Medicine and Health Sciences Commons^™

A Market Of Care Skills: Profiting From Professional Education And Practice, Yasmin Y. Ortiga

Research Collection School of Social Sciences

Who profits from the commodification of care and how does such accumulation occur? Focusing on the case of the nursing care market, this paper shows how professional schools and local hospitals within source nations like the Philippines profit from nurses seeking the credentials to qualify for jobs overseas. While existing studies show how nursing skills are exploited and undervalued, this paper argues that it is the process of skilling itself that allows for the accumulation of profit, regardless of whether nurses leave their origin countries to work abroad. This study reveals how global care economies are tightly linked to local …

Secondary Syphilis Mimicking Marginal Zone B-Cell Lymphoma In A 70-Year-Old Man., Hannah Gier, Shannon Trotter

Ambulatory and Primary Care Articles

No abstract provided.

Umbilical Cord Milking Versus Early Cord Clamping In Late Preterm And Term Neonates Who Are Non-Vigorous At Birth: A Cluster-Randomized Controlled Trial (Cordmilk Trial), Zubair H. Aghai, Sangappa M. Dhaded, S Yogeshkumar, Sunil S. Virnekar, Benjamin L. Leiby, Vinita Jain, Yvonne E. Vaucher, Nitin Chouthai, Meenakshi Girish, Seema Parvekar

Conference Presentation Abstracts

No abstract provided.

Exploring Single Celled Rna Biomarkers Using Deconvolution Analysis For Severe Retinopathy Of Prematurity In Extremely Premature Newborns, Vighnesh Ghatpande, Saachi A. Bodas, Nitin Chouthai

Conference Presentation Abstracts

Background: Timely, precise diagnosis of Retinopathy of Prematurity (ROP) is key to implementing appropriate treatment, as distinctions between mild-ROP and severe-ROP are the primary factors in its characterization. Deconvolution analysis of bulk RNA sequencing is an indirect method to identify static and dynamic molecular and physiological associations.

Objective: The objective of this this study was to evaluate if deconvolution analysis can be used to identify cellular biomarkers of ROP.

Design/Methods: This is a prospective study (IRB#086113MP2E) with a convenience sample size of 8 neonates with no ROP, 6 neonates with mild to moderate ROP (M-ROP), and 7 neonates with severe …

The Role Of Loneliness On College Freshmen Retention, Amy Berg

Libraries Undergraduate Research Award (LURA) Winners

What factors contribute to student retention, dropout, and success within the first semester? We hypothesized that persistent feelings of loneliness across the semester play a major role in a student’s intentions to continue enrollment, and a lack of social connection to the university mediates this relationship. We assessed this in a sample of n = 30 first semester freshman enrolled in a university success seminar across the Fall 2025 semester, of whom n = 8 completed Wave 1 and Wave 4 surveys of a four-wave study spanning the whole semester. We used the 20- item UCLA Loneliness Scale, the 24-item …

Kidney Disease And Heart Failure: Recent Advances And Current Challenges: Conclusions From A Kidney Disease: Improving Global Outcomes (Kdigo) Controversies Conference, Carolyn S P Lam, Biykem Bozkurt, David Z I Cherney, Justin A Ezekowitz, Meg J Jardine, Sadiya S Khan, Magdalena Madero, Mark J Sarnak, Jozine M Ter Maaten, Michael Cheung, Jennifer M King, Morgan E Grams, Michel Jadoul, Nisha Bansal

Faculty, Staff and Students Publications

Heart failure (HF) and chronic kidney disease (CKD) frequently coexist, which elevates the risks of hospitalization, disease progression, and death. Despite advances in treating each condition independently, many challenges remain in diagnosing and managing them in combination. In March 2024, Kidney Disease: Improving Global Outcomes (KDIGO) held the Controversies Conference on Kidney Disease and Heart Failure: Recent Advances and Current Challenges. Discussions highlighted the complex, bidirectional relationship between HF and CKD, including shared risk factors and overlapping pathophysiology as well as nuances in interpreting biomarkers such as natriuretic peptides and serum creatinine. Sodium-glucose cotransporter-2 inhibitors, renin-angiotensin-aldosterone system inhibitors, and emerging …

Comprehensive Profiling Of The Human Tear Fluid Mirnome Using Small Rna Sequencing, Garrett Jones, Drew Mayernik, Saleh Ahmed, Eliza Williams, Jeremy Altman, Tae Jin Lee, Amy Estes, Cintia S De Paiva, Pamela Martin, Shruti Sharma, Ashok Sharma

Faculty, Staff and Students Publications

Purpose: To generate a comprehensive profile of microRNAs (miRNAs) present in human tear fluid using next-generation sequencing (NGS), establish a reference miRNome for healthy human tear fluid, and investigate whether miRNA expression varies by sex, race, or age.

Methods: Tear samples were collected from 32 adults using Schirmer strips. RNA was isolated using the miRNeasy Serum/Plasma Kit, and cDNA libraries were prepared using the QIAseq miRNA Library Kit. Barcoded libraries were sequenced on the NovaSeq 6000 platform. Bioinformatic analyses included adapter trimming, alignment to miRBase, normalization with DESeq2, and functional annotation using multiMiR and clusterProfiler. Differential expression analysis was performed …

Atopic Dermatitis, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Caregiver Challenges And Health Access For Individuals With Developmental Disabilities In Mississippi, Kirsten Cunningham

Honors Theses

Current literature has highlighted the health disparities faced by individuals within the disability community and how it affects the care they receive. However, for many individuals with developmental disabilities, they require caregivers to make medical decisions for them. The purpose of this study is to focus on the caregiver’s perspective of caregiver stress, physical access to care, and health literacy to combat the challenges faced when getting access to healthcare resources for individuals with developmental disabilities in Mississippi. The researcher hypothesized, based on the literature review, that caregivers with higher levels of educational attainment would have less caregiver stress, more …

Association Of Higher Body Mass Index With Imaging Escalation And Operative Complexity In Pediatric Appendicitis, Ryan T. Davis, Sahithi Pemmasani, Margaret Menoch

Conference Presentation Abstracts

Background: Obesity may complicate clinical assessment and ultrasound (US) evaluation in children with appendicitis, potentially increasing reliance on computed tomography (CT). At the same time, national pediatric quality-improvement initiatives and ALARA-driven imaging pathways emphasize reducing CT use and promoting US-first approaches. Data examining how body mass index (BMI) influences diagnostic pathways within these modern low-radiation protocols are limited.

Objective: To determine whether higher BMI is associated with greater CT utilization, escalation from US to CT, nondiagnostic US examinations, emergency department (ED) length of stay (ED-LOS), and operative duration in children with appendicitis.

Design/Methods: This retrospective cohort study included patients < 18 years with surgically confirmed appendicitis presenting to a tertiary pediatric ED from January 1, 2010, to December 31, 2023. Consistent with prior dataset methodology, encounters were identified through structured EHR query using ICD-10 and CPT codes and restricted to unique first visits. A total of 2,275 children were included; BMI was available for 2,012 (88%). BMI was analyzed in quartiles. Imaging modality (US-only, CT-only, or CT after US) and operative duration (proxy for case complexity) were evaluated. χ² and Wilcoxon tests and odds ratios (OR) with 95% CI were used. IRB approval was obtained (Corewell Health IRB No. 2024-128).

Results: …

Ethical Controversies In Organ Procurement: A National Survey On Public Perceptions Of Thoracoabdominal Normothermic Regional Perfusion, Trevor M Bibler, Jill Oliver Robinson, Adam Omelianchuk, Tariq Nisar, Savitri Fedson, Ariel N Levchenko, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Thoracoabdominal normothermic regional perfusion (TA-NRP) would likely expand the quantity and quality of organs procured after controlled circulatory death donation in the United States, yet its ethical permissibility remains contested. We surveyed a representative sample of US adults (n = 975) with the goal of assessing their perspectives on the ethical permissibility of TA-NRP. After reading a neutral description of TA-NRP, participants judged its permissibility, reviewed 5 critic and 5 supporter arguments (in random order), and chose which argument they found most convincing. Multivariable logistic regression examined predictors of agreeing with critics. Before exposure to the arguments, 51.5% stated that …

Author Correction: Phenome-Wide Analysis Of Copy Number Variants In 470,727 Uk Biobank Genomes, Xueqing Zoe Zou, Fengyuan Hu, Haiyi Lou, Oliver S Burren, Xiaoyin Li, Karyn Megy, Eleanor Wheeler, Qiang Wu, Santosh S Atanur, Marcin Karpinski, Douglas Loesch, Zammy Fairhurst-Hunter, Sri V V Deevi, Erin Oerton, Sean Wen, Xiao Jiang, Cecilia Salvoro, Jonathan Mitchell, Abhishek Nag, Ben Hollis, Amanda O'Neill, Astrazeneca Genomics Initiative, Jen Harrow, Stewart Macarthur, Sebastian Wasilewski, Sean O'Dell, Lifeng Tian, Katherine R Smith, Guillermo Del Angel, Margarete Fabre, Ryan S Dhindsa, Quanli Wang, Slavé Petrovski, Keren Carss

Duncan NRI Faculty and Staff Publications

No abstract provided.

Diagnostic Criteria And Management Of Melas And Stroke-Like Episodes: Consensus-Based Statements, Michelangelo Mancuso, Marcello Bellusci, Valerio Carelli, Irenaeus De Coo, Daria Diodato, Felix Distelmaier, Omar Hikmat, Michio Hirano, Rita Horvath, Amel Karaa, Thomas Klopstock, Mary Kay Koenig, Cornelia Kornblum, Chiara La Morgia, Piervito Lopriore, Mika Henrik Martikainen, Robert Mcfarland, Olimpia Musumeci, Robert D S Pitceathly, Guido Primiano, Shamima Rahman, Fernando Scaglia, Andrew Schaefer, Manuel Schiff, Luisa Semmler, Costanza Lamperti, Serenella Servidei

Faculty, Staff and Student Publications

Background and purpose: Mitochondrial Encephalomyopathy, Lactic acidosis and Stroke-like episodes (MELAS) is a rare multisystem mitochondrial disorder with clinical heterogeneity. Diagnostic criteria and management strategies for MELAS and mitochondrial stroke-like episodes (SLE) remain inconsistent. This work provides international consensus recommendations on the definition, diagnosis, and management of MELAS and SLE in pediatric and adult populations.

Methods: An international Delphi consensus process was conducted within the European Reference Network for Neuromuscular Diseases (ERN EURO-NMD), in collaboration with the US Mitochondrial Medicine Society, the ERN for Hereditary Metabolic Disorders (MetabERN), and patient representatives. Following a systematic literature review, 54 statements addressing diagnostic …

Methodological Progress Note: Logic Models, Molly J Horstman, Kyler M Godwin

Faculty and Staff Publications

Logic models are an accessible tool to organize the planning, management, and evaluation of programs across healthcare disciplines. This methodological progress note describes the five standard components of a logic model (Inputs, Activities, Outputs, Outcomes, and Impact) and provides guidance for developing a logic model. Logic models offer a visual representation of the work and theory of a program and should be created with input from all interested parties. Logic models are living tools that need to be revised as programs evolve and new information becomes available.

Weaning Drives Microbiome-Mediated Epigenetic Regulation To Shape Immune Memory In Mice, Li Yang, Robert C Peery, Shirui Zhou, Xiaomin Chen, Leah M Farmer, Fabiola Gutierrez, Stephanie Fowler, Lanjing Zhang, Julia M Salamat, Karen Riggins, Jiejun Shi, Lanlan Shen

Children’s Nutrition Research Center Staff Publications

During weaning, the transition to solid food diversifies the gut microbiome, triggering a programmed immune response critical for long-lasting mucosal immunity. Previous work showed that the gut microbiome mediates epigenetic development in intestinal stem cells (ISCs) during suckling, but what happens during weaning is unclear. Here, genome-wide profiling revealed that weaning-driven microbiome changes shape the DNA methylome and transcriptome of murine ISCs in an IFNγ-dependent manner. Specifically, we observe demethylation of enhancer elements essential for MHC class II genes, which results in a transcriptional memory that persists through differentiation into adulthood. IFNγ blockade, or low-dose penicillin to target Gram-positive bacteria, …

Complex Iliac Artery And Iliocaval Venous Reconstruction Using Temporary, Redundant Graft To Facilitate Resection Of Recurrent Metastatic Sex Stromal Tumor, Shah-Jahan M Dodwad, Blaz Podgorsek, Ezra Koh, Taha S Zaidi, Justin E Bird, Shalin S Patel, Thanila A Macedo, Gustavo S Oderich

Faculty, Staff and Student Publications

We report a complex case of recurrent, metastatic sex cord stromal tumor involving the pelvic vasculature and spinal nerves. Posterior and anterior approaches were required with redo iliac artery reconstruction using a temporary, redundant aortoiliac to right external iliac artery graft and iliocaval venous reconstruction. After completion of tumor resection from nerve structures, reconstruction of the right iliac veins was completed and the redundant aortoiliac arterial graft was shortened. The redundant graft minimized ischemia time, enabling meticulous dissection and tumor removal. This case underscores the importance of multidisciplinary collaboration in managing rare, aggressive malignancies with complex vascular and neural involvement.

Bridging The Gap: A Trauma-Informed Approach To Real-Time Counselor Support Training At Kesem, Elizabeth Fallon

Capstone Projects

This capstone project involved the development and implementation of a trauma-informed care training program for college-aged counselors within Kesem, a nonprofit organization supporting children affected by a parent or caregiver’s cancer. The project addressed gaps in existing counselor training related to recognizing and responding to trauma in real time. The literature identified increased risk for psychosocial challenges in this population, including anxiety, depression, as well as the importance of peer support, safe environments, and developmentally appropriate communication.

The training program included different modules on trauma, grief, and child development, as well as interactive role-play scenarios tailored to different age groups …

From Theory To Practice: Splint Fabrication Through Occupational Therapy Video Library, Caitlyn Mccaughey

Capstone Projects

This doctoral capstone experience (DCE) highlights the need for educational resources on occupational therapy splint fabrication by producing a comprehensive video library to aid skill acquisition among students and new graduates. This project involved developing 21 tutorial videos featuring detailed, step-by-step demonstrations designed to accommodate visual, auditory, and kinesthetic learning styles amongst individuals. A literature review emphasized the growing popularity of video-based education and the lack of accessible, high-quality splinting resources, with a needs assessment revealing low confidence levels among occupational therapy students due to limited educational support. Through collaboration and integration of evidence-based practices, this project successfully produced an …

Creation And Implementation Of Nature And Sensory Based Therapy Programming To Support The Health And Well-Being Of Catholic Dominican Sisters, Sydney Payne

Capstone Projects

As the older generation ages, diseases such as dementia can cause sensory processing systems to be less efficient. When they become less efficient, it can create confusion and undermine one’s sense of safety (Champagne, 2018 pg 29-30). Engaging in sensory experiences provides support for these deficits while fostering participation in everyday life activities (Champagne, 2018 pg 30). This capstone project included a sensory garden (nature-based therapy) and associated multi-sensory activities. This was done through creation of nature and sensory-based programming, implementation of this programming one-on-one with sisters, two group sensory, dementia-friendly activities, and formation of a sustainability binder. Occupational therapy …

The Bronco Well: An Educational Podcast For Pediatric Caregivers’ Wellbeing & Quality Of Life, Molly Veldheer

Capstone Projects

Pediatric caregivers of children with increased and complex physical, cognitive, and emotional needs are an often-overlooked population. Though their children may be involved in many essential services including occupational therapy, the needs of these caregivers largely go unmet. Occupational therapists are equipped to provide valuable care and education to the entire family and not just their pediatric clients. In efforts to fill the unmet needs, this occupational therapy-based podcast was created as resource for pediatric caregivers about pediatric caregivers. The development of this capstone considered the time, energy, and financial strains that are often placed on pediatric caregivers and determined …

Implementation Of A Cardio Drumming Program To Promote Health And Wellbeing In Community-Dwelling Older Adults, Amanda Moyer

Capstone Projects

This doctoral capstone experience focused on implementation of a cardio drumming program at the Ecumenical Senior Center (ESC), a day center for older adults, in Kalamazoo Michigan. Cardio drumming is a unique way of exercise that combines drumming to upbeat music with an exercise ball, laundry basket, and drumsticks. Cardio drumming is low impact and can be adapted to many different abilities. This form of exercise can be done in a seated or standing position. The program began once a week for 30 minutes but soon increased to two times a week for 35 minutes and lasted 9 weeks due …

Life Skills To Promote Independence Following Discharge From Inpatient Psychiatric Care, Alli Bammert

Capstone Projects

This doctoral capstone experience focused on program development through the creation and implementation of a structured life skills program and the initial planning of a simulated life skills training space within an inpatient psychiatric setting at Kalamazoo Psychiatric Hospital. Individuals with serious mental illness often experience barriers to community reintegration following hospitalization and benefit from opportunities to practice daily living skills prior to discharge (Gibson et al., 2011). In response to this need, a 12-week life skills curriculum was developed and piloted to address topics including daily routines, medication management, emotional regulation, grocery shopping, cooking, employment readiness, technology use, and …

Social Skill Program Development: Social Thinking Curriculum, Anna Holman

Capstone Projects

This capstone project examined the implementation of the Social Thinking It: Tweens and Teens curriculum to support adolescent social participation within a group-based setting. Social participation is a core domain of occupational therapy; however, many adolescents experience challenges with communication, emotional regulation, and peer relationships. This project addressed a gap in structured, evidence-based social skills programming at the capstone site. Primary objectives included implementing the Social Thinking curriculum, facilitating weekly group sessions, evaluating participant engagement, and skill development. Intervention strategies included role-playing, guided discussion, modeling, and reflective activities embedded within the curriculum framework. Outcomes demonstrated increased participant engagement and improved …

Creative Art-Based Program To Address Body Image In Cancer Survivors And Caregivers, Tisa Lightfoot

Capstone Projects

This doctoral capstone experience (DCE) explored the role of occupational therapy in promoting the use of creative art-based interventions to address body image in cancer survivors and caregivers. Within the oncology population, body image concerns are a prevalent psychosocial factor that affects survivors’ self-perception, emotional well-being, and occupational engagement in their daily lives. To address this gap, a six-week program was developed to promote art as a meaningful occupation to support the psychosocial well-being related to body image in cancer survivors and caregivers. Additional initiatives of the program included resource development and integration of education on current literature on the …

Occupational Therapy And Grief: Building Knowledge, Justifying Scope, And Supporting Practice, Jessica Jacques

Capstone Projects

Grief can disrupt individuals’ ability to participate in meaningful daily occupations (Hoppes & Segal, 2010), yet occupational therapy (OT) remains underutilized in grief support. Given OT’s focus on occupational performance, practitioners are uniquely positioned to address the functional and emotional challenges associated with grief. Despite this alignment, a gap exists in structured, occupation-based grief support, as well as limited integration of OT within community-based grief services. This capstone aimed to address this need by developing and implementing grief-informed, occupation-based resources and educational materials. Objectives included revising a grief resource manual, creating evidence-based handouts for community and school settings, promoting sensory …

Occupational Therapy & Zoo Exhibit Design: Embedding Accessibility Within, Jacqui Randall

Capstone Projects

This doctoral capstone project was completed at the Indianapolis Zoo. Zoos and museums infrequently contract, but very few employ an occupational therapist to assist with exhibit design development. An occupational therapy consultant could assess exhibit accessibility and provide potential solutions to make them more accessible and inclusive for individuals with disabilities. The goal of the project was to create a list of refined recommendations to make the oceans building more accessible and incorporate more multisensory experiences when it is renovated in the spring of 2027. Also, the Accessibility and Sensation Among Zoo Exhibits and Interactives: Checklist and Application Guide was …

Developing And Implementing Pediatric Pelvic Health Education Groups For Autistic Youth Focused On Toilet Training, Sasha Poland

Capstone Projects

Occupational therapists (OTPs) have a crucial role in treating pelvic health conditions as toileting is an activity of daily living. However, pelvic health research is primarily focused through a physical therapy lens and doesn’t always address challenges pertaining to children, and even more so neurodivergent youth. Furthermore, there is a gap in the literature in how specifically OTPs can assist in providing pelvic health care to all individuals including neurodivergent youth. The goal of this doctoral capstone was to create and provide educational sessions to educate parents, educators, and BCBAs on the role of pelvic health OT in solving their …

Sensory Processing At A Children’S Advocacy Center: Staff Education And Resource Development To Support Trauma-Informed Care, Hayley Jackson

Capstone Projects

This capstone addresses a critical gap in understanding sensory processing within trauma-informed care for children who have experienced sexual abuse. Occupational therapy (OT) offers a unique perspective for supporting children’s sensory processing and regulation needs; however, OT is not utilized in Children’s Advocacy Center (CAC) settings. This project aimed to enhance understanding of OT's scope within trauma-informed care, provide education on sensory-based strategies, and develop resources to support regulation in clinical, home, and school settings. Project objectives were achieved through the development of caregiver and educator handouts, a SMART room sensory binder, a visual schedule binder, SMART movement cards, and …

Designing Inclusive Dog Training Opportunities For Handlers With Diverse Access Needs: An Occupational Therapy Approach, Lauren Huffman

Capstone Projects

This doctoral capstone focused on designing inclusive dog training opportunities in the community by integrating occupational therapy approaches to empower meaningful participation and increase carryover of skills into daily life. The project addressed a need for options that are supportive of dog owners (typically referred to as “handlers” in the dog training setting) who experience health and learning barriers impacting human-dog interactions and the ability to attend dog training classes in a group setting. Occupational Therapy’s role in adaptive recreation and use of occupation-based practice guided the development of a foundations-level accessible small group class, individual adaptive sessions, and educational …

Enhancing Feeding Skills: Development And Implementation Of A Pediatric Feeding Group Program In An Outpatient Setting, Alexia Spyrka

Capstone Projects

Children with autism spectrum disorder are five times more likely to present with feeding difficulties when compared to the general pediatric population (Baraskewich,et.al., 2021). Pediatric feeding difficulties can include picky eating, restrictive diets, limited independence with feeding skills, and limited food repertoire. Not only can this effect the child’s nutrition and growth but can affect family members as they are additionally focusing on their child's socialization, communication, and regulation. When addressing feeding difficulties, occupational therapy services are provided 1:1 with clients while educating and supporting family members to improve carry over into the home. However, there is a gap in …