Digital Commons Network^™

Supporting Occupational Engagement And Regulation For Pediatric Multiple Sclerosis, Robert E. Oehl 3rd, Zeida Gutierrez

Summer 2026 OTD Capstone Symposium

Children diagnosed with pediatric multiple sclerosis (MS) can face cognitive, physical, and emotional symptoms. The symptoms they experience can be barriers to participation in occupations and activities of daily living. For occupational therapy, there is very limited resources for pediatric MS specifically, and it is almost an unknown diagnosis. Occupational therapy in management can help ensure that children reach their developmental milestones in mobility, grasp, social, cognitive, and academic circles. This capstone project was meant to improve awareness and comprehensive treatment and resources through program development. The capstone experience resulted in a project featuring a webinar about pediatric MS and …

Unleashing Potential: Educating Ot Practitioners On Animal-Assisted Therapy For Children With Cp, Karley B. Smith, Lakeisa Boykin

Summer 2026 OTD Capstone Symposium

The purpose of this capstone project is to develop and evaluate the efficacy of an animal-assisted therapy educational package for occupational therapy practitioners treating children with cerebral palsy. This educational package serves as an adjunctive occupational therapy service to address the ongoing need for engaging, holistic interventions that support motor development and participation. The primary focus of this project is practitioner education and training to promote safe, structured, and clinically sound integration of animal-assisted therapy into occupational therapy practice. The methods for this project included a literature review, informal needs assessment, development of an educational package, QR code video demonstrations, …

A Cooking Skills Intervention For Long-Term Weight Loss In Young Adults With Intellectual Disabilities: Rationale And Design For A Randomized Trial., Lauren T. Ptomey, Jessica C. Danon, Delwyn Catley, Richard A. Washburn, Amy Bodde, Francisco J. Diaz, Brian C. Helsel, Anna M. Rice, Joseph R. Sherman, Madison Koester, Walker S. Mckinney Ph.D., Joseph E. Donnelly

Manuscripts, Articles, Book Chapters and Other Papers

Young adults with intellectual disability (ID) are an underserved population with a high prevalence of obesity, obesity-related health conditions, and reduced ability to complete instrumental and basic activities of daily living (I/ADLs). After leaving the structured environment of public school, many young adults with ID spend more time at home or in day programs, begin living more independently, or enter the workforce. These transitions may increase reliance on fast or processed foods and reduce opportunities for physical activity, contributing to accelerated weight gain. Previous research has demonstrated clinically meaningful short- and long-term weight loss (18-24 months) in adults with mild-to-moderate …

​​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 …

Improving Knowledge Of Obesity-Related Risks And Healthy Lifestyle Behaviors In Adolescents, Tehroop Notra, Samreet Kaur, Karina Heredia

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

This quality improvement project evaluated the effectiveness of a school-based educational intervention aimed at improving ninth-grade students’ knowledge and understanding of obesity prevention, nutrition, and physical activity. Adolescent obesity remains a significant public health concern, showcasing the need for early, evidence-based education. A total of 57 students participated in the two classroom sessions. Of these students, 49 completed the pre-intervention survey, and 48 completed the post-intervention survey. The intervention included an interactive presentation, group discussions, and educational materials. Student knowledge was assessed using a six-item survey administered before and after the session. The results demonstrated improvements across multiple knowledge areas, …

Id-More Vision: Real-Data Machine-Learning Assessment For A Digital-Twin-Inspired, Xr-Ready Rehabilitation Prototype, Rickey L. Clark

Master's Theses

Rehabilitation assessment often relies on periodic observation, while many XR prototypes show scripted rather than recorded-motion evidence. iD-MORE Vision is an offline pipeline trained on KIMORE and IRDS and linked through JSON packets to a two-mode Unity desktop prototype. Both datasets include controls and rehabilitation participants with neurologic, musculoskeletal, or mobility impairments. This improves relevance but does not clinically validate the system.

Under fixed subject-wise splits, the primary five-seed Random Forest predicted KIMORE clinician scores with MAE 6.087 ± 0.044 cTS and R² 0.568 ± 0.006; the subject-level R² interval crossed zero. The primary IRDS five-run CUDA GRU averaged 0.877 …

Characterization Of Catechol-Type Siderophore(S) From P. Mosselii Cfml 90-83, Kemper R. Rasnake

Electronic Theses and Dissertations

Iron is essential for many biological processes, where it is used as a cofactor. Even though it is abundant in the Earth’s crust, it is in an insoluble form unavailable to microorganisms in the soil. To overcome this, bacteria produce siderophores, which are secondary metabolites that have a high affinity for iron. This allows bacterial cells to obtain insoluble iron that is essential for survival. Pseudomonas mosselii, a Gram negative bacterium, was isolated from soil. It was selected for further analysis as it was found to produce siderophore(s) under iron-limited conditions, which have not been characterized previously. Therefore, we aimed …

A Geometric Morphometric Analysis Of Acetabular Shape Variation Across Bat Families, Jordan L. Huff

Electronic Theses and Dissertations

Bats are the only mammals capable of powered flight, and research is concentrated on this adaptation. Their non-flight locomotion has received comparatively little attention. Previous studies show that non-flight locomotor behaviors vary across families. Members of Pteropodidae are efficient climbers but cannot effectively walk, whereas Phyllostomidae and Vespertilionidae are better at terrestrial locomotion but show reduced arboreal capabilities. The non-flight locomotion of Hipposideridae and Rhinolophidae is less understood, although rhinolophids exhibit limited terrestrial locomotion. This study examined whether differences in locomotor behavior are associated with variation in acetabular morphology. A geometric morphometric analysis of acetabular shape was conducted across multiple …

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 …

A Longitudinal Multi‑Proxy Geospatial Classification Of Peri‑Urban Transitions Across Community Health Units In Coastal Kenya, Prissy Makena, Felix Oluoch, Rosebella Iseme, Fredrick Gudda, Alfred Keter, Jai Das, Zulfiqar Bhutta, Anthony Ngugi

Population Health, East Africa

Background Urbanization is spatially heterogeneous in many sub-Saharan African settings. This complicates community health planning when rural and peri-urban labels are applied informally or updated inconsistently. We assessed whether multiple publicly available geospatial proxies could characterize settlement dynamics and support Community Health Unit (CHU) level classification within the Kaloleni Rabai Health and Demographic Surveillance System (KRHDSS) in coastal Kenya.

Methods We conducted a longitudinal ecological analysis across 10 CHUs in Kilifi County with annual observations from 2017 to 2024. Five geospatial proxy indicators of settlement intensity were summarized within CHU boundaries: Visible Infrared Imaging Radiometer Suite (VIIRS) nighttime lights radiance, …

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 …

A Mindfulness-Based Stop Technique Training To Improve Nurses’ Knowledge And Self-Efficacy In Stress And Burnout Prevention, Rukiat Abolanle Afinni

Walden Dissertations and Doctoral Studies

Nurse burnout and stress are well-documented occupational concerns in outpatient clinical settings, where high patient acuity and chronic staffing shortages leave nurses with little structured support for proactive self-care. To address this gap, a mindfulness-based STOP (stop, take a breath, observe, proceed) training program was developed and evaluated for outpatient nurses. The evidence-based practice question was: Among nurses in an outpatient clinical setting, what is the impact of a mindfulness-based STOP technique training on nurses' knowledge of stress and burnout prevention and self-efficacy in applying the technique? A one-group pretest-posttest design was used with eight participants. A project-developed questionnaire measured …

Transfusion Intensity In The Icu: Reasons And Triggers, Merijn Reuland, Senta Raasveld, Jimmy Schenk, Claudia Oord, Sanne Bruin, Caroline Schaap, Andrew Flint, Jan Bakker, Maurizio Cecconi, Marcus Lance

Anaesthesiology, East Africa

Background The reasons and physiological triggers for blood transfusion in critically ill patients are not well characterized. Beyond hemoglobin levels, hemodynamic instability is frequently cited, but its role across clinical contexts remains unclear.

Aims (1) To determine whether reasons and triggers for RBC transfusion differ across intensive care unit (ICU) days with varying transfusion intensity. (2) To describe reasons for non-RBC transfusions across these intensity groups.

Methods This sub-study of the prospective International Point Prevalence Study of Intensive Care Unit Transfusion Practices (InPUT) classified ICU days by transfusion intensity: nonmajor (1 RBC unit), major (≥2 units), and massive (≥6 units …

August 2026, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

• National Wellness Month

• Stress Management Tips for Bulldogs

• Bulldog Resources

• Bulldog Wellness Bingo Challenge

Improving Adherence To Regulatory Standards In A Medicaid-Funded Intellectual And Developmental Disability Setting Through Evidence-Based Nursing Policy Implementation, Waveney R. Lagrone, Ut Health Houston Cizik School Of Nursing

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement (QI) project aimed to improve adherence to health and safety regulatory requirements by implementing an evidence-based nursing policy framework to strengthen documentation consistency and clinical practice in a Medicaid-funded Home and Community-Based Services (HCS) program serving adults with intellectual and developmental disabilities.

Background: A baseline review (January–June 2025) identified documentation and regulatory compliance gaps, including three falls, eight psychotropic medication changes requiring follow-up, two emergency department visits or hospitalizations, and five late or incomplete Comprehensive Nursing Assessments (CNAs), highlighting the need for standardized nursing policies.

Methodology: Guided by the Model for Improvement using Plan-Do-Study-Act …

The Comfort Cart Initiative: A Quality Improvement Intervention To Improve Patient Satisfaction In The Emergency Department, Heidy Cladimir Ayala

Doctor of Nursing Practice Final Project Abstract

The Comfort Cart Initiative: A Quality Improvement Intervention to Improve Patient Satisfaction in the Emergency Department

Purpose

The Comfort Cart QI project aimed to improve Emergency Department patient, parent, and guardian satisfaction by 10% over an 8-week implementation period.

Background

In healthcare, patient satisfaction is an important indicator of the quality of care provided, and many literature reviews suggest it is closely associated with patient-centered care.

 Methodology

The Comfort Cart intervention is an evidence-based quality improvement project employing a pre- and post-intervention design, conducted over an 8-week period, in the Emergency Department. The project was guided by Kolcaba's Comfort Theory …

Integrating Music Therapy Into Post-Surgical Care: A Quality Improvement Strategy For Reducing Post-Operative Anxiety, Yosdania Hernandez Benitez

Doctor of Nursing Practice Final Project Abstract

Integrating Music Therapy into Post-Surgical Care: A Quality Improvement Strategy for Reducing Post-Operative Anxiety

Purpose

This quality improvement (QI) project aimed to reduce postoperative anxiety among adult patients after general surgery in the post-anesthesia care unit (PACU) by 30% using nurse-led music therapy in an ambulatory surgical center.

Results

Mean VAS-A scores decreased from 6.9 (SD = 0.5) pre-intervention to 4.0 (SD = 0.5) post-intervention, representing a 2.9-point (41.9%) reduction in anxiety and exceeding the project's target of 30%. Nurse adherence to the intervention protocol was 100%, and the mean patient satisfaction score was 4.6/5.0. All 100 patients completed both …

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.

The Relationship Between Depression And Cognitive Proficiency Index Across Biological Sex, Angela N. Ferdinardo

Dissertations

Depression is a widely studied mood disorder, and understanding its effect on cognitive functioning has become an important area of research. While research has examined relationships among depression, working memory, and cognitive deficits, limited research has explored depressive symptoms and cognitive proficiency across biological sex. Depression manifests similarly in men and women, though men are more likely to experience irritability, impulsivity, and anger, while women tend to experience sadness, stress, and sleep disturbances (Johns Hopkins Medicine, 2023). Women are also more likely to seek treatment and cope differently than men. This study examined the relationship between depression and cognitive proficiency …

Leveraging Administrative Health Data To Capture Rare Adverse Drug Reactions: Identifying Pediatric Patients With Trimethoprim-Sulfamethoxazole Acute Respiratory Distress Syndrome., Keith Feldman, Jenna Miller, Katherine Doane, Laura Loftis, James W. Antoon, Kevin J. Downes, Jennifer Goldman

Manuscripts, Articles, Book Chapters and Other Papers

Rare adverse drug reactions (ADRs) are underrecognized and underreported in the electronic medical record (EMR). These events often require clinical review, making systematic identification challenging. The study aim was to develop an approach to prioritize identification and validation of a rare ADR to trimethoprim-sulfamethoxazole causing acute respiratory distress syndrome (TMP-SMX ARDS) across medical institutions. We developed a clinical phenotype based on 2 local TMP-SMX ARDS cases mapped to standardized elements of a national comparative healthcare database (PHIS). We validated identification of TMP-SMX ARDS at scale across medical institutions. A set of scoring criteria was created to prioritize cases and generate …

Rural And Urban Availability Of Substance Use Treatment Facilities, Aaron P. Smith, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Rural counties have higher per capita numbers of substance use disorder treatment facilities than urban counties on average, but also greater variability and large pockets of unmet need.

• The highest proportions of residents living in counties without any treatment facilities are concentrated in rural areas within the Midwestern and Southern United States.

• Rural and urban treatment facilities offer medications for opioid use disorder (MOUD) at similar rates, with inpatient facilities most likely to provide MOUD, followed by residential and outpatient settings.

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 …

Concerns With The Statistical Analysis In “Effect Of Combined Glp-1 Analogue And Bupropion/Naltrexone On Weight Loss: A Retrospective Cohort Study”, Thirupathi Reddy Mokalla, Henry T Robertson, Sherri Pals, David B Allison

Children’s Nutrition Research Center Staff Publications

No abstract provided.

All-Cause And Cause-Specific Mortality In Gambling Disorder: Evidence From A Nation-Wide Matched And Sibling Cohort Study In Taiwan, Yang-Chieh Brian Chen, Chih-Wei Hsu, Liang-Jen Wang, Mu-Hong Chen, Yao-Hsu Yang, Chih-Sung Liang, Edward Chia-Cheng Lai

Children’s Nutrition Research Center Staff Publications

Background and aims: Gambling disorder (GD) has been linked to suicidal ideation and suicide deaths; however, evidence on all-cause and cause-specific mortality-particularly in Asian populations-remains limited. Using a retrospective cohort study based on nationwide matched and sibling cohort, we investigated all-cause and cause-specific mortality risk in patients with GD.

Design, setting and participants: A retrospective cohort study was conducted using 2000-2022 data from Taiwan's National Health Insurance Research Database. A cohort of 961 individuals diagnosed with GD was identified. An age- and sex-matched control cohort (n = 3,844) and an unaffected sibling cohort (n = 675) were constructed. Cumulative survival …

The Invisible Work: On Expertise, Showmanship, And The Trust That Makes Surgery Work, Anish Gupta D.D.S.

The Journal of the Michigan Dental Association

This commentary examines how clinicians can make their expertise more visible to patients through communication, education, and clinical narration. Drawing parallels to surgical checklists and professional mastery, the author argues that trust is built not only through excellent outcomes but also through helping patients understand the complexity and judgment behind treatment. The article emphasizes communication, transparency, education, and mentorship as important elements of patient-centered care.

From The Editor: Is Giving Actually Better Than Receiving?, Romesh Nalliah

The Journal of the Michigan Dental Association

This editorial examines the relationship between generosity, volunteerism, and well-being. Using the Michigan Dental Association Foundation’s Mission of Mercy as a focal point, the author highlights research suggesting that prosocial behavior can improve mental and physical health while benefiting communities in need. The article encourages oral health professionals to use their skills and resources to support underserved populations through volunteer service, mentorship, and community engagement.

Mission Of Mercy: Restoring Smiles With Dignity, Anne Berquist

The Journal of the Michigan Dental Association

This feature chronicles Michigan’s 2026 Mission of Mercy clinic, where more than 1,200 volunteers provided 5,656 procedures to 771 patients. The article describes patient experiences, volunteer contributions, and the extensive planning required to transform a sports arena into a temporary dental clinic. Beyond oral healthcare delivery, the program restored confidence, relieved pain, and highlighted the dental profession’s commitment to serving underserved populations.