Medicine and Health Sciences Commons^™

Graduate School Blog - April 2025 Volume 1, Cynthia Haynes

UofM Grad School Blog

The April 2025 UofM Graduate School Blog highlights a month full of events, stories, and celebrations, beginning with Dr. Deborah Tollefsen’s personal graduate school journey, shared during the “Is Graduate School Right for Me?” virtual workshop an inspiring narrative of resilience, mentorship, and finding purpose through education. This edition also spotlights Graduate Student Appreciation Week, featuring a robust lineup of events such as a virtual town hall, resume and job market workshop, student social and awards ceremony, study session, and social dinners all designed to support, celebrate, and connect the UofM graduate student community. With opportunities to hear from …

The Impact Of Discretion On Human Service Workers Supporting The Health Of Unaccompanied Minors In Foster Care, Diana M. Clark

Senior Theses

Unaccompanied children (UCs) are a vulnerable population that enters government custody and accesses healthcare via the Office of Refugee Resettlement (ORR)'s system of care. While prior research has focused on generating policy recommendations to improve healthcare services available to UCs both in ORR custody and following release from custody, this thesis will instead expand upon the experiences of staff members working at ORR-contracted agencies. These workers make decisions that have short- and long-term implications on the health and wellbeing of UCs. Drawing from 65 in-depth interviews with human service workers in ORR-contracted voluntary agencies, this thesis uses street-level bureaucracy framework …

"Health Gatekeepers": The Influence Of Women On Health Practices In Rural, Central Appalachia, Reese Lycan

Senior Theses

Women have historically assumed leadership roles in familial and community health promotion, intervention, and facilitation. While the role of women in family health is globally understood and the historical importance of female leadership has been documented, there remains a gap in knowledge regarding the role of women as “health gatekeepers”. Furthermore, when considering the Appalachian region, there are limited studies regarding women’s place in leadership as far as health is concerned. Therefore, this study employs a hermeneutic phenomenological framework to explore the lived experiences of women in relation to their family and community’s health in rural, Central Appalachia- a region …

Inked Insight: A Consensual Qualitative Research Study Exploring The Perspectives Of Visibly Tattooed Counselors, Megan Ashley Lalonde-Pittman

Counseling & Human Services Theses & Dissertations

This study explored the experiences of visibly tattooed mental health counselors (VTMHC) through consensual qualitative research (CQR), examining how visible tattoos were perceived to have impacted the participants (N=14) professional experiences, development, and relationships within the counseling field. Seven domains arose from the data: Prejudices experienced by VTMHC, VTMHC Interactions with others, Culture experienced by VTMHC, Appearances of the VTMHC, Professional therapeutic work of the VTMHC, Workplace environment of the VTMHC, Processing the experience of being a VTMHC The implications for multicultural education and future research are explored.

Fostering Cognitive Complexity In Behavioral Health Providers: Perspectives From Supervisors In Integrated Primary Care, Katherina Nako

Counseling & Human Services Theses & Dissertations

The integration of behavioral health into primary care settings, known as Integrated Primary Care (IPC), offers a holistic approach to addressing both physical and mental health needs (Ramanuj et al., 2019). Efforts to expand access to mental healthcare have contributed to the growing presence of IPC settings (Martin 2017), with mental health providers, such as mental health counselors, joining these teams as Behavioral Health Providers (BHPs; Blount, 2017). However, the unique complexities of IPC often leave BHPs feeling underprepared, largely due to the traditional training frameworks emphasized in many graduate counseling programs. The need for BHPs to adapt to the …

Acculturation Experiences Of International Students In The U.S. Cacrep-Accredited Counselor Education Programs: Challenges, Support Systems, And Systemic Barriers, Nargiza Amirova

Counseling & Human Services Theses & Dissertations

International students significantly enrich U.S. counselor education and supervision programs by contributing diverse cultural perspectives that inspire teaching, research, and professional growth. Yet, these students often face complex challenges including cultural adjustment, language barriers, social isolation, and the academic demands of counseling academic programs that impact their educational outcome s and psychological well-being. Systemic barriers, such as visa restrictions and institutional unawareness, further complicate their experiences. This study explored acculturation experiences of international students enrolled in CACREP-accredited counselor education programs in the United States.

Using Interpretative Phenomenological Analysis (IPA), in-depth interviews were conducted with seven international students on J1/F1 visas, …

Supervisees’ Responsiveness In Supervision With Doctoral Student Supervisors, Zübeyde Akpakır

Counseling & Human Services Theses & Dissertations

This study explores the factors that influence the responsiveness of master’s-level counselors-in-training (CITs) to university-based supervision with doctoral student supervisors. Supervision is an important element and the requirement of CITs' professional development (Bernard & Goodyear, 2019; CACREP, 2024), and many counselor education programs educate their doctoral student to supervise master’s-level CITs (Luke, 2019). Despite its significance, there is no empirical data on how CITs engage with feedback and guidance, particularly in supervision led by novice doctoral supervisors. The study employed an exploratory sequential mixed methods design, Q methodology (McKeown & Thomas, 2013), to analyze CITs' subjective perspectives and identify factors …

Examining The Features Of Former Research Regarding Substance Abuse Treatment, Autumn Gonzales

Posters - 2025

“Drug misuse is one of the major social, legal, and publichealth challenges in the modern world” (Nutt et al., 2007). This study explored the characteristics of former research on substance abuse treatment approaches and treatment settings. Past literature showed short-term treatment can be beneficial depending on what works best for the individual and studies have shown short-term treatment has helped individuals with Substance Use Disorder (SUD). However, long-term treatment is the preferred method for individuals as it has a lower chance of relapse. A small systematic review was conducted from which data were coded of former published articles. A frequency …

The Acute Effects Of High-Intensity Functional Training On Inhibitory Control, Julia Daniel, Amaryllis Rubalcaba, Brianna Valadez

Posters - 2025

High-Intensity Functional Training (HIFT), such as CrossFit®, integrates high-intensity, multi-joint movements and has gained attention for its potential to enhance both physical and cognitive performance. While acute resistance exercise (RE) is known to influence physiological responses like heart rate variability (HRV) and cognitive functions such as inhibitory control, the specific effects of CrossFit®—a structured HIFT program—on cognitive outcomes remain underexplored, particularly when comparing trained CrossFit participants to untrained or non-CrossFit populations. HIFT’s unique combination of cardiorespiratory and muscular stress may uniquely enhance cognitive processing speed and response stability, especially in individuals with chronic CrossFit® experience. However, it is unclear how …

How Sexism Affects Women In Healthcare And Medical Training In The United States And The United Kingdom, Emily Kerr

Honors Projects

This in-depth secondary research was performed to review existing literature about how sexism affects women in healthcare and medical training in the United States and the United Kingdom. Despite previous legislation passed to limit sexism and sexual harassment in both countries, sexism and sexual harassment are still relevant today, especially in the medical and healthcare field. In fact, despite a continued increase of women in medicine, 91% of qualified female health professionals have experienced sexism at work and 54% of both male and female health professionals believe that sexism acts as a barrier to career progression (BMA, 2024). Based on …

Academic Productivity At Orthopaedic Surgery Sports Medicine Fellowship Programs In The United States Has A Weak Positive Correlation With Nonresearch Lifetime Industry Earnings, Benjamin Miltenberg, William Johns, Anthony Baumann, Faheem Pottayil, Bradley Richey, Albert Anastasio, Kempland Walley, Christopher Dodson, Sommer Hammoud

Rothman Institute Papers

PURPOSE: To characterize the relationship between academic productivity, as defined by the h-index, and industry payments for fellowship-trained sports medicine surgeons in faculty positions at sports medicine fellowships.

METHODS: The American Orthopaedic Society for Sports Medicine fellowship directory was used to create a comprehensive list of all fellowship programs nationwide. Fellowship websites were then reviewed to generate a list of the teaching faculty associated with each program. Total nonresearch lifetime earnings were obtained from the Centers for Medicare & Medicaid Services website. Academic productivity of each fellowship faculty was assessed via the h-index. Frequency counts and other descriptive statistic measures …

Cultivating Compassionate And Inclusive Care For People With Disabilities, Evelyn Echevarria Cruz, Aila Cordero, Maria Fioletova, Amanda Escudero

be Still

The disparity between physicians' preparedness to treat people with disabilities (PWD) and the prevalence of disabilities is a critical healthcare issue. The 2022 Behavioral Risk Factor Surveillance System reported that over 25% of U.S. adults have a disability, yet many healthcare providers feel unprepared. A poll found that only 40.7% of 714 physicians were confident in providing quality care to PWD, while 61% of 600 surveyed PWD indicated that their providers needed more training. Additionally, only 36% of medical schools included disability education in their curricula, often focusing on brief simulations rather than immersive experiences. To effectively address the diverse …

The Masculine Way, Jessica Asuquo

be Still

This painting was conceptualized after a particularly impactful patient visit. During the visit, the patient described a traumatic event in greater detail, stating that the doctor and I were the first people he had ever spoken to about the event.

I felt both honored and disheartened by this statement. I was honored that this man trusted us with this knowledge. Still, I was immensely sad that he dealt with the trauma of this event alone for decades. I believe he released some of the grief, pain, anger, fear, and hurt when he shared his burden with us, and I will …

2025 Research Day Program, Lincoln Memorial University

Research Day

This program contains poster presentation summaries from LMU's 2025 Annual Research Day conference.

What's Missing From Value-Based Care-Accounting For The Costs And Benefits Of Quality Improvement, Donald E. Casey

College of Population Health Faculty Papers

No abstract provided.

Hubungan Dukungan Sosial Rekan Kerja Dengan Stres Kerja (Studi Pada Pekerja Di Pt X), Aisyah Permatasari

Jurnal Ilmu Kesejahteraan Sosial

Workers are vulnerable to work-related stress due to job demands, time constraints, and limited leisure time, leading to psychological issues such as anxiety related to their work. In the context of social welfare studies, job stress affects overall workers’ well-being and disrupts their social functioning in the workplace. Social support from coworkers is potentially reduce stress in workplace, which is crucial for creating organizational well-being. It also helps workers improve job engagement, cope with fatigue, and manage stress. This study examined the relationship between social support from coworkers and job stress among 90 employees …

Caring Across Borders: Demographic Shifts And Migrant Care In Asean-Korea Dynamics, Saqib Fardan Ahmada, Wahid Nur Kartiko

Jurnal Ilmu Kesejahteraan Sosial

This article aims to examine the migration policies and migrant care in the context of relations between ASEAN Member States (AMS) and Korea. As Korea is dealing with an aging population, an increase in female labour force participation, and an ultra low fertility rate, caregiving, especially for the elderly, has become a pivotal issue. Besides, the traditional nuclear family structure, which has historically served as the primary caregiver for the elderly, is also losing its prominence. In such demographic shift, migrant care workers from AMS are filling the demand for caregiving in Korea, leading to a cross-border international migration from …

Physiotherapy In Community-Based Rehabilitation In Middle And Low-Income Countries: A Scoping Review, Er D. Petil Jr., Napoleon R. Caballero

Philippine Journal of Physical Therapy

Introduction: Community-based rehabilitation (CBR) is a widely recognized approach to address the rehabilitation needs of individuals with disabilities in low- and middle-income countries (LMICs). Physical therapy (PT) plays a crucial role within CBR programs. This study aimed to synthesize the current state of literature regarding the integration of PT in CBR programs in LMICs across Asia, Africa, and Latin America, examining key characteristics, reported outcomes, and challenges to implementation.

Methods: A comprehensive review of literature was conducted, focusing on studies published in the past decade. Data were extracted and synthesized in matrix format to compare and contrast findings across the …

Developing A Pandemic-Related Mental Health Micro-Collection For An Academic Library, Dee Anna Phares

Faculty Articles, Papers, and Other Scholarship

Academic library patrons dealing with the impact of trauma, depression, anxiety, or addiction spawned or exacerbated by the COVID-19 pandemic require materials that address the unique conditions that have shaped mental health since late 2019. This paper demonstrates how one academic library endeavored to address patrons’ needs for mental health resources by developing a “Coping and COVID-19” micro-collection.

Understanding Adolescent Perinatal Wellbeing In Rural Parts Of Kenya: A Qualitative Study, Evaline Chepchirchir Langat, Marleen Temmerman, Margrette Hanselmann, Kethakie Lamahewa, Violet Naanyu, Mellan Lilumbi, Tatiana Taylor Salisbury

Centre of Excellence in Women and Child Health

Introduction: Despite global efforts to reduce adolescent birth rates, the problem persists in low- and middleincome countries. Sub-Saharan Africa has the highest rates (97.9 births per 1000 women). In Kenya, more than 15 % of adolescent girls become pregnant. Forty-three percent of these develop depression. This study investigated adolescent pregnancy in rural Kenya to understand the challenges and context-specific factors that can help adolescents maintain good mental health during pregnancy and the motherhood.

Methods: An exploratory qualitative study was conducted in Kilifi County between October and November 2021. A total of 73 participants consented to participate in the …

Preferences And Willingness For Starting Daily, On-Demand, And Long-Acting Injectable Hiv Pre-Exposure Prophylaxis Among Transfeminine Persons In The Us, 2022-2023, Duygu Islek, Travis Sanchez, Stefan Baral, Carolyn Brown, Joanna A. Caldwell, Jennifer L. Glick, Danielle Friedman Nestadt, Jeb Jones, Iaah L. Lucas, Supriya Sarkar, Annemiek De Ruiter, Patrick S. Sullivan, Mariah Valentine-Graves, Savannah Winter, Vani Vannappagari

School of Public Health Faculty Publications

Background There remains limited information concerning US transfeminine persons preferences across varying PrEP options. We examined PrEP option willingness, preferences, and associated factors among a US nationwide sample of transfeminine persons. Methods Sexually active transfeminine persons age 15 + were recruited online between June 2022-October 2023 through social media advertisements. Transfeminine persons not diagnosed with HIV were asked about willingness to initiate, and ranked preference, of three PrEP options- daily oral (DO), on-demand, and long-acting injectable (LA-PrEP). Log-binomial models were used to examine PrEP modality willingness and associated sociodemographic and behavioral characteristics. Results Among 2657 transfeminine persons not currently using …

An Evaluation Of Exercise-Related Self-Efficacy Metrics Following A Resistance Training Program In Individuals Treated For Cancer, Kayla S. Adler

Senior Theses

As the number of cancer survivors grows, managing treatment side effects and promoting healthy behaviors like physical activity is crucial. Low exercise self-efficacy, an individual's belief in their capability to perform exercise, is a significant barrier to physical activity adherence. This study assessed if an 8-week supervised resistance training program could improve self-efficacy for exercise (SEE) and outcome expectations of exercise (OEE) in individuals treated for cancer. Participants (n=25) attended twice-weekly, one-hour sessions. SEE and OEE scales were administered pre- and post-intervention. Results indicated a significant increase in SEE scores (mean difference = 8.96 ± 19.87, p = 0.041), demonstrating …

Impacts On College-Aged Asian American Mental Health, Zahra Soherwardy

Senior Theses

This study explores the relationship between different forms of racial harassment and mental health issues in Asian American college students. Asian American mental health is a growing concern in the field of public health. Asian Americans have the lowest treatment rates and some of the highest stigma levels of any demographic. They are also impacted by the model minority myth and discrimination, further alienating them from getting help. The topics of subtle racism, blatant racism, and current racial discrimination were compared to depressive symptoms, anxiety, self-esteem, and four domains of aggression using survey data. Subtle racism was found to be …

Estimation Of Therapeutic Threshold For Tuberculosis Using Adapted Nominal Group Technique And Clinical Vignettes In Clinical And Community Settings In Southern Africa, Alfred Kipyegon Keter, Alastair Van Heerden, Tom Decroo, Tom Boyles, Shannon Bosman, Thandanani Madonsela, Lindani Innocent Msimango, Lenika Naiken, Carlos Kiyan, Mashaete Kamele

Population Health, East Africa

Background: When confronted with diagnostic uncertainty and a decision on whether to start treatment or not, clinicians consider the potential harm and benefit of offering versus withholding treatment. Treatment can be offered if the probability of tuberculosis (TB) in the patient is above the “therapeutic threshold” (ThT): the probability of disease at which the expected utility of treating and not treating is the same. We estimated ThT for TB in clinical and community settings in Southern Africa using two methods: an adapted nominal group technique (aNGT), and decisions made based on clinical vignettes (CVs).

Methods: We enrolled health …

Selected Social And Lifestyle Correlates Of Brain Health Markers: The Cross-Cohort Collaboration Consortium, Leslie Grasset, Joshua C Bis, Stefan Frenzel, Daniel Kojis, Jeannette Simino, Amber Yaqub, Alexa Beiser, Claudine Berr, Jan Bressler, Robin Bülow, Charles S Decarli, Alison E Fohner, Laura B Harrington, Catherine Helmer, M Arfan Ikram, Rozenn N Lemaitre, Oscar L Lopez, W T Longstreth, Julia Neitzel, Michelle C Odden, Priya Palta, Carsten O Schmidt, Rajesh Talluri, Meike W Vernooij, Henry Völzke, Trudy Voortman, Quest Whalen, Katharina Wittfeld, Hans J Grabe, Thomas H Mosley, Bruce M Psaty, Frank J Wolters, Sudha Seshadri, Carole Dufouil

Faculty, Staff and Student Publications

Introduction: To investigate the associations of education level, marital status, and physical activity with dementia risk and brain MRI markers.

Methods: Data from six community-based samples from the Cross-Cohort Collaboration Consortium were analyzed. Self-reported education level, marital status, and physical activity at age 60 to 75 years were harmonized. Subsamples of participants with brain MRI markers at time of exposure were selected. Associations with dementia risk and cross-sectional MRI markers were meta-analyzed.

Results: Higher education level was associated with lower dementia risk (hazard ratio [HR] = 0.65, 95% confidence interval [CI] = 0.59; 0.72 vs low level) but not significantly …

Analyzing Social Media Trends In Cosmeceuticals: Insights From Google Trends And Tiktok Analytics, E. Correia, Jenna Mandel, Stephanie R. Jackson Cullison

Department of Dermatology and Cutaneous Biology Faculty Papers

OBJECTIVE: Social media usage has surged, particularly since the COVID-19 pandemic. Dermatology invokes intense interest on social media, and cosmeceuticals are among the most trending topics, offering a unique space for dermatologists to share their expertise. By using tools like Google Trends and TikTok viewership, we aim to capture cosmeceutical trends to guide dermatologists' educational efforts.

METHODS: A Google Trends search from January 2004 to December 2023 was performed on retinol, bakuchiol, salicylic acid, glycolic acid, azelaic acid, hydroquinone, niacinamide, vitamin C serum, and hyaluronic acid. Trend lines were created for each term, and yearly percent differences in relative search …

A Novel Method For Semi-Quantitative Detection Of Hpv16 And Hpv18 Mrna With A Low-Cost, Open-Source Fluorimeter, Kathryn A Kundrod, Mary E Natoli, Chelsey A Smith, Jackson B Coole, Megan M Chang, Emilie Newsham Novak, Elizabeth Chiao, Elizabeth A Stier, Jane R Montealegre, Michael E Scheurer, Philip E Castle, Kathleen M Schmeler, Rebecca R Richards-Kortum

Center for Medical Ethics and Health Policy Staff Publications

Despite global calls to eliminate cervical cancer, rates of cervical cancer incidence and mortality remain high in resource-limited settings, where it is challenging to implement and sustain screening, diagnosis, and treatment programs. The presence of high-risk HPV mRNA in cervical cells is a sensitive and specific biomarker of cervical precancer. Yet, current testing methods are too costly and complex for use in resource-limited settings. Here, we present a novel method for semi-quantitative detection of HPV16 and HPV18 mRNA with minimal infrastructure requirements. The assay relies on isothermal reverse transcription recombinase polymerase amplification (RT-RPA) with real-time fluorescence readout, demonstrated on rugged, …

Crispr/Cas9 Gene Therapy Increases The Risk Of Tumorigenesis In The Mouse Model Of Hereditary Tyrosinemia Type I, Tong Chen, Mercedes Barzi, Nika Furey, Hyunjae R Kim, Francis P Pankowicz, Xavier Legras, Sara H Elsea, Ayrea E Hurley, Diane Yang, David A Wheeler, Malgorzata Borowiak, Beatrice Bissig-Choisat, Pavel Sumazin, Karl-Dimiter Bissig

Center for Medical Ethics and Health Policy Staff Publications

Background & aims: The therapeutic potential of CRISPR gene editing has been demonstrated in various animal models; however, little is known about its long-term consequences. This study seeks to bridge this gap by investigating the lasting consequences of CRISPR gene therapy in an animal model of hereditary tyrosinemia type I (HT-I). We compared the standard of care-nitisinone, a small molecule inhibitor of hydroxyphenylpyruvate dioxygenase (HPD)-with the deletion of the Hpd gene by CRISPR gene therapy. Both treatments block flux through tyrosine catabolism and thereby prevent the accumulation of toxic catabolites in HT-I.

Methods: We assessed the efficacy and safety of …

Ethical Considerations For Sharing Aggregate Results From Pragmatic Clinical Trials, Stephanie R Morain, Abigail Brickler, Joseph Ali, Patricia Pearl O'Rourke, Kayte Spector-Bagdady, Benjamin Wilfond, Vasiliki Rahimzadeh, Caleigh Propes, Kayla Mehl, David Wendler

Center for Medical Ethics and Health Policy Staff Publications

A growing literature has explored the ethical obligations and current practices related to sharing aggregate results with research participants. However, no prior work has examined these issues in the context of pragmatic clinical trials. Several characteristics of pragmatic clinical trials may complicate both the ethics and the logistics of sharing aggregate results. Among these characteristics include that pragmatic clinical trials may affect the rights, welfare, and interests of not only patient-subjects but also clinicians, meaning that results may be owed to a broader range of groups than typically considered in other research contexts. In addition, some pragmatic clinical trials are …

Navigating Nonlinear Pathways: Challenges And Opportunities For Diversity, Equity, And Inclusion Leaders In Academic Emergency Medicine, Melanie F Molina, Annika Bhananker, Beatrice Torres, Dalia Owda, Edgardo Ordoñez, Anita N Chary

Faculty, Staff and Students Publications

OBJECTIVES: Diversity, equity, and inclusion (DEI) leadership roles have grown in academic emergency medicine (EM). We sought to elucidate specific pathways to DEI leadership roles among current DEI leaders in academic EM.

METHODS: From March to May 2023, we conducted semistructured, qualitative interviews with DEI leaders in academic EM across 5 US regions to investigate their pathways to leadership. Participants were recruited via email using Accreditation Council for Graduate Medical Education-accredited EM residency websites and the Academy for Diversity and Inclusion in EM. After recording and transcribing the interviews, we used an inductive approach to identify major themes.

RESULTS: Of …