Digital Commons Network^™

Food Insecurity And At-Home Vegetable And Sugar-Sweetened Beverage Availability: Tx Sprouts Randomized Controlled Trial, Keally Haushalter, Shreela V Sharma, Marissa Burgermaster, Natalie S Poulos, Erin A Hudson, Jennifer M Daspin, Mariela Jimenez Rivero, Jaimie N Davis

Faculty, Staff and Student Publications

Food insecurity and the at-home availability of vegetables and sugar-sweetened beverages both influence dietary intake. However, most research on food insecurity and the at-home availability of vegetables and sugar-sweetened beverages is cross-sectional, which is problematic as both change frequently. Therefore, this study assessed how changes in food insecurity were associated with changes in the at-home availability of vegetables and sugar-sweetened beverages among those in the intervention and control groups of TX Sprouts. Parents who participated in TX Sprouts, a gardening, cooking, and nutrition cluster-randomized trial conducted with primarily Hispanic, low-income 3rd-5th-grade students, completed surveys at baseline and at the nine-month …

A Remote Intervention To Improve Medication Nonadherence Guided By A Marker Of Risk Derived From The Electronic Health Records Of Adolescent Transplant Recipients, Eyal Shemesh, Ravinder Anand, Rachel A Annunziato, Emily M Fredericks, Jennifer Garcia, Nitika Arora Gupta, Lawrence C Kleinman, Alyssa Kriegermeier, Krupa R Mysore, Vicky L Ng, Steven J Lobritto, Shreena Patel, Emily Rothbaum Perito, Elizabeth B Rand, Rene Romero, Robert S Venick, Sarah Duncan-Park, Jeffrey Mitchell, Sarah G Anderson, Margaret L Stuber, Miguel Reyes-Múgica, George V Mazariegos, Benjamin L Shneider

Faculty, Staff and Students Publications

Improving medication adherence in adolescents who had a liver transplant (iMALT), a prospective, block-randomized, single-blind, controlled multisite study in 13 pediatric transplant centers, used the medication level variability index (MLVI) to identify nonadherent adolescents. It compared a 2-year remote behavioral telemetric intervention (TI) that focused on adherence and addressed barriers to standard of care (SOC). The primary endpoint was the composite incidence of centrally determined (3 masked pathologists) rejection, death, retransplantation, or consent withdrawal. In 148 participants (TI group, n = 72 and the SOC group, n = 76), with a mean age 15.5 years, there were twice as many …

Food Insecurity And Mental Health Among High School Students: Evidence From National And Virginia Youth Risk Behavior Surveillance Data, Nigel C. James, Asef Raiyan Hoque, Jada Pedersen, Huong Doan, Liam Hayes, Leah Suggs

Health Studies Faculty Publications

Background

Youth mental health problems are rising nationally. Virginia ranks among the lowest states in youth mental health access and has concentrated pockets of food insecurity (FI), underscoring the urgency of policy responses. FI is a known risk factor, yet surveillance often relies on single-item measures. We introduce a multidimensional Food Insecurity Index (FII) to examine associations with adolescent mental health.

Methods

We analyzed 2023 Youth Risk Behavior Surveillance System data from Virginia (n = 1866) and the United States (n = 10,724). The FII combined five indicators capturing acute scarcity and chronic dietary compromise. Survey-weighted logistic regression …

Recognizing Early Eating Disorder Signs In Pediatrics, Sarah Gubara, Sara R. Gould

Pediatrics in Practice: A CME Podcast

A concise guide for frontline clinicians on early physical and behavioral red flags — changes in growth trajectory, micronutrient concerns, exam‑time anxiety or sudden “healthy” eating shifts. Dr. Sara Gould emphasizes practical 24‑hour recalls, when to order labs/EKG and how to use longitudinal data from well visits to detect problems sooner.

Click here to stream the podcast episode.

Internalized Homophobia As An Influence On Participation In Hiv Prevention Among Young Men Who Have Sex With Men (Ymsm), Kasey I. Brazee

Honors Scholar Theses

Stigma is a known barrier to accessing preventative services for human immunodeficiency virus (HIV), however, the types of stigmas involved in this relationship remain not well defined. Homophobia, or negative attitudes directed towards homosexuality, is a particularly important type of stigma considering the disproportionate effect of HIV on men who have sex with men (MSM). Young MSM (YMSM) are especially impacted, making them a key population in the context of HIV prevention research.  Internalized homophobia, which refers to homophobia that one directs towards themselves, is under researched regarding its role in participating in HIV prevention. In this study, we aimed …

Staff Education To Improve Treatment Adherence Among Young Adults With Mental Health And Substance Use Disorders In An Outpatient Behavioral Health Clinic, Nkechinyere Eririma Nwachukwu

Walden Dissertations and Doctoral Studies

No abstract provided.

An Emotional Intelligence Staff Education Program For Patient-Aligned Care Team (Pact) Members, Linda Rogers

Walden Dissertations and Doctoral Studies

No abstract provided.

Epileptic Seizure Prediction From Eeg Using Continual Learning With Cnns, Adnan Amin, Ammar Bathich, Feras Al-Obeidat, Safa Naes, Maria Jose Sousa

All Works

Epilepsy is a persistent neurological disorder that affects over 50 million people worldwide, with nearly one-third of patients remaining unresponsive to conventional therapeutic treatments. This study introduces a progressively adaptive seizure prediction framework designed to enhance early detection and clinical decision-making. The proposed model employs a deep learning strategy grounded in continual learning (CL) principles, using Convolutional Neural Networks (CNNs) in combination with knowledge distillation techniques. This enables the model to assimilate new data while retaining previously learned information. The approach was evaluated on the publicly available Bonn University EEG dataset, following a sequential learning process in which each successive …

Probiotic Intake Related To Hemoglobin A1c Among U.S. Veterans With Type 2 Diabetes Mellitus, Maryann Martin

Walden Dissertations and Doctoral Studies

No abstract provided.

Experiences Of First-Generation Immigrant Parents In Caring For Children With Type 1 Diabetes, Nahel Kibreab

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving Antihypertensive Medication Adherence Through Patient-Centered Assessment In Rural Primary Care, Tiesha Keoni Mathis

Walden Dissertations and Doctoral Studies

No abstract provided.

Lessons Learned In Providing Infant And Early Childhood Mental Health Consultation During The Covid-19 Pandemic, Rashele Wade

Journal of Global Awareness

Access to quality childcare is a protective factor from lifelong issues such as school failure, school drop-out, and incarceration. Conversely, preschool suspension and expulsion are significant risk factors. Evidence-based interventions, such as Infant and Early Childhood Mental Health Consultation, aim to reduce and eliminate the incidence of preschool suspensions and expulsions. The COVID-19 pandemic disrupted access to quality childcare for many children across the country and globally. This study utilized a qualitative action research approach and generic qualitative inquiry to examine the research question, “How can we improve Infant and Early Childhood Mental Health Consultation through lessons learned during the …

Caring For The Carers: Exploring The Mental Wellbeing Of Informal Palliative Caregivers Of Cancer Patients In Kenya, James Kariuki, Rose Njiraini

Journal of Global Awareness

Cancer cases have been on the increase globally, and this has led to economic burden on the affected households. One way of reducing the cost of care is through home-based care by informal palliative caregivers who include family members, friends, and other people assigned by the family members to take care of the patient. The objectives of this study were to assess the status of the mental wellbeing of palliative caregivers of cancer patients; to examine the relationship between the ability of the patient to cope with cancer diagnosis and the mental wellbeing of the caregiver; and to investigate the …

Navigating Burnout: The Role Of Workplace Support For Social Work Clinicians, Melanie Fulton

Journal of Global Awareness

The shortage of mental health workers is a growing concern in the United States, and social workers a substantial portion of employees who work with individuals with mental health concerns. This shortage stresses the importance of studying factors that impact burnout for mental health clinicians, particularly social work clinicians. While burnout among social workers in some settings have been documented in the literature, less research has focused on independently licensed clinical social workers in private practice. This study had participants complete a survey to examine the relationship between workplace support, burnout, and professional fulfillment among this population (N = 57). …

Exploring The Role Of Magnesium Deficiency In Inflammatory Bowel Disease, Victor A. Bob-Yellowe, Shaunte Hadnot, Sonya Bhatia, Anesu K. Murambadoro

MEDI 9331 Scholarly Activities Clinical Years

Inflammatory Bowel Disease (IBD) is a group of chronic gastrointestinal disorders, including Ulcerative Colitis and Crohn’s disease. As of 2020, it was estimated that IBD significantly impacts the lives of approximately 2.39 million Americans. Magnesium (Mg) is an essential mineral involved in many bodily functions, including immune response and gut health. Recent studies suggest that Magnesium levels may be linked to IBD. Therefore, this review aims to explain how Magnesium might play a role in the development or progression of IBD. Additionally, this article discusses the overall role that Magnesium’s plays in gut health and whether Magnesium supplementation could be …

Brain Age Prediction In Generalized Anxiety Disorder Using A Convolutional Neural Network, Corey Richier, André Zugman, Anita Harrewijn, Elise M. Cardinale, Parmis Khosravi, Moji Aghajani, Willem B. Bruin, Kevin Hilbert, Narcis Cardoner, Anderson M. Winkler

Human Genetics Publications

Higher predicted brain age difference has been associated with several psychiatric disorders. Generalized anxiety disorder (GAD) is associated with markers of accelerated aging. In this study, we determined brain predicted age difference (PAD) in individuals with GAD and healthy controls (HC) as well as group differences in PAD variability using voxel-wise structural MRI. The training dataset included 3511 controls, and the testing dataset included 1595 individuals with GAD and 4552 HC from the ENIGMA-Anxiety GAD Working Group. A convolutional neural network model using four input modalities per subject and a model ensemble approach was used to predict brain age. The …

Brain Age Prediction In Generalized Anxiety Disorder Using A Convolutional Neural Network, Corey Richier, André Zugman, Anita Harrewijn, Elise M Cardinale, Parmis Khosravi, Moji Aghajani, Willem B Bruin, Kevin Hilbert, Narcis Cardoner, Daniel Porta-Casteràs, Marta Cano, Savannah Gosnell, Ramiro Salas, Andrea P Jackowski, Pedro M Pan, Giovanni A Salum, Karina S Blair, James R Blair, Mohammed R Milad, Katie L Burkhouse, K Luan Phan, Heidi K Schroeder, Jeffrey R Strawn, Katja Beesdo-Baum, Neda Jahanshad, Sophia I Thomopoulos, Jared A Nielsen, Jordan W Smoller, Jair C Soares, Benson Mwangi, Mon-Ju Wu, Giovana B Zunta-Soares, Michal Assaf, Gretchen J Diefenbach, Paolo Brambilla, Eleonora Maggioni, David Hofmann, Thomas Straube, Carmen Andreescu, Rebecca B Price, Gisele G Manfro, Federica Agosta, Elisa Canu, Camilla Cividini, Massimo Filippi, Milutin Kostić, Ana Munjiza Jovanovic, Brenda Benson, Gabrielle F Freitag, Ellen Leibenluft, Grace V Ringlein, Kathryn Werwath, Hannah Zwiebel, Hans J Grabe, Sandra Van Der Auwera, Katharina Wittfeld, Henry Völzke, Robin Bülow, Nicholas L Balderston, Monique Ernst, Lilianne R Mujica-Parodi, Helena Van Nieuwenhuizen, Hugo D Critchley, Elena Makovac, Matteo Mancini, Frances Meeten, Cristina Ottaviani, Gregory A Fonzo, Martin P Paulus, Murray B Stein, Raquel E Gur, Ruben C Gur, Antonia N Kaczkurkin, Bart Larsen, Theodore D Satterthwaite, Jennifer Harper, Michael T Perino, Chad M Sylvester, Qiongru Yu, Patrick Mcclure, Francisco Pereira, Ulrike Lueken, Dick J Veltman, Paul M Thompson, Nynke A Groenewold, Janna Marie Bas-Hoogendam, Dan J Stein, Nic J A Van Der Wee, Anderson M Winkler, Daniel S Pine, Chelsea K Sawyers

Faculty, Staff and Student Publications

Higher predicted brain age difference has been associated with several psychiatric disorders. Generalized anxiety disorder (GAD) is associated with markers of accelerated aging. In this study, we determined brain predicted age difference (PAD) in individuals with GAD and healthy controls (HC) as well as group differences in PAD variability using voxel-wise structural MRI. The training dataset included 3511 controls, and the testing dataset included 1595 individuals with GAD and 4552 HC from the ENIGMA-Anxiety GAD Working Group. A convolutional neural network model using four input modalities per subject and a model ensemble approach was used to predict brain age. The …

Associations Between Neighborhood Disadvantage, Cannabis Use, And Patient-Reported Outcomes Among Patients With Cancer, Brittney Greene, Shilpa Ghosh, Craig Colder, Salimah Meghani, Brooke Worster, Rebecca Ashare

Kimmel Cancer Center Faculty Papers

INTRODUCTION: Cannabis use is proliferating among oncological populations. However, research is limited on whether cannabis routes and sources are associated with neighborhood disadvantage and whether it moderates the relationship between neighborhood disadvantage and patient-reported outcomes (PROs). This analysis evaluates the relationship between neighborhood disadvantage and cannabis source and route, and their association with PROs.

METHODS: Analyses included 106 patients with cancer from varying levels of neighborhood disadvantage. Logistic regressions tested the association of neighborhood disadvantage with cannabis source (i.e., regulated vs. unregulated) and route (i.e., inhaled vs. consumed/other formulations). Multilevel regressions tested the association of neighborhood disadvantage with PROs (e.g., …

Postpartum Depression: A National Crisis Calling For Federal Support, Sarah A. Stallsworth

Doctor of Nursing Practice Final Manuscripts

Postpartum depression (PPD) is the leading cause of maternal mortality in the United States, yet it remains significantly underdiagnosed and undertreated. Despite decades of research illuminating its prevalence and detrimental consequences, federal intervention has been limited.  States retain responsibility to address the issue and possess inconsistent and limited legislation.  The purpose of this paper is to propose adding PPD screening as a National Performance Measure (NPM) within the Title V Maternal and Child (MCH) block grant. MCH is a longstanding and resourceful program that provides states funds to address maternal mental health needs. This proposal suggests leveraging a PPD NPM …

The Parent Phone Use Regulation Efficacy Scale (P-Pure): Initial Validation And Associations With Problematic Smartphone Use, Self-Regulation, Impulsivity, Mindfulness, And Self-Efficacy, Brandon T. Mcdaniel, Sabrina Uva, Adam M. Galovan

Health Services and Informatics Research

Parents often rely on smartphones in daily life. While smartphones offer benefits, they also present challenges, such as potential distraction and delayed responsiveness. It is also possible that problematic smartphone habits may develop, such as repeated checking or difficulty controlling use. Furthermore, self-efficacy around regulating one’s phone use is tied to the ability to change, meaning self-efficacy could be a key mechanism impacting the effectiveness of interventions regarding problematic phone use. Thus, we developed and explored the validity of the Parent Phone Use Regulation Efficacy Scale (P-PURE) to assess parents’ self-efficacy in managing phone use around their children. We developed …

Implementing Cbt-I Coach App Education During Initial Psychiatric Evaluations At The Va Pec: A Provider-Facing Quality Improvement Initiative, Sarah J. Kang

Doctor of Nursing Practice Final Manuscripts

Objective: This evidence-based practice project aims to increase provider implementation of gold standard insomnia treatment, Cognitive Behavioral Therapy for Insomnia (CBT-I), by integrating CBT-I Coach app education into initial psychiatric evaluations within a VA psychiatric emergency clinic (PEC).

Background: Insomnia is highly prevalent among veterans and commonly co-occurs with PTSD, depression, and anxiety. National guidelines from the VA, DoD, and American Academy of Sleep Medicine endorse CBT-I as first-line treatment. Despite this, pharmacotherapy is the dominating intervention in psychiatric emergency settings. The CBT-I Coach app offers evidence-based CBT-I as a free, VA-developed digital tool, but it remains underutilized in acute …

Intimate Partner Violence Screening And Awareness Pilot Project, Eleasha P. Partner

Doctor of Nursing Practice (DNP) Projects

Background: In the United States, one in four women experiences intimate partner violence (IPV), highlighting the critical need for improved screening and intervention within the healthcare system. Routine visits in healthcare settings present a significant opportunity for healthcare providers to identify and address IPV.

Local Problem: A primary care family practice clinic in San Leandro, California , currently lacks a standardized evidence-based screening toolkit for IPV.  The absence of such a toolkit creates a gap in practice, leaving patients at risk of undiagnosed IPV and its related consequences.  To address this gap, there is a pressing need for the development …

Slouching Towards Inefficiency? The Cardiometabolic And Cognitive Costs Of Poor Posture, Ava Mae Fitzenrider

Honors Projects

Posture affects all of our lives. It is both static and dynamic, adapting continuously to environmental demands. One postural alteration frequently observed in occupational settings is hyperkyphosis, which can be induced by sitting position. During computer use, individuals commonly adopt a slouched posture, which can exacerbate hyperkyphosis, and contribute to dis-ease within the body. Previous research has demonstrated that such postural deviations can negatively affect pulmonary function, as well as other bodily functions. Despite these findings, the effects of acute hyperkyphosis (“slouching”) on cardiometabolic function and cognition remain largely unexplored. Therefore, the purpose of this study was to examine the …

Advancing School-Based Sexual Reproductive Health Education Through A Fifth-Grade Educator Toolkit, Emira Romero

Doctor of Nursing Practice (DNP) Projects

Background: Although sexual and reproductive health (SRH) education is a critical component of early health literacy and health promotion, educators remain underprepared to deliver this education. Local Problem: A gap analysis conducted at School A, a public elementary school in the San Francisco Bay Area, revealed the absence of a SRH curriculum for their fifth graders. Methods: A Doctor of Nursing Practice (DNP) student-led quality improvement project to introduce a SRH educator toolkit to increase educator confidence and self-efficacy was conducted at School A among fifth grade teachers. Pre- and post-intervention data were collected on implementation day to evaluate the …

Standardizing Preoperative Screening: A Color-Coded Triage Tool Quality Improvement Project, Lyn Green

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Ambulatory surgery centers (ASCs) require effective preoperative screening to ensure appropriate patient selection and minimize day-of-surgery (DOS) cancellations, which affect patient safety, operational efficiency, and financial performance.

Local Problem: In a Northern California ASC serving a racially diverse, predominantly older-adult population with a high burden of chronic diseases, the DOS cancellation rate was 3.84%, exceeding the 2.3% institutional benchmark. Inconsistent preoperative screening contributed to avoidable cancellations.

Methods: A pre- and post-intervention quality improvement design evaluated the effect of a standardized screening tool and staff education on DOS cancellations.

Interventions: The Preoperative Stoplight Tool, a color-coded triage system classifying …

Soft Power, Arab Media And Sports Mega Events: Coverage Of Fifa 2022 And Lessons For Future Arab Hosting, Lynne Kennedy, Maaira Shahbaz, Ala Al Rajabi

All Works

Sport mega-events (SMEs) increasingly transcend athletic competition, functioning as strategic instruments for national identity formation, statecraft, and soft power projection. This dynamic is particularly pronounced in the Gulf, where Qatar’s successful hosting reignited regional rivalries and attracted unprecedented global scrutiny. While existing scholars have extensively examined Western media portrayals of SMEs, a notable gap remains for academic engagement with Gulf media. Dismissed as state-controlled and analytically lacking, we contend that such media offer a rich site for exploring how small states use media as soft power, to construct and contest legitimacy, identity, and global influence. This analysis suggests how state-aligned …

Exploring Clinical Ladder Program Participation Among Operating Room Nurses, Camille Sistoso-Lorenzana

Doctoral Projects

Continuous professional development among nurses is vital, yet not all nurses embark on this career journey. The Clinical Ladder Program (CLP) is a retention strategy among various health institutions to retain talent and improve nurses' satisfaction, but this plan is unappealing or indifferent to some nurses. While the CLP is a motivation tool for nurses to focus on clinical expertise in bedside care (Riley et al., 2009), and resources are available to increase a nurse's chances of successfully advancing the ladder, participation in and perspectives on the CLP remain unknown, especially among operating room nurses. This project is guided by …

Waterway: A Steam-Based Therapeutic Device System, Mingyuan Dong

Masters Theses

Across history and global cultures, water has played a central and often spiritual role in practices of care, from cleansing rituals to saunas and steam therapies. Yet, within contemporary product design, water is typically treated as a utility rather than as an experiential material capable of shaping perception, attention, and well-being. This thesis, Waterway, investigates how water, specifically in its steam state, can be designed as both a therapeutic medium and a ritualized experience that engages the body and mind.

Waterway proposes a steam-based wellness system that addresses physical pain and somatic discomfort while cultivating slower, more attentive interaction. Rather …

Somatic Prosthetics For Planetary Resonance, Disha Dharesh Kumar R

Masters Theses

This thesis investigates how industrial design can transcend extractive technological paradigms in favor of relational interfaces that foster planetary attunement. Framing the climate crisis as a 'crisis of imagination', the research challenges the Western bifurcation of nature and culture by drawing on Indic cosmologies- which recognize stones, plants, and ecosystems as conscious at different levels and participants in a shared cosmic field. By synthesizing research in Biosemiotics, Quantum Information Pansycishm, and Neuroscience, the project redefines intelligence as a distributed, more-than-human phenomenon.

The research materializes as a speculative design artifact: a device that functions as a somatic prosthetic for planetary resonance. …

Joint Disease And Demographic Factors In Clinical Populations Of Medically Underserved Communities, Blake C. Martin, Juan Lopez-Alvarenga, Michael Sander

School of Medicine Publications

Background: The Rio Grande Valley is a medically underserved, demographically unique population that warrants the exploration of various conditions.

Objectives: We sought to analyze the demographic disparities between the different types of common joint conditions in this community. We hypothesized that osteoarthritis would be the most common joint condition and that the demographics between the various joint conditions would vary depending on age, sex, BMI, and ethnicity.

Methods: This was a retrospective cohort, from January 1, 2018, to September 4, 2024. Patients’ charts were obtained using the ICD-10 diagnosis codes M15-M19 for osteoarthritis, M05-M06 for rheumatoid arthritis, M10 or M1A …