetic testing. Both harbor rare biallelic …

Quantifying The Functional Impact Of Chronic Patellofemoral Pain And Its Relationship To Perceived Duty-Related Medical Readiness Among Active Duty Service Members, Emma H. Beisheim-Ryan, Sara R. Gorczynski, Ryan W. Smith, Shawn Farrokhi

Physical Therapy Faculty Articles and Research

Introduction

Chronic patellofemoral pain (PFP) is a heterogeneous pain condition that may significantly burden active duty service members, whose rigorous physical training demands include activities such as running and heavy load carriage. While chronic PFP is often defined by its pathoanatomical characteristics, evidence from other pain conditions (e.g., chronic low back pain) suggests classifying pain by its functional impact on work, social, and self-care activities may better inform personalized treatment approaches. As this approach has not been previously undertaken in chronic PFP or younger populations with chronic pain, this study aimed to characterize the global impact of PFP on day-to-day …

High-Pressure Excursion In Oxygenators During Adult Cardiopulmonary Bypass: A Scoping Review, Anne Nguyen

Student Works

Background: High-pressure excursions (HPE) in oxygenators during cardiopulmonary bypass (CPB) are rare but clinically significant events that can lead to compromised perfusion and adverse patient outcomes. HPE occurs due to fibrin and platelet deposition within the oxygenator, leading to increased transmembrane pressure and potential obstruction of blood flow. Despite its clinical importance, HPE remains an underrecognized issue with limited standardized guidelines for detection, prevention, and management.

Methods: A comprehensive literature search was conducted across multiple databases and grey literature sources to identify studies reporting on HPE in CPB oxygenators. The selection process followed the PRISMA-ScR framework, with articles screened based …

The Havcr1-Centric Host Factor Network Drives Zika Virus Vertical Transmission, Wenzhe Yu, Jun Tao, Hongmin Cao, Wanshan Zheng, Beiang Zhang, Yue Zhang, Peiqun Xu, Yiwei Zhang, Xuan Liu, Yinan Wang, Han Cai, Gang Liu, Fan Liu, Haibin Wang, Haiyan Zhao, Indira U Mysorekar, Xiaoqian Hu, Bin Cao

Center on Aging Staff Publications

Zika virus (ZIKV) vertical transmission results in devastating congenital malformations and pregnancy complications; however, the specific receptor and host factors facilitating ZIKV maternal-fetal transmission remain elusive. Here, we employ a genome-wide CRISPR screening and identify multiple placenta-intrinsic factors modulating ZIKV infection. Our study unveils that hepatitis A virus cellular receptor 1 (HAVCR1) serves as a primary receptor governing ZIKV entry in placental trophoblasts. The GATA3-HAVCR1 axis regulates heterogeneous cell tropism in the placenta. Notably, placenta-specific Havcr1 deletion in mice significantly impairs ZIKV transplacental transmission and associated adverse pregnancy outcomes. Mechanistically, the immunoglobulin variable-like domain of HAVCR1 binds to ZIKV via …

Improving Nursing Processes To Reduce Hospital-Acquired Venous Thromboembolism In Adult Surgical Patients, Stephanie Masson

Doctor of Nursing Practice Final Project Abstract

INTRODUCTION Hospital-acquired venous thromboembolism (VTE) is a preventable outcome that can increase morbidity and mortality. This quality improvement (QI) project aimed to evaluate and improve the nursing prophylaxis processes to reduce the VTE outcome. The project was implemented in a Level I Trauma Center in the Texas Medical Center, Houston, Texas.

METHODOLOGY The QI project was structured using the Lean Six Sigma methodology. Data was collected and analyzed from reports built within the electronic medical record (EMR). A multidisciplinary team evaluated the current state of clinical practice and the electronic workflow for mechanical VTE prophylaxis. The team worked to redesign …

Quality Of Perinatal Care: Experiences Of Clients And Providers In Three District Hospitals Of Western Uganda– A Mixed Methods Study, Mercy Muwema, Joaniter Nankabirwa, Dan K. Kaye, Gorrette Nalwadda, Joanita Nangendo, Gloria Odei Obeng-Amoako, Jean Claude Nkurunziza, Wilson Mwanja, Elizabeth N. Ekong, Joan N. Kalyango, Grace Edwards, Emmanuel Otieno, Robert Basaza

School of Nursing & Midwifery, East Africa

Background: It is anticipated that closing the quality gap through provision of effective antenatal, intrapartum and postnatal care for mothers and newborns in facilities will reduce morbidity and mortality. Mothers’ and health care providers’ experiences play a vital role in achieving quality care during the perinatal periods.

Purpose: To assess the health care providers’ (HCPs) and clients’ experiences on quality of perinatal care at three district hospitals in Bunyoro region, Western Uganda.

Methods: A convergent parallel mixed methods study design was utilized to explore experiences of 1) mothers as they sought antenatal, intrapartum, and postnatal care; and 2) …

Speed Of Shear Waves As A Function Of Frequency In Micellar Fluid, Michael Basha

Honors Theses

The purpose of this experiment was to investigate the frequency dependence of shear wave speed in a micellar fluid. A high-concentration CTAB-NaSal micellar fluid seeded with microspheres was used in the experiment. Shear waves were generated using a wave driver and a function generator, while a high-speed camera captured video recordings. Since the frequency of the wave driver producing the shear waves in the micellar fluid is a constant value set by the experimenter, changes in shear wave speed can be determined by measuring their wavelengths at different frequencies.The captured video was then broken down into frames using MATLAB. These …

Socioeconomic Status, Parental Sex Education, And Race: Intersecting Influences On Adolescent Sexually Transmitted Infection Rates, Kiersten Hawkins-Moore

Walden Dissertations and Doctoral Studies

Adolescents and young adults represent many of the new sexually transmitted infections diagnosed each year in the United States, with pronounced disparities among minority racial and ethnic groups. This study examined 3,480 participants aged 15-24 from the 2017-2019 National Survey on Family Growth to explore the influence of race and socioeconomic status (SES) on the likelihood and comprehensiveness of parental sex education before the age of 18, using the Intersectionality Theory and Social Determinants of Health as frameworks. Controlling for formal sex education, binary and multinomial logistic regression models demonstrated that formal sex education significantly increased the odds of adolescents …

Executive Summary: Quality Improvement Initiative Retrospective Program Evaluation Of Sms Reminder System In Decreasing Outpatient Mental Health Clinic No-Show Rates, Jordan Rogers

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project presents an organizational quality improvement initiative implementing a text message reminder system to decrease appointment no-show rates in the outpatient mental health clinic. The project was developed based on the high rate of appointment no-shows at the DNP project site. Appointment no-shows are costly to both clinics and patients. Clinics experience decreased revenue and efficiency, and patient outcomes can be compromised. The project evaluated whether text message reminders sent 24 hours before a scheduled appointment time decreased no-show rates by at least 10%. Preimplementation data were collected for months October, November, and December, …

Evaluation Of The Adjunctive Effect Of Photodynamic Therapy For The Treatment Of Residual Periodontal Pockets: A Systematic Review, Shankargouda Patil, Charles Miller, Ryan Moffat, Kade Janes, Brooklyn Janes, Peter M. Loomer, Frank W. Licari

Journal of Patient-Centered Research and Reviews

Purpose: Adjunctive use of photodynamic therapy in combination with scaling and root planing for periodontal maintenance offers an alternative to antibiotic therapy, potentially mitigating the risk of antibiotic resistance and its genotoxic or mutagenic effects. This systematic review analyzed studies, as of January 2023, that included the effects of a single application of photodynamic therapy in residual periodontal pockets with the probing depth and clinical attachment level as the primary and secondary outcomes, respectively.

Methods: PubMed, Scopus, and Web of Science databases, as well as the US National Institutes of Health and WHO Clinical Trials Registry, were searched for eligible …