Medicine and Health Sciences Commons^™

Exploring The Role Of Bingocize® Workshops In Enhancing Health And Well-Being In Older Adults, Kaitlyn Gray

Mahurin Honors College Capstone Experience/Thesis Projects

As the population of older adults grows, the need for better health and well-being also grows, making it necessary to implement effective strategies for healthy aging to improve the length and quality of life of older adults (CDC, 2024). This study evaluates the effectiveness of a Bingocize^® Workshop in improving the physical health of older adults. Bingocize^®, a unique program combining bingo with exercise, is designed to increase physical activity. Eleven (11) participants aged 68.55 ± 6.235 attended a ten-week workshop, two times per week focusing on physical exercises tailored to their abilities. The primary objective was …

Exploring The Challenges And Interventions For Type 1 Diabetes In Young Children, Patra Chisom Ezeamii, Nenrot Gopep, Ho-Jui Tung

Eagles Talking About the Public’s Health

No abstract provided.

Domestic Violence And Mental Health: A Complementary Perspective, Olayemi Aloba, Jacob Gakpo, Katie M. Mercer

Eagles Talking About the Public’s Health

No abstract provided.

Forgiveness Of Self And Others: A Group Approach To The Treatment Of Ptsd And Other Trauma Related Experiences, Jarrod A. Mask

Psychology Doctoral Specialization Projects

Forgiveness is often misinterpreted as the act of forgetting what happened or offering one’s offender the ability to redeem themselves for their wrongdoings. This is simply not the case. Rather, forgiveness is the process of the individual making the unprovoked choice to release their resentment in their own voyage towards living a free and happy life without being imprisoned from the emotions un-forgiveness produces. Forgiveness, as it may be a necessary process for the individual is to attain a sense of peaceful acceptance and liberation from their pain, is not an easy process. Providing a peer-based support system in the …

Demonstration Of An Enhanced Dosing Pattern For Debulking Large And Bulky Unresectable Tumors Via Differential Hole-Size Spatially Fractionated Radiotherapy, Joshua Misa, William St. Clair, Damodar Pokhrel

Radiation Medicine Faculty Publications

Purpose/objective

We propose a novel lattice deployment for spatially fractionated radiotherapy (SFRT) treatments. In this approach, a larger diameter high-dose sphere is centrally placed in the bulky tumor mass and surrounded by smaller diameter high-dose spheres.

Materials/methods

Thirty SFRT patients (10 head and neck [HN], 10 abdominal/pelvis, and 10 chest/lung cases) treated with an MLC-based crossfire method were retrospectively analyzed. Eleven differential hole-size lattice patterns were benchmarked against the clinically delivered SFRT plans (1 cm diameter cylinders, 2 cm spacing) and the standard uniform lattice pattern (1.5 cm diameter spheres, 3 cm spacing). These patterns varied in core diameter (C: …

In Vitro Α/Β Ratio Variations In Cervical Cancer, With Consequent Effects On Equivalent Dose In 2 Gy Fraction In High-Dose-Rate Brachytherapy, Cameron Thayer-Freeman, Brien Washington, Denise Fabian, Dennis C. Cheek, William St. Clair, Mark E. Bernard, Wei Luo

Radiation Medicine Faculty Publications

Purpose: To determine the distributions of published α/β values measured in vitro and the resulting uncertainties in the equivalent dose in 2 Gy fractions (EQD ₂ ) when applied to high-dose-rate brachytherapy (HDR-BT) for cervical cancer.

Methods and Materials: An analysis of 98 published α/β values from 31 papers was conducted, spanning 23 cervical cancer cell lines. Values were further divided into squamous cell carcinoma and adenocarcinoma histologies. Probability distributions were fit to histograms using the bootstrapped Kolmogorov-Smirnov goodness-of-fit test. Both average and most probable α/β values for cervical cancer were determined. The probability distributions were then applied to three …

Trends In Missing Race And Ethnicity Data In A National Surgical Database, Kevin Gao Hu

Yale Medicine Thesis Digital Library

Accurate data collection on race and ethnicity is critical to detecting and characterizing disparities in surgical care. This study explores the prevalence and impact of missing race and ethnicity data in the National Surgical Quality Improvement Project Pediatric (NSQIP Pediatric) database. NSQIP Pediatric from 2016-2020 was assessed for patients who were missing data for race (RM), ethnicity (EM), or both (BM). Changes in proportion of RM, EM, and BM patients were assessed with Cochran-Armitage tests. Surgical outcomes were modeled using linear mixed-effects models, treating CPT codes as random effects. Models were bootstrapped with 1000 iterations for each outcome. Of 596,571 …

Tigit And Gdf-15 As Biomarkers And Targets In Renal Cell Carcinoma Resistant To Immune Checkpoint Inhibitors, Oscar Norberto Perales

Yale Medicine Thesis Digital Library

Immune checkpoint inhibitors have become the standard of care treatment for local and systemic clear cell renal cell carcinoma (RCC). However, a subset of patients fail these therapies due to the development of disease refractory to such treatments. Therefore, it is imperative that we study the potential mechanisms of resistance to immune checkpoint inhibition within the tumor microenvironment. Likewise, establishing biomarkers indicative of treatment resistance may benefit clinicians and patients when it comes to the initial selection of treatment. Moreover, biomarkers of resistance might also serve as potential drug targets. In this study we analyzed expression of TIGIT and GDF-15, …

Maternal-Infant Attachment, Depression, Anxiety, And Breastfeeding Self-Efficacy Among Marginalized Populations, Leslie B. Lantz, Merilyn Arikkat, Amy Salisbury, Sara Moyer, Sally Russell, Leroy Thacker, Candice Gault, Josselyn Valenzuela, Kimberly Cruz-Lopez, S Bodnar-Deren, Patricia Kinser

School of Nursing Publications

No abstract provided.

Advance Care Planning Utilization Among Non-White Individuals With Heart Disease And Cancer Using Health Retirement Study (Hrs) Data, Trizah M. Njoroge

Nursing Dissertations - Archive

Advance Care Planning (ACP) is a critical component of patient-centered care, yet its utilization remains disproportionately low among Non-White populations in the United States, particularly among individuals with chronic illnesses such as heart disease and cancer. This article explores racial disparities in ACP engagement using secondary analysis of the 2018 and 2020 waves data from the Health and Retirement Study (HRS), guided by Bandura’s self-efficacy theory (SET). The study examines how race, disease type, comorbidity, and survey year predict ACP service utilization, defined as completing five key ACP components: a legal will, a medical care discussion, surrogate assignment (DPOA), a …

Improvement Of Hpv Vaccination Rate In Pediatric Patients In A Clinic Through Implementation Of A Bundle, Macalah Jenschke

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction: Human papillomavirus (HPV) is a major cause of several cancers, and vaccination is a highly effective preventive measure. However, HPV vaccination rates remain suboptimal, particularly in rural pediatric populations. This quality improvement (QI) project aims to enhance HPV vaccination rates through the implementation of a comprehensive vaccination bundle targeting provider education, patient and parent education, appointment reminders, and the use of a vaccine waiver when needed.

Method: This QI project was conducted over twelve weeks in a rural pediatric clinic with approximately 130 patients seen daily. The intervention bundle included provider education on effective communication regarding HPV vaccination, educational …

Improving Glucose Levels In Adults With Type 2 Diabetes, Kaitlin Castillo

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Type 2 diabetes is a growing health crisis, posing significant challenges not only to individual well-being but also to healthcare systems' financial sustainability. The prevalence of type 2 diabetes continues to rise annually, contributing to increased medical costs, hospitalizations, and long-term complications. Houston, Texas, has a diabetes prevalence of 13.5%, exceeding the national average of 10%. A clinical gap exists in providers’ ability to prevent and manage type 2 diabetes. Prioritizing prevention, early intervention, and improved patient monitoring can reduce incidence rates, lower healthcare costs, and enhance overall population health. A Plan Do Study Act model was utilized for the …

Reducing Stress Related To Injection Therapy: A Zen Bundle Approach, Valoree Bowen

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Needle fear and stress are common barriers preventing adults from seeking necessary medical treatments, including intramuscular (IM) injection therapy. Research highlights the need for evidence-based interventions to mitigate this fear and improve patient experience.

Objective: This evidence-based pilot project included a Zen Bundle—an intervention incorporating shared decision-making, aromatherapy, and distraction—to evaluate the impact on stress reduction and patient satisfaction in a retail vitamin shop in North Texas.

Methods: The project utilized a pre-and post-intervention design over eight weeks. Participants completed pre-surveys assessing stress levels using a Visual Analog Scale before choosing an intervention (aromatherapy, distraction, or both) during IM …

Management Of Obesity In Adults 18 And Older, Donna Callicoat

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Obesity is a significant public health concern in the United States, with increasing prevalence and substantial healthcare costs. Despite evidence-based guidelines for obesity management, primary care clinics often fail to implement them effectively, leading to missed opportunities in preventing obesity-related comorbidities such as cardiovascular disease, type 2 diabetes, and certain cancers.

Purpose: This evidence-based project aimed to implement the American Heart Association/American College of Cardiology/Obesity Society (AHA/ACC/TOS) obesity guidelines in a rural Texas primary care clinic. The goal was to assess the effectiveness of these guidelines in reducing weight, body mass index (BMI), and waist circumference among adults with …

Multidisciplinary Approach To Reduce The Heart Failure Readmission Rate, Nisha Thekkedam

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States, 6.7 million adults have been diagnosed with heart failure (HF), a number projected to rise to 8.5 million by 2030. National data indicate a 30-day readmission rate of 18.2% among HF patients from 2010 to 2017. In Texas, around 12% of the Medicare population in Texas, and specifically 11% of the Medicare population in North Texas County, have been treated for HF. A North Texas hospital reports an 18-20% HF readmission rate over the past several years. Purpose: This EBP project included the implementation of a care bundle using the Dutch Heart Failure …

Reducing Caregiver Burden For The Caregivers Of Heart Failure Patients, Joyce W. Kimani

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Family members and friends of heart failure patients serve as informal caregivers for many heart failure patients, helping with the management of day-to-day heart failure care. Many caregivers of heart failure patients experience stressors associated with caregiving, including social, psychological, financial, emotional, and physical stress. Reducing caregiver burden is important in improving both patient and caregiver well-being. Healthcare systems can improve caregiver outcomes and encourage the long-term sustainability of informal caregivers by addressing caregiver needs through focused support strategies. The Agency for Healthcare Research and Quality framework was used to develop an evidence-based guideline that healthcare professionals can follow in …

Efficient Treatment Of Postoperative Nausea And Vomiting In Adults Recovering From General Anesthesia, Peter A. Palko

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

This manuscript explores strategies to address postoperative nausea and vomiting (PONV), a significant complication affecting up to 30% of surgical patients and 80% of those at high risk. Despite its prevalence, appropriate prophylactic administration of antiemetic medications remains suboptimal, with national rates at 67% and certain academic facilities reporting only 32%, far below the 90% recommended threshold. These deficiencies underscore the urgent need for evidence-based interventions to enhance clinical adherence and improve patient care outcomes.

A quality improvement (QI) initiative was implemented to enhance prophylactic treatment and reduce inefficiencies in PONV management. Following a comprehensive literature review, the project employed …

Guideline For The Management Of Immunotherapy-Related Adrenal Insufficiency At A Cancer Center, Rachna R. Patel

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Immunotherapy has become an important treatment option for cancer care and is being utilized more often. Immunotherapy-related adrenal insufficiency (irAI) is a potential adverse effect of immunotherapy that requires endocrine expertise for management. The goal of this project was to create a guideline with an algorithm for the safe and comprehensive management of irAI in an advanced-practice provider-led clinic.

Methods: A guideline project utilizing the Agency for Healthcare Research and Quality (AHRQ) National Quality Measures Clearinghouse (NQMC) Measure Domain Framework was conducted at this cancer care facility. A literature search was conducted to gather the best available evidence and …

Evidence-Based Discharge Bundle To Reduce Heart Failure Readmissions, Chelsea Zepeda

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Heart failure (HF) affects over 6.7 million adults in the United States, resulting in frequent hospitalizations and readmissions, increased mortality, and billions of dollars spent annually on healthcare costs. Reducing readmission rates is a priority for the healthcare industry.

Objective: This evidence-based practice project aimed to reduce HF readmission rates through a bundled approach to address socioeconomic factors that place patients at higher risk for readmission, provide patient-centered education for HF management at home, and provide follow-up phone calls after discharge to assess patient symptoms.

Methods: English-speaking patients, aged 65 or older, with any active diagnosis of HF were …

Implementing The Tips Toolkit To Prevent Falls In Hospitalized Older Adults: A Rural Hospital Approach, Viridiana G. Gonzalez Msn, Rn

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Falls remain the leading cause of injury-related deaths among hospitalized older adults, contributing to significant morbidity, extended hospital stays, and increased healthcare costs. Implementing effective fall prevention strategies is especially challenging in rural hospitals due to staffing shortages, limited funding, and variability in clinical practice.

Local Problem: A 30-bed Medical-Surgical Unit in a rural Southwest Texas hospital experienced a rise in patient falls among older adults aged 65 and older, including several incidents requiring advanced medical treatment and one resulting in serious injury. A gap analysis revealed inconsistent implementation of tailored fall prevention strategies.

Methods: A quality improvement (QI) …

Bundled Approach To Improve Colorectal Cancer In Primary Care, Elizabeth Reddiar

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in the United States, despite being preventable through timely screening. National guidelines recommend regular screening for adults aged 45 to 75; (American cancer Society (ACS), 2025) however, screening rates remain suboptimal, particularly in primary care settings serving diverse and high-volume populations. Local Problem: At the project site, a community-oriented primary care clinic in North Texas, baseline data revealed CRC screening completion rates were below benchmarks set by the organization. Barriers included limited patient awareness, inconsistent provider reminders, and workflow challenges in distributing and tracking fecal immunochemical test …

Implementing The Gad-7 Screening Tool In An Adult Outpatient Psychiatric Clinic, Elizabath George

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Anxiety disorders are among the leading causes of disability worldwide and the most prevalent mental illness in the United States. Despite affecting 6.8 million adults annually, fewer than half with Generalized Anxiety Disorder (GAD) receive treatment. Many patients present with somatic complaints, leading to underdetection. Standardized screening tools such as the Generalized Anxiety Disorder-7 item (GAD-7) can improve identification and outcomes.

Purpose: This quality improvement (QI) project implemented the GAD-7 screening tool in an adult outpatient psychiatric clinic in North Texas and evaluated its impact on identifying patients with GAD, compared to the prior year without structured screening. …

An Application Of The Transtheoretical Model To Vaping Cessation: Measure Development For The Processes Of Change, Autumn Tamlyn

Open Access Master's Theses

Statement of the Problem: An estimated 18.6% of individuals aged 18-24 and 15.9% of individuals aged 25-29 are vaping, with approximately half of the individuals in each of these groups reporting daily use. With vaping behavior on the rise, the current study aims to provide valuable information to understand patterns of vaping behavior to support intervention development and implementation.

Method: The aim of the current study was to develop a Processes of Change (POC) measure for vaping cessation in a young adult population in the United States. Previous POC measures, extensive qualitative literature review, and review of existing …

Association Between Vitamin D Status And Cortisol Concentration Among Pregnant Women, Kenneth Addae

Open Access Master's Theses

Objective: Vitamin D deficiency (VDD) and high circulating cortisol during pregnancy have each been linked to adverse maternal and child outcomes such as preterm birth. However, limited research has explored the association between vitamin D status and cortisol concentration during pregnancy. Our objective for this study was to determine the association between vitamin D status and cortisol concentration among pregnant women.

Methods: The Prenatal Health and Nutrition (PHAN) study was a pilot cross-sectional study of 30 healthy pregnant women conducted in targeted areas in Rhode Island. Data was collected on sociodemographic characteristics, substance use, perceived stress scale, household food security, …

Financial Factors And Relationship Satisfaction: A Systematic Review Using The Tccm Framework, David Gardner

Open Access Master's Theses

Relationship satisfaction is critically important for the overall health of the relationship and is therefore inherently desirable for anyone who wants to maintain a long-term romantic relationship. Financial factors have been associated with relationship satisfaction in past research, demonstrating a need for systematic exploration. The purpose of the study is to systematically explore how financial behaviors, values, and macroeconomic systems are connected to relationship satisfaction. The current systematic review follows the PRISMA framework for exclusion and identifies 30 articles studying financial factors and relationship satisfaction from Scopus, PsychInfo, and Web of Science. The analysis followed the Theory, Context, Characteristic, and …

Innovative Biomechanical And Engineering-Based Assessments Of Hip Mechanics In Individuals With Hip-Related Pain, Holly M. Stanze

Theses and Dissertations--Kinesiology and Health Promotion

Individuals with hip-related pain exhibit altered movement patterns, and worse fear of movement (kinesiophobia), compared to asymptomatic controls. Exacerbation of hip pain during movement and the role of hip symptom duration may help further our understanding of specific movement patterns that are associated with hip-related pain. A better understanding of the potential connections between hip-related symptom duration, kinesiophobia, hip pain during movement, and lower limb mechanics in those with hip-related pain may allow for more efficient referrals to clinicians and lead to more effective rehabilitation. In addition, the impact of hip-related pain on intra-articular hip loading patterns is not well …

Psychological Impacts In Exercise Riders And Professional Jockeys Following Injury, Kelley M. Renner

Theses and Dissertations--Kinesiology and Health Promotion

One of the most well-known equestrian sports, horse racing, is not only a cornerstone of Kentucky’s economy, but also a vital part of its culture, with professional jockeys playing an essential role in the local communities and traditions that define the state. Despite its popularity and financial impact, mental health challenges within the sport have continually been shrouded in silence and ignored in research (Ball et al., 2007). Equally concerning is the high injury prevalence, and psychological impact of these injuries (e.g., psychological distress, depression, anxiety, loss of identity, and self-esteem (King et al., 2022; Losty et al., 2019; McConn-Palfreyman …

The Effects Habitual Training Shoe Use Has On Running Economy When Transitioning To High Performance Running Shoes, Dalton C. Harris

Theses and Dissertations--Kinesiology and Health Promotion

Background: The recent increase in popularity of minimal shoes in endurance running is linked to potential improvements in running economy and reduced injury risk. However, high performance running shoes, specifically designed to improve running economy remain the fastest shoe to wear when racing. Purpose: Knowing this, the aim of this paper is to examine whether or not the habitual use of minimal shoes increases the benefits of the high performance shoes. This will guide practitioners and athletes when establishing shoe rotations and training plans during race preparation. Methods: The study consisted of 4 sessions: Sessions 1 and 2 were maximal …

Proximity And Density Of Tobacco Retail Locations To Kentucky Schools And The Relationship To Youth Perceptions Of Harm And Susceptibility To E-Cigarette Use, Hannah Cardona

Theses and Dissertations--Kinesiology and Health Promotion

Purpose: To explore the potential relationship between tobacco retailer proximity/density around Kentucky elementary, middle, and high schools, and students’ perceptions, perceived norms, susceptibility to, and use of e-cigarettes. Design: A mixed-methods analysis of youth’s self-reported survey results and geographical data. Setting: 106 Kentucky elementary, middle, and high schools which participated in #iCANendthetrend’s tobacco education program between September 2023 and May 2024. Subjects: Convenience sample of students from Ky schools (N = 7,823) Measures: Items assessing e-cigarette use, susceptibility, perceptions, and perceived norms. Analysis: ANOVA tests used to compare responses of elementary, middle, and high school students. Chi-squared tests were used …

You’Re Too Slow! Self-Selected Volitional Efforts Reveal Unexploited Neuromuscular Reserve Capacity Compared To Maximal Efforts During Fatiguing, Load Equated Resistance Exercise, Brian Benitez

Theses and Dissertations--Kinesiology and Health Promotion

This investigation examined how movement intent influences neuromuscular excitation strategies during fatiguing resistance exercise, comparing maximal intended concentric efforts versus self-selected volitional efforts during load-equated Smith machine back squat exercise to quantify reserve capacity and characterize underlying neuromuscular mechanisms. Twenty-three resistance-trained participants (12 males, 11 females) completed a repeated-measures design, with replication, across six visits, performing smith machine back squat repetitions-to-failure at 70% 1RM under maximal intent (accelerate rapidly) and volitional intent (self-selected effort) conditions. Maximal voluntary isometric contractions used rapid (instantaneous 10-second effort) and ramp (5-second build-up, 5-second maximal) protocols. Surface electromyography (sEMG) was recorded from vastus lateralis and …