Medicine and Health Sciences Commons^™

Supporting Healthy Siblings In Pediatric Cancer: Advancing Relational Interventions To Heal Invisible Wounds, Kristen K. Wederski

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Healthy siblings of children diagnosed with cancer occupy a uniquely vulnerable position within the pediatric oncology landscape. Individuals within this population often demonstrate significant emotional distress and can experience long-term psychological challenges. Despite their risk, healthy siblings remain under-researched and under-supported compared to pediatric patients and caregivers. Existing interventions tend to prioritize individual coping skills and psychoeducation and often overlook the critical relational dynamics that shape healthy siblings' psychological adjustment. Grounded in systematic and relational theories, this paper proposes a paradigm shift toward relationally focused interventions that strengthen the caregiver-sibling bond as a core mechanism of change to foster resilience …

Prolonged Exposure To Food Odors Suppresses Feeding Via An Olfactory Bulb-To-Hypothalamus Circuit, Yao Liu, Hailan Liu, Huey-Xian Kelly Wong, Niccole Auld, Kristine M Conde, Yongxiang Li, Meng Yu, Yue Deng, Qingzhuo Liu, Xing Fang, Mengjie Wang, Yuhan Shi, Olivia Z Ginnard, Yuxue Yang, Longlong Tu, Hesong Liu, Jonathan C Bean, Junying Han, Megan E Burt, Sanika V Jossy, Yongjie Yang, Chunmei Wang, Qingchun Tong, Benjamin R Arenkiel, Hongjie Li, Yong Xu, Yang He

The Brown Foundation: Institute of Molecular Medicine

Olfactory perception of food odors is a key determinant of eating behavior, including triggering appetite, facilitating food seeking and influencing food choice. While transient food-related olfactory cues stimulate appetite and provoke cravings in states of hunger, emerging evidence implies that prolonged and sustained exposure to food-derived odor (FO) suppresses feeding. However, the mechanisms by which olfaction induces hypophagia remain elusive. In this study, we show that prolonged FO exposure significantly suppresses food intake in male mice. We identified a subset of neurons in the ventral subiculum (vSub) that are specifically activated by FO. We further discovered that these FO-activated neurons …

A Developmental Evaluation Of A Dental Hygiene Program And A Community Health Partnership, Laura Jacob

Higher Education: Doctoral Research Projects

Today, dental hygiene education commonly occurs in community college settings which are removed from dental schools thus dental hygiene students graduate with relatively little to no exposure to dentistry or directly with a clinically practicing dentist. With dental hygiene workforce shortages at an extremely high level, locally and nationally, it is imperative to matriculate students who are poised to be successful in the changing landscape of healthcare.

The purpose of this program evaluation was to investigate via the developmental program evaluation model, the perceived benefits of a potential collaboration between the Colorado Mountain College (CMC) dental hygiene program and a …

Using The R = Mc2 Heuristic To Assess Whole-Of-School Physical Activity Implementation In Elementary Schools: A Cross-Sectional Study, Derek W Craig, Kevin Lanza, Christopher D Pfledderer, Andjelka Pavlovic, Kempson Onadeko, Natalia I Heredia, Jizyah Injil, Laura F Defina, Timothy J Walker

Faculty, Staff and Student Publications

Background: Schools are recommended to use a whole-of-school (WOS) approach to promote physical activity opportunities before, during, and after school. Yet, the barriers and facilitators to implementing a WOS approach successfully are not well understood. The R = MC2 heuristic, which defines readiness for implementation as a combination of an organization's motivation and capacity to implement, can enhance our understanding of implementation in the school setting. This study examines associations between constructs from the R = MC2 heuristic and schools' implementation of a WOS approach.

Methods: We conducted a secondary analysis of cross-sectional data from U.S. elementary schools participating in …

Surgeon Ergonomics While Performing Total Knee Arthroplasty, Cameron Dahman

Electronic Theses and Dissertations

One of the most prevalent hazards to orthopedic surgeons are musculoskeletal disorders with 97% of arthroplasty surgeons reporting procedural-related musculoskeletal pain and 66% of orthopedic surgeons reporting procedural-related musculoskeletal injury [1], [2], [3]. With the annual number of total knee arthroplasties (TKA) on the rise, orthopedic surgeons are taking on larger annual caseloads and retiring later in life [4], [5]. The goal of this study was to quantify postural demand for 11 discrete surgical steps of TKA to identify ergonomically unfavorable positions surgeons experience while operating. Four orthopedic surgeons performed TKA while their motions were recorded using marker-based motion capture. …

Review Of Human Papillomavirus Vaccination Programs In United States Schools, Cassandra Duran, Aditi Gupta, Lynda Aririguzo, Norma Castillo, Sanghamitra M Misra

Faculty, Staff and Students Publications

Background: School vaccination programs (school-based and school-located) that include the human papillomavirus (HPV) vaccine have been implemented throughout the United States since 2009.

Methods: We conducted a review of school HPV vaccination programs in PUBMED, Google Scholar, Web of Science, Ovid, Medline, and Embase and included peer-reviewed studies originating in the United States that focused on any aspect of HPV school vaccination programs.

Results: Our review yielded 47 articles that fell into several categories: (1) parent and child perceptions, (2) school nurse perceptions, (3) development, (4) implementation, (5) outcomes, and (6) barriers and facilitators of HPV vaccination programs in schools. …

Blood And Neuronal Extracellular Vesicle Mitochondrial Disruptions In Schizophrenia, A Ankeeta, Ashutosh Tripathi, Bindu Pillai, Yizhou Ma, Joshua J Chiappelli, Jessica N Jernberg, Keiko Kunitoki, Xiaoming Du, Si Gao, Bhim M Adhikari, Consuelo Walss-Bass, Giselli Scaini, Peter Kochunov, Anilkumar Pillai, L Elliot Hong

Faculty, Staff and Student Publications

The high energy demand of the human brain obligates robust mitochondrial energy metabolism, while mitochondrial dysfunctions have been linked to neuropsychiatric disorders, including schizophrenia spectrum disorders (SSD). However, in vivo assessments that can directly inform brain mitochondrial functioning and its etiopathophysiological path to SSD remain difficult to obtain. We hypothesized that system and brain mitochondrial dysfunctions in SSD may be indexed by elevated cell-free mitochondrial DNA (cf-mtDNA) levels in the blood and in neuronal extracellular vesicles (nEVs). We also explored if these mtDNA marker elevations were associated with brain metabolites as measured by magnetic resonance spectroscopy (MRS). We examined blood …

Predicting Regional Cerebral Blood Flow Using Voxel-Wise Resting-State Functional Mri, Hongjie Ke, Bhim M Adhikari, Yezhi Pan, David B Keator, Daniel Amen, Si Gao, Yizhou Ma, Paul M Thompson, Neda Jahanshad, Jessica A Turner, Theo G M Van Erp, Mohammed R Milad, Jair C Soares, Vince D Calhoun, Juergen Dukart, L Elliot Hong, Tianzhou Ma, Peter Kochunov

Faculty, Staff and Student Publications

Background: Regional cerebral blood flow (rCBF) is a putative biomarker for neuropsychiatric disorders, including major depressive disorder (MDD).

Methods: Here, we show that rCBF can be predicted from resting-state functional MRI (rsfMRI) at the voxel level while correcting for partial volume averaging (PVA) artifacts. Cortical patterns of MDD-related CBF differences decoded from rsfMRI using a PVA-corrected approach showed excellent agreement with CBF measured using single-photon emission computed tomography (SPECT) and arterial spin labeling (ASL). A support vector machine algorithm was trained to decode cortical voxel-wise CBF from temporal and power-spectral features of voxel-level rsfMRI time series while accounting for PVA. …

Applying Contextual Behavioral Science To Address Addictions In Monsters, Chase Hollander

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The dominant essentialist paradigm in addiction treatment often conceptualizes addiction as a curse or plague which seizes the individual afflicted by it. Such views are reinforced by neurobiological interventions like Medication-Assisted Treatment (MAT). While MAT can reduce cravings and withdrawal symptoms, its long-term efficacy is mixed, and its emphasis on abstinence as a primary outcome limits its scope. Addiction is a multifaceted phenomenon shaped by physiological, psychological, social, and systemic factors—including stigma, moral judgment, and structural oppression. Essentialist approaches frequently pathologize individuals and obscure these broader influences. In contrast, contextual behavioral sciences and therapies aligned with functional contextualism such as …

Unleashing Nk Cells For Cancer Immunotherapy In Lung Cancer: Biologic Challenges And Clinical Advances, Quinlan Mclaughlin, Dorothy K Sojka, Kathleen Kennedy, Sytse J Piersma, Nan Sethakorn

2020-Current year OA Pubs

Natural killer (NK) cells are a crucial part of the innate immune system and serve as an important effector for killing tumor cells through direct cytolytic activity or immunomodulatory signaling to T cells and antigen presenting cells. NK cells are correlated with increased tumor control and better overall patient survival across various types of cancers including non-small cell lung cancer (NSCLC). Despite their promising potential for anti-tumor killing, NK cell function is often diminished within the tumor microenvironment. There are many factors that lead to decreased tumor-infiltrating NK cell killing, including immunoinhibitory factors from tumor cells and resident tissues, acquired …

Building An Interdisciplinary Workforce In Geroscience: Aligning Perspectives And Educational Goals, Iman M Al-Naggar, Miranda E Orr, Et Al.

2020-Current year OA Pubs

The National Institute on Aging-funded Geroscience Education and Training Network held the "Building an Interdisciplinary Workforce in Geroscience: Aligning Perspectives and Educational Goals" preconference workshop at the 2023 Gerontological Society of America's Annual Meeting. Parties involved in geroscience education and interested stakeholders addressed the development of didactic educational materials, training, and career development opportunities to equip learners with the skills to meet the demands of the emerging field of geroscience, from research to clinic and industry. Recent successes were presented, existing opportunities, gaps, and challenges identified and discussed, and solutions and future directions described.

Sars-Cov-2 Antibody Responses In Children Exhibit Higher Fcr Engagement And Avidity Than In Adults, Carolyn A Cohen, Ludivine Grzelak, Susan S Chiu, David Sc Hui, Mike Yw Kwan, Owen Ty Tsang, Wai Hung Chan, Yat Sun Yau, Kelly Wk Lee, Masashi Mori, Gaya K Amarasinghe, Samuel Ms Cheng, Leo Lm Poon, Malik Peiris, Sophie A Valkenburg

2020-Current year OA Pubs

As intrinsic differences in humoral immune response to SARS-CoV-2 between children and adults remain unclear, we improved characterisation by defining the kinetics, specificity and function of antibodies to SARS-CoV-2 in children (n = 146, aged 9.4 ± 4.8 years with n = 257 samples) compared to adults (n = 85, aged 39.5 ± 15.2 years with n = 122 samples). We used plasma samples from an infection and vaccination-naive cohort study with RT-PCR confirmed ancestral B.1* SARS-CoV-2 virus infection with asymptomatic or mild disease, collected in Hong Kong between March to December 2020, from acute (0-14 days post infection) to …

Enhancing Cataract Surgery Outcomes: Optimal Use Of Pre- And Post-Operative Eye Drops, Keith Skolnick M.D., Anu Valiaveedu

Mako: NSU Undergraduate Student Journal

Many preoperative and postoperative cataract patients struggle with comprehending the use of prescription medication as directed. Language barriers and low health literacy levels are major factors contributing to improper use of prescriptions. To increase patients comprehension, the Fort Lauderdale Eye Institute employed an educational intervention consisting of a live presentation and an instructional video. Results found that 44% of patients were hesitant to ask questions to clinical staff, 32% felt overwhelmed, and nearly 70% lacked confidence in using their prescribed eye drops. Following the intervention, 91% of patients reported increased confidence in their medications, and most indicated that the video …

Host, Microbiome, And Parasite: How Apicomplexan Microorganisms Interact With Gut Microbiota, Senia Bu, Andrew T. Ozga

Mako: NSU Undergraduate Student Journal

The gut microbiome, a complex ecosystem of microorganisms residing in the human gastrointestinal tract, plays a crucial role in maintaining overall health. It functions in immune system regulation, digestion, and protection against pathogens. Apicomplexan parasites, such as Toxoplasma gondii, Plasmodium spp., and Cryptosporidium spp., are major pathogens that can significantly disrupt the gut microbiota, leading to alterations in microbial composition and function. This review explores the bidirectional interactions between Apicomplexan parasites and the gut microbiome, focusing on how these parasites influence microbial diversity, immune responses, and host metabolism. It examines the mechanisms by which infection-induced inflammation, altered …

From Infection To Restoration: A Case Study On Dental Extraction In The Maxilla Anterior, Melanie Ramirez

Mako: NSU Undergraduate Student Journal

A dental implant is a restorative surgical procedure that serves as a solution to replace missing teeth that imitate the function, sensation, and appearance of natural teeth. The objective of this dental case study is to examine the diagnosis, treatment, and post-operation of a patient with a history of tooth loss and infection in the anterior maxilla. This case follows a 55-year-old patient, Jorge Marquez, name changed for confidentiality, who presented a severe tooth abscess on tooth #10 on the anterior maxilla which had previously undergone root canal treatment (Figure 1B). Radiographic evaluations illustrated the severity of the abscess the …

The Residual Impact Of Slavery On How Enslaved Black Females Defined And Made Meaning Of Sexual Violence: A Content Analysis, Suzanne R. Bates

Dissertations

Thompson-Miller & Picca (2016) and Feimster (2023) argued that enslaved African American women, and even free African Americans after the Civil War were victims of non-consensual sexual activity and rape. The NISVS report revealed that before the age of 18 years old, 35.5% of African American women experienced contact sexual violence, 29.5% experienced non-contact unwanted sexual encounters, and 20.7% experienced rape (Basile et al., 2022). Researchers of slave scholarship have made the case for the importance of including discourse on slavery and enslaved Black females’ experiences when discussing present day sexual violence among Black women in the US today (Balfour, …

Oncogenic Effects Of Ecm Remodeling In Obesity And Breast Cancer, Mackenzie L. Hawes, Marcus A. Moody, Caroline R. Mccauley, Abigail G. Huddleston, Maansi Solanky, Dara H. Khosravi, Ayushi R. Patel, Ronald M. Lynch, Suresh K. Alahari, Bruce A. Bunnell, Jorge A. Belgodere, Van T. Hoang, Matthew E. Burow, Elizabeth C. Martin

School of Medicine Faculty Publications

Extracellular matrix (ECM) components are key regulators in breast cancer progression, as ECM remodeling is essential for breast cancer cells to invade into surrounding tissue. This process is characterized by the alignment of fibrillar collagens, breakdown of basement membrane components, and increased interstitial collagen stiffness. In patients with obesity, pre-existing ECM changes, including excessive collagen deposition and heightened matrix stiffness, mimic alterations detected in breast cancer. Given that obesity is a predictor of poor prognosis and resistance to treatment in breast cancer, it is crucial to understand how ECM conditioned by obesity affects disease outcomes. In this review, we highlight …

Leveraging Artificial Intelligence (Ai) For Competency-Based Course Design: A Quality Improvement Project In Nursing Education, Lesslie Bull

Doctor of Nursing Practice Projects

This quality improvement project addressed inefficient, manual course design processes contributing to faculty workload and declining National Council Licensure Examination (NCLEX) pass rates at a rural Texas university’s baccalaureate nursing program. Guided by the Roy Adaptation Model and the Plan-Do-Study-Act framework, the project evaluated the effect of integrating artificial intelligence (AI) tools on faculty perceptions of technology adoption, specifically perceived usefulness (PU), perceived ease of use (PEOU), and behavioral intention (BI). Using a quasi-experimental pre-/post-intervention design, twelve faculty members completed a one-hour, evidence-based training using the Generative AI for Instructional Development and Education (GAIDE) framework, and eight faculty participated in …

Characteristics And Effectiveness Of Premarital Thalassaemia Educational Interventions Worldwide: A Scoping Review, Maisarah N. Anwar, Nik Nairan Abdullah, Dalila Roslan, Aimi N.M. Ruzlin

Sultan Qaboos University Medical Journal

Thalassaemia, a hereditary blood disorder, remains under-recognised due to limited awareness, particularly among young people. This scoping review aimed to evaluate the characteristics and effectiveness of premarital thalassaemia educational interventions globally. Following PRISMA-ScR guidelines, six databases were searched for English-language studies targeting adolescents and young adults. Eight studies met the inclusion criteria, and data were extracted using a standardised form adapted from the Joanna Briggs Institute, focusing on intervention characteristics, outcomes and key findings. Most studies involved school students and young adults from culturally diverse, resource-limited settings. The interventions—traditional, technology-based or culturally adapted—consistently improved knowledge (P < 0.001). However, behavioural outcomes, such as increased uptake of screening, were inconsistent. While educational strategies enhanced knowledge effectively, socio-cultural barriers limited the translation into behavioural changes. These findings support the need for future interventions to integrate behavioural change theories, leverage digital tools and address cultural sensitivities to improve their overall impact.

Efficacy Of Submuscular Transposition For Revision Cubital Tunnel Release: Comparative Outcomes Analysis, Joshua Riklan, Alexzandra Mattia, Markos Mardourian, Harvey Chim

School of Medicine Faculty Publications

Purpose: To assess outcomes after revision cubital tunnel release and submuscular transposition and compare these to a cohort of patients undergoing primary release with in situ decompression. Methods: Patients who underwent revision cubital tunnel release and submuscular transposition (n = 16) were enrolled. Mean follow-up was 21.4 months (range 12.8–55.6). Patients were evaluated in person using the Michigan Hand Outcomes Questionnaire (MHQ) and Disabilities of the Arm, Shoulder and Hand (DASH). Dellon stage, McGowan grade, visual analog scale for pain, and improvement of symptoms using the Messina's criteria and Modified Bishop score were assessed. Comparative analysis was performed with a …

Adaptive Deep Brain Stimulation Targeting The Subthalamic Nucleus In A Patient With Parkinson's Disease: A Care Compliant Case Report, Tirath Patel, Christopher Hanani, Anaya Noor, Shamikha Cheema, Muhammad Farhan, Rohab Sohail, Abhishek Goyal, Jabez David John, Adekunle E. Omole, Richard M. Millis

School of Nursing Faculty Publications

RATIONALE: Adaptive deep brain stimulation (aDBS) represents a notable advancement in treating Parkinson's disease (PD), as it offers enhanced therapeutic outcomes and personalized management by adjusting stimulation parameters in real-time according to individual neural signals. This approach minimizes adverse effects commonly associated with standard continuous deep brain stimulation (cDBS). This case report describes the progress of a 62-year-old man with severe PD who demonstrated notable enhancement in motor symptoms and quality of life throughout a 3-month trial period using aDBS. PATIENT CONCERNS: A 62-year-old man who has been suffering from Parkinson's disease. DIAGNOSES: The patient had been diagnosed with PD …

Transforming Fall Prevention Using A Systems-Wide Approach, Jessica Pierce

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project proposal targets fall reduction and injury prevention in a Veteran Affairs Medical Center (VAMC). The initiative implements a non-restrictive, evidence-based fall prevention program that excludes side rails and bed alarms, emphasizing systematic patient safety and personalized care. Falls are a major safety concern at the VAMC due to ineffective traditional methods, inconsistent assessments, and reliance on restraints, contributing to high fall rates and increased healthcare costs. The project successfully achieved consensus from an interprofessional team on developing a comprehensive fall reduction program. Evidence indicates that removing restrictive devices enhances staff engagement and protocol …

An Anesthesia Informed Consent Checklist And Ahrq Share Decision-Making Model For Labor And Delivery Patients: A Quality Improvement Project, Katherine C. Burnett

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Background and Significance: Informed consent is the disclosure of all benefits, risks, and alternatives to patients for a given intervention. Recalling all important details during the consenting process can prove difficult for providers. The process is further complicated for obstetric patients since healthcare decisions also have consequences for the fetus. The American College of Obstetricians and Gynecologists’ Committee (ACOGC) (2021) recommends shared decision-making models (SDMs) for the obstetric patient population. SDMs engage patients in healthcare decisions by reaching a decision through provider expertise, best evidence, and patient values. In addition, surgical informed consent checklists have emerged as useful …

Challenging Life Events Of Undergraduate Students, Kristi Lewis, Gayle Roux, Catherine Dingley

The Qualitative Report

College students often face many difficult or stressful personal life events such as academic pressure, financial worries, family stress, or a relationship breakup. These events can impact their mental health and academic performance. Amid the growing mental health crisis on college campuses, it is important to explore the strategies that college students employ to tackle challenging life events. The purpose of this study was to (1) explore the experience of college undergraduates as they navigate challenging life events; and (2) examine strategies and resources utilized by the students. We conducted a qualitative descriptive study informed by phenomenology (Giorgi, 2009) using …

Premenopausal And Postmenopausal Malignant Cervical Cancer Diagnosis Among Disaggregated Subethnic Groups Of Asian American Women In The United States, Nilofar Haider Mirza

Walden Dissertations and Doctoral Studies

Despite being the United States' fastest-growing and diverse population, Asian Americans are often aggregated with Native Hawaiian and Pacific Islanders in prior research, resulting in masking disparities in cervical cancer screening/diagnosis among Asian American subethnic groups. Guided by Bronfenbrenner's ecological model, the association between disaggregated subethnic groups and cervical cancer diagnosis among Asian American women aged 20+ in the United States was examined using binary logistic regression. How histology type/behavior and age at diagnosis moderate the relationship between disaggregated subethnic groups and cervical cancer diagnosis was also explored. A quantitative cross-sectional design was employed using cases (N=1014) from the U.S. …

Staff Education Focused On Screening Patients For Depression Using The Phq-9 Tool, Eveline Mankom Gwaabe

Walden Dissertations and Doctoral Studies

The doctor of nursing practice (DNP) project at a community health center (CHC) addressed a performance improvement measure related to the usability of the depression screening tool, Patient Health Questionnaire (PHQ-9), for patients 12 years and older. At CHC, the mental health providers underutilized this tool, leading to missed opportunities in identifying patients 12 years and older with depressive disorders. These missed opportunities may contribute to suboptimal patient treatment outcomes. The purpose of the staff educational program was to increase CHC staffs’ understanding of the PHQ-9 screening tool for routine depression screening. Ten mental health providers participated in the program, …

Staff Education To Nursing Leadership On Implementation Requirements Of A Nurse Residency Program, Sherri Ulfig

Walden Dissertations and Doctoral Studies

Nurse residency programs provide new graduate nurses with a solid foundation to support their transition into practice. The DNP students completed a staff education project to educate nurse leaders on the implementation requirements of a nurse residency program at a not-for-profit hospital in the Midwest. The identified practice problem was that the organization paused its nurse residency program during the COVID-19 pandemic due to critical staffing needs, and the leaders wanted to redesign the program to meet current practice standards. The educational project question addressed whether education for site leaders would increase their knowledge of the implementation requirements of a …

Prolonging Lung Cancer Response To Egfr Inhibition By Targeting The Selective Advantage Of Resistant Cells, Lisa Brunet, David Alexandre, Jiyoung Lee, Maria Del Mar Blanquer-Rosselló, David Bracquemond, Alexis Guernet, Houssein Chhouri, Mathilde Goupil, Zoulika Kherrouche, Arnaud Arabo, Maicol Mancini, Dorthe Cartier, Shen Yao, David Godefroy, Julie Dehedin, Jian-Rong Li, Céline Duparc, Philippe Jamme, Audrey Vinchent, Caroline Bérard, David Tulasne, Sabrina Arena, Alberto Bardelli, Chao Cheng, Byoung Chul Cho, Olivier Wurtz, Cédric Coulouarn, Antonio Maraver, Stuart A Aaronson, Alexis B Cortot, Youssef Anouar, Luca Grumolato

Faculty, Staff and Students Publications

Non-small cell lung cancers (NSCLCs) treated with tyrosine kinase inhibitors (TKIs) of the epidermal growth factor receptor (EGFR) almost invariably relapse in the long term, due to the emergence of subpopulations of resistant cells. Through a DNA barcoding approach, we show that the clinically approved drug sorafenib specifically abolishes the selective advantage of EGFR-TKI-resistant cells, while preserving the response of EGFR-TKI-sensitive cells. Sorafenib is active against multiple mechanisms of resistance/tolerance to EGFR-TKIs and its effects depend on early inhibition of MAPK-interacting kinase (MKNK) activity and signal transducer and activator of transcription 3 (STAT3) phosphorylation, and later down-regulation of MCL1 and …

Factors Associated With Adolescents' Self-Efficacy To Meet With Their Health Care Provider Alone, Albert C Hergenroeder, Blanca Sanchez-Fournier, Cassandra Enzler, Mary Majumder, Beth H Garland, Constance M Wiemann

Center for Medical Ethics and Health Policy Staff Publications

Adolescents with special health care needs (ASHCNs) must develop self-management skills to effectively transition into adult-based care. This requires having the self-efficacy to meet with their health care provider independent of caregivers. This study aims to identify the factors associated with self-efficacy in meeting with a provider alone among ASHCN preparing for this transition.Eighty-three English-speaking 18-year olds with renal, gastrointestinal, neurologic, or rheumatologic diseases, and their English- or Spanish-speaking caregivers were recruited at a large children's hospital, and completed a one-time assessment as the historical control group for a larger intervention study. The main outcome measure was self-efficacy to meet …

Staff Education Project To Train Charge Nurses On The Use Of The Tsam Framework To Improve Leadership Competencies, Natoya Gaye Langley

Walden Dissertations and Doctoral Studies

The purpose of this doctoral project was to improve charge nurse leadership competencies through education on the tiered skills acquisition model (TSAM), addressing challenges of high turnover, limited orientation, and compromised care quality in an inpatient psychiatric facility. The background reveals a two-year financial loss of over $1.8 million tied to staff attrition, highlighting the urgent need for a structured training framework. TSAM, a progressive, competency-based model, offers a pathway for deliberate skill acquisition, leadership growth, and enhanced role clarity. A staff education program was implemented with ten charge nurses, incorporating a pretest, PowerPoint training, scenario-based roleplays, and a posttest. …