Medicine and Health Sciences Commons^™

Empowering Voices: A Qualitative Exploration Of Shared Governance Among Healthcare Workers In Clinical Practice, Ayman Alhazaymeh

Doctoral Projects

This project intervention evaluated the implementation of shared governance (SG), focused on partnership council activities and staff perception. The shared governance framework has several pillars, such as Partnership, Equity, Ownership, Accountability, and Shared Decision-Making, to support the design of healthcare organizations for excellent patient care (Porter-O’Grady, 2009). To effectively evaluate the SG implementation and ensure the ongoing success of the SG process, the author investigated staff contributions and actively sought feedback. He provided templates and guidelines for the partnership council and collected staff feedback. Murray et al. (2016) stated that the partnership council reported empowering staff to implement innovative solutions …

The Effect Of Stress Hormones On Memory Formation And Academic Performance, Emma L. Hooks

Senior Honors Theses

With chronic stress becoming increasingly prevalent in academic settings, researchers have identified significant effects on learning and academic performance. Cortisol, a glucocorticoid hormone, is released following the activation of the hypothalamic-pituitary-adrenal (HPA) axis and plays a vital role in the stress response. Although acute increases in cortisol can improve attention and memory, sustained activation of the stress response can impair memory, executive functioning, and academic performance. This thesis draws on neuroscience, psychology, and education research to examine how chronic cortisol exposure affects the hippocampus and prefrontal cortex, and how the effects manifest in learning and academic performance, particularly in developmental …

Nuclear Export As A Therapeutic Vulnerability In Zfta-Rela Ependymoma, Siri M Ippagunta, Amir Arabzade, Srinidhi Varadharajan, Erik Emanus, Amanda Bland, Alisha Kardian, Nicholas Laboe, Hua Sun, Tuyu Zheng, Amelia Hancock, Mark Zhai, Emma Caesar, Maxwell Park, Wilda Orisme, Melissa Johnson, Brittany Rodgers, Gregory H Turner, Jeffrey Steinberg, Burgess Freeman, Martine F Roussel, Anang Shelat, Richard Kriwacki, Thomas E Merchant, Benjamin Deneen, Michael D Taylor, Sameer Agnihotri, Shondra Pruett-Miller, Jacob A Steele, Anoop Murthy Kavirayani, David W Ellison, Arzu Onar-Thomas, Giles Robinson, Stephen C Mack, Kelsey C Bertrand

Faculty, Staff and Students Publications

Background: Ependymoma (EPN) is the third most common pediatric brain tumor with no targeted therapies available to patients. In supratentorial ependymoma, the most frequent driver alteration is a gene fusion between ZFTA and RELA (denoted ZR), leads to constitutive localization of ZR in the nucleus. Because ZR is not currently druggable, we tested whether ZR expression leads to aberrant protein interactions that could represent therapeutic vulnerabilities.

Methods: Using CRISPR-Cas9 pooled screening, we identified many novel druggable ZR interacting proteins including XPO1, CARM1, SMARCA4, and CDK1. We focused on the nuclear export protein (XPO1), given the ability of most XPO1 inhibitors …

Tractor Workflow: A Scalable Nextflow Framework For Local Ancestry-Aware Genome-Wide Association Studies, Nirav N Shah, Taotao Tan, Jessica Honorato-Mauer, Yi-Sian Lin, Adam X Maihofer, Clement C Zai, Pgc-Ptsd Ancestry Working Group, Marcos Santoro, Caroline M Nievergelt, Elizabeth G Atkinson

Faculty, Staff and Students Publications

Motivation: The routine exclusion of admixed individuals from traditional genome-wide association studies (GWAS) due to concerns about spurious associations has limited multi-ancestry genetic discovery. Tractor addresses this issue by incorporating local ancestry into association testing, enabling the identification of ancestry-enriched signals and generating ancestry-specific summary statistics. However, adoption has been constrained by the complexity of prerequisite steps, including phasing and local ancestry inference, which require substantial bioinformatics expertise and introduce key analytical decision points.

Results: We developed a scalable, automated Nextflow workflow that integrates phasing, local ancestry inference, and Tractor association testing into a reproducible end-to-end pipeline. To demonstrate its …

Tropomyosin-Related Kinase Receptor Type B Agonism In Geographic Atrophy-The Translational Challenges From Preclinical Data To A First-In-Human Trial, David Brown, Oliver Zeitz, Clare Bailey, Sunir J. Garg, Karl Csaky, James Talks, Sobha Sivaprasad, Peter M. Benz, Rolf Herrmann, Remko A. Bakker, Sebastian Bandholtz, Ankit Mittal, Qihong Huang, Serge Kosobokovs, Gudrun Simons, Andrea Giani, Jochen Huber, Martin Gliem

Wills Eye Hospital Papers

OBJECTIVE: To report results of the first-in-human trial of intravitreal tropomyosin-related kinase receptor type B (TrkB) agonist BI 754132 in participants with geographic atrophy (GA). To discuss BI 754132 clinical data in the context of the preclinical findings and their translation into human data.

DESIGN: An open-label, uncontrolled, nonrandomized phase I trial (NCT04002310) assessing the safety, tolerability, and pharmacokinetics of BI 754132 in participants with GA supported by preclinical data.

PARTICIPANTS: Participants with GA recruited between July 2019 and August 2022 in the United States and UK.

METHODS: Clinical trial comprising a single rising dose (SRD) part (n = 15) …

Isolated Giant Aneurysm Of The Acute Marginal Branch Of Right Coronaryartery Presenting As Nstemi: Successful Direct Surgical Repair Preserving The Native Flow, Sai Kumari Ms., Anbarasu Mohanraj Dr, Saranya Damodaran Ms

Journal Of Indian Physician Associates

Abstract

Background: A “giant” coronary artery aneurysm is variably defined in the literature—commonly as a dilatation of a coronary vessel exceeding four times the diameter of the adjacent normal segment, or exceeding a fixed threshold such as > 8 mm or > 20 mm in diameter^1.

Case presentation: We report the case of a 61-year-old woman with type II diabetes mellitus and systemic hypertension, who presented with breathlessness and chest pain radiating to the back. She had recently suffered a non-ST elevation myocardial infarction (NSTEMI) and was found on coronary angiography to have a large aneurysm of the acute marginal branch …

Extra Of Extracorporeal: Use Of Vv-Ecmo In Complex Tracheal Ring Resection Surgery, Saurabh Ashok Holamb Mr, Ravinath Swami Mr

Journal Of Indian Physician Associates

 Abstract

Background:

Tracheal stenosis may arise from congenital malformation, trauma, prolonged intubation, or malignancy. Surgical correction of such lesions poses a major challenge, especially when airway management becomes difficult due to the location and extent of narrowing.

Case Summary:

We report a case of a 64-year-old male with circumferential thickening of the trachea at the D2–D3 level, exhibiting a 1.3cm long segmental narrowing. The patient underwent tracheal ring resection with veno-venous extracorporeal membrane oxygenation (VV-ECMO) support. Two apnea periods were maintained intraoperatively, totaling 3.5 hours, with stable hemodynamics and 100% oxygen saturation throughout. ECMO support was continued overnight as a …

Stereotactic Radiosurgery For Unruptured Arteriovenous Malformation Of The Left Medial Temporal Lobe In A Young Female, Muhammed Suhail S, Gajalakshmi M Bpa, Danish Ansari Brt

Journal Of Indian Physician Associates

Background

Arteriovenous malformations (AVMs) are congenital vascular anomalies that can be present with seizures or hemorrhage. Management strategies vary based on Spetzler-Martin (SM) grading.

Case Presentation

I report a case of a 22-year-old female presenting with recurrent seizures due to an unruptured AVM (SM Grade 3) located in the left medial temporal lobe. Diagnosis was established using MRI and Digital Subtraction Angiography (DSA).

Intervention

The patient underwent single-fraction stereotactic radio-surgery (SRS) with curative intent using a TrueBeam linear accelerator.

Outcome

Post-treatment course was uneventful, and the patient was discharged in stable condition with excellent seizure control and progressive nidus reduction …

Endo-Epicardial Ventricular Tachycardia Ablation In Arrhythmogenic Right Ventricular Cardiomyopathy- A Case Report, Selva Maheswari M Dr, Sharon Jabamalar Dr, Usnish Adhikari Dr, Deep Chandh Raja S Dr

Journal Of Indian Physician Associates

ABSTRACT:

Background

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare genetic disorder marked by progressive fibrofatty replacement of the right ventricle, causing life-threatening ventricular arrhythmias and sudden cardiac death (SCD). It is predominantly seen in young adults. As the substrate often involves both RV endocardium & epicardium, conventional ablation is often not successful. One of the effective therapies is combined endo- epicardial ablation, which gives good arrhythmia control and reduction of AICD (Automated Implantable Cardioverter Defibrillator) shock. Here we present two such cases.

Methods

Two patients presented with history of recurrent ventricular tachycardia (VT) which were reverted with DC (Direct …

From Confidence To Competence: Embedding Critical Genai Literacy In Physician Associate Education, Chanceeth Chandrakanthan, Amy H. Donaldson-Perrott Mrs, Jane Secker, Julie Voce, Tamara S. Ritsema

Journal Of Indian Physician Associates

Background: Generative artificial intelligence is now embedded in how many healthcare students learn. Tools provide rapid explanations, summaries and practice questions, but use does not equal AI literacy, particularly where accuracy, medicines safety and guideline alignment matter.

Objective: To describe current use of generative AI by Physician Associate students and outline a practical approach to teaching critical AI literacy.

Methods: Educational evaluation using three activities: (1) baseline survey of students about use and attitudes, (2) an embedded compare and critique session in applied pharmacology where small groups assessed AI answers against trusted UK sources, including BNF and NICE guidance, followed …

Evaluating The Suitability Of The Berg Balance Scale For Assessing Balance In Diabetes With And Without Prior Covid-19: A Methods-Validation Study, Garima Kaushik Dr, Sheetal Malhan Dr., Apoorva Tiwari Dr, Vishakha Daga Dr

Journal Of Indian Physician Associates

ABSTRACT

Background: Balance impairment in diabetes mellitus is predominantly driven by somatosensory loss secondary to peripheral neuropathy. The Berg Balance Scale (BBS) is widely used to evaluate functional balance, yet it mainly reflects motor performance and may not adequately represent sensory mechanisms. Following COVID-19, additional concerns regarding deconditioning have emerged, but interpretation depends on the measurement tool employed.

Objective: To examine the construct behavior and suitability of the BBS for assessing balance in individuals with diabetes with and without prior COVID-19 infection, and to determine whether the scale reflects known determinants of diabetic imbalance.

Methods: A cross-sectional analysis was conducted …

Exploring Identity Through Clay: A Humanistic Art Therapy Case Study With A Blind Chinese Adoptee, Virginia Jade Leicht

Expressive Therapies Theses

This qualitative case study explored how working with clay in art therapy can help support a blind man’s identity exploration. This paper addresses the problem of many traditional therapeutic approaches within the art therapy realm: They rely too heavily on visual engagement, which can limit the accessibility and opportunities for self-exploration and identity development for those who are blind. The study was grounded in current research and foundational theories based on the humanistic art therapy approach. Clay is considered an accessible medium that engages multiple senses and allows for emotional exploration and meaning making, specifically through tactile and sensory-based engagement …

Reimagining Occupational Therapy Fieldwork Mentorship Through A Cultural Wealth Lens: A World Café Study, Nandita A. Singh, Mph, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Occupational therapy (OT) fieldwork education plays a critical role in professional socialization; however, supervision models often privilege dominant sociocultural norms, disadvantaging students from non-dominant cultural and linguistic backgrounds and potentially limiting equitable workforce preparation.

Objectives: To examine how OT fieldwork partners conceptualize reciprocal mentorship within fieldwork education identify strategies grounded in Community Cultural Wealth (CCW) to support inclusive communication and strengths-based professional development.

Methods: Participatory qualitative study using a virtual World Café methodology, involving United States-based academic and clinical OT fieldwork contexts. Data were collected through audio-recorded discussions, digital whiteboards, and reflexive memos, and were analyzed using Braun …

How Do Autobiographical Memory Abilities Compare With Other Cognitive Functions In An Adult Presenting With Hsam (Highly Superior Autobiographical Memory) And Autism? A Case Study., Emilia Rzeszutek, Dr. Jamie Mayer

Honors Capstones

Autism Spectrum Disorder (ASD) is a condition widely researched in relation to social communication differences and challenges in areas such as memory and executive functioning. Many areas of research highlight ASD’s deficits, shortcomings, and risk factors. However, research has begun to recognize that autistic individuals demonstrate cognitive strengths that differ from typical patterns of functioning. An example of such ability is Highly Superior Autobiographical Memory (HSAM), a rare phenomenon characterized by the ability to recall specific life events with remarkable accuracy and detail. This study was conducted on a 25-year-old male diagnosed with ASD and presents with characteristics of HSAM. …

Developing Engagement Programming To Increase Leisure Participation Among Individuals Living With Cognitive Impairments, Anthony Valentino, Bethany Horne Otd, Ms, Otr/L

Occupational Therapy Doctorate Capstones

Low-cost leisure activities are implemented at The Bridge Center to increase engagement and promote health and well-being. This program incorporates occupational therapy perspectives to promote engagement through meaningful activities to expand people with cognitive impairments opportunities. The results of this project will provide intrinsic benefits to people with cognitive impairments and aid the development of future projects at The Bridge Center.

The Efficacy Of An Educational Program On The Benefits Of Aquatic Therapy: An Occupational Therapy Perspective, Matile Kaplan, Kathryn Burke Otd, Otr/L

Occupational Therapy Doctorate Capstones

Aquatic therapy has been a therapeutic modality since 2400 B.C and offers multisystem physiological effects including cardiovascular, musculoskeletal, immune, gastrointestinal, and more. The aquatic environment offers buoyancy, hydrostatic pressure, resistance, and drag force to ease engagement and recovery. Individuals have a higher rate of participation in aquatic therapy compared to on-land therapy, although referral rates are low due to the existing perceptions and insufficient awareness of the benefits.

Educating Birthing Professionals About The Benefits Of Occupational And Physical Therapy In The Acute Postpartum Period, Jayde Monteiro, Kathryn Burke Otd, Otr/L

Occupational Therapy Doctorate Capstones

Purpose: Across all developed countries, the US has the highest maternal mortality rate. The acute postpartum period is considered the first 6 weeks after birth and is often the most prevalent time medical complications arise. Currently there is a trend of OT and PT referral after these complications have already happened negatively impacted patients. To bring awareness and relevance to acute postpartum OT and PT, birthing professionals need more education to gain knowledge on how therapy can produce successful recovery outcomes in their patients. The research question "How does online educational programming increase birthing professionals’ knowledge about the benefits of …

Choosing Your Line: Training Adaptive Ski Instructors How To Facilitate Occupational Participation For Individuals With Complex Communication Needs., Jordan E. Chizmadia, Monique Dawes Otd, Otr/L Cpam

Occupational Therapy Doctorate Capstones

The project will explore communication methods for individuals with complex communication needs (CCN) in adaptive skiing, focusing on alternative communication methods and the development of a Picture Exchange Communication System. A communication training program for ski instructors will be implemented. Findings will advance occupational therapy by highlighting the role of self-directed communication and autonomy in promoting occupational engagement for individuals with CCN.

Advancing Social-Emotional Wellness In Adolescents Through Structured Physical Fitness Programming, Serena Mora, Tania Rose Otd, Otr/L, Amy Wheadon Otd, Otr/L

Occupational Therapy Doctorate Capstones

Neurodivergent (ND) adolescents tend to struggle with participating in physical activity (PA) compared to their neurotypical (NT) peers. Current programs available that focus on PA are competitive and can add anxiety to an already difficult adjustment. This doctoral capstone project investigates the effect of participation in PA on social emotional well-being in ND adolescents. An 8-week PA program was created and implemented in this pre-post test quasi-experimental study.

Investigating The Sensory Needs Of Bereaved Children In A Therapeutic Group Setting, Eleanor Gemma, Bethany Horne Otd, Ms, Otr/L

Occupational Therapy Doctorate Capstones

Childhood bereavement is experienced by one in eleven children by age eighteen and is associated with a range of symptoms that impact function (Judi’s House, 2024; Stikkelbroek et al., 2016). Bereaved children often show increased internalizing symptoms for more than two years following loss and demonstrate challenges with self-regulation, which can impact a child’s participation in their everyday environments (Edgar-Bailey & Kress, 2010; Stikkelbroek et al., 2016). While dysregulation has been researched in children exposed to other forms of trauma, it and the resulting sensory needs of bereaved children are largely unexplored. This occupational therapy capstone project utilized mixed methods …

Effectiveness Of Occupation-Based Mindfulness Strategies For Older Adults Experiencing Anxiety Or Depression, Jennifer G. Macnie, Kathryn Burke Otd, Otr/L

Occupational Therapy Doctorate Capstones

The purpose of this capstone is to gain an understanding of how sensory-based mindfulness strategies impact feelings of anxiety and depression amongst older adults living in an assisted living facility. Anxiety and depression are extremely prevalent among residents in assisted living facilities, with depression affecting 29% of older adults and anxiety affecting 20%. In light of the fact that mental health amongst older adults is often overlooked in assisted living facilities, it is necessary to evaluate the potential benefits of mindfulness strategies on feelings of anxiety and depression amongst this population. An investigation of how sensory based mindfulness strategies impact …

Advancing Neurodiverse-Affirming Care: Educating Caregivers To Improve Knowledge And Confidence​, Olivia Miller, Bethany Horne Otd, Ms, Otr/L

Occupational Therapy Doctorate Capstones

This capstone project aimed to implement a six-week education course on neurodiverse-affirming care to caregivers of neurodiverse children at Extraordinary Kids Therapy outpatient clinic in Chepachet RI. The goal of this capstone project was to increase confidence and knowledge of neurodiverse-affirming care in the caregivers participating in the course. To analyze the impact of the education course, pre and post surveys, along with semi-structured asynchronous zoom interviews were administered and analyzed.

Building Adolescents' Social Emotional Wellness Through Physical Fitness Programming, Serena Mora, Tania Rosa Otd, Otr/L

Occupational Therapy Doctorate Capstones

Neurodivergent (ND) adolescents tend to struggle with participating in physical activity (PA) compared to their neurotypical (NT) peers. Current programs available that focus on PA are competitive and can add anxiety to an already difficult adjustment. This scoping review investigates the effect of participation in PA on behaviors and well-being connected to ND conditions.

A Multifaceted Approach To Managing Agitation In Assisted Living Residents With Dementia ​, Emily Hamed

Occupational Therapy Doctorate Capstones

Purpose: Dementia is a growing concern and will continue to increase. One symptom of dementia is agitation, which can be disruptive in an assisted living facility (ALF) and can impact quality of life for residents and caregivers/staff. Evidence shows that creating a conducive environment and equipping staff with skills can lead to better resident outcomes (Wong et al., 2024). This capstone project aims to address agitation by implementing physical and social environmental modifications in an (ALF). Design: This quasi-experimental mixed methods design will be conducted in an ALF to measure resident agitation pre and post intervention and staff confidence in …

“Empowering Peer Mentorship” Developing Best Practices Of Peer Mentoring At Empowersci Inc., Caitlyn Menard, Monique Dawes Otd, Otr/L Cpam

Occupational Therapy Doctorate Capstones

Each Year, 250,000-500,000 people sustain a spinal cord injury (SCI) , facing challenges in social participation, quality of life, activities of daily living (ADLs), returning to work, and unmet needs in mental health, self-efficacy, and community mobility (Beauchamp et al., 2016 & Divanoglou et al., 2017). While interdisciplinary rehabilitation and peer mentorship aim to support adaptation, growth, and independence, there remains a lack of standardization in adequately preparing individuals for the peer mentor role (Rocchi et al., 2022). Aim: EmpowerSCI is a nonprofit organization that aims to bridge the gap in rehabilitation by offering in-person, holistic residential programming. EmpowerSCI currently …

Teacher Perceptions Of The Impact Of Sensory Integration And Processing On Student Occupational Engagement, Kyla Campbell, Colleen Cameron Whiting

Occupational Therapy Doctorate Capstones

Sensory Integration (SI) is defined as the brain's ability to organize and respond to information within the body and environment. School-aged children begin school with varying difficulties in SI and processing, which affects their social and academic performances. The field of occupational therapy (OT) promotes engagement in meaningful activities, in which going to school and participating in activities is vital to a child's development and wellbeing. The school setting is the second-largest employer of occupational therapy practitioners (OTPs) in the United States. Children with SI and processing difficulties have decreased participation in the classroom compared to their peers with typical …

Understanding Occupational Therapy Referral Patterns And Knowledge Gaps Among United States Medical Providers, Zachery Edwards, Shannon Strate Otd, Ms Otr/L

Occupational Therapy Doctorate Capstones

Medical providers in the United States (US) have limited education and understanding of occupational therapy’s (OTs) full scope of practice (SOP), contributing to reduced access to OT services and potential negative consequences for client outcomes, interprofessional collaboration, and the profession’s viability (Rouch et al., 2022; Vij, 2023). This study aimed to examine US medical providers perspectives on OT utilization and identify areas of desired knowledge. Qualitative data was attained via a national survey administered to medical providers with analysis focused on responses to question three (Q3): “Why don't you refer clients to OT?” (n=424) and question six (Q6): “If you …

Utilization And Impacts Of Pediatric Caregiver Programming On Therapeutic Engagement And Wellbeing: A Pilot Program, Venisa Rodriguez, Tania Rose Otd, Otr/L

Occupational Therapy Doctorate Capstones

Purpose: The proposed doctoral capstone aims to measure the utilization and impacts of pediatric caregiver programming on therapeutic engagement and wellbeing. A scoping literature review and needs assessment of pediatric caregivers of children receiving OT services found that limited access to quality, caregiver-specific resources and programming impact the wellbeing of caregivers, their ability to care for their child, and their confidence and ability to engage in the therapeutic process. The literature points to a want and need for caregiver-specific programming and the use of a family-centered care approach to improve caregiver and child outcomes.

Design: This study will utilize a …

Development Of A Unique Surgical Implant To Address The Development Of Iatrogenic Trigeminal Neuralgia Following Maxillomandibular Advancement Surgery For Osa, Erika L. Manning, Kun Yoon, Robert Diecidue, Joseph Harrington

Department of Oral and Maxillofacial Surgery Faculty Papers

A 58 y/o male with no significant past medical history presented in 2021 with obstructive sleep apnea (OSA), including trouble breathing through his nose due to hypoplastic maxilla, retrognathic mandible and chin, and microgenia. He underwent a LeFort 1 maxillary osteotomy, bilateral sagittal split osteotomy (BSSO), and genioplasty with fat graft on 2/10/2022. Postoperatively, the patient developed moderate pain and facial edema, which progressed into hypoesthesia with pain in the face with a sensation of fullness in the left ear and left masseter tightness. He also developed a positive Tinel sign in the left mandibular area and was diagnosed with …

Evaluating The Impact Of A Meaningful Recognition Bundle On The Health Of The Emergency Department Work Environment And Emergency Nurse Burnout, Sean Truesdell

Doctoral Projects

Background: The health of the work environment significantly influences emergency nurse practice. The Emergency Nurses Association and the American Association of Critical-Care Nurses have called for the establishment of a healthy work environment (HWE) to improve outcomes, reduce burnout and turnover, and increase job satisfaction. Meaningful recognition is consistently among the lowest-performing HWE standards. Purpose: To implement a bundle of meaningful recognition elements in the Emergency Department (ED) and evaluate the outcomes. Methods: A quality improvement project was conducted in the ED of a non-profit community health system in Northern California. The Healthy Work Environment Assessment Tool (HWEAT) and Oldenburg …