Medicine and Health Sciences Commons^™

Analysis Of The Cannabinoid Compositions, Byproducts And Heavy Metals In Unregulated Cannabinoid Products By Hplc-Ms/Icp-Ms, Simone K. Melle

All NMU Master's Theses

The rapid expansion of unregulated hemp-derived products has created a need for analytical methods that characterize both cannabinoid composition and contaminant occurrence. This thesis used liquid chromatography-tandem mass spectrometry (LC-MS/MS) to quantify cannabidiol (CBD), Δ8-tetrahydrocannabinol (Δ8-THC), and Δ9-tetrahydrocannabinol (Δ9-THC), and inductively coupled plasma mass spectrometry (ICP-MS) to measure Al, As, Cd, Cr, Cu, Fe, Mg, Ni, Pb, and Zn in commercial hemp-derived products, laboratory-prepared hemp oils, cultivated hemp tissues, extracted material, and post-harvest soil. Commercial products showed wide cannabinoid variability, with several samples containing more than one target cannabinoid, while laboratory-prepared plant oils showed a more consistent profile dominated by …

Recover Well: Reducing Readmissions Through Nurse-Led Follow-Up After Urologic Surgery – A Quality Improvement Project, Candace Brigette Mike

Doctor of Nursing Practice Projects

Hospital readmissions within 30 days following urologic surgeries are often associated with catheter complications, infections, poor pain management, and limited patient understanding of discharge instructions and therefore represent a significant quality and safety concern for patients and institutions alike. The purpose of this quality improvement project was to evaluate whether implementing structured, nurse-led telephone follow-up in conjunction with standard discharge education reduced unplanned 30-day hospital readmissions among adult patients undergoing urologic surgery. Guided by the Logic Model framework, this project used a quasi-experimental, two-group pre- and post-intervention design to compare outcomes at a high-volume outpatient urology clinic in Houston, Texas. …

Myocarditis, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Small But Mighty: How Can Pediatric Psychologists Harness The Power Of Digital Single-Session Interventions?, Christina Amaro, Alexandra Monzon, Melissa Alderfer, Kimberly Canter, Michael Amylon, Stephanie Fooks-Parker, Jessica Schleider, Susana Patton, Katie Devine

Department of Pediatrics Faculty Papers

OBJECTIVE: Single-session interventions (SSIs) are an innovative, scalable approach for addressing the unmet behavioral and mental health needs of pediatric patients and their families. Specifically, digital SSIs, which are self-guided and delivered online, offer a low-cost and accessible approach but are currently underutilized in pediatric psychology.

METHODS: This topical review aims to describe SSIs broadly and the specific need for digital SSIs, explore potential applications within pediatric psychology, outline future directions and considerations, and present two examples of community-engaged digital SSI design.

RESULTS: SSIs evidence small to medium effects across a range of mental health concerns, including distress, anxiety, and …

Visible Light Kinetics Of N-Heterocyclic Carbenes As Additives For Native Chemical Ligation, Hannah M. Werle, Kaitlyn S. Marley, John P. Morgan

SURF Posters 2026

Spectroscopic data have been obtained demonstrating that N-heterocyclic carbenes are effective catalysts for linking shorter peptides to form longer ones, a reaction known as “native chemical ligation” (NCL).  This reaction is key to the preparation of GLP-1 agonists, such as Zepbound®, Ozempic®, and Wegovy®, which are currently undergoing an explosion in popularity due to their treatment of diabetes, obesity, and cardiac issues.  To assess which catalysts are faster, the kinetics model developed by Raines et al., involving the reaction of N-acetylphenylalanine p-nitrophenylthioester and L-cysteine, is being utilized. This published model allows for easy monitoring of the rate of reaction for …

A Replication Study - Mental Health And Suicide Risk Among High School Students And Protective Factors — Youth Risk Behavior Survey, United States, 2023, Hannah Baiyor

Capstone Experience: Master of Public Health

The original study (Verlenden et al., 2024) aims to analyze how various protective factors may buffer poor mental health and suicide risk outcomes among US students in grades 9-12, an important public health topic as suicide is one of the leading causes of death among US teens (Centers for Disease Control and Prevention, 2024a). Through studying these associations, this study aims to uncover pathways to positive mental health outcomes and reduced suicide risk. The study utilizes the 2023 YRBS dataset, a nationally representative sample of US public and private school students in grades 9-12, to estimate prevalence of four mental …

Quality Improvement Initiative To Improve Adherence To Ob Hemorrhage Policy And Standardize Pitocin Administration During Cesarean Sections To Reduce Postpartum Hemorrhage Risk, Lauren R. Litz, Monica Blauser

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality, and Pitocin administration is an important component of hemorrhage prevention and management during cesarean delivery. Variation in Pitocin timing, dosing, method of administration, and adherence to evidence-based recommendations may compromise patient safety and create barriers to standardized obstetric anesthesia care. The purpose of this Doctorate of Nurse Anesthesia Practice quality improvement project was to evaluate current anesthesia provider practices for Pitocin administration during cesarean delivery, compare observed practices with the California Maternal Quality Care Collaborative hemorrhage toolkit and Society for Obstetric Anesthesia and Perinatology Enhanced Recovery After Cesarean recommendations, …

Enhancing Patient Outcomes In Obstetric Neuraxial Anesthesia: Evaluation Of A Structured Documentation Tool For Post-Dural Puncture Headache Tracking (Pdph), Jacqueline Saldana Tovar, Ahmad Hasaan

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

The purpose of this Doctor of Nursing Practice (DNP) project is to evaluate the incidence, management, and practice variation of post-dural puncture headache (PDPH) in an obstetric population using retrospective data from standardized follow-up tools. The project aims to identify inconsistencies in procedural techniques, documentation practices, and adherence to evidence-based guidelines across anesthesia provider levels. By analyzing key clinical variables and patient outcomes, this project seeks to identify gaps in current practice, improve data reliability, and support the development of standardized protocols for PDPH assessment and management. Ultimately, the goal is to enhance quality of care, promote evidence-based decision-making, and …

Enhancing Sbar Documentation And Telecommunication Between Nursing And Anesthesia Teams In The Obstetric And Labor And Delivery Unit, Apollonia C. Anderson, Celeste Meda

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Effective communication during obstetric handoffs is essential for promoting maternal and neonatal safety, yet communication failures remain a significant contributor to adverse events due to inconsistent and unstructured handoff practices. This Doctor of Nursing Anesthesia Practice (DNAP) quality improvement project was developed following the recommendations of the 2025 DNAP project, which implemented the OB/L&D-specific SBAR tool. This project evaluated the use of this communication tool in areas of OB interdisciplinary team communication accuracy, efficiency, and collaboration, particularly during obstetric epidural requests within a community-based labor and delivery unit. Guided by the Plan-Do-Study-Act (PDSA) framework (Institute for Healthcare Improvement, 2020). Utilized …

Dnp Final Report: Improving Diabetes Self-Efficacy Through Nutrition Education: A Quality Improvement Project, Lakimberely S. Wooten

DNP Final Reports

Diabetes affects 12.7% of residents in Northeast Texas and is the 7th leading cause of death. Internal evidence indicates low health literacy and a heavy disease burden in the service area, underscoring the need for a standardized, low-cost, and feasible approach to nutrition education. This quality improvement project evaluated the feasibility of implementing an instructor-led nutrition education session. Guided by the Johns Hopkins Evidence-Based Practice Framework and the ADKAR behavioral change model, adult participants with Type 2 diabetes received instruction on the Plate Method. Participants enrolled in a 4-week, instructor-led diabetes education class completed a 1-hour, nutrition education session using …

Supporting Occupational Engagement And Regulation For Pediatric Multiple Sclerosis, Robert E. Oehl 3rd, Zeida Gutierrez

Summer 2026 OTD Capstone Symposium

Children diagnosed with pediatric multiple sclerosis (MS) can face cognitive, physical, and emotional symptoms. The symptoms they experience can be barriers to participation in occupations and activities of daily living. For occupational therapy, there is very limited resources for pediatric MS specifically, and it is almost an unknown diagnosis. Occupational therapy in management can help ensure that children reach their developmental milestones in mobility, grasp, social, cognitive, and academic circles. This capstone project was meant to improve awareness and comprehensive treatment and resources through program development. The capstone experience resulted in a project featuring a webinar about pediatric MS and …

Unleashing Potential: Educating Ot Practitioners On Animal-Assisted Therapy For Children With Cp, Karley B. Smith, Lakeisa Boykin

Summer 2026 OTD Capstone Symposium

The purpose of this capstone project is to develop and evaluate the efficacy of an animal-assisted therapy educational package for occupational therapy practitioners treating children with cerebral palsy. This educational package serves as an adjunctive occupational therapy service to address the ongoing need for engaging, holistic interventions that support motor development and participation. The primary focus of this project is practitioner education and training to promote safe, structured, and clinically sound integration of animal-assisted therapy into occupational therapy practice. The methods for this project included a literature review, informal needs assessment, development of an educational package, QR code video demonstrations, …

Computational And Ai Tools For Understanding Telomere-Associated Cancer Mechanisms, Eleni Adam

Computer Science Theses & Dissertations

Telomeres are the protective caps of the human chromosomes and are critical for genome stability. Dysfunctional telomeres caused by their erosion with age and cell proliferation as well as by defects in their maintenance is a major early event leading to genome changes and cancer. Subtelomeres possess the critical role of regulating adjacent telomeres. Due to their complex repeat structure and high variance from one person to another, these areas have not been analyzed in detail. We present a set of computational and machine learning tools to aid in the understanding of subtelomere structure and its rearrangements in cancer.

Initially, …

Pavlovian Conditioning And Self-Control: From Laboratory To Classroom Application, Saba Mahmoudi

All Graduate Theses and Dissertations, Fall 2023 to Present

Impulsive choice, the preference for a smaller-sooner reward (SSR) over a larger-later reward (LLR), is associated with various challenging behaviors (e.g., gambling and substance-used disorders). Many interventions can reduce impulsive choice but those that produce long-lasting effects typically require long training durations or are difficult to implement in applied settings. This dissertation evaluated a novel Pavlovian training approach designed to promote self-control. In Experiment 1, procedures from Mahmoudi and Madden (2024) were replicated in the laboratory with the addition of a truly random control group. The study also assessed whether presenting the conditioned stimulus (CS) before a choice would increase …

The Mediating Role Of Hope In The Relationship Between Everyday Discrimination And Depression Among College Students, Busra Vurkun

Counseling & Human Services Theses & Dissertations

Research shows that marginalized populations experience disproportionately higher psychological distress (Budhwani et al., 2015; Bailey et al., 2019). Everyday discrimination, defined as chronic interpersonal mistreatment such as microaggressions and disrespect, is associated with greater depression and lower psychological well-being (Essed, 1991; Calabrese et al., 2015). Although the negative effects of discrimination are well established, less is known about protective factors that may reduce these outcomes. One such factor is hope, conceptualized by Snyder et al. (1991) as agency thinking and pathways thinking and linked to lower depression and greater resilience (Arnau et al., 2007; Banks et al., 2008). This study …

Strategies Black Male Students With Social Anxiety Use To Persist And Succeed At Rural Community Colleges, Gwendolyn F. Houston

Educational Leadership & Workforce Development Theses & Dissertations

Social anxiety, one of the more common types of anxiety, has been linked to poor concentration, impaired performance, and lower academic achievement (BlackDeer et al., 2021; Derakshan & Eysenck, 2009; Leigh et al., 2021). This study addresses the questions: “How do Black male students with social anxiety at rural community colleges in the Southeastern United States handle both academic and non-academic challenges and cope with these stressors?” and “How do Black male students with social anxiety navigate barriers during their journey at rural community colleges in the Southeastern United States, and what strategies do they use to manage these obstacles?” …

Kindergarten Teachers’ Perceptions, Experiences, And Challenges Using Visual Supports For Children With Autism, Jasmine M. Mcnair

Electronic Theses and Dissertations

This qualitative case study examined kindergarten teachers’ perceptions, experiences, and challenges related to the use of visual supports for students with autism spectrum disorder in East Texas. Grounded in cognitive load theory, the study explored whether visual supports enhance learning outcomes by reducing cognitive overload. Four research questions addressed teachers’ perceptions of effectiveness, implementation challenges, the influence of teacher attitudes, and differences based on teaching experience. The researcher collected data through semistructured interviews with 10 kindergarten inclusion teachers and supplemented by classroom observations. Thematic analysis revealed five primary themes: emotional impact and student growth, visual supports as essential instructional tools, …

Reducing Falls In The Cardiac Care Unit: An Improvement Project, Andrea Otero, Aryanna Campa, Nia Butac

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Abstract

Background: Patient falls persist as a leading cause of preventable harm in hospitals, particularly among cardiac care patients who are at increased risk because of medication effects and mobility limitations. Despite existing fall `prevention measures in the Cardiac Care Unit (CCU) at Sutter Medical Center, Sacramento, 43 falls occurred, highlighting the need for improved patient education and consistent staff communication.

Purpose: This quality improvement project evaluated the effectiveness of implementing a standardized fall prevention communication script to reduce the average monthly fall rate in the CCU from 3.583 to fewer than 2 falls per month.

Methods: Using the Plan-Do-Study-Act …

Improving Knowledge Of Obesity-Related Risks And Healthy Lifestyle Behaviors In Adolescents, Tehroop Notra, Samreet Kaur, Karina Heredia

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

This quality improvement project evaluated the effectiveness of a school-based educational intervention aimed at improving ninth-grade students’ knowledge and understanding of obesity prevention, nutrition, and physical activity. Adolescent obesity remains a significant public health concern, showcasing the need for early, evidence-based education. A total of 57 students participated in the two classroom sessions. Of these students, 49 completed the pre-intervention survey, and 48 completed the post-intervention survey. The intervention included an interactive presentation, group discussions, and educational materials. Student knowledge was assessed using a six-item survey administered before and after the session. The results demonstrated improvements across multiple knowledge areas, …

Id-More Vision: Real-Data Machine-Learning Assessment For A Digital-Twin-Inspired, Xr-Ready Rehabilitation Prototype, Rickey L. Clark

Master's Theses

Rehabilitation assessment often relies on periodic observation, while many XR prototypes show scripted rather than recorded-motion evidence. iD-MORE Vision is an offline pipeline trained on KIMORE and IRDS and linked through JSON packets to a two-mode Unity desktop prototype. Both datasets include controls and rehabilitation participants with neurologic, musculoskeletal, or mobility impairments. This improves relevance but does not clinically validate the system.

Under fixed subject-wise splits, the primary five-seed Random Forest predicted KIMORE clinician scores with MAE 6.087 ± 0.044 cTS and R² 0.568 ± 0.006; the subject-level R² interval crossed zero. The primary IRDS five-run CUDA GRU averaged 0.877 …

A Longitudinal Multi‑Proxy Geospatial Classification Of Peri‑Urban Transitions Across Community Health Units In Coastal Kenya, Prissy Makena, Felix Oluoch, Rosebella Iseme, Fredrick Gudda, Alfred Keter, Jai Das, Zulfiqar Bhutta, Anthony Ngugi

Population Health, East Africa

Background Urbanization is spatially heterogeneous in many sub-Saharan African settings. This complicates community health planning when rural and peri-urban labels are applied informally or updated inconsistently. We assessed whether multiple publicly available geospatial proxies could characterize settlement dynamics and support Community Health Unit (CHU) level classification within the Kaloleni Rabai Health and Demographic Surveillance System (KRHDSS) in coastal Kenya.

Methods We conducted a longitudinal ecological analysis across 10 CHUs in Kilifi County with annual observations from 2017 to 2024. Five geospatial proxy indicators of settlement intensity were summarized within CHU boundaries: Visible Infrared Imaging Radiometer Suite (VIIRS) nighttime lights radiance, …

Wisdom In Counseling And Psychotherapy: A Conceptual Model For Practice, Mitchell Waters

Papers

Wisdom is increasingly recognized as a critical construct in counseling and psychotherapy, yet it remains conceptually diffuse and underdeveloped for clinical application. This article proposes an integrative conceptual model of wisdom that extends the Dialectical Behavior Therapy (DBT) WISE MIND framework by incorporating temporal and self-transcendent dimensions. Wisdom is defined as a dynamic, context-sensitive capacity to coordinate cognitive, affective, temporal, and spiritual processes in response to complex life demands. The model includes four components: (a) cognitive–affective integration, reflecting the synthesis of emotion and reason; (b) temporal integration, involving adaptive coordination of past experiences and future possibilities; (c) self-transcendent orientation, conceptualized …

Transfusion Intensity In The Icu: Reasons And Triggers, Merijn Reuland, Senta Raasveld, Jimmy Schenk, Claudia Oord, Sanne Bruin, Caroline Schaap, Andrew Flint, Jan Bakker, Maurizio Cecconi, Marcus Lance

Anaesthesiology, East Africa

Background The reasons and physiological triggers for blood transfusion in critically ill patients are not well characterized. Beyond hemoglobin levels, hemodynamic instability is frequently cited, but its role across clinical contexts remains unclear.

Aims (1) To determine whether reasons and triggers for RBC transfusion differ across intensive care unit (ICU) days with varying transfusion intensity. (2) To describe reasons for non-RBC transfusions across these intensity groups.

Methods This sub-study of the prospective International Point Prevalence Study of Intensive Care Unit Transfusion Practices (InPUT) classified ICU days by transfusion intensity: nonmajor (1 RBC unit), major (≥2 units), and massive (≥6 units …

Trauma: Cervical Spine Clearance, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

From The Editor: Is Giving Actually Better Than Receiving?, Romesh Nalliah

The Journal of the Michigan Dental Association

This editorial examines the relationship between generosity, volunteerism, and well-being. Using the Michigan Dental Association Foundation’s Mission of Mercy as a focal point, the author highlights research suggesting that prosocial behavior can improve mental and physical health while benefiting communities in need. The article encourages oral health professionals to use their skills and resources to support underserved populations through volunteer service, mentorship, and community engagement.

Mda At Your Service: Updating Your Practice Roster With The Mda, Mda Membership Department Staff

The Journal of the Michigan Dental Association

This question-and-answer article provides practical guidance for MDA members on updating practice rosters, accessing continuing education opportunities, addressing staffing shortages through virtual assistants, and participating in the MDA LEAD Program. The article highlights available member resources and emphasizes professional development, workforce support, and leadership growth within organized dentistry.

J Mich Dent Assoc August 2026

The Journal of the Michigan Dental Association

Each month, the Journal of the Michigan Dental Association delivers news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200-plus members. It remains the main publication reaching Michigan dentists and is available worldwide through ADA Commons.

The August 2026 (Volume 108, No. 8) issue of the Journal is published in print format to provide updates and insights for Michigan's oral health community and MDA members. Print editions occur every other month beginning with January.

The August 2026 issue of the Journal of the Michigan Dental Association explores clinical, professional, legal, leadership, and public …

Mission Of Mercy: Restoring Smiles With Dignity, Anne Berquist

The Journal of the Michigan Dental Association

This feature chronicles Michigan’s 2026 Mission of Mercy clinic, where more than 1,200 volunteers provided 5,656 procedures to 771 patients. The article describes patient experiences, volunteer contributions, and the extensive planning required to transform a sports arena into a temporary dental clinic. Beyond oral healthcare delivery, the program restored confidence, relieved pain, and highlighted the dental profession’s commitment to serving underserved populations.

The Power Of The Tripartite: Defending Fluoridation Together, Sarah Stuefen Dds

The Journal of the Michigan Dental Association

This article describes a successful grassroots effort to preserve community water fluoridation in Vinton, Iowa. The author details how local dental professionals, state dental associations, the American Dental Association, public health experts, and community stakeholders collaborated to educate decision makers and advocate for evidence-based public health policy. The experience demonstrates the importance of coordinated advocacy and organized dentistry in protecting oral health initiatives.

The Invisible Work: On Expertise, Showmanship, And The Trust That Makes Surgery Work, Anish Gupta D.D.S.

The Journal of the Michigan Dental Association

This commentary examines how clinicians can make their expertise more visible to patients through communication, education, and clinical narration. Drawing parallels to surgical checklists and professional mastery, the author argues that trust is built not only through excellent outcomes but also through helping patients understand the complexity and judgment behind treatment. The article emphasizes communication, transparency, education, and mentorship as important elements of patient-centered care.