Medicine and Health Sciences Commons^™

Long Work Hours, Suboptimal Diabetes Management, And Differences By Sex And Race/Ethnicity, Nhanes (2011-2018), Tailisha Gonzalez, Margrethe Horlyck-Romanovsky, Terry T.-K. Huang, Sandra E. Echeverria

Publications and Research

In the United States (US), occupational segregation by sex and race/ethnicity can contribute to health disparities. Although work schedule characteristics have been previously linked to elevated cardiovascular risk, little is known about the effects on chronic disease management in women and minoritized workers. We examined the association between work hours and diabetes management among US workers, testing for differences by sex and race/ethnicity. We utilized 2011–2018 National Health and Nutrition Examination Survey (NHANES) data on working adults (age ≥20 years) with diagnosed diabetes (n = 1041). Suboptimal diabetes management was defined as HbA1c ≥7%. Work hours were categorized per WHO …

Stress-Induced Il-6 Response Patterns Amplify The Link Between Daily Negative Affect And Later Depressive Symptoms During Bereavement, E Lydia Wu-Chung, Daniel L Argueta, Robert Suchting, Ryan L Brown, Michelle A Chen, Angie S Leroy, Kyle W Murdock, Cobi J Heijnen, Christopher P Fagundes

Faculty, Staff and Student Publications

Depressive symptoms frequently follow exposure to major life stressors, such as spousal bereavement. However, long-term mental well-being varies considerably. Previously, daily negative affect significantly predicted future depressive symptoms. Higher daily negative affect may signify worse long-term mental health for individuals who also show enhanced inflammatory responses to acute stress, as heightened physiological reactivity to acute stress has been linked with increased susceptibility to depression. Among widow(er)s, we examined whether stress-induced inflammatory responses altered the magnitude of the association between daily negative affect and future depressive symptoms. In exploratory analyses, we examined whether these patterns differed between bereaved and nonbereaved adults. …

Diagnostic Potential For Igm Antibody Detection By The Dpp Syphilis Tnt Assay In Neonates At Risk For Congenital Syphilis, Irene A Stafford, Lierni Ugartemendia Ugalde, Laura M Goetzl, Analuisa Mosqueda, Sabrina Dacosta, Dhammika Gunasekera, Mark Rivieccio, Javan Esfandiari, Konstantin P Lyashchenko

Faculty, Staff and Student Publications

Neonatal IgM antibodies reflect an in utero immune response to Treponema pallidum and may offer added diagnostic value. This study evaluated the test performance of treponemal IgM levels measured by the research-use-only (RUO) Dual Path Platform (DPP) Syphilis TnT point-of-care (POC) assay for congenital syphilis (CS) risk stratification. Conducted from May 2023 to May 2025, this study tested neonatal serum samples from infants born to mothers with syphilis using the DPP Syphilis TnT RUO POC assay, which reports treponemal and nontreponemal IgM levels as relative light units (RLU). Neonates were classified as confirmed proven or highly probable CS, possible …

Implementation Of A Process For Tracking Hgb A1cs In A Community Mental Health Organization, Devin Gill

Doctoral Dissertations & Projects

Background: Individuals with a serious mental illness (SMI) are 2 to 3 times more likely to develop type 2 diabetes, yet are less likely to receive routine screening of hemoglobin A1c (HbA1c) testing. The purpose of this quality improvement project is to implement a standardized workflow process to ensure consistent tracking of HbA1cs in adult consumers greater than 18 years of age with SMI receiving services at a rural community mental health (CMH) organization.

Methods: The primary intervention is a workflow process, with focus on the clinical information systems and organizational system. This quality improvement project was guided utilizing the …

Pharmacological Treatment Options For Vasoplegia Syndrome During And After Cardiopulmonary Bypass: A Scoping Review, Bradley Darby

Student Works

ABSTRACT

2: Structured summary

Background

Vasoplegia Syndrome (VS) is a form of distributive shock that is characterized by profound hypotension, low systemic vascular resistance, and high to normal cardiac output during/after cardiopulmonary bypass. VS is associated with increased mortality, morbidity, and length of stay in the intensive care unit.

Objective

The main objectives of this scoping review are to note the available treatment options, characterize potential risk factors, and identify gaps in knowledge for vasoplegia syndrome during and after cardiopulmonary bypass.

Method

This scoping review utilized the Preferred Reporting Items for Systematic reviews and MetaAnalyses extension for Scoping Reviews (PRISMA-ScR) …

Quality Improvement Project Enhancing Maternal Health Outcomes: Evaluating The Impact Of Universal Social Determinants Of Health (Sdoh) Screening In An Interdisciplinary Pregnancy Care Model, Shannon Morgen

Doctor of Nursing Practice Projects

Social determinants of health (SDOH), including housing instability, food insecurity, transportation barriers, and interpersonal violence, significantly influence maternal outcomes and contribute to disparities such as preterm birth and maternal morbidity. Despite national recommendations for universal SDOH screening, implementation in prenatal care remains inconsistent, limiting opportunities to identify and address social needs. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to implement and evaluate a standardized SDOH screening and documentation process to improve referral completion and examine its impact on hospital readmissions among obstetric patients. Guided by Bronfenbrenner’s Socio-Ecological Model and the Plan-Do-Study-Act framework, the project …

Quality Improvement Project: Enhancing Efficacy And Reducing Urine Contamination Through Simulation In The Ed, Kimberley Strong

Doctor of Nursing Practice Projects

Urine specimen contamination in emergency department settings contributes to diagnostic inaccuracies, unnecessary antibiotic use, increased healthcare costs, and decreased patient satisfaction. This quality improvement project evaluated the impact of a simulation-based educational intervention on staff knowledge, self-efficacy, and urine specimen contamination rates among emergency department nurses and patient care technicians with less than six years of clinical experience in a rural Texas hospital. The aim of this project was to enhance knowledge and self-efficacy while reducing contamination rates over a six-week period. The project was guided by Knowles’ Adult Learning Theory as the theoretical framework, supported by Lewin’s Change Theory, …

Keratopigmentation: A Comparative Review Of Safety, Indications, And Clinical Outcomes, Emmy L. Colon Alamo

Undergraduate Scholarship and Creative Works

Throughout the years, there has been an upsurge in the quantity of cosmetic procedures aimed at changing eye color or appearance. This trend raises significant concerns about patient safety and visual health, as although many methods are promoted worldwide, their efficacy and, most importantly, safety varies greatly. This review looks at the safety of procedures that alter eye color or appearance, focusing mainly on cosmetic keratopigmentation, which is currently the only legally accepted method for changing eye color in the U.S.

A review of clinical studies was conducted to evaluate the outcomes and complications related to keratopigmentation. Then, these findings …

Nature-Based Occupational Therapy For Enhancing Education Participation, Malia M. Mendiola, Susan Macdermott

Spring 2026 OTD Capstone Symposium

The project developed nature-based interventions (NBI) resources to support the education participation of neurodivergent high school students. The objective was to increase students’ school participation through nature-based OT for improving emotional regulation, lowering physiological stress, and attention restoration.  Nature immersion was explored through the school's OT program, as well as interdisciplinary collaboration with teachers, other services providers, and community partners. The resource guide focused on benefits, impacts, and practical implementation of NBI for the Winston School and for the broader school-based occupational therapy community.

Implementing Simulation-Based Learning In Fieldwork Bootcamp To Enhance Level Ii Fieldwork Preparedness, Kathryn Livingston

OTD Capstone Projects

This doctoral capstone project was completed in collaboration with Belmont University’s School of Occupational Therapy (OT) and the Center for Interprofessional Engagement & Simulation. A needs assessment of OT Faculty, Level II Fieldwork Educators, and the OTD Class of 2026 identified essential skill expectations and common areas of difficulty related to Level II placements. In response, this project developed multiple simulation experiences for Fieldwork Bootcamp to provide students with hands-on practice of core skills in preparation for their Level II placements. A resource manual was developed containing case studies, training guides, debriefing scripts, and setting-specific materials for use during Fieldwork …

Promoting Participation In Leisure Activities At The Center For Living And Learning, Katie Eison

OTD Capstone Projects

The Center for Living and Learning is a private nonprofit residential treatment facility on a 30-acre farm in Franklin, TN, housing adults who experience severe and persistent mental illnesses such as schizophrenia and schizoaffective disorder. The Center provides opportunities for leisure activities during the day; however, due to symptomology such as avolition, anhedonia, and social withdrawal, residents often struggle with participation in valued leisure activities. This doctoral capstone project aimed to promote participation in leisure activities, social participation, and community engagement. The Interest Checklist and Leisure Satisfaction Measure were administered to determine residents’ individual interests and satisfaction levels with leisure …

Quality Improvement Project: The Impact Of The Clinical Judgment Measurement Model In Nursing Faculty, Lamia Zeidan

Doctor of Nursing Practice Projects

Clinical judgment is essential for nursing practice and can be taught using the Clinical Judgment Measurement Model (CJMM). A needs assessment conducted at the project site revealed that students had limited clinical judgment skills, there was no emphasis on clinical judgment in nursing skills courses, and the faculty had a limited understanding of the CJMM. In response to the findings of the needs assessment, the quality improvement (QI) project was developed using a quasi-experimental design. Guided by Lewin’s Change Theory and Benner’s Novice to Expert Educator theoretical framework, the project aimed to provide faculty with education on the CJMM and …

Optimizing Central Line Discontinuation In The Surgical Intensive Care Unit: A Quality Improvement Initiative Using A Visual Aid To Reduce The Risk Of Central Line-Associated Bloodstream Infections, John Quyen D. Van

Doctor of Nursing Practice Final Project Abstract

PURPOSE 

The aim of this quality improvement (QI) project was to reduce unnecessary central line dwell time by 20% in a surgical intensive care unit (SICU) in Central Texas.

BACKGROUND 

Central line–associated bloodstream infections (CLABSIs) contribute to patient harm and increased healthcare costs. The literature strongly supports the timely removal of central venous catheters (CVCs) to reduce this risk; however, delays often occur due to workflow demands, communication gaps, and inconsistent daily necessity assessments.

METHODOLOGY 

Guided by the Health Belief Model (HBM) and the Institute for Healthcare Improvement (IHI) Model for Improvement, the QI project consisted of an 8-week baseline …

Analyzer-Less X-Ray Interferometry With Super-Resolution Methods, Murtuza S. Taqi

LSU Master's Theses

X-ray interferometry provides valuable information on attenuation, small-angle scattering, and differential phase contrast. This multi-modal contrast can aid in many clinical applications, such as lung diseases and breast cancer. However, standard inter- ferometry has an analyzer grating that can increase the dose requirement to maintain the same image quality as a standard X-ray. We propose the use of super-resolution methods for X-ray grating interferometry without an analyzer, with detectors that fail to meet the Nyquist sampling rate needed for traditional image recovery algorithms. Detector phase- steps are used to nominally recover the sampling and iteratively recover the visibility and the …

Vasculature Of The Anterior Abdominal Wall And Surface Anatomy Of The Liver And Stomach: Considerations For Minimal Access Surgeries In Neonates, Daniël J. Van Tonder, Natalie Keough, Martin Louis Van Niekerk, Albert Van Schoor

COM Scholarship

Background: Minimal access surgeries are growing more common in neonatal care, but the risk of accidental injury to abdominal wall blood vessels remains a concern. This risk is increased by limited precise anatomical data specific to neonates. Therefore, this study aimed to quantitatively map the superficial and deep blood vessels of the neonatal anterior abdominal wall concerning important surgical landmarks to develop evidence-based recommendations for safer laparoscopic port placement. Methods: Thirty formalin-fixed low-birth-weight neonatal body donations (≤4 weeks old) were dissected. An anatomical grid based on palpable landmarks—including the umbilicus, xiphoid process, and anterior superior iliac spines—was utilised to measure …

Equine-Assisted Interventions For Pediatric Clients With Cerebral Palsy: A Handbook For Occupational Therapists, Draydin Ferguson, Lesley Khan-Farooqi, Phd, Otd, Otr

Spring 2026 OTD Capstone Symposium

This poster outlines the development of an evidence-informed instructional handbook intended to guide Occupational Therapists in implementing equine-assisted interventions with pediatric clients diagnosed with Cerebral Palsy.

Groove ‘N’ Grow: Promoting Social Participation Through Dance And Movement, Juliana N. Ward, Karen Park

Spring 2026 OTD Capstone Symposium

Groove ‘n’ Grow is a structured pediatric occupational therapy group program designed to improve social participation, engagement, and sensory regulation in children with developmental and sensory processing differences through dance and movement-based activities. The program was developed as part of an occupational therapy doctoral capstone project and implemented within a pediatric outpatient therapy clinic. The purpose of the program is to provide children with developmental and sensory processing differences opportunities to practice peer engagement, cooperative participation, emotional regulation, and emotional awareness in a supportive small-group environment.

Barriers Of Animal Assisted Therapy, Taylor Blanchard, Amy Lyons-Brown

Spring 2026 OTD Capstone Symposium

This study employs a mixed-methods design, integrating online surveys, semi-structured interviews, and clinical observations to examine the use of animal-assisted therapy (AAT) within occupational therapy practice. The primary objectives are to characterize the demographics of occupational therapists and therapy animals engaged in AAT, identify barriers to its implementation, and evaluate the resources currently available to support practitioner knowledge and competency. By addressing these areas, the study seeks to clarify existing gaps in education and practice, with the broader goal of strengthening the evidence base and enhancing the accessibility, consistency, and impact of AAT in occupational therapy.

Astrocyte Circadian Regulation In Neurodegeneration: In Vivo Bmal1 Occupancy Mapping Using Macs-Calling Cards, India Reiss

Arts & Sciences Graduate Student Theses and Dissertations

Astrocytes maintain neuronal homeostasis through cellular programs that are frequently disrupted early in neurodegenerative disease, many of which are regulated by the circadian clock. The core clock transcription factor BMAL1 is required for normal astrocyte function, yet whether its regulatory activity is altered during neurodegeneration remains unclear. BMAL1 expression changes in disease are often inconsistent, suggesting that transcription factor binding, rather than expression, may be a more informative readout of BMAL1 function. We used a Cln3Δex7/8 model of neurodegeneration, which exhibits early astrocyte dysfunction prior to widespread neuronal loss, to test whether degenerative pathology reprograms BMAL1 binding in astrocytes. We …

Impact Of Provider Self-Efficacy On Caring For Patients With Prediabetes, David R. Knight

Doctor of Nursing Practice Projects

Prediabetes affects millions of adults in the United States, yet inconsistent provider knowledge and confidence limit evidence-based screening and management in primary care, a gap well-documented in the literature. The purpose of this quality improvement project was to evaluate whether a structured educational intervention improved provider self-efficacy related to prediabetes identification and management. Guided by Social Cognitive Theory and the Transtheoretical Model, with implementation guided by the Plan-Do-Study-Act cycle, this project asked: among family practice providers, how does prediabetes education affect provider self-efficacy over four weeks? A quasi-experimental pre/post design was used. Four asynchronous educational modules focused on evidence-based screening, …

Quality Improvement Project: The Critical Role Of Provider Knowledge In The Golden Hour, Kimberly Mcglothan

Doctor of Nursing Practice Projects

Maternal and infant mortality rates in the Southern United States remain disproportionately high, and inconsistent implementation of the Golden Hour, defined as uninterrupted skin to skin contact for at least the first hour after birth, continues to limit its evidence based maternal and neonatal benefits. The aim of this Doctor of Nursing Practice (DNP) quality improvement project was to evaluate the impact of a structured provider education intervention on Golden Hour compliance and provider confidence. Guided by Benner’s Novice to Expert Theory and implemented using Kotter’s 8-Step Change Model, a quantitative, quasi experimental pre-post design was used. The project was …

Quality Improvement Project: Faculty Preparedness For Recognition, De Escalation, And Reporting Of Violence In Clinical Education Settings, Dawn "Deedee" D. Moline

Doctor of Nursing Practice Projects

Violence and aggression in healthcare settings present ongoing safety concerns for nursing faculty supervising students during clinical education, particularly when teaching occurs in hospital environments where faculty are not employed. Faculty often rotate across multiple clinical sites and may lack consistent preparation or access to standardized safety education and reporting systems. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the effect of a targeted educational intervention on nursing faculty perceived preparedness to recognize, de escalate, and report aggression encountered during clinical instruction. Guided by Bandura’s Social Cognitive Theory and Lewin’s Three Stage Change Model, …

Albumin Use In Cardiopulmonary Bypass Pump Prime And Its Association With Postoperative Renal Function And Acute Kidney Injury: A Scoping Review, Hannah Talbot

Student Works

ABSTRACT

1.Structured summary:

Background: Cardiopulmonary bypass (CPB) is associated with significant hemodilution, inflammatory activation, and alterations in renal perfusion, all of which may contribute to postoperative acute kidney injury (AKI). Albumin is frequently used as a component of CPB pump prime due to its oncotic properties and potential to mitigate fluid shifts and support intravascular volume. However, the extent to which albumin-containing priming solutions influence postoperative renal outcomes remains unclear.

Objective: This scoping review aimed to map the available literature examining the use of albumin in CPB pump prime and its reported effects on renal function and the incidence …

An Educational Intervention To Increase Nurses’ Knowledge And Confidence Of Patient Mobility, Debbie Ann Pytak

Walden Dissertations and Doctoral Studies

Immobility is a significant concern given that nearly half of all hospitalized adults are immobile during their hospitalization, placing them at increased risk for adverse outcomes. As a result, it is critical for nurses to implement strategies that promote safe, structured patient mobility. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine if an educational intervention focused on patient mobility and standardized mobility tool utilization increased knowledge and confidence among nursing staff in an acute care setting. Ten participants volunteered to attend the educational intervention. The average age of the participants was 44.30 years (SD …

First, Do No Trend: Aligning Parenteral Lipid Therapy With Physiology And Evidence In Neonates, Parvesh Mohan Garg, Srinivas Bolisetty, Camilia R Martin, Muralidhar H Premkumar

Faculty, Staff and Students Publications

Lipid injectable emulsions (ILE) are essential components of parenteral nutrition in neonatal intensive care units. Over the past two decades, the expanded availability of ILE has led to rapid changes in clinical practice, largely driven by concerns about intestinal failure–associated liver disease. Despite these evolving trends, the evidence supporting one ILE over another remains limited and nuanced. Importantly, no currently available ILE replicates the intrauterine supply of critical long-chain polyunsaturated fatty acids, particularly arachidonic acid and docosahexaenoic acid, both of which decline postnatally regardless of emulsion type. Neonates requiring ILE represent a heterogeneous population of preterm and term infants, with …

Lotilaner Ophthalmic Solution 0.25% In The Treatment Of Demodex Blepharitis: A Case Report, Paul Karpecki, Brandon Ayres, Eric Donnenfeld, Marjan Farid, Ian Benjamin Gaddie, Preeya K Gupta, Cecelia Koetting, Richard Lindstrom, Selina Mcgee, Kelly K Nichols, Laura M Periman, Stephen Pflugfelder, Christopher Starr, Nandini Venkateswaran, Elizabeth Yeu

Faculty, Staff and Students Publications

Demodex blepharitis is a chronic inflammatory ocular condition caused by Demodex mite infestation of the eyelid that can negatively impact quality of life. Currently, lotilaner ophthalmic solution 0.25% is the only FDA-approved treatment for Demodex blepharitis. The Demodex Expert Panel on Treatment and Eyelid Health has established consensus that lotilaner ophthalmic solution 0.25% should be considered the preferred first-line treatment for Demodex blepharitis. We report a patient who presented with collarettes, the pathognomonic sign of Demodex blepharitis, meibomian gland dysfunction, and poor visual acuity. The patient also had a history of neovascular age-related macular degeneration. Consistent with the Demodex Expert …

Trends In The National Resident Matching Program: Shifting Applicant Priorities In The Setting Of Application Limits And Pass/Fail Step 1 Grading, Joshua Morrow, Siena Blackwell, Zibi Gugala, Atul Maheshwari, Peter Boedeker

Faculty, Staff and Students Publications

Purpose: This study evaluated differences in expected and observed proportions of activities, average Step 2 scores, and abstracts, publications, and presentations since the adoption of a 10-experience maximum for residency applications and pass/fail Step 1 grading.

Method: The authors queried National Resident Matching Program data for MD senior applicants from 2016 to 2024 across 22 specialties. Data included average Step 2 scores; research, work, and volunteer experiences; and number of research products for matched and unmatched students by specialty. Repeated-measures multilevel models were used to estimate the difference in observed outcome in 2024 and expected outcome based on trends from …

Enhancing Post‑Discharge Outcomes: A Quality Improvement Project To Reduce 30‑Day Readmission Rates For Patients With Schizoaffective Disorder, Samson Laryea Norteye

Walden Dissertations and Doctoral Studies

This DNP quality improvement project aimed to reduce 30-day readmission rates for patients with schizoaffective disorder (SAD) by enhancing discharge planning interventions. Using pre- and post-intervention methods, the project compared readmission rates before and after implementing interventions and gathered feedback from patients and staff to identify barriers and facilitators. The intervention bundle included patient education, participation in psychotherapy or support groups, medication reconciliation, and the use of long-acting injectables (LAIs) during hospitalization and prior to discharge. Evaluation of postintervention data revealed that none of the 10 patients in the intervention group were readmitted within 30 days, indicating a significant reduction …

Memory Processes In Older Adults With Hearling, Camryn L. Kirkham

AuD Capstone Projects - Communication Sciences and Disorders

Emerging research has shown links between hearing loss in older adults and memory declines; however, findings remain mixed. The present study examined differences in memory performance between older adults with hearing loss and normal-hearing peers, as well as associations between hearing ability and memory. An exploratory analysis of associations between high-frequency hearing ability and memory performance was also conducted. Participants included 38 older adults with hearing loss (n=20) and normal hearing (n=18) who completed audiologic testing and memory tasks assessing working, semantic, and episodic memory. Contrary to expectations, no significant group differences in memory performance were observed between the hearing …

Knowledge, Skills, And Attitudinal Gaps In Fibrodysplasia Ossificans Progressiva Diagnosis And Management In The United States, Patrice Lazure, Matthew Drake, Michelle Davis, Corrie Crowe, Zvi Grunwald, Lu Fan, Suzanne Murray

Department of Anesthesiology Faculty Papers

Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare and disabling disease. Preventing unnecessary and/or harmful medical procedures to patients requires early and accurate diagnosis, multidisciplinary care, and access to specialists with FOP expertise. This study aims to assess the needs of healthcare providers (HCPs) when providing care to patients with FOP. Knowledge, confidence, and management practices were measured through a short awareness survey, completed by 400 HCPs from different specialties who may encounter patients with FOP. Complementary qualitative data were obtained from a dialogue session about FOP. Quantitative data was analyzed using descriptive and inferential analysis, while qualitative data underwent thematic …