Medicine and Health Sciences Commons^™

A Multi-Modal Intervention To Decrease Hpv Vaccine Hesitancy And Increase Uptake In Young Adult Women, Rylee Cartales

Evidence-Based Practice Project Reports

Human Papillomavirus (HPV) is the leading cause of cervical cancer worldwide and the most common sexually transmitted disease, yet hesitancy towards the HPV vaccine remains high and uptake of the HPV vaccine remains remarkably low (CDC, 2021b). The purpose of this evidence-based practice (EBP) project was to determine if the implementation of a multimodal intervention including a motivational interview, strong provider recommendation, and educational materials will decrease HPV vaccine hesitancy and consequentially increase uptake of the vaccine. Eleven young adult women ages 18-26 from a rural outpatient Obstetrics and Gynecology (OBGYN) clinic in Indiana participated in this project. After agreeing …

A Multi-State Look Into Early Intervention Speech-Language Pathologists’ Confidence Identifying And Diagnosing Autism, Adelaide Parr

Honors Capstones

Although autism can be reliably diagnosed by 18 months of age, long wait times and limited access to qualified providers prevent families from obtaining diagnostic services. Trained speech-language pathologists (SLPs) are qualified to diagnose autism, ideally as part of a multidisciplinary team. SLPs working on early intervention (EI) teams are well-situated to help close this diagnostic wait time gap. The purpose of this survey study was to explore EI SLPs’ experiences serving autistic children on their caseloads, confidence in identifying and diagnosing autism, and potential barriers/facilitators to increasing diagnostic confidence and decreasing wait times. 287 EI SLPs from 23 states …

Addressing Stroke Care Disparities Through Patient Education, Christina Annerino

Honors Capstones

It has been found across current studies and evaluations of stroke care and patient outcomes that there is a disparity in disability and mortality between male and female patients who have experienced stroke. The aforementioned studies did not identify the cause of this disparity, although a number of hypotheses for this phenomenon were provided. This study then conducted a preliminary survey of 130 participants, both men and women, aged 18-80 years old, to evaluate potential barriers to accessing stroke care and receiving treatment effectively. Preliminary survey data demonstrated consistent gaps in knowledge related to stroke risks, stroke symptoms, and when …

Efficacy Of Intravesical Nadofaragene Firadenovec For Patients With Bacillus Calmette-Guérin-Unresponsive Nonmuscle-Invasive Bladder Cancer: 5-Year Follow-Up From A Phase 3 Trial, Vikram M. Narayan, Stephen A. Boorjian, Mehrdad Alemozaffar, Badrinath R. Konety, Neal D. Shore, Leonard G. Gomella, Ashish M. Kamat, Trinity J. Bivalacqua, Jeffrey S. Montgomery, Seth P. Lerner, Joseph E. Busby, Michael Poch, Paul L. Crispen, Gary D. Steinberg, Anne K. Schuckman, Tracy M. Downs, Joseph Mashni, Brian R. Lane, Thomas J. Guzzo, Gennady Bratslavsky, Lawrence I. Karsh, Michael E. Woods, Gordon Brown, Daniel Canter, Adam Luchey, Yair Lotan, Brant A. Inman, Michael B. Williams, Michael S. Cookson, Sam S. Chang, Alexander I. Sankin, Michael A. O'Donnell, David Sawutz, Richard Philipson, Nigel R. Parker, Seppo Yla-Herttuala, Dorte Rehm, Jørn S. Jakobsen, Kristian Juul, Colin P.N. Dinney

Department of Urology Faculty Papers

Purpose: Nadofaragene firadenovec-vncg is a nonreplicating adenoviral vector–based gene therapy for bacillus Calmette-Guérin (BCG)–unresponsive carcinoma in situ (CIS) with/without high-grade Ta/T1. We report outcomes following 5 years of planned follow-up.

Materials and Methods: This open-label phase 3 trial (NCT02773849) enrolled patients with BCG-unresponsive nonmuscle-invasive bladder cancer in 2 cohorts: CIS ± Ta/T1 (CIS; n = 107) and Ta/T1 without CIS (Ta/T1 cohort; n = 50). Patients received 75 mL (3 × 1011 vp/mL) nadofaragene firadenovec intravesically once every 3 months with cystoscopy and cytology assessments, with continued treatment offered to those remaining high grade recurrence–free (HGRF).

Results: One hundred fifty-seven …

Expressive Therapies And Resiliency – Resistance In Mental Health: A Literature Review, Gabrielle Lopez

Expressive Therapies Capstone Theses

This review evaluates the current literature on psychological resistance amongst human service professionals experiencing burnout and the effect of Expressive Arts interventions on resiliency. Concepts include identifying the main symptoms, risk factors, causes, and treatments for burnout in education faculty, medical staff, and clinicians. Qualitative, quantitative, and meta-analysis studies are included to identify the most prevalent intervention frameworks for reducing stress including Arts-Based and Mindfulness-compassion based techniques. The effectiveness of Arts-based tools on strengthening identity, self-esteem, emotional regulation, and meaning-making in combating burnout is presented. Based on analysis of the literature, the author proposes a three-step intervention framework for utilizing …

A Scoping Review Of Drama-Based Interventions With Migrant Populations For Health Outcomes, Cassandra Doria

Expressive Therapies Capstone Theses

This scoping review investigates the breadth and nature of literature that currently exists on the topic of utilizing drama-based interventions with migrant populations for therapeutic goals. This author searched for empirical studies on the topic and charted data to understand the quality, number, and type of studies that have been done, and risk factors for epistemic injustice or misrepresentation of marginalized participants. A brief overview of methods, results, and discussions of articles revealed the most prevalent outcomes, limitations, and forms of data collection. Social connection and belonging, education, communication skills, empathy, identity reconstruction, meaning making, and adaptive adjustment to the …

Neuroqueering Art Therapy: Bringing Neurodivergent Gender Diversity Into The Creative Arts Therapy Room: A Literature Review, Avital Eisen

Expressive Therapies Capstone Theses

Recent research across disciplines has established the significance of the overlap between neurodivergence and gender diversity, a truth long espoused by the community. Acting on this research, some mental health disciplines have begun addressing neurodivergent transgender and gender diverse people as a unified population in their research, but the field of art therapy has not yet followed suit. Theoretical frameworks of intersectionality, queer theory, and disability justice highlight the importance of centering the unique experiences and needs of neurodivergent gender diversity. Using these frameworks, this literature review synthesizes community knowledge with art therapy research on both neurodivergence and gender diversity, …

The Hero’S Journey Through Therapy: A Literature Review, Rylee Blake

Expressive Therapies Capstone Theses

The Hero’s Journey (Campbell, 1949) is a common narrative structure throughout ancient mythology and modern storytelling which describes the transformation of a hero through a journey of trials and represents the experience of psychological healing throughout various cultures. Because of the ancient and common nature of this structure and the psychological importance of personal narrative and storying even from an early age (Boyd, 2018; Klees, 2016), this thesis hypothesizes that a client’s experience throughout psychotherapy will follow the stages of the Hero’s Journey and that invoking this structure within the therapy room, particularly for drama therapists, will empower clients toward …

Method Acting As A Therapeutic Intervention For Trauma Recovery, Remi Moses

Expressive Therapies Capstone Theses

While considered controversial by some, Method acting as popularized by Lee Strasberg is a technique that elicits powerful and authentic results on stage and screen. The foundational Method acting techniques, the Relaxation Exercise (RE) and the Sense Memory Exercise (SME), share similarities to bottom-up therapeutic processes like Somatic Experiencing and Eye Movement Desensitization and Reprocessing. By implementing a trauma-informed drama therapy framework with these two exercises, the RE and SME were restructured as a therapeutic intervention for people in trauma recovery. The author implemented a study of three consecutive group therapy sessions for people healing from trauma where clients participated …

A Community Re-Integration Mental Health Occupational Therapy Program For Veterans At The Sioux Falls Veterans Affairs Hospital, Holly M. Forrester

Occupational Therapy Capstone Presentations

The Veteran population continues to be disproportionately impacted by mental health disorders despite growing efforts to address this epidemic. Despite an increase in Veterans Affairs (VA) sponsored programs to mitigate the disparity, the interdisciplinary team tasked with implementing the novel programs remains undiversified. My capstone project aimed to provide a comprehensive community reintegration program to the Veterans in the inpatient behavioral health setting and advocate for the role of occupational therapy on the mental health interdisciplinary team. The literature and needs assessment indicated a need for the implementation of occupational therapy specific groups that aimed to increase functional independence and …

Examining The Rate Of Failed Hearing Tests In Children >15 Months Of Age Who Are Referred To Speech Therapy: A Retrospective Analysis, Malika Goel, Kerry Mychaliska

Conference Presentation Abstracts

No abstract provided.

Exploring Early Language Acquisition Through English And French, Rebecca C. Aguilar

Honors Capstones

Knowing that there is no singular event that leads to learning a language, and factoring in the extent an individual’s culture can affect language learning, this study emphasizes the importance of a cross-linguistic approach to continue to broaden the scope of language acquisition research. The primary objective is to identify and analyze the critical commonalities in the initial stages of learning English and French as first languages through two major categories: speech/language and culture. This project carried out an analytical review of 24 pieces of relevant literature, in both languages, in an effort to highlight key findings. Those findings include: …

Physical Activity And Knee Health Outcomes After Anterior Cruciate Ligament Reconstruction, David Werner

Theses & Dissertations

Anterior cruciate ligament reconstructions (ACLR) have increased in incidence worldwide. After ACLR, individuals are at higher risk for developing early onset knee osteoarthritis. Individuals after ACLR also participate in less physical activity (PA), contributing to an increased risk for early onset knee osteoarthritis and poor overall health outcomes.

The two goals of this work were to 1) determine the relationship between PA and knee health outcomes 18 months after ACLR and 2) determine the feasibility and acceptability of a PA intervention early after ACLR that considered participant thoughts and feelings.

Findings for the first goal suggest that there is no …

Toilet Training And Teaching Self-Initiations To Children With Autism Who Use Augmentative And Alternative Communication, Darcy A. Douglass

Honors Capstones

Within this project, we address the challenges faced by individuals, particularly those with autism spectrum disorder (ASD), during toilet training, which often takes longer than neurotypical children. Practitioners who use traditional methods often overlook teaching children how to request bathroom use, especially among those who use augmentative and alternative communication (AAC) devices. Drawing from literature and expert recommendations, we summarize the importance of teaching independence in bathroom use for children with complex communication needs by incorporating their AAC devices when teaching toilet training.

Inspired by Perez et al. (2020), who demonstrated positive responses from individuals with ASD to reinforcement-based procedures, …

Bronchopulmonary Dysplasia: Pathophysiology And The Effects Of The Microbiome, Anjali Jacob

Senior Honors Theses

Bronchopulmonary dysplasia (BPD) is a chronic neonatal lung disease that occurs in over 50% of premature infants. BPD is characterized by damage to the alveoli and bronchioles and improper vasculature formation. It is primarily caused by overexposure to oxygen through mechanical ventilation, but there are other risk factors that make infants more susceptible to BPD. Microbial composition impacts risk for developing BPD, and research is ongoing about the effects of the microbiome on BPD pathogenesis; this information is also valuable for preventative treatment. This paper reviews the normal function of the lungs, pathogenesis of BPD and how it affects normal …

Amelioration Of Age-Related Cognitive Decline And Anxiety In Mice By Centella Asiatica Extract Varies By Sex, Dose And Mode Of Administration, Nora E. Gray, Wyatt Hack, Mikah S. Brandes, Jonathan A. Zweig, Liping Yang, Luke Marney, Jaewoo Choi, Armando Alcazar Magana, Natasha Cerruti, Janis Mcferrin, Seiji Koike, Thuan Nguyen, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: A water extract (CAW) of the Ayurvedic plant Centella asiatica administered in drinking water has been shown to improve cognitive deficits in mouse models of aging and neurodegenerative diseases. Here the effects of CAW administered in drinking water or the diet on cognition, measures of anxiety and depression-like behavior in healthy aged mice are compared.Methods: Three- and eighteen-month-old male and female C57BL6 mice were administered rodent AIN-93M diet containing CAW (0, 0.2, 0.5 or 1% w/w) to provide 0, 200 mg/kg/d, 500 mg/kg/d or 1,000 mg/kg/d CAW for a total of 5 weeks. An additional group of eighteen-month-old mice …

Promoting The Incorporation Of Regional Anesthesia To Improve Pain Management For Lower Extremity Surgeries, Kendra Knaga

Doctor of Nursing Practice Projects

Opioid addiction in the United States is a healthcare crisis and continues to increase yearly. Multimodal pain management is a priority intervention that needs to be implemented to manage pain with less intra and postoperative opioid use. Peripheral nerve blocks are one alternative that can be used to decrease opioid use and assist in controlling pain for foot and ankle surgeries. This project aims to educate, develop, and create a protocol for popliteal nerve blocks at Hillsboro Area Hospital in Hillsboro, Illinois. As a result, the long-term goal is to reduce opioid administration and improve pain control. An educational PowerPoint …

Implementing An Insomnia Assessment And Management Algorithm In A Rural Pirmary Care Clinic, Rebekah Gaffin

Doctor of Nursing Practice Projects

Insomnia is the most common sleep complaint and significantly impacts quality of life and productivity. The accumulated total of direct and indirect healthcare costs related to insomnia is estimated to be as high as $100 billion/year and is associated with an increased risk of cardiovascular and cerebrovascular disease. Primary care providers play a critical role in identifying and implementing early interventions to address insomnia. However, this can be time-consuming, and providers may be unaware of the latest treatment guidelines and available resources. This project provided a research-based algorithm to identify and initiate treatment for patients 18+ with chronic insomnia in …

Screening For Suicide In Veterans With Cancer, Dina E. Mcneil

Doctor of Nursing Practice Projects

Veterans are at a higher suicide risk than the general population. Veterans with cancer are at a 47% higher risk for suicide. The Veterans Health Administration has an annual suicide screening requirement, but no requirement for more frequent assessment in this high-risk population. Clinical staff may also be hesitant due to fear and anxiety, serving as a barrier to screening. The objective of this project was to educate oncology clinical staff about risk factors for suicide in veterans with cancer, the use of the Columbia-Suicide Severity Rating Scale (C-SSRS), referral processes, and local resources, and intended to increase the number …

A Qualitative Interview Study To Determine Barriers And Facilitators Of Implementing Automated Decision Support Tools For Genomic Data Access, Vasiliki Rahimzadeh, Jinyoung Baek, Jonathan Lawson, Edward S Dove

Center for Medical Ethics and Health Policy Staff Publications

Data access committees (DAC) gatekeep access to secured genomic and related health datasets yet are challenged to keep pace with the rising volume and complexity of data generation. Automated decision support (ADS) systems have been shown to support consistency, compliance, and coordination of data access review decisions. However, we lack understanding of how DAC members perceive the value add of ADS, if any, on the quality and effectiveness of their reviews. In this qualitative study, we report findings from 13 semi-structured interviews with DAC members from around the world to identify relevant barriers and facilitators to implementing ADS for genomic …

Assessing Quality Of Health-Related Social Needs Screening Across Jefferson Hospital’S Clinical Sites, Aparna Sarin, Md, Mph, Olivia Quinn, Mph, Nolan Chiles, Bs

Health Equity and Quality Improvement (HEQI) Summit

Objectives

• Assess the rate of completed health-related social needs (HRSNs) screenings at different TJUH sites
• Compare screening outcomes across TJUH clinical sites

Background

- Centers for Medicare and Medicaid (CMS) is mandating Health Related Social Needs (HRSNs) screening for all admitted patients

- First-year Sidney Kimmel Medical College (SKMC) students screen patients at four different Jefferson clinical sites alongside Community Health Workers (CHWs) as part of their ‘Clinical Experience’ curriculum

- SKMC screens 7 domains

• Food*
• Housing*
• Utilities*
• Transportation*
• Medication expenses
• Primary care
• Insurance
  
  *Screened by CMS, as well as interpersonal safety

- The data is gathered from:

• inpatient floors …

Impact Of Sepsis Education For Emergency Department Staff: A Quality Improvement Project, Shayna E. Thoene, Shannon Mills

Doctor of Nursing Practice Projects: College of Nursing

Background: Sepsis continues to be a critical issue worldwide. New sepsis guidelines instituted by the Centers of Medicare and Medicaid Services (CMS) list evidence-based standards to comply with regarding care for sepsis patients. To help a new acute care facility meet compliance, a sepsis educational program has been developed to assess staff knowledge and confidence in caring for these patients.

Methods: This quality improvement (QI) project was developed using a pre-post study design to assess the impact of implementing a sepsis educational program for emergency department staff at this new acute care institution. A sepsis educational program was derived from …

Successful Application Of Craniosacral Therapy In A Case Of Acute Ptosis Following A Covid-19 Infection., Efterpi Rompoti

Journal of Transformative Touch

This case study offers a unique insight on the effectiveness of CranioSacral therapy (CST) in a 49 year old woman experiencing an acute stage of a viral infection (Covid-19) causing a partial left Oculomotor nerve palsy. A CST glial/Cerebrospinal Fluid (CSF) specific protocol was utilised over 2 consecutive days. The patient recovered fully after 5 days. The results of this particular case can open up the possibility of utilising CST more widely in treating cranial nerve palsies following a viral infection to support the healing process and the functional restoration.

Implementation Of An Algorithm To Reduce Wait Times For College-Aged Women Presenting With Uti Symptoms, Mallory Beck, Miranda Neu

Doctor of Nursing Practice Projects: College of Nursing

Urinary tract infections, UTIs, are among the most common reasons college-aged women seek medical care. The selected University clinic has a difficult time triaging walk-in UTI patients promptly. Long patient wait times have a negative effect on patient and employee satisfaction scores. An algorithm was created to assist the University clinic in triaging walk-in UTI patients using guidelines from the American Academy of Family Physicians updated with the most current clinical practice recommendations. The algorithm includes the utilization of a point-of-care urine analyzer which provides urinalysis results in 120 seconds. With the algorithm and point-of-care urine analyzer, the student health …

Patient-Centered Preimplant Education Session And Bi-Weekly Text Message Adherence Reminders In Patients With A Newly Implanted Cardiomems® Device: A Quality Improvement Study, Elizabeth M. Miller, Alicia Abboud, Audrey Cooper

Doctor of Nursing Practice Projects: College of Nursing

Rationale

Heart failure is a deadly disease, affecting over 6.2 million individuals and costing the United States an estimated 30.7 billion dollars (Virani et al., 2020). By 2023, heart failure costs in the United States are estimated to grow to 70 billion dollars with 75-80% of these costs attributed to inpatient hospitalizations (Heidereich et al., 2022). The CardioMEMs® is a small device placed in the patient’s pulmonary artery via a minimally invasive procedure by an interventional cardiologist. The use of remote patient data from the CardioMEMs® device has been shown to reduce hospital re-admissions, facilitate tailored medication management, detect increased …

The Relationship Between Sun Protective Behavior, Health Beliefs, Attitudes, And Norms Of Sun Exposure Among College Athletes, Avery B. Snyder

Honors Theses

The purpose of this study was to access the relationship between sun protective behavior, health beliefs, attitudes, and norms of sun exposure among college athletes. An electronic survey was provided to student athletes for about two weeks in October of 2023. Prior to student participation the Institutional Review Board approved the protocol and data collection. The survey was sent to the students by the athletic director through an app called Teamworks that connects to all the athletes at Coastal Carolina. The majority of students who took the survey reported they did not wear sunscreen in past games/practices. Of those who …

Heart Failure Zone Tool: A Quality Improvement Project, Emily Scahill, Cindy Driggers, Angelica Marquez

Doctor of Nursing Practice Projects: College of Nursing

Purpose

Heart failure is the leading cause of hospital admissions among adults over 65 years old and lack of patient knowledge regarding the self-management of heart failure is a key factor in rising readmission rates. This project enhances inpatient heart failure education using a laminated heart failure zone tool handout to guide heart failure education. The intent was to increase patients’ confidence regarding heart failure self-management and positively impact patients’ knowledge regarding the management of heart failure.

Materials and Methods

The process included identifying hospitalized patients who had been flagged as a heart failure core measure or had been identified …

Mortality In Medicine, Maren Dougherty

Honors Projects

Practitioners in the medical field attend to health issues across one’s lifespan from birth to death and everything in between. A common conflict in today’s practice of medicine is establishing the true function of medicine. The complete reliance on medicine to ward off death proliferates the biomedicalization of natural life processes, like death. Biomedicalization is the process in which medical authority and its accompanying technology begin to control other aspects of daily life. With medicine’s ultimate goal being to cure disease and fight death, it interferes with the inevitability of human mortality. End-of-life treatment can be taken too far without …

Empowering Pregnancy And Postpartum: Supporting Motherhood Through Occupational Therapy Education, Alison Drexler

Occupational Therapy Capstone Presentations

During pregnancy and postpartum, women are at increased risk for physical and psychological health concerns due to the changes and challenges that come with the transition. The purpose of this 14-week capstone was to develop and implement educational sessions using occupational therapy concepts and integrate them into a community parenting program to ease the transition during the perinatal period. It also aimed to advocate for the role of occupational therapy in pregnancy and postpartum. Methods included preparing and sharing supplemental educational materials, developing and implementing occupation-based sessions, creating a folder of resources, and developing a manuscript advocating for occupational therapy …

Facilitating Community Integration Following Inpatient Rehabilitation: The Importance Of Caregivers, Alysa N. Jensen

Occupational Therapy Capstone Presentations

Community integration (CI) is a significant benchmark for successful rehabilitation following traumatic brain injury (TBI). The purpose of this capstone was to utilize occupational therapy assessments, interventions, and resources to support patients and their caregivers during the transition from the clinical setting to the community. Methods included assessment and intervention for patient function, cognition as it relates to burden of care, patient discharge statistics, development and implementation of caregiver resources, and semi-structured caregiver interviews. The outcomes of this project indicate that although TBI survivors are discharging home, they continue to require substantial caregiver support. Outcomes also indicate that there is …