The First Cut Is The Deepest: Understanding Learner Trauma In The Emergency Medicine Clerkship, Dimitrios Papanagnou, Leela Raj, Karen E. Watkins, Xiao C. Zhang, Andres Fernandez, Md, Victoria J. Marsick

Department of Emergency Medicine Faculty Papers

BACKGROUND: As third-year medical students transition into high-stakes, high-stress clinical environments like the emergency department (ED), they may experience significant personal trauma. However, little is known about how this trauma is experienced early in their training - specifically during the transition from preclinical to clinical learning environments. This study addresses that gap by exploring third-year medical students' experiences of trauma during the emergency medicine (EM) clerkship through the lens of Trauma-Informed Care (TIC) and identifies workplace factors and intersectional demographics influencing these experiences.

METHODS: This qualitative study used the critical incident technique to explore emotionally-significant events encountered by third-year medical …

Exploring Stem Cell-Based Approaches To Ameloblast-Like Cell Development: Progress And Limitations In Enamel Formation, Ava L. Abruzzese

Honors Scholar Theses

Enamel is one of the most critical structural components of the tooth. As the outermost layer, it serves as a protective barrier, shielding the underlying dentin and dental pulp from physical trauma and mechanical forces. The formation and mineralization of enamel are regulated by specialized cells known as ameloblasts. Once enamel maturation is complete, these cells undergo apoptosis. Consequently, enamel lacks the capacity for natural regeneration after damage or erosion, which can result from various environmental factors. When enamel is compromised, current clinical interventions focus on preventing further deterioration rather than true regeneration. These approaches include the use of remineralizing …

Implementation Of A Standardized Short Stay Pain Protocol To Reduce Pain In Short Term Care Facility, Maggie O'Brien, Kenzie Reuter, Holly Hansen, Elle Wichmann

Celebrating Scholarship and Creativity Day (2018-)

Pain is a common symptom across all areas of nursing care, yet it is often undertreated in skilled nursing facilities, particularly among residents receiving rehabilitation services. Pain in this population may result from a variety of causes, including musculoskeletal conditions, wounds and pressure injuries, neuropathic pain, and chronic illnesses. A review of Minimum Data Set (MDS) reports and resident pain reports from the short-term rehabilitation unit revealed a concern of disparity. Long-term care residents demonstrated strong quality indicator scores (9.21 out of 10), while short-term stay residents scored significantly lower (2.76 out of 10). This discrepancy raised concerns about pain …

Probing The Roles Of Connexin 43 Hemichannels In A Mouse Model Of Alzheimer's Disease, Madison Treasure-Areno

All Graduate Theses and Dissertations, Fall 2023 to Present

Alzheimer’s disease is a progressive disorder involving neuronal death and cognitive decline, such as memory loss and changes in personality. One feature of the disease is buildup of abnormal protein called amyloid-beta in the brain. Amyloid-beta may activate support cells called astrocytes, triggering them to release large amounts of chemicals, possibly harming nearby cells. This study set out to examine the roles of the channels on astrocytes involved in releasing these chemicals, called connexin 43 hemichannels. Using a mouse model of Alzheimer’s disease, this study blocked the hemichannels using the drug Tonabersat, and measured spatial learning and memory in a …

Recommendations For Sharing Cardiovascular Implantable Electronic Device Data With Patients Based On Clinician Interviews, Carly Daley, Jonathan Shirazi, Tina Allmandinger, Mindy Flanagan, Stephanie Pruitt, Hung-Yeh Lin, Victor P. Cornet, Jeanne Carroll, Yi Rong Tan, Tammy Toscos, Michael Mirro

Health Services and Informatics Research

BACKGROUND Cardiovascular implantable electronic devices (CIEDs) capture an abundance of data that requires specific medical knowledge to interpret. Currently, there are no clear recommenda tions for sharing clinically meaningful CIED data with patients from the abundance of data in CIED remote monitoring reports.

OBJECTIVE The objectives of this study were to explore clinicians’ perceptions of clinical care gaps related to CIED data that could be improved through patient access to data and to generate recom mendations for sharing CIED data with patients.

METHODS In this institutional review board-exempt, 2-phase sequential qualitative study, 42 semi-structured phone interviews were conducted with 32 …

Neuropsychological Functioning And Coping Strategy Intervention Approaches In Youth With Posttraumatic Stress Disorder, Kalliopi Megari, Dimitra V. Katsarou, Georgios A. Kougioumtzis, Evangelos Mantsos, Maria Sofologi, Agathi Argyriadi, Alexandros Argyriadis, Efthymia Efthymiou

All Works

Background: Posttraumatic stress disorder (PTSD) in ages 3–18 is associated with disturbances in attention, working memory, processing speed, and executive control, as well as persistent difficulties in affect regulation. These neuropsychological vulnerabilities might interfere with learning, peer relationships, and the consolidation of age-appropriate developmental skills. Methods: We conducted a narrative review informed by a structured literature search in PubMed, Scopus, PsycINFO, Embase, EBSCOhost, Web of Science, and Google Scholar. English-language publications from 1990 to 2025 were considered if they examined (1) neuropsychological outcomes of trauma exposure or PTSD in youth and/or (2) interventions with potential to modify neurocognitive or affective …

Relationship Between Disordered Eating Behaviors And Sport In Female Collegiate Athletes, Elizabeth Files

General Human Environmental Sciences Undergraduate Honors Theses

Disordered eating behaviors and body image concerns remain prevalent among collegiate athletes, yet the role of sport type and sport-related environmental factors, such as uniforms, is not fully understood. The purpose of this study was to examine the relationship between sport type, uniform perception, and disordered eating behaviors among female collegiate athletes at the University of Arkansas. A quantitative, non-experimental design was used, with 36 athletes completing an anonymous Qualtrics survey incorporating demographic questions, uniform perception items, and the Eating Disorder Examination Questionnaire Short Form (EDE-QS).

Descriptive analyses indicated a predominantly young (ages 18–21), White, and underclassman sample. Chi-square analyses …

Prefrontal Engagement In Cognitive Flexibility Across Paradigms, Katarina Kalajzic

Honors Scholar Theses

Cognitive flexibility is an executive function that involves dynamically adapting behavior in the face of changing environmental circumstances to achieve a particular goal. Disrupted in numerous psychiatric disorders such as Alzheimer’s disease, schizophrenia, OCD, and depression, the neural correlates of cognitive flexibility are not well understood. However, the prefrontal cortex (PFC) is strongly implicated in executive function and attentional control processes. Thus, we sought to examine the neural circuitry involved in distinct cognitive flexibility tasks – the attentional set-shifting task and the probabilistic 2-armed bandit task. Through optogenetic suppression, we targeted pyramidal neurons of the rodent medial prefrontal cortex, an …

Factors Affecting Pedestrian-Vehicle Conflicts: An Empirical Analysis, Christo D. Jamo

Honors Scholar Theses

The number of pedestrian deaths increased by 78% between 2009 and 2023, while other motor vehicle crash deaths increased by 13% in the same period [1]. To identify potential pedestrian safety measures, this study analyzed the effects of location-based demographics, pedestrian phasing type, and other physical infrastructure and behavior variables on the probability of pedestrian-vehicle conflicts at signalized intersections, which is a surrogate measure of crash risk. Data were collected from 55 intersections in Connecticut, and the pedestrian-vehicle interactions were classified by severity based on the Swedish Traffic Conflict Technique: undisturbed passage, potential conflict, minor conflict, or serious conflict. Because …

Diagnostic Ability Of Rate Of Torque Development For Patellofemoral Pain, Arun Loganathan, Neal R. Glaviano Phd, Sungwan Kim Phd

Honors Scholar Theses

Context: Patellofemoral pain (PFP) is a highly prevalent condition (22.7% in general population) that significantly impacts the quality of life of those who suffer from it. However, there is no gold standard test to diagnose it yet, leading to inconsistencies with treatment as well as delayed intervention. Rate of torque development (RTD) is a neuromuscular measure that has shown strong connections to PFP.

Objective: The purpose of this study is to determine the diagnostic ability of RTD for PFP.

Design: Cross-sectional.

Setting: Laboratory.

Participants: Thirty-five individuals with PFP (24 males and 11 females, 22.7 ± 3.7 years, 1.67 ± 0.1 …

Undergraduate Nursing Students’ Reactions To Germ Exposure Based On The Big 5 Personalities, Elizabeth Macdonald

Honors Scholar Theses

Despite extensive didactic and clinical training, variability in adherence to infection prevention practices in undergraduate nursing students exists. Individual differences, such as personality, may help to explain this inconsistency. The purpose of this study was to examine the extent to which the Big Five personality traits were associated with self-reported pathogen mitigation or avoidance behavior in undergraduate nursing students. An online survey design was used with undergraduate nursing students. Participants were presented with scenarios depicting different pathogen exposures and asked to indicate their likelihood of engaging in pathogen mitigation behaviors. The Big Five personality traits were also assessed, and bivariate …

Tips For Health Care Practitioners: A Guide For Adolescent Obesity, Regina Santana

Electronic Theses, Projects, and Dissertations

Adolescent obesity continues to be a significant public health concern that is associated with long term physical consequences. The purpose of this project was to develop an evidence based, user friendly guidebook that supports healthcare professionals in the education of adolescents with obesity and their families. A structured literature review development process was used to inform the current development of the guidebook. The guidebook includes components of obesity management such as nutrition and physical activity recommendations. The validity of the content was established through the evaluation of five healthcare professionals that include registered dietitians and licensed therapists. The guidebook was …

Easy Travel-Friendly Snack Recipes For College Students To Support Mental Well-Being, Lidia Vides

Electronic Theses, Projects, and Dissertations

College is a pivotal period in life of a young adult, marked by newfound independence, increased responsibilities, heightened academic pressure, and significant changes in daily routine. While this transition can often be exciting for a young adult, it also presents many different challenges. As a result, many students experience increased levels of stress, anxiety, and depression. Nutrition plays a powerful yet often overlooked role in supporting mental and physical health. Current research studies show that a balanced diet rich in whole food ingredients can help regulate mood and promote emotional well-being through multiple biological pathways. However, despite this knowledge, convenient, …

Examining Physical Activity Behaviors And Associated Health Indicators In College Students, Elizabeth A. Reyes

Electronic Theses, Projects, and Dissertations

Background: Physical activity (PA) is a critical determinant of both physical and mental health, yet many individuals fail to meet recommended guidelines. College students face increasing challenges related to physical inactivity, elevated stress levels, and poor sleep quality, all of which negatively impact their overall health and academic success. College students who fail to meet recommended PA guidelines are at an increased risk of chronic diseases. This study aimed to examine patterns of PA among college students and explore associations with sleep quality and perceived stress.

Methods: A cross-sectional design was employed using a self-administered questionnaire that included items on …

Glucagon-Like Peptide-1ra As A Public Health Interventions, Briana Sepeda

Electronic Theses, Projects, and Dissertations

Glucagon-like peptide receptor agonist (GLP-1RA) medications have become a prominent topic of interest both in clinical medicine and broader societal discussions. Although the medication are relatively new and expensive, ongoing research continues to explore pharmacologic modifications aimed at improving therapeutic effectiveness and prolonged drug half-life. GLP-1RAs have gained significant traction due to their ability to lower glycosylated hemoglobin (A1c) and blood glucose levels in individuals who have been diagnosed with type 2 diabetes (T2D). In addition to glycemic control, evidence suggests its associations with appetite suppression, weight loss, reducing cardiovascular disease, improved renal dysfunction, neuroprotective effects related to neurodegenerative disease …

University Student Mental Health: Service Utilization, Equity Gaps, And Strategies To Improve Access, Richard Mutua Kilonzo

Electronic Theses and Dissertations

Student mental health and access to care are pressing concerns in higher education. This study assesses mental health outcomes and access to campus mental health services at East Tennessee State University. Survey data from the 2023–2024 Healthy Minds Study were analyzed to report the prevalence of depression, anxiety, and suicidal ideation across the student population. The study evaluates disparities in these outcomes and barriers to care across student groups, with particular attention to equity-impacted students, especially sexual and gender minority students.

Findings indicate widespread psychological distress alongside persistent barriers, including long wait times, limited-service availability, and stigma-related concerns. These barriers …

Malnutrition And Frailty Risk Among Community Dwelling Older Adults In Northeast Tennessee, Shreeyesha Pradhan

Electronic Theses and Dissertations

Frailty and malnutrition are prevalent conditions among community-dwelling older adults, affecting approximately 10% and 25% of this population, respectively. Despite overlapping symptoms such as functional decline, their relationship remains underexplored in community dwelling older adults. This cross-sectional feasibility study examined the association between frailty and nutritional status among 47 older adults in the East Tennessee Tri-Cities area using the Fried’s Frailty Phenotype (FFP) and the Mini Nutritional Assessment-Long Form (MNA-LF®). Results indicated 13% were pre-frail, 24% were frail, 21% were at risk for malnutrition, and 2% were malnourished. Regression analyses revealed that self-perceived nutritional status (37.6%), daily meal frequency (29.0%), …

Feasibility Of Assessing Dietary Patterns And Anxiety In College Students: A Pilot Study Using Nutrition Questionnaires, Gad-7, And Asq, Kylie Ford

Electronic Theses and Dissertations

Anxiety is highly prevalent among college students representing a significant public health concern. Research indicates that dietary patterns may influence mental health outcomes; however, the practicality of collecting comprehensive dietary and psychological data in college populations remains unclear. This pilot study assessed the feasibility of evaluating dietary patterns and anxiety using self-report instruments. Participants completed the Nutrition and Eating Habit questionnaire, the Generalized Anxiety Disorder-7 (GAD-7), and the Anxiety Sensitivity Questionnaire (ASQ). Although twenty-one students were recruited, survey completion rates were low, with only seven participants completing the nutrition questionnaire necessary to calculate the Dietary Inflammatory Index (DII). Descriptive analyses …

Ethical Engagement In Global Missions: A Qualitative Inquiry Into Planner Motivations And Host Experiences, Harrison J. Ihrig

Electronic Theses and Dissertations

Short-term mission (STM) trips are limited duration service experiences, commonly organized by faith-based organizations (FBO), in which volunteers travel domestically or international to provide ministry, community outreach, and/or health-related services. In recent decades, the number of these trips organized by organizations in the United States has increased exponentially, but the phenomenon is difficult to accurately measure due to its decentralized nature and the lack of standardized terminology. Despite their prominence, limited research has been conducted to examine planning, implementation, and evaluation processes of international STMs organized by FBO, particularly through a public health lens. The purpose of this study was …

Children’S Resilience After A Wildfire: Clinical Themes Of An Art Therapy-Based Curriculum, Rebecca Cuellar, Colter Engber, Gina Robinson, Chloe Seeger, Jenna Siteman, Charliemagne Tapia, Ethel Zafranco

LMU Theses and Dissertations

The present study explored the efficacy of an art therapy-based resilience curriculum for elementary school students in educational settings, whose communities have been impacted by the 2025 Eaton Canyon Wildfires. This art therapy-based curriculum aims to promote post-disaster recovery for early elementary students affected by wildfire-related stress by using a particular focus on traits of resilience. To measure the efficacy of this study, a mixed methods research approach was conducted to evaluate the curriculum’s impact in building resilience. The study uses early elementary student surveys using a Pre/post Emoji Survey, a modified Emoji Current Mood and Experience Scale (ECMES), teacher …

May 2026 News You Need, David Foe

The Journal of the Michigan Dental Association

This source provides comprehensive updates on organized dentistry, including the appointment of Dr. Nader A. Nadershahi as the new ADA executive director. It reports on the MDA's current membership market share, which remains high at approximately 70% despite national trends. Significant health topics covered include Mental Health Awareness Month resources like the Well-Being Index and a patient fact sheet linking oral health to systemic conditions like heart disease and diabetes.

J Mich Dent Assoc May 2026

The Journal of the Michigan Dental Association

Each month, the Journal of the Michigan Dental Association delivers news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200-plus members. It remains the main publication reaching Michigan dentists and is available worldwide through ADA Commons.

The May 2026 (Volume 108, No. 5) issue of the Journal is published in print format to provide updates and insights for Michigan's oral health community and MDA members. Print editions occur every other month beginning with January.

The May 2026 issue of the MDA Journal introduces Dr. Melanie Mayberry as the new association president, highlighting her …

How Are Women Dealing With Polycystic Ovary Syndrome?, Adrianna A. Brown

Electronic Theses, Projects, and Dissertations

Background and Aims: PCOS is one of the leading multisystem conditions among women of reproductive age. Dietary changes may help improve outcomes associated with PCOS and its comorbidities. While a lower carbohydrate, moderate protein diet is often recommended, those with PCOS often use temporary diets or dietary supplements instead of or in addition to prescription medications due to dissatisfaction with their treatment options. Additionally, studies examining the usefulness of supplements and their effects on PCOS symptoms are lacking. This study explored the prevalence of use of temporary diets, prescription medications, and dietary supplements among women with PCOS.

Methods: An anonymous …

The Effects Of Administration Policies On Patient Care Quality And Healthcare Service Costs, Rajveer Kaur

Electronic Theses, Projects, and Dissertations

This study examines how administrative policies in U.S. healthcare systems affect patient care quality and service costs. It addresses a gap by analyzing the combined effects of policy, leadership, and technology on both clinical outcomes and financial performance. Using a qualitative descriptive approach guided by the PRISMA protocol, the study systematically identified and analyzed eighteen peer-reviewed articles. The findings show that value-based purchasing policies relate to improved patient safety indicators. Standardized clinical protocols and workforce competency initiatives strengthen care consistency and reduce hospital readmissions. The use of digital health technologies, such as telehealth and predictive analytics, helps optimize resources and …

Associations Between Water Intake, Dietary Quality, And Beverage Consumption Among University Students, Mohammad A. Qazi

Electronic Theses, Projects, and Dissertations

Title: Associations Between Water Intake, Dietary Quality, and Beverage Consumption Among University Students

Background and Aims: Sugar-sweetened beverage (SSB) and ultra-processed food (UPF) consumption significantly contribute to chronic disease risk and is often more common in underserved and racially/ethnically diverse communities. Drinking water is a low-cost, calorie-free behavior that may support healthier beverage and dietary patterns. Previous studies show that increased daily water consumption positively correlates with better diet quality and is inversely correlated with SSB and UPF consumption. This study aims to examine whether (1) increased daily water intake is associated with self-reported diet quality and (2) self-reported hydration …

Promoting Influenza Vaccination Among College Students, Wajeeha Khan Valley

Electronic Theses, Projects, and Dissertations

Influenza remains a significant public health concern on college campuses, where high population density, shared living environments, and frequent social interaction increase the risk of viral transmission. Despite the availability of safe and effective influenza vaccines, vaccination rates among college-aged students remain consistently low. Many students underestimate their personal risk for influenza and hold persistent misconceptions regarding vaccine safety, effectiveness, and side effects. The widespread use of social media further influences these attitudes, as misinformation can rapidly spread while credible health messaging often struggles to gain visibility. It is important to eliminate vaccine hesitancy among college students through innovative, behavior-focused …

Targeting The Dorsolateral Prefrontal Cortex With Transcranial Direct Current Stimulation To Improve Depression And Anxiety In Parkinson's Disease, Brock Renicks

Honors Theses

The aim of this study is to observe the outcomes of transcranial direct current stimulation (tDCS) as a treatment for Parkinson’s Disease (PD). This study will primarily look at changes in depression and anxiety, as these symptoms are often comorbid with Parkinson’s Disease. Transcranial direct current stimulation is a non-invasive, very low-intensity form of electrical stimulation of the brain. It is being increasingly used as a form of treatment for Parkinson’s Disease and depression and anxiety, however the literature is ambiguous, showing mixed results throughout various studies, with no standardization of tDCS administration. To determine the effect of tDCS on …

A Program Evaluation Of A Family-Based Healthy Weight Program For Overweight And Obese Children And Their Families, Ashley Heimbouch, Margaret Platel, Kelly Betts

Doctor of Nursing Practice Projects: College of Nursing

This project’s purpose was to complete a program evaluation of the Building Healthy Families (BHF) program to determine its effect on children and their families’ health outcomes. The specific aims of success were 1) an improved perception of health-related quality of life for children and parents and 2) decreased body mass index (BMI) percentiles for age and sex in children from baseline measurements and scores compared to measurements and scores at 3 months and 6 months of program completion. The project was completed in a community setting on the University of Nebraska Medical Center’s Western Nebraska campus, and the population …

Platelet Gαz Regulates Ovarian Tumor Growth And Mediates The Effects Of Chronic Stress, María G. Torres Carrizalez

Dissertations and Theses (Open Access)

Ovarian cancer is the most aggressive gynecologic cancer, with 12,450 estimated deaths in 2026. Elevated platelet counts are commonly observed in patients with ovarian cancer and are associated with enhanced tumor growth and poor prognosis. Patients with ovarian cancer are frequently exposed to elevated levels of stress, which has been correlated with accelerated disease progression and increased mortality. Interestingly, the platelet Gαz protein is activated by epinephrine through the α2A-adrenergic receptor, suggesting a potential mechanistic link between stress signaling and platelet-driven tumor progression. To investigate this, I evaluated the role of platelet Gαz in ovarian cancer using control (Gz^{fl/fl …}

Learning About The Direct Experiences Of Very Young Children With Hearing Loss: A Feasibility Study, Jenni M. Funk

Undergraduate Honors Capstone Projects

We aimed to explore the feasibility of employing a developmentally appropriate, modified puppet interview method to elicit thoughts and perspectives directly from very young children (ages 3 to 6 years old) who are deaf or hard-of-hearing. Little is known about the direct experiences of children with hearing loss, making it difficult to improve care. In our field of speech and hearing sciences, there is no current method of gathering direct experiences of young children and placing them at the center of care. We proposed that researchers may be able to learn about the direct experiences of very young children who …