Medicine and Health Sciences Commons^™

Caregiver Self-Reflection: Does It Matter? A Study Of The Relationship Between Caregiver Self-Reflection And Participation In Home Programs In Outpatient Pediatric Physical Therapy Settings, Andrea Myane

Graduate Theses and Dissertations

Despite evidence that caregiver coaching can improve patient outcomes and caregiver participation, little information exists on the effects of its individual components. Additionally, previous research has highlighted the importance of home programs in improving pediatric physical therapy outcomes. The aim of this study is to explore the role that caregiver self-reflection, a component of caregiver coaching, plays in facilitating outcomes in the pediatric physical therapy outpatient setting. Caregivers will be asked to complete a series of self-reflection questions based on Gibbs’ Reflective Cycle, while also recording the number of minutes they spend facilitating a prescribed home program. All study participants …

Developmental Assets And Risk-Related Restraint And Resistance Orientations Among Emerging Adult College Students: Examining Protective Associations, Summer N. Beck

Graduate Theses and Dissertations

Abstract Background: Although developmental assets are well established as protective factors during childhood and adolescence, less is known about their role during emerging adulthood, a period when the prevalence of several types of risk behaviors peak. For the U.S. college student, campus can provide ideal conditions for supporting the extended transition to adulthood. However, that same environment may increase exposure to health risk behaviors. This study examined associations between developmental assets and the risk-related restraint and resistance orientations involving sexual activity, alcohol, and illicit drugs among emerging adult college students. Methods: A cross-sectional correlational design was employed with a sample …

Dental Therapy: From Resistance To Responsibility, 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.

Macomb Dental Society Journal Spring 2026

Journal of the Macomb Dental Society

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

• MDS General Meeting

• Defever Seminar

• Ski Seminar

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

Personality Characteristics Of Emergency Nurses And Their Subjective Fit In The Emergency Department, Jose Michael Maria

Theses & Dissertations

Nursing workforce challenges in the United States persist despite widespread recruitment and retention efforts, and the COVID-19 pandemic has further exacerbated shortages, turnover, and workforce instability. Despite interventions such as residency programs, financial incentives, and organizational initiatives, long-term retention remains inconsistent, particularly in high-demand settings like emergency departments. Ongoing issues such as overcrowding, rising patient acuity, and workforce attrition contribute to burnout, compassion fatigue, and compromised patient outcomes, perpetuating a cycle of staffing strain. Grounded in Person–Environment Fit theory, this research proposes that aligning emergency nurses’ personality traits with the specialty practice environment, the emergency department, may offer a more …

Caring For Transgender People In Healthcare: A Qualitative Descriptive Study With Nurses Working In An Acute Healthcare Setting, Gabriela Roxana Matson

Theses & Dissertations

Transgender individuals frequently encounter numerous obstacles when accessing healthcare services, including stigma, discrimination, and inadequate understanding from healthcare providers. Structural, interpersonal, and anticipation barriers significantly hinder transgender patients' access to care. Structural barriers include a lack of healthcare providers knowledgeable in transgender health and financial constraints. Interpersonal barriers involve discrimination, such as refusal to use correct pronouns or provide gender-affirming care. Anticipation barriers stem from fear of mistreatment, causing many to avoid seeking medical care altogether. Nurses play a vital role in upholding inclusive and affirming healthcare This qualitative descriptive study explored the subjective experiences of registered nurses who provided …

The Impact Of Structured Family Meetings In The Intensive Care Unit, Loyce T. Mofor

Doctor of Nursing Practice Final Project Abstract

The Impact of Structured Family Meetings in the Intensive Care Unit (ICU)

Purpose

Train providers at an academic institution in a large metropolitan area to conduct family meetings using a structured approach and evaluate this intervention's impact on family satisfaction with communication in the ICU.

Background

Inadequate communication between families and healthcare teams leads to lower family satisfaction, heightened feelings of guilt, and diminished capacity for making clinical decisions.

Methodology

VitalTalk training was utilized to improve providers’ communication skills. Structured family meetings were conducted for Surgical and Thoracic ICU patients with an ICU length of stay of > 5 days or …

Improving The Quality Of Bone Marrow Specimen Collection Through Powered Bone Marrow Device Simulation And Supervised Procedures, Ethel C. Estrada

Doctor of Nursing Practice Final Project Abstract

Improving the Quality of Bone Marrow Specimen Collection Through Powered Bone Marrow Device Simulation and Supervised Procedures

Purpose

This quality improvement (QI) project aimed to implement powered bone marrow simulation training and supervised procedures for the Advanced Practice Provider (APP) proceduralists to increase proceduralists' use of powered bone marrow devices and reduce poor bone marrow sampling.

Background

This project was implemented within the Bone Marrow Aspiration Clinic (BMAC) of an academic cancer center in Houston, Texas.

Methodology

Five APP proceduralists completed powered bone marrow device simulation training on the Bone Marrow (BM) Skills Simulator, followed by supervised procedures. Data were …

A Comparison Of Treadmill Preferred Walking Speed Assessments: Reliability Of Common Protocols And The Novel Treadpws Test, Kirsty A. Mcdonald, Ella Li, John Kerr, Jessica C. Selinger, Kimberley S. Van Schooten

Research outputs 2022 to 2026

Background: Human locomotion studies often require participants to self-select a preferred walking speed (PWS), yet there is no consensus or standard protocol for determining this speed. We developed a new protocol to determine PWS (TreadPWS Test). Research question: We compared the TreadPWS Test to three other common protocols in the literature (Dingwell PWS Test, Jordan PWS Test, Dal PWS Test) across a range of reliability and implementation metrics. Methods: Healthy participants (N = 20) attended two sessions within a seven-day period, during which a PWS was determined using each protocol. One test (Dal PWS Test) was conducted overground, and the …

Gme As A Healthcare And Economic Driver In Southern Nevada, Tripp Umbach

Policy Briefs and Reports

In early 2025, the Nevada Health and Bioscience Corporation (NHBC) commissioned Tripp Umbach to conduct a comprehensive study examining the current state and future expansion of physician training and retention in Southern Nevada. The approach recommended in this report is rooted in strategic partnerships among medical institutions, proven funding approaches, and needed policy changes. Tripp Umbach, a nationally renowned private consultancy specializing in medical education expansion strategies, reviewed data, conducted interviews, and developed recommendations to expand GME, highlighting its profound economic impact in Southern Nevada.

Transitioning To Adolescent And Young Adult Or Adult Cancer Survivorship Care: A Systematic Review Of Contemporary Guidelines And Trials, Darren Haywood, Hammersley, Ursula Sansom-Daly, Jordana Mcloone, Evan Dauer, Helen Wilding, Nicolas H. Hart, Thomas Walwyn

Research outputs 2022 to 2026

Background: Health service transitions of child, adolescent, and young adult cancer survivors between paediatric and adult cancer care services are pervasively fragmented, resulting in poor coordination, reduced satisfaction, and adverse outcomes for cancer survivors and significant others (e.g., caregivers and family members). Numerous trials and clinical guidelines have been developed to support care transitions, but their convergence, divergence, and methodological quality remain unclear. To advance clinical practice and quality research about care transitions, a synthesis of trials and guidelines on child, adolescent, and young adult care transition across age-appropriate cancer services is required to inform future research, practice, guideline, and …

A Clinical Study Examining The Effects Of Dietary Nitrate On Urinary N-Nitrosamines, Catherine P. Bondonno, Michaela L. Sundqvist, Sujata Shinde, Kevin Croft, Jonathan M. Hodgson, Mattias Carlström, Eddie Weitzberg, Jon O. Lundberg

Research outputs 2022 to 2026

BackgroundInorganic nitrate from dietary sources has raised health concerns due to its possible conversion into carcinogenic N-nitrosamines, leading to strict regulations on nitrate concentrations in food and drinking water.ObjectivesIn this study, which was a part of a larger randomized controlled trial, we evaluated urinary excretion of N-nitrosamines in response to daily dietary nitrate intake over a 5-wk period using 2 different forms of nitrate administration.MethodsA total of 231 participants with mild hypertension were randomly assigned into 3 groups. Group 1 (n = 78) consumed vegetables low in nitrate along with a placebo capsule (300 mg potassium chloride). Group 2 (n …

Digital Decoding Of The Multidimensional Pain Experience In People Living With Dementia, Kreshnik Hoti, Ipsit V. Vahia, Paola Chivers, Jeffery David Hughes

Research outputs 2022 to 2026

Background: Understanding how pain manifests in people living with dementia can facilitate pain management but evidence from large real-world studies is limited. Through digitally compiled large number of pain assessments, we explore how behavioural indicators manifest across all widely used domains of pain assessment. Methods: This is a population based observational study with data from aged care homes across Australia, New Zealand and the United Kingdom. Pain assessments were conducted over a period of 5.3 years in 89 230 residents living with advanced dementia. The primary outcome was to determine pain indicator occurrence across pain levels and explore their predictive …

Diacylglycerol Kinase Eta As A Novel Target In Nras Mutant Melanoma, Haley P. Wilson, Casey D. Stefanski, Signe Caksa, Glenn L. Mersky, Scott D. Varney, Jelan I. Haj, Dan A. Erkes, Timothy J. Purwin, Vivian Chua, Andrew E. Aplin

Research outputs 2022 to 2026

NRAS mutations occur in 10%–30% of cutaneous melanomas and are associated with high tumor mutational burden. Mutant NRAS signaling drives aberrant cell growth and proliferation, in part, through activation of the RAF–MEK-ERK1/2 kinase pathway; however, targeted therapies to this pathway have limited effectiveness in patients with NRAS mutant melanoma. The role of other targetable signaling pathways in NRAS mutant melanoma is poorly characterized. Here, we demonstrated that one isoform of diacylglycerol kinase, diacylglycerol kinase eta (DGKη), a lipid signaling regulator, was highly expressed in NRAS mutant melanoma patient samples. Knockdown of DGKH in NRAS mutant melanoma cell lines resulted in …

Neuromuscular Performance Changes In Response To The Australian Special Forces Selection Course, Angela Uphill, Kristina L. Kendall, Stuart Guppy, Michael Vacher, Simon Parker, Hannah Brown, Brendan Ashmore, Travis Zomer, G. Gregory Haff

Research outputs 2022 to 2026

Introduction: Strenuous military activities, such as Special Forces (SF) selection courses, are known to involve high physical loads in the presence of food and sleep deprivation, which can have detrimental impacts on physical performance. Understanding the magnitude of performance deficit and the time required for recovery associated with these events, is important for injury prevention and maintaining operational readiness. The purpose of this study was to investigate the changes in physical performance in response to the Australian SF Selection Course (SF-SC) and to monitor recovery throughout 8 weeks following the course. Materials and Methods: Ninety-three healthy male participants (age: 28 …

Clinical Pathway For Rhogam Administration In The Emergency Department, Lauren Kyzar, Amy Bigham

Appalachian Student Healthcare Research Review

Background: Clinical pathways in emergency departments (ED) are designed to standardize patient care and reduce variability in clinical practice. In a rural hospital setting, the ED management of RhoGAM administration in pregnant patients with vaginal bleeding varied by provider with no standard of care achieved. This approach raised concerns about potential patient safety issues.

Methods: In response, the local emergency department medical director, in conjunction with local perinatal providers developed a clinical pathway to standardize care and optimize RhoGAM administration. The clinical pathway was implemented to the local ED providers over a three-month period. Retrospective chart review for Type and …

A Narrative Of The Plague Doctor And How Its Historical Context Translates To The Modern View Of The Plague Doctor, Callie P. Johnston

Honors Theses

The Plague Doctor was once a historical figure who practiced medicine primarily on those infected with the bubonic plague. The plague doctor, as a historical figure and physician, has been transformed in modern culture and media. Originally perceived as a harbinger of both hope and death, the Plague Doctor has undergone a historical transformation from a masked physician to a more stylized character that appears in modern media, digital art, toys, costumes, video games, and popular culture. This thesis examines the evolution of the Plague Doctor from its historical role as a plague physician to its current iconography as a …

A Meta-Analysis Of Endometrial Cancer Metabolites As Potential Non-Invasive Biomarkers, Makenna K. Johnson

Honors Theses

Endometrial Cancer (EC) is the most prevalent gynecological cancer in the United States and causes tens of thousands of deaths. Despite its massive negative impact in developed countries, there currently is no reliable screening tool used to diagnose women. Due to this urgent need for minimally invasive and precise techniques to diagnose this malignancy, the metabolomics field has been at the forefront of current research. An untargeted mass-spectrometry approach is used by many researchers to form an initial hypothesis as to which metabolites are key in identifying EC cases. However, there are sometimes inconsistencies between studies. A meta-analysis approach examines …

Domain-Specific Concussion Knowledge And Reporting In United States Major League Rugby Players, Julie Stamm, Katherine Hunzinger, Owen Sheehy, Christine Baugh

Department of Exercise Science Faculty Papers

Previous research indicates high concussion knowledge is not associated with better concussion reporting, with research examining the relationship between reporting and global concussion knowledge. Concussion knowledge has not yet been investigated in United States Major League Rugby (MLR) players. This study evaluated domain-specific concussion knowledge, concussion history, and reporting behaviors among active MLR players. In a cross-sectional design, 207 MLR athletes (age 26.6 ± 3.4 years) completed a survey assessing concussion history, knowledge, and nondisclosure reasons. While in the MLR, 24% reported an undisclosed concussion, with nondisclosure reasons related to a lack of concussion knowledge, a desire to continue playing, …

Systemic Barriers To Educational And Employment Attainment Among Individuals With Substance Use Disorders, Mollie B. Mccann Poblocki

Creativity and Change Leadership Graduate Student Master's Projects

Substance use disorders (SUDs) and opioid use disorder (OUD) represent one of the most pressing yet poorly understood public health crises in the United States. Despite decades of clinical intervention, recovery outcomes remain deeply unequal, not because individuals lack motivation, but because the structural systems surrounding them are fundamentally broken. This project explored that reality through a comprehensive literature review examining how systemic barriers across educational systems, labor markets, poverty dynamics, and healthcare infrastructure shape vulnerability, treatment access, and recovery outcomes for individuals with SUDs. Major findings revealed a consistent socioeconomic gradient of harm: individuals with lower educational attainment, unstable …

An Investigation Of The Roles Aging, Gender And Age-Related Hearing Loss Play In Emotional Prosody Recognition, Giavanna Yowell

Undergraduate Honors Thesis Collection

Emotional prosody recognition is crucial for social interactions but is influenced by aging, gender, and age-related hearing loss (Lambrecht et al., 2012; Oerlemans et al., 2014; Palermo et al., 2013). No past studies have looked at all of these factors collectively. To address this shortcoming, the current study explored the relationships between aging, hearing loss and gender differences in emotional prosody recognition. The ability to recognize emotions through facial expressions was also included as a comparative measure. One hundred fifteen individuals (42 men and 73 women), ages 50 and older (M = 60.39, SD = 8.12), completed a hearing handicap …

Acute Effects Of Tempering On Biomechanical Tissue Characteristics In The Lower Back, Danielle Rae Marie Alley

Undergraduate Honors Thesis Collection

Body tempering (BT) is a novel, myofascial release technique that is growing in popularity among sports medicine and performance practitioners. No studies have explored its effects on biomechanical tissue characteristics or its influence on perceived disablement within the thoracolumbar spine region. The aim of this study was to examine the acute effects of BT on soft-tissue characteristics and perceived disablement in the thoracolumbar spine region. A randomized controlled trial was used to study 22 young adults (10 males, 12 females, age=21.1±0.68 years, height=170.6±11.8 cm, mass=65.2±14.2 kg). Treatment group participants received a 1-minute BT treatment to the soft tissues of their …

The Effects Of Private Equity Ownership Of Acute Care Hospitals On Patient Experience, Abigail M. Huffman

Theses and Dissertations

In 10 years, private-equity firms' share of hospitals has grown from 2-3% to 8%.  Using data from two sources: the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient surveys and the Private Equity Stakeholder Project (PESP), I demonstrate a causal effect of private-equity ownership on patient satisfaction using difference-in-difference methods.

Synthetic Explorations Towards Phenyl Benzazepine-Inspired Scaffolds And Synthesis Of Minor Cannabinoid Derivatives, Vishwashiv Kumar Emogaje

Theses and Dissertations

D1R is a compelling therapeutic target for correcting dopaminergic imbalances. However, existing ligands exhibit suboptimal pharmacokinetic properties. As such, we synthetically explored untouched structural modifications to the phenyl benzazepine scaffold. Cannabinoid-based molecules also display potential to treat neurological maladies and cancer. We synthesized Cannabichromene derivatives and uncovered enhanced anticancer activities.

Neuroprotective Effects Of Prophylactic Brivaracetam On Memory And Anxiety Following Traumatic Brain Injury, Sofia Dumic

Theses and Dissertations

Prophylactic brivaracetam (BRV) was evaluated in a rat TBI model for effects on behavior and serum tau. BRV reduced anxiety-like behavior with optimal dose-dependent effects at 2.1mg/kg, but did not affect working memory. Serum tau was detectable early post-injury, supporting its use as a biomarker.

Enhancing Healthcare Communication With Artificial Intelligence Translation Methods For Improved Patient Healthcare Satisfaction, Mireille Signe

Doctor of Nursing Practice Final Project Abstract

Purpose:

To evaluate whether artificial intelligence (AI) verbal translation improved communication-related satisfaction during routine nurse–patient interactions.

Background:

In the ICU, brief, frequent conversations with patients with Limited English Proficiency (LEP) often occur without timely access to professional interpreters, contributing to delays, improvised communication, and lower satisfaction. AI tools offer immediate access for low‑complexity exchanges but require evaluation for feasibility and effectiveness as a supplement to certified interpreter services.

Methodology:

Twelve nurse-LEP proxy patient dyads were evaluated using a mixed-methods design (8/2025-12/2025) in a 16-bed ICU during QI PDSA cycles. Standardized care communication scenarios were completed using the AI tool. Process …

Measuring School Anxiety In Pediatric Chronic Pain: Initial Investigation Of The Psychometric Properties Of The School Anxiety Inventory For Chronic Pain (Sai-Cp), Caitlyn Maye, Robert C. Gibler, Kristen E. Jastrowski, Dustin Wallace Phd, Cara M. Hoffart, Jenny Scheurich Phd

Posters

Introduction: School anxiety is common among adolescents with chronic pain and often impacts academic and social functioning. Existing anxiety measures lack specificity for capturing the unique sources and symptoms of school-related anxiety in this population. To address this gap, a bank of new potential measure items (the School Anxiety Inventory for Chronic Pain [SAI-CP]), was developed based on the original School Anxiety Inventory (SAI), qualitative interviews with adolescents with chronic pain, and expert clinician input. The objective of this study was to evaluate the construct validity and internal consistency of the SAI-CP and identify avenues for future measure refinement. Method: …

Recognizing What Matters Most: Using Safety-Critical Tasks To Strengthen Central Line-Associated Bloodstream Infection (Clabsi) Prevention Rounds, Lacey Bergerhofer, Christian Anthony Schneider, Emily Evans

Posters

Background: Our CLABSI improvement team developed high-risk rounding processes on the Hematology/Oncology unit. Expanding this model to additional Med/Surg units was challenging due to limited staffing and time-intensive tasks required during rounds. Concurrently, CLABSI rates across other Med/Surg units increased, necessitating a scalable approach. Objectives: Apparent Cause Analysis (ACA) review in Med/Surg units identified an opportunity to strengthen surveillance by engaging Vascular Access subject-matter experts. Our proactive high-risk rounds pilot led to CLABSI rate reduction. The objective was to expand service coverage without compromising established high-risk rounding quality standards. Our goal is to assess > 90% of central lines in Med/Surg …

Newly Registered Nurses With Neurodiversities: A Qualitative Study Of Their Experiences During Transition To Professional Practice, Heather Wallace

Dissertations and Theses (Open Access)

Abstract Introduction: Transition-to-practice (TTP) programs play a crucial role in bridging the academic-to-practice gap for newly licensed Registered Nurses (NLRNs) and improving first-year retention rates. However, these programs may fall short in addressing the specific needs of NLRNs with neurodiversities (NLRN-ND). Neurodiversity (ND) encompasses Autistic Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Tourette Syndrome, and the 3 Ds – Dyslexia, Dyscalculia, and Dysgraphia. Unsupportive environments for disclosing neurodiversity and requesting accommodations may contribute to the 10-25% NLRNs leaving their jobs within the first year, with 1-3% exiting the nursing profession altogether. Objectives: This study aimed to (1) explore NLRN-ND …

Exploring Teamwork Between Virtual And Bedside Nurses, Caitlin Weinheimer

Dissertations and Theses (Open Access)

Background: Advancing technologies and the use of telehealth have expanded in hospitals to include telenursing. Telenursing introduces a unique dynamic where virtual and bedside nurses work together as a remote team to provide patient care. Published literature reports that teamwork among nurses and healthcare professionals impacts patient and workforce outcomes. However, there is a gap in exploring teamwork between virtual and bedside nurses. Addressing this knowledge gap is critical to ensure positive patient and nursing workforce outcomes in hospital-based telenursing settings.

Objective: To generate a grounded theory that explains teamwork between virtual and bedside nurses in the hospital setting. A …