Digital Commons Network^™

A Decision Analytic Approach To Hierarchical Decisions For Double-Crested Cormorant Conflict Resolution, Kelly F. Robinson, Travis O. Brenden, Alex Maguffee, Charles R. Bronte, Randall M. Claramunt, Thomas R. Cooper, Robin L. Debruyne, Brian S. Dorr, James F. Farquhar, Jana R. Lantry, James R. Jackson, David G. Fielder, Rachel L. Pierce, Doug Schultz

United States Department of Agriculture Wildlife Services: Staff Publications

Double-crested cormorants (Nannopterum auritum) are piscivorous, migratory waterbirds that often conflict with fisheries interests in North America, stemming from depredation effects on fish populations. A new permitting process in the United States allows natural resource agencies to request permits for lethal take of cormorants in special instances like depredation of managed fish stocks. This rule does not include guidance for when cormorant take might be actionable. We developed a hierarchical structured decision making (SDM) framework for evaluating whether, when, and how much cormorant take might be necessary. A broad-scale, or “umbrella,” SDM framework established the overarching problem, objectives …

The Development And Piloting Of A Novel Client-Rated Trans And Gender Expansive Clinical Competence Scale For Mental Health Providers, Karen Abraham

Dissertations, Theses, and Capstone Projects

Transgender and gender expansive individuals (TGEI) are people who encompass a broad and comprehensive set of experiences of gender diverse individuals and identities that exist both within and beyond a binary framework. In the United States, the Williams Institute identified a proportion of 0.5% of American adults identifying as transgender (Herman et al., 2022). TGE samples report poorer physical and mental health than their cisgender counterparts across the lifespan (Rastogi et al., 2025; Reisner et al., 2015; Reisner, Poteat, et al., 2016). Health disparities of TGEI relative to their non-TGE counterparts can be seen in the prevalence of mood disorders …

Understanding Barriers To Systems Change Among Regional Western Australian Food Security Initiative Leaders, Isabelle Chiera, Melissa Stoneham, Jess Doe, Amanda Devine, Stephanie L. Godrich

Research outputs 2022 to 2026

Food security (FS) is a complex, 'wicked' issue involving regular and reliable physical, social, and economic access to food. People living in geographically isolated areas are disproportionately affected by FS challenges and addressing these issues demands a systems-based approach. The Food Community project has implemented an adapted Systemic Innovation Lab (SIL) approach to support FS initiatives operating across rural, regional, and remote Western Australia to enhance their effectiveness. This paper aimed to identify what FS initiative leaders perceive as barriers to delivering their services, in relation to undertaking activities that align with the 36 systems change characteristics embedded within the …

Culturally Safe Nursing: Transformative Learning Experiences Through Critical Reflection Assessment, Lesley Andrew, Michelle Pedlow, Bev Ewens

Research outputs 2022 to 2026

Aim: To explore the transformative learning experiences of postgraduate nursing students engaging in an Aboriginal culture and history module, through an analysis of a critical reflection assessment, in particular the student development of cultural awareness and culturally safe practice.

Background: Despite mandated inclusion of Aboriginal cultural content in Australian nursing curricula, culturally unsafe practices and racism persist. Transformative learning, underpinned by critical reflection, can challenge fixed assumptions and promote cultural awareness and culturally safe care.

Design: A qualitative descriptive study using thematic analysis. Methods: Written critical reflections from 15 consenting postgraduate nursing students who completed the Ngany Kalyakal Katatjiny Boordawan …

Forty Years In The Making: Reporting On The Co-Creation Of A National Roadmap For Birthing On Country Services For The Best Start To Life, Res Mccalman, Anneka J. Bowman, Roianne West, Kristie Watego, Jyai Allen, Claire Clack, Sue Kildea, Sue Kruske, Melanie Briggs, Cleone Wellington, Rebecca Coddington, Yu Gao, Isabella Garti, Sascha Kowalenko, Sarah Ireland, Catherine Austin, John D. Boffa, Marah Prior, Kelsie Kahl, Bettina Chaseling, Sarah Khaw, Emily Armstrong, Donna Hartz (Kamilaroi), Yvette Roe (Njikena Jawuru)

Research outputs 2022 to 2026

For over 40 years, First Nations communities in Australia have called for community-controlled birthing and maternal–infant health programs that restore First Nations-led, community-controlled birthing systems grounded in cultural authority and sovereignty. ‘Birthing on Country’ services have demonstrated improved First Nations maternal–infant health outcomes, more babies kept out of the child protection system, and reduced health system costs. Restoration and expansion of Birthing on Country services across regions has been inconsistent, and has lacked support for national implementation. In 2022, a large national gathering (‘Best Start to Life’) was co-hosted in Mparntwe (Alice Springs). The focus was Birthing on Country service …

The Influence Of Childhood Experiential History On U.S. Vice President Jd Vance’S Personality, Amelia Brower, Aubrey Immelman

Psychology Faculty Publications

This paper presents the results of a developmental causal analysis of the adult personality of U.S. vice president JD Vance, from the conceptual perspective of personologist Theodore Millon.

Psychodiagnostically relevant data relating to Vance’s personality were collected from biographical sources and media reports and synthesized into a personality profile using the Millon Inventory of Diagnostic Criteria (MIDC), which yields 34 normal and maladaptive personality classifications congruent with DSM-III-R, DSM-IV, and DSM-5-TR.

The findings of the personality assessment were previously reported in a separate paper. Vance’s primary personality patterns were found to be Dominant/controlling and Ambitious/confident, supplemented by …

Best Practices For Supporting Occupational Therapy Students With Disabilities During Clinical Education: Results From A Three-Round Delphi Study, Courtney Gohean, Katie Mclaughlin, Aster Harrison

Department of Occupational Therapy Faculty Papers

INTRODUCTION: Disabled occupational therapy students face systemic barriers in clinical education. Although legal mandates require reasonable accommodations, implementation is often inconsistent, and few standardized guidelines exist for fieldwork education. This study is aimed at establishing best practices for supporting occupational therapy and occupational therapy assistant students with disabilities during fieldwork.

MATERIALS AND METHODS: A three-round Delphi study was conducted with a panel of 30 experts, including disabled occupational therapy students, disabled occupational therapy practitioners, academic fieldwork coordinators (AFWCs), fieldwork educators (FWEs), disability services staff, and researchers. In Round 1, participants answered open-ended questions about challenges, accommodations, and environmental supports. Responses …

Using Early And Periodic Screening, Diagnostic, And Treatment (Epsdt) To Improve Access To Obesity Pharmacotherapy: A Practical Guide For Clinicians Caring For Youth With Obesity Across United States Medicaid Programs:, Jaime M. Moore, Valerie M. O'Hara, Cassie Totman, Brooke Sweeney, Sarah Hampl, Alaina P. Vidmar

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Coverage of obesity pharmacotherapy for youth varies substantially across state Medicaid programs. This variability limits access to evidence-based treatment for pediatric obesity. The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit is a federally mandated Medicaid provision requiring coverage of medically necessary services for individuals under age 21, even when such services are not included in standard state Medicaid benefits. Despite its broad scope, EPSDT remains underutilized due to limited awareness and operational complexity.

METHODS: We developed a clinician-facing, practice-oriented framework to operationalize EPSDT for pediatric obesity treatment. This approach integrates (1) review of federal EPSDT policy and …

Patient-Specific Computational Fluid Dynamics Modeling Of Airway Collapse In Infants With Robin Sequence., Gautam Jalori, Michael Barbour, Michael Bindschadler, Kelly Evans, John P. Dahl, Alberto Aliseda

Manuscripts, Articles, Book Chapters and Other Papers

Robin Sequence (RS) is a congenital condition in which patients experience dynamic, periodic obstruction or collapse of the upper airway due to an underdeveloped jaw and a posteriorly displaced tongue. Current clinical techniques for evaluating airway obstruction do not provide quantifiable data and fail to account for the dynamic nature of obstruction or collapse. There is no standardized criterion to characterize obstruction or collapse severity. This study presents the first method that extracts airway motion from 4-dimensional computed tomography and performs a patient-specific, moving-mesh computational fluid dynamics (CFD) analysis of RS patients with complete airway collapse or obstruction. To quantify …

Constrained Multiview Contrastive Learning For Jointly Supervised Representation Learning, Siyuan Dai, Kai Ye, Kun Zhao, Yang Du, Haoteng Tang, Liang Zhan

Computer Science Faculty Publications

Purpose

Materials and Methods

Impact Of Exercise On Mental Health In Inpatient Settings, Samuel Blake Rn, Nathaniel Clark Rn

Nurse Residency

In adult psychiatric inpatients with mental illness, how does participation in a structured exercise program compared with standard inpatient care affect depression, anxiety, and overall mental health outcomes during hospitalization?

Night Shift-Specific Training & Engagement, Keith Procell Rn, Kyleigh Keitel Rn

Nurse Residency

In night shift hospital workers (P) does mandatory daytime attendance for required education (I), compared to shift-aligned, asynchronous, or flexible scheduling of education (C), increase health risks associated with circadian disruption (O), as supported by current research?

Gene-Environment Interactions In Cardiovascular Aging: Volunteering, Polygenic Risk, And Biomarker Change In European And African Ancestry Populations, Seoyoun Kim, Byeongju Ryu, Erin Ware, Koichiro Shiba, Cal J. Halvorsen

Brown School Faculty Publications

Volunteering has been associated with better cardiovascular health, but whether this association varies by genetic susceptibility to cardiovascular disease remains unclear. This study examined associations between volunteering and cardiovascular biomarkers, assessed associations between biomarker-specific polygenic scores (PGSs) and these outcomes, and tested whether polygenic risk moderated volunteering–biomarker associations among U.S. adults aged 51 years and older.

Effect Of Multisensory Stimulation On Delirium, Pain, And Anxiety Among Patients Undergoing Major Abdominal Surgery: A Quasi Experimental Study, Nesma Yousef Said Said

Nursing

Background: Major abdominal surgery is frequently associated with postoperative complications, including delirium, pain, and anxiety, which may delay recovery, increase healthcare utilization, and negatively affect patients' overall well-being. Multisensory stimulation has emerged as a promising non-pharmacological intervention that may improve postoperative outcomes by creating a calming and supportive healing environment. Purpose of the study: This study was conducted to examine the effectiveness of multisensory stimulation in reducing delirium, pain, and anxiety among patients undergoing major abdominal surgery Method: A quasi-experimental pretest–posttest design was employed at National Liver institute, Menoufia university, Egypt. A purposive sample of 150 patients (75 intervention group …

Longitudinal Association Between Midlife Cardiovascular Health And Cognitive Change In A Bi-Ethnic Cohort, Janette Vazquez, Rebecca Bernal, Luis Aguirre, Jesus D. Melgarejo, Gladys Maestre, Sudha Seshadri, Helen P. Hazuda, Chen-Pin Wang, Claudia Satizabal

School of Medicine Publications

Introduction: Midlife cardiovascular burden contributes to cognitive decline and dementia. However, research in diverse populations remains scarce.

Methods: We included 402 San Antonio Heart Study participants (1979–1988; midlife mean age 57.9 ± 3.8, 58.5% women, 52% Mexican American) later enrolled in the San Antonio Longitudinal Study of Aging (1992–2004). Midlife cardiovascular health was assessed using Life's Simple 7. Cognition was measured up to four times with the Mini-Mental State Examination. Generalized estimating equation models adjusted for age, sex, income, and education were used to relate cardiovascular factors to cognitive change. Sensitivity analyses evaluated attrition bias.

Results: Physical activity was associated …

An Evaluation Of Next Generation Biological Control Methods For The Invasive Brown Treesnake In The Mariana Islands, Jonathan Q. Richmond, Tim Harvey-Samuel, Melia G. Nafus, Adam Perez, Renee Bellinger, Antoinette J. Piaggio, Riley Taitingfong, Margaret E. Hunter, Robert N. Fisher

United States Department of Agriculture Wildlife Services: Staff Publications

No abstract provided.

Towards Human-Centered Digital Health Interventions, Kristin M Kostick-Quenet, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

This article discusses the potential of digital health interventions (DHIs) in mental health care, emphasizing the importance of designing them to foster genuine humanistic care. It highlights current challenges in measuring engagement and outcomes, advocating for integrating human-centered endpoints such as dignity, autonomy, and therapeutic alliance into evaluation frameworks. The authors call for mechanistic research to identify effective engagement strategies and context-specific implementation approaches. Ultimately, successful DHIs should demonstrate both clinical efficacy and the preservation of humane, person-centered care, ensuring ethical and meaningful mental health support through technology.

Acute Hamstring Fatigue In Elite Male Sixes Lacrosse Players Following A Single Competitive Match, Nicholas Joel Ripley, Jack Fahey, Matthew W. Collier, Christopher Bramah

Research outputs 2022 to 2026

Background/Objectives: Decreases in hamstring isometric strength have been observed post-competition, but research has currently focused only on soccer players. Therefore, the purpose of the present study was to observe if acute reductions in isometric hamstring force production in elite male lacrosse players occur post-match.

Methods: Peak isometric force measurements were collected from ten male outfielders from the British Lacrosse squad (24.6 ± 2.3 years, 1.80 ± 0.08 m, 86.3 ± 4.5 kg) using force plates. The 90:90 isometric assessment was conducted before and after a single sixes lacrosse match to observe changes in hamstring force production. Bayesian paired sample’s t-test …

Bridging Data Gaps In Retinal Imaging: From Structural Domain Adaptation To Topology-Aware Synthesis, Gözde Merve Demirci

Dissertations, Theses, and Capstone Projects

Comprehensive visualization of the retina is essential for diagnosing and monitoring blinding diseases such as Diabetic Retinopathy and Retinopathy of Prematurity (ROP), where pathological changes often extend beyond a single field of view. Despite significant advances in automated retinal image analysis, clinical deployment remains limited by two fundamental data gaps: a structural learning gap, arising from scarce expert annotations and poor generalization across imaging domains, and a spatial coverage gap, caused by the difficulty of acquiring multi-view retinal images in fragile populations. Although these challenges are often addressed independently, this dissertation argues that they are tightly coupled: accurate, …

Optimizing Nanoparticle Quality And Function In Applied Research, Angela M. Fried

Dissertations, Theses, and Capstone Projects

Radiology tests are among the fastest-growing categories of diagnostic analysis, and the gold standard of radiology tests is MRI.  MRI can be more informative if a contrast agent is used, and the standard of care contrasting agents (CA) are gadolinium-based.  Gadolinium is a heavy metal, toxic, and contraindicated for renal-compromised patients and the critically ill.  We propose a nanogel (NG) vehicle for an alternative organic CA.  CNs like 4-hydroxy-2,2,6,6-tetramethylpiperidin-1-oxyl (TEMPOL) and its derivatives have a variety of medical and industrial uses.  These cyclic CNs are stable, synthetic radicals with distinctive EPR/ESR signals and are helpful for various experimental applications, from …

New York City Women’S Experiences With Perinatal Depression Inquiries, Diagnosis, And Treatment Initiation, Caterina Pisciotta

Dissertations, Theses, and Capstone Projects

Perinatal depression represents a significant public health concern, yet many women who experience depression symptoms during the perinatal period (either during pregnancy and/or after birth) do not receive treatment. Initiatives, such as ThriveNYC, were designed to address these gaps by screening and treating perinatal women for maternal depression, integrating screening into routine perinatal care and strengthening pathways to treatment. Using representative survey data collected between 2016 and 2021 via the Center for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System (PRAMS), this study examined trends in perinatal depression inquiries (a proxy for “screening”) and postpartum diagnosis, as well as …

Parenthood And Re-Appraisal Of Childhood Maltreatment, Gayathri Cheran

Dissertations, Theses, and Capstone Projects

Background: Child maltreatment is associated with poorer physical and mental health outcomes across the lifespan.  Individuals’ appraisals of childhood maltreatment have important implications for these outcomes.  Appraisal is shaped by biological, psychological, and social-cultural factors, each of which undergoes change in parenthood.  Parenthood may prompt re-appraisal of childhood maltreatment in that being a parent evokes one’s experience of being parented.

Hypotheses: (1) Re-appraisal will be more likely in parents than non-parents.  In parents, re-appraisal will be more likely among: (2) primiparous parents, (3) parents with offspring of the same sex, and (4) parents who experienced maltreatment older in childhood (at …

Opportunities For Learning Through Object Exploration During Early Physical Therapy: Physical Therapists’ And Caregivers’ Assistance And Interference Behaviors, Michele Goncalves Maia

Dissertations, Theses, and Capstone Projects

Early physical therapy (EPT) for infants with motor delays has traditionally emphasized motor milestone acquisition, yet growing evidence indicates that motor and cognitive development are fundamentally interconnected. Grounded in embodied cognition and developmental cascade theories, this dissertation conceptualized object exploration as a primary mechanism through which infants learn during EPT and examined how intervention approaches and adult behaviors shape opportunities for object exploration. Using retrospective analyses of video-recorded EPT sessions, two studies investigated how intervention approaches and adult behaviors influence infants' opportunities to learn through object exploration. Study 1 compared object exploration in the START-Play (SP) intervention and Usual Care …

Artificial Intelligence (Ai) In Home-Care And Community Nursing: A Scoping Review, Haiying Wang, Grace Y. Wang, Tao Wang, Lori Delaney, Jonathan Bayuo, Mengyuan Li, Jing Yu Tan

Research outputs 2022 to 2026

Background/Objectives: Artificial intelligence (AI) is increasingly being applied across healthcare, but empirical evidence on its use in home-care and community nursing remains fragmented across technologies, clinical contexts, nursing roles, and stages of implementation. This scoping review aimed to map current AI applications in home-care and community nursing and synthesize reported implementation experiences, benefits, challenges, and future considerations.

Methods: Guided by Joanna Briggs Institute methodology and reported according to PRISMA-ScR, eight databases and grey literature via ProQuest were searched for English-language empirical studies published from 1 January 2020 to 14 May 2026. Retrieved records were screened independently by two reviewers, with …

New Zealand Osteopaths And The Management Of Older Adults: Outcomes From A Practice-Based Research Network, Ana Paula Antunes Ferreira, Michael Fleischmann, Lee Muddle, Jack Feehan, Kesava Kovanur Sampath, Brett Vaughan

Research outputs 2022 to 2026

Older adults represent a growing proportion of healthcare consumers, and yet little is known about the osteopathic practitioners who regularly manage this population. This study set out to understand what characteristics are common among New Zealand osteopaths who regularly treat older adults. This cross-sectional, exploratory study was a secondary analysis of questionnaire data collected through a practice-based research network. The questionnaire captured osteopaths’ demographic characteristics, practice settings, and clinical management approaches. Of the 277 osteopaths who completed the questionnaire, 188 (67.9%) reported frequently treating older adults. Those most likely to do so were based in urban areas, treated wrist and …

Selecting Force Plate Tests And Metrics To Complement Physical Preparation Strategies Prior To Commencing Strenuous Military Training Courses, Peter Ladlow, Nicholas J. Ripley, Damjana V. Cabarkapa, Dimitrije Cabarkapa, Dale W. Chapman, Mary Claire Geneau, G. Gregory Haff, Lachlan P. James, Paul Jones, Jason P. Lake, Christopher J. Sole, Anthony Turner, Marina De Vecchis, Natalie Masters, Charles Coussens, Robyn Holton, Russell J. Coppack, Colin Suffield, Paul Comfort

Research outputs 2022 to 2026

Background: The aim of this study was to seek opinion (via an online survey) and gain consensus of which force plate tests and metrics may be considered by military operating/training staff to better screen physical performance characteristics prior to military personnel attending a physically arduous military training course.

Methods: Ten responders with known experience and/or expertise in using force plate technology for the measurement of force production characteristics completed the survey. Responders were asked to select the most important force plate test and metrics to complement a pre-course physical performance battery to assess physical readiness, musculoskeletal injury risk and likelihood …

Cardiovascular Disease Incidence And Cancer Risk In Two Large European Prospective Cohorts, Emma Fontvieille, Vivian Viallon, Laia Peruchet-Noray, Quan Gan, N. Charlotte Onland-Moret, Yvonne Koop, Anne Tjønneland, Nicola Bondonno, Verena Katzke, Rudolf Kaaks, Matthias B. Schulze, Catarina Schiborn, Calogero Saieva, Vittorio Simeon, Claudia Agnoli, Rosario Tumino, Fulvio Ricceri, Leila Luján-Barroso, Maria José Sánchez, Conchi Moreno-Iribas, Konstantinos K. Tsilidis, Marc J. Gunter, Adam Butterworth, Elio Riboli, Heinz Freisling, Pietro Ferrari

Research outputs 2022 to 2026

Our study investigated the association between incident cardiovascular disease (CVD) and subsequent cancer risk in two large European prospective cohorts. We included 568,926 adults from the European Prospective Investigation into Cancer and Nutrition and United Kingdom Biobank, all of whom were free of CVD, cancer and type 2 diabetes at baseline. Multivariable Cox proportional hazards regression models were used to estimate cancer hazard ratios (HRs) and 95% confidence intervals (CIs) in relation to incident CVD events. CVD was treated as a time-varying exposure, and models accounted for time since CVD diagnosis and other lifestyle factors. Study-specific estimates were pooled using …

Underfunded And Undervalued: Community-Based Health Promotion Practitioners’ Experiences Of Western Australia’S Prevention Sector, Ruth M. Wallace, Leesa N. Costello, Elizabeth J. Cook

Research outputs 2022 to 2026

Prevention is a central policy focus of contemporary health promotion, offering cost-effective strategies to reduce disease burden and improve population well-being. Despite this, Australia allocates a small proportion of its health budget to prevention, with funding models characterized by short-term cycles and competitive tendering. While the consequences for public health are well documented, the impact on the health promotion workforce remains underexplored. Workforce health and stability are critical for program delivery, ethical practice, continuity of relationships with communities, and the capacity to sustain long-term prevention efforts. This qualitative study examined the experience of 19 community-based health promotion practitioners in Western …

Content And Design Of Educational Interventions/ Training On Respectful Maternity Care For Maternal Healthcare Providers In South Asia: A Scoping Review Protocol, Shirin Rahim, Khairunnisa Mansoor, Zulekha Saleem, Rafat Jan

Journal of Asian Midwives (JAM)

Background: Respectful Maternity Care (RMC) is a key component of quality maternal healthcare that upholds women's dignity, privacy, autonomy, and freedom from harm during childbirth. Despite increasing recognition of RMC, disrespect and abuse (D&A) remain common in facility-based maternity care across South Asia, negatively affecting women's experiences, trust in health services, and maternal outcomes. Educational interventions for maternal healthcare providers have been developed to promote RMC principles based on the White Ribbon Alliance Charter; however, the content, design, and evaluation of these interventions have not been comprehensively mapped in the South Asian context.
Objective: This scoping review aims to map …

Beyond Medical Illness: A Phenomenological Study Of Mother’S Lived Experience Of ‘Evil Eye’ In Neonatal Illness, Aijaz Ahmed, Rahat Jabeen, Sanghamitra Sheel Acharya

Journal of Asian Midwives (JAM)

Background: Cultural explanations of unexplained infant illness can shape maternal distress and care-seeking, particularly where access to biomedical services is constrained. This study explored how mothers understood neonatal illness that they associated with the evil eye (nazar), and how those understandings influenced care decisions.
Methods: A Heideggerian interpretive phenomenological design was used. Fifteen mothers from Dhandal and Gurmul villages in Doda district were purposively selected and interviewed face to face in Saraji using a semi-structured interview schedule. Interviews lasted 45–90 minutes. Translated interview accounts and field notes were examined using Braun and Clarke’s six-phase thematic analysis.

Findings: Six themes were …