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EXPERT CONSENSUS ON PRACTICES, FACILITATORS, AND BARRIERS OF COMMUNITY ENGAGED LEARNING : A DELPHI STUDY
Get PDFThesis (Ph.D.)--Michigan State University. Psychology - Doctor of Philosophy, 2025Community engaged learning (CEL) is a promising pedagogical approach to higher education that promotes mutually beneficial partnerships with communities (Nguyen & Condry, 2023). To date, there are not well-established best practices for CEL (Da Cruz, 2018; Nguyen & Condry, 2023). To address this gap, I conducted a two-phase Delphi study that allowed me to: (1) describe how CEL is incorporated into undergraduate education across higher education institutions in a land-grant, research-intensive university\u2019s sphere of influence; (2) identify facilitators and barriers to the success of CEL in undergraduate higher education across these same institutions; and (3) identify concrete supports that a land-grant, research-intensive university could offer to enhance and strengthen CEL in undergraduate education within their sphere of influence. In phase one, I identified and recruited 15 expert CEL practitioners to participate in interviews regarding CEL techniques and practices, factors influencing implementation, and the role of MSU in promoting CEL. I then analyzed transcripts of these interviews to identify overlapping themes and practices. In phase two, I asked these experts to rate the themes and practices emerging from phase one based on their impact and, in the case of techniques and practices, the effort required to implement them. Findings inform recommendations for best practices in CEL implementation and the role of higher education institutions in supporting the practice. They also provide information pertaining to factors that impact CEL implementation. These findings should be further examined in the future by other researchers. Practitioners can use findings to assess and improve their CEL practice.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
Three Essays on the Economics of Dialysis
Get PDFThesis (Ph.D.)--Michigan State University. Economics - Doctor of Philosophy, 2025Chapter 1: Quality Disclosure and Patient Switching: Evidence from the Dialysis Industry:In 2012, the Centers for Medicare & Medicaid Services (CMS) implemented the End Stage Renal Disease Quality Incentive Program (QIP) to improve information transparency between dialysis patients and their treatment center by publishing novel quality scores. How dialysis patients respond to these new scores is unclear. This paper explores the extent to which the publication of quality scores influences patients' likelihood of switching dialysis centers, and whether the salience of these scores induces a behavioral change in patients. My findings show that patients at centers with lower quality scores are significantly more likely to switch than those at high quality centers. Specifically, patients at centers with a published score in the 10th percentile are nearly 19% (1.10 percentage points) more likely to switch than patients at centers with a published score in the 90th percentile. Furthermore, patients who learn they are at a low-quality center when scores are published increase their likelihood of switching by over 1.18 percentage points, suggesting that patients respond to the salience of quality scores. These results show that increasing transparency around treatment quality can affect patient decision-making and improve provider-patient matching, with implications for patient welfare and resource allocation. Chapter 2: Patient Preference of Provider Influence: Variation in Health Care Spending Among Dialysis Patients: Dialysis patients spend a substantial amount of time interacting with the staff and peers at their dialysis center, making these environments a potentially important influence on patient behavior. In this paper, I use patient switching to disentangle the demand- and supply-side factors that influence general health care spending. Leveraging an event study design, I examine changes in non-dialysis medical spending before and after a patient switches to a new dialysis provider, relating these changes to the utilization patterns of their new peers. The results show that switchers experience an immediate and persistent change in non-dialysis spending. Point estimates suggest that dialysis centers account for between 37.6% and 61.2% of the variation in a patient's non-dialysis health care spending. The effects are strongest in spending categories with greater patient discretion, such as non-dialysis outpatient visits, suggesting that policies aimed at reducing costs may benefit from appropriate targeting. Chapter 3: Value-Based Purchasing and Payment Reductions: Dialysis Center Response to the End Stage Renal Disease Quality Incentive Program: The Centers for Medicare & Medicaid Services introduced the End Stage Renal Disease Quality Incentive Program in 2012 to improve the quality of dialysis services and reduce costs. A key feature of this program is the implementation of value-based purchasing, which reduces reimbursement to dialysis centers that perform poorly on quality metrics. This paper evaluates whether such payment penalties are effective at improving clinical quality. Using administrative data from Medicare, I compare penalized and non-penalized dialysis centers and estimate the effect of penalties on clinical quality using three empirical approaches: a two-way fixed effects difference-in-differences model, a dynamic event study, and a model allowing treatment effect heterogeneity. The results suggest that dialysis centers penalized for low quality exhibit sustained improvements in septic infections, lower mortality rates, and fewer hospitalizations. These findings support value-based purchasing as an effective tool to incentivize improvements in treatment quality.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
ENDOPLASMIC RETICULUM STRESS DISRUPTS THERAPEUTIC PROTEIN SECRETION AND SIRNA PROCESSING
Get PDFThesis (Ph.D.)--Michigan State University. Chemical Engineering - Doctor of Philosophy, 2025Therapeutic proteins and small interfering RNA (siRNA) therapeutics are emerging technologies to increase beneficial protein levels or reduce disease causing protein expression. To develop new therapeutics, critical challenges relating to the cost of production and delivery to the cells of interest will need to be overcome. The cell membrane, as part of the endomembrane system, is a barrier to both secretion of therapeutic proteins from cells and entry of siRNA therapeutics into cells. Disruption of normal cell function due to environmental stresses is known to alter the function of the endomembrane system. The effects of this disruption on the production and function of biotherapeutics remains poorly understood. To inform protein production process and siRNA therapeutic designs, we examined how environmental stresses altered protein secretion and siRNA processing. Industrial scale production of many therapeutic proteins relies on mammalian cells grown in batch bioreactors. To maximize productivity, the bioreactor contents must be mixed. However, excessive mixing can damage cells through shear. As a result, pockets of low nutrients and oxygen, high or low temperature, and cellular waste products can form. The cellular response to these types of environmental stresses is often to increase the production of protective proteins, which when combined with the burden of therapeutic protein production, overwhelms the cellular protein quality control system and activates the Unfolded Protein Response (UPR). Using small molecule inhibitors and activators, this research investigated how the UPR-activated protein degradation pathways of autophagy and proteasomal degradation impacted protein production. Interestingly, we showed that increasing proteasomal degradation improved protein secretion. Obesity, smoking, hypertension, and diabetes activate the UPR in patients\u2019 cells. For patients receiving siRNA-based therapeutics, activation of UPR is likely to alter the intracellular processing of the siRNAs. We compared the changes in function of cationic lipid delivered siRNAs between control cells and cells with the UPR activated. Using chemical inhibitors and activators, we found that endosome/autophagy crosstalk is linked to differences in siRNA accumulation, distribution, and activity. Our results will inform future siRNA therapeutic designs by reinforcing that accumulation of siRNAs in a cell does not necessarily correlate to silencing levels and that the disease state of individual patients may affect the activity of siRNA therapeutics.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
Understanding Patterns of Production in Upper Elementary Writing
No full textThesis (Ph.D.)--Michigan State University. School Psychology - Doctor of Philosophy, 2024Educators often observe differences in students\u2019 writing productivity, with some students stopping early while others continue to write for the given time. This study demonstrates how planning and goal setting are related to these written production patterns. A Growth Mixture Model identified three groups of writers: the Early Terminators who stopped writing early, the Decelerating Producers who continued to write for the 15 minutes though at a slowing rate over time, and the Steady Writers who wrote at a constant rate across the task. Students who had an additional year of instruction and who created more structured plans to use as a writing goal were more likely to continue writing across the task, pointing to the importance of strong instruction in planning and goal setting for upper elementary writing.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
Some Problems on Manifolds with Lower Bound on Ricci Curvature
No full textThesis (Ph.D.)--Michigan State University. Mathematics - Doctor of Philosophy, 2024In this work, we delve into geometric analysis, particularly examining the interplay between lower bounds on Ricci curvature and specific functionals. Our exploration begins with an investigation into the implications of Yamabe invariants for asymptotically Poincar\ue9-Einstein manifolds and their conformal boundaries under conditions of . We establish a relationship wherein the type II Yamabe invariant of the conformal compactification of the manifold is bounded below by the Yamabe invariant of its conformal boundary. Additionally, we focus on compact manifolds with boundary where and , obtaining partial results concerning Wang's conjecture.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
Educating on Xylazine-associated wound care best practices : a DNP project
No full textProblem: There has been an increase in xylazine use across the United States. This is due to xylazine being used as an adulterant into illicit drugs. There are several adverse effects from xylazine use, with a major complication being xylazine-associated wounds. Purpose: To spread awareness about the dangers of xylazine to healthcare professionals and the general public. Also, to make healthcare professionals aware of the most current evidence based practice treatment for xylazine-associated wounds. Methods: Conducting a case conference at a Michigan hospital to educate healthcare providers including physicians, advanced practice providers (APPs), clinical nurse specialists, and nurses. By utilizing a media platform, awareness of xylazine will also be able to reach a more general public. Results: Case conference participants that partook in the post-education survey showed increase confidence in diagnosing and treating xylazine-associated wounds. Conclusions: Increasing awareness and spreading education regarding current xylazine-associated wound care best practices has the potential to increase confidence in healthcare professionals.Thesis (D.N.P.)--Michigan State University. Psychiatric mental health practitioner, 2025Includes bibliographical references (pages 25-29
Re-membering mathematics : A site of healing
No full textThesis (Ph.D.)--Michigan State University. Mathematics Education - Doctor of Philosophy, 2025With the medium of comic art, this dissertation shares three moments that unfolded in a Midwestern K-8 Spanish immersion school as part of the project Advancing Teacher Learning Theory with Students and Teachers Animating Mathematical Concepts, where dominant conceptualizations of time, space, and mathematics were interrupted and other possibilities lived. With these moments and Anzald\ufaa\u2019s notion of re-membering, this dissertation expresses how, while dominant mathematics can act as sharp fragmented pieces that cut bodies and worlds, they can also be brought back together with/in life, and in turn, bring back together other fragmented pieces as an act of healing. The whole comic is drawn from a place of understanding our world as complex, wise, and lively metabolism/s of which we are an inseparable part of\u2014as a world of interrelated, dynamic, and open worlds, each with multiplicities of rhythms and ways of moving that at the same time continuously transform each other. The comic first introduces the notion of philosophies of nothingness to unearth hidden assumptions that currently drive dominant conceptualizations of time, space, and mathematics, and how they in turn shape how one relates with and understands oneself and the places one inhabits. Drawing (from) what unfolded in a dancing activity that asked children to symbolize an invented dance of their own, the first chapter offers a conceptualization of mathematics as rather relational and emergent, as inseparable from moving bodies and the materiality of the world to bring mathematics back to life. Guided by two children\u2019s conversation on the relationship between dominant mathematics and \u2018truth\u2019 and \u2018knowledge,\u2019 the second chapter invokes feminist scholars and philosophies to embrace Liv\u2019s (one of the children) invitation to re-turn to our whole bodies as knowing, as trustworthy on their own right. At the same time, this chapter shows how dominant understandings of mathematics as exclusively \u2018mental\u2019 and as the ultimate form of knowledge and truth are rather entangled with patriarchal and colonial projects of knowledge that are driven by desires for control and domination. Moved by the story of a growing flower and doubling numbers, the third chapter problematizes the closed and linear understanding of time that predominantly drives (mathematics) education and offers a time that is rather indeterminate and effervescent, where past, present, and future are no longer trapped in a linear relationship but are rather open seas meeting and shaping each other, which in turn opens how (mathematics) education can be understood and lived. At the same time, the third chapter presents the body itself as open\u2014as what opens us to the world that gives us life\u2014and freedom as returning to the openness of our own bodies as part of the spiritual flow that is the world that we are all a part of. Returning to oneself thus is returning to our intrinsic inseparability, interconnectedness, and responsibility with/in each other, with/in the world. The comic desemboca into the reminder that one can always do differently and that we are all born wise; we are all born complete.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
CHARACTERIZATION OF SEED DEVELOPMENT AND ACQUISITION OF DESICCATION TOLERANCE IN WILD PEA (PISUM SATIVUM SUBSP. ELATIUS)
No full textThesis (M.S.)--Michigan State University. Crop and Soil Sciences - Master of Science, 2025Seed development is an essential phase in a plant's lifecycle, allowing plants to survive adverse environmental conditions, disperse their offspring, and support successful sexual reproduction. There are three major phases of seed development: embryogenesis, seed fill, and maturation. During maturation seeds acquire several traits that enable them to survive desiccation, remaining alive in the dry state, and to germinate when conditions are acceptable. There has been little work focusing on the regulatory network controlling desiccation tolerance acquisition in non-model species, which is essential as model species do not have many of the seed traits that are found in wild species. The objective of this work was to profile gene expression throughout seed development in wild pea with a focus on seed maturation and desiccation tolerance acquisition. We performed a RNAseq experiment on a developmental time course of wild pea, using weighted gene co-expression network analysis (WGCNA) on a set of 14,609 differentially expressed genes in either cotyledon or embryonic axis tissue, resulting in a gene network representing 31 gene expression modules. Three modules were positively correlated and one module being negatively correlated with seed maturation and desiccation tolerance and therefore of particular interest. In positively correlated modules, LEAs and HSP were found to be core components for the acquisition of desiccation tolerance. In addition, there was strong overlap between modules genes and essential genes for desiccation tolerance in wild pea with model species. DREB2a and RAP2-1 were specifically identified as important hub genes associated with seed maturity. This work characterized several known and novel genes for both seed maturation and the acquisition of desiccation tolerance which serve as a resource for further gene characterization.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
THE ROLE OF ARYL HYDROCARBON RECEPTOR IN BREAST CANCER
No full textThesis (Ph.D.)--Michigan State University. Pharmacology and Toxicology - Doctor of Philosophy, 2025Why do breast cancer cases continue to rise despite significant advancements in treatment? This underscores the urgent need to understand the factors driving cancer promotion and to uncover the underlying biological mechanisms. What makes breast cells particularly susceptible to malignancy? Identifying these vulnerability factors is crucial for developing targeted prevention strategies to intervene at the earliest stages, preventing cancer before it takes hold. Triple-negative breast cancer (TNBC) is an aggressive subtype that lacks effective preventive therapies due to the absence of estrogen, progesterone, and human epidermal growth factor 2 receptors. Conversely, although estrogen receptor-positive breast cancer (BC) is more responsive to treatment, many patients eventually develop resistance to endocrine therapies. While the exact causes of BC remain complex, one factor, obesity, has seen a parallel rise in incidence and contributes to all stages of breast carcinogenesis. Despite decades of observation, the mechanistic link between excess adiposity and breast tumorigenesis is poorly understood. My research aims to address this gap by investigating a novel, hormone receptor-independent pathway driven by the aryl hydrocarbon receptor (AhR). I demonstrated that high AhR expression is associated with worse overall survival in breast cancer, and previous studies have implicated AhR in the development and progression of the disease. Using an innovative in vitro model, I have shown that non-tumorigenic breast epithelial cells undergo malignant transformation when exposed to adipose tissue-derived kynurenine (Kyn). Elevated Kyn levels are observed in patients with BC and subjects with obesity. I further showed that adipocytes metabolize tryptophan into Kyn, now recognized as an oncometabolite. Additionally, exposure to environmental toxicants such as benzo[a]pyrene increases circulating Kyn in obese preclinical models. Importantly, I provided evidence that inhibiting AhR, either through genetic knockdown or pharmacological inhibition, prevents transformation of mammary cells. This thesis has broad implications for oncology, as Kyn is implicated in multiple cancer types. Understanding these mechanisms could open new avenues for targeted prevention and therapeutic strategies.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references
CROWN-BASED ALLOMETRIC SCALING FOR LARGE-SCALE ABOVEGROUND BIOMASS ESTIMATION IN TREES OUTSIDE OF FOREST LANDSCAPES IN AFRICA
No full textThesis (M.S.)--Michigan State University. Forestry - Master of Science, 2025Nature-based Solutions (NbS) have garnered substantial scientific and policy interest as cost-effective, multifunctional strategies aimed at achieving net-zero CO2 emissions by 2050 through activities that create carbon removals, such as tree planting, agroforestry, and other tree-based systems. In Africa, a critical application of NbS for carbon removals is centered on the framework of Forest and Landscape Restoration (FLR). However, while models for restoration opportunities assessment and implementation exist, there are no monitoring approaches that adequately assess carbon stock in landscapes dominated by Trees Outside Forests (TOF). Remote sensing monitoring of TOF holds promise because it could map carbon stocks in trees across large areas, thereby overcoming the sampling issues associated with sample-based estimates from standard forest inventories. But TOF mapping is challenged by the lack of allometric scaling models using remote sensing-based parameters such as crown dimensions; most common allometries are based on tree stem diameter, which satellite observations cannot directly measure. This study develops and validates a protocol for calibrating Crown Area (CA) allometric models with tree stem diameter models, to deploy standard tree allometry tailored for large-scale biomass measurement and monitoring in such landscapes.Allometric models were developed from data comprising 5,218 trees sampled across 24 for AFR100 restoration project sites in Ghana, Kenya, Malawi, and Rwanda, employing one-hectare fixed-radius, centroid-based plots. The resulting equations demonstrate robust fits, explaining between 43% and 75% of observed variation in DBH based on crown area measurements. The prediction errors (bias) across all developed models were below \ub11% of the mean DBH. This research contributes to the accurate measurement and monitoring of biomass in FLR initiatives.Description based on online resource. Title from PDF t.p. (Michigan State University Fedora Repository, viewed ).Includes bibliographical references