Medicine and Health Sciences Commons^™

Navigating Insulin Access For Pediatric Type 1 Diabetes: Caregivers' Experiences And Challenges, Ella Anderson

Doctoral Dissertations

Between 2012 and 2018, the annual 14% increase in insulin prices made Type 1 Diabetes (T1D) the most expensive chronic health condition, significantly raising out-of-pocket costs for uninsured or underinsured individuals in the United States (Hayes & Farmer, 2020; Willner et al., 2020). This study utilized a qualitative content analysis methodology to explore the challenges and experiences of parents with children diagnosed with T1D with accessing insulin for their child. Five participants from various areas of the United States responded to open-ended questions both in person and via Zoom. The analysis revealed three main themes: pragmatics of managing diabetic care, …

The Development Of A Trauma Interventional Radiology Alert Protocol Reduces Time To Vessel Puncture In Cases Of Active Hemorrhage., Aahad Khan, Akhil Gangisetty, Steve Mitchell, Nick Daughtery, Brent Goslin, William B Devoe, John Bach

Trauma and Acute Care Articles

Introduction Trauma continues to be a major cause of death in the United States, with uncontrolled bleeding contributing to a significant portion of trauma-related fatalities. In recent years, the management of hemorrhagic trauma patients has expanded to include interventional radiology (IR). The American College of Surgeons Committee on Trauma recommends that Level 1 and 2 trauma centers ensure IR availability within 60 minutes of the decision to proceed with angiography. Delays in IR intervention are associated with poorer outcomes and increased mortality. To address this, our Level 2 trauma center developed and implemented an institutional protocol involving trauma surgeons, interventional …

Examining The Mediating Effects Of Symptoms Of Depression, Anxiety, And Perceived Stress On The Association Between Bereavement And Inflammation, Kylee Faith Behringer

Master's Theses

Bereavement is a stressor that impacts the psychological well-being of an individual and their physical health. This study aimed to develop a more nuanced understanding of the association between bereavement and its psychological and biological consequences, and the potential mediating role of symptoms of depression, anxiety, and stress within the relationship between bereavement and inflammation. Data was collected through Midlife in the United States (MIDUS) Refresher 1, a longitudinal study that examines social, psychological, and biological vulnerabilities associated with potential health outcomes (Weinstein et al., 2019). The study consisted of 863 participants (bereaved=373, non-bereaved=490) who completed an in-person study visit …

Improving Blood Culture Contamination Rates In The Emergency Department: An Evidence-Based Quality Improvement Project, Kerri Maciejko

DNP Projects

Background/Significance

Blood culture (BC) contamination in the Emergency Department (ED) leads to false-positive results, unnecessary antibiotic use, prolonged hospital stays, and increased healthcare costs. Contamination rates at the project site ranged from 2.2% to 6.8%, exceeding the hospital goal of <1%. Addressing this issue is critical for accurate diagnosis, effective treatment, and optimal resource utilization.

Purpose

The purpose of this project was to reduce BC contamination rates in the ED by implementing a modified BC kit, providing staff education, and conducting real-time blind audits with feedback over three months.

Methods

An evidence review, appraisal, and synthesis using Melnyk and Fineout-Overholt’s EBP process confirmed that BC kits and diversion devices are effective interventions to reduce contamination. …

J Mich Dent Assoc May 2025

The Journal of the Michigan Dental Association

The Journal of the Michigan Dental Association is published digitally each month through ADA Commons, reaching 166 countries and accumulating over 35,800 downloads. This extensive reach provides news, information, and features about Michigan dentistry, our state's oral health community, and the MDA's 6,200+ members. It serves as the main publication for connecting with Michigan dentists.

The May issue features:

• An informative interview with Dr. Cheri Newman, the MDA’s new president.
• A feature article from Delta Dental on the utilization of dental services pre- and post-COVID-19 and how the continuing decline in the utilization of restorative services may impact plan design. …

Mda Foundation: Lead Leads To A Key Role On The Mda Foundation, Anne Berquist

The Journal of the Michigan Dental Association

This article highlights the role of the MDA Foundation in providing opportunities for professional development and expanding the impact of dentists' careers. It focuses on Dr. Beth Rosenberg's experience, who became a Foundation Board Member after participating in the MDA's Leadership Exploration and Development Program (LEAD).

The LEAD program builds leadership skills through immersion in organized dentistry. The Foundation raises funds through various events to provide scholarships to dental students and grants to community organizations that improve access to care. The article encourages MDA members to participate in Foundation fundraisers and to consider volunteering or donating.

The Impact Of Hazardous Noise Levels On The Hearing Mechanism Of Marching Band Students, Margaret Westbrook

Honors Theses

Marching band participants are exposed to hazardous noise levels, and they are at risk of developing hearing loss. In this study, the impact of marching band noise on the hearing mechanism of marching band students was examined. Participants who were not in the marching band and were not exposed to noise were used as controls. Detailed case history and noise exposure history were collected using a noise exposure questionnaire (NEQ). The pure tone audiometry test was conducted to examine their hearing, distortion product otoacoustic emissions (DPOAEs) were recorded to examine the inner ear function, and auditory brainstem responses (ABR) were …

Lateral Violence Awareness In Nursing Students At The University Of Southern Mississippi, Aika Owens

Honors Theses

The purpose of this honors thesis was to obtain descriptive data about how nursing students at the University of Southern Mississippi School of Professional Nursing Practice perceive lateral violence in their clinical rotations and educational environments. This Honors thesis is significant to nursing because although lateral violence is a well-researched topic among scholars of nursing practice, there is little gathered data regarding lateral violence among nursing students, specifically at the University of Southern Mississippi. Nursing students are a vital population to examine because nursing students are often first exposed to lateral violence within a clinical setting, leading to early internalization …

Adopting An International Human Rights Approach In The U.S. To Combat Sizeism And Related Racism And Sexism In Healthcare, Public Health Efforts, And Food Advertising Policy, Kristina Bergman, Denisse Cordova Montes

Journal of Food Law & Policy

Evidence of size stigma in U.S. food and health industries is overwhelming. Many policies affecting consumer and patient health and care look to patient Body Mass Index (BMI), a ratio of patient weight to height that anthropologists describe has roots in eugenics, scientific racism, and sexism, and that even the American Medical Association describes as being used for racist exclusion and not encompassing of sex-based differences. Many healthcare policies, public health messages, and food advertising strategies boast goals of reducing BMI in hopes of improving health status, but, in addition to having abhorrent origins, BMI has been shown to be …

Rectosigmoid Intussusception Due To A Nonmalignant Etiology: An Extremely Rare Cause Of Acute Lower Gastrointestinal Bleeding In An Elderly Patient, Kashif Ali, Samra Sohail, Grecia Dominguez Rivera, Valeska Balderas

School of Medicine Publications

An intussusception at the rectosigmoid junction with acute gastrointestinal bleeding is exceedingly rare. We present a case of an 88-year-old man who presented in the emergency department with bilateral lower quadrant abdominal pain and frank rectal bleeding for 2 days. A computed tomography abdomen pelvis angiogram with contrast showed a target sign, and a flexible sigmoidoscopy showed congested bowel, ischemia, frank blood, and intussusception at the rectosigmoid junction. He underwent an exploratory laparotomy with the removal of the affected part. The pathology and the peritoneal fluid cytology results came out negative for dysplasia and malignancy.

Trends In The Prevalence Of Orofacial Clefts Among Hispanic Infants In The Rio Grande Valley Of Texas (1997-2018), Yossef Alsabawi, Aaron Dadzie, Kelsey Baker

School of Medicine Publications

Background Orofacial clefts (OFCs), including the cleft lip with or without cleft palate (CLP) and cleft palate alone (CP), represent significant congenital anomalies with implications for feeding, speech, and psychosocial development. The Rio Grande Valley (RGV) of Texas, a predominantly Hispanic region that faces socioeconomic and healthcare challenges, may have a distinct OFC profile compared to non-border counties (NBCs) of Texas. Methods Prevalence data with 95% confidence intervals for OFCs from 1997 to 2018 were obtained from the Texas Department of State Health Services (DSHS). Definitions provided by the DSHS were adhered to, including only definite diagnoses. Given the large …

Local Systems Change: Applied Research Methods For Sustainable Communities, Taylor Barrett Hill

Graduate Student Portfolios, Professional Papers, and Capstone Projects

No abstract provided.

What References Are Chatgpt, Gemini, Copilot, And Perplexity Providing For Consumer Health Questions?, Scott Johnson, Catherine Johnson, Ivan Portillo

Library Presentations, Posters, and Audiovisual Materials

Background

With the growing popularity of generative artificial intelligence (AI) models such as ChatGPT, consumers may turn to these tools to easily seek health information. To our knowledge, no study has analyzed the references provided by multiple models for consumer health questions.

Objective

We aimed to analyze the references provided by ChatGPT, Gemini, Copilot, and Perplexity for consumer health questions in order to determine the most frequently appearing references.

Methods

AI generative models ChatGPT 4.0, Google Gemini, Microsoft Copilot, and Perplexity were each asked 30 consumer health questions and prompted to provide the corresponding references. The references were recorded.

The …

Digital Activism In Kenya: Moving From The Digital Center To The Digital Periphery Of Long Covid Experience, Emily Mendenhall, Lucy Kamau, Nora Kenworthy, Edna Bosire

Brain and Mind Institute

Digital activism around Long covid has reverberated around the globe, as patients, researchers, and clinicians worked together to understand the chronic condition. However, Long Covid networks, much like other social networks, have hierarchies and barriers that can impede equitable access. In this article, we examine how the global digital center and periphery shape how people with Long covid connect to networks to learn about their illness symptoms, diagnoses, treatments, and experiences. We introduce case narratives of two Kenyan women—one elite Nairobian who was connected to the digital center and another middle class woman who connected with her through a peripheral …

Global Multi-Specialty Clinician Perspectives On The Implementation Of Alzheimer's Disease Blood Biomarkers, Joanne Rodda, Lindsey A. Kuchenbecker, Wyllians V. Borelli, Mari L. Demarco, Raphael M. Castilhos, Erin E. Cawston, Tinatin Chabrashvili, Melissa M. Budelier, Claudia Duran Aniotz, Chinedu Momoh

Brain and Mind Institute

Introduction: Clinicians' views on the clinical readiness of Alzheimer's disease (AD) blood biomarkers (BBMs) are not well understood.

Methods: The Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment Biofluid-Based Biomarkers Professional Interest Area conducted a survey to elicit clinician opinions on AD BBM implementation, including contexts of use, assay selection, reporting, and result interpretation.

Results: Clinician respondents (n = 212) practiced in Europe (56%), North America (24%), the Caribbean and Central/South America (11%), and other continents (9%). Most respondents were medical doctors (80%) practicing in secondary or tertiary care (88%). For 56%, cerebrospinal fluid AD …

Reforming Pensions In Africa: Addressing Coverage, Payout Disparities, And Dementia Outcomes For Sustainable Aging, Cyprian Mostert, Catherine Ajalo, David Andai

Brain and Mind Institute

No abstract provided.

Reducing Stigma Through School Meals For All Programs: New Evidence From Eight U.S. States, Dania Orta-Aleman, Juliana Cohen, Lorrene D. Ritchie, Monica D. Zuercher, Wendi Gosliner

Health Sciences Faculty Publications

Objectives: School meals are the healthiest food source for US children, yet stigma around free or reduced-price meals often hinders participation. School Meals for All (SMFA), also known as universal school meals, may improve children’s nutritional status and school social dynamics, but whether these policies effectively alleviate stigma remains unclear. This study examines whether embarrassment about school lunch predicts participation and how SMFA policies relate to stigma across household income levels. Methods: A cross-sectional, natural experiment was conducted in eight states (four with SMFA, four without) during the 2022–2023 school year. Surveys from 1,066 middle and high school students assessed …

California Middle And High School Students Report Wanting Fresh And Healthy School Lunch In The Context Of Universal School Meals, Carolyn Chelius, Kassandra A. Bacon, Dania Orta-Aleman, Monica D. Zuercher, Lorrene D. Ritchie, Juliana Cohen, Christina A. Hecht, Kenneth Hecht, Wendi Gosliner

Health Sciences Faculty Publications

Objective

Design

Setting

Participants

Main Outcome Measure

Analysis

Results

Dean's Research Newsletter, May 2025, Neil W. Schluger

SOM Dean's Research Newsletter

No abstract provided.

Optimum Volume Of Serious Fluid For The Detection Of Malignancy: A Systematic Review, Sarah Atieno Okech

Master of Medicine in Anatomic Pathology

No abstract provided.

Influence Of Medicaid And Medicare On Total Joint Arthroplasty Outcomes: 10-Year Report Of Michigan Hospitals, Madeleine Declercq, Jacob Keeley, Robert Runner, Kevin Weisz, Leonardo Cavinatto, Drew Moore

Posters

Access to healthcare significantly varies by medical insurance type, particularly for individuals for low socioeconomic status.

• Medicaid often covers these individuals (a government-funded program for low-income adults and children).

• Only 45% of primary care providers accept new Medicaid patients, versus 94% for private insurance.1

• Large non-profit medical centers accept Medicaid but still present considerable access challenges for patients.

• Lower reimbursement rates, complex medical needs, and extensive administrative requirements are key barriers for providers accepting Medicaid.

• Studies, such as those by Deans et al., highlight greater travel burdens for Medicaid patients needing revision hip or knee …

Does The Possibility Of No Surgery In Watch And Wait For Rectal Cancer Affect Patient Decision-Making?, Joanna F. Wasvary, Ga-Ram Han, Jacob A. Applegarth, Matthew A. Ziegler

Posters

INTRODUCTION & OBJECTIVE

Prior studies have established that the watch and wait protocol for rectal cancer is a reasonable approach in patients with excellent response to total neoadjuvant therapy (TNT). Current guidelines stipulate that patients eligible for this protocol have no residual tumor on re-staging imaging and endoscopy. Patients who have evidence of residual disease are referred for surgery. This study assessed all patients in our institution who underwent TNT for rectal cancer and the subsequent recommendations for treatment. Primary aim: assess patient compliance with surgeon recommendations for residual disease after TNT.

Secondary aim: assessment of oncologic outcomes and the …

Implementation Of An Opioid Free Pediatric Hernia Repair Protocol, Corey Shafer, Antonela Muca, Randy Hilleary, Kristin Lemarbe, Diane Studzinsk, Kaveh Aslani, Nathan Novotny, Pavan Brahmamdam, Begum Akay

Posters

Surgery most often provides children with their first exposure to opioids which may lead to misuse and overuse. Protocolizing pain management perioperatively can reduce opioid exposure in children while still providing adequate pain management.

Surgical Site Infection Bundle For Babies: Preliminary Data, Cullen Woodley, John Nida, Alexis Lonjin, Katelyn Ward, Diane Studzinski, Begum Akay

Posters

Surgical Site Infections (SSIs) are infections that occur in or around the area where a surgery was recently performed. They are estimated to account for 20% of all healthcare associated infection, and lead to an increase in morbidity and mortality. Perioperative care bundles show promise in reducing SSIs in adults but are not often used in neonatal surgery. Infections in babies after surgery are less common than adults but carry significant morbidity in a fragile patient.

Enhancing Reproductive Anatomy Education: A Comprehensive Approach Integrating Near-Peer And Reciprocal Peer Tutoring, Hope Hefferan, Emelie-Jo Scheffler, Erin Mueller, Varna Taranikanti

Posters

• Near-peer tutoring (NPT): Tutors are more advanced than tutees, typically offering support in understanding complex concepts.1

• Reciprocal peer tutoring (RPT): Students with similar levels of training alternate between tutor and tutee roles, facilitating collaborative learning.1

• Peer tutoring fosters professional development and improves long-term retention of complex medical concepts.3,4,5

• Reproductive anatomy is a challenging area for many medical students; Innovative peer tutoring methods may help improve understanding and retention of anatomical structures.

• We hypothesize that integrating NPT and RPT within the laboratory setting in the reproductive organ system course will enhance student motivation, self-efficacy, and long-term …

Stroke Risk After Lowering Elevated Blood Pressure In Transient Ischemic Attack, Alexsandra Biel, Jacob Keeley, Brett Todd

Posters

• There is a relationship between the diagnosis of TIA and the subsequent development of a stroke1–4.
• The risk of developing a stroke within 90 days of a TIA is approximately 10.5% with about half of these occurring in the first 1-2 days of the TIA3.

Risk factors that may increase the likelihood of developing a stroke following a TIA include:

• Having age over 60
• A blood pressure of 140/90 or greater
• Diabetes
• Increased TIA duration
• Increased symptomatology at the time of presentation5–8.

Manual Versus Mechanical Cardiopulmonary Resuscitation Complications After Successful Resuscitation For Out-Of-Hospital Cardiac Arrest, Connie Chen, Jacob Keeley, Julian Sit, Robert Swor

Posters

Over 300,000 people in the United States annually suffer from an out of hospital cardiac arrest (OHCA); 90% of cases are fatal.1

EMS-treated OHCA approximately has a 30% rate of Return of Spontaneous Circulation (ROSC), but not all survive to hospital admission or discharge.2

Quality cardiopulmonary resuscitation (CPR) provides vital organ reperfusion until cardiac activity can be restored.

Mechanical CPR is increasingly being used for field OHCA care. It is most often performed by the Lund University Cardiopulmonary Assist System (LUCAS) device, a piston chest compressor which incorporates a mechanism for active chest recoil.

Benefits of mechanical CPR:

• Uninterrupted …

Examining Health Disparities: An Observational Study On Peripheral Vascular Access Outcomes Among Hospitalized Patients, Charlotte O’Sullivan, Nicholas Mielke, Yuying Xing, Amit Bahl

Posters

Peripheral intravenous catheter (PIVC) placement is the most common invasive procedure performed in healthcare, with an estimated 90% of hospitalized patients requiring PIVC access during their stay. This equates to around two billion PIVCs used annually.1–3 Studies report 36% to 63% of catheters fail due to a variety of complications, including infiltration, occlusion, phlebitis, dislodgment, and infection. 2–6 These failures not only cause immediate patient discomfort and increased clinical workload but also have wider implications such as prolonged hospital stays and delays in critical treatments.2 The factors contributing to PIVC failure are multifaceted, involving clinical presentation, patient anatomy, provider skill …

Pr Novel Hematoma Prevention Device, Nolan Shoukri, Steven Pearl, Nishaki Mehta

Posters

• Hematomas are a common complication in cardiac internal electronic device (CIED) placement procedures, they occur in up to 20-25% of CIED implants.

• Previous RCT tested a novel hematoma compression device (PR) and showed good tolerability, decreased hematoma formation from 15% to 6%, and wound improvement.

• Based on feedback collected from the nurses, physicians, allied health professionals during the randomized control trial, iteration of the PR was done (Gen 2 PR).

• This study evaluated 1) bench testing of the Gen 2 PR device and 2) healthy volunteer testing of Gen 2 PR device.

Beyond The Epi-Pen: Prehospital Use Of Epinephrine In Anaphylaxis, Randy Hilleary, Corey Shafer, Margaret Menoch

Posters

• Prehospital epinephrine administration has been historically low by the individuals having the reaction, their caregivers, or emergency medical service (EMS) personnel
• With rising anaphylaxis cases, it becomes more imperative that there is appropriate administration of epinephrine to improve outcomes in both pediatric and adult populations