Digital Commons Network^™

Building Trust In The Absence Of Certainty: Community As Trust In Action, Jennifer A. Owens

Patient Experience Journal

This personal narrative explores how trust is experienced and sustained in the context of serious illness, where uncertainty is persistent and control is limited. Drawing on the lived experience of caregiving for a child with an undiagnosed congenital diaphragmatic hernia (CDH), this personal narrative examines how trust emerges not as a matter of belief or individual choice, but as something recognized through the actions of others.

Rebuilding Trust After Bondi Beach: Healing Patients, Protecting Caregivers, And The Sacred Work Of Care, Anne Marie Hadley

Patient Experience Journal

The Bondi Beach tragedy of December 14, 2025 profoundly disrupted Australia's collective sense of safety, belonging, and trust. Beyond the immediate loss of life and injury, such events exert lasting impacts on healthcare systems and the people who work within them. This article explores how trust can be rebuilt not only for patients and communities, but also for caregivers themselves. Drawing on trauma-informed care, psychological safety, and human experience design, it examines the often-overlooked dimensions of staff safety, the essential role of pastoral care and chaplaincy, and the particular vulnerabilities experienced by faith-based caregivers during periods of social fracture and …

Supporting The Human Experience: Why Compassion Outperforms Empathy In Care Delivery, Katelyn Carey

Patient Experience Journal

Healthcare professionals are often taught that empathy, defined as imagining oneself in the emotional experience of another, is essential to providing excellent care. Yet in high-stress, high-stakes clinical environments, the very tool given to increase patient and employee connection can contribute to disengagement, burnout, and diminished resiliency. This research review article examines the longstanding conflation of empathy and compassion in healthcare and argues that the distinction between the two is not merely semantic but critical to provider well-being and patient outcomes. Drawing on research from neuroscience, psychology, and communication studies, the piece outlines how emotional, perspective-taking empathy activates the brain's …

Racial Concordance And The Assumption Of Trust: Why Engagement Is Often Mistaken For Partnership In The Care Of Black Men, Samantha Faith Calhoun, Lacretia Carroll, Y'Esha Williams-Click, Kola Brown

Patient Experience Journal

Race concordance between patients and clinicians is frequently promoted as a strategy to improve trust and engagement for Black men in healthcare. Evidence suggests that encounters with Black male clinicians often increase patient comfort and observable engagement; however, engagement alone does not necessarily reflect trust. Drawing on professional experience as a nurse and researcher working with Black men, and on prior research examining shared decision-making preferences among Black men with hypertension in the U.S. Mid-South, this Personal Narrative examines how race-concordant encounters may rely on presumed trust, leading clinicians to advance diagnosis and treatment planning without adequate co-construction of care. …

Building Or Breaking Trust In Healthcare Through Patient And Family Engagement In Research And Service Design: The Need For Authentic Engagement Practices, Lisa D. Hawke, Hajar Seiyad, Shoshana Hauer, Charlotte Munro, Natasha Y. Sheikhan

Patient Experience Journal

Trust in the healthcare system is an important driver of public health, but is sometimes lacking among individuals and communities. Patient and family engagement in research and service development is one proposed means of influencing trust. Patients and families can be engaged authentically and meaningfully as partners in the conduct of research and the development of healthcare services. When engagement is conducted following best practices, patients and families have the opportunity to build strong mutual relationships with project leads, hold a share of the power in the discipline, and exercise choice to influence the research and service development agenda. These …

Co-Designing Trust: Patient Experience, Relationships, And The Design Of Care, Toni Land

Patient Experience Journal

Trust can have a positive or negative impact on patients, families, and community healthcare experience. Although important, it is often treated as something soft and intangible rather than something intentionally measured and designed. Currently, healthcare organizations collect and report patient experience data related to communication, courtesy, respect, and responsiveness. But these measures do not capture the specific behaviors that influence whether trust builds or whether it stalls. This commentary explores trust as a foundational behavioral and environmental element in healthcare and challenges that improving trust requires more than good intentions; it requires bringing voices to the table through co-design. Starting …

A Modern Playbook For Trust Across The Health Ecosystem, Erin O'Malley

Patient Experience Journal

Public trust in health care delivery, public health, and biomedical innovation is at a historic low. While many place the blame on the COVID-19 pandemic and the proliferation of social media, the reality is that distrust is a deeply rooted structural challenge that has plagued the U.S. for centuries. It is tied to historical movements for medical freedom and centuries of systemic discrimination and earned mistrust among minoritized communities. Today, this crisis is compounded by a lack of shared values and facts and the rising dominance of tribal identity over objective science. The Coalition for Trust in Health & Science …

Healing The Social Covenant: Rebuilding Trust And Re-Humanizing Healthcare, Cynda Hylton Rushton

Patient Experience Journal

Violence against healthcare workers continues to escalate despite substantial investments in security measures, workplace violence prevention programs, and legislative protections. Although these interventions are necessary, they have not produced sustained improvements in workforce safety or retention, suggesting that workplace violence is more than a behavioral or security problem. This commentary argues that it also reflects a deeper erosion of trust within healthcare. Drawing on evidence linking workplace violence to burnout, moral injury, psychological distress, and turnover intention among nurses, we propose that repairing trust is essential to sustaining the workforce and healthcare.Building on our earlier work, Rebuilding a Foundation of …

Trust: Why A Commitment To Human Experience Matters, Jason A. Wolf

Patient Experience Journal

Trust is one of the most essential elements in our overall human existence. It is a critical part of our human experience, one that reaches well beyond the boundaries of healthcare. Trust is the element that holds society together. It emerges in the relationship of one human being connecting with another human being, and it reaches to the engagements people have with organizations, institutions, and systems as well. Trust, while hard to hold, is ever present. It is a powerful force that guides our way of being, our interactions, our choices, even if we ourselves are not directly conscious of …

Descriptive Anatomy Of The Female Reproductive Organs In Thamin Eld’S Deer (Rucervus Eldii Thamin) And Fea’S Muntjac (Muntiacus Feae) With Utilizing Of The Glycerin Impregnation Technique For Specimen Preservation, Paisan Tienthai, Pawana Chuesiri, Itti Boonorrana, Piyaporn Kongmakee, Ampika Thongphakdee

The Thai Journal of Veterinary Medicine

The reproductive anatomy of rare cervid species remains insufficiently documented, limiting comparative studies and preservation efforts. This study describes the anatomical details in the female reproductive organs of Thamin Eld’s deer (Rucervus eldii thamin) and Fea’s muntjac (Muntiacus feae), while the application of a modified glycerin impregnation technique was achieved for specimen preservation. Dissections of female reproductive tracts revealed morphological variations that correlate with the known female reproductive characteristics of domestic and closely related species. In both species, the ovaries were characterized as small, ovoid structures, exhibiting prominent follicles or corpora lutea consistent with the stage …

Enhancing Nutrition Communication Skills Through Community-Based Learning To Create Cooperative Extension Resources, Elizabeth Lucas Combs, Anna Cason, Courtney Luecking, Heather Norman-Burgdolf

Journal of Dietetic Education

Strong communication and transferable skills are essential for future dietitians. This Best Evidence Teaching Strategy describes a community-based approach within an upper-level community nutrition course that partnered with the Cooperative Extension Service. Over six weeks, scaffolded assignments emphasized written, oral, and digital media skills, aligning with current trends in scientific communication. Students created information releases, podcasts, and short videos to translate evidence-based nutrition content into accessible formats for public audiences. Collaboration with Extension provided authentic context and motivation, as high-quality projects could be disseminated statewide.

Measuring The Empathy Of Nutrition And Dietetics Students With The Jefferson Scale Of Empathy – Health Professions Student Version: A Pilot Study, Sara Tamsukhin, Youn Seon Lim

Journal of Dietetic Education

The purpose of this study was to learn about undergraduate nutrition and dietetics students’ empathy scores. The study was a descriptive quantitative design with a web-based, cross-sectional survey. Participants were undergraduate nutrition and dietetics students from two universities who completed a survey with demographic questions, clinical experience questions, and the Jefferson Scale of Empathy – Health Professions Student version (JSE-HPS©). Seventy-one nutrition and dietetics students completed the survey. Most respondents were female, white, and non-Hispanic. The mean total empathy score was 114.69 (SD=11.09) with a range of 81 to 137. Welch’s t-test did not show significant differences by gender, ethnicity, …

Disability-Related Educational Content In Nutrition And Dietetic Programs: An Exploratory Study, Wendy Medunick, Allison Gomes, Joachim Sackey, Laura Byham-Gray, Jane Ziegler

Journal of Dietetic Education

Background: Health disparities experienced by people with disabilities (PWD) are partly attributed to inadequate knowledge, training, confidence and competence regarding disabilities among health professionals. While registered dietitian nutritionists (RDNs) are key members of the healthcare team, it is unclear how pre-professional nutrition and dietetics (ND) programs prepare future RDNs to care for PWD. This study examined the status of disability-related education within ND programs in the United States. Methods: A descriptive cross-sectional electronic survey was distributed to 570 directors of accredited ND programs. The survey, which adapted questions from a previously validated instrument and published studies, included questions assessing disability-related …

Assessing And Addressing Cultural Competence And Cultural Humility In Dietetic Education, Zoe Duran, Nicholas Slagel, Lisa Caldwell, Katie Kage

Journal of Dietetic Education

Limited theory-informed, dietetic-specific resources are available to guide the development, evaluation, and refinement of culturally competent (CC) curricula. This pilot study used a mixed-methods, theory-informed approach to evaluate CC integration within an undergraduate dietetics curriculum and examine the applicability of existing CC self-assessment tools for dietetic students. A senior-level undergraduate community nutrition curriculum was evaluated using the Tool for Assessing Cultural Competence Training (TACCT), guided by the Campinha-Bacote Model of Cultural Competence in Healthcare Delivery. James Banks’ Model of Multicultural Curriculum Reform was then applied to refine curricular content and learning activities. In addition, 74 students enrolled in a didactic …

Virtual Reality: The Future Of Didactic And Experiential Education For Nutrition And Dietetics, Michael Holik, Dexter Richardson

Journal of Dietetic Education

The integration of virtual reality (VR) into nutrition and dietetics education provides an innovative answer to challenges in accessing experiential learning. This study examined student perceptions of immersive VR experiences designed to simulate hospital foodservice operations and nutrition counseling sessions, guided by the Diffusion of Innovation Theory (DOI). A quasi-experimental design involved 55 participants who engaged with 360° VR modules featuring interactive elements, avatars representing key healthcare roles, and embedded critical-thinking questions. Results demonstrated strong support for VR’s educational value across DOI’s five key attributes: relative advantage, compatibility, complexity, trialability, and observability. Participants reported enhanced understanding of registered dietitian roles, …

Cover, Table Of Contents, About The Journal

Journal of Dietetic Education

No abstract provided.

Assessing And Addressing Financial Risk In Capitated Primary Care Contracts, Michael R. Wieck Dba, Laurence Smith, Steven R. Stout Dba

Engaged Management ReView

We employ multivariate statistical modeling and Monte Carlo simulation to study systematic and unsystematic financial risk faced by physician groups under capitated contracts with Medicare Advantage Organizations (MAOs). We use mixed methods and a standard reimbursement formula for risk-sharing contracts with primary care physicians (PCPs). We find that diversifying risk simply by increasing the size of a practice is insufficient to mitigate risks of large negative cash flows from capitation contracts and can result in financial failure. However, if use of costly medical services by patients is reduced from levels typically experienced under traditional Medicare to the levels of patients …

Differences In Response Rates To A Previsit Electronic Portal Questionnaire In Outpatient Clinics: A Retrospective Observational Study Of The Standard Dermatology Outcome Measures, Rene F. Chen, Udeyvir S. Cheema, Beiyu Liu, Cynthia L. Green, Matilda W. Nicholas, Suephy C. Chen

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Fraction-Seq: An Integrated Experimental And Computational Workflow For Determining The Localization And Abundance Of Small Non-Coding Rnas In Subcellular Compartments, Siddhartha Shah, Tess Cherlin, Yi Jing, Stepan Nersisyan, Benjamin E. Leiby, Isidore Rigoutsos

Computational Medicine Center Faculty Papers

Small non-coding RNAs (sncRNAs) have garnered considerable attention in recent years, following accumulating evidence of their critical roles in many cellular processes. Among sncRNAs, microRNAs (miRNAs) and their isoforms (isomiRs), tRNA-derived fragments (tRFs), rRNA-derived fragments (rRFs), and Y RNA-derived fragments (yRFs) account for more than 95% of all sncRNAs found in cells. Despite their critical regulatory roles, most sncRNAs remain uncharacterized because their functionalization is a lengthy and challenging undertaking. Knowing an sncRNA's abundance helps prioritize among the various choices, while knowing where it localizes in the cell greatly limits the number and identity of its potential targets and helps …

Integrating Matrescence Into Birth Worker Practice: A Practice Improvement Project, Kelsey B. Green

Doctor of Nursing Practice (DNP) Projects

Background: Perinatal mood and anxiety disorders (PMADs) affect 20–25% of mothers worldwide and are a leading cause of maternal complications. Stigma, fragmented care, and limited provider training leave families vulnerable, while birth workers offer trusted, continuous support.

Problem: Birth workers' maternal mental health (MMH) training is minimal and often excludes matrescence, the developmental transition to motherhood, limiting their ability to distinguish normal adjustment from clinical PMADs and delaying intervention.

Methods: A single-group, pre-/post-test design evaluated a matrescence-informed workshop at Roots Community Health's 2nd Annual Symposium. Anonymous surveys measured knowledge, attitudes, and confidence, analyzed with Mann–Whitney U, Wilcoxon signed-rank tests, and …

Endoscopic Versus Catheter-Based Minimally Invasive Evacuation Of Spontaneous Supratentorial Intracerebral Hemorrhage: A Systematic Review And Meta-Analysis, Shaan Patel, Shiva A Nischal, Kush M Kale, Angelette Mendonca, Keenan Piper, Pious D. Patel, Michael R. Gooch, Stavropoula Tjoumakaris, Pascal M. Jabbour

Department of Neurosurgery Faculty Papers

Minimally invasive surgery (MIS) for spontaneous supratentorial intracerebral hemorrhage (sICH) includes endoscopic evacuation and catheter-based evacuation (aspiration or drainage ± thrombolysis), but comparative performance remains uncertain. We performed a systematic review and meta-analysis comparing MIS approaches. PubMed, Embase, and CENTRAL were searched (December 2025) for studies in adults undergoing endoscopic or catheter-based MIS for supratentorial sICH. Random-effects meta-analysis was conducted. Prespecified subgroup analyses stratified catheter-based techniques by thrombolysis use. Risk of bias and certainty of evidence was assessed. Twenty-nine studies (8221 patients; 5041 endoscopic; 3180 catheter-based) were included. Endoscopic evacuation was associated with lower mortality (RR 0.64; 95% CI: 0.47–0.87; …

Childhood Cancer Predisposition Study: A Prospective Registry And Biorepository Protocol, Melissa R Perrino, Suzanne P Macfarland, Luke Maese, Jennie Vagher, Junne Kamihara, Surya Rednam, Philip J Lupo, Garrett M Brodeur, Joshua Schiffman, Lisa Diller, Lauren Desrosiers-Battu, Sharon E Plon, Kim E Nichols, Samuel L Volchenboum, David Malkin, Anita Villani, Christopher C Porter

Faculty, Staff and Students Publications

Introduction: Cancer is the most common cause of disease-related mortality in children, highlighting the urgent need for improved care in this population. It is estimated that >15% of children diagnosed with cancer harbour a germline pathogenic variant in a cancer predisposition gene which confers an increased risk to develop cancer. There are over 100 genes associated with cancer predisposition syndromes (CPSs) and greater availability and acceptability of genetic testing in the last decade has facilitated their recognition in childhood. However, individually, each of these CPSs is rare, impeding robust research and advancement of clinical care. Once a specific CPS is …

Staphylococcus Aureus Urease Is Controlled By A Complex Regulatory Network To Promote Dissemination During Cauti, Jana Gomez, Jesus Duran-Ramirez, Maristhela Alvarez, Shane Cristy, Jennifer N Walker

Faculty, Staff and Student Publications

Catheter-associated urinary tract infections (CAUTIs) are one of the most common hospital-associated infections in the United States, accounting for >1 million cases annually. One CAUTI pathogen, Staphylococcus aureus, is commonly found persisting asymptomatically in the bladder of catheterized individuals, increasing these individuals' risk of developing infection. Importantly, S. aureus is not only associated with severe symptoms during CAUTI, including bacteremia and septic shock, but it also produces a common uropathogen-associated virulence factor, urease. Despite its importance, urease has only been well-studied in another uropathogen, Proteus mirabilis. While previous studies identified three S. aureus urease regulators, including CodY, …

An Online Epilepsy Self-Management Tool For Patients With Epilepsy: A Formative Usability Study, Katarzyna Czerniak, Ross Shegog, Refugio Sepulveda, Robert Addy, Youngran Kim, Sahiti Myneni, Alejandra Garcia-Quintana, Kimberly Martin, David M Labiner

Faculty, Staff and Student Publications

Background: Epilepsy is a serious chronic neurological condition with no permanent cure. Continual self-management is important to mitigate seizure frequency and optimize quality of life in people with epilepsy who have greater disparities in accessing epilepsy care. The Management Information & Decision Support Epilepsy Tool (MINDSET [UTHealth, University of Arizona, and Radiant Digital]) was developed to enhance accessibility to epilepsy self-management (ESM) assessment and treatment. The purpose of this formative usability pilot study was to assess the user experience and functionality of MINDSET 2.0, an enhanced cross-platform online version of MINDSET, among a sample of patients with epilepsy prior to …

Protocadherin 9 Promotes Cell Survival Of Different Bipolar Cell Types In The Developing Mouse Retina, Marlon F Mattos, Daniela Becerril, Jingyao Guo, Collin Todora, Cesiah C Gomez, Elizabeth Zuniga-Sanchez

Faculty, Staff and Students Publications

Neural circuit assembly relies on different neuronal types coming together to form a functional circuit. The question of how the appropriate number of each type is integrated into an emerging circuit remains relatively unknown. To answer this question, we used the mouse retina to uncover the molecular mechanisms responsible for neuron-type integration in a developing circuit. In the mammalian retina, bipolar cells (BCs) are a class of interneurons that relay visual information from photoreceptors to ganglion cells. Extensive studies have shown there are 15 distinct BC types: 6 types of OFF cone bipolars, 8 types of ON cone bipolars, and …

Larotrectinib In Trk Fusion Differentiated Thyroid Carcinoma: Updated Trial Data, Steven Waguespack, Marcia Brose, Jessica J Lin, Ray Mcdermott, Mohammed Almubarak, Jessica Bauman, Michela Casanova, Shivaani Kummar, Se-Hoon Lee, Damian Rieke, Do-Youn Oh, Changsong Qi, Natascha Neu, Domnita-Ileana Burcoveanu, Chiara Mussi, Alexander Drilon, David Hong, Maria Cabanillas

Department of Medical Oncology Faculty Papers

Larotrectinib is a first-in-class, highly selective, central nervous system-active tropomyosin receptor kinase (TRK) inhibitor approved for tumour-agnostic use in TRK fusion cancer. It has previously demonstrated rapid and durable disease control and favourable safety in patients with advanced TRK fusion thyroid carcinoma (TC). After an additional 4 years of follow-up with the inclusion of two additional patients, and utilising an independent review committee (IRC) to assess overall response rate (ORR), we report updated pooled analyses from three phase 1-2 larotrectinib clinical trials, focusing only on patients with TRK fusion differentiated TC (DTC). The primary endpoint was the IRC-determined ORR per …

The 2025 Measles Outbreak In Texas, Tamer Oraby, Martial L. Ndeffo-Mbah

School of Mathematical & Statistical Sciences Faculty Publications

Background: In 2025, Texas experienced its largest measles outbreak in decades, reporting 762 cases by mid-August. Measles is a highly contagious but vaccine-preventable infection transmitted mainly among unvaccinated individuals and capable of causing severe outcomes.

Methods: We investigate counterfactual measles control scenarios based on daycare and school closures and reactive vaccination of infants and children, including mixed interventions. We analyze the 2025 Texas outbreak using an age-structured multi-stage SEIR model formulated as a system of ordinary differential equations. The model is fit to case data using Bayesian inference to estimate the effective reproduction number and generate posterior predictive trajectories under …

Prescription Opioid Misuse Among High School Athletes During The Opioid Prescribing Limit Law Era: Yrbss 2017-2023, Francine R Vega, Andrea J Yatsco, Audrey Sarah Cohen, James R Langabeer, Tiffany Champagne-Langabeer, Rakshitha Vijendra, Christine Bakos-Block

Faculty, Staff and Student Publications

Background/Objectives: School-age athletes occupy a paradoxical position in the adolescent opioid crisis, combining health-oriented activity with elevated risk of sports-related injury and prescription opioid exposure. In response to the opioid epidemic, states enacted opioid prescribing limit laws (OPLLs) beginning in 2016-2017, yet whether these supply-side policies reached high-risk youth subgroups remains unclear. This study evaluated national temporal trends in prescription opioid misuse among U.S. high school students during the period of OPLL implementation and examined differences across athletic participation, concussion history, sex, grade, race/ethnicity, and substance-use profiles.

Methods: Using four biennial waves of the Youth Risk Behavior Surveillance System with …

Same-Day Cancellation Reduction In An Ambulatory Surgery Unit, Anthone Dalit Vengersammy

Master's Projects and Capstones

Problem: Same-day surgical cancellations in the outpatient surgery setting remain a significant operational and patient care challenge. Preventable cancellations negatively affect patient experience, operating room efficiency, staff productivity, and healthcare costs. 

Context: A microsystem and organizational culture assessment identified several factors contributing to same-day cancellations, including unclear preoperative instructions, incomplete medical clearance, inconsistent patient education, lack of standardized workflows, unclear staff responsibilities, and communication gaps among interdisciplinary teams. SWOT and gap analyses were used to identify opportunities for improvement and guide intervention planning.

Interventions: Quality improvement interventions were implemented through iterative Plan-Do-Study-Act (PDSA) cycles. Strategies included revising preoperative patient instructions, …

Addressing Obesity In Rural Health Clinics, Morgan P. Trusley

Student Scholarly Projects

Practice Problem: According to the Centers for Disease Control and Prevention (CDC), more than 2 in 5 adults in the United States are obese (CDC, 2024a). In a rural primary care clinic in South Carolina, approximately 70% of patients are obese and there is no current intervention in place to help educate and guide these patients in weight loss strategies.

PICOT: In obese adults over the age of 18 at a rural health clinic with a Body Mass Index (BMI) greater than or equal to 30, does implementing weekly virtual and in person multicomponent behavioral intervention educational sessions compared to …