Digital Commons Network^™

Navigating Child Oral Health In Western Australia: A Caregiver's Perspective, Lesley Andrew, Elizabeth Wenden, Mohamed Estai, Ruth Wallace

Research outputs 2022 to 2026

Background: Early childhood caries (ECC) is the most common chronic health condition among Australian preschool-aged children. Untreated, ECC can affect children's physical and emotional health and future social opportunities. ECC is largely preventable through primary caregivers' correct understanding of oral health promoting diets, oral hygiene practices and dental service engagement. The study aim is to explore Western Australian (WA) primary caregivers' child oral health knowledge, experience and practices. The Fisher-Owens socioecological model of child oral health was applied across the study to structure and interpret the findings across the complex, interactive sociocultural influences on child oral health. Methods: The mixed-methods …

Sociodemographic Influences On Substance Use In Psychosis In An African Cohort, Megan L. Campbell, Raymond Odokonyero, Dickens Akena, Melkam Alemayehu, Lukoye Atwoli, Lori B. Chibnik, Bizu Gelaye, Stella Gichuru, Symon M. Kariuki, Karestan C. Koenen

Internal Medicine, East Africa

Background: Substance use is common among individuals with psychotic disorders, but limited research exists on the variations in substance use across countries in Africa. This study aims to investigate the frequency of alcohol, tobacco, cannabis, and khat consumption in individuals with bipolar disorder (BD) and schizophrenia (SCZ) across four African countries: South Africa, Ethiopia, Kenya, and Uganda.

Methods: We utilized data from the Neuropsychiatric Genetics of African Populations-Psychosis project, a large case-control study which will soon have genetic data on over 42,000 participants, half with psychosis. Information on substance use was collected using the Alcohol, Smoking and Substance Involvement Screening …

The Landscape Of Malignant Transition: Unraveling Cancer Cell-Of-Origin And Heterogeneous Tissue Microenvironment, Ruihan Luo, Jiajia Liu, Tiangang Wang, Weiling Zhao, Yanfei Wang, Jianguo Wen, Hongyu Wang, Shanli Ding, Xiaobo Zhou

Faculty, Staff and Student Publications

Understanding disease progression and sophisticated tumor ecosystems is imperative for investigating tumorigenesis mechanisms and developing novel prevention strategies. Here, we dissected heterogeneous microenvironments during malignant transitions by leveraging data from 1396 samples spanning 13 major tissues. Within transitional stem-like subpopulations highly enriched in precancers and cancers, we identified 30 recurring cellular states strongly linked to malignancy, including hypoxia and epithelial senescence, revealing a high degree of plasticity in epithelial stem cells. By characterizing dynamics in stem-cell crosstalk with the microenvironment along the pseudotime axis, we found differential roles of ANXA1 at different stages of tumor development. In precancerous stages, reduced …

Evaluating The Predictive Value Of Basc-3 Anxiety Scale And Working Memory Index Scores For Clinically Significant Test Anxiety: A Comprehensive Analysis Of Non-Classifiable Cases, Des'tiana S. Williams

Electronic Theses and Dissertations

This dissertation will explore how test anxiety (TA) affects working memory (WM) and whether certain factors can help predict higher levels of test anxiety. Anxiety has been defined as a common experience that can show up in various forms—like general worry, social fears, panic attacks, and specific phobias (APA, 2022). It was described as often triggering our natural “fight-or-flight” response, which can impact our ability to focus, think clearly, and remember things. For students, test anxiety has been especially challenging, affecting how they perform in high-stakes academic settings. Using data from a university based psychological assessment center, this study will …

Evaluating The Predictive Value Of Basc-3 Anxiety Scale And Working Memory Index Scores For Clinically Significant Test Anxiety: A Comprehensive Analysis Of Non-Classifiable Cases, Des'tiana S. Williams

Electronic Theses and Dissertations

This dissertation will explore how test anxiety (TA) affects working memory (WM) and whether certain factors can help predict higher levels of test anxiety. Anxiety has been defined as a common experience that can show up in various forms—like general worry, social fears, panic attacks, and specific phobias (APA, 2022). It was described as often triggering our natural “fight-or-flight” response, which can impact our ability to focus, think clearly, and remember things. For students, test anxiety has been especially challenging, affecting how they perform in high-stakes academic settings. Using data from a university based psychological assessment center, this study will …

Childhood Obesity Body Mass Index And Gut Microbiome: A Cluster Randomized Controlled Pilot Feasibility Study, Marilyn Frenn, Nita Salzman, Vy Lam, Mary Holtz, Andrea Moosreiner, Mauricio Garnier-Villarreal, Maharaj Singh

College of Nursing Faculty Research and Publications

Background:

Prebiotic fiber has been examined as a way to foster gut bacteria less associated with obesity. Tests of prebiotic fiber in reducing obesity have occurred mainly in animals, adults, and Caucasians when the highest obesity rates are in African American and Latinx youth. Response to prebiotic fiber is determined by the pre-existing intestinal microbiota. The type of microbiota varies based on diet and physical activity (PA), so it is important to examine acceptability and response to prebiotic fiber in those most at risk for obesity.

Methods:

This cluster randomized controlled feasibility trial included an online program designed to improve …

A Survey Study Of Roadblocks In Translational Science, Fasiha Kanwal, Christopher I Amos, Katherine H Sippel, Claudia Neuhauser, Ariel Harrison, Mary E Dickinson, Charles Minard, Bettina M Beech

Faculty, Staff and Students Publications

Clinical and translational science needs to address roadblocks to the translational processes. We conducted a survey at two institutions, a private medical school and a large public university, to understand the frequency and distribution of barriers and roadblocks to research. We reviewed the literature to compile a pool of barriers and roadblocks and convened a panel of relevant stakeholders to develop a 20-item questionnaire. Survey respondents were asked to select and prioritize the five leading clinical and translational roadblocks, provide information regarding their academic degrees and rank/position, complete open-ended items regarding their areas of research, and optionally add additional remarks …

Interprofessional Education Confidence In Health Professions Education Assessment: Are Learners Ready For Interprofessional Collaborative Practice?, Nicole E. Brown, Anthony J. Goreczny, Natalie Schirato, Jodi Schreiber, Sarah Jameson, Timothy Braun, Mary Dee Fisher

Internet Journal of Allied Health Sciences and Practice

Purpose: Interprofessional education (IPE) is critical to developing skills necessary for interprofessional collaborative practice (IPCP). Although much IPE research focuses on competence as an outcome, little research examines learner confidence in competence, which is likely to translate didactic knowledge into application of clinical skills. The current study aimed to assess student levels of confidence in skill competence related to the Interprofessional Education Collaborative (IPEC) core competencies. Methods: Students from multiple health professions programs (nursing, occupational therapy, physical therapy, physician assistant, graduate psychology), graduate biology, and undergraduate programs participated in the study (N=188). The Interprofessional Education Evaluation of Confidence (IPEEC) …

Transforming Care: An Academic And Community Symposium On Transgender Care And Experience, Alison Sutton-Ryan, Kimberly Van Vulpen

Transforming Communities

Background: Transgender experience is often excluded from education and training. An emphasis has been often placed on sexual identities instead of gender differences rendering transgender care invisible in the healthcare system (Gahagan & Colpitts 2017). Lack of education and training has created significant barriers to accessible gender-affirming care, contributing to disproportionately high levels of discrimination for transgender individuals seeking medical services (Redcay et al., 2021). Purpose: The Interprofessional Education Symposium on Transgender Care and Experience was an innovative initiative developed by the newly formed Transgender Interprofessional Care Team (TICT) at a medium-sized suburban university. This collaborative team, comprising key …

Inadequate Healthcare For Women In The United States, Grace Loveless

Journal of Nonprofit Innovation

Barriers to adequate healthcare for women stem from a lack of research on their specific health needs, gender-based biases in healthcare, and harmful societal norms. One key aspect highlighting these disparities is the menstrual cycle—a topic unique to women. Menstrual health, defined as a state of complete physical, mental, and social well-being, illustrates the urgent need for greater focus on reproductive health. Despite its significance, the dialogue and knowledge about reproductive health remain limited; an issue which is exacerbated by societal attitudes of secrecy and shame. These attitudes create barriers that hinder many women in the United States from accessing …

A Call For Change: Supporting Children With Tourette Syndrome, Matt Reall

Journal of Nonprofit Innovation

Tourette Syndrome affects 1 in 100 U.S. children but remains widely misunderstood due to stigma, delayed diagnosis, and media misrepresentation. This neurological disorder is characterized by involuntary tics and often co-occurs with ADHD, anxiety, and sleep disorders. Children with Tourette Syndrome face disproportionate challenges in social, academic, and emotional settings—despite having average or above-average intelligence. One-third engage in self-harm, and suicide rates are four times the national average. Peer-education programs like the Tourette Association of America’s Youth Ambassador initiative have shown promise in reducing stigma, but unequal access and weak institutional support limit their impact. This paper calls for early …

Do Minorities Attend Culturally Competent Hospitals? The Case Of Minority-Serving And Safety-Net Hospitals, Rumel Mahmood

Journal of Social, Behavioral, and Health Sciences

Minorities disproportionately attend minority-serving hospitals (MSHs) and safety-net hospitals (SNHs). This study examines whether MSHs or SNHs are more culturally competent than their counterparts. No research to date has examined the cultural competency of MSHs and SNHs with hospitals outside of these categories. The literature on the determinants of hospital-level cultural competence is sparse, with limited measures used nationally and a robust measure used in a single U.S. state. I calculated a 100-point score of hospital cultural competence from a nationally representative survey of hospitals (N = 849 respondents). Using multilevel regression models, I found that MSHs are culturally …

Living Heritage, Resilience And Ethically Informed Infrastructures In Malawi, Martha B. Lerski, Frank Puluputu Mwale

Publications and Research

Rooted in a rural community’s needs, this paper explores how historically, and ethically informed infrastructures can support community engagement towards identification, documentation, and dissemination of local, traditional, and indigenous knowledge relating to climate change. The paper examines climate adaptation and sustainability issues through the lenses of community organizing and Library & Information Science best practices. It draws on a growing body of literature identifying a role for expanded epistemological and subject discipline perspectives. While the impacts of climate on material culture are increasingly recognized, intangible, and biocultural heritage have not received as much attention. Living heritage traditions and knowledge systems …

Exploring The Link Between Physicians’ Familiarity And Biosimilar Prescribing In Thailand, Ekapong Kachai, Chaoncin Sooksriwong, Wanruchada Katchamart, Tuangrat Phodha

The Thai Journal of Pharmaceutical Sciences

Background: Despite the availability of various biosimilars in Thailand, the link between physicians’ familiarity and biosimilars prescribing practice remains still unclear.

Objectives: This study aimed to find the association between physicians’ familiarity and biosimilars prescribing practice among physicians in Thailand.

Methods: This research adopted an extended analysis framework, utilizing survey data from a pilot study on the surveillance of Thai physicians regarding biosimilar uptake. The familiarity with biosimilars among respondents was evaluated.

Results: The result showed that 82 respondents were included in the study. There was 79.3% of respondents indicated prescribing biosimilars. Overall, most respondents (75.6%) showed an “adequate” level …

U.S. Young Adults’ Family-Building Intentions In The Event Of Infertility And Knowledge Of Associated Costs, Jean Marie Place, John Horowitz, Minh Nguyen, Maya Guinn, Brennan Peterson

Marriage and Family Therapy Faculty Articles and Research

Introduction: Infertility affects approximately 8.5% of married women in the United States, yet there is limited understanding of how young adults anticipate and prepare for potential barriers to biological parenthood. As reproductive planning increasingly intersects with social, medical, and financial considerations, it is important to examine how emerging adults perceive and approach family-building options. This study aims to explore college students' intentions regarding childbearing, their openness to non-traditional family-building methods, and their awareness of the associated financial costs.

Methods: A cross-sectional survey was administered to undergraduate students (mean age = 20) at a Midwestern public university. Most participants had not …

Gender Differences In Regretted Consensual Sexual Experiences And Problematic Alcohol Use Among First-Year College Students, Shannon Shen, Soyoung Kwon, Sukho Lee

Journal of Social, Behavioral, and Health Sciences

Regretted sexual behaviors and alcohol use often occur in tandem for college students; however, few studies have examined their interrelationships or the variance across gender. This study tested gender differences in how regretting a consensual sexual experience is related to college students’ alcohol use. One hundred and forty first-year students (63% women, 69% Hispanic) surveyed in 2018 and 2019 reported their sexual behavior and alcohol use (following the Rutgers Alcohol Problem Index [RAPI]). Twenty-one percent of men and 16% of women reported a regretted sexual encounter. Interaction effects from regression models revealed that men with sexual regret had a significantly …

Do Female Patients Experience Worse Outcomes Than Male Patients After Inguinal Hernia Repair? An Analysis Of The Abdominal Core Health Quality Collaborative Database, Amrita Iyer, Sunjay Kumar, Martina Rama, Sourav Podder, Li-Ching Huang, Sami Tannouri, Talar Tatarian, Francesco Palazzo

Department of Surgery Faculty Papers

BACKGROUND: Inguinal hernia repair is one of the most common general surgery operations. Some evidence suggests that female patients are at greater risk of chronic postoperative pain and hernia recurrence. We investigated rates of chronic inguinal pain and recurrence after inguinal hernia repair in both male and female patients using the Abdominal Core Health Quality Collaborative database.

METHODS: The Abdominal Core Health Quality Collaborative database was queried for patients undergoing elective, unilateral inguinal hernia repair who completed 30-day clinical follow-up and baseline and 1-year European Registry for Abdominal Wall Hernias Survey surveys. Both open and minimally invasive cases were included. …

Increasing Community Members' Engagement In Cancer Research: The Making Research Clear Program, Rebecca J. Melillo, Christiane J. El Khoury, Joshua Blanding-Godbolt, Q. Greene, Karen M. Bussard, Amy Leader

Kimmel Cancer Center Faculty Papers

BACKGROUND: Despite the importance of engaging community members in research, multiple barriers from the perspective of the investigator and community member exist. The Making Research CLEAR (Community Learning and Experience about Research) Program aims to bridge the gap between research conducted at an NCI-designated cancer center and the community.

METHODS: Community members and a cancer center investigator were paired for a 6-month immersive research experience. Community members had at least one research experience per month with their investigator, while also attending cancer center activities such as Institutional Review Board (IRB) meetings, research lectures, protocol review meetings, and community outreach events. …

The Social Standing Versus The Mind Standing Of Older Adults In Egypt: Cross-Sectional Analysis Of The Relationship Between Social Capital And Cognitive Functions, Shaza H. Shinaishen Dr

Theses and Dissertations

Introduction: Egypt's population, much like that of other countries, is expected to age considerably over the course of the coming decades. Although biological and socioeconomic predictors of cognitive function have been studied widely, personal level social capital remains unexplored, especially in LMICs.

Purpose: This study primarily investigates the relationship between individual social capital and cognitive functioning among older adults aged 65 years and older in Egypt using the structural and cognitive components of social capital, including group membership, civic engagements, and caregiving roles.

Methods: A cross-sectional survey on 363 older individuals in different geographical and demographic segments of Egypt using …

Psycho-Analysis Will Not Save Us: Reflections On The Gen Z Mental Health Crisis, Victor Dubitans

Middle Voices

Generation Z (born between 1997 – 2012) is characterized as having both unprecedented mental health awareness and unprecedented mental distress. An apparent contradiction with troubling implications for the mental health field: Either the response to the mounting crisis has been insufficient or the field forms part of the problem. Taking seriously Wilks’ (2023) criticism of “therapeutic overreach” of the contemporary mental health field in the lives and development of youth, this paper attempts a selfanalysis and moral inventory about the field’s potential complicity in the crisis and in the history of hysteria. Lacan’s writings on the “analyst’s discourse” are considered …

The Role Of Neuroscience In Mental Health Management Within The Adhd Population, Kadi Rae Smith

University Honors Theses

Neuroscience-based educational interventions play a role in the management of Attention Deficit Hyperactive Disorder (ADHD), including the regulation of ADHD-correlated depression and anxiety. Existing research shows that elevated rates of depression correspond to anxiety within the ADHD community; approximately 8.83% of the global population. Social ostracization and isolation are established contributors to depression and anxiety which are commonly comorbid with ADHD. The need exists for further investigation of the beneficial impact that an accurate, biological understanding of how the brain works has on the mental health of the ADHD population, and by extension their families, education systems, and medical industries. …

Trauma In The Middle Ages: The Viking Experience Of Trauma Through Saga, Kagan L. Vogt

University Honors Theses

Trauma is a fundamental part of human experience and the ways in which human beings experience trauma differs drastically depending on the time and culture represented. Research on trauma in the Middle Ages does exist, however, often offers windows into very narrow intersections within the study of historical trauma. Other cultures and particularly oral traditions lack the same attention from scholars in trauma. The specific experience of Vikings as referenced in the oral tradition of sagas offers a unique window into the traumatic experience of Vikings as well as how they responded to trauma. This unique response to trauma is …

Beyond The Genome: The Racialized Exposome, Flourishing, And Stress Biology In African Americans, A Non-Exhaustive Review, Enye Washington

University Honors Theses

Racial health disparities remain an enduring challenge in the United States, disproportionately impacting African American communities through higher rates of chronic disease and premature mortality. This non-exhaustive literature explores how the racialized exposome - a term denoting the totality of social, environmental, and structural stressors rooted in systemic racism - biologically embeds itself via stress-responsive pathways. Specifically, it examines the interaction between racial stress, flourishing, and key biological markers, including allostatic load and telomere length, considering the gut-brain axis. The review highlights robust evidence that chronic exposure to racial discrimination and structural adversity contributes to multisystem dysregulation and accelerated cellular …

Do Perceived Social Support And Positive Religious Coping Moderate Any Relationship Between Post-Intensive Care Syndrome–Family Symptoms And Quality Of Life In Informal Caregivers Of Intensive Care Unit Survivors?, Carol R. Hirschkorn

Doctoral Dissertations and Projects

Family members and close friends often act as informal caregivers (CGs) for survivors of critical illness, assisting with activities of daily living, ongoing care needs, and adjustment to life after critical illness. These CGs simultaneously cope with their own mental, physical, and social sequelae, including significant changes (to roles and responsibilities) in everyday life. Qualitative researchers have examined this constellation of CG symptoms, which constitute post-intensive care syndrome–family (PICS-F), to understand the experiences, needs, and coping of CGs of intensive care unit (ICU) survivors. None have looked at the impact of religious coping and perceived social support on PICS-F and …

Analysis Of Personality Traits, Intelligence Level And Ability To Cope With Stressful Situations And Their Impact On The Evaluation Of Judo Fights, Maciej Kostrzewa, Jan Supinski, Slawomir Kownacki, Miłosz Drozd, Anna Ścisłowska-Czarnecka, Jarosław Markowski, Jan Pilch, Alicja Markiel, Marcin Żak, Adam Maszczyk

Baltic Journal of Health and Physical Activity

Background: The aim of the study presented in this article was to conduct an analysis that would answer the research question: do personality traits such as extraversion, neuroticism, openness to experience, agreeableness, conscientiousness, intelligence level, and ability to cope with stressful situations correlate with the assessment of judo fights? Materials and Methods: Ninety individuals participated in the study, including international-class referees, national-class referees, coaches, and active judo athletes. The study used a correlational analysis approach to examine the relationships between personality traits and fight assessment criteria in judo. Results: The results indicate that in the referees' group, there is a …

Urban-Rural Divide In Inequality’S Impact On Substance Abuse, Jonathan E. Flores

Undergraduate Theses, Capstones, and Recitals

This thesis focuses on investigating the relationship between income inequality, measured through the Gini coefficient, and drug addiction, proxied through substance-related mortality. Specifically, this thesis focuses on how these dynamics vary across rural and urban counties in the United States, using population size as a proxy. County-level data from 2016 to 2020 were collected through both the CDC and the Census Bureau and subsequently analyzed using Stata, with crude death rates from drug and alcohol causes serving as a function of the Gini coefficient, labor force participation, racial composition, and other socioeconomic indicators. Through a quadratic version of the model, …

Enhancing Mental Health Through Mind-Body Exercises In Sedentary Students: A Systematic Review With An Indonesian Perspective, Izmi Alya Khairunnisa, Aditya Denny Pratama

Jurnal Sosial Humaniora Terapan

Sedentary Behavior (SB) among students is associated with increased risks of depression, anxiety, stress, and weakened immune function. According to the WHO, SB contributes to approximately two million deaths each year. This systematic literature review aims to evaluate the effectiveness of mind-body exercises in improving mental health outcomes—specifically stress reduction, anxiety management, and emotional regulation—among students with sedentary lifestyles. Using the PRISMA framework, 2,201 articles were identified from databases including Scopus, PubMed, and ProQuest, with six studies meeting the inclusion criteria. The review found that mind-body exercises such as yoga, tai chi, and pilates significantly reduce stress and anxiety, enhance …

Enhancing Dementia Classification For Diverse Demographic Groups: Using Vision Transformer-Based Continuous Scoring Of Clock Drawing Tests., Mengyao Hu, Yi Lu Murphey, Tian Qin, Edmundo R Melipillán, Laura B Zahodne, Richard Gonzalez, Vicki A Freedman

Faculty, Staff and Student Publications

Objectives: Alzheimer's disease and related dementias significantly affect older adults' quality of life. The clock-drawing test (CDT) is a widely used dementia screening tool due to its ease of administration and effectiveness. However, manual CDT-coding in large-scale studies can be time-intensive and prone to coding errors and is typically limited to ordinal responses. In this study, we developed a continuous CDT score using a deep learning neural network (DLNN) and evaluated its ability to classify participants as having dementia or not.

Methods: Using a nationally representative sample of older adults from the National Health and Aging Trends Study (NHATS), we …

One Health Integration To Control And Prevent Zoonoses: Application Of Organizational Theory Literature, Lisset M. Dumet Poma, Sherril Gelmon, Julia M. Goodman, Seth E. O’Neal

Hatfield Graduate Journal of Public Affairs

Zoonoses are infectious diseases transmitted between animals and people that disproportionately affect low- and middle-income countries (LMICs). The One Health (OH) approach aims to integrate systems, incentivizing collaboration among animal, human, and environmental systems to address zoonoses and improve health. Innovative solutions for effectively and sustainably achieving systems integration are needed. Organizational theories can facilitate the study of the context of OH implementation, applying comprehensive approaches that recognize the interconnections among organisms, the environment, and social systems, including the diverse entities needing integration (e.g., policy, community, public organizations). This narrative review examines organization and systems literature to provide recommendations for …

Support Beyond Services: Examining The Role Of Neighbor Relationships, Housing Staff, And Place In Mental Health Recovery, Kenna Estell Dickard

Dissertations and Theses

This dissertation explores the role of non-clinical support for individuals with serious mental illness (SMI). Through three interconnected manuscripts, this dissertation highlights the importance of housing staff support, places in the community, and neighbor relationships in fostering recovery for individuals with SMI. The first manuscript analyzes how housing staff support influences residents' well-being through an ecological lens. This study found that staff support is associated with reduced loneliness, higher residential satisfaction, and increased sense of community. This study also considers the role of self-determination as a moderator, demonstrating the importance of resident agency in maximizing well-being outcomes. The second manuscript …