Medicine and Health Sciences Commons^™

Living Guidelines: A Giant Leap For Patient Care, Clinical Practice, And Dental Journalism, Christopher J. Smiley

AADEJ - The Communicator

Dr. Smiley's President's message recognizes the collaboration between the American Dental Association (ADA), the University of Pennsylvania and other stakeholders in launching the "living guideline collaboration" as a significant advancement for the profession. This initiative, focusing on oral health, will be continually updating clinical practice guidelines with new evidence, providing timely, rigorously reviewed, and reliable clinical guidance. He notes that previous ADA Clinical Practice Guidelines (CPGs) were high-quality but many are now outdated, a point emphasized by the ADA Science & Research Institute’s External Review Committee. The Living Guideline Program, a collaboration with the University of Pennsylvania School of Dental …

Novel Electrophysiological Biomarkers In Pediatric Drug Resistant Epilepsy And Genetic Epilepsy Syndromes, Sakar Rijal

Bioengineering Dissertations - Archive

Pediatric epilepsies, particularly those that are drug-resistant or genetically driven, represent some of the most complex neurological disorders encountered in childhood. Central to their pathophysiology is a disruption in the delicate balance between cortical excitation and inhibition (E/I), often resulting from impaired GABAergic interneuron function. This imbalance manifests as aberrant network dynamics and altered neural oscillations, giving rise to seizures and long-term cognitive impairments. In this thesis, we developed a translational framework to identify electrophysiological biomarkers that (i) assess cortical E/I imbalance and (ii) map epileptogenic zones, with the aim of enhancing diagnosis, guiding surgical planning, and informing therapeutic monitoring …

Associations Between Older Hispanics’ Diabetes Control And Their Caregiver’S Health Literacy, Jorge Rico

Nursing Dissertations - Archive

Background: Older Spanish-speaking Hispanics are a rapidly growing population in the United States that face disproportionally high rates of diabetes and inadequate health literacy. Familism is valued among Hispanics and caregivers may play an important role in overcoming the social determinants of health facing this vulnerable population. Methods: This descriptive correlation study sought to explore correlations between the caregiver’s health literacy and the patient’s control of diabetes. Findings: Mixed effects model found a significant correlation between the caregiver’s print literacy and the patient’s hemoglobin A1c. Conclusion: The findings are encouraging for future research to explore interventions that target the caregivers …

Perception Of Spirituality By Intensive Care Unit Nurses, Adejoke Felicia Ogidan

Nursing Dissertations - Archive

ICU nurses are identified as a population of nurses with a high risk of experiencing psychological stress due to the nature of their job in the ICU (Lyndon, 2015; Welp et al., 2015). Psychological stress is detrimental to nurses' mental health and the quality of patient care.

According to Watson’s Transpersonal Human Caring Theory, the spiritual perception of the nurse influences the nurse’s spiritual care practice, which in turn affects their self-care and care provided by the nurse to patients (Watson, 2021)This research explored the ICU-Ns' perception of spirituality and its relationships with spiritual care practices and self-assessed competency in …

The Lived Experiences Of Older Adults With Cancer Who Are Non-Adherent To Prescribed Oral Chemotherapy: A Descriptive Phenomenological Study, Ludmila Kosmari

Nursing Dissertations - Archive

Background: Despite the ease of receiving OCT, patients’ OCT adherence is low. With this low prevalence rate, patients are not likely obtaining the full life-promoting effects of OCT. Since medication adherence is often related to lived experiences and standardized medication adherence instruments may not capture these experiences completely, the purpose of this study was to explore how the lived experiences of older adults with cancer influence their adherence to OCT.

Methods: the researcher used a descriptive phenomenological design and conducted individual interviews with 20 older adults with cancer. All participants were prescribed OCT and reported missing at least one dose. …

Case Management For End-Stage Renal Disease Patients, Jamie L. Andrews

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Social determinants of health (SDOH) and health literacy directly impact adults with end-stage renal disease (ESRD) on hemodialysis (National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK], 2022; Ulrich, 2020). Adults with ESRD account for 1.5 million hospital admissions and 500,000 re-admissions within 30 days annually (NIDDK, 2022). Case management is essential in reducing re-admissions for adult ESRD patients, requiring abilities to identify factors affecting adult ESRD patients appropriately.

Methods: Therefore, an evidence-based practice (EBP) project using the IOWA Model framework was implemented to increase the knowledge base in identifying care and resources for ESRD patients for telephonic …

Nursing Workplace Rituals: Communication Before, During, And After Covid-19, Angel Infante

Nursing Dissertations - Archive

ABSTRACT

NURSING WORKPLACE RITUALS: COMMUNICATION BEFORE, DURING, AND AFTER COVID-19

Angel Infante, PhD

The University of Texas at Arlington, 2025

Professors: Dr. Deborah Behan (Committee Chair), Dr. Yungfei Kao (Committee Member), and Dr. Jessica Grace Smith (Committee Member)

Background: According to Griner et al. (2021) many disruptions caused confusion for healthcare workers during the pandemic. Communication is imperative when dealing with everyday disruptions in a hospital setting. However, it is even more important to learn about the different types of communication and what is communicated during a past pandemic to know how and what to communicate in a future pandemic. …

Factors Contributing To Technostress In Nursing Education: A Study Of Master Of Science In Nursing (Msn) Education Students, Jennifer Weber

Nursing Dissertations - Archive

This mixed-methods study examined factors contributing to technostress among Master of Science in Nursing (MSN) Education students enrolled in a fully online program. Guided by the Technostress Trifecta Model, the study explored the relationships among age, grade point average (GPA), years of nursing experience, and self-rated technical skills, as well as students’ perceptions of technology use in learning.

Data were collected from 94 participants using the Technostress Scale by Upadhyaya and Vrinda (2021). Quantitative analyses showed that self-rated technical skill was significantly associated with lower perceived technological complexity, while age was significantly associated with both techno-invasion and techno-uncertainty. GPA and …

Guideline On The Education And Use Of The Cognitive Assessment And Care Planning Services Visit For Patients 65 And Older With Cognitive Impairment, Katherine J. Koonce

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction: The lack of education and use of the Cognitive Assessment and Care Planning Services (CACPS) visit creates a gap in care for Medicare patients over the age of 65 with cognitive impairment.

Methods: Recommendations were created from a robust collection of graded, evidence-based literature. The recommendations were presented to a set of stakeholders who rated each recommendation on a Likert scale from 1 (poor) to 4 (excellent).

Results: The twelve stakeholders agreed with the recommendations to support the education and use of the CACPS visit for Medicare patients 65 and older.

Conclusion: This guideline promotes provider education to investigate …

Improving Pediatric Delirium Assessment Documentation And Nursing Knowledge In A Pediatric Cardiovascular Intensive Care Unit, Heather E. Herrera

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Pediatric delirium is prevalent in the Pediatric Cardiovascular Intensive Care Unit (PCICU). It is associated with longer PCICU stays, extended hospital stays, prolonged duration of mechanical ventilation, and higher hospital costs (Mallick et al., 2022). It has also been associated with increased mortality risk and decreased quality of life after hospital discharge (Rohlik et al., 2021). Due to the adverse sequelae associated with pediatric delirium, routine screening with a validated screening tool is recommended (Flagg & Mauney, 2023). Despite consensus guidelines advocating routine screening for pediatric delirium, routine screening is not being completed (Flagg & Mauney, 2023).

Decreasing Hospital-Acquired Clostridium Difficile Infections, Angel S. Louder

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Clostridium Difficle Infection (CDI) is a significant healthcare threat due to its ability to be transmitted rapidly in healthcare settings. Patient engagement and participation in infection prevention initiatives at admission will lead to early implementation of isolation precautions, diagnosis of infectious pathogens, and treatment. A quality improvement project was implemented at a south-central Texas acute care hospital to engage alert and oriented adult patients, using a bundled approach to screen for the early detection of CDI within 48 hours of hospital admission, thereby reaching the goal of reducing hospital-acquired CDIs. This initiative improved patient engagement with CDI screening, reducing confirmed …

Enhancing Patient-Centered Efficiency: Reducing Cardiology Clinic No-Shows Using Technology, Pre-Visit Planning & Patient Resources, Pat Shirey

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Cardiovascular disease (CVD) affects 48% of U.S. adults, requiring regular cardiology visits to manage risk factors and the early detection of complications (American Heart Association, 2019). No-shows disrupt continuity of care, worsen health outcomes (Choi et al., 2020), and decrease clinic efficiency (Goossens et al., 2022). A North Texas cardiology clinic reported a 31.9% overall no-show rate and a 42.1% no-show rate for new patients, costing $1.3 million annually.

Purpose: This quality improvement project aimed to reduce no-show rates through a patient-centered cardiology appointment bundle to improve continuity, patient outcomes, and efficiency.

Methods: This eight-week project utilized the Plan-Do-Study-Act …

Reducing Spinal Induced Hypotension In Cesarean Sections: A Multimodal Approach, Tyran D. Heilig

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Spinal anesthesia is the preferred method for elective cesarean sections due to its rapid onset, ability to keep the mother awake, and lower risk of complications compared to general anesthesia (Shitemaw et al., 2020). However, spinal-induced hypotension (SIH), caused by a sympathetic block, occurs in up to 75% of cases (Sklebar et al., 2019). A 2019 global study conducted in Ethiopia of 410 women found the incidence of SIH in cesarean sections to be 64% (Shitemaw et al., 2020). A Texas study found that 99.4% of cesarean deliveries experienced SIH, and 12% of those cases resulted in severe hypotension, …

Toolkit To Promote Good Hand-Hygiene Among Kenyan School Children, Jo Martinez

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction: Among healthcare providers and educators in Kenya who work with and educate school-aged children, a toolkit that includes a guideline, educational hand-hygiene posters, handouts, and resources on hand hygiene for children using graded literature, assists educators and healthcare providers with education of school-age children regarding sanitation.

Methods: The recommendations were created using a collection of graded literature. The recommendations were presented to stakeholders of healthcare providers and educators from urban and rural areas. The stakeholders rated each recommendation using a Likert scale from 1 – very poor to 4 – very good.

Results: Five of the six stakeholders who …

Improving Knowledge And Confidence Of Family Nurse Practitioners In Offering The Hpv Vaccine, Leni Terano Fisher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Despite the recommendations of the United States Advisory Committee on Immunization Practices, HPV immunization lags behind other routine vaccines by up to 31%. Although there are many reasons for the low vaccine rate, provider hesitancy and lack of confidence significantly contribute to suboptimal HPV vaccine uptake.

Objectives

This project aimed to utilize evidence-driven interventions to increase family nurse practitioners' (FNPs) knowledge and confidence in offering the HPV vaccine.

Methods

Participants were given pre- and post-questionnaire surveys. The Wilcoxon Rank Test was used to compare, quantify, and measure the results of the eight-week data collection.

Results

The subjects were …

A Quality Improvement Approach To Reducing Post-Surgical Acute Care Falls, Tiffany C. Mitchell

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Inpatient falls remain one of the most preventable adverse events in hospitals. Falls result in serious injuries and increasing healthcare costs. This quality improvement project evaluates the implementation of Fall TIPS to reduce fall incidence and promote sustainable safety practices.

Safe Schedule Ii Stimulants Prescribing Bundle For Adults With Adhd, Etienne C. Poufong

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The evidence-based practice (EBP) project aimed at improving the prescribing and monitoring of Schedule II stimulant medications for adults aged 18 and older diagnosed with ADHD in private practice settings. The project addresses the growing concerns of stimulant overprescription, shortages, abuse, and diversion, which have significant public health implications. Despite the increasing use of stimulants, there is no standardized protocol for prescribing these medications to adults. The proposed intervention includes a prescribing bundle consisting of provider education, mandatory in-person visits, periodic urine drug screens (UDS), access to the Prescription Drug Monitoring Program (PDMP), and the use of diagnostic tools, such …

Impact Of A Breast Cancer Diagnosis On Finances And Marital Status In Young Women, Tamara Hamlish, Michelle L. Foster, Sarah Strom, Rana Jaber, M. Courtney Hughes

Faculty Articles, Papers, and Other Scholarship

Purpose

A breast cancer diagnosis can impact every aspect of a woman’s life, particularly for women diagnosed before age 45 when they are in the process of establishing stability in their personal and professional lives. This study investigated the impact of a breast cancer diagnosis on employment, finances, and personal relationships among young breast cancer survivors.

Methods

We conducted descriptive statistical analysis of survey data from 315 women diagnosed with breast cancer before age 45. Surveys were administered electronically and included 40 questions on demographics asking about employment, insurance, income, and marital status at two time points: at diagnosis and …

Exploring Large Language Models For Summarizing And Interpreting An Online Brain Tumor Support Forum, Christy Muasher-Kerwin, M. Courtney Hughes, Michelle L. Foster, Ibrahiim Al Azher, Hamed Alhoori

Faculty Articles, Papers, and Other Scholarship

Objective

Methods

Patients’ Experiences And Management Practices Of Hypertension Among The Pastoralist Community Of Marsabit County, Christine Chepkemoi Chesiror

MSc in Advanced Practice Nursing

Hypertension is a global public health challenge and a leading cause of morbidity and mortality, particularly in low- and middle-income countries, where it accounts for 86% of deaths from non-communicable diseases. With over 1.5 billion cases projected by 2025, hypertension significantly increases the risk of heart disease and stroke. Despite this, little is known about the experiences and self-care practices of pastoralist communities living with hypertension.

This study employed a descriptive, exploratory, cross-sectional design to investigate the experiences and self-care practices of individuals managing hypertension among the pastoralist of Marsabit County. Twelve participants receiving follow-up care at Uran and Sololo …

Evaluating A Novel Lifestyle Intervention Trial: Mitigating Type 2 Diabetes, Hypertension And Depression In Adults With Intellectual And Developmental Disabilities Living In Adult Family Homes, Matthew Lee Velissaris

Dissertations and Theses

This study evaluated a 90-day lifestyle intervention for nine ambulatory adults with intellectual and developmental disabilities (IDD) residing in three adult family homes (AFHs). The intervention integrated approximately 120 minutes per week of structured exercise, promotion of the Mediterranean-style eating pattern emphasizing whole foods and omega-3–rich seafood, and adjunctive mindfulness-based cognitive therapy. Using a single-group pre–post design, outcomes included a primary endpoint (A1C) and secondary endpoints (systolic and diastolic blood pressure and depressive symptoms assessed by the Glasgow Depression Scale adapted for adults with IDD). Mixed-effects regression analysis indicated that group-level change in A1C was not statistically significant at α …

Parting Thoughts Li, Tracy L. Mainieri

Faculty Publications - Kinesiology and Recreation

This Paring Thoughts reflects on how leisure scholars could use their expertise to preserve or increase the humanity in higher education policies related to sabbatical leave and beyond.

Prioritization Among School Nurses: An Integrative Review Of The Literature, Melissa Calvillo, Susana J. Calderon, Maureen Rabbitte, Cherrill Stockmann, Sheryl Henry

Faculty Publications - Mennonite College of Nursing

With a median caseload of 750–1,000 clients, school nurses face setting-specific challenges involving multiple, competing demands. This necessitates effective prioritization to prevent missed opportunities to provide appropriate care. This integrative review synthesizes the current state of the literature related to prioritization among school nurses in the United States. Three themes were identified relating to prioritization among school nursing: knowledge, attitudes and values; self-efficacy and intention to act; and the nursing process. The prioritization behavior of school nurses can be facilitated by organizational and community collaboration and strong evidence-based practice recommendations. High workloads and inadequate resources among school nurses are the …

Optimizing Pelvic Health: Evaluating The Efficacy Of Prenatal Strength And Resistance Training Combined With Pelvic Floor Muscle Exercises In Reducing Pelvic Organ Prolapse Risk, Samantha Requilman

Nursing | Senior Theses

While postnatal recovery is focused on the newborn, the mother’s health is equally important – particularly in preventing pelvic organ prolapse (POP), a condition that results in pelvic discomfort, incontinence, and a reduced quality of life. Although clinicians encourage pelvic floor muscle exercises (PFME) throughout pregnancy, POP is still prevalent among women, especially those who deliver vaginally. There are limited research studies on the effectiveness of prenatal resistance training in the prevention of pelvic dysfunctions and this study aims to address the gaps in the literature. So the question to address this study is: Does combining prenatal resistance training with …

The Effect Of Length Of Nursing Shift On The Development Of Medical Errors, Andrew J. Hom

Nursing | Senior Theses

The relationship between extended nurse work hours and increased clinical errors is a growing concern in nursing and healthcare systems. This issue has only grown more pronounced since the pandemic, which exacerbated staffing shortages and placed unprecedented demands on the nursing workforce. Longer shifts often lead to fatigue, impaired decision-making, and decreased cognitive performance, creating challenges for both nurses and patients. To better frame the analysis, this thesis relied on The Swiss Cheese Model to better conceptualize risk management. This thesis examined the correlation between consecutive hours worked and the frequency of errors made by nurses while also exploring the …

The Role Of Sexual Assault Nurse Examiners: Addressing The Shortage And Its Implications For Healthcare, Isabel Mary Mccarthy

Nursing | Senior Theses

Background: Sexual Assault Nurse Examiners (SANE) are registered nurses specifically trained to perform forensic examinations and provide medical and emotional support to sexual assault victims. Many nursing programs lack formal education on SANE practices, which can hinder students' preparedness to address such cases in their future careers.

Method: A mixed-methods, three-phase approach to evaluate the effectiveness of a Sexual Assault Nurse Examiner (SANE) training module within the Dominican University of California Nursing Program. 40- 60 nursing students will be separated into two separate community health classes with one given module in SANEs nursing and the other not. Both classes …

Catalytic Effect Of Amyloid-Β On Native Tau Aggregation At Physiologically Relevant Concentrations, Rakhi Chowdhury, Apu Chandra Das, Ruan Van Deventer, Luda S. Shlyakhtenko, Yuri L. Lyubchenko

Journal Articles: Pharmaceutical Sciences

Alzheimer's disease (AD) is characterized by the accumulation and aggregation of tau and amyloid-β (Aβ). The pathophysiology and progression of AD are facilitated by the neurotoxic effects of these aggregated proteins, resulting in neurodegeneration and memory loss. In this context, the interaction between tau and Aβ42 is considered, but the mechanism underlying their pathogenic interplay remains unclear. Here, we addressed this question by studying the aggregation of full-length, unmodified tau and Aβ42 at physiologically low concentrations using atomic force microscopy (AFM). AFM imaging and data analyses demonstrate an increase in tau aggregation in the presence of Aβ42, characterized by increased …

Improving Internal Medicine And Emergency Department Communication - The Ed Map Project, Syed Raza, Srinidhi Shyamkumar, Eric Riha, Zuhair Ali

Gulf Coast Division GME Research Day 2025

No abstract provided.

Mycosis Fungoides: A Mimicker Of Atopic Dermatitis, Christian Scheufele, Paige Loux, Henry Lim, Garrett Furth, Marshall Hall, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction Cutaneous T cell lymphoma (CTCL) is a rare, cutaneous, malignant neoplasm of the resident T cell lymphocytes within the skin. CTCL encompasses a spectrum of morphologically and prognostically distinct entities, the most common of which is mycosis fungoides (MF). The incidence of mycosis fungoides is about 6 cases per million per year in the United States and Europe. MF is notoriously difficult to diagnose clinically. It can masquerade as several common dermatologic conditions and may be treated as such for years until a biopsy reveals the correct diagnosis. One of the most common diseases that MF mimics is atopic …

A Standardized Surgical Protocol For Placenta Accreta Spectrum Disorder At An Accreta Center Of Excellence, Ana Adams, Monica Rodriguez, Kate Hansen, Aysu Erdemir, Robert Cohen

North Texas Research Forum 2025

Introduction Placenta Accreta Spectrum Disorder (PASD) refers to a spectrum of abnormal invasion of the placenta into the uterus during pregnancy. PASD ranges in severity from involvement through the endometrial layer of the uterus to complete invasion involving other pelvic structures. This abnormal invasion can result in significant postpartum hemorrhage, often requiring large-volume transfusions, about six units of packed red blood cells on average. The maternal mortality rate associated with PASD is approximately 4-7%. The Society for Maternal-Fetal Medicine (SMFM) recommends that pregnancies complicated by PASD be delivered in hospitals with dedicated interdisciplinary teams, referred to as “Accreta Centers of …