Digital Commons Network^™

Transition To Home Guideline For Patients With Diabetes, Kathleen R. Burgner

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Diabetes is a leading contributor to preventable hospital readmissions. These hospital readmissions often result from fragmented discharge planning, poor care coordination, and limited post-discharge support. At a 915-bed academic medical center in Southern California, the diabetes-related readmission rate was 13.3%, compared with 11.4% among patients without diabetes. This project aimed to develop an evidence-based Transition-to-Home (TTH) guideline for hospitalized patients with diabetes and evaluate the strength of its recommendations through multidisciplinary stakeholder review.

Methods: An evidence-based guideline development project was conducted over 8 weeks. A comprehensive literature search in CINAHL, MEDLINE, PubMed, and ScienceDirect identified current evidence on transitional …

Technological Interventions For Reducing Climate Change Impacts On Health: An Overview Of Future Possibilities, Sujatha Alla, Vijay Kumar Chattu, Bawa Singh

Engineering Management & Systems Engineering Faculty Publications

Globally, over five million deaths annually are attributed to extreme weather events exacerbated by climate change, such as heatwaves, hurricanes, wildfires, droughts, and floods, which create health crises and economic losses. The 2015 Paris Declaration emphasized climate technology mechanisms, including research and development, to enhance resilience and reduce greenhouse gas emissions. Biotechnological advancements have mitigated about 20% of economic losses since the 1960s, highlighting technology’s potential to address climate-induced health risks.

A Framework For Digital Energy Modulation And Translation In Projectional X-Ray Imaging, Richard R. Wargo

Theses and Dissertations

In projectional X-ray imaging, acquisition energy fundamentally influences subject contrast, image noise, and radiation dose. While dual-energy techniques exploit spectral differences to optimize contrast and enable material separation, acquiring multiple images of the same anatomy often requires additional exposures and increased system complexity.

This dissertation presents a framework for digital energy modulation (DEM), in which computational models are trained to translate projection images between energy domains without requiring additional X-ray acquisitions. DEM is conceived as a generalizable strategy for controlled contrast modulation in projection imaging, with potential applications in image optimization, radiation therapy alignment, and dual-energy applications.

The framework was …

Embracing Imperfection And Stress As The Foundation For Growth, Excellence, And Well-Being In Dentistry, John W. Claytor Jr., Dds, Magd-Llsr, Facd

Journal of the American College of Dentists

Studies reveal that stress in dentistry begins early in training and may progress throughout a dentist’s career. Fear of managing patient dissatisfaction, demanding schedules, time constraints, staff issues, and the stressors of clinical dentistry all contribute to professional strain. Difficulties associated with perfectionistic tendencies, burnout, and mental health concerns remain ever-present challenges within the profession. This article discusses evidence-based strategies, coping skills, organizational approaches, and professional resources that may help mitigate the effects of stress in dentistry. Particular emphasis is placed on reducing stigma surrounding mental health care and supporting initiatives such as the Lorna Breen Heroes Foundation’s “Safe Haven” …

The Knowledge, Experiences, And Attitudes Of Nurses Regarding Trauma-Informed Care For Sexually Abused Intrapartum Patients, Kayleigh Mcgraw

Honors Undergraduate Theses

Labor and delivery nurses care for women from diverse backgrounds who are preparing for a life-changing event, often marked by fear, excitement, sadness, and joy. However, 1 in 5 women in the United States have experienced rape or attempted rape, and for these survivors, labor can become re-traumatizing. Many report flashbacks, dissociation, and a sense of “being back in the rape” during childbirth. Research further links prior sexual assault to unplanned cesareans, traumatic births, and childbirth-related PTSD. Trauma-informed care (TIC) provides a framework to reduce these risks by encouraging providers to understand trauma, recognize signs of distress, and act to …

Timelines Of Care: Analyzing Treatment Access For Women With Ongoing Reproductive Health Needs, Nyla M. Keith

Honors Undergraduate Theses

Mandates in the United States created pressure on an already strained healthcare system post-COVID-19 pandemic. With new regulations placed upon abortion care forcing the closing of low-cost health clinics such as Planned Parenthood, legislation that has made health insurance more expensive, and rising pharmaceutical prices, women’s OB/GYN care in America has struggled to meet patient needs. A cross-sectional survey was developed and distributed to four clinics in the Orlando area to assess patients' perceived access to care and identify barriers to receiving OB/GYN care. The survey took approximately 10 – 15 minutes to complete, was available in print and online …

Oral Health Access Among Ethnic Minority Older Adults In The United States, Jasleen K. Sodhi

Honors Undergraduate Theses

Oral healthcare is a critical yet often overlooked component of overall health among U.S. adults. Ethnic minorities for older adults face heightened risks of poor oral health and related health conditions, while experiencing disparities in access to care. This study aimed to systematically examine and synthesize existing literature to assess the extent to which oral health disparities exist among ethnic minority older adults in the U.S. and explore the roles of socioeconomic factors on these disparities. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, we conducted a systematic review of peer-reviewed articles published in English …

The Impact Of Parental Influence On The Sexual Health Of College Students In South Florida, Lauren Barthel

Honors Undergraduate Theses

College students account for some of the highest rates of sexually transmitted infections (STIs) annually in America. Interventions aimed at reducing the number of cases in this emerging population are needed. This study utilized a secondary data analysis of an online survey administered to college students from August 2018 to December 2022 to examine their sexual literacy and overall sexual health. The objective of this study was to explore the relationship between parental influence and the sexual health of college students by exploring variables such as parent-child communication, race/ethnicity, and parental background. Using IBM SPSS Statistics 30, results indicated that …

A Qualitative Analysis Of Youtube-Based Dietary Messaging On Type 2 Diabetes For South Asians, Sukhmani K. Dhaliwal

Honors Undergraduate Theses

While South Asians experience a disproportionately high risk of Type 2 Diabetes Mellitus (T2DM), culturally tailored dietary guidance remains limited within healthcare settings. As digital platforms increasingly serve as sources of health information, YouTube has grown as a prominent space for the publishing and consumption of dietary advice. This study examines how diet-related messaging about T2DM is communicated in YouTube videos directed at South Asian populations.

Using qualitative thematic analysis, 21 videos published between 2016 and 2025 by influencers with a wide reach were analyzed. Videos were selected based on relevance to South Asian audiences, focus on dietary management of …

Building Ai Literacy To Redesign Graduate Public Health Courses: A Case Study Of Pubh 520, Darren Liu

2026 Scholarly Teaching Conference: Concurrent Session Papers

As artificial intelligence (AI) becomes increasingly embedded in public health practice, graduate education must move beyond ad hoc responses to AI toward intentional, ethically grounded instructional design. This conference paper presents a case study of the redesign of PUBH 520, a graduate-level public health course, to explicitly integrate AI literacy within course outcomes, assessments, and learning activities. Guided by higher-education AI literacy frameworks, the redesign foregrounded faculty AI literacy as a prerequisite for responsible AI integration, emphasizing ethical reasoning, technical understanding, pedagogical alignment, and reflective assessment practices. Findings suggest that the redesigned course improved coherence among learning outcomes, assessment integrity, …

Genetic Diversity Of Cryptosporidium Species In New York State, Kimberly A. Mergen

Electronic Theses & Dissertations (2024 - present)

The knowledge regarding Cryptosporidium infections in New York State (NYS) is severely lacking in two ways: 1) there are currently no NYS-based data regarding the subtypes of Cryptosporidium parvum and Cryptosporidium hominis, which are the two most prevalent species that infect humans and 2) information regarding uncommon Cryptosporidium species that infect the New York population is also unavailable. Filling these gaps concerning this pathogenic parasite would provide a substantial amount of information when considering public health, outbreak investigations, and prevention measures. Therefore, improving Cryptosporidium subtype and species surveillance in NYS will aid in prevention and control efforts as well …

Photovoice Exploration Of Afghan Refugee Background Women's Food-Related Well-Being, Eileen C. Lindemann

Graduate Research Theses & Dissertations

More than 117,000 Afghans have been relocated to the United States following the U.S. military withdrawal in August 2021. Research indicates that Afghan refugees resettled in the U.S. are at increased risk of psychological distress, with Afghan women particularly susceptible compared with Afghan men, and diet-related chronic disease. However, research also shows that traditional food and eating customs foster cultural identity, social support, integration, and well-being. The purpose of this study was to collaboratively explore the food-related well-being and daily life contexts of resettled refugee participants through the photovoice method, a participatory research strategy in which participants photograph aspects of …

Air Quality Risks In Public Housing, Brynn Sheehan, Carolyn Caraballo Velez, Vaughan W. Rees, Miasha T. O'Neal, Kristen E. Moore, Katie M. Jones, Jessica Meadows, Sarah Gehlert, Richard Grucza, Andrew Plunk, Kelli J. England

Department Psychiatry & Behavioral Science Faculty Publications

Importance Public housing residents face elevated environmental health risks, yet indoor air quality in these settings remains underexamined. OBJECTIVE: To evaluate indoor air quality in public housing 5 years after implementation of the federal smoke-free housing policy and compare it with outdoor air quality in the same regions.

Design, Setting, and Participants A 1-year cohort study of indoor air quality (particulate matter ≤2.5 μm in diameter [PM2.5]) across 12 multifamily public housing communities in southeastern Virgina for individuals 65 years and older or persons with disability in cities with the highest rated outdoor air quality. Indoor PM2.5 was continuously measured …

Aging With A Chronic Illness: Symptom Burden, Everyday Challenges, And Quality Of Life Among Older Adults With Multiple Sclerosis, Swasati Handique

Social Work Dissertations

This three-article study examined the quality of life and everyday lived experience of older adults living with multiple sclerosis (MS). The first article is a scoping review of 14 peer-reviewed studies published between 2012 and 2025, conducted in accordance with Arksey and O’Malley’s five-stage framework and the PRISMA checklist. The second article is a cross-sectional study using the Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) Phase II data set of 60 older adults living with MS. Multiple linear regression and moderation analysis was conducted to examine the association between physical symptom burden and quality of life, and whether participation …

“If He Did It, I Can Do It, Too. I Can Change My Life Around”: The Social Model Of Recovery Within The Context Of Recovery Homes Accepting Residents Prescribed Medications For Opioid Use Disorder, Jodie M Dewey, Kathryn R Gallardo, Meenakshi S Subbaraman, Amy A Mericle

Faculty, Staff and Student Publications

Introduction: This paper provides an in-depth examination of examines four recovery residences, that serve individuals prescribed medications for opioid use disorder (MOUD). The study has two primary aims: first, to deepen understanding of how recovery residences adopt and operationalize Social Model of Recovery principles; and second, to identify gaps in staff integration of residents receiving MOUD-gaps that may either support or undermine the integrity of the social model within these settings.

Methods: We conducted semi-structured interviews with 17 residents receiving MOUD living in four participating recovery homes. The interviews were conducted between August 2022 and January 2024 using a semi-structured …

Plasma Proteomic Profile Of Dietary Potassium And Incident Ckd, Jiaqi Yang, Lauren Bernard, Jingsha Chen, Valerie K Sullivan, Bing Yu, Eugene P Rhee, Paul A Welling, Casey M Rebholz

Faculty, Staff and Student Publications

Background:: There is a need for objective biomarkers of dietary potassium. The mechanisms through which dietary potassium influences kidney health are incompletely understood.

Methods:: Atherosclerosis Risk in Communities study participants at visit 3 (1993–1995) with dietary and proteomics data were randomly divided into discovery (N=6,814) and replication (N=3,380) sets. We examined associations between dietary potassium and 4,955 aptamers using multivariable linear regression, adjusting for sociodemographic factors, health behaviors, and estimated glomerular filtration rate, with a false discovery rate of 0.05. Then, we tested the prospective associations between potassium-related proteins and incident chronic kidney disease (CKD).

Results:: …

Adapting A Smartphone-Based Auricular Point Acupressure Self-Management Program For Rural Chronic Musculoskeletal Pain: Qualitative Study, Jungkyung Min, Peiyin Hung, Jane N Bolin, Rupsikha Bora, Sarah Pace, Patricia Pitones, Hulin Wu, Jennifer Kawi

Faculty, Staff and Student Publications

Background: Chronic musculoskeletal pain is more prevalent in rural areas where access to pain interventions, including complementary approaches like Auricular Point Acupressure (APA), remains limited. APA is a non-invasive, needle-free approach, and its smartphone-based self-management delivery model has not been optimized for rural contexts.

Objectives: To explore the perspectives of rural partners on adapting a smartphone-based Auricular Point Acupressure-Self-Management (APA-SM) program to better meet rural needs. Study objectives were to: (1) refine the APA-SM program for rural adults, (2) identify implementation barriers, (3) understand practice workflows and engagement, and (4) identify strategies to integrate the APA-SM program into rural pain …

Subgroup Identification Of Disparities In Buprenorphine Discontinuation In Opioid-Use Disorder: A Virtual Twins Machine Learning Approach Using Nationwide United States Claims Data, 2006–2022, Kehe Zhang, Paula A Jaimes-Buitron, Wanru Guo, Yanmin Gong, Yuanxiong Guo, Carolina Vivas Valencia, Cici Bauer

Faculty, Staff and Student Publications

Buprenorphine retention is crucial for effective treatment of opioid use disorder (OUD), yet disparities in treatment discontinuation persist. This study aims to identify and quantify disparities in buprenorphine treatment retention using a machine learning framework adapted from Virtual Twins approach focusing on disparities related to sex, age, insurance type, geographic region, mental health status and community-level Social Vulnerability Index (SVI). Using a nationwide longitudinal cohort, we applied a two-stage machine learning approach. In Stage one, we trained classification models to estimate the counterfactual differences in treatment discontinuation across disparity types. Model performance was assessed using C-statistics and precision-recall curve. In …

A Qualitative Examination Of Human Papillomavirus Vaccine Access, Beliefs, And Behaviors Among Adult Males Aged 18–35: Applying The Health Stigma And Discrimination Framework, Jacquelin I Cordero, Louis D Brown, Jesús M Alemán, María E Fernández, Serena A Rodríguez, Eva M Moya

Faculty, Staff and Student Publications

Background: Males, who disproportionately account for 83% of oropharyngeal cancer cases, are underrepresented in health promotion research, including human papillomavirus (HPV) vaccination studies. The initial exclusion of males in HPV vaccine research, policies, and interventions has negatively affected male vaccine uptake. Furthermore, stigma, a well-documented barrier to healthcare engagement, has been overlooked in HPV vaccination behaviors. This study aimed to provide a more contextualized understanding of HPV vaccine disparities among adult males by applying the Health Stigma and Discrimination Framework (HSDF) to examine how stigma is produced, enacted, and sustained across social systems, which may impact male vaccine uptake.

Methods: …

Dupilumab For Patients With Allergic Fungal Rhinosinusitis, Amber U. Luong, Joshua M. Levy, Sarah K. Wise, Joseph K. Han, Mamoru Yoshikawa, Luo Zhang, Rodney Schlosser, Prerna Ranganathan, Paula Dakin, Jennifer Maloney, George D. Yancopoulos, Andrew P. Fontenot, Neelam A. Phadke, Lacey R. Robinson

Department of Otolaryngology (ENT) Faculty Publications

Background

Allergic fungal rhinosinusitis (AFRS) is a severe subtype of chronic rhinosinusitis characterized by fungal hypersensitivity and accentuated type 2 inflammation. Dupilumab-a fully human monoclonal antibody blocking interleukin-4/13, approved for type 2 inflammatory diseases, including chronic rhinosinusitis with nasal polyps-may benefit patients with AFRS.

Objective

We sought to understand the effect of dupilumab in AFRS

Methods

In this phase 3 trial, patients with AFRS aged ≥6 years were randomized to dupilumab or matched placebo for 52 weeks. The primary end point was Lund-Mackay computed tomography (LMK-CT) score, quantifying sinus opacification, at 52 weeks. Secondary end points were multiplicity-controlled and hierarchically …

The Role Of Physicians In Society: Perspectives From First-Year Mbbs Aspirants, Jesymol Joy, Dr Rashmi S, Amogha Shree, Dr Sunil Kumar D

Digital Journal of Clinical Medicine

Background: Physicians occupy a pivotal role in society as healers and communicators, with ethical leadership embedded in professional practice. In India, this role is evolving in response to changes in healthcare systems, increasing commercialization, and shifting societal expectations. Understanding how medical students perceive the physician’s role at the onset of medical education is vital for early professional identity development.

Objectives: To assess the motivations, perceptions, and values of first-year MBBS students regarding the societal roles, qualities, and responsibilities of physicians.

Methods: A cross-sectional study was conducted among 430 first-year MBBS students at a tertiary medical college in Mysuru, Karnataka, using …

From Controversy To Comeback: The Renewed Role Of Pralidoxime In Op Poisoning, Dr Sanaa Jain, Dr Savitha V, Dr . Shashidhara K C

Digital Journal of Clinical Medicine

Organophosphorus compounds are commonly used as pesticides in agriculture, but they are responsible for approximately one-third of suicide deaths in Asian countries.The symptoms of organophosphate (OP) poisoning vary over time and are categorized into three phases: Acute Cholinergic Crisis (minutes to 24 hours), Delayed Phase (24 hours to 2 weeks), which may include intermediate syndrome, coma, and extrapyramidal symptoms, and Late Phase (OPIDP). Treatment typically involves Atropine, Pralidoxime, and symptomatic management, including airway support and mechanical ventilation.

24-H Circadian Rest-Activity Rhythms And Physical Frailty In Older Adults: A Biopsychosocial Perspective On Sex Differences And Social Capital, Jisu Kim

Theses and Dissertations

Physical frailty is a prevalent geriatric syndrome characterized by age-related decline across multiple physiological systems. Physical frailty is associated with an elevated risk of adverse health outcomes, including chronic disease progression and all-cause mortality, representing a significant and growing public health concern. Disrupted circadian rest-activity rhythms (RARs) are increasingly recognized as clinically meaningful markers of physical frailty in older adults. However, the extent to which biological sex and social determinants of health (SDoH), particularly social capital, contribute to or modify the associations between RARs and physical frailty remains underexplored.

Therefore, this dissertation summarizes the existing literature on age-related changes in …

Assessing Sustainable E-Cigarette Prevention Messaging In Public Health Communication, Addo Anim Adinkrah

Graduate Research Theses & Dissertations

This study examines the sustainability of e-cigarette or vaping prevention messaging on X (formerly Twitter) and the message-design strategies used by public health institutions to maintain message visibility over time. Using the McGuire Communication/Persuasion Model and Media Framing theoretical frameworks, the research employs a qualitative thematic analysis based on Braun and Clarke’s six-phase approach to analyze 506 tweets from official accounts affiliated with the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA). The findings reveal that prevention messages are sustained through repeated core warnings and reinforcement of institutional authority rooted in scientific and …

Surgical Interventions For Treating Vesicovaginal Fistula In Women, Yoshiyuki Okada, Tomomi Matsushita, Takeshi Hasegawa, Hisashi Noma, Erika Ota, Bob Achila, Yasukuni Yoshimura

Obstetrics and Gynaecology, East Africa

Objectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows:

To assess the benefits and harms of surgical interventions for treating vesicovaginal fistula in women.

Food Delivery Services For Enhancing Participation In The Special Supplemental Nutrition Program For Women, Infants, And Children (Wic) In The United States: Bridging The Wic-Eligible Access Gap, Jingjing Gao, Muinat Abolore Idris, Lilian O Ademu, Bryan Colby Griffin, Yue Zhang, Yun Hang, Gabriela A Gallegos

Faculty, Staff and Student Publications

Background: Diet-related health disparities among U.S. children persist despite the availability of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits to eligible women, infants, and children. Participation remains suboptimal: only 51.2% of eligible individuals were enrolled in 2021. Transportation and food-environment constraints pose salient barriers, especially for caregivers of infants in food deserts. Emerging online ordering and delivery options may reduce access frictions, but grocery delivery coverage is limited, and fees are often not covered by benefits.

Methods: We linked USDA Food and Nutrition Service state-level WIC participation data (November 2024 vs. September 2025) with demographic, …

“I Can’T Just Talk It. I Have To Live It”: The Roles, Needs, And Recruitment Of Recovery Home House Managers, I Niles Zoschke, Kathryn R Gallardo, Hannah L N Stewart, Serena A Rodriguez, Danielle Gillespie, Sheryl A Mccurdy, J Michael Wilkerson

Faculty, Staff and Student Publications

Introduction: Recovery homes are an increasingly important recovery support service for people with substance use disorders, yet limited research has examined the roles of house managers or how individuals are recruited into these positions. This study examines how house managers understand and enact their roles, how recovery home operators recruit for these positions, and how the demands and sustainability of the role are perceived in practice.

Methods: We conducted a qualitative thematic analysis of interviews with 29 operators and staff working in 10 Level II and Level III recovery homes across five Texas cities.

Results: Findings indicate that house managers …

Building The Infection Prevention Workforce: Development, Implementation And Evaluation Of Texas Epidemic Public Health Institute Infection Prevention And Control 300 Series, Kayla E Ruch, Janelle Rios

Faculty, Staff and Student Publications

Background: The Texas Epidemic Public Health Institute (TEPHI) was established to strengthen infectious disease preparedness across Texas. The Infection Prevention and Control (IPC) 300 Series represents the third year of a multi-tiered educational initiative designed to provide free, accessible, evidence-based IPC training and continuing education credits for the healthcare workforce.

Methods: Registration and attendance data were collected through Zoom™ and Microsoft Teams™. Knowledge assessments, post-module surveys, and mid- and end-of-series evaluations were administered through QuestionPro™. Module content was informed by guidance from APIC, CDC, CMS, and OSHA. Descriptive statistics and the Kirkpatrick Model of Training Evaluation were used to assess …

Feasibility And Preliminary Outcomes Of A Remotely-Delivered Exercise Training Intervention For English-Speaking Hispanics/Latinos With Multiple Sclerosis: Results From The Ferla Ms Study, Victoria A Flores, Stephanie L Silveira, David X Marquez, Dominique Kinnett-Hopkins, Augusto Miravalle, Fabian Sierra-Morales, Robert W Motl

Faculty, Staff and Student Publications

Background: There is limited evidence on the feasibility of remotely delivered exercise interventions for English-speaking Hispanics/Latinos with MS.

Objectives: To evaluate the feasibility and exploratory efficacy of a remotely-delivered, home-based exercise program for English-speaking Hispanics/Latinos with MS and to explore associations among feasibility metrics, outcomes, and social determinants of health (SDOH).

Results: Of 340 individuals contacted, 112 were eligible (33%), 33 enrolled (9.7%), 30 randomized, and 26 completed (87% retention). Adherence averaged 81% (exercise) and 89% (control). No serious adverse events occurred. Exploratory within-group improvements were observed in the exercise group for physical activity (p = 0.03, d = …

Understanding Practices Of Lactation And Infant Feeding Together With Women With Hiv: The Uplift Observational Study Protocol, Christiana Smith, Emily Anne Barr, Karen Hampanda, Mark Trumbull, Hulin Wu, Jennifer Mckinney, Sarah Buisson, Carly Hoffmann, Ciarra Brown, Angela B Hutchinson, K Rivet Amico, Ifeyinwa V Asiodu, Elizabeth J Mcfarland, Margaret A Lampe, Preetam A Cholli, Olga Varechtchouk, Allahna Esber, Athena P Kourtis, Lisa Abuogi

Faculty, Staff and Student Publications

Introduction: There is a limited understanding of infant feeding decisions, practices, and outcomes for women living with HIV (WLHIV) and their infants since U.S. guidelines were updated in 2023 to support breastfeeding for virally suppressed women on antiretroviral treatment.

Methods and analysis: The Understanding Practices of Lactation and Infant Feeding Together with women with HIV (UPLIFT) study is a convergent mixed-methods, multisite, observational study designed to address key knowledge gaps. Twelve US sites will begin enrollment in early 2026 to accomplish three core activities (CA). In CA1, we explore infant feeding decision-making and experiences via in-depth interviews with pregnant/postpartum WLHIV …