Digital Commons Network^™

Multisystem Predictors Of Dynamic Gait Stability Across Fall Risk In Older Adults, Ashwini Kulkarni, Neda Moghim, Ross Gore, Soumya Banerjee, Christopher K. Rhea, Brittany Samulski

Rehabilitation Sciences Faculty Publications

Gait stability arises from interactions between physiological, cognitive, and psychological systems, yet these domains are often assessed in isolation. This study examined multisystem predictors of anteroposterior margin of stability during walking (MoSAP) in community-dwelling older adults. Of 340 participants, 143 were retained after data quality screening (105 females; age: 70.8 ± 7.8 years). Participants completed the Physiological Profile Assessment (PPA), cognitive testing using Montreal Cognitive Assessment (MoCA), fear-of-falling evaluations using Modified Falls Efficacy Scale (MFES) and a biomechanical gait assessment during preferred and fast speeds. Participants were stratified into four PPA-based fall-risk groups: low, mild, moderate, and high risk. MoSAP …

Enhancing Leisure Opportunities For People With Disabilities In Rural Communities, Joslyn Mary Nordmark

Occupational Therapy Capstones

Purpose. The purpose of this scholarly project was to promote access to leisure opportunities for people with disabilities in rural areas. The author addressed unmet needs among this population considering personal, occupational, environmental, cultural, and socioeconomic factors. The goal was to develop a product that provided opportunities regardless of abilities to promote leisure exploration and participation, social engagement, and life skill development for people with disabilities

Methods. The author conducted a needs assessment through a literature review following the Model of Human Occupation (MOHO), collaborations with site staff, and an on-site observation and environmental analysis. Data was examined to identify …

Increasing Leisure Exploration In Older Adults As They Age, Jackie Middendorf

Occupational Therapy Capstones

Background: As individuals age, it is common for them to experience deficits that impact how and where they age (Dieuleveult et al., 2017; Nakahara & Yokoi, 2024; Park et al., 2021; Rimland et al., 2016; Szanton et al., 2016). These deficits commonly impact functional mobility and their ability to complete self-cares, leading to them having to leave their homes or receive services (Dieuleveult et al., 2017; Feller & Baker, 2022; Lindquist et al., 2021; Mayo et al., 2021; Spang et al., 2024). Along with deficits with functional mobility and self-cares, older adults experience decreases in their social engagement and leisure …

Quality Of Life Of Individuals Residing In Senior Living Facilities, Meagan R. Danda

Occupational Therapy Capstones

Introduction: Formal caregivers play an essential role in supporting residents’ physical, emotional, and social needs which contribute to overall health and well-being (Spilsbury et al., 2024). Due to these responsibilities, caregivers need to be properly equipped with the knowledge and skills necessary to perform clinical duties with confidence. The purpose of this scholarly project is to develop a product that increases caregiver confidence by providing caregivers with occupational therapy informed education. By enhancing caregivers’ knowledge and skill set, this product may contribute to a supportive environment that fosters resident engagement in meaningful occupations and promotes improved quality of life (QoL) …

Watching Over Cold Waves: The Influence Of Social And Technology Surveillance On Independent Older Adults’ Safety, S M Ashfaqur Rahman

All Graduate Theses, Dissertations, and Other Capstone Projects

Cold waves pose a recurring and serious hazard for independently living older adults, yet the monitoring arrangements that shape their protective responses remain understudied. This study examined how social surveillance, defined as check-ins and support from family, neighbors, and community contacts, and technological surveillance, defined as weather applications, smart devices, and emergency alert platforms, jointly and independently predicted cold-wave safety behavior. A cross-sectional, exploratory mixed-methods design was employed. One hundred independently living adults aged 65 and older, residing in cold-prone U.S. states, completed a survey measuring monitoring frequency, source trust, perceived autonomy, concern across six cold-wave hazard types, and a …

Evaluating The Burnout Mitigating Effects Of A Structured Mentorship Program In Newly Hired Advanced Practice Providers, Melissa Soper

DNP Projects

Importance: Burnout is a leading driver of clinician intent to leave, lower productivity, increased medical errors, and increased resource use.

Objective: The purpose of this project was to evaluate the effects of an evidence-based mentorship program on newly hired advanced practice providers’ (APPs’) level of stress, burnout, and professional fulfillment.

Results: At baseline, APPs demonstrated higher stress levels, moderate professional fulfillment, and low burnout. Outcomes showed improvement at the end of a mentorship program.

Conclusion: Longitudinal studies with larger sample sizes are needed to determine the true effect of a 6-month mentorship intervention on APP burnout, stress, and professional fulfillment.

Designing Narrative-Based Ai Assistance For Sensemaking In Collaborative Environments: Case Studies In Education And Dementia Care, Dylan Edward Moore

Dartmouth College Ph.D Dissertations

This thesis addresses a gap in the human-computer interaction literature regarding the design, development, and evaluation of narrative-based AI assistance for collaborative, complex problem solving. I explore this design space through three case studies across the domains of education and dementia care. This work encompasses multi-year industry partnerships and longitudinal fieldwork, user-centered design, dataset curation, model training, and system evaluation.

Specifically, the first case study considers a story-based web platform for teaching AI literacy through peer-generated, personalized narrative scaffolding. Learners on the platform showed significant knowledge gains and other learning-related outcomes. To describe the novel design of this system, I …

Adipose Tissue-Derived Small Extracellular Vesicles In Plasma Reveal Molecular Circuitries Underlying Glucose Intolerance, Shalini Mishra, Yixin Su, Ashish Kumar, Sangeeta Singh, Brian S. Finlin, Fang-Chi Hsu, Jingyun Lee, Cristina M. Furdui, Philip A. Kern, Swapan K. Das, Gagan Deep

Internal Medicine Faculty Publications

Objective: Glucose tolerance (GT) is a major effector for adipose tissue (AT) remodeling in obesity, yet its molecular mechanisms remain incompletely defined. We hypothesized that the biophysical and molecular profiles of AT-derived small extracellular vesicles (sEV^AT) change in response to glucose availability and differ by GT status.

Methods: sEV^AT were isolated from plasma of individuals with normal GT (NGT) and impaired GT (IGT) (n = 5/group) at fasting (0 h) and 1 h post glucose challenge during oral glucose tolerance test (OGTT). sEV^AT were characterized for size, concentration, surface expression of insulin receptor-α (INSRα), proteome, …

Eastern Michigan University, Spring Commencement, May 2, 2026, Eastern Michigan University

Commencement Programs and Materials

No abstract provided.

Does One Size Fit All? Well-Being Environmental Assessment Criteria In Low- And Middle-Income Aging Communities In Thailand, Sujitra Jiravanichkul, Sarin Pinich, Atch Sreshthaputra, Trirat Jarutach

NAKHARA (Journal of Environmental Design and Planning)

The effectiveness of well-being environment assessment criteria for aging communities in diverse contexts, particularly in developing countries, remains underexplored. This study aimed to fill this gap by employing Thailand Well-Being Environment and Age-Friendly Communities criteria to assess the living environment of 15 low- and middle-income aging communities in Thailand and determine their well-being status. The results of the overall quantitative assessment showed an average score of 60.78/100. Findings indicated high scores in categories such as healthy food environment, community open space, community asset, and street lighting, indicating a strong foundation for the well-being of low- and middle-income communities. Medium-scoring categories …

Speaking Up Online And Offline: The Effects Of Social Media-Based E-Portfolios In Empowering Efl Students' Speaking Performance, I Putu Indra Kusuma, Luh Indrayani

Journal of Educational Technology Development and Exchange (JETDE)

Although e-portfolios are widely acknowledged for enhancing EFL students’ speaking skills, most studies assessed performances offline, leaving limited evidence of their impact across both modes. This study examined the effects of social media-based e-portfolios combined with classroom instruction on students’ speaking performance in online and offline contexts. A mixed-methods experimental design was employed, involving 46 Indonesian university students divided into an experimental and a control group. Data were collected through online and offline pre- and post-speaking tests, a speaking performance rubric, and semi-structured interviews. Quantitative analysis using One-Way MANOVA, Univariate ANOVA, paired sample t-test, and effect size revealed significant improvements …

Expanding The Boundaries Of Bedside Practice: Transport Nursing As A Living Model Of Clinical Nurse Specialist Competencies, Ian A. Lane

Faculty Publications (Peer-Reviewed)

Objectives: The purpose of this paper is to argue that clinical nurse specialist (CNS) education represents the most conceptually and professionally continuous advanced practice pathway for critical care transport nurses, and to highlight transport nursing as an underrecognized practice context that aligns closely with CNS competencies and warrants deliberate attention from CNS educators and programs.

Description:  This paper presents a conceptual analysis of transport nursing through the CNS spheres of influence, emphasizing continuity with bedside nursing expertise while extending into quality improvement and systems leadership. This perspective examines how transport nurses routinely navigate high-acuity clinical cases and interfacility system constraints. …

Increased Mortality And Reduced Survival In Nonagenarians With Hip Fractures: Implications For Geriatric Care, Roman Austin, Julio Avila, Audrey Wassef, Kate Parker, Katherine Gavin

Western Journal of Orthopaedics

Background: Hip fractures in nonagenarians (patients aged ≥ 90 years) are becoming increasingly common as the population ages, yet outcomes in this group remain poorly characterized. This study compared in-hospital mortality and survivorship at three months, six months, and one year after hip fracture surgery in nonagenarians with a younger elderly cohort aged 65 years to 89 years. Secondary outcomes included fracture characteristics, surgical management, and discharge disposition. Methods: A retrospective chart review was conducted on patients who underwent hip fracture surgery at a single Level I Trauma Center from August 2019 to December 2021. Patients were grouped into nonagenarians …

Resilience Shields And Grit Intensifies Subjective Cognitive Decline In Middle‐To‐Older Aged Black Americans, Sunkanmi Folorunsho, Maria Clark, Obinna Odo, Yolanda L. Jackson, Candidus C. Nwakasi, Darlingtina K. Esiaka

Behavioral Science Faculty Publications

Background: There is growing interest on the relationship between psychosocial factors and cognitive health trajectories in adulthood. While grit and resilience have been shown to influence health outcomes, their differential effects on subjective cognitive decline (SCD) in Black American adults remain understudied. The purpose of this study is to help fill this gap.

Methods: The study utilized a cross-sectional research design. Black American participants (N = 242; Mean age = 44.32) responded to a survey assessing SCD, grit, resilience, and sociodemographic factors. Linear regression analysis was performed to test the associations between grit and resilience and SCD, and to …

Why Person-Environment Fit Matters When Addressing Homelessness: An Intersectional Analysis Of King County, Washington’S Coordinated Entry System, Cori L. Cafaro

Theses and Dissertations from DePaul University

Coordinated Entry (CE) systems aim to address homelessness by allocating resources based on need and prioritizing the most vulnerable individuals. However, system success depends on appropriately matching people to housing. This study examined person-environment fit (P-E fit) and associated housing outcomes for single adults matched to permanent supportive housing through King County, Washington's CE for All system, with intersectionality as a secondary lens. This was a secondary analysis using Qualitative Content Analysis of interview and focus group transcripts from tenants (n = 18), staff (n = 27), and policy leaders (n = 11). Five dimensions of fit emerged as consequential …

How Do Individual And Environmental Covariates Impact The Immune Response Of Deer Mice In Western Montana?, Rachel A. Throckmorton, Angela Luis

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Sin Nombre Virus (SNV) is an exceptional model system for studying wildlife disease because of how simple it is to capture, take samples, and obtain disease status from the primary host. Immune response is an important factor to consider when testing for SNV because it can affect susceptibility of the host as well as transmission of the virus. We examined individual and environmental conditions that may predict immune response and therefore possibly SNV transmission in wild populations. We investigated whether SNV infection status, reproductive status, sex, and season correlate with immune response through examining total white blood cell (WBC) counts …

Parental Incarceration As A Root Cause Of Food Insecurity: A Faith-Based Inquiry Into Grandparent-Led Households, Jennifer L. Eckert

Doctor of Leadership

Parental incarceration is often seen solely in terms of crime and punishment, overlooking the profound disruption that can destabilize entire households. Grandparents who step in to raise children are frequently left to bear the burden of the collateral damage with limited or fixed incomes, increasing the risk for food insecurity while facing stigma and emotional strain.

Although incarceration and food insecurity are often treated as separate issues, this project, Standing in the Gap: Exploring Family Stability through Immersive Learning, recognizes their connection, particularly when the circumstances stem from parental incarceration. At the same time, many faith communities remain on …

Aging With Mercy, Thriving In Place, Emma Layne Katzman, Karen Weis, Jennifer Rugletic Washko

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2026

Occupational engagement, spirituality, and quality of life are recognized as important dimensions of aging, however, these factors remain underexplored among older adults residing within faith-based communal living environments. This doctoral capstone experience, Aging with Mercy, Thriving in Place, consisted of two distinct but complementary components: an Institutional Review Board (IRB)-approved mixed methods research study and a quality improvement initiative. The purpose of the research study was to explore occupational engagement, occupational role transitions, spirituality, identity, and perceived quality of life among older adults residing within a faith-based communal living environment. Quantitative data were collected using the World Health Organization Quality …

The Sequence (S) Index As A Marker Of Diminished Step-To-Step Transition Efficiency In Older Adults, Elham Alijanpour, Ashwini Kulkarni, Peter G. Adamczyk, Daniel M. Russell

Rehabilitation Sciences Faculty Publications

Introduction: Age-related declines in walking efficiency are often attributed to musculoskeletal and neuromuscular changes, yet the mechanisms underlying these inefficiencies remain poorly understood. One key contributor is the step-to-step transition (STST), during which the center of mass (CoM) is redirected between limbs. The Sequence (S) index quantifies the temporal overlap between push-off and collision forces during STST, with higher values indicating greater mechanical energy loss. This study investigated whether aging affects STST efficiency, as quantified by the S index, and examined the timing and impulse characteristics underlying observed differences.

Methods: Thirteen young and eleven older healthy adults walked at five …

Memory For Everyday Chores In Younger And Older Adults, Cameron Mccleary, Katie Cherry

Distinguished Undergraduate Researcher Program

This study examined episodic memory performance for everyday household chores in younger (18-32 years) and older adults (65-79 years). With the increasing older adult population in the United States, understanding age-related memory differences and identifying strategies to enhance memory performance in later life is needed. Building on previous research demonstrating the pictorial superiority effect and benefits of semantic encoding across the adult lifespan, this study utilized a 2 × 2 × 2 between-groups factorial design to investigate the effects of age group (younger, older), encoding task (standard intentional learning, semantic elaboration), and stimulus format (text only, text with pictorial illustrations) …

Relearning Language: A Meta-Analysis Of Syntactic Priming In Aphasia, Ally Miller, Willem Van Boxtel

Distinguished Undergraduate Researcher Program

Background: Despite the importance of grammatical skills for participation
in daily life, treatments for sentence–level abilities in aphasia
are comparatively scarce. The psycholinguistic paradigm of syntactic
priming has recently been advanced as a potential assessment and
treatment for grammatical skills, and existing evidence on priming in
aphasia is highly promising. Nevertheless, a comprehensive analysis of
the strength of priming effects in aphasia, as well as treatment components
which might amplify these effects, has not been reported.
This meta–analysis synthesizes existing findings on syntactic priming
in aphasia, aiming to provide a comprehensive picture of priming
effects and their potential application for …

To Treat Or Not To Treat: Evaluating Antipyretic Use And Patient Outcomes In Febrile Care, Nico Teodosio, Brynley Harris

Williams Honors College, Honors Research Projects

This honors project aims to critically examine the evidence-based practice use of antipyretics in fever management, questioning whether suppressing fever is truly in the patient's best interests and if it benefits patient outcomes. Grounded in nursing, past nursing courses, and emerging research, this project aims to answer the following PICOT question: In febrile patients, how does withholding, or not administering, antipyretics compared to administering antipyretics affect patient outcomes during hospitalization? Through a literature review, this project will analyze studies from databases like PubMed and Google Scholar, focusing on outcomes like recovery time, symptom severity, complications, and mortality. Using the PRISMA …

The Interplay Between Loneliness, Cortisol, And Nk Cell Function: The Role Of Cortisol In Nk Cell Dysfunction, Abhinav Saurabh, Yvonne Baumer, Laurel G. Mendelsohn, Elizabeth M. Aquino Peterson, Dana Sadler, Shirley J. Lopez De Leon, Ayushi Dave, Andrew S. Baez, Lola R. Ortiz-Whittingham, Mario A. Pita, Manuel A. Cintron, Hannatu A. Tarfa, Sandy T. Reynolds, Shelby R. Hicks, Sonal Sharda, J. Eleanor Seo, Maria Lopez-Ocasio, Pradeep K. Dagur, Skyler A. Kuhn, Neelam R. Redekar, James F. Troendle, Ayanna L. Wells, Marie Marah, Katherine J. Tolentino, Michael J. Corley, Alika K. Maunakea, Lynnette K. Nieman, Marcus R. Andrews, Tiffany M. Powell-Wiley

Department of Biomedical and Translational Sciences Faculty Publications

Chronic psychosocial stressors contribute to cardiovascular disease (CVD) and related risk factors, particularly in under-resourced communities. Psychosocial stressors activate the hypothalamic-pituitary-adrenal (HPA) axis, leading to sustained cortisol action on immune cells. Natural killer (NK) cells are altered in distribution and function in cardio-metabolic diseases; however, pathways linking cortisol as a marker of chronic stress to NK cell dysfunction remain understudied. We recruited 186 African American women from the Step It Up Community-Engaged, Digital Health Physical Activity Intervention study and collected cortisol, NK cell measures, and psychosocial stress measures using validated questionnaires, including chronic stress and loneliness. Plasma cortisol levels were …

Exploring The Challenges Faced By Home Care Workers In Dublin, Camila Melo Dos Santos

Business ETD Collections

This study explores the challenges faced by home care workers employed by private healthcare providers in Dublin, and how the workers perceive the training and organisational support available to manage job demands. Using a mixed methods approach, quantitative data was collected through a survey that received 24 responses, and qualitative data from four in depth interviews. The findings identify time pressure as the most significant challenge, and discovered that formal training is available but it is not considered relevant by the workers, who rely on their experience to deliver the service. Organisational support was perceived as inconsistent, with lack of …

Kidney Dysfunction, Biochemical Changes, Dna Alteration, And Mapks Regulation Following Chronic Exposure To Regular And Occasional Hookah Smoke In Mice, Naserddine Hamadi, Anas Nemmar, Sumaya Beegam, Nur Elena Zaaba, Ozaz Elzaki, Abderrahim Nemmar

All Works

Regular hookah smoking (Reg-HS) has become a major global public health issue, linked to significant health risks, including kidney damage. A less frequent pattern of use, known as occasional hookah smoking (Occ-HS), is also common; however, there has been little progress in understanding the direct impact of Occ-HS on kidneys. To investigate how varying frequencies of HS inhalation affect the kidney, we exposed mice to nose-only HS under two regimens, occasional (30 min once weekly) and regular (30 min five times per week) for a duration of 6 months. This study explored the impact on renal damage, inflammatory responses, oxidative …

Tracking Antibiotic Resistant And Multidrug Resistant Bacteria And Antibiotic Resistance Genes In The Huron River Watershed: A Vital Water Resource In Southeast Michigan, Evan Siemienkiewicz

Master's Theses and Doctoral Dissertations

Antibiotic resistance is a growing global public health concern that extends beyond clinical settings and into natural freshwater environments, where resistant bacteria and antibiotic resistance genes (ARGs) can persist and disseminate through watersheds. Despite growing recognition of freshwater systems as environmental reservoirs of resistance, no published studies have examined antibiotic resistance within the Huron River watershed in Southeast Michigan. Water samples were collected monthly from May through October 2025 at 10 sites along the Huron River. E. coli and Enterococcus isolates were evaluated for resistance to eight antibiotics using the Kirby-Bauer disk diffusion method, and environmental DNA was analyzed by …

Love In The Fast Lane: Rapid Physiological Senescence At Sexual Maturity In Male Colorado Brown Tarantulas (Aphonopelma Hentzi), Spencer Poscente

Master's Theses and Doctoral Dissertations

Sexual dimorphism in longevity represents a striking example of natural selection favoring reproductive success over survival: in Colorado brown tarantulas (Aphonopelma hentzi), females live over two decades while males survive just months after reaching sexual maturity. I collected sexually mature males at three time points (August, September, October) across two years and quantified metabolic rates, locomotor performance, and survival under controlled laboratory conditions. This thesis comprises two articles examining complementary dimensions of that decline: metabolic senescence and locomotor performance. Open-flow respirometry revealed significant seasonal shifts: minimum metabolic rate increased through October, and metabolic scope peaked in September before declining. Survival …

Promises Fulfilled: 114-Year-Old Alelia Murphy’S Life Of Faith And Resilience, Jacqueline B. Koonce

Bilingual and Literacy Studies Faculty Publications

Alelia Murphy was the oldest living person in the United States, turning 114 in July 2019 until her death in November 2019. She and her family credit her longevity to her faith in God. This premise is explored through her words as she stated she had not seen everyone she needed to see and compared that statement to Simeon from the Bible who did not die until he saw the Messiah. Alelia Murphy also had not seen everything. She was seeing the relative success of her much admired, former President Barack Obama, and she had just met me, her great …

Association Between Caregiver Status And Physical And Mental Health Among National Senior Games Athletes, Chibuzo Uchechukwu Victor Obasi

Graduate Research Theses & Dissertations

As the population ages, more people rely on informal caregivers, which puts many older adults at risk for health problems. Caregiving can be meaningful and strengthen family bonds, but it often leads to more psychological stress, especially for older adults who also have their own health concerns. Research shows that regular physical activity can help older adults build resilience and improve their mental well-being. Still, we know little about the health of older caregivers who stay very active. This study examines the health effects of caregiving among members of the National Senior Games Association (NSGA), a group of highly active …

The Effectiveness Of Behavioral Skills Training In Improving Digital Fraud Identification Among Older Adults In Low-Income Housing, Catharine Mohar

Masters Essays

Older adults, particularly those residing in low income housing facilities, are increasingly targeted by digital scams via text and email. This study evaluated the effectiveness of Behavioral Skills Training (BST) in improving fraud identification skills among this vulnerable population. BST is a structured method involving instructions, modeling, rehearsal, and feedback. A checklist was utilized in individual BST sessions with five participants aged 60 or over living in a low-income senior residential facility in the Midwest of The United States. The intervention aimed to increase participants’ ability to accurately discriminate between legitimate and fraudulent digital communications. A single case design was …