Medicine and Health Sciences Commons^™

Cohort Study Of Opioid Utilization In Post-Tonsillectomy Pediatric Patients, Noor Ali, Tulio Valdez, Anna Messner, Iram Ahmad

Faculty, Staff and Students Publications

Objectives: Prospective observational cohort study at a tertiary care academic center to evaluate the post-operative use of oxycodone in pediatric tonsillectomy patients and caregiver knowledge of opioid disposal.

Methods: Pediatric patients 6-18 years old undergoing tonsillectomy were enrolled. Patients were excluded if they required prolonged inpatient care, had a history of organ transplantation, chronic pain or narcotic use, congenital or chromosomal disorders, inability to take acetaminophen or ibuprofen, and other significant medical diagnoses that could potentially alter postoperative pain management. All patients were prescribed a standard amount of oxycodone to be used for breakthrough pain in addition to ibuprofen and …

Measuring Treatment Burden With The Treatment Burden Questionnaire (Tbq): A Narrative Literature Review And Implications For Geriatric Research And Clinical Practice, Jack Banks, Aanand Naik, Dana Giza

Faculty, Staff and Student Publications

Background: Treatment burden refers to the demands that healthcare places on a patient's daily life, including managing appointments, medications, and lifestyle adjustments. It is a critical concern for older adults, particularly those with multiple chronic conditions. High treatment burden has been associated with poorer treatment adherence, increased disruptions in care, and diminished quality of care. The Treatment Burden Questionnaire (TBQ) is a validated tool that has been successfully used to measure treatment burden in a variety of geographic, clinical, and research settings.

Methods: We conducted a narrative literature review to identify studies that have applied the TBQ in older adult …

Decoding Spatial Transcriptomics Across Multicellular And Subcellular Resolutions, Chongyue Zhao, Hanqiu Zhao, Zhiyu Dai, Et Al.

2020-Current year OA Pubs

Current whole-genome spatial transcriptomics (ST) platforms, which range from multicellular (e.g., Visium) to subcellular resolution (e.g., Visium HD, Stereo-seq), face significant challenges in accurately decomposing or aggregating spots into single cells-the fundamental units of biological activity. To date, most existing computational methods operate at the spot level, and no method has effectively reconstructed transcriptomes at single-cell resolution. In this study, we present STARS (Spatial Transcriptomics across Resolutions for Single Cells). Leveraging Vision Transformer model and contrastive learning, STARS combines high-resolution histology images with spot-level transcriptomics data to reconstruct single-cell-level gene expression from multicellular and subcellular platforms. We demonstrate the advantage …

Biodegradable Pcl–Plga Electrospun Nanofibers For Localized Cancer Therapy, Rahul Tiwari, Pranav, Joel Delossantos, Eswara N.H.K. Ghali, Luis Chavez, Vishal Sharad Chaudhari, Songyang Han, Subhash Chauhan, Murali Yallapu

School of Medicine Publications

Localized chemotherapy offers a promising strategy to improve therapeutic efficacy while minimizing the systemic toxicity of conventional cancer treatment, particularly following tumor resection. Electrospun nanofibers are well suited for this purpose due to their high porosity, extracellular matrix-mimicking architecture, and capacity for localized drug release. In this study, electrospun nanofibers based on PCL and PLGA were developed for localized cancer therapy. Three distinct nanofibrous architectures were fabricated: PCL nanofibers, PCL−PLGA blended nanofibers, and PCL−PLGA multilayered (tetra-layered) nanofibers, and their encapsulation efficiency was determined by high-performance liquid chromatography (HPLC). Scanning electron microscopy confirmed uniform, bead-free nanofibrous morphologies, while Fourier transform infrared …

Caregiving Experiences And Challenges Among Caregivers Of Children With Epilepsy In Thailand: A Qualitative Study, Arthittaya Kaenkrai, Pramote Thangkratok, Pawanrat Panjatharakul, Apasri Lusawat, Moritz Tacke

Journal of Health Research

Background: Childhood epilepsy requires long-term management and places substantial responsibilities on caregivers. In Thailand, limited public awareness and persistent stigma surrounding epilepsy may intensify caregivers’ psychosocial and practical burdens. This study aimed to explore the lived experiences of caregivers of children with epilepsy in Thailand.

Methods: A qualitative study using two semi-structured focus group discussions (FGDs; 5 participants per group) and 15 in-depth interviews (IDIs) was conducted with primary caregivers of children with epilepsy receiving care at a neurological referral institute in Thailand. Participants were purposively selected to capture a diverse range of caregiving experiences. Data were audio-recorded, transcribed verbatim, …

Comparison Of Selected Supply Chain Management Practices Of Three Major Regional/Metropolitan Hospitals, Alan D. Smith

Atlantic Marketing Association Proceedings

No abstract provided.

Implementation Of A Nurse-Driven Early Mobility Algorithm In Critically Ill Adults, Andrea Saito

Doctoral Projects

Background: Early mobilization of critically ill patients is recommended in clinical practice guidelines to mitigate ICU-acquired weakness, delirium, and improve recovery. This intervention is inconsistently implemented in many health systems due to a variety of barriers. One frequent barrier is uncertainty regarding whether patients meet safety criteria for mobilization. Purpose: The purpose of this quality improvement project was to implement a nurse-driven early-mobility algorithm with a clinical safety screen in an adult medical-surgical ICU and evaluate its impact on patient mobility scores, delirium rates, and ICU length of stay.​ Methods: The intervention was evaluated using a quasi-experimental before and after …

Demystifying Longitudinal Melanonychia: Low-Cost 3d-Printed Nail Models For Patient Education, Nuran C. Golbasi, Zachary J.K. Neubauer, Nataliedeana Badillo, Shari R. Lipner

Student Papers, Posters & Projects

No abstract provided.

Investigating Racial Differences In The Receipt Of Antenatal Interventions Prior To Periviable Delivery, Niurka Monteserin, Whitney Bender

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: The Society for Maternal Fetal Medicine (SMFM) provides guidance on the use of antenatal corticosteroids, antibiotics, and cesarean delivery in the periviable period. Although racial differences exist in postnatal active management of periviable neonates have been described, less is known about racial differences in antenatal interventions preceding delivery.

OBJECTIVE: To evaluate differences in the receipt of antenatal interventions before periviable delivery by birthing parent race.

METHODS:  We conducted a population-based cohort study using the National Center for Health Statistics database including periviable deliveries (20w0d-25w6d) from 2016-2021. Individuals delivering a non-anomalous live singleton gestation in a hospital were included. Births …

Rehabilitation Belief And Engagement Transformation (Rbet) Model: A Grounded Theory Approach, Jade Ibhar V. Cuambot, Marc Eric S. Reyes, Karen Katrina V. Trinidad

Makara Human Behavior Studies in Asia

Competitive sports injuries have significant physiological and psychological consequences for athletes. While rehabilitation medicine effectively addresses the physical aspects of injury recovery, the psychological and emotional journey of injured athletes remains neglected. Thus, the current study addresses this gap by examining athletes’ transforming belief systems and emotional experiences during injury rehabilitation. A qualitative research design grounded in grounded theory principles was conducted with professional athletes to understand how their beliefs toward rehabilitation evolved over time. Findings revealed a dynamic process of belief transformation consisting of seven interconnected stages, captured in the Rehabilitation Belief and Engagement Transformation (RBET) Model: (1) Pre-rehabilitation …

Use Of Tyrx Antibacterial Envelope In Inflatable Penile Prosthesis Surgery: A Prospective Pilot Study., Jack T. Rifkin, Julia A. Baran, Brian H. Im, Tej J. Desai, Jordan Dehoratius, Oleksandr Kolesnikov, Paul Chung

Department of Neurology Faculty Papers

BACKGROUND: Infection remains a major concern in inflatable penile prosthesis (IPP) surgery. Medtronic's TYRX Absorbable Antibacterial Envelope is a polypropylene mesh pocket delivering minocycline and rifampin for 7 days and fully absorbing in 9 weeks. It is currently FDA-approved for use with cardiac pacemakers and neuromodulation devices. There is no indication for use in IPP surgeries, particularly for enveloping the scrotal pump during implantation.

AIM: This pilot study evaluates the feasibility, safety, and early patient-reported outcomes with the use of the absorbable antibacterial envelope during IPP surgery.

METHODS: Fifteen men who underwent primary or revision IPP placement by a single …

Tiktok And The Brain: Neuropsychological Correlates Of Short-Form Video Consumption, Caty Enders

Psychology ETDs

Short-form video platforms like TikTok have quickly become the fastest growing segment of social media, thanks to powerful algorithms serving up personalized content driven by large quantities of user data. This study investigates the neuropsychological correlates of digital media use, with a particular focus on TikTok and smartphone screen time among young adults. Combining correlational analyses and an experimental design (n = 49; n = 44 included in final sample), we examined the relationship between digital media use and cognitive and emotional functioning across multiple domains. Objective measures of digital media consumption (daily average screen time and time on TikTok) …

From Cranes To Clinics: Genomic Epidemiology At The Human-Animal Interface, Sarah Shrum

Biology ETDs

Emerging infectious diseases represent a significant, increasing threat to human life, economic stability, and global security. The One Health framework, which promotes human health and wellness through the understanding that animal, environmental, and human health are interwoven, is critical to understanding pathogen emergence and transmission. This is underscored by the fact that roughly 60% of all human pathogens and 75% of emerging infectious disease are zoonotic, meaning they are transmitted from animals to humans.

The work presented in this dissertation integrates genomic epidemiology, ecological analysis, and One Health Surveillance approaches to characterize cross-species circulation of opportunistic yeast pathogens (Candida …

Healthcare Professional Knowledge About Food Insecurity And Treatment Options, Amberlyn Jarman

Doctor of Nursing Practice Scholarly Project

Food insecurity is a significant social determinant of health associated with obesity, chronic disease, increased healthcare utilization, and higher mortality, particularly in rural and underserved populations. Healthcare providers are uniquely positioned to identity and address food insecurity; however, gaps in provider knowledge and awareness of available community resources persist. This scholarly project evaluated whether an educational intervention could improve healthcare providers' knowledge and awareness of food insecurity and local treatment options. A mixed-methods approach of quantitative and qualitative measure was utilized for research. Pre- and post-test design was used with healthcare providers from a four-state rural region, including Kansas, Missouri, …

Dental Hygienists' Views On Salivary Diagnostics, Julie Justice

Dental Hygiene ETDs

This study assessed dental hygienists’ views on salivary diagnostic testing in the United States, including awareness, utilization, perceived barriers, and whether years of experience, clinical setting, or education level influenced these views. A descriptive cross-sectional design was used to collect data via an 18-item email survey distributed through the American Dental Hygienists’ Association’s mailing list. Eligible participants were licensed dental hygienists currently practicing in the United States. The survey included demographic items and Likert-scale questions on knowledge, clinical use, perceived value, and limitations of salivary diagnostic testing. Survey responses were analyzed using descriptive statistics, frequency distributions and Spearman correlations. Despite …

Policy Concerning Student Use Of Magnification Loupes By American Dental Hygiene Schools, Amye M. Burruss

Dental Hygiene ETDs

This descriptive study was to assess whether dental hygiene schools require students to purchase magnification loupes, at what point in the program they implement the use of loupes, and which type of loupes they require students to purchase. A survey link through Microsoft Forms consisting of nineteen multiple-choice questions was emailed to 327 dental hygiene program directors and was open for a total of three weeks. With a response rate of 13% (45 respondents), results indicate that most dental hygiene programs mandate or strongly encourage the use of magnification loupes and allow students to start wearing loupes in the first …

Urobiome Composition Varies With Vesicoureteral Reflux Grade And History Of Febrile Urinary Tract Infection, Theresa C. Barrett, Kelvin Li, Adam Fitch, Asha Patel, Bhanu Sharma, Jacqueline Holden, Kermina Abdelsayed, Nina N. Kowalewski, Sridhar Narla, Daniel Bushnell, Barbara A. Methé, Catherine S. Forster

Department of Medicine Faculty Papers

Vesicoureteral reflux (VUR) is a risk factor for urinary tract infection (UTI). However, data describing the urobiome in children with VUR are limited. Here, we characterized the urobiome in children with and without VUR to better understand its potential role in VUR pathogenesis. Catheterized urine samples were obtained from children who presented for voiding cystourethrogram (VCUG) between 12/1/2020 and 10/3/2023. Children were excluded if they had any surgical procedures of the genitourinary tract in the 30 days prior to VCUG or were on treatment antibiotics at the time of VCUG. 16S rRNA gene sequencing and taxonomical classification identified the urobiome. …

Thoughts From The Pit: Can Raving Change The World? A Literature Review Exploring Rave Culture As Expressive Arts Healing, Marissa Rose Renella

Expressive Therapies Theses

This literature review examines the structural and philosophical commonalities between expressive arts therapy (EXA) and rave culture. Drawing on scholarship from anthropology, cultural studies, health sciences, transpersonal psychology, neuroscience, and expressive arts therapy, this review identifies five core principles shared between the two fields: transformational experiences, multimodality, entrainment and flow, containment and ritual, and community and social action values. Across each principle, the literature reveals not surface-level similarity but deep convergence — two fields that have, independently and through different lineages, arrived at the same understanding of what human beings need in order to heal, grow, and connect. To the …

Re-Painting Motherhood: A Community-Based Expressive Arts Project Exploring Motherhood’S Myths, Realities, And Hopes Through A Narrative Therapy Lens, Lauren Grignaffini-Morris

Expressive Therapies Theses

This thesis examines how socially constructed ideals of motherhood shape maternal identity, distress, and isolation, and explores the potential of addressing these experiences through a community-based expressive arts project. Drawing on motherhood studies, expressive arts therapy, and narrative therapy, the project highlights the potential benefits of utilizing expressive arts in a community setting to ease the tension between romanticized cultural narratives and the lived realities of mothers. Conducted with a support group for mothers in rural Vermont, the project used visual art, movement, creative writing, and collaborative mixed-media painting to examine problem-saturated motherhood stories, connect through embodied experience, and explore …

Playfulness And Awe: How Ecodramatherapy Can Facilitate The Experience Of Positive Emotional States To Reduce Perceived Stress, Corey Jennifer Maier

Expressive Therapies Theses

This paper investigates the question, “can a play and awe-based Ecodramatherapy intervention help to reduce levels of perceived stress in a group of food forest volunteers?” Methods for investigation and subsequent discussion of results draw from the Biophilia Hypothesis, Stress Reduction Theory, and Trait Activation Theory to guide conceptualization. Based on a review of the literature suggesting that playfulness and awe have an effect on both perceived and physiological stress, the author created an Ecodramatherapy intervention designed to evoke playfulness and awe for a group of 4 stressed food forest volunteers. The volunteer group was of mixed ethnicities and genders …

Embodied Identity In Dementia: Art Therapy As A Pathway To Selfhood, Sarah E. Southwick

Expressive Therapies Theses

Older adults living with dementia have often been erroneously perceived as inhabiting a singular lived experience marked by degeneration in cognitive functioning and considerable losses in self-identity. There is substantial literature to suggest that multisensory stimulation and art therapy are well-positioned as conduits for self-expression. However, a gap exists related to artistic media and how they may be implemented and tailored for people with dementia. This capstone explores the paradigm of selfhood as a subjective essence of being that may be accessed through creative expression and sensory engagement. Arts-based directives were implemented through a person-centered expressive arts therapy framework. Two …

Opening Space For Joy: Play As A Pathway In Dance/Movement Therapy With Adults In Addiction Recovery, Brittany M. Walsh

Expressive Therapies Theses

This literature review examines the cultivation of joy through play in dance/movement therapy (DMT) for adults in addiction treatment. Substance use disorders (SUDs) and addictive behaviors are complex, multifaceted conditions influenced by biological, psychological, social, and systemic factors; however, treatment approaches often prioritize symptom reduction and traditional talk-based models. Although necessary, these approaches often fail to honor the whole person, and can inadvertently reinforce shame, stigma, isolation, and dehumanization. Drawing on trauma-informed, neurobiological, relational, and decolonizing frameworks, this review positions joy as a fundamental aspect of human experience and an affirmation of dignity. Playful processes in DMT have the potential …

From Worry To Invention: Developing The Lunch Bunch As A Multimodal Expressive Arts Model For Regulation, Collaboration, And Peer Connection In Elementary Schools, Pascale Lauren Mimran-Ugbabe

Expressive Therapies Theses

This thesis documents the development of the Multimodal Expressive Arts Lunch Bunch, a small group intervention for elementary students delivered during the school lunch period at a public elementary school in Boston, Massachusetts. Grounded in multimodal expressive arts therapy, intermodal transfer theory, polyvagal-informed co-regulation, and principles of externalization, the intervention was designed as a low-barrier creative support group accessible regardless of diagnosis, referral status, or family pursuit of clinical services. Two cohorts of teacher-nominated students, one group of fourth-grade girls and one mixed-gender third-grade group, participated in a sequenced arc moving from worry externalization through collaborative invention, prototype construction, and …

Rhythms Of Hippocampal Function And Memory After Moderate Prenatal Alcohol Exposure, Lilliana May Sanchez

Psychology ETDs

Fetal Alcohol Spectrum Disorders involve morphologic and neurobiological abnormalities in offspring subjected to prenatal alcohol exposure. Although not as well studied as high exposure, moderate prenatal alcohol exposure represents the most common and undetected form in humans. While learning and memory deficits have been well characterized at the behavioral level in humans with Fetal Alcohol Spectrum Disorders and in animal models of moderate prenatal alcohol exposure, few studies have determined the circuit or systems level mechanisms of the behavioral deficits. A complete understanding of the neural bases of memory deficits after moderate prenatal alcohol exposure is needed to ultimately identify …

Pneumomlpred: Innovating Pneumonia Management With Guideline Adherence Review And Explainable Machine Learning-Based Mortality Prediction - A Single-Centre Retrospective Study, Kamel A. Samara, Hiba Jawdat Barqawi, Saryia Adra, Batool Aldaher, Drishti D. Kampani, Enad Haddad, Hebah Soudan, Islam Ibrahim Anwar, Mohamad Besher Adi, Omar Hamadi, Yumna Almour, Mohamed Nassef, Zaher Al Aghbari, Eman Abu-Gharbieh

Abington Jefferson Health Papers

Introduction: Community-acquired pneumonia (CAP) is one of the leading causes of death globally. Changing antibiotic resistance profiles, paucity of reliable CAP mortality prediction models, and ageing populations will increase its burden. This study aims to evaluate adherence to CAP management guidelines as well as develop an ML-based mortality prediction model.

Methods: This retrospective, chart review included all CAP cases between 2016 and 2021. Variables collected included patients' demographics, comorbidities, vitals, laboratory, imaging, and culture findings, as well as initial and targeted antibiotic regimens. Data was pre-processed and analysed in python-3. Adherence to the American thoracic society/infectious diseases society of America …

Improving Health Literacy And Self-Management In Adults With Heart Failure: A Nurse-Led Virtual Intervention In Outpatient Support Groups, Vivian Efosa Osunde

Doctoral Projects

Heart failure is a leading cause of morbidity and hospital readmissions, with limited health literacy contributing to poor self‑management and adherence challenges. The purpose of this Doctor of Nursing Practice project was to evaluate the feasibility and preliminary outcomes of a nurse‑led, virtual education-intervention designed to improve health literacy, self‑care behaviors, and medication adherence among adults with chronic heart failure who participate in an outpatient support group. A quality improvement design was used. Convenience sampling yielded nine adult participants with a documented diagnosis of chronic heart failure who attended at least one virtual support group session. The intervention consisted of …

Whiny Women: How Medical Gaslighting Becomes Medical Trauma, Neena Marcus

Honors Projects

Background: The idea of “medical gaslighting” has been present since 1969, but it has increased in popularity in the recent century. Women in particular are at increased risk of being dismissed by their healthcare providers, as throughout history they have been deemed “hysterical” or untrustworthy when recounting their symptoms.

Methods: Articles were compiled from CINAHL Complete, Google Scholar, and the University of Washington library. A total of 33 articles were chosen and reviewed.

Results: Medical gaslighting results in lasting medical trauma, a decreased quality of life and detachment from standard healthcare. Six themes were recurrent in the papers utilized: sexism, …

Perception, Payment, And Pollution- Examining The Effects Of Air Quality On Health And Healthcare, Colin Sleeper

Economics ETDs

Abstract

This dissertation examines how air quality and public attention to environmental shock affect perceived health status and healthcare utilization. The first chapter uses publicly available survey data from BRFSS and a triple difference framework to analyze the effects of the 2018 wildfire season in Oregon on self-reported mental and physical health. Findings indicate that those in Oregon in 2018, during the period of heightened attention to wildfire smoke, experienced approximately 1.4 additional poor mental health days, on average. The second chapter includes Merative MarketScan commercial insurance claims data to test whether these changes translate into a behavioral response. Results …

Impact Of Third Trimester Alcohol Exposure (Ttae) On Oligodendrocyte Development And Behavior In Mice, Estrella Villicana

Biomedical Sciences ETDs

Prenatal alcohol exposure (PAE) during late gestation can cause cognitive, behavioral, and motor impairments associated with fetal alcohol spectrum disorders (FASDs). The third trimester corresponds to a critical period of brain growth and maturation. This study examined the effects of Third Trimester-equivalent Alcohol Exposure (TTAE) on oligodendrocyte development and adult behavior. Neonatal mice were exposed to ethanol or air vapor from postnatal day (P) 4–8. Immunohistochemical analyses were performed at P8 and P30 to assess myelination, apoptosis, and oligodendrocyte lineage progression. TTAE significantly reduced myelin basic protein (MBP) expression at P8, which was recovered by P30, indicating delayed developmental myelination. …

Design And Optimization Of Epitope Based Malaria Vaccine Targeting Pre-Erythrocytic Stage, Yogesh Nepal

Biomedical Sciences ETDs

Malaria remains a major global health challenge. Currently available vaccines provide only modest and transient protection. In this work, we developed virus like particles (VLPs) based vaccine to target vulnerable epitopes of circumsporozoite protein, a key surface protein of pre-erythrocytic sporozoite stage, across different structural contexts. The immunogenicity of these highly immunogenic vaccines were further enhanced using immune stimulating agents, adjuvants, and the most promising VLP and adjuvant combinations were evaluated in preclinical challenge models to assess efficacy. In parallel, we performed research in an antigen agonistic manner using VLP library immunization that displays different fragments of a target protein …