Digital Commons Network^™

Referral Strategies For Recruitment And Engagement Of Community Adults Into Online Extension Health Programs, Cheryl L. Eschbach, Dawn A. Contreras, Holly B. Tiret

Journal of Human Sciences and Extension

This article shares details behind building organizational capacity to establish program referrals for statewide recruitment of community adults into Cooperative Extension’s online health programs. This study explores the role of intentional recruitment strategies (active and passive) to increase participant program enrollment into health education and shares examples from one state that has created a trained workforce that offers ongoing research- and evidence-based programs. After many years of trying paper, phone, and electronic medical record methods to increase program reach, Michigan State University Extension tried an electronic referral process via a QR code and web link, accompanied by program marketing, to …

Exploring The Educational Needs Of Family Caregivers For Patients With Dementia, Karen L. Franck, Janet Fox, Ann A. Berry, Kristen Johnson, Jessica Taylor, Matt Devereaux

Journal of Human Sciences and Extension

Family members who care for patients diagnosed with Alzheimer’s and dementia often face significant stressors and challenges that impact their quality of life. As part of a project to develop Extension educational materials and resources specifically for family caregivers, we conducted an online needs assessment survey with 196 adults in the U.S. Participants identified doctors, the internet, and caregiver support groups as top sources of information about dementia. They were interested in strategies to help them manage stress, address patient behavioral issues, and access locally available resources. Furthermore, they were interested in attending educational programs with other caregivers. These findings …

Full Issue, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.

The Role Of Fast-Food Consumption, Residential Fast-Food Exposures, And Urinary Essential Trace Heavy Metals In Colorectal Cancer (Crc) Outcomes., Jeevan Adhikari

Electronic Theses and Dissertations

Background: Colorectal cancer (CRC) is a public health concern. Within the United States (US), fast-food consumption and environmental exposure to heavy metals have increased. The impact of fast-food consumption frequency from fast-food restaurants, residential fast-food exposures, and urinary essential trace heavy metals in relation to CRC outcomes have not yet been rigorously evaluated in the US. Methods: Within the LEAPS-CRC study, we used geographic information systems (GIS) and logistic regression to study the association of fast-food consumption, residential proximity to a fast-food outlet, and urinary essential trace metals with CRC incidence. Additionally, within Kentucky Cancer Registry (KCR) CRC cases, the …

Residential Segregation And Breast Cancer In Louisville: Impact Of Race And Contextual Factors On Advanced-Stage Diagnosis, Delayed Treatment, And Disease-Specific Mortality., Toheeb Ajani Mustapha

Electronic Theses and Dissertations

Female breast cancer (BC) remains the most commonly diagnosed non-skin cancer and the second leading cause of cancer death among U.S. women. Despite advances in detection and treatment, substantial inequities in BC outcomes persist, driven in part by structural forces such as residential segregation. This dissertation examined the relationship between residential segregation, BC outcomes, and key contextual factors in Louisville, Kentucky. Using data from the Kentucky Cancer Registry, American Community Survey, CDC’s Population-Level Analyses and Community Estimates, and the National Neighborhood Data Archive, the study tested two hypotheses: (1) higher Black/low-income segregation is associated with elevated risks of adverse BC …

Increasing Histidyl Dipeptides In Skeletal Muscle Preserves Muscle Mass And Function In Heart Failure., Mamata Hiraman Chaudhari

Electronic Theses and Dissertations

Introduction: Heart failure is a systemic disease associated with multiple comorbidities, such as skeletal muscle wasting and cardiopulmonary disease. Muscle wasting in heart failure patients is a severe comorbidity associated with decreased exercise capacity and poor quality of life. Previous reports show that oxidative stress is increased in the skeletal muscle of heart failure patients, which can directly lead to muscle wasting. However, antioxidant intervention in these patients was unable to improve cardiac function and consequently had no effect on muscle wasting. Although oxidative stress is the primary driver of skeletal muscle atrophy, no attempt has been made to examine …

Articulator Volume 31, Issue 4

Metro Denver Dental Society Articulator Magazine

The 4^th Quarter 2025 of the MDDS Articulator Magazine offers a preview of the 2026 Rocky Mountain Dental Convention, taking place January 22–24 in Denver. The collection spotlights RMDC speakers and the future of dentistry, from the rise of AI and the shift toward integrated whole-health care to the hidden challenges of chronic illness, and a commitment to preserving natural dentition. The articles challenge dental professionals to rethink assumptions, embrace interdisciplinary collaboration and adopt more personalized and evidence-driven approaches to care.

Implementation Of The Modified Severity Assessment Scale (Msas) For Alcohol Withdrawal In An Inpatient Psychiatric Unit, Grace R. Lindsey

Doctor of Nursing Practice

Background: Alcohol withdrawal is a potentially life-threatening condition frequently seen in psychiatric inpatient settings, especially among individuals with co-occurring alcohol use disorder and mental illness. The Clinical Institute Withdrawal Assessment for Alcohol Scale-revised, while widely used, depends on patient self-report, making it less effective for individuals with altered mental status or psychosis.

Purpose: This quality improvement project implemented the Modified Severity Assessment Scale, an objective, observation-based alcohol withdrawal protocol, in an inpatient psychiatric setting to improve safety, treatment accuracy, and care standardization.

Objectives: The project focused on ensuring full staff adoption of the protocol, reducing intensive care unit transfers …

Diabetes And Hypertension Frequencies And Trends In The Health Districts Of Sololá, Alejandro Cerón, Sophie Perfetto, Ana Textor, Sidona Alemayehu, Emilia Alvear Escobar, Adele Beard, Sarah Berson, Rachel Bryant, Jennifer Calzontzi, Rylee Castro, Eva Cress Palencia, Jake Czarnecki, Jordyn Epstein, Nikki Harris, Patience Hinojos, Max Hippisley, Erin House, Jackson Hullett, Nathan Johnson, Amelie King, Saule Lankelyte, Juan Loya, Ashley Mackenzie, Ilana Mighdoll, Molly Morrill, Maria De Jesus Ramos Jimenez, Lilly Teklemedhin, Joseph Trujillo, Lauren Verachtert, Nathan Verachtert, Violet Vreeland, Alex Welch, Jada Wright

Anthropology: Undergraduate Student Scholarship

This report was prepared by the students, Graduate Teaching Assistants, and instructor of “The Social Determination of Health” class taught in the fall of 2025 at the University of Denver. The report was prepared for Dr. Luis Pablo Méndez, of the Vice Ministry of Health Regulation, Surveillance and Control, of the Ministry of Public Health and Social Assistance of Guatemala. The work used the following guiding question: How can available data about service production can be used to inform the planning process for the implementation of the Global Hearts Initiative’s HEARTS technical package in the Distrito de Redes Integradas de …

Across The Pond, Across The Waistline: A Comparative Look At The Childhood Obesity Crisis In The United States And United Kingdom, Samantha N. Eales

Honors College Theses

Childhood obesity is no longer just a local concern; it’s a global epidemic shaping the health of future generations. This paper compares how two similar nations with drastically different healthcare systems, the United States and the United Kingdom, tackle this growing crisis. Although both countries struggle with fast food culture, sedentary lifestyles, and targeted marketing, their health policy strategies differ dramatically. The U.S. leans on community programs and education, while the U.K. enforces stronger national regulations and advertising restrictions. By examining nutrition, physical activity, and policy, this thesis explores what each country does well and where they fall short. It …

Issue 16: Pulmonary & Critical Care Insider, Bharat Bajantri Md, Sarah Ellsworth Mls

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 16

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health.

Topics:

EVERDAC Trial: Do All Shock Patients Need Arterial Lines?

Beyond MAP: Redefining Perfusion Pressure in Septic Shock

ECG Findings You Cannot Miss in Acute Pulmonary Embolism

Food for Thought: When Private Equity Buys Hospitals, Who Pays …

Sustaining Community Health Through Impactful Snap-Ed Initiatives In Utah, Lacee Jimenez, Kristi Strongo, Lea Palmer, Lendel K. Narine, Heidi Leblanc

Outcomes and Impact Quarterly

Create Better Health (CBH), Utah’s SNAP-Ed program, addresses food insecurity and chronic disease prevention through nutrition education, policy, systems, and environmental (PSE) initiatives, and social media marketing. From 2024 to 2025, CBH reached over 13,500 Utahns through direct education and 81,000 through community interventions. Evaluation results showed significant improvements in nutrition behaviors, including increased fruit and vegetable intake, food resource management, and label use. Follow-up surveys showed sustained behavior change. CBH’s comprehensive approach demonstrates measurable public health impact and points to the importance of continued investment in nutrition education and food access programs to build healthier, food-secure communities.

Integration Of Oral Health Assessment In Medicare Visits: A Survey Of Primary Care Physicians In Montana And Their Role In Patients Aged 65+, Cheyenne R. Smith

Dental Hygiene ETDs

The integration of oral health assessments into primary care settings has been strongly advocated to enhance access to care for elderly individuals. Medical and dental professionals recognize the critical connection between oral health and systemic health. Physicians can play a key role in enhancing oral health care by incorporating an oral health assessment into routine general health appointments, such as the Medicare Annual Wellness Visit (AWV). Physicians in Montana were invited to participate in an anonymous study to gather their opinions on conducting oral health assessments in primary care settings, identify barriers to providing these assessments, and evaluate their knowledge …

Health Workforce Issues And Recommended Practices In The Implementation Of Universal Health Coverage In The Philippines: A Qualitative Study, Veincent Christian Pepito, Arianna Maever Loreche, Ruth Shane Legaspi, Ryan Camado Guinaran, Theo Prudencio Juhani Z. Capeding, Madeline Mae A. Ong, Manuel M. Dayrit

Ateneo School of Medicine and Public Health Publications

Background

The transition towards Universal Health Coverage (UHC) in a devolved healthcare system such as the Philippines is beset by health workforce issues considering that it is among the world’s leading source countries for health workers. This study aims to document health workforce issues and recommended practices in the implementation of UHC in the Philippines.

Methods

We conducted focus group discussions and key informant interviews with health policymakers and UHC implementers in the national, regional, and local levels. Participants included local chief executives, healthcare facility administrators, and healthcare providers at tertiary, secondary, and primary levels, as well as patients. We …

A Randomized Study To Examine The Ability Of A Caffeine-Based Energy Drink To Impact Energy Expenditure, Fat Oxidation, And Cognitive Performance, Joesi Krieger, Alex Schrautemeier, Anthony M. Hagele, Connor Gaige, Olivia Mennemeyer, Sydney Tolbert, Joshua Iannotti, Chad Kerksick, Chris Noonan, Petey Mumford

Faculty Scholarship

Objectives: This study evaluated the effects of acute and 28-day supplementation with a caffeine-based energy drink on energy expenditure, fat oxidation, and cognitive performance.

Methods: In a double-blind, placebo-controlled trial, 33 males and 27 females (27 ± 8 years, 26.7 ± 2.2 m/kg2) consumed a caffeinated energy drink (200 mg; CAF) or placebo (PLA) for 28 days. Indirect calorimetry assessed energy expenditure and fat oxidation at 0, 30, 60, 90, and 120 min after ingestion on day 1 and 28. Cognition assessments (Dynavision reaction, Serial Sevens, Trail Making Test A (TMT-A) and B (TMT-B)) were performed at 0, …

Rural Mental Health Challenges: Addressing Community-Specific Needs Of Rural Mississippians, Mary Marshall Waller, Mary Nelson Robertson, Holli H. Seitz, Michael R. Nadorff, David R. Buys

Journal of Human Sciences and Extension

America’s mental health crisis uniquely impacts rural areas. Challenges surrounding intention and accessibility to engage in mental health-fostering behaviors exacerbate disparities in rural mental healthcare. In this study, Cooperative Extension personnel assess rural Mississippians’ intention to engage in mental health-fostering behaviors, accessibility to mental health-fostering behaviors, and helpfulness of increased access to resources for mental health challenges to determine if relationships exist between these variables. Rural Mississippi adults were recruited via an online survey panel to complete a 147-item web-based questionnaire (n = 274). Findings suggest rural adults’ intention to engage in mental health-fostering behaviors favored connecting with family and …

The Effects Of The Cooking For One Curriculum On Nutrition, Food Safety, Food Resource Management, And Physical Activity Behaviors: A Pilot Study, Tyler B. Becker Dr., Ronald L. Gibbs Jr, Becky Henne, Erika Garner

Journal of Human Sciences and Extension

The number of single adult households has increased over the previous decades, and few health education interventions address these unique living situations, which come with various economic challenges. The Cooking for One curriculum is a cooking-based intervention designed to improve nutrition, food safety, food resource management, and physical activity (PA) behaviors among single adults. This curriculum includes six lessons, each with an educational and hands-on cooking component. Participants included 1,546 adults recruited through Supplemental Nutrition Assistance Education programs in the state of Michigan. Each of the participants underwent the six-lesson Cooking for One curriculum. Prior to and following the intervention, …

Bridging The Communication Gap In Natural Disaster Information: An Exploratory Study Of Extension Service Websites, Emmanuel Chisom Okolo, Rafael Landaverde, Laxmi Prasanna Kandi, Kim E. Dooley, Sarah Mccord, Kelsi Opat, Abdul Saboor Rahmany

Journal of Human Sciences and Extension

Natural disasters are expected to become more frequent and severe, increasing the need for effective disaster management. Governments are emphasizing community awareness and local self-reliance, with the Cooperative Extension Services (CES) playing a vital role in distributing science-based knowledge and supporting preparedness efforts. This qualitative content analysis (QCA), guided by Framing Theory, examined how CES disseminated weather-related disaster preparedness and response information from 2003 to 2023 on Extension Service websites. We explored: (1) the frequency of information on natural disaster preparedness and response published on Extension Service websites, (2) dissemination methods, and (3) the quality of disaster preparedness and response …

Full Issue, Volume 13, Number 3, Donna J. Peterson Dr., Scott Cummings, Elizabeth Gregory North

Journal of Human Sciences and Extension

No abstract provided.

Burden Of Neurodevelopmental Disorders In Kenyan Children, Symon Kariuki, Patricia Kipkemoi, Martha Kombe, Mary Bitta, Jacqueline Phillips Owen, Amina Abubakar, Charles Newton

Institute for Human Development, East Africa

Importance: Neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and intellectual disability contribute to one-tenth of the global burden of mental and neurologic disorders. The burden of NDDs is not well documented in Africa.

Objective:To assess the prevalence, risk factors, and comorbidities of NDDs in young Kenyan children.

Design, setting and participants: This cross-sectional study was conducted among children aged 6 to 9 years residing in the Kilifi Health and Demographic Surveillance System in Kenya. In stage I of the study, children were screened for NDDs from March 16, 2015, to September 14, 2016; those …

Optimizing Endothelial Cell Specific Polymersome-Based Atheroprotective Therapies, Ally C. Brawner

All Theses

Atherosclerotic cardiovascular disease is the number one cause of death in the United States and the world. Every year, billions of dollars are spent in the US alone for direct treatments of this disease, especially on prescription medicines like statins. However, these medications have been unable to curtail global mortality rates, partially because they do not target the entirety of atherosclerotic pathophysiology. A key area of this pathophysiology is that atheroprone arteries typically include pro-inflammatory endothelial cells that exhibit decreased levels of apoAI-mediated cholesterol efflux and an increased release of adhesion molecules, such as VCAM-1. The objective of my project …

Impact Of Multimodal Analgesia In Comparison To Conventional Analgesia In Coronary Artery Bypass Graft Patient With Implementation Of An Enhanced Recovery After Surgery Order-Set, Rhoda Musyoka, Radhan Gopalani, Maura Falli, Maria Ruiz, Cathleen Charles, Yanija Zhang, Esty Trimino, Laura Dominguez Vasquez, Tom Nguyen

Nursing & Health Sciences Research Journal

Background: An Enhanced Recovery After Surgery (ERAS) pilot program was implemented for coronary artery bypass graft (CABG) procedures under a single cardiothoracic surgeon in May 2024 across two community hospitals. We assessed the impact of multimodal analgesia facilitated through the ERAS CABG order-set compared to the non-ERAS (conventional) CABG order-set.

Methods: This study was an Institutional Review Board-approved, multi-site, retrospective chart review of participants admitted to two community hospitals for a CABG procedure from June 2024 to January 2025. Participants who utilized the preand post-ERAS or the pre- and post-conventional CABG order-sets were included. The primary outcome was the opioid …

Breastfeeding Safety Following Maternal Anesthesia: A Guideline Development, Megan Honea, Mary Johnson

Doctoral Projects

Recommendations regarding breastfeeding following maternal anesthesia are inconsistent and often not up to date with current best practice guidelines. Previous recommendations have led to mothers unnecessarily “pumping and dumping” breast milk has benefits for both mother and baby. These benefits include (a) increasing the infant’s access to colostrum, (b) encouraging mother-baby bonding, (c) improving the mother’s breastfeeding experience, (d) and providing significant health benefits to the infant. The purpose of this scholarly project was to develop a set of evidence-based recommendations that focus on mothers who desire to breastfeed following general anesthesia. These recommendations will highlight maternal- fetal transfer of …

The Effect Of Exercise On The Development Of Gestational Diabetes Mellitus In Pregnancy: A Systematic Review Of Literature, Abigail Reiche

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this systematic review is to synthesize literature examining the relationship between using exercise as a preventative method for gestational diabetes development during pregnancy, and the effect it may have on lowering glycemic levels. Health Source: CINAHL and PubMed were systematically searched for peer-reviewed journal articles that studied pregnant women (P), and the relationship of consistent exercise (I), compared to no physical exercise (C), on lowering glycemic levels resulting in positive pregnancy outcomes (O), throughout gestation (T). Twenty articles were retrieved in accordance with the PICOT objectives. Additional criteria included only articles from 2019-2024 and articles that were …

Influence Of Rec-Connect On Youth Physical Activity: A Multi-Year Look At Behavior Change, Cailyn A. Van Camp, Bree Bode, Jocelyn Hayward, Lauryn Lin, Nicole Jess, Marci Scott

Michigan Journal of Public Health

Background: Physical activity (PA) engagement in youth is associated with numerous health benefits. However, youth PA behaviors are influenced by a complex set of factors including school and community environments and broader societal influences. Rec-Connect^TM is a community-based intervention that aims to impact PA behavior in youth. Purpose: To assess changes in youth PA behavior across multiple years of Rec-Connect^TM implementation. Methods: SNAP-eligible youth [aged 8 to 17 (n=261, matched)] who participated in Rec-Connect^TM completed a pre and post survey to assess PA knowledge and behavior change. Educators completed implementation fidelity logs. Descriptives were conducted to examine …

Environmental Sanitation In Long-Term Care Facilities: A Focus On Regulations And Implementations, Ruwan Dissanayake Dissanayake Mudiyanselage

All Theses

Environmental sanitation is a fundamental component of infection prevention in long-term care facilities (LTCFs), where residents are at increased risk due to advanced age, underlying health conditions, and communal living arrangements. Despite its critical role, significant gaps remain in implementing environmental sanitation procedures and the regulatory frameworks that guide them.

This study combines two components: (1) an across-state regulatory review of environmental sanitation in LTCF regulations and (2) a cross-sectional survey assessing environmental sanitation characteristics of nursing homes (NHs) and assisted living facilities (ALFs) and Rural and Urban LTCF observation study in South Carolina (SC) . For the regulatory review …

Maternal-Infant Mortality In West Michigan: A Comparative Literature Review, Mia Cichowlas, Riley Bourlier

Honors Projects

This literature review aimed to examine and analyze data to identify causes of disparities in infant mortality rates across West Michigan’s four counties, assess demographic factors influencing infant mortality, and explore cultural practices impacting infant outcomes. A comprehensive review of existing literature, public health data, and community health reports from Allegan, Kent, Muskegon, and Ottawa counties was conducted. Key variables examined included race, maternal age, culture, health literacy, education level, income, insurance coverage, employment status, and marital status. Findings indicate that infant mortality rates vary significantly between counties and are higher among certain racial and socioeconomic groups compared to state …

Investigating The Cardiovascular And Autonomic Responses To Energy Drink Consumption: The Role Of Energy And Calorie Content, Sophia Schmidt

Honors Theses

Energy drinks (EDs) are among the most consumed functional beverages, often marketed to enhance focus, alertness, and physical performance. Despite their popularity, the combined cardiovascular and autonomic effects of caffeine and sugar during exercise remain poorly understood. The purpose of this study was to examine the acute cardiovascular, metabolic, and autonomic responses to sugar-sweetened (ED-S), non-nutritive sweetened (ED-NNS), and placebo beverages during submaximal cycling in healthy young males.

Nine male participants (age 22.2 ± 2.4 yrs; BMI 26.2 ± 2.9 kg/m²) completed three experimental visits in a randomized, repeated-measures design. Each visit involved ingestion of one drink (ED-S, ED-NNS, or …

Defining The Causal Contribution Of The Gut Microbiota To Cardiomyopathy Pathogenesis As A Basis For Developing Microbiome-Targeted Therapies, Xu Shi

Department of Food Science and Technology: Dissertations, Theses, and Student Research

Heart failure (HF) is a leading cause of morbidity and mortality worldwide, placing substantial clinical and economic burdens on society. Although advances in therapy have improved patient outcomes, the biological mechanisms that drive HF onset and progression remain incompletely understood. Increasing evidence suggests that the gut microbiota, the trillions of microorganisms residing in the gastrointestinal tract, plays a key role in some forms of heart disease, especially cardiovascular disease. Moreover, gut microbial dysbiosis has been associated with systemic inflammation, metabolic imbalance, and immune dysregulation, all of which contribute to the pathophysiology of HF. Cardiomyopathy, a primary disorder of the heart …

A Scoping Review Of Maternal Active Smoking During Pregnancy And Low-Birth Weight, Naomi Sondang, Nindi Oktavia, Qorinah Estiningtyas Sakilah Adnani, Lani Gumilang, Hadi Susiarno, Victor Abiola Adepoju

Journal of Asian Midwives (JAM)

Background: Low-birth weight (LBW; < 2.5 kg) infants are at increased risk of early mortality, impaired growth, neuro-developmental delay and chronic disease later in life. Maternal behavior, especially cigarette smoking, remains one of the most modifiable determinants of birth weight. We therefore synthesized recent evidence on the association between active maternal smoking during pregnancy and LBW.
Methods: Following PRISMA guidance, we systematically searched PubMed, Scopus and ScienceDirect for the period January 2020 to 31 January 2025 for English-language observational studies that quantified the relationship between active prenatal smoking and LBW. Risk of bias was appraised, and findings were summarized narratively.
Results: In total 26,650 papers were found and eight eligible studies (four cohort, three cross-sectional, one case-control) from Asia, Europe and the Middle East were included. Across all designs and exposure metrics—self-report, exhaled carbon-monoxide, urinary cotinine, and cord-blood DNA-methylation, active smoking was consistently associated with …