Digital Commons Network^™

The Acute Effect Of A Single Dose Of Berberine On Blood Glucose Response Following A Standardized Meal And 2-Mile Walk Performance In Healthy Adults, Victor Emmanuel Obaro

Master's Theses

It is clear that exercise improves overall health status, and it is possible that berberine (BR) may work through some similar mechanisms to improve health status as well.  Purpose: The purpose of this study was to explore the acute effects of a single dose of BR on health status following a standardized meal and a 2 mile walk treadmill protocol with outcomes including blood glucose (BG), blood pressure (BP), heart rate (HR), rate of perceived exertion (RPE), and a two-mile walk time trial performance. Methods: This study used a cross-over design where 14 healthy, young adults were given berberine (BBR) …

Advancing Experiential Learning And Student Participation Through An Adl Suite, Megan E. Craig

Occupational Therapy Doctorate Capstone Posters

This capstone project was completed within the Occupational Science and Occupational Therapy Department at Eastern Kentucky University. The practice setting was the ADL Suite; a simulated home environment located in the Dizney Building at Eastern Kentucky University. The primary ACOTE focus area(s) applied was program development, with an additional focus area on clinical practice skills. The purpose of this capstone project was to support the development and sustainable use of the ADL Suite as a learning environment for students and faculty to practice ADL/IADL skills, clinical reasoning, activity analysis, assessment, competency development, and fieldwork preparation. A needs assessment and literature …

A Mixed-Methods Study Of Patient And Caregiver Experiences With Home Health Occupational Therapy, Peyton A. Mendias, Cassandra Nelson, Gwen Morris

Summer 2026 OTD Capstone Symposium

Home health occupational therapy (HHOT) promotes independence and safety within the home, yet patients and caregivers often experience challenges implementing therapy recommendations after discharge. This mixed-methods study explored the lived experiences of patients and caregivers who participated in HHOT to identify barriers and facilitators to implementing occupational therapy recommendations and inform the development of a caregiver education toolkit. Adults who received HHOT within the previous six months and informal caregivers completed an online survey, with a subset participating in semi-structured interviews. Quantitative data were analyzed using descriptive statistics, and qualitative interview data were analyzed using reflexive thematic analysis. Findings emphasized …

Attrition Of The Midwifery Workforce: Understanding Factors Associated With Leaving The Profession, E. Brie Thumm, Amy H. Goh, Elizabeth G. Phillips, Zachary Giano

College of Health Professions Faculty Papers

OBJECTIVE: To understand why advanced practice midwives (certified nurse-midwives and certified midwives) leave the workforce.

STUDY SETTING AND DESIGN: A multi-method, multi-source investigation included secondary analysis of certification data of advanced practice midwives and a cross-sectional online survey with closed- and open-ended items. Advanced practice midwives' active certification data were used to compare self-reported demographic characteristics of advanced practice midwives who reported working in the discipline of midwifery to those who did not (n = 9704). A survey was conducted in 2022 with individuals who allowed their certification to lapse between 2017 and 2021 (n = 303) and individuals who …

Facilitating Occupational Participation In Older Adults With Chronic Pain, Emily K. Ruesch

Occupational Therapy Capstone Presentations

This capstone project developed doctoral-level clinical skills in the management of chronic pain. This capstone project also implemented a six‑week chronic pain management program for independent community‑dwelling older adults at Dow Rummel Village. Eleven adults aged 50–95 participated in weekly 45‑minute group sessions addressing adaptive equipment use, graded exercise, energy conservation, nervous system regulation, stress management, and sleep hygiene. Seven participants completed pre‑ and post‑intervention measures using the Brief Pain Inventory–Short Form and the Pain Self‑Efficacy Questionnaire. A paired samples t‑test assessed changes in pain severity, pain interference, and self‑efficacy. Results demonstrated a decrease in pain severity (t(6) = −3.96, …

The Difference In Social Media Coverage For Male And Female Athletes, Amanda Thomas

Communications and Digital Media Theses

Pulling back the curtain on the reality women athletes face when it comes to their social media coverage. Sports have been male-dominated since the start, but over the years women have become more and more involved in sports as they have their own teams and even sports. However, this issue lies with the overall support and coverage they are receiving from well-known Sports coverage networks. For this study, I looked at social media posts from ESPN, FOX Sports, and NBC Sports focused on the sports of Basketball, Baseball/Softball, and Tennis. In doing this study, I analyzed how many posts men …

The Effects Of An Educational Intervention To Enhance Knowledge And Awareness Of The Prevention Of Sexually Transmitted Infections Among College Students, Darcy Yates

Doctor of Nursing Practice Projects

Purpose

The DNP student implemented a single group pretest-postest design underpinned by the Health Belief Model to address the PICOT question: Among a purposive sample of college students at a mid-west college (Population) to what degree does participation in an evidence-based intervention providing information about STIs (Intervention), compared with before that intervention (Comparison), result in to an increase in knowledge and awareness regarding STI infections and associated risks and treatment options (Outcomes) over a six-week period (Time)?

Methods

The pretest and postest scores of 15 students for the 27 items in the Sexually Transmitted Diseases Knowledge Questionnaire (STD-KQ) were evaluated. …

Occupational Health Hazard: Silicosis Policy In California's Engineered Stone Industry, Devany G. Rocha

Master's Projects and Capstones

This policy analysis evaluated the effectiveness of current California regulations that were enacted after the STOP Act was passed to address silicosis incidence rates against Australia's complete ban on manufacture, supply, processing and installation of engineered stone with greater than 1% crystalline silica content. Silicosis is a deteriorating fibrotic lung disease caused by the prolonged or massive inhalation of crystalline silica (Dynamed, 2023). To assess the scope of the problem under the STOP Act, we used data from the California Department of Public Health (CDPH) surveillance from 2019 to present. We assessed incidence rates, mortality rates, and patient demographics. We …

Macomb Dental Society Journal Summer 2026

Journal of the Macomb Dental Society

In the Summer 2026 issue, the reader will find the following feature articles:

• Give Kids a Smile
• Dedicated Dental Sportsman’s Club - 2026 Pistol Shoot
• Macomb, Oakland, Genessee, and Detroit Golf Event

Also included are regular columns from the President, Executive Director and Editor, as well as news shorts and information on upcoming events.

Polyphenol Diet And Exercise As Neuroprotection From Effects Of Alzheimer's Disease, Michelle Morgan

Loma Linda University Electronic Theses, Dissertations & Projects

Healthy non-pharmacological lifestyle factors, such as regular physical exercise and a dietary supplementation, have been shown to significantly improve cognitive outcomes over time compared to a more sedentary lifestyle and poor diet. Furthermore, exercise may serve as a potential protective factor in attenuating the effects associated with cognitive decline that are characteristic of neurodegenerative disorders, such as Alzheimer's disease (AD). Further, evidence indicates that certain diet interventions can also attenuate the effects of neurodegeneration and positively impact longevity. Supplementation of polyphenols, such as ellagic acid (EA), which are abundant in pomegranate juice, may help provide neuroprotective benefits and elicit a …

Analysis Of The Cannabinoid Compositions, Byproducts And Heavy Metals In Unregulated Cannabinoid Products By Hplc-Ms/Icp-Ms, Simone K. Melle

All NMU Master's Theses

The rapid expansion of unregulated hemp-derived products has created a need for analytical methods that characterize both cannabinoid composition and contaminant occurrence. This thesis used liquid chromatography-tandem mass spectrometry (LC-MS/MS) to quantify cannabidiol (CBD), Δ8-tetrahydrocannabinol (Δ8-THC), and Δ9-tetrahydrocannabinol (Δ9-THC), and inductively coupled plasma mass spectrometry (ICP-MS) to measure Al, As, Cd, Cr, Cu, Fe, Mg, Ni, Pb, and Zn in commercial hemp-derived products, laboratory-prepared hemp oils, cultivated hemp tissues, extracted material, and post-harvest soil. Commercial products showed wide cannabinoid variability, with several samples containing more than one target cannabinoid, while laboratory-prepared plant oils showed a more consistent profile dominated by …

Parkinson's Disease: Immunometabolic Control Points Across Neural, Vascular, And Peripheral Systems, Y Narvaez Irizarry Felix, Alondr M. Bermudez Adorno, Boris Ermolinsky, Lilia Kucheryavykh, Mikhail Inyushin

School of Integrative Biological & Chemical Sciences Faculty Publications

Parkinson's disease (PD) is a progressive neurodegenerative disorder most associated with degeneration of dopaminergic neurons in the substantia nigra pars compacta. Increasing clinical and experimental evidence, however, indicates that PD is a multisystem disease in which immune, metabolic, vascular, and peripheral nervous system dysfunction precede and shape motor circuit failure. Nonmotor manifestations, including olfactory impairment, sleep and autonomic disturbances, gastrointestinal dysfunction, and cognitive decline, often arise years before motor diagnosis, highlighting pathogenic mechanisms beyond dopamine deficiency alone. In this review, we synthesize evidence supporting the view that PD represents a disorder of chronic immunometabolic dysregulation rather than isolated neuronal loss. …

Recover Well: Reducing Readmissions Through Nurse-Led Follow-Up After Urologic Surgery – A Quality Improvement Project, Candace Brigette Mike

Doctor of Nursing Practice Projects

Hospital readmissions within 30 days following urologic surgeries are often associated with catheter complications, infections, poor pain management, and limited patient understanding of discharge instructions and therefore represent a significant quality and safety concern for patients and institutions alike. The purpose of this quality improvement project was to evaluate whether implementing structured, nurse-led telephone follow-up in conjunction with standard discharge education reduced unplanned 30-day hospital readmissions among adult patients undergoing urologic surgery. Guided by the Logic Model framework, this project used a quasi-experimental, two-group pre- and post-intervention design to compare outcomes at a high-volume outpatient urology clinic in Houston, Texas. …

Quality Improvement Initiative To Improve Adherence To Ob Hemorrhage Policy And Standardize Pitocin Administration During Cesarean Sections To Reduce Postpartum Hemorrhage Risk, Lauren R. Litz, Monica Blauser

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality, and Pitocin administration is an important component of hemorrhage prevention and management during cesarean delivery. Variation in Pitocin timing, dosing, method of administration, and adherence to evidence-based recommendations may compromise patient safety and create barriers to standardized obstetric anesthesia care. The purpose of this Doctorate of Nurse Anesthesia Practice quality improvement project was to evaluate current anesthesia provider practices for Pitocin administration during cesarean delivery, compare observed practices with the California Maternal Quality Care Collaborative hemorrhage toolkit and Society for Obstetric Anesthesia and Perinatology Enhanced Recovery After Cesarean recommendations, …

Enhancing Patient Outcomes In Obstetric Neuraxial Anesthesia: Evaluation Of A Structured Documentation Tool For Post-Dural Puncture Headache Tracking (Pdph), Jacqueline Saldana Tovar, Ahmad Hasaan

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

The purpose of this Doctor of Nursing Practice (DNP) project is to evaluate the incidence, management, and practice variation of post-dural puncture headache (PDPH) in an obstetric population using retrospective data from standardized follow-up tools. The project aims to identify inconsistencies in procedural techniques, documentation practices, and adherence to evidence-based guidelines across anesthesia provider levels. By analyzing key clinical variables and patient outcomes, this project seeks to identify gaps in current practice, improve data reliability, and support the development of standardized protocols for PDPH assessment and management. Ultimately, the goal is to enhance quality of care, promote evidence-based decision-making, and …

Enhancing Sbar Documentation And Telecommunication Between Nursing And Anesthesia Teams In The Obstetric And Labor And Delivery Unit, Apollonia C. Anderson, Celeste Meda

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Effective communication during obstetric handoffs is essential for promoting maternal and neonatal safety, yet communication failures remain a significant contributor to adverse events due to inconsistent and unstructured handoff practices. This Doctor of Nursing Anesthesia Practice (DNAP) quality improvement project was developed following the recommendations of the 2025 DNAP project, which implemented the OB/L&D-specific SBAR tool. This project evaluated the use of this communication tool in areas of OB interdisciplinary team communication accuracy, efficiency, and collaboration, particularly during obstetric epidural requests within a community-based labor and delivery unit. Guided by the Plan-Do-Study-Act (PDSA) framework (Institute for Healthcare Improvement, 2020). Utilized …

Dnp Final Report: Improving Diabetes Self-Efficacy Through Nutrition Education: A Quality Improvement Project, Lakimberely S. Wooten

DNP Final Reports

Diabetes affects 12.7% of residents in Northeast Texas and is the 7th leading cause of death. Internal evidence indicates low health literacy and a heavy disease burden in the service area, underscoring the need for a standardized, low-cost, and feasible approach to nutrition education. This quality improvement project evaluated the feasibility of implementing an instructor-led nutrition education session. Guided by the Johns Hopkins Evidence-Based Practice Framework and the ADKAR behavioral change model, adult participants with Type 2 diabetes received instruction on the Plate Method. Participants enrolled in a 4-week, instructor-led diabetes education class completed a 1-hour, nutrition education session using …

Dnp Final Report: Improving School Nurse Confidence In Managing Student Anxiety Through Simulation-Based Training, Jessica Marish

DNP Final Reports

Evidence has shown that students with untreated or poorly managed mental health concerns are at higher risk for absenteeism, psychiatric hospitalization, and school dropout. School nurses are often among the first healthcare professionals students encounter when experiencing emotional distress; however, many report limited preparation in mental health screening, grounding techniques, and referral support. The purpose of this quality improvement project was to determine the feasibility of a simulation-based educational intervention for school nurses in managing student anxiety. Guided by the Johns Hopkins Nursing Evidence-Based Practice Model and Neuman Systems Model, this initiative also included the Plan-Do-Study-Act (PDSA) quality improvement model …

Perceived Effectiveness Of Cigar Warnings Among Young People In The U.S., Leah M. Ranney, Rime Jebai, Michael Jetsupphasuk, Sonia A. Clark, Kristen L. Jarman, Sarah D. Kowitt, Jim Thrasher Ph.D., Ma, Ms, Adam O. Goldstein, Jennifer Cornacchione Ross

Faculty Publications

Introduction: The effectiveness of warning size and format on cigar packaging in influencing youth and young adult smoking behaviors is not well understood. This study tested these cigar warning characteristics among youth and young adults who use or are susceptible to using little cigars or cigarillos.

Methods: The study recruited 506 U.S. youth and young adults, aged 15−20 years, between April and June 2023. Participants reported ever or past 30-day use of little cigars or cigarillos or were susceptible to using little cigars or cigarillos. A 2 £ 2 between-subjects online experiment was conducted where youth and young adults were …

De Novo Complex Genomic Rearrangement Spanning 2q31.1 In A Proband With Congenital Malformations: Genotype-Phenotype Correlation And Development Of A Cgr Detection Pipeline, Katherine Helle, Jesse D Bengtsson, Mira Gandhi, Christopher M Grochowski, Ming Yin Lun, Neha Sudhir, Shalini N Jhangiani, Fritz J Sedlazeck, Seema R Lalani, Neil A Hanchard, Claudia M B Carvalho

Faculty, Staff and Students Publications

The 2q31 region is commonly associated with pathogenic alleles of the HOXD cluster leading to various clinical phenotypes related to skeletal development. We present a proband with tetralogy of Fallot and multiple congenital anomalies. Genomic variant screening including an in-house CGR detection pipeline pairing genome sequencing (GS) structural variant calls with read-depth data revealed a de novo complex genomic rearrangement (CGR) spanning 2.7 Mb across 2q31 characterized by a series of duplications and triplications including the HOXD gene cluster. The genomic structure was assembled by applying combined methodologies including short-read and long-read GS, and optical genome mapping (OGM). This in-house …

​​Hospital-Acquired Pressure Injury Prevention In The Sutter Sacramento Cardiac Care Unit ​Qi Proposal, Angelina Lucido, Amy Roderick, Karly Link

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background: Hospital-acquired pressure injuries (HAPIs) remain a significant source of preventable patient harm despite established prevention protocols. In the Cardiac Care Unit (CCU) at Sutter Medical Center Sacramento, inconsistent patient education and limited patient engagement were identified as potential contributors to ongoing HAPI occurrence. This quality improvement (QI) project evaluated whether implementing structured, individualized patient education could strengthen existing pressure injury prevention efforts.

Methods: A seven-week QI project was conducted in the CCU using the Plan-Do-Study-Act (PDSA) framework. The intervention consisted of nurse-led, individualized pressure injury prevention (PIP) education supported by a standardized patient handout tailored to each patient's risk …

Reducing Falls In The Cardiac Care Unit: An Improvement Project, Andrea Otero, Aryanna Campa, Nia Butac

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Abstract

Background: Patient falls persist as a leading cause of preventable harm in hospitals, particularly among cardiac care patients who are at increased risk because of medication effects and mobility limitations. Despite existing fall `prevention measures in the Cardiac Care Unit (CCU) at Sutter Medical Center, Sacramento, 43 falls occurred, highlighting the need for improved patient education and consistent staff communication.

Purpose: This quality improvement project evaluated the effectiveness of implementing a standardized fall prevention communication script to reduce the average monthly fall rate in the CCU from 3.583 to fewer than 2 falls per month.

Methods: Using the Plan-Do-Study-Act …

Improving Clostridioides Difficile Prevention Practices Through Standardized Stool Collection And Hand Hygiene, Dunya Khateeb, Laura Martin, Jessica Zhang

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Healthcare-associated Clostridioides difficile (C. diff) infections increase patient morbidity, length of stay, and healthcare costs (Simor, 2010). Our quality improvement project seeks to reduce C. diff infection rates and enhance prevention practices on the Med-Acute Unit at Sutter Medical Center Sacramento (SMCS) by utilizing the Plan-Do-Study-Act (PDSA) framework. Interventions will be implemented between March 2026 and July 2026. The project examined whether introducing a standardized stool collection tote and improving hand hygiene compliance would reduce C. diff infection rates. Participants included all nursing staff on the unit. Data is being collected through observational hand hygiene audits, collaboration with the SMCS …

Weathering More Than Storms: Understanding The Mental Health Disparities Of Black Farmers In The Appalachian Region, Aliyah Smith

Electronic Theses and Dissertations

Black farmers in Appalachia represent a vital and historically marginalized population within one of America’s most economically distressed regions. Black farmers have endured generations of systemic racism, resulting in land loss, economic hardship, and mental stressors. This study examines the intersection of race, agriculture, and behavioral health to illustrate how structural barriers and cultural stigmas shape the mental well-being of Black farmers across Appalachia.

Findings from the analysis will guide the development of a conceptual model based on constructs from the Social-Ecological Model (SEM), Intersectionality Theory, and Critical Race Theory (CRT). This study will use Key Informant Interviews (KIIs) conducted …

Wisdom In Counseling And Psychotherapy: A Conceptual Model For Practice, Mitchell Waters

Papers

Wisdom is increasingly recognized as a critical construct in counseling and psychotherapy, yet it remains conceptually diffuse and underdeveloped for clinical application. This article proposes an integrative conceptual model of wisdom that extends the Dialectical Behavior Therapy (DBT) WISE MIND framework by incorporating temporal and self-transcendent dimensions. Wisdom is defined as a dynamic, context-sensitive capacity to coordinate cognitive, affective, temporal, and spiritual processes in response to complex life demands. The model includes four components: (a) cognitive–affective integration, reflecting the synthesis of emotion and reason; (b) temporal integration, involving adaptive coordination of past experiences and future possibilities; (c) self-transcendent orientation, conceptualized …

Staff Education On The Implementation Of An Evidence-Based, Suicide-Risk-Assessment Education Program For Psychiatric Staff, Yemurai Emily Dzikiti

Walden Dissertations and Doctoral Studies

Suicide is a major public health concern, and consistent suicide risk assessment is essential for patient safety in psychiatric settings. This Doctor of Nursing Practice staff education project addressed a knowledge gap in evidence-based suicide risk assessment among psychiatric clinicians in an outpatient mental health setting. The practice-focused question examined whether an evidence-based suicide risk assessment education program would improve clinicians' knowledge from pre- to post-education. The educational intervention consisted of a 60-minute in-person training session on evidence-based suicide risk assessment using the Columbia-Suicide Severity Rating Scale (C-SSRS) and the Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) framework. Ten psychiatric …

Trauma: Cervical Spine Clearance, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Staying Connected In A World Of Constant Communication, Chris Gorecki Dds

Journal of the Macomb Dental Society

This article features a monthly column from the Macomb Dental Society Executive Director, Dr. Christopher Gorecki.

Hyperadhesive Von Willebrand Factor Contributes To Pathogenesis Of Preeclampsia, Yajuan Wang, Chenyu Wang, Katie L Houck, Xiaoli Gao, Yuanyuan Chen, Xin Xu, Xue Zhao, Miguel A Cruz, Shu Zhang, Chester Q Li, Fengxia Xue, Min Li, Swati Shree, Jing-Fei Dong, Cha Han

Children’s Nutrition Research Center Staff Publications

Background: Preeclampsia is the most common complication of pregnancy, significantly affecting maternal and fetal health, and is characterized by placental and systemic endotheliopathy. Patients with preeclampsia have elevated levels of VWF (von Willebrand Factor), which is associated with poor clinical outcomes. However, whether VWF serves as a marker for endotheliopathy or contributes to the pathogenesis of preeclampsia remains poorly understood.

Methods: We investigated the role of hyperadhesive VWF in the development of preeclampsia by studying patients, evaluating mouse models, and performing in vitro experiments.

Results: We show that patients develop VWF- and fibrin-rich thrombosis in the placenta and have significantly …

Bridging Models And Real-World Performance: Capturing Represented, Hidden, And Unrepresented Dynamics In Complex Systems, Dixizi Liu

All Dissertations

Complex systems often depend on adaptive performance that is difficult to capture using structured data or formal models alone. This dissertation asks how predictive modeling, coordination-cost measurement, and simulation can be integrated to better represent the visible, hidden, and unrepresented dynamics that shape real-world system performance.

Sterile Processing Departments (SPDs) provide the empirical context for this work because they support safe and timely surgical care while operating under high workload variability, time pressure, and tight coordination with operating rooms. Hospitals rely on SPDs to clean, assemble, sterilize, and deliver surgical instrument trays so surgeries can start on time and proceed …