Digital Commons Network^™

Unplugging For Wellness: Psycho-Behavioral Impact Of Social Media Detox In Medical Students, Hazhmat Ali, Deemah Shalan, Lubna Ahmed, Ahmed Abdulazeez, Bira Ahmed, Mohammed Khamo

Makara Human Behavior Studies in Asia

Social media detoxification has emerged as a strategy for enhancing well-being. This study investigates the effects of social media detox on the psychological well-being and academic performance of students. A total of 361 medical students participated in this study. After obtaining formal consent, the participants completed a structured survey administered in a controlled setting. The survey included sections on demographics, patterns of social media use (e.g., time spent, platforms accessed, and primary motivations), and standardized psychological assessment scales. Data analysis was conducted using the Statistical Package for the Social Sciences version 26. Most students (75.9%) reported using multiple social media …

Threaded Belonging: Strengthening Cultural Identity Through Armenian Embroidery In The Diaspora, Krysten A. Lee

Art Therapy | Master's Theses

The current study examined the impact of an Armenian textile arts workshop on cultural identity among members of the Armenian diaspora in the Bay Area of California (n = 25). Grounded in relational-cultural theory, it explored how culturally grounded, community-based, traditional art practices may strengthen cultural identity and reduce cultural disconnection resulting from forced displacement following the Armenian Genocide of 1915. A mixed-methods, arts-based design was implemented where participants engaged in an embroidery workshop centered on traditional Armenian textile practices. Data was collected through pre- and post-intervention Inclusion of Other in the Self (IOS) scale (Aron, Aron, & Smollan, 1992) …

Art As Activism: Emotional Expression And Collective Empowerment Among Muslim Participants Creating Protest Posters, Menhal Sheikh

Art Therapy | Master's Theses

Muslim Americans are among the most underserved populations in mental health care in the United States. In the wake of the ongoing genocide in Gaza, many Muslim Americans have experienced intensified psychological distress, including anxiety, grief, and a heightened sense of helplessness, while continuing to show up in the streets in protest. This mixed-methods study examined whether the collective process of protest poster-making leads to emotional expression among Muslim American participants. Eleven Muslim American participants across two groups in the San Francisco Bay Area completed a pre and post Positive and Negative Affect Schedule (PANAS) to measure changes in affect, …

Spiritual-Soul Care: Art Sacralization, Active Imagination, And Eco Therapy, Andrea N. Miller

Art Therapy | Master's Theses

This thesis reasons that spiritual-soul care is, at times, an ethically necessary dimension of mental health care for many individuals yet remains underdeveloped within the field. In response, this research aims to articulate a foundational, non-dogmatic “baseline” language that is simple and accessible, while remaining nuanced enough to capture the depth and essence of spiritual-soul care. This study proposes a culturally flexible approach for individuals who identify outside of traditional religious frameworks. This multidimensional model includes three domains—the self, spirit-soul, and the transpersonal levels—each contributing to wellbeing through developmental themes.

Using a qualitative design, 9 participants engaged in contemplation, Jungian …

Loneliness And Social Isolation: Finding Connection Through Art, Elijah K. Wong

Art Therapy | Master's Theses

This study explored whether creativity might help alleviate feelings of loneliness and social isolation. The COVID-19 pandemic was an extraordinary event that significantly impacted people's emotional, physical, psychological, and social health globally. To gain insight into these impacts, the research focused on participants’ creative activities and their experiences of loneliness during and after the pandemic. The aim was to find possible links between making and viewing art and reducing feelings of loneliness and loneliness-related experiences. Ten participants were surveyed and asked about their artistry, their time during the COVID-19 pandemic, and their sense of belonging to a community. This investigation …

Shadow Garments: Costume Creation For Integrating Alienated Parts Of The Self, Mega M. Galvin

Art Therapy | Master's Theses

This study explores costume creation as a narrative-based intervention for integrating "shadow" parts, or aspects of the self that are repressed or alienated due to shame, trauma, or social pressure. Grounded in Jungian analytic psychology, narrative therapy, and expressive arts theory, the research addresses the limitations of traditional talk therapy in accessing somatic memory and proposes costume making as a pathway for externalization and re-authorship. Using a qualitative, participatory study inspired by Pat B. Allen’s Open Studio Process, four adult participants engaged in a three-session workshop to design, construct, and wear costumes representing their identified shadow aspects. Data was collected …

Restorative Environments And Therapeutic Artmaking: A Strengths-Based Art Gallery Workshop To Enhance Well-Being In Emerging Adults, Jeannine Case

Art Therapy | Master's Theses

Emerging adults aged 18 to 29 face increased mental health risks yet encounter considerable barriers to traditional care, which highlights the need for accessible, preventive alternatives. This mixed-methods pilot study investigated whether an art gallery environment could serve as a supportive setting for a strengths-based, positive art therapy-informed wellness workshop aimed at promoting well-being for this population. Six participants between the ages of 20 and 27, all enrolled in post-secondary education, took part in this study. Five identified as female and one as male. Three participants (50%) identified as Hispanic/Latino, one as Asian, one as White, and one as Hispanic/Latino …

Using Randomization To Compare Ai And Expert-Generated Formative Assessment Questions In Medical Education, Akshat Kumar, Katie Stinson, Litao Wang, Elizabeth Nugent, Yongsu Lee, Mark Hormann, Latanya Jones Love, Toufeeq Ahmed Syed

Faculty, Staff and Student Publications

Background: AI-generated content is being used across the education spectrum and is beneficial for creating complex multiple-choice questions, such as those used in medical education. However, evaluating AI-generated content is challenging, and existing testing and evaluation methods are falling short. This study uses randomization to compare medical students' performance on and subjective evaluation of AI versus expert-generated questions. We hypothesized that there would be no difference in student performance or subjective evaluation of AI vs expert-generated questions.

Methods: We designed a single-center, randomized study where medical student participants received either one AI- or expert-generated question per day over four weeks. …

Limosilactobacillus Reuteri Promotes Melatonin Release From Human Intestinal Organoids Via 5′Ectonucleotidase Activity, Micah D Forshee, Erika J Nachman, Esha R Shenoy, Heather A Danhof, Ludwig Ermann Lundberg, Stefan Roos, Robert A Britton

Faculty, Staff and Students Publications

Strains of Limosilactobacillus reuteri have been used to prevent or treat various conditions; however, the mechanisms by which they exert beneficial effects are not completely understood. Infant colic is one example in which L. reuteri DSM 17938 reduces clinical symptoms. While the etiology of colic is unknown, abnormal melatonin levels in infants have been suggested as a possible contributor. L. reuteri DSM 17938 has been shown to produce adenosine from AMP via production of the extracellular enzyme 5′ectonucleotidase (5′NT). Adenosine is a potent signaling molecule that impacts several important aspects of host physiology, including the release of melatonin from the …

When Probiotics Guidelines Differ: A Practical Guide For Clinicians And Researchers, Geoffrey A Preidis, Hania Szajewska, Marla Cunningham, Howard Bauchner, Daniel J Merenstein

Faculty, Staff and Students Publications

Many professional organizations publish clinical practice guidelines for the use of probiotics in gastrointestinal disorders. Generally, no two guidelines align perfectly, and some differ markedly. These discrepancies occur because clinical practice guidelines are not purely mechanical outputs of data synthesis. They are shaped by structured interpretation, value judgments, and predefined thresholds for uncertainty. These elements become particularly visible when effect sizes are small, heterogeneity is high, and outcomes vary in clinical relevance-as is the case with probiotic research. This article examines why discordance among probiotic guidelines is predictable and provides practical guidance for clinicians who must decide among conflicting recommendations …

Steroid Receptor Coactivator 3-Deficient Regulatory T Cells Eradicate Multiple Solid Tumors In Syngeneic Mouse Models, Nuri Sung, Eunsu Kim, Yosef Gilad, Yuri Park, Adam M Dean, Yan Xia, Jianming Xu, Clifford C Dacso, David M Lonard, Sang Jun Han

Faculty, Staff and Students Publications

Steroid receptor coactivator 3 (SRC-3) is highly expressed in regulatory T cells (Tregs) and is important for their immunosuppressive activity. Recently, we demonstrated that disrupting SRC-3 expression in Tregs eliminates triple-negative breast cancer (TNBC) and prostate cancer in syngeneic animal models by generating an anti-tumor immune microenvironment without inducing immune-related adverse events (irAEs). Further analysis of these mice revealed that SRC-3 knockout (KO) Tregs infiltrated breast tumors and facilitated the infiltration of CD8

Reducing Acute Healthcare Services With Self-Management Of Blood Pressure Monitoring Through Remote Patient Monitoring For Hypertensive Patients A Quality Improvement Project, Becky J. Wagner

Doctor of Nursing Practice (DNP) Manuscripts

Hypertension (HTN) affects nearly half of U.S. adults and remains a leading cause of preventable emergency department (ED) visits, hospitalizations, and healthcare costs due to poor blood pressure (BP) control (Fryar et al., 2024; Mullins et al., 2019). Traditional care models often lack the continuous monitoring and timely intervention needed for effective chronic disease management. Remote Patient Monitoring (RPM) provides an innovative approach by delivering real-time BP data, enabling early clinical intervention, and encouraging patient engagement in self-management (Omboni et al., 2020).

This Doctor of Nursing Practice (DNP) project evaluated the effectiveness of an RPM intervention in reducing acute healthcare …

Impact Of Implementing Standard Wound Care Guidelines For Patients In The Home Care Setting On Patient Outcomes, Raymond Anthony Flores Jr

Doctor of Nursing Practice (DNP) Projects

Wound care is among the most significant public health concerns, affecting millions of people worldwide. Most individuals with wounds end up self-managing their condition from their homes due to being discharged early from the hospital, owing to various reasons, and the costs associated with health care. Although home wound management offers convenience and lower costs for patients, it is also associated with substantial challenges, including limited access to and use of appropriate care protocols, wound management tools, and sufficient education on the topic, as well as limited professional advice. These limitations contribute to poor outcomes, including slow healing rates, infections, …

Gauging Understanding Of Information In Discharge Education In Trauma And Burn Patients, Marissa N. Thibodeaux

Summer Research Program Abstracts

No abstract provided.

Adolescent And Young Adult Cancer Survivorship: Supportive Care Needs, Resources, And Barriers, Allison Bryn Koplos

Master's Projects and Capstones

Background: Adolescent and young adult (AYA) cancer survivors experience unique physical, psychosocial, developmental, and healthcare-related challenges that often persist beyond treatment completion. Although survivorship resources have expanded, gaps in supportive care needs persist. This scoping review examined the supportive care needs, survivorship resources, and barriers to accessing supportive care among AYA cancer survivors.

Methods: A scoping review was conducted following the Arksey and O'Malley framework and reported in accordance with the PRISMA-ScR guidelines. Peer-reviewed literature published between 2000 and 2026 was identified through searches in PubMed and Google Scholar. Studies examining supportive care needs, survivorship resources, or supportive care services …

Knowledge, Attitudes, And Practices (Kap) Of Parents Regarding The Prevention And Control Of Childhood Iron Deficiency Anemia In Egypt: A Cross-Sectional Study, Omnia Soliman

Theses and Dissertations

Childhood Iron Deficiency Anemia (IDA) remains a major public health challenge in Egypt, where its persistently high and rising prevalence carries substantial consequences for child growth, cognitive development, immunity, and long-term health outcomes. Globally, approximately 40% of children aged 6–59 months are affected by anemia (World Health Organization, 2025), and Egypt mirrors this burden, with national data showing a worsening trend in recent years. In Egypt, national strategies have traditionally focused on biomedical interventions such as iron supplementation and food fortification, while less attention has been directed toward behavioral and household-level determinants, particularly parental knowledge, attitudes, and practices (KAP) related …

Understanding Patient Reported Outcome Measures And Perceptions In Trauma, Jerome D. Scott

Summer Research Program Abstracts

No abstract provided.

Analysis Of U.S. Army Body Composition Policies: Implementation Effectiveness And Recommendations For Policy Enhancement At Brooke Army Medical Center, Michael L. Rizzo

Doctor of Nursing Practice (DNP) Manuscripts

US Army body composition policies (AR 600-9 and recent directives) are essential for military readiness, injury prevention, and force health protection, yet implementation gaps persist, particularly with the 2026 Department of Defense (DoD)-mandated waist-to-height ratio (WHtR < 0.55) transition. This DNP project evaluated policy implementation effectiveness at Brooke Army Medical Center using the W.K. Kellogg Foundation Logic Model and CFIR 2.0 framework. Analysis of 2022–2025 de-identified administrative data and 16 stakeholder questionnaires identified ≥10 implementation gaps, including low awareness of new standards and workload impacts. The project developed 8 evidence-based recommendations and an implementation roadmap to improve compliance, optimize resources, reduce administrative burden, and strengthen military readiness.

Implementing Updated Npo Guidelines For Inpatient Procedures, Yasamin Ghanivand

Doctor of Nursing Practice (DNP) Projects

Background: Nil per os (NPO) guidelines are utilized for patient safety during procedures to reduce the risk of pulmonary aspiration. The American Society of Anesthesiologists (ASA) recommends clear liquids up to 2 hours before non-emergent procedures, although many facilities still implement the outdated practice of ordering NPO after midnight. This practice can lead to prolonged fasting, which may cause increased hunger, thirst, hypotension, nausea, and dizziness, ultimately resulting in patient dissatisfaction and discomfort.

Purpose: To review and assess current ASA NPO guidelines that describe best practice to enhance the patient experience without increasing perioperative risk of pulmonary aspiration.

Methods: A …

Weathering The Divide: Social Determinants, Neighborhood Context, And Systemic Lupus Erythematosus Among African American Women, Vanessa Cl Morman

Electronic Theses and Dissertations

Background: Systemic lupus erythematosus (SLE) disproportionately affects African American women and contributes to racial health disparities in the United States. Although genetic susceptibility influences disease risk, growing evidence suggests that social determinants of health (SDOH), including neighborhood conditions, structural racism, and socioeconomic disadvantage, contribute to disease development and progression. Epigenetic mechanisms may provide a biological pathway linking adverse social conditions to chronic disease disparities. This dissertation examined the influence of SDOH on SLE disparities through evidence synthesis and empirical investigation to inform public health practice and policy.

Methods: This integrated learning experience consisted of three complementary manuscripts. Aim 1 was …

Impact Of School Nurse Education On Factors Influencing Hpv Vaccine Communication With Parents, Jihye Choi, Efrat K Gabay, Jeanette Deason, Elizabeth Baumler, Diane Santa Maria, Daisy Mullassery, Lara S Savas, Erika Thompson, Sanghamitra M Misra, Paula M Cuccaro

Faculty, Staff and Student Publications

Human papillomavirus (HPV) can cause six cancer types but can be prevented with timely vaccination in early adolescence. However, despite the wide availability of the HPV vaccine, uptake remains suboptimal among US adolescents. School nurses are invaluable resources to students and their families regarding adolescent immunization needs. As part of the All for Them vaccination program, we assessed the impact of the continued nurse education (CNE) intervention on school nurses’ HPV vaccine communication with parents. Seventy-two school nurses and nurse administrators in Texas participated in the study. Using a single-arm study design, we measured participants’ potential barriers to and self-efficacy …

In-Hospital Mortality Patterns And Readmissions In Patients With Chronic Obstructive Pulmonary Disease: An Analysis Of The Role Of Pulmonary Hypertension, Saad Afzal Khan, Trishna Parikh, Adishwar Rao, Akriti Agrawal, Aarohi Parikh, Farah Kazzaz, Sarah Shin, Harry Karmouty-Quintana, Maulin Patel, Kha Dinh, Bela Patel, Bindu Akkanti

Faculty, Staff and Student Publications

Chronic obstructive pulmonary disease (COPD) may be complicated by pulmonary hypertension (PH). We aimed to understand the impact of PH on in-hospital mortality and quantify the 30-day readmission rate among patients with COPD. For this cross-sectional study, we used the Nationwide Readmissions Database from 2017-2020 to identify adults ≥18 years with COPD. Patients were stratified according to PH diagnosis. Baseline characteristics between groups were compared using the Pearson chi-square test and two-sample t-test. Predictors of in-hospital mortality were determined using multivariate logistic regression analysis adjusted for demographics and confounders. The 30-day readmission rate and prevalence of PH subgroups by baseline …

Ambulatory Blood Pressure Variability In Prediction Of Target Organ Injury: The Ship Ahoy Study, Coral D Hanevold, Jang Dong Seo, Stephen R Daniels, Bonita E Falkner, Michael A Ferguson, Joseph T Flynn, Julie R Ingelfinger, Philip R Khoury, Marc B Lande, Kevin E Meyers, Mark Mitsnefes, Joshua Samuels, Elaine M Urbina

Faculty, Staff and Student Publications

Background: Ambulatory hypertension is associated with elevated left ventricular mass index (LVMI), cardiac dysfunction, and increased arterial stiffness in adolescents. Whether the addition of measures of BP variability improves the prediction of subclinical cardiovascular target organ damage (TOD) over mean BP measures is not known.

Methods: We assessed clinic and ambulatory BP (ABP), anthropometrics, and TOD in 397 adolescents. ABP means standard deviation (SD), BP, and heart rate (HR) dipping were calculated; coefficients of variability (CV) were calculated (SD/mean) to assess ABP variabilities. Measures of TOD included LVMI, left ventricular hypertrophy (LVH), LV systolic shortening, LV diastolic function (e'/a'), and …

The Impact Of Virtual Reality Simulation On Developing Competence And Confidence In Non-Technical Skills In Nursing. A Scoping Review, Katie Janz, Karen Clark-Burg, Khaya Morris-Binelli, Brennen Mills, Amanda Graf

Research outputs 2022 to 2026

Background: Medical errors are a global concern and can compromise patient safety, with up to 80% of these errors directly linked to non-technical skills (NTS) failures. Traditional simulation using mannikins is resource-intensive, and virtual reality simulation (VR) has the potential to offer comparable outcomes with enhanced consistency and lowered resource requirements, but the effectiveness of VR to teach and enhance NTS has been underexplored.

Aim: This scoping review explores the existing literature on VR simulation as a method for teaching NTS in nursing to evaluate whether VR simulation yields positive learning outcomes, particularly in comparison to traditional training methods such …

Mtorc2-Nav1.2 Signaling Drives Early Hyperexcitability In Alzheimer’S Disease Mouse Model, Nolan M Dvorak, Jeffrey L Noebels

Faculty, Staff and Students Publications

Hyperexcitability is a biomarker of early-stage Alzheimer’s Disease (AD) and hastens cognitive decline later in its course. Mechanistic target of rapamycin (mTOR) signaling contributes to the slope of this trajectory, as evidenced by early increased brain expression and the rescue of hyperexcitability by genetic deletion of mTOR complex 2 (mTORC2); however, a molecular mechanism directly linking mTOR signaling to membrane hyperexcitability in early-stage AD remains elusive. Here, we show that hyperactive mTOR signaling stimulates the voltage-gated Na+ channel 1.2 (Nav1.2), a previously identified downstream phosphorylation target of mTORC2 and a key regulator of membrane electrogenesis. Augmented Nav1.2 channel function induced …

Application Of Artificial Intelligence (Ai) In Cancer Symptom Management For Adult Cancer Survivors: A Scoping Review, Tao Wang, Haiying Wang, Mengyuan Li, Daniel Bressington, Daniel Terry, Guanjin Wang, Wai Hang Kwok, Jing Yu (Benjamin) Tan

Research outputs 2022 to 2026

Background and aim: Artificial Intelligence (AI) has been increasingly used in cancer survivorship to support symptom management. This scoping review aimed to map existing evidence on AI applications in cancer symptom management for adult cancer survivors, including AI model development, AI-enabled intervention delivery and adoption, symptom targets, key features of the AI approaches used, reported outcomes, influencing factors, and research gaps to inform future priorities.

Method: This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. Eight electronic databases were comprehensively searched in November 2025 and updated in March 2026. Empirical studies published in …

Glial Dysfunction And Memory Impairments In A Model Of Pediatric Obstructive Sleep Apnea, Michael R Williamson, Jorge Botas, Mahyar J Hedayatpour, Thea Zlatkov, Akdes Serin Harmanci, Christopher J Yates, Kenneth Nobleza, Roshan Ailani, Adam C Adler, Farrah Kheradmand, Hyun Kyoung Lee, Benjamin Deneen, Hyun-Hwan Jeong, Arvind Chandrakantan

Faculty, Staff and Students Publications

Pediatric obstructive sleep apnea (POSA) is a common childhood disease that often causes aberrant brain development and cognitive deficits. The pathophysiological underpinnings of cognitive impairments in POSA remain unclear. Here, we examined cellular and molecular aspects of pathology in a mouse model of POSA that features learning and memory deficits. We performed single-nucleus RNA-sequencing (snRNA-seq) of the hippocampus to examine gene expression changes in an unbiased and cell type-specific manner. This dataset revealed a striking perturbation of transcriptomes across all brain cell types, particularly within glia and neural stem cells. We validated reduced expression of several differentially expressed genes at …

Maternal Characteristics And The Social Determinants Of Health In Fetal Vs Postnatal Myelomeningocele Repair, Amy Rose Hardcastle

Summer Research Program Abstracts

No abstract provided.

Building Bots That Teach Thinking: Using Custom Ai Chatbots To Enhance Critical Thinking And Decision-Making, Megan Biagi

AI in the Classroom: A Virtual Summit

Generative AI is increasingly common in education, but its effect on student learning depends largely on how it is used. This interactive session will introduce practical strategies for creating custom AI chatbots that encourage students to think through problems rather than simply ask for answers. Participants will explore ways to design bots that ask learners to explain their reasoning, consider alternative perspectives, identify assumptions, and revise their thinking before receiving feedback.   Examples from healthcare education and other disciplines will show how these tools can support guided inquiry, reflective questioning, clinical reasoning, and decision-making. Participants will review and revise sample chatbot …

Influence Of Head Posture In Sitting And Standing Positions On The Vertical Dimension Of Rest Value In Dentate Patients: A Comparative Clinical Study, Mia Bardawil, Carole Abi Ghosn, Jihad Fakhouri

International Arab Journal of Dentistry

Introduction: This study investigates the value of the vertical dimension of rest (VDR) in dentate patients in different head postures, supported and unsupported by the headrest of the dental chair, as well as in standing position.

Methods: The VDR was measured and compared in 60 dentate individuals aged 20–25 in different positions (sitting with and without head support, and standing) three times per position. The head was aligned according to the Frankfurt plane when unsupported or standing. Data were analyzed using the Shapiro-Wilk test for normality and ANOVA to assess the effects of posture, gender, and their interaction. …