Medicine and Health Sciences Commons^™

Reduced Achilles Tendinopathy Symptoms (E.G. Stiffness), But Not Pain, Relate To Patient-Perceived Resolution Of Achilles Tendinopathy: A Cross-Sectional Study, Myles C. Murphy, Fletcher Bright, George White, Ruth L. Chimenti, Andrea B. Mosler, Ebonie K. Rio

Research outputs 2022 to 2026

We aimed to determine whether pain, symptoms and/or physical function are associated with perceived recovery in people with current or resolved Achilles tendinopathy. We performed a cross-sectional cohort study, including people who reported having either “current” or “resolved” Achilles tendinopathy. Participants completed an online survey, including the Tendinopathy Severity Assessment- Achilles (TENDINS-A). We used multivariable binary logistic regression and reported odds ratio (OR) to quantify the strength of the association. We included 100 cases (n = 63 current, n = 37 resolved). There were no associations of age, sex, BMI, TENDINS-A (Pain) or TENDINS-A (Physical Function) with whether participants reported …

Can Quantitative Sensory Testing Predict Treatment Outcomes In Hip And Knee Osteoarthritis? A Systematic Review And Meta-Analysis Of Individual Participant Data, Myles C. Murphy, Andrea Mosler, Ebonie K. Rio, Molly Coventry, Isaac Selva Raj, Paola T. Chivers, Lars Arendt-Nielsen, Fabio Marcon Alfieri, Martin F. Bjurström, Dennis Boye Larsen, Wei Ju Chang, Anne Estrup Olesen, Emma Hertel, Paetur Mikal Holm, Thomas Graven-Nielsen, Cid André Fidelis De Paula Gomes, Marius Henriksen, N. Jennifer Klinedinst, Jerin Mathew, Asbjørn Mohr Drewes, Guilherme S. Nunes, Helen O'Leary, Håvard Østerås, Ozgul Ozturk, Miklos Pozsgai, Érika Patrcia Rampazo

Research outputs 2022 to 2026

An individual participant data (IPD) meta-analysis can assess the predictive value of data on outcomes at the individual level, offering a potential tool for developing personalized pain management. Pretreatment quantitative sensory testing (QST) may stratify patient groups, which are then linked to treatment outcomes. Our objective was to determine if measures of QST at baseline are related to treatment outcomes (at any time point) for pain and disability in lower-limb osteoarthritis. We performed a systematic review with an IPD meta-analysis. Searches were conducted in 9 databases until May 5, 2023 for intervention studies that measured baseline QST and longitudinal measures …

The Potential Impact Of Social Prescribing On Meaningful Engagement In Collective Aged Care Settings: Perspectives From The Global South, Melissa Kilian, Tania Rauch Van Der Merwe, Itumeleng Tsatsi, Ronelle Jansen, Marieta Visser, Rayne Stroebel, Sanetta Henrietta Johanna Du Toit

Research outputs 2022 to 2026

Background: Promoting collective care philosophies in residential aged care homes that enhances person-centred care remains a global challenge. More success is evident when an organisation’s approach to care impacts the well-being of everyone who lives and works in the home. However, funding systems are seldom applied in favour of a collective approach. The uptake of social prescribing is potential yet another obstacle in eradicating the prevailing dominance of the medical model of care in aged care homes. Objective: In the Global South, institutionalised care is becoming a more acceptable and viable option to ensure health and well-being of older adults. …

To Discard Or Not To Discard 1pns? A Systematic Review And Meta-Analysis On 291,474 Embryos, T. Lee, F. Qi, K. Peirce, J. Natalwala, V. Chapple, P. J. Mark, K. Sanders, Y. Liu

Research outputs 2022 to 2026

Unlike embryos that display two pronuclei (2PN), monopronucleated (1PN) embryos are assumed to be haploid and can be routinely discarded. Although there are reports of live births after 1PN embryo transfer, the developmental and clinical prognosis of 1PN embryos has not been systematically evaluated. The aim of this review was to elucidate the developmental, clinical and neonatal outcomes of 1PN embryos compared with 2PN embryos. Twenty-four studies met the inclusion criteria. The blastulation rate was lower in 1PN embryos compared with 2PN embryos [risk ratio (RR) 0.50, 95% CI 0.48–0.51]. The live birth rate was lower in 1PN blastocysts when …

Nursing Assessment Of Mental Health Issues In The General Clinical Environment: A Descriptive Study, Irene Ngune, Beverley Ewens, Sharlene Bell, Brendon Burns, Claire Sutton, Craig Creswell, Yvonne Middlewick

Research outputs 2022 to 2026

Aims: To evaluate the effectiveness of a mental health screening form for early identification and care escalation of mental health issues in general settings. A secondary aim was to explore general nurses' use of the form and their confidence to discuss mental health issues with patients. Methods: A cross-sectional design comprising a review of clinical records to determine use of the form, instances of missed care and escalation to the mental health team. The survey focused on nurses' confidence in general settings to engage in discussions with patients about mental health. Data were collected from April to December 2022. The …

Enhancing Nutrition Information Utilisation, Confidence, And Role Legitimacy And Adequacy Among Early Childhood Education Professionals Through Evidence-Based Online Training, Ruth Wallace, Ros Sambell, Shih Ching Fu, Johnny Lo, Elizabeth J. Cook, Amanda Devine

Research outputs 2022 to 2026

This study evaluated the effectiveness of an online short course based on the Health Promoting Schools Framework and specifically designed for Early Childhood Education and Care (ECEC) professionals. The short course aimed to enhance ECEC professionals’ nutrition knowledge, confidence, role legitimacy and adequacy to model healthy behaviours, teach healthy food habits and create health-promoting environments. Participants (n = 116) working at Australian ECEC services were assigned to control (n = 62) or intervention (n = 54) groups. Both groups completed a pre-intervention survey. The intervention group accessed the four-week course and completed the post-intervention survey. The control group completed a …

Emotional Safety In Maternity Care: An Evolutionary Concept Analysis, Elliesha O'Reilly, Kate Buchanan, Sara Bayes

Research outputs 2022 to 2026

Background: Safety in maternity care is a priority, and a broadened view of safety (e.g., emotional, psychological, cultural) is evident in scientific literature and in lay discourse. ‘Emotional safety’ is being referred to with increasing frequency in this context; however, there is a lack of clarity in its use and meaning. Aim: The aim of this concept analysis was to examine the concept of emotional safety in maternity care. Methods: The evolutionary approach was used for this concept analysis. Data sources: This concept analysis was literature-based, with a systematic search conducted of CINAHL, MIDIRS, and MEDLINE databases. Ten articles published …

Hospital Volunteer Programs For Older People: A Systematic Scoping Review, Rosemary Saunders, Francine Antoinette Ocampo, Renée Graham, Angela Christiansen, Michelle Gay, Karla Seaman

Research outputs 2022 to 2026

Introduction: Volunteers play an important role in supporting patients in hospitals, especially older adult patients who may have increased care needs. This systematic scoping review aimed to synthesise evidence related to qualitative evaluations of hospital-based therapeutically oriented volunteer programs for older patients from the perspective of clinicians (nurses, doctors, and allied health professionals), and stakeholders (patients, families, and volunteers). Methods: Nine databases were searched from January 2002 to November 2022. Of the 549 articles identified, 15 were included in the final review. Results: The evidence demonstrated that clinicians, patients, families, and volunteers could all see the benefits of volunteer programs …

How Does Trauma Informed Care Education For Paediatric Healthcare Professionals’ Impact Self-Reported Knowledge And Practice. An Integrative Review, Megan Thornton, Julie Blamires, Mandie Foster, Rebecca Mowat, Stephanie Haven

Research outputs 2022 to 2026

Aim: To examine the literature on the impact of Trauma Informed Care education on paediatric health care practitioners’ self-reported knowledge and practice. Background: Psychosocial trauma during childhood is prevalent and linked to increased risk of adverse physical and mental health outcomes. Trauma Informed Care recognises the significant impact of childhood trauma in health outcomes. Education is key to health care practitioners’ integrating Trauma Informed Care into practice. Design: Integrative review of the literature. Methods: The review employed Whittemore and Knafl's (2005) framework and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2021 statement. A systematic search …

Exploring The Impact: Eating Disorder Treatment And Mortality In The United States, Brittany Tolbert

College of Graduate Studies: Theses & Dissertations

This study explores adolescent eating disorder trends in the United States between 1999-2013, identifies national eating disorder mortality trends, and analyzes data for in-patient adolescent hospital admissions. Additionally, this study uses public-facing data for residential eating disorder treatment centers to explore issues related to insurance coverage, gender inclusivity, and evidence-informed treatment practices. The findings will highlight gaps in data collection and policy, support advocacy, and contribute to the research into eating disorder prevalence, prevention, treatment outcomes, and economic impact, leading to greater visibility to promote change.

Providing Healthcare Access For The African Population Using An International Care Coordination System: A Case Study Of Nigeria And Ghana, Aminat B. Nwaonumah

College of Graduate Studies: Theses & Dissertations

Introduction: Healthcare access is a major population health challenge among underserved populations in many parts of the world, and the situation in Africa is no exception. Foreign aid, a significant component of healthcare financing in Africa, has played a crucial role in mitigating communicable diseases. However, there is a lacuna in care for non-communicable diseases, such as chronic illnesses, especially among the elderly. This study explored an innovative approach to expanding healthcare access in Nigeria and Ghana through care coordination sponsored by migrant family members residing in the United States. Beyond foreign aid, this research elucidates how the International Care …

Barriers To Seeking Medical Care And Their Effects Among Fat Patients With A Fat Liberation Praxis In The United States, Christina Seiko Cook

College of Graduate Studies: Theses & Dissertations

Weight stigma and weight bias have significant effects on the health of individuals (Alberga et al., 2019; Pearl, 2018; Puhl & Heuer, 2010; Schwartz et al., 2003; Udo et al., 2016). These biases can show up in the form of fatphobia or anti-fat bias. Physicians who hold anti-fat bias can affect their relationship with their patients, leading to poorer health outcomes and worse patient experiences for larger-bodied and fat people (Phelan et al., 2015). The purpose of this study is to contribute to the current literature regarding the positive and negative experiences of fat patients with a fat liberation praxis …

Perceptions And Influences On Physical Activity Engagement During Pregnancy Among Rural Southern Black Women, Sandra Ofosuhemaa

College of Graduate Studies: Theses & Dissertations

Black women living in the rural South experience disproportionately high rates of hypertension, gestational diabetes, excessive gestational weight gain, and adverse birth outcomes. Although physical activity during pregnancy is known to improve maternal and fetal health, Black pregnant women remain less likely to meet recommended activity guidelines. This qualitative study examined the perceptions, beliefs, and multilevel factors influencing physical activity during pregnancy and the postpartum period among Black women in rural Southeast Georgia. Guided by the Health Belief Model (HBM) and Social Ecological Model (SEM), the study explored how individual, interpersonal, community, and structural conditions shaped women’s decisions, motivations, and …

Exploratory Analysis Of Gait Mechanics In Farmers, Mariana V. Jacobs, Kate N. Jochimsen, Jody L. Clasey, Michael A. Samaan

Kinesiology and Health Promotion Faculty Publications

Farmers may be at a higher risk of developing hip osteoarthritis (OA) due to the high demands of their occupation. To the authors’ knowledge, the gait patterns of farmers that may be associated with hip joint degeneration have yet to be analyzed. Therefore, this study compares gait mechanics between farmers and non-farmers (controls). It is hypothesized that farmers would exhibit altered lower extremity joint mechanics during walking when compared to matched controls. This exploratory study included five farmers and five sex-, age-, and body mass index (BMI)-matched controls. A 3D gait analysis was performed while study participants walked at a …

Assessment Of Hip Joint Mechanics During Walking In People With Marfan Syndrome, Mariana V. Jacobs, Justin Melan Pol, Aaron D. Fain, Jody L. Clasey, Brecca M. M. Gaffney, Christopher J. Mclouth, Mary B. Sheppard, Michael A. Samaan

Kinesiology and Health Promotion Faculty Publications

Background: Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder and is associated with muscle dysfunction. Individuals with MFS exhibit quadriceps weakness, hip joint pain, and an increased incidence of hip osteoarthritis (OA) compared to the general population, yet the underlying biomechanical factors associated with these poor hip-related outcomes are not well understood.

Research Question: The purpose of this study was to assess the effects of MFS on gait mechanics and to determine the relationship of gait mechanics with hip-related outcomes within the MFS group. Methods: Eighteen people with MFS and 18 healthy, asymptomatic controls underwent 3D gait analysis. …

The Effect Of The Ketogenic Diet On The Circadian Rhythmicity Of Glymphatic Function In Mice, Tanner Metcalfe

Yale Medicine Thesis Digital Library

The glymphatic system is a network of perivascular spaces that coordinates removal of waste products from brain parenchyma. It is known that the glymphatic system is under control of the circadian rhythm, however little is known about factors that influence this control. Data has shown that the expression of specific circadian rhythm genes is altered when exposed to the ketogenic diet. In this experiment, we show that the day-night rhythmicity of glymphatic function is extinguished in mice exposed to the ketogenic diet through the up-regulation of influx of cerebrospinal fluid to brain parenchyma and the reduction in cervical lymph node …

Clinical Predictors Of Fluid-Responsive Acute Kidney Injury, Cindy Khanh Nguyen

Yale Medicine Thesis Digital Library

CLINICAL PREDICTORS OF FLUID-RESPONSIVE ACUTE KIDNEY INJURY

Cindy Khanh Nguyen, Abinet M. Aklilu, Yu Yamamoto, Bashar A. Kadhim, Claudia Coronel-Moreno, Francis P. Wilson. Section of Nephrology, Department of Internal Medicine, Yale University, School of Medicine, New Haven, CT.

Specific Aims: We aimed to explore and identify common clinical variables that may be helpful in selecting patients who will benefit from volume challenge when the fluid-responsiveness of AKI is unclear.

Methods: Our study is a retrospective secondary analysis of a clinical trial that prospectively enrolled adult patients at Yale-New Haven Hospital with AKI defined by the 2012 Kidney Disease: Improving Global …

Development Of Cerium Oxide Based Polymer Composites With Enhanced Cytocompatability For Biomedical Applications, Roshna Cherugail

Honors Undergraduate Theses

This thesis presents the synthesis and characterization of cerium oxide nanoparticles (CNPs), and silver-doped cerium oxide nanoparticles (AgCNPs) loaded in alginate beads that were designed to be applied in biomedical settings. Cerium oxide was chosen for its antioxidant and anti-inflammatory capabilities, and silver oxide was selected to enhance antimicrobial functionality, both of which are pivotal in expedited wound closure and promoting cellular proliferation. Through the use of an advance electrospray encapsulation apparatus, alginate-based polymer beads were created by incorporating either CNPs or AgCNPs into the matrix. These beads were later characterized using a range of microscopic and FTIR analyses, in …

Implementing A Routine Patient Health Questionnaire-9 (Phq-9) Screening Bundle For Adults (18-65 Years) Scheduled For A Psychiatric Evaluation, Olivier Bertrand Djoumessi

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Depression affects 21 million American adults (8.4%), yet only 28% receive appropriate screening. In Texas, where 20.8% of adults experience depression, systematic screening remains inconsistent. This quality improvement project addressed a critical gap at an outpatient mental health clinic in the Dallas-Fort Worth metroplex, where Patient Health Questionnaire-9 (PHQ-9) screening occurred in only 40% of psychiatric evaluations, resulting in missed diagnoses and inconsistent treatment. Using the Plan-Do-Study-Act framework, the project implemented a comprehensive PHQ-9 screening bundle consisting of staff training, electronic health record integration, and a treatment algorithm based on severity thresholds. The intervention targeted adults, aged 18-65, scheduled for …

A Comprehensive Evaluation Of Thigh Mineral-Free Lean Mass Measures Using Dual Energy X-Ray Absorptiometry (Dxa) In Young Children, Trey R. Naylor, Mariana V. Jacobs, Michael A. Samaan, Laura C. Murphy, Douglas J. Schneider, Margaret O. Murphy, Hong Huang, John A. Bauer, Jody L. Clasey

Kinesiology and Health Promotion Faculty Publications

This study aimed to (1) demonstrate the intra- and interrater reliability of quadriceps (QUADS) and hamstring (HAMS) mineral-free lean (MFL) mass measures using DXA scanning, (2) determine the association of total thigh MFL mass measures with MFL mass measures of the hamstrings and quadriceps combined and (3) analyze the association between total thigh MFL mass and total body MFL mass measures. A total of 80 young children (aged 5 to 11 yrs) participated and unique regions of interest were created using custom analysis software with manual tracing of the QUADS, HAMS, and total thigh MFL mass measures. Repeated-measure analysis of …

Sex-Specific Roles Of The Adipocyte Mineralocorticoid Receptor In Obesity And Early Life Stress, Meghan B. Turner

Theses and Dissertations--Pharmacology and Nutritional Sciences

Obesity is a burgeoning health epidemic caused by chronic overnutrition and exacerbated by genetic, environmental and developmental factors. The adipocyte mineralocorticoid receptor (MR), a transcriptionally active nuclear receptor, is speculated to contribute to metabolic dysfunction in the obese state. MR expression is increased in obese adipose tissue, and MR modulates the expression of fat-derived hormones such as leptin and adiponectin. In women, obesity can be exacerbated by early life stress, such as adverse childhood experiences (ACEs). Studies show that women display a positive association between cumulative ACE exposures and increased body mass index. Previously, we demonstrated that maternal separation and …

2025 North Dakota American Indian & Alaska Native Maternal Child Health Profile, Kilyn R. Parisien

Public Health Student Publications

This report was created to identify and address the health needs and inequities of American Indian and Alaska Native (AI/AN) women and their children who reside in North Dakota

Data in this report has been collected from a variety of federal and state agencies, such as the North Dakota Department of Health and Human Services, U.S. Census Bureau (American Community Survey), and Centers for Disease Control and Prevention. The NDDoH’s approach for this report was to focus on having high-level discussions for each of the sections of AI/AN maternal and child health. This report is one of four components in …

Mechanistic Insights Into The Antimicrobial Action Of Fungus-Derived Xanthoquinodins Against Clostridioides Difficile, Erika A. Serravalle

Graduate Thesis and Dissertation post-2024

The bacterial pathogen Clostridioides difficile is the leading cause of antibiotic- and healthcare-associated diarrhea, imposing significant clinical and economic impacts. The emergence of hypervirulent strains, such as PCR ribotype 027 (RT027), has exacerbated disease severity, recurrence rates, antibiotic resistance, and epidemiological spread. Expanding resistance profiles among C. difficile strains continue to limit the effectiveness of current IDSA-SHEA recommended therapies, which are already compromised by high recurrence rates due to antibiotic-induced disruption of the gut microbiota. These challenges highlight the urgent clinical need to identify and characterize antimicrobial compounds targeting alternative pathways in C. difficile physiology. We report the discovery and …

Synthesis And Evaluation Of Chalcones As Treatment For Negative Sense Single Stranded Rna Viruses And Applications As Broad-Spectrum Antivirals, Lorael Kirton

Graduate Thesis and Dissertation post-2024

Chalcones are a class of compounds naturally found in plants and are predicated upon a 1,3-diphenylprop-2-en-1-one scaffold. Chalcones possess many biological activities ranging from anticancer to antiviral activities. This thesis investigates the broad-spectrum antiviral properties of chalcones. Some chalcones have been reported to affect host cell mechanisms such as mammalian target of rapamycin (mTOR) signaling cascade or the cell cycle to reduce viral replication. Previously, a series of chalcones 8 were synthesized and investigated in human cytomegalovirus virus (HCMV) and human immunodeficiency virus (HIV). In this study, ten new chalcones predicated upon the design of 8 were synthesized and a …

Fgf19 Facilitates Metastatic Phenotypes In Colorectal Cancer, Joseph W. Nolff

Graduate Thesis and Dissertation post-2024

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. With 154,000 new cases estimated in 2025, there is an increased need for early screening to detect CRC prior to metastasis. Our laboratory has focused on enteroendocrine hormone Fibroblast Growth Factor-19 (FGF19) as it is overexpressed in a subset of CRC tumors. FGF19 is an intestinal-derived hormone involved with lipid homeostasis when bound to its receptor, Fibroblast Growth Factor Receptor-4 (FGFR4). Our objective focuses on FGF19 contribution towards an epithelial-to-mesenchymal transition (EMT) and overall metastatic properties including rapid proliferation and/or increased cell motility. Immunofluorescence was …

Fructose Induces Metabolic Changes Distinctly Different From Glucose In A N2a Cell Line., Catherine A. Ghigleri

All Master's Theses

Over the last 50 years, there has been a rise in diagnoses of Alzheimer’s Disease and other dementias associated with metabolic stress. This parallels an increase in fructose consumption and has led to research on the effects of fructose on the hippocampus, a brain structure responsible for learning and long-term memory formation. The hippocampus is also a region of the brain that metabolizes fructose. Experiments using animals fed diets containing fructose have shown a correlation between fructose consumption, learning impairment, and structural changes to the hippocampus in animals’ brains. However, the effects of fructose on hippocampal neurons have not been …

Facilitating Engagement In Meaningful Occupations Through Nature-Based Experiences, Sydney Johnson

Occupational Therapy Capstones

Background: Many children, especially those living in urban areas, are spending less time in nature than ever before which is decreasing their engagement in meaningful occupations such as sleep, play, education, social participation, and activities of daily living. Interacting with nature can improve children’s emotional regulation, development, attention span, mental health, and overall well-being. It is important that children have access to nature and its benefits to ensure they are reaching their full potential in life. One method to improve children’s access to nature is providing them with nature-based activities that can be modified or adapted for those living in …

Symbol-Temporal Consistency Self-Supervised Learning For Robust Time Series Classification, Kevin Garcia, Cassandra Garza, Brooklyn Berry, Yifeng Gao

Computer Science Faculty Publications

The surge in the significance of time series in digital health domains necessitates advanced methodologies for extracting meaningful patterns and representations. Self-supervised contrastive learning has emerged as a promising approach for learning directly from raw data. However, time series data in digital health is known to be highly noisy, inherently involves concept drifting, and poses a challenge for training a generalizable deep learning model. In this paper, we specifically focus on data distribution shift caused by different human behaviors and propose a self-supervised learning framework that is aware of the bag-of-symbol representation. The bag-of-symbol representation is known for its insensitivity …

Tissue Kallikrein 1 Cleaves Complement Factor C3 And Activates The Alternative Complement Pathway, Sarah E. Sartain, Andrew Yee, Paula Jacobi

Research Data

Hematopoietic stem cell transplant-associated thrombotic microangiopathy (HSCT-TMA), characterized by microvascular endothelial damage and severe renal injury, negatively affects HSCT survivorship with high mortality and long-term renal morbidity. After HSCT, innate immunity and inflammation are often dysregulated. The alternative complement pathway (AP) of the innate immune system is overactivated in HSCT-TMA, but the mechanisms of its initiation are poorly described. Complement component C3 of the AP can be cleaved by proteases outside of the AP. Because mRNA expression of tissue kallikrein 1 (KLK1), an inflammatory serine protease that produces kinins, has been found to be markedly elevated in the renal endothelium …

Oil And Wine: A Christian Reflection On The Sacred Oath, Faith Abraham

be Still

This essay explores the intersection of medicine, faith, and the deeper calling to heal. Reflecting on experiences at the Christian Community Health Fellowship (CCHF) Conference, it examines the weight of the physician’s oath—not just as a professional obligation, but as a sacred commitment to justice, dignity, and human connection.