The National Bleeding Disorders Foundation (NBDF) has announced its 2026 Excellence Fellowship recipients, recognizing outstanding healthcare professionals whose research aims to improve care and outcomes for people living with bleeding disorders. This year's fellowship projects focus on self-compassion among women and girls with bleeding disorders, the long-term impact of childhood trauma on health outcomes, and advanced imaging techniques to detect joint damage in athletes with hemophilia.

• Nursing Excellence Fellowship: Mary Lesh, CPNP-PC, MSN, CNS, PHN, RN, UCSF Benioff Children's Hospital
• Social Work Excellence Fellowship: Eleanore Denegre, LICSW, Washington Center for Bleeding Disorders
• Physical Therapy Excellence Fellowship: Alexander Harms, PT, DPT, University of Nebraska Medical Center/Children's Nebraska

Nursing Excellence Fellowship Awarded to Mary Lesh, CPNP-PC, MSN, CNS, PHN, RN
 Mary Lesh, CPNP-PC, is a pediatric nurse practitioner at the University of California, San Francisco, Benioff Children’s Hospital in Pediatric Hematology. She has twenty years of experience providing care to families in the hemophilia treatment center. Her interests include partnering with others in improving therapeutic pathways for best outcomes in individuals and families managing hematologic conditions. 

Funded research project: North American Nursing Research in Bleeding Disorders- Self Compassion in Women and Girls with Bleeding Disorders Project 
Self-compassion, which means being kind and understanding toward yourself during difficult times, has been shown to support mental health and wellbeing in several health conditions. This project supports research in understanding how women and girls with inherited bleeding disorders experience self-compassion.  

Social Work Excellence Fellowship Awarded to Eleanore Denegre, LICSW
Eleanore Denegre, LICSW has been a clinical social worker with the Washington Center for Bleeding Disorders (WACBD) since April 2025. She received her Master of Social Work from the University of Washington in 2021. Prior to joining the team at WACBD, Eleanore spent the first four years of her social work career as a community mental health therapist, with a particular focus on treating trauma- and stressor-related disorders in adolescents and young adults. She has worked with patients and their families in outpatient, school-based, and residential settings. These experiences inform her passion for delivering holistic and trauma-informed care as part of the HTC multidisciplinary team. Eleanore’s research aims to explore how experiences of stress and trauma in childhood impact health and wellbeing through the lifespan for patients with bleeding disorders.

Funded research project: The Impact of Adverse Childhood Experiences on Health Outcomes in Adulthood in Patients with Bleeding Disorders 

Stressful things that happen to us as children can increase the risk of health problems when we become adults. There are no studies about what that means for people who have bleeding disorders. We want to find out whether having more stressful things happen as a child leads to having more health problems as an adult for people with bleeding disorders. We will ask people in our study about their childhood experiences and their health to see if there is a connection.

Physical Therapy Excellence Fellowship Awarded to Alexander Harms, PT,DPT

Alex Harms, PT, DPT, is a pediatric physical therapist at Children’s Nebraska with a background in sports performance and rehab. Alex’s early career focused on helping athletes return to sport after injury, which gave him an appreciation for the role of targeted exercise and movement quality in long-term joint health. Working in the HTC, he saw that children with hemophilia face many of the same performance and participation challenges as athletes, but with added complexity from joint bleeds, pain, and fear of activity. This experience motivated Alex’s commitment to a career dedicated to optimizing movement, participation, and physical activity in youth with bleeding disorders.

In his current role, Alex provides musculoskeletal assessments including diagnostic ultrasound of joints, individualized exercise programming, and education for children and families with hemophilia and other bleeding disorders. He collaborates closely with hematologists, nurses, and social workers, on prophylaxis planning, joint protection, and return to play. Alex’s clinical interests include early identification of joint changes, prevention of overuse and deconditioning, and practical strategies to keep children safely active in sports and recreation.

Funded research project: Diagnostic Ultrasound Versus Weight-bearing CT for Detection of Joint Degeneration in Athletes With Hemophilia on and off Prophylaxis

Even with modern treatments, athletes with hemophilia can still develop joint damage that routine clinic exams may not fully detect. This study will test whether two imaging methods, standing CT scans and ultrasound, can better show early joint changes, and how joint health differs between athletes who take regular preventive treatment and those who do not. Standing, low dose CT scans create detailed 3D pictures of the joints while the athlete is standing, showing how the bones and joint space look under real life load. Ultrasound allows quick imaging in the clinic and can detect early joint inflammation and other soft tissue changes during sports rehabilitation visits.

We will compare how well ultrasound and weight bearing CT detect joint damage in athletes with hemophilia. We expect that weight bearing CT will be better at picking up small, early structural changes, that athletes on prophylaxis will have less joint damage on both tests, and that ultrasound will agree closely enough with weight bearing CT to be used as a practical screening tool in the hemophilia clinic. We will test how closely ultrasound and weight bearing CT agree when rating joint damage in ankles and knees, using CT as the main reference. We will also compare joint damage between athletes on versus off prophylaxis, using both imaging methods and their factor trough levels. We will also assess how realistic and useful it is to add a brief, standardized ultrasound exam to routine sports physical therapy visits.

NBDF continues to support innovative research from nurses, social workers, and physical therapists that expands understanding of bleeding disorders and improves care across disciplines. The 2026 fellowship projects reflect NBDF's commitment to advancing patient-centered care, addressing unmet needs, and improving quality of life for people living with bleeding disorders.