Digital Commons Network^™

Compassionate Communities, Māori Ageing And End-Of-Life: A Systematic Review, Melissa Carey, Kathleen Mason, Levi Fox, Tess Moeke-Maxwell, Merryn Gott

Research outputs 2022 to 2026

Background: Māori people in Aotearoa New Zealand and Australia experience significant healthcare inequity as they age and towards the end of their lives. Compassionate community approaches to ageing and end-of-life care are increasing in popularity throughout the world. However, this approach has arisen from Eurocentric knowledge systems and not from First Nations people and their communities. Objectives: This research aimed to gain insight into what the Compassionate Communities approach means for First Nations people and identify implications for Māori in Aotearoa New Zealand and Australia. A systematic literature review explored the intersection of Compassionate Communities and First Nations peoples’ perspectives …

Facilitators To The Implementation Of Exercise Into Cancer Care: A Systematic Review, Georgia L. White, Mary A. Kennedy, Brent J. Cunningham, Riley Dunn, Jason Martin, Meegan Walker, Craig T. Wallington-Gates, Hattie Wright, Bryan Chan, Grace L. Rose

Research outputs 2022 to 2026

Purpose: Although governing bodies urge the importance of integrating exercise into routine cancer care, facilitators to implementation have not been systematically identified and collated. This review aimed to summarise facilitators to implement exercise services within real-world settings. Methods: A systematic review of qualitative, quantitative, and mixed-method studies was conducted (three databases, 13th September 2024). Reports were included if they documented the implementation of co-located exercise services (delivered onsite within cancer centres) or referral pathways to external exercise services from cancer centres. The updated Consolidated Framework for Implementation Research (CFIR 2.0) was used to code and synthesise facilitators. Results: Of 8544 …

A Collaborative Communities-Of-Practice Methodology For Environmental Design Research: A Case Study Application In Palliative Care, Emil E. Jonescu, Benjamin Farrell, Chamil Erik Ramanayaka, Lori Delaney, Edward Litton, Talia J. Uylaki, Gareth Watts, Bella Brigham, Frances Bellemore, Davinia Seah

Research outputs 2022 to 2026

Environmental design in palliative care settings receives increasing attention, yet methodologies for studying such environments often lack interdisciplinary integration. Traditional research designs may overlook the lived expertise of clinicians and designers. Objectives: This article describes a collaborative, cross-disciplinary communities-of-practice model developed as a methodological framework to enable effective environmental evaluation and design processes in healthcare settings. Its application is illustrated through a case study in a palliative care unit. Methods: A co-designed, multi-methods approach was developed by a team of clinicians, facility managers, and academic researchers. The methodology included a scoping review, site-specific environmental data logging (sound, temperature, lighting), and …

Gwas Meta-Analysis Provides New Insights Into Uveal Melanoma Risk, Matthew D’Mellow, Huanwei Wang, Jane M. Palmer, Kari Hemminki, Colleen M. Cebulla, Aaron B. Beasley, Nikolaos E. Bechrakis, Antonia L. Pritchard, Karin W. Wadt, Peter A. Johansson, Lenha Mobuchon, Samantha Barlow, Kelly Brooks, Timothy Beckman, Catherine M. Olsen, Sunil K. Warrier, Lindsey Byrne, Helen Kalirai, Colette Mustard, Nathan Ingold, Asta Försti, Timothy Isaacs

Research outputs 2022 to 2026

Objective: The aim of this research is to identify germline genetic variants that predispose to uveal melanoma (UM) using data from nine studies involving 5839 individuals with UM (3853 novel) and 349,863 healthy controls. Methods: Five novel UM genome-wide association studies (GWAS) were performed and included for meta-analysis with four previously published UM GWAS. A fixed-effects inverse-variance weighted (IVW) meta-analysis was performed by combining data from these nine UM case-control cohorts. A follow-up transcriptome-wide association study (TWAS) was conducted to identify candidate target genes at UM risk loci. Genetic correlations with melanoma-related phenotypes were measured to elucidate UM’s genetic architecture. …

Feasibility And Preliminary Efficacy Of Integrative Neuromuscular Training For Childhood Cancer Survivors: A Pilot Study, Anna Maria Markarian, U. Newton, Dennis Taaffe, Nicholas G. Gottardo, Santosh Valvi, Carolyn J. Peddle-Mcintyre, Jodie Cochrane Wilkie, Daniel A. Galvão

Research outputs 2022 to 2026

Background: Survivors of childhood acute lymphoblastic leukemia (ALL) often exhibit early deficits in muscle and movement competence, which can compromise long-term health. Integrative neuromuscular training (INT), a multifaceted approach combining fundamental movement activities with strength exercises, may help address these deficits during critical developmental periods. Methods: Eight children treated for ALL (aged 6–12 years) completed a supervised INT intervention (2 sessions/week for 8 weeks). Primary outcomes were feasibility (recruitment, retention, adherence, compliance, and tolerance) and program acceptability. Secondary outcomes included muscle function (isometric midthigh pull [IMTP], countermovement jump, and handgrip strength), dual-energy x-ray absorptiometry (DXA)-derived body composition, peripheral quantitative computed …

Association Of Rurality Status With All-Cause And Cancer-Specific Survival: A Systematic Review And Meta-Analysis Adjusting For Clinical Factors, Demographics, And Geographical Remoteness, Skye Marshall, Charlene Wright, Lucy Leigh, Sharina Riva, Megan Crichton, Helena Rodi, Hannah Jongebloed, Elizabeth A. Johnston, Rebecca J. Bergin, Anna Chapman, Fiona Crawford-Williams, Nicolas H. Hart, Laura Alston, Joel Rhee, Lan Gao, Kate Gunn, Anna Ugalde

Research outputs 2022 to 2026

The association of rurality status with cancer survival has not been consistently reported. In people diagnosed with cancer, this review aims to determine the association of rural and remote living with survival as compared to urban living, and to determine the modifying effects of geographical, medical, demographic, and socioeconomic factors on cancer survival. A systematic review with meta-analysis and meta-regression was conducted, searching four databases in August 2024. Observational cohort studies were eligible if they reported all-cause or cancer-specific survival according to rurality status in Organisation for Economic Co-operation and Development (OECD) countries. All ages, sexes, and cancer types were …

Measuring Cancer Equity Globally: Harmonising International Rural-Urban Classifications For Exploring Cancer Outcomes, Charlene Wright, Sharina Riva, Megan Crichton, Helena Rodi, Hannah Jongebloed, Lucy Leigh, Elizabeth A. Johnston, Rebecca J. Bergin, Anna Chapman, Laura Alston, Fiona Crawford–Williams, Nicolas H. Hart, Joel Rhee, Lan Gao, Kate Gunn, Harry Gasper, Anna Ugalde, Skye Marshall

Research outputs 2022 to 2026

Geographic disparities in cancer outcomes represent a critical health equity challenge, with rural populations consistently experiencing poorer outcomes than urban populations. The lack of harmonised rurality measures creates substantial barriers to evidence synthesis and has precluded meta-analyses. This perspectives paper discusses concepts of rurality, identifies rurality classification systems used by cancer researchers in OECD countries that can be harmonised with the OECD Extended Typology, and develops recommendations for consistent rural-urban coding. Targeted searches of grey and published literature on cancer policy and rurality classification systems were conducted. The secondary analysis examined studies identified through systematic database searching of OVID Medline, …

Cardiovascular–Kidney–Metabolic Syndrome Through The Lens Of Gut‑Derived Uremic Toxins, Chudan Xu, Matthew Snelson, Francine Z. Marques

Research outputs 2022 to 2026

Cardiovascular–Kidney–Metabolic (CKM) syndrome represents a complex, interconnected cluster of cardiovascular disease, chronic kidney disease, and metabolic disorders such as obesity and type 2 diabetes. These conditions share overlapping metabolic, inflammatory, and vascular pathways, with the gut microbiome increasingly recognised as a key contributor and common underlying risk factor. Uremic toxins, traditionally considered waste products of host and microbial metabolism, are now recognised as active mediators of tissue damage across the CKM spectrum, particularly in the context of impaired renal function. Their production and accumulation are amplified by disrupted intestinal barrier integrity, chronic inflammation, and reduced renal clearance, collectively driving systemic …

Priorities For Multimorbidity Management And Research In Cancer: A Delphi Study Of Australian Cancer Survivors, Clinicians, And Researchers, Rebecca L. Venchiarutti, Haryana Dhillon, Carolyn Ee, Nicolas H. Hart, Michael Jefford, Bogda Koczwara

Research outputs 2022 to 2026

Purpose: Multimorbidity is common in people with cancer and associated with increased complexity of care, symptoms, mortality, and costs. This study aimed to identify priorities for care and research for cancer survivors with multimorbidity. Methods: A Delphi consensus process was conducted. Elements of care and research were based on Australia’s National Strategic Framework for Chronic Conditions, a literature review, and expert input. In Round 1, health professionals, cancer survivors, and researchers rated the importance of 18 principles, 9 enablers, and 4 objectives. In Round 2, new elements were rated and all elements were ranked. Results: In Round 1, all elements …

Ultrasound-Derived Liver Composition And Metabolic Flexibility Under Exercise Stress, Rhodes Van Houten

All Master's Theses

Metabolic Associated Fatty Liver Disease (MAFLD) is characterized by abnormal liver fat accumulation in conjunction with metabolic syndromes. MAFLD affects 33% of individuals worldwide, though little is known about how increased liver fat impacts physiological responses to exercise. This study aimed to analyze the relationship between liver composition and metabolic flexibility during a graded exercise test.  Body composition was analyzed via dual-energy X-ray absorptiometry. Liver ultrasound was evaluated for echogenicity, where elevated mean gray volume (MGV) indicates abnormal liver tissue. Rates of fat (FATox) and carbohydrate (CHOox) oxidation (g/min), respiratory exchange ratio (RER), and blood lactate concentrations ([LA^-], …

Circulating Tumor Cells In Uveal Melanoma: Multi-Marker Detection And Association With Disease State, Daniel P. De Bruyn, Fabiana Lucia Bassil, Mike Wu, Aaron B. Beasley, Jolanda Vaarwater, Mai N. Van, Jaco Kraan, Robert M. Verdijk, Dion Paridaens, Caroline M. Van Rij, Nicole C. Naus, Annelies De Klein, Elin S. Gray, Erwin Brosens, Emine Kiliç

Research outputs 2022 to 2026

Purpose. Uveal melanoma (UM) is primarily treated with eye-sparing radiotherapy, leaving limited tumor tissue for molecular analysis. Circulating tumor cells (CTCs) may offer a minimally invasive alternative for genomic tumor profiling. This pilot study evaluated the feasibility of a multi-marker CTC capture approach in UM patients at diagnosis, during fractionated stereotactic radiotherapy (fSRT), and at metastatic progression. Methods. Patients with localized or metastatic UM were prospectively enrolled. Peripheral blood samples were collected at baseline, during fSRT, and on detection of metastases. CTCs were captured and enumerated using a multi-marker approach and fluorescence microscopy. Results. A total of 76 patients were …

Rapid Decentralized Prostate Cancer Risk Stratification By Portable Liquid Biopsy Analysis Within A Clinical Biosensor Validation Framework, Kevin M. Koo, Grant Phillips, Sriganesh Srihari, Áine Farrell, Binny Jaradi, Kira J. Fitzpatrick, John W. Yaxley, Hemamali Samaratunga, Paul N. Mainwaring, Ke-Lin Ru, Darren J. Korbie, Scott A. Tomlins, Matthew J. Roberts, Robert A. Gardiner, Matt Trau

Research outputs 2022 to 2026

Clinical liquid biopsy (e.g., blood or urine) specimens, as a minimally invasive source of crucial molecular information, continue to grow in importance for efficacious targeted cancer treatment. Yet, current molecular profiling technologies are still confined to centralized laboratory testing, which escalates testing costs, result turnaround time, and patient anxiety. Crucially, there is also a scarcity of purposeful clinical validation studies to rigorously evaluate emerging liquid biopsy technologies from research settings to facilitate clinical translation. Here, we report liquid biopsy biosensor advancements in achieving rapid, accurate, and decentralized molecular profiling of a clinically accredited prostate cancer (PCa) urinary circulating RNA biomarker …

Adjuvant Pembrolizumab For Stage Iib Or Iic Melanoma: A Secondary Analysis Of A Randomized Clinical Trial, Sancy A. Leachman, Jason J. Luke, Paolo A. Ascierto, Georgina V. Long, Muhammad Khattak, Piotr Rutkowski, Zhi Jin Xu, Mizuho Fukunaga-Kalabis, Clemens Krepler, Alexander M.M. Eggermont, Dirk Schadendorf

Research outputs 2022 to 2026

Importance Patients with melanoma are at risk of developing subsequent cutaneous malignant neoplasms, and the effect of prior immunotherapy is unknown. Objective To analyze new skin cancers in participants with high-risk stage II melanoma treated with adjuvant pembrolizumab or placebo. Design, Setting, and Participants The multicenter double-blind, phase 3 KEYNOTE-716 randomized clinical trial enrolled 976 participants 12 years or older with completely resected stage IIB or IIC cutaneous melanoma between September 23, 2018, and November 4, 2020. Follow-up was completed on February 16, 2024. This analysis was not prespecified in the trial protocol. Interventions Participants were randomly assigned to receive …

Diet, Gut Microbiota, And Intestinal Permeability: Emerging Mechanisms In Hypertension Pathogenesis, Esha Vashisht, Helen Nguyen, Francine Z. Marques, Matthew Snelson

Research outputs 2022 to 2026

Hypertension is a leading contributor to global morbidity and mortality, arising from the interplay of genetic and environmental risk factors together with the dysregulation of multiple physiological systems involved in blood pressure control. Recent advances have established the gut as a central regulator, implicating the intestinal microbiota and barrier integrity in the modulation of blood pressure. Alterations in the gut microbial consortium, along with changes in levels of metabolites produced by the microbiota, have been associated with blood pressure regulation in animal models and human studies. Key microbial metabolites, including short-chain fatty acids, trimethylamine-N-oxide, and bile acids influence endothelial function, …

Dose–Response Association Between Systemic And Dermatologic Glucocorticoid Use And Type 2 Diabetes Mellitus: A Nationwide Case–Control Study, David Vadsholt, Annika V. Kvist, Chano Sandiramoorthy, Joshua R. Lewis, Peter Vestergaard, Johan Røikjer, Nicklas H. Rasmussen

Research outputs 2022 to 2026

Aims: To investigate the association and dose–response between systemic and topical glucocorticoids and odds of Type 2 diabetes mellitus. Materials and Methods: We conducted a nationwide case–control study using Danish registry data from 2013 to 2021. People aged 40 years or older with incident type 2 diabetes mellitus (n = 149 113) were matched 1:3 with controls (n = 447 339) by age, sex and weighted Charlson Comorbidity Index. Glucocorticoid exposure was defined as ≥ 1 prescription within 1 year before the date of diagnosis and ≥ 2 within 3 years and classified as systemic or topical. Conditional logistic regression …

It Was Part Of The Plan, So I Showed Up: An Exploration Of Patient Experiences With An Embedded Exercise Referral Process During Cancer Treatment, Mary A. Kennedy, Jack Dalla Via, Kim Edmunds, Pam Eldridge, Yvonne Zissiadis, Lauren Fortington

Research outputs 2022 to 2026

Introduction: Exercise is a key part of cancer care, yet its integration into routine practice remains limited. This study explored the experiences of people living with and beyond cancer, with an updated, opt-out referral model embedded within a supportive oncology setting, focusing on initial engagement with exercise physiology appointments. Through this model, patients were automatically scheduled for a consultation with an in-house exercise professional during their cancer treatment. Methods: A qualitative descriptive design comprised of two focus groups with 13 participants was employed to explore views across pre-defined elements of the model: referral to exercise, appointments, counselling, and tailoring. Results: …

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

The Impact Of Gastric Sleeve And Roux-En-Y Gastric Bypass On Chief Cell Function And Protein Digestion In Obese Patients, Garikoitz Mikel Gainza

Honors Undergraduate Theses

Obesity has become one of the largest global health concerns of the 21^st century, correlating with numerous associated diseases. To help address the growing prevalence and burden of obesity, sleeve gastrectomy and Roux-en-Y gastric bypass have become two commonly performed surgical procedures done to promote weight loss by altering the anatomical structure of the stomach and surrounding organs of the gastrointestinal system. Although the benefits of improved metabolism linked to these surgical procedures are well studied, their impact on the physiology of gastric cells, and more specifically chief cells as they relate to protein digestion post-surgery, is yet to …

Iron Deficiency And Iron Deficiency Anemia: Inconsistent Screening Practices And Delayed Result Processing In Children 12-18 Months, Madonna J. Mahoney Marshall

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction:

Iron deficiency and iron deficiency anemia in children aged 12 to 18 months are prevalent conditions that, if not identified and treated early, are associated with adverse neurodevelopmental outcomes.

Purpose:

This quality improvement project evaluated the impact of a standardized screening and follow-up protocol on laboratory result retrieval, provider review, and caregiver follow-through in a military pediatric clinic.

Method:

A pre-post intervention design guided by the Plan-Do-Study-Act framework was implemented over 11 weeks and included staff education, standardized workflows, and caregiver outreach.

Results:

The intervention improved laboratory completion and caregiver follow-up rates; however, sustainability was limited by staffing constraints …

Long-Term Incidence Trends And Stage Distribution Of Cutaneous Melanoma In The United States (1975–2022): A Seer Population-Based Analysis, Thea Danielle Amadasun, Shahzaib Maqbool

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Smarca4-Deficient Carcinoma Of The Gastroesophageal Junction, Hanna Riga, Austin Lehr

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

A Rare Case Of New Onset Lisinopril-Induced Angioedema Improved With Tranexamic Acid: A Case Report, Hafiz Numan Ijaz, Shahzaib Maqbool, Yugandhar Kandimalla

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Atypical Del(5q) Mutation In Myelodysplastic Syndrome Presenting With Thrombocytopenia: A Case Report Of Tp53-Mutated High-Risk Biology, Shahzaib Maqbool, Munaf Siyamwala, Amelia Goslin, Shivani R. Scharf, Katsiaryna Laziuk

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Intestinal Tuberculosis Masquerading As Crohn’S Disease: A High-Risk Diagnostic Mimic, Maikel Tawadrous, Tejaswi Vadde, Subuhee Ahmed, Lawrence San Jose, Chelsea Curry, Aradhana Pandey

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

High-Flow Ectatic Anomalous Right Coronary Artery From The Pulmonary Artery With Stimulant-Induced Cardiomyopathy: A Case Report, Prithvi Basu Roy, Danish Bawa, Louis Orlando

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

From Focal Peroneal Neuropathy To Complex Regional Pain Syndrome: A Case Of Progressive Unilateral Lower Extremity Pain, Ali Haider, Yu-Shiuan Hsu

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Alpha 1 Antitrypsin Deficiency In Primary Care: A Case Presentation, John Sweetman, Gazala Parvin

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Intermittent Hypoxia In A Middle-Aged Woman With A Probable Bethlem Myopathy Carrier State And Suspected Complex Sleep-Related Hypoventilation, Jonathan Paul Ladera, Louis Orlando

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

"Qt Okay, Bowel Not Okay"- Dofetilide Masking An Evolving Small-Bowel Obstruction, Tejaswini Yeshala, Pankti Shah, Syed Ali Abidi, Archana Machavarapu

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Efficacy Of A Vertically Integrated, Module-Based Small Group Discussion And Virtual Patient Simulation Model To Enhance Cardiology Knowledge And Clinical Reasoning In Medical Students, Kumar Abhishek, Pratyush Kumar, O Puri, M Pathania

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.