Digital Commons Network^™

Investigation Of Genx Exposure To Pathways Associated With Colorectal Cancer Risk, Emily J. Ferguson

Theses and Dissertations--Toxicology and Cancer Biology

Per- and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants widely detected in drinking water and food sources, resulting in chronic human exposure. Among these compounds, hexafluoropropylene oxide dimer acid (HFPO-DA), commonly known as GenX, has been introduced as a short-chain replacement for legacy PFAS such as perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA). Although GenX is believed to be a safer alternative, emerging research suggests it can still affect human health.

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer-related death in the United States, highlighting the need to better understand environmental …

Strong Foundations: Supporting Mental Well-Being In School-Age Youth, Skylar Simpson

Occupational Therapy | OTD Capstone Projects

School-age youth in the United States increasingly face stressors that disrupt their overall mental well-being, highlighting a need for accessible preventative interventions. To address this gap, this doctoral capstone project developed a program titled Strong Foundations: Supporting Mental Well-Being in School-Age Youth, an evidence- and occupation-based program consisting of various interventions designed to enhance the well-being of youth attending a San Francisco Recreation and Park (SFRPD) community-based summer camp. Through embedding occupational therapy-based programming into an environment that currently lacks dedicated mental well-being promotion methods, the Strong Foundations aims to foster mental well-being among school-age youth through occupational engagement that …

Sensory Modulation For Adults With Developmental Disabilities: An Occupational Therapy Approach For Adult Day Programs, Aveen Dulai

Occupational Therapy | OTD Capstone Projects

This occupational therapy (OT) doctoral capstone project focused on the development and implementation of a proactive sensory modulation program with the use of Assistive Technology (AT) for adults with Developmental Disabilities (DD) at an adult day program. Adults with DD have diverse needs such as - motor, communication, behavioral, cognitive, and sensory processing challenges. These varying abilities often require AT and environmental adaptations to afford meaningful participation in occupations.  Providing customized and accessible programing for adults with DD arediversity, equity, inclusion, justice and accessibility (DEIJA) issues (Kripke, 2018). Often, adult day programs are limited in OT services, including accessible sensory …

Long Acting Beta2-Adrenergic Receptor Agonists Reverse Diabetic Nephropathy And Liver Steatosis In Murine Models Of Diabetes And Are Associated With Protection In Retrospective Human Studies, Brennan Winkler

MUSC Theses and Dissertations

Diabetes Mellitus (DM) affects 13.9% of men and 14.3% of women worldwide, a total of approximately 828 million people. Patients with diabetes are at risk of several complications including diabetic nephropathy (DN) and metabolic-associated steatohepatitis (MASH). These diseases eventually lead to end stage kidney disease (ESKD) and liver failure requiring dialysis and organ transplantation. In addition, diabetes exacerbates disease severity of autosomal dominant polycystic kidney disease (ADPKD), the most common potentially lethal genetic disease to affect humans with a prevalence of 1 in 500-1000. Therefore, a therapeutic approach that can attenuate organ damage and restore function in patients with DM, …

2026 Nebraska Beef Cattle Report

Nebraska Beef Cattle Reports

The 2026 Nebraska Beef Cattle Report brings together applied research, emerging technologies, and management insights that directly address the evolving challenges and opportunities facing today’s beef industry. This year’s collection includes 36 articles that span the full beef production system, from cow/calf and forage management to feedlot nutrition, animal health, behavior, meat quality, and sustainability, providing science-based guidance grounded in real-world production contexts.

Cow/Calf Nutrition, Reproduction, and Management

This section highlights management strategies that influence reproductive success and long-term herd performance. Articles focus on late-gestation heifer nutrition and practical applications of artificial insemination to support efficient, productive cow/calf systems.

Forage, …

A Case Of Primary Gastric Diffuse Large B-Cell Non-Hodgkin Lymphoma With Tumor Lysis Syndrome And The Warburg Effect, Sarah Barnhardt, Brooke Escoe, Mary Carter

South Atlantic Division GME Research Day 2025

No abstract provided.

Art Of Medicine - 2026

The Art of Medicine

No abstract provided.

The Impact Of Heavy Resistance Training On Type Ii Muscle Fibers Throughout Female Reproductive Stages, Lily G. Colberg

Scripps Senior Theses

Type II muscle fibers, also known as fast-twitch muscle fibers, are reliant on aerobic glycolysis and are crucial for high-force contractions, mobility, and rapid movements, such as fast reflexes. Heavy resistance training has been found to increase type II muscle fiber concentration in young, middle-aged, and elderly individuals. However, there have been few studies conducted on female-only sample populations. In women, the impact of heavy resistance training on type II muscle fibers is affected by the progressive decline of estrogen that defines the transition throughout the four female reproductive stages: premenopause, perimenopause, late-transition menopause, and postmenopause. Menopausal estrogen depletion causes …

Developing A Community-Driven, Locally Sourced Medically Tailored Meal Model: A Pilot Linking Healthcare, Farmers, And Patients, Julie Brown, Ashton Potter, Leandra Forman, Jairus J. Rossi, Anna Cason, Christa Mayfield, Alison Gustafson

Dietetics and Human Nutrition Faculty Publications

Background: Food is Medicine (FIM) programs improve health outcomes by integrating nutrition interventions into healthcare delivery, yet gaps remain in community partner capacity and local food system integration. This program aimed to build community capacity to develop a locally sourced, medically tailored meal (MTM) model connecting farmers, healthcare providers, and patients. Methods: Meals were developed by a registered dietitian following American Heart Association (AHA) Heart-Check and MyPlate nutrition standards. Recipes were adapted for freezing, scaled for production, and sourced from 26 central Kentucky farms. Eligible participants with hypertension or type 2 diabetes (T2D) were referred through the Food as Health …

Championing Weight-Neutral Healthcare: A Review Of Resources From Medical Students For Size Inclusivity, Samantha Guss

VCU Libraries Faculty and Staff Publications

Medical Students for Size Inclusivity (MSSI) is a volunteer-led organization of medical students across the United States challenging weight bias in healthcare and advocating for equitable, weight-inclusive care (https://sizeinclusivemedicine.org). Recently MSSI has developed three “informed consent resources” about intentional weight loss interventions, focusing on glucagon-like peptide-1 (GLP-1) receptor agonist medications (such as Ozempic©), bariatric surgery, and pediatric weight management. The three resources are grounded in weight-neutral care and are designed to supplement information from healthcare providers by sharing more nuanced information about the research on the interventions, potential alternatives, and approaches to health that are not focused on body weight. …

Reducing Childhood Obesity In Rhode Island, Julia Caputo

Student Research Design & Innovation Symposium

This project examined childhood obesity among youth in Rhode Island and proposed a school- and community-based intervention to improve nutrition and physical activity behaviors. Guided by the ecological model and evidence-based public health frameworks, the program was developed with envisioned collaboration with Brown University Community Health, Rhode Island KIDS COUNT, local schools, and community partners. The intervention aimed to increase nutrition knowledge, promote healthy eating behaviors, expand access to safe physical activity opportunities, and strengthen family engagement. Key components included culturally tailored nutrition workshops, after-school physical activity clubs, monthly family health nights, and the distribution of family toolkits with recipes …

Atypical Antipsychotic-Induced Weight Gain Preventive Bundle: A Quality Improvement Project, Jocelyn Urbano

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Antipsychotic-induced weight gain (AIWG) is a common, clinically significant adverse effect associated with second-generation antipsychotic medications and contributes to increased cardiometabolic risk among individuals with serious mental illness (SMI; Carolan et al., 2025; Hegde et al., 2024). Individuals experiencing homelessness or social instability often encounter additional barriers to maintaining healthy lifestyle behaviors and consistent engagement in healthcare, further increasing metabolic risks and treatment issues (Hamel et al., 2024; Kelly et al., 2025). This preventive care bundle, designed to reduce the risk of AIWG, was implemented in an outpatient behavioral health clinic serving an underserved urban Texas population.

As metformin may …

Meta-Analysis: Diabetes Mellitus And The Risk Of Endometrial Cancer, Tricia Ho, Marika Ongpauco, Han Ha Ngoc Nguyen

Physician Assistant Studies | Graduate Research Papers

Background: Many studies have looked at the relationship between diabetes mellitus and development of endometrial cancer. This study provides an updated systematic review and meta-analysis of the estimated effect of diabetes and the risk of endometrial cancer.

Methods: Some studies were found on databases such as PubMed and Iceberg. The remaining studies were extracted from the initial studies found. Binary data was collected and the raw data was imputed into a Fixed Effects Model.

Results: A total of 25 studies were included in this meta-analysis, generating statistically significant results (p < 0.001, OR 2.05, 95% Cl 1.92-2.19).

Discussion: Diabetes is found to be …

Child Poverty And Nutritional Health In Rural And Non-Rural Ohio Counties, Viraj Chegu, Macy Puthoff

Scholarship in Medicine - All Papers

Child poverty is an ongoing issue in the United States, placing children at a risk of nutritional deficits. While community interventions and reduced price school lunch programs have improved food insecurity outcomes for children, there is limited knowledge of how these programs can alleviate potential health problems in rural versus urban areas. Thus, this project aims to compare various variables such as food environment index, food insecurity, and enrollment in reduced price school lunch among counties in Ohio of different poverty levels as well as whether the counties are rural or nonrural. Methods: Factors such as food insecurity, food environment …

Childhood Factors That Affect Adult Obesity In Ohio And Mississippi, Rhea Lal, Danielle Wolford

Scholarship in Medicine - All Papers

Over 40% of adults in the United States struggle with obesity. While several social determinants of health have been tied to obesity, only limited research on the effect of childhood education, food environments, and physical activity resources on a state-wide level has been conducted. It is imperative that we identify connections between obesity, associated comorbidities, education, and SDoH as these will inform improvements in national social structures and healthcare systems. States Ohio (OH) and Mississippi (MS) differ in high school completion rates, food access, and exercise opportunities yet both states continue to experience rising adult obesity rates. This study analyzed …

The Association Of Social Determinants Of Health On Mortality Among Adults With End-Stage Kidney Disease: A Systematic Review And Meta-Analysis, Prince Agyapong, Lauren Longacre, Patti Brooks, Hossein Moradi Rekabdarkolaee, Surachat Ngorsuraches, Aine O'Connor, Semhar Michael, Brandon Varilek

Journal Articles: College of Nursing

RATIONALE/OBJECTIVE:: Synthesize evidence from published studies on end-stage kidney disease (ESKD) mortality and determine associations between social determinants of health (SDOH) and ESKD mortality.

STUDY DESIGN:: This PRISMA-guided study examined all published research across four electronic databases.

STUDY POPULATIONS:: Adults with ESKD living in the United States.

SELECTION CRITERIA FOR STUDIES:: Clinical trials, observational, cross-sectional, and prospective/retrospective cohort studies were considered if one or more of the five domains of SDOH were present in the analysis.

EXTRACTION/ANALYSIS:: Extraction was performed independently by two reviewers using a standardized form that captured study purpose and design, outcomes, SDOH domain, setting, participant characteristics, …

Breaking The Boom-Bust Cycle: Supporting Pediatric Fatigue And Participation After Hsct Using The 5-Pet And Caregiver Education, Annelie Claire Kershaw

OTD Capstones

Pediatric patients recovering after hematopoietic stem cell transplant (HSCT) often experience persistent fatigue, physical deconditioning, cognitive changes, and decreased participation after discharge. Fatigue is complex and multidimensional, making it difficult for children to understand, communicate, and manage as they return to school, play, social activities, and daily life. Occupational therapists are well positioned to support participation, activity pacing, caregiver education, and health management for children recovering after HSCT.

This capstone project addressed the need for developmentally appropriate fatigue management resources through the creation of multiple deliverables. The primary deliverable was the 5-Zone Pediatric Energy and Fatigue Scale (5-PET), which is …

Metabolic Syndrome Beyond Diagnostic Criteria: Population-Scale Integrative Metabolomics Characterization, Marwa Talal

Theses and Dissertations

Background: Metabolic syndrome (MetS) is a complex cluster of interrelated metabolic abnormalities associated with elevated cardiometabolic risk. While diagnosis is based on well-established five clinical criteria, these may overlook early or atypical metabolic alterations. Large-scale metabolomic profiling offers an opportunity to identify biochemical signatures of MetS beyond diagnostic bias and to evaluate their relative importance across different presentations of the syndrome.

Methods: Data from 117,147 UK Biobank participants were analyzed in a cross-sectional design. High-throughput NMR quantified 75 circulating metabolites, for. Univariate analyses, MetS subtype stratification, and elastic net models with SHAP interpretation were applied to assess feature …

Review Of Current Research Describing The Influence Of Non-Health Care Drivers Of Health In Rural And Urban Populations, Katie Youngen, Julia Cecil, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Social determinants of health (SDOH) (also called social drivers of health) are the conditions of the environment where people live, learn, work, and play that are known to affect health outcomes.¹ The primary objective of this literature review is to summarize the most recent literature related to the Healthy People 2030 domains of a) economic stability, b) education access and quality, c) neighborhood and built environment, and d) social and community context.² Our particular focus is on non-health care drivers of health. The secondary objective is to identify gaps in literature applied to rural populations.

Felt Ambivalence Weakens The Attitude-Intention Pathway For Regular Leisure-Time Physical Activity In Chinese Adolescents: A Three-Wavee Prospective Study, Yaogang Han, Yubing Wang, Pan Li, Guohua Zheng

Human Movement Studies & Special Education Faculty Publications

Background: Favorable attitudes toward regular leisure-time physical activity may not always translate into intention if adolescents feel ambivalent about the behavior. This study tested whether felt ambivalence weakens the prospective attitude–intention association and the indirect effect of attitude on later behavior through intention. Methods: Chinese adolescents (N = 1714; Grades 7–12; mean age = 15.0 years) completed a three-wave survey at approximately two-week intervals. Wave 1 assessed attitudes toward regular leisure-time moderate-to-vigorous physical activity, felt ambivalence, and physical activity habit; Wave 2 assessed intention; and Wave 3 assessed leisure-time physical activity. Moderated mediation was tested in a structural equation model …

Chronic Dislocations And Pain In A College Athlete, Rachel Joseph, Trina Walker, University Of Wisconsin - Madison, Rebecca Kronk, Karen J. Whitt, Deborah O. Himes

Faculty Publications and Presentations

This diagnostic case study describes an 18-year-old woman and competitive gymnast who presents with recurrent joint dislocations, chronic musculoskeletal pain, and dermatologic findings suggestive of a heritable connective tissue disorder. Early recognition of connective tissue disorders is essential for accurate diagnosis, genetic evaluation, injury prevention, and long-term management planning.

Decreased Exercise-Induced Pulmonary Capillary Recruitment In Pulmonary Arterial Hypertension, David Langleben, Stylianos E. Orfanos, Benjamin D. Fox, Michele Giovinazzo, Magali Kaddis, John D. Catravas

Bioelectrics Publications

The human lung normally accommodates exercise-induced cardiac output increases mainly via recruitment of non-concomitantly perfused pulmonary capillaries. Recruitment is detectable by measuring the first-pass transpulmonary metabolism of ³H-benzoyl-Phe-Ala-Pro, providing an estimate of functional capillary surface area (FCSA). Pulmonary arterial hypertension (PAH) results from luminal narrowing of small precapillary arterioles, reducing downstream perfused FCSA. We hypothesized that exercising PAH patients would not be able to recruit FCSA normally. We studied two patients with severe PAH. Despite exercising to maximal dyspnea, neither could recruit FCSA. These limited data are the first direct measurements of FCSA in exercising PAH patients.

Nutrient-Driven Transcription Factor-Dna Interactions And Their Signaling Mechanisms In Metabolic Disease, Evelyn A. Bates

Theses and Dissertations--Nutritional Sciences

Metabolic homeostasis is maintained through tightly coordinated signaling networks that integrate diverse physiological inputs. Central to this regulation are transcription factors, which sense nutrient, hormonal, and vitamin-derived signals and translate them into coordinated gene expression programs. Transcription factor activity is governed by DNA binding, recruitment of coregulatory proteins, and interactions with specific response elements in gene promoters, which allows them to selectively modulate diverse metabolic pathways. Owing to their multifactorial and tunable nature, transcription factors have emerged as promising targets for the treatment and diagnosis of metabolic diseases, including metabolic dysfunction-associated steatotic liver disease (MASLD). This dissertation explores the molecular …

An Analysis Of Eating Disorders As A Comorbidity Of Autoimmune Diseases, Madeleine Shore

Scripps Senior Theses

For many autoimmune disease patients, psychiatric conditions are a common comorbidity. Although there are many shared mechanisms between autoimmune disease and psychiatric conditions, current research surrounding mental health among autoimmune disease patients often focuses on mood disorders rather than eating disorders. Despite the high risk for developing psychiatric conditions, most autoimmune disease patients are not screened for eating disorders. This lack of screening is significant, because if an eating disorder is missed by a healthcare provider, the autoimmune or eating disorder condition could be exacerbated, resulting in severe illness or even fatality. Given an existing link between comorbid psychiatric disorders, …

"It's A Dance": Examining Midwives As Choreographers Of Reproduction In Maine, Annie Goldstein

Honors Theses

This thesis examines the contemporary work of community-based Maine midwives through the theoretical framework of choreography. In the context of this work, choreography can be understood as the well-thought-out, purposeful undertaking of a process during which negotiation, coordination, and improvisation are required to adapt to constantly changing circumstances. Using choreography, this thesis attempts to understand how Maine midwives navigate global market processes and practice under authoritative forms of biomedicine, ultimately linking them to other midwives across various global sites. Situated within Maine’s maternal health landscape that is characterized by the ongoing closure of labor and delivery units and rural hospitals, …

Meconium Metal Concentrations And Infant Temperament And Development, Fiona Fogarty

Dissertations and Theses

BACKGROUND: Prenatal exposure to metals poses significant health consequences for early childhood development. Understanding the factors influencing metal concentrations that infants are exposed to in-utero is crucial for developing targeted interventions, particularly when maternal characteristics and environmental factors, may contribute to varying levels. Meconium offers insight into in-utero exposures for the developing infant, and the effect of each individual metal may be mediated or exacerbated by another and therefore should be studied in the context of a mixture. The effect of metal mixture exposure, as measured in meconium, on milestone and temperament outcomes has yet to be determined.

DESIGN: …

College Student Perceptions Of A Pilot Cooking And Nutrition Education Workshop Through The Lens Of The Social Cognitive Theory: A Qualitative Study, Emma Watras, Amelia Sullivan, Emalee Harrington, Mona Therrien-Genes, Kathryn Yerxa, Makenzie Barr-Porter, Jade Mcnamara

Dietetics and Human Nutrition Faculty Publications

This study qualitatively examined college students' perceptions of a pilot cooking and nutrition workshop, College Cooking Connection (CCC), through the Social Cognitive Theory (SCT) framework. Undergraduate students who attended at least one CCC workshop (N = 29) were invited to a 30 min virtual focus group. A trained moderator guided the discussion to gather perceptions of the program. Themes were identified using thematic analysis with a directive and deductive approach based on SCT. Focus groups revealed eight major themes across the SCT. Cognitive themes included: (1) improved nutrition literacy, (2) understanding the nutrition-mental health connection, and (3) increased awareness of …

Addressing Obesity And Diabetes In Appalachian Kentucky, Hannah E. Orens

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Type 2 diabetes and obesity are major public health concerns in Appalachian Kentucky. Populations in this region experience much higher rates of chronic disease than the rest of the state, have limited access to preventive care, and ongoing economic challenges that affect health. Many rural counties face increased poverty, transportation challenges, and shortages of healthcare professionals, all of which contributed to poor health outcomes and reduced access to evidence-based prevention programs. As a result, there is a strong need for focused, feasible, community-based interventions that improve access to evidence-based prevention while addressing the social and economic factors influencing health in …

Purchasing A Healthier Future: A Nutrition-Focused, Community-Centered Approach To Reduce Obesity And Diabetes In Graves County, Kentucky, Marissa Stephens

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Obesity and type 2 diabetes are among the most significant public health challenges in the United States, with Kentucky consistently ranking among the states with the highest prevalence of both conditions. Together, these conditions contribute to reduced quality of life, rising healthcare costs, and increased morbidity and mortality, underscoring the need for targeted, community-centered interventions. The disease burden of obesity and diabetes is particularly pronounced in rural areas, including the state’s westernmost region, the Jackson Purchase. Among rural populations, chronic disease risk is driven by a combination of factors, including low socioeconomic status, limited access to healthcare/supermarket options, and food …

Improving Hypertension Management With An Educational Patient Intervention Bundle, Gertie Silva

Doctor of Nursing Practice (DNP) Scholarly Projects

Aim

Uncontrolled hypertension remains a significant risk factor for cardiovascular disease. This quality improvement project aimed to improve hypertension knowledge and blood pressure control among adults with uncontrolled hypertension by implementing lifestyle counseling, home blood pressure monitoring, and regular follow-up.

Design

This quality improvement project used a pre- and post-intervention design.

Methods

Forty-one adults with uncontrolled hypertension took part in an eight-week educational program. Outcomes measured included weight, systolic and diastolic blood pressure, and HK-LS scores. Descriptive statistics and paired-samples t-tests analyzed the results.

Results

Participants showed significant improvements in weight, blood pressure, and hypertension knowledge. Mean weight decreased from …