Digital Commons Network^™

High Dietary Fiber Is Associated With Improved Outcomes In Patients With Melanoma And Sarcoma Treated With Immunotherapy Regardless Of Gut Microbiome Dysbiosis And Social Vulnerability, Brittany C Fields, Raymond S Traweek, Kai Jiang, Russell G Witt, Ashish Damania, Nadim Ajami, Emily Z Keung, Manoj Chelvanambi, Xiaotao Zhang, Christine B Peterson, Jennifer A Wargo, Carrie R Daniel, Christina L Roland, Ashley M Holder

Faculty, Staff and Student Publications

Background: Social vulnerability, dietary fiber, and the gut microbiome have been individually implicated in clinical outcomes for melanoma and sarcoma patients. This study hypothesized that increasing social vulnerability is associated with insufficient dietary fiber intake and negatively associated with microbiome composition and clinical outcomes.

Methods: Clinicopathologic data, baseline fiber intake, and gut microbiome profiles were assessed in 153 patients with melanoma or sarcoma treated with immune checkpoint blockade (ICB) and prospectively followed. Patients' social vulnerability index (SVI) and fiber intake were evaluated for associations with microbiome composition, treatment response, and overall survival (OS).

Results: SVI percentile was 0.4 (interquartile ratio …

Simulated Hearing Loss In Healthy Young And Older Adults Results In Poor Reaction Time In Older Adults., Victoria Kowalewski, Nicoleta Bugnariu, Rita M. Patterson, Jessica Hartos

Pacific Journal of Health

Emerging evidence links hearing loss to increased fall risk in older adults, yet mechanisms remain unclear. This study examined the impact of simulated hearing loss on reactive balance control in healthy young and older adults. Participants performed dual-task scenario involving auditory sentence repetition and unexpected surface translations. Hearing loss was simulated using Adobe Audition, applying frequency-specific attenuation based on moderate sensorineural hearing loss levels from the literature.

Speech-in-noise performance significantly declined under simulated hearing loss for both age groups (p < .001), confirming effective simulation, but not significant differences were found between age groups. Maximum COP-COM displacement (the scalar distance between Center of Pressure and Center of Mass) increased with perturbation intensity (Level 1 vs. Level 2: p < .001), but no significant differences were found between hearing conditions or age groups (p > .05), suggesting compensatory step execution was preserved.

Reaction time analysis revealed a significant interaction between hearing condition and perturbation level …

Decision-Making At The Edges Of Capacity: Brain Science And Caregiving, Dr. Julie Yonker

University Faculty Publications and Creative Works

Keynote address at the Disabilities Resources Symposium at City Hope Church in Grand Rapids on 3/14/2026. Attached is her powerpoint.

• Describe why our brains don’t like decisions
• Understand the impact of different types of decisions
• Value suggestions for more sustained decision making
• Consider a faith perspective

The Relationship Between Guilt And Self-Blame With Early Maladaptive Schemas In Patients With Cancer: A Cross-Sectional Study, Mohadeseh Nikandish, Seyede Salehe Mortazavi, Shahrbanoo Ghahari, Mahdiyeh Salehi, Roghie Bagheri

Sultan Qaboos University Medical Journal

Objectives: Cancer is still one of the leading causes of death worldwide and a high percentage of patients with cancer face emotional challenges such as guilt and self-blame. Early maladaptive schemas (EMSs) can make these feelings even stronger. This study aimed to explore how guilt and self-blame relate to EMSs in individuals with cancer, while taking overall psychological distress into account. Methods: This cross-sectional study was conducted at Rasoul-e-Akram and Firoozgar hospitals in Tehran, Iran, from October 2022 to June 2023. Patients with cancer answered the Early Maladaptive Schema Questionnaire-Short Form, Eysenck's Guilt Questionnaire (2007) and the Cognitive Emotion Regulation …

4. Impacting Nurse Leader Satisfaction And Retention Through Standardized Support And Education., Rebecca Hawkins

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Exploring The Roles Of The Coach Developer: A Uscce White Paper, Christine Nash, Melissa Thompson, Sean Dahlin, Andrea Woodburn, Jeremy Elliott

Journal of Coach Development

Organizational white papers serve as a mechanism for strategic communication and to establish thought leadership, build credibility, and drive informed decision-making across stakeholder groups. It is the belief of the USCCE that the official launch of the Journal of Coach Development offers the appropriate outlet and timing to publish this official stance of the organization to explore the multiple roles of the coach developer. As the field continues to evolve, our shared understanding of the roles and responsibilities of those serving to support the growth and development of sport coaches will be essential. Further, as a critical focus of the …

Professional Quality Of Life Among Medical Surgical And Telemetry Registered Nurses, William Lim, Emy-Lee Marie Anglo Ricafrente, Jenny Carrillo

Providence Nursing Research Conference 2023 – Present

No abstract provided.

What Is Coach Development? A Uscce White Paper, Melissa Thompson, Christine Nash, Sean Dahlin, Andrea Woodburn, Jeremy Elliott

Journal of Coach Development

Organizational white papers serve as a mechanism for strategic communication and to establish thought leadership, build credibility, and drive informed decision-making across stakeholder groups. It is the belief of the USCCE that the official launch of the Journal of Coach Development offers the appropriate outlet and timing to publish this official stance of the organization defining the term ‘coach development.’ As an emerging term in the field, there is need for clarity around what coach development is and what it looks like in practice. Further, as a critical focus of the Journal of Coach Development, this paper will serve to …

Reducing Surgical Site Infections Post Cesarean Section Through Multi-Modal Standardized Education, Ari Meyers, Fereshteh Pirayesh, Tracie Tolme

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Staff Education To Improve Nurses’ De-Escalation Skills In Substance Abuse Treatment Settings, Joy Atufunwa

Walden Dissertations and Doctoral Studies

Nearly 50% of patients in substance abuse treatment settings exhibit aggressive behaviors, placing staff and other patients at risk. In the absence of structured de-escalation training, clinicians frequently rely on physical restraints or pharmacologic interventions, which contribute to staff burnout, injury, and ethical concerns. The project implemented an evidence-based staff education program to improve nurses’ knowledge, confidence, and competence in managing aggression using nonviolent de-escalation strategies. The project question guiding this initiative was: Can education improve nurses’ de-escalation skills in a substance abuse treatment setting? Using an evidence-based practice (EBP) approach and the PICO framework, the project evaluated the impact …

Quality Of Prenatal Care, Provider Preference, And Preeclampsia Among African American Women In Georgia, Lyteasha Bass

Walden Dissertations and Doctoral Studies

African American women experience disproportionately high rates of preeclampsia in the United States; however, the contributions of prenatal care provider type, health care access, and quality of care to this disparity were insufficiently defined. Guided by the quality health outcomes model, this quantitative case-control study used primary data to examine associations between these factors and the occurrence of preeclampsia among African American women age 18–40 who had given birth within the previous 5 years in Georgia. Descriptive statistics and binary and multinomial logistic regression analyses were conducted. Prenatal care quality was measured using the Quality of Prenatal Care Questionnaire (QPCQ), …

Enhancing Staff Knowledge And Confidence In Depression Screening Using The Patient Health Questionnaire-9, Melkamzer Chari

Walden Dissertations and Doctoral Studies

Depression is a serious public health concern affecting over 280 million people globally and leading to significant morbidity and mortality if left undetected and untreated. At the local organization, leadership identified inconsistent depression screening as a practice problem among nursing staff. Thus, the purpose of this doctor in nursing practice (DNP) project was to determine if an educational intervention focused on depression, the importance of depression screening, and the use of the Patient Health Questionnaire-9 (PHQ-9) increased knowledge and confidence among nursing staff working in a local organization. Fifteen participants volunteered to participate in the project. The average age was …

Gastrointestinal Symptoms After Sport-Related Concussion In Irish Athletes, Emma Finnegan, Ed Daly, Katherine Hunzinger, Lisa Ryan

Department of Exercise Science Faculty Papers

Background/Objectives: Sport-related concussion (SRC) elicits multi-systemic symptoms, including nausea, fatigue, and cognitive changes. Gastrointestinal (GI) symptoms are not well captured in current concussion assessments and may be under-recognised in clinical follow-up. GI disturbances may influence intake tolerance and day-to-day fuelling during post-SRC recovery. This study investigated the prevalence and severity of self-reported GI symptoms in Irish athletes after their most recent SRC, examined sex-based patterns, and evaluated the rationale for integrating GI symptom checks into standard concussion tools (e.g., SCAT6) and post-injury monitoring. Methods: An online survey was completed by recreational, competitive, and elite athletes who retrospectively self-reported concussion history, …

Cannabis Stigma And Symptom Management Considerations In Cancer Survivors: A Mixed-Methods Exploration Of Patient Perspectives, Sera Levy, Salimah Meghani, Brooke Worster, Colleen Kilanowski, Danielle Smith, Amy A. Case, Rebecca L. Ashare

Department of Medical Oncology Faculty Papers

PURPOSE: This study aims to assess for indications of stigma and attitudes toward cannabis among cancer survivors (CS) who use or consider the use of cannabis.

METHODS: This study employed a convergent, parallel mixed methods design utilizing focus group and questionnaire data to assess the presence of stigma among a sample of CS (n = 23) who use (n = 10) and do not use (n = 13) cannabis to manage symptoms. CS were recruited from a multi-site observational study in the Northeast U.S. region that assesses cannabis use among oncology patients.

RESULTS: A total of 23 CS participated in …

Symptomatic Manifestations Of Hip Dysplasia In Young Adults: How Do Patients Present Before Or After Surgery? Results From A Social Media Cohort, John M. Gaddis, Amanda J. Wheeler, Erika Shults, Charles South, Stephen T. Duncan, Joel Wells

School of Medicine Publications

This study aimed to analyse the symptomatic differences of hip dysplasia before or after separate surgical interventions, including pain location and characteristics, severity, patient-reported outcomes, and a body pain diagram. A REDCap-based survey was distributed through social media from October 2023 to May 2024 and targeted individuals with current or past hip pain. The survey gathered data on demographics, comprehensive hip-specific history, and various patient-reported outcome measures. Of 509 completed surveys, 287 respondents reported a diagnosis of hip dysplasia and were divided into cohorts based on treatment history: no surgery (n = 65), post-periacetabular osteotomy (PAO) (n = 162), post-THA …

The Effect Of Transcranial Near-Infrared Laser Therapy On Chronic Ischemic Stroke Patients: A Randomized, Single-Blind, Sham-Controlled Trial, Merna Hassan, Osama Al Balah, Ahmed Hegazy, El Sayed Satour

Journal of the Saudi Heart Association

Background: Transcranial photobiomodulation (TPBM) using near-infrared (NIR) light is a novel, non-invasive neuromodulation strategy with potential to enhance neurorecovery. While preclinical studies are promising, clinical evidence in chronic stroke remains limited and inconsistent.

Objective: To evaluate the efficacy and safety of 980 nm transcranial NIR laser therapy as an adjunct to standard rehabilitation in improving neurological function in patients with chronic ischemic stroke.

Methods: In this randomized, single-blind, sham-controlled trial, 40 chronic ischemic stroke patients (>6 months post-onset, NIHSS 7-22) were allocated to active treatment (n=20) or sham control (n=20). The active group received 980 nm laser therapy (6W, …

Social Network Determinants Of Cigarette Forgoing And Quit-Related Conversations In A 15-Day Ecological Momentary Assessment Study In Mexico And The Us, Lizeth Cruz-Jiménez, Kevin A. Carson, Jim Thrasher Ph.D., Ma, Ms, Katia Gallegos-Carrillo, Dèsirée Vidaña-Pérez, Diego F. Leal

Faculty Publications

Introduction

Methods

Social Determinants Of Health And Quality Of Life Among Korean Americans With Chronic Hepatitis B, Cindy Xin Fang, Yoonjin Nam, Ann C. Klassen, Hee-Soon Juon

Department of Medical Oncology Faculty Papers

BACKGROUND: Hepatitis B virus (HBV) infection disproportionately affects Korean Americans, who often experience persistent social and structural challenges that may influence quality of life. Recent community studies showed most Korean Americans with chronic hepatitis B (CHB) were disengaged from clinical care, emphasizing the need to better understand factors affecting their well-being. This study examined associations between social determinants of health (SDOH) and physical and mental health related quality of life (HRQoL) among Korean Americans with CHB.

METHODS: A total of 365 CHB patients completed the enrollment survey. SF-12 was used to measure quality of life, calculating physical and mental components …

No Effect In Plasma Corticosterone Levels After Observation Of Diseased Conspecifics, B. M. Hardy, M. Chang, S. Mccallum, S. Santangelo, Patricia C. Lopes

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Organisms commonly respond to stressors in their environment by increasing the secretion of corticosterone (CORT). While increased CORT is acknowledged as a response to predation risk by organisms inhabiting a landscape of fear, new research raises the potential for changes in CORT as a response to the risk of infection by organisms in their environment. An increase in CORT of a healthy, uninfected individual in response to their perception of the risk of infection in their environment could change their susceptibility to infection, highlighting a significant role for CORT to alter host–pathogen dynamics. To investigate the effects of infection risk …

Longitudinal Profiles Of Executive Function In Autistic And Non-Autistic Children At High Likelihood Of Autism, Tanya St John, Neva M Corrigan, Ariel Rokem, Annette M Estes, Heather C Hazlett, Juhi Pandey, Robert T Schultz, Natasha Marrus, Lonnie Zwaigenbaum, Chimei M Lee, Stephen R Dager, Joseph Piven, Ibis Network

2020-Current year OA Pubs

BACKGROUND: Executive functioning (EF) difficulties are common in autistic children and may aggregate in families. Longitudinal studies examining EF development in autistic children and their siblings are limited. In the current study, we characterized EF development from later infancy through school-age in autistic and non-autistic high likelihood (HL; with an older autistic sibling) and low likelihood (LL; without older autistic sibling) children. METHODS: Participants were 83 autistic and 235 non-autistic HL children, and 132 LL children from the Infant Brain Imaging Study. EF was assessed at ages 12 and 24 months using the A-not-B task and ages 5–14 years (school-age) …

Cortical-Limbic Circuit Dynamics Of Approach-Avoidance Conflict In Humans, Brooke R Staveland, Julia Oberschulte, Barbara Berger, Tamas Minarik, Olivia Kim-Mcmanus, Jon T Willie, Peter Brunner, Mohammad Dastjerdi, Jack J Lin, Elizabeth L Johnson, Michelle Paff, Ming Hsu, Robert T Knight

2020-Current year OA Pubs

Choosing to approach or avoid is common in everyday life and excessive avoidance is a cardinal feature of anxiety disorders. We use intracranial EEG to define a prefrontal-limbic circuit supporting approach and avoidance. Presurgical epilepsy patients (n = 20) performed an approach-avoidance conflict decision-making task inspired by the arcade game Pac-Man, where patients trade off rewards against losses from ghost attack. During approach, theta power increases across a limbic circuit including the hippocampus, amygdala, orbitofrontal cortex and anterior cingulate cortex, which drops during avoidance. Theta connectivity between this circuit and lateral prefrontal cortex increases during approach and falls during avoidance. …

Associational Inference With Many Potential Covariates: Bayesian Information Criterion Elastic Net, Farideh Bagherzadeh Khiabani, I-Chan Huang, Jose Miguel Martinez Martinez, Shizue Izumi, Sedigheh Mirzaei, Tiange Zheng, Irina Dinu, Yutaka Yasui

COBRA Preprint Series

Background: An emerging feature in modern biomedical research is collecting and analyzing numerous variables. In the presence of many potential covariates, inference becomes challenging requiring both distinguishing a set of covariates truly associated with an outcome and estimating their corresponding regression coefficients consistently. Traditional statistical inference typically focuses on estimating coefficients assuming a pre-specified set of covariates. Further, advanced machine/statistical learning methods performing both selection and estimation predominantly focus on outcome prediction rather than association inference.

Methods: Motivated by our epidemiological research on long-term childhood cancer survivors, where we aimed to investigate associations between a large pool of longitudinal symptom …

Multi-Dimensional Research Appraisal: A Holistic Approach To Evidence-Informed Practice, John Damiao

Translational Science in Occupation

The field of occupational therapy (OT) and healthcare in general have made great strides in enhancing their scientific rigor through study methodologies that prioritize internal validity. However, concerns regarding reproducibility and replicability in research have cast doubt on traditional evidence-based models. This paper critically examines the limitations of an over-reliance on internal validity in evidence reviews and advocates for a multi-dimensional approach to evidence-based practice. By integrating methodological holism, contextual analysis, and a critical appraisal of external validity, this approach provides practitioners with a more nuanced and applicable framework for decision-making. The implications for research credibility and clinical confidence are …

Development And Validation Of A Life Participation Self-Assessment Tool For People Living With Obesity: The Life Participation Impact Questionnaire (Lpiq-O), Marie-Claude Touchette

Translational Science in Occupation

Purpose: Obesity is a chronic condition affecting over 40% of adults in the U.S. Given the well-documented impact of obesity on life participation, a comprehensive, population-specific assessment tool is needed. We aimed to establish the face and content validity of the Life Participation Impact Questionnaire for People with Obesity (LPIQ-O), an occupation-focused assessment tool measuring the impact of obesity on areas of life participation.

Method: This study included seven iterative phases: (a) literature review, (b) interviews, (c) synthesis of the literature review and interviews, (d) item development, (e) expert validation, (f) face validation, and (g) final expert review. Six participants …

Integration Of The Science Of Team Science (Scits) With Applied Healthcare Frameworks: Interprofessional Education Through A University-Based Head Injury Clinic, Part Ii: Mixed Methods, Emily Balog, Susan Paparella, Natalia Noce, Stephanie Hubbell, Kelly Pena

Translational Science in Occupation

Introduction: Effective healthcare delivery requires clinicians to function within high-performing, collaborative teams. To support this, interprofessional education (IPE) must provide opportunities that move beyond siloed training. This paper details the clinical application of a team science-informed educational intervention designed to prepare students for interprofessional practice (IPP) through a university-based head injury head injury clinic. Methods: The research team conducted a mixed methods case study with a convergent design to evaluate student outcomes. Eighteen graduate students from occupational therapy, physical therapy, and speech-language pathology participated in a 10-week clinic. Faculty delivered training in IPEC competencies, TeamSTEPPS® tools, and clinical processes before …

Pedaling Through Discomfort: A Feasibility Study Of Faculty-Led Spin Classes And Their Impact On Student Engagement, Resilience, And Faculty-Student Relationships, Gabriela Baza, Elizabeth Hathaway

Pursuit - The Journal of Undergraduate Research at The University of Tennessee

This study explored the feasibility and impact of faculty-led Spin classes on college students’ engagement, well-being, and connection with faculty. Offered twice weekly at 7 AM during Fall 2024, the classes aimed to promote physical activity, resilience, and faculty-student relationships. Twenty-six students attended at least one class, with a median attendance of 4.5 sessions. Post-semester surveys (88% response rate) assessed perceived exertion, interest, enjoyment, challenge, improvement, and instructor encouragement. Students reported high levels of engagement and positive challenge (RPE = 15.3; challenge = 6.4/7). Those attending 7 or more sessions reported significantly greater perceived improvement than those attending fewer sessions …

Communication Challenges Experienced By Telephone Triage Registered Nurses Providing Assessment Of Health Symptoms, Stacy Huddleston

Walden Dissertations and Doctoral Studies

Telephone triage nurses routinely assess symptoms and make clinical decisions without visual contact, which introduces complex communication challenges. Language differences, emotional distress, cultural misunderstandings, and the absence of visual cues may influence how symptoms are described, interpreted, and acted upon during telephone encounters. The purpose of this qualitative interpretive description study, guided by Peplau’s theory of interpersonal relations, was to explore how RNs experience and manage communication barriers in telephone triage practice. Six RNs with recent experience in telephone triage participated in semistructured interviews, and the data were analyzed using interpretive description and thematic analysis. Findings indicated that participants relied …

Adolescent And Parent Dyad Perceptions On The Utility And Implementation Ability To Use Cellphone-Based Technology To Reduce Distracted Driving In Philadelphia, Pennsylvania, Usa, Kevin Rix, Rachel Solomon, Mallory Lacy, M Kit Delgado, Jeffrey P Ebert, Douglas J Wiebe, Catherine Claire Mcdonald

Faculty, Staff and Student Publications

Introduction: Losing focus while driving, including cellphone-based distractions (phone calls, text messages, other apps), is a prominent problem for adolescent drivers. Internal cellphone-based technologies designed to reduce distractions are prominent, but little is known about how parents and their children feel about their ability to successfully reduce distracted driving. This study interviews parents and adolescents to understand the utility and what is needed for implementation of these technologies.

Methods: Twenty (20) adolescent-parent dyads participated in semistructured qualitative interviews. Participants reflected adolescent drivers and their parents who previously had been documented as ranging from 'very low' risk drivers to 'very high' …

94th Annual Georgia Public Health Association Meeting And Conference Report, Angela H. Peden, Beverley Townsend, Patrina L. Bowles, Sarah L. Mosley

Journal of the Georgia Public Health Association

The 94th Annual Meeting and Conference of the Georgia Public Health Association (GPHA) was held in Jekyll Island, Georgia, at the Jekyll Island Convention Center, on May 1-3, 2024. The goal of the 2024 Georgia Public Health Association Annual Meeting and Conference was to assemble public health professionals, students, County Board of Health members, and stakeholders for networking and educational opportunities to support the mission and vision of GPHA.

The theme for the 2024 Georgia Public Health Association Annual Meeting and Conference was selected by the GPHA Executive Board during a meeting in the early fall of 2023: “Lighting the …

Rates And Predictors Of Intention To Get Preventive Screenings Among Individuals In Recovery From Substance Use Disorders, Afsha Hossain, Ban A. Majeed, Lia Pierson Bruner

Journal of the Georgia Public Health Association

Background: Individuals with substance use disorders (SUDs) are at greater risk for chronic disease but often face barriers to access and uptake of preventive screenings, so the aim of this study was to identify rates and predictors for intention to get preventive screenings among residents at two recovery centers.

Methods: We used a cross-sectional survey (N=95, response rate 51%) to determine previous screening rates and the intention to get recommended preventive screenings among residents of two long-term recovery programs in Athens, GA, using bivariate analysis with chi-square to look for associations with intention.

Results: Prior use of preventive health services …