Digital Commons Network^™

Qualitative Evaluation Of The Seated Physical Activity Intervention (Spin) Randomized Controlled Trial For Wheelchair Users With Multiple Sclerosis (Ms): Formative Feedback And Future Directions, Angela J Piasecki, Robert W Motl, Katherine Froehlich-Grobe, Stephanie L Silveira

Faculty, Staff and Student Publications

Background/objectives: Wheelchair users with multiple sclerosis (MS) often face barriers that restrict participation in physical activity and exercise training. This manuscript reports on participant feedback to guide evaluating and refining a novel exercise training program, Seated Physical activity INtervention (SPIN). SPIN was adapted from the Guidelines for Exercise in MS (GEMS) approach using a three-step community-engaged research framework based on meeting the needs of wheelchair users with MS.

Methods: Semi-structured interviews were conducted with 9 participants who completed the 16-week SPIN intervention. The key SPIN intervention components were the exercise prescription, exercise equipment, and behavioral coaching grounded in Social Cognitive …

Bone Marrow Adiposity, Obesity, And Tumor Burden In Newly Diagnosed Multiple Myeloma, Ananya Deshpande

ETDs from 2020-2029

Multiple Myeloma (MM) is the second most common hematologic malignancy in the United States. It is characterized by the accumulation of clonally expanded plasma cells in the bone marrow, which leads to end organ damage and myeloma-defining events requiring treatment. The only modifiable risk factor for MM is obesity. However, associations between obesity, bone marrow adipocytes, and tumor burden at MM diagnosis remain unclear. We evaluated associations of bone marrow adipocytes, body mass index (BMI), and clinical features of tumor burden among 168 patients with histologically confirmed newly diagnosed multiple myeloma (NDMM) enrolled in the Integrative Molecular and Genetic Epidemiology …

Evaluating The Service Life Of A Respirator Cartridge When Exposed To Various Volatile Organic Compounds, Neha Murad Alwani

ETDs from 2020-2029

Inhalation is the most common exposure pathway. With the significant presence of respiratory exposure, respirator cartridges are widely used as personal protective equipment (PPE) to reduce exposure to gases, vapors, and volatile organic compounds (VOCs). This study evaluated the breakthrough time of respirator cartridges under various VOC environments commonly encountered in beauty salons and automotive repair shops. Breakthrough time is the duration a respirator cartridge can provide protection before contaminants can be inhaled and the respirator cartridge is no longer effective. The breakthrough time of three VOCs was examined: acetone, toluene, and m-xylene. Using a custom designed test chamber equipped …

Parental Perspectives On Their Children’S Mental Health Changes During And After The Covid-19 Pandemic In A Florida Community, Brianna Yumul

Walden Dissertations and Doctoral Studies

No abstract provided.

Hiv Preexposure Prophylaxis (Prep) Satisfaction Amongst Female Sex Workers And Men Who Have Sex With Men In Cameroon, Zacheaus Zeh Akiy

Walden Dissertations and Doctoral Studies

No abstract provided.

From Scenario To Safety: Simulation As A Catalyst For Infection Prevention, Brianne M. Bachman, Jennifer E. Jones, Jessica L. Mcclusky, Mallory Davis

Posters

Simulation-based education has emerged as a transformative tool in healthcare, bridging the gap between theoretical knowledge and clinical practice.

In the realm of infection prevention, simulation offers a controlled, risk-free environment to reinforce essential protocols, build competency, and identify system level vulnerabilities before harm occurs.

Proactive Strategies For Catheter-Associated Urinary Tract Infection (Cauti) Reduction: Leveraging Audit Tools And Interdisciplinary Collaboration, Mica Blauw

Posters

Catheter-associated urinary tract infections (CAUTIs) are a known cause of harm to patients. Policies enforcing infection prevention measures may help minimize the risk of harm to patients, but written policies do not always translate to bedside practice. We implemented a proactive daily audit to increase awareness of, and compliance with, CAUTI prevention tactics.

Using Social Return On Investment To Evaluate Services That Support The Health Of People Experiencing Homelessness In Australia: A Scoping Review, Cate Mckenna, Christopher Rouen, Mary O'Loughlin

Research outputs 2022 to 2026

The increasing demand for homelessness services in Australia highlights the need for robust evaluation methodologies to assess their social impact. Traditional economic evaluation methods often struggle to capture the intangible social and health outcomes associated with homelessness. Social return on investment (SROI), an outcomes-based framework driven by stakeholders, offers a flexible and comprehensive approach to measuring social, economic and environmental impacts. This scoping review examines the application of SROI in evaluating services that support the health of people experiencing or at risk of homelessness in Australia. A total of 25 reports from grey literature (2010-2023) were reviewed. The findings reveal …

Testing Potential Correlations Between Childhood Lead Exposure And Authoritarianism In Adulthood, Kragen Anderson

University Honors Theses

A significant body of research links lead exposure during childhood to negative effects ranging from increased impulsivity to societal level effects such as an increased likelihood of committing violent crime in adulthood. Due to exposure vectors such as lead water pipes, lead solder, lead based paints, and leaded gasoline there was significant lead exposure during childhood for large portions of the American population. This paper tested and found a statistically significant association between average population level lead exposure in childhood and likelihood of voting for candidate Trump later in life.

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

When School Culture Excludes: Deficit Discourse, Microaggressions, And The Mental Health Of Marginalized Students – A Conceptual Framework With Implications For School Psychology Practice And Equity Policy, Modupe Mercy Oyewunmi

Publications

Deficit-laden language like ‘behavior problem,’ ‘not college material,’ ‘won’t fit in’, ‘not a cultural fit’, operates as a systemic form of implicit bias and microaggression in school settings. Despite decades of research on school belonging and well-being, school psychology has yet to integrate these exclusionary discursive practices into a coherent health-determinant model that also accounts for the current anti-diversity, equity, and inclusion (DEI) policy environment. This conceptual paper proposes a testable framework linking deficit discourse and school-based microaggressions to student identity suppression, academic impostor phenomenon, and educator moral injury, with downstream effects on school mental health outcomes. We situate these …

Publisher Correction: Whole Genome Sequence Analysis Of Pulmonary Function And Copd In 44,287 Multi-Ancestry Participants, Wonji Kim, Xiaowei Hu, Kangjin Kim, Sung Chun, Peter Orchard, Dandi Qiao, Ingo Ruczinski, Aabida Saferali, Francois Aguet, Lucinda Antonacci-Fulton, Pallavi P Balte, Traci M Bartz, Wardatul Jannat Anamika, Xiaobo Zhou, Junyi Duan, Jennifer A Brody, Brian E Cade, Martha L Daviglus, Harshavadran Doddapaneni, Shannon Dugan-Perez, Susan K Dutcher, Christian D Frazar, Stacey B Gabriel, Sina A Gharib, Namrata Gupta, Brian D Hobbs, Silva Kasela, Laura R Loehr, Ginger A Metcalf, Donna M Muzny, Elizabeth C Oelsner, Laura J Rasmussen-Torvik, Colleen M Sitlani, Joshua Smith, Tamar Sofer, Hanfei Xu, Bing Yu, David Zhang, John Ziniti, R Graham Barr, April P Carson, Myriam Fornage, Lifang Hou, Ravi Kalhan, Robert Kaplan, Tuuli Lappalainen, Stephanie J London, Alanna C Morrison, George T O'Connor, Bruce M Psaty, Laura M Raffield, Susan Redline, Stephen S Rich, Jerome I Rotter, Edwin K Silverman, Ani Manichaikul, Michael H Cho

Faculty, Staff and Student Publications

This corrects the article "Whole genome sequence analysis of pulmonary function and COPD in 44,287 multi-ancestry participants", 28.

Assessing Indoor Heat Vulnerability And Cooling Strategies In Three Mobile Home Communities In Boulder, Colorado, Usa, Mehdi P. Heris, Skye Niles, Alana Wilson, Megan Mccurdy, Amy Lacourse, Nick Lankau

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Extreme heat is an increasing public health and environmental threat shaped by both physical and social factors. This study assesses the vulnerability of mobile homes and their residents at three mobile home parks in Boulder, Colorado. We examined indoor temperature, housing conditions, and social and personal risk factors of the households. We monitored indoor and outdoor temperatures using 27 indoor and 5 outdoor temperature data loggers, comparing mobile homes with air conditioning, swamp coolers, and passive cooling designs. This work provides a detailed analysis of indoor temperature patterns and demonstrates how evaluating trends yields insights into the performance and effectiveness …

Auricular Point Acupressure Self-Management (Apa-Sm) Program For Chronic Musculoskeletal Pain Among Rural Populations: A Protocol For A Pragmatic, Randomized Controlled Trial, Jennifer Kawi, Jane Bolin, Hulin Wu, Jungkyung Min, Rupsikha Bora, Sarah Pace, Idara N Akpan, Alee Lockman, Tonychris Nnaka

Faculty, Staff and Student Publications

Introduction: Chronic musculoskeletal pain (CMP) is a leading cause of incurred personal healthcare costs and disability in the USA. It disproportionately affects rural populations, who are more likely to be uninsured, lack access to a regular healthcare provider and experience a higher prevalence of CMP. As a result of reduced access to non-pharmacological care, there is greater reliance on opioids. The Auricular Point Acupressure - Self-Management (APA-SM) program is a simple, needleless, evidence-based therapy that empowers individuals to self-manage their pain. Preliminary studies, including a recent UG3 pilot testing, demonstrated feasibility, safety and significant improvements in pain and function. Guided …

Multidomain Expert Evaluation Of Leading Large Language Models As Providers Of Vaccination And Preventive Medicine Information, Marcello Di Pumpo, Leonardo Villani, Vittorio Maio, Maria Rosaria Gualano, Eleonora Marziali, Lucia De Maio, Rossella Mancini, Stefania Boccia, Walter Ricciardi, Patrizia Laurenti

College of Population Health Faculty Papers

OBJECTIVES: Vaccination is one of the most effective public health interventions. Large language models (LLMs) show great capability for providing health information. This study compared the performance of ChatGPT 3.5 (G3E), ChatGPT 4o in English (G4E), Claude 3.0 (CDE), Gemini 1.5 (GME), and ChatGPT 4o in Italian (G4I) in delivering information on vaccination and preventive medicine.

STUDY DESIGN: Mixed-method analysis evaluating large language models.

METHODS: Twenty-six expert-designed healthcare scenarios were used to evaluate each model through an adapted DISCERN-based instrument. Four experts independently rated outputs across six domains: Information Reliability, Information Quality, Medical Appropriateness, Impact on Vaccine Hesitancy, Potential for …

Extraction Of Key Themes In Online Health Discourse Using Unsupervised Learning And Large Language Models, Miranda G. Scully

Computer Science Senior Theses

Health online discussion boards are a modern platform that allow patients to interact with each other and the healthcare system as a whole, making them valuable sources of information for clinicians seeking to better anticipate treatment experiences and barriers. This study focuses on one such community, r/suboxone, a subreddit where patients using Suboxone share their experiences and ask questions. Our analysis is motivated by previous work that proposes event-based classification systems for such posts which buckets posts from r/suboxone into one or more of five high-level labels (Access Logistics, Co-Occurring Drug Usage, Medication for Opioid Use Disorder Administration, Psychophysical Effects, …

Bullying, Early Sexual Debut, And Sexual Health Behaviors Among Adolescents In New York City, Valentina I. Ramirez

Dissertations and Theses

Adolescent sexual and reproductive health remains a critical public health priority in the United States, particularly given the persistent burden of HIV and sexually transmitted infections (STIs) among young people. Adolescents and young adults account for a disproportionate share of STI cases, reflecting ongoing gaps in prevention, early detection, treatment, and equitable access to sexual health care and services. These patterns are shaped not only by individual behaviors but also by broader social, structural, and developmental contexts that influence adolescents’ opportunities to engage in preventive sexual health care.

This dissertation examined associations between early sexual debut, experiences of bullying, and …

Epstein–Barr Virus Common And Rare Complications In Iraq: Review Paper, Ameer Mohammed Kadhim, M. Jafar Zainaldeen, Zainab Haider Abdulmajeed

Maaen Journal for Medical Sciences

Background: Epstein–Barr Virus (EBV) is a highly ubiquitous herpesvirus found globally, it is associated to both a wide range of condition including common, pervasive infections and severe, rare diseases. In Iraq, despite a significant increased incident of chronic illnesses and viral- related malignancies, the local overview of EBV-associated complications remains fragmented. Aim: This review synthesizes the current available Iraqi literature to delineate the dual nature of EBV’s impact, distinguishing between common epidemiological manifestations and its role in severe clinical complications in local cohorts. Key Findings: high seroprevalence (~80%) of EBV in healthy Iraqi population, with noteworthy association observed in autoimmune …

A Predictive Coding Account Of Spatial Working Memory Following Prophylactic Levetiracetam Administration Prior To Traumatic Brain Injury, Omeima Mutwali

Dissertations, Theses, and Capstone Projects

Traumatic brain injury (TBI) symptom prevention and remediation is an important area of research that would benefit vulnerable groups, including active-duty and veteran soldiers. These patients can sustain penetrative forces in fields of combat or in training, which result in focal lesions that trigger inflammatory and degenerative processes in the brain. Both primary and secondary injuries are associated with changes to cognition, behavior and affective state. This disease poses increased risk of epileptogenesis, as well. Given these outcomes, prior research has evaluated levetiracetam (LEV) as a prophylactic treatment for seizures, cognitive deficits and negative emotionality. LEV acts as a presynaptic …

Reflections And Revisionism: Rethinking The U.S. Response To Covid-19, Wendy E. Parmet

Michigan Law Review

A review of In Covid’s Wake: How Our Politics Failed Us. By Stephen Macedo and Frances Lee.

Socioeconomic Inequalities In Health-Related Quality Of Life During The Covid-19 Pandemic: A Six-Country Comparison Using The Eq-5d-5 L, Joëlle Eijkens, Joshua M. Bonsel, You-Shan Feng, M. F. Bas Janssen, Erica I. Lubetkin, Juanita A. Haagsma

Publications and Research

Purpose

Despite the growing attention to health inequalities, there is no global consensus on how to measure socio-economic status. This study examined inequalities in health-related quality of life (HRQoL) during the early phase of the COVID-19 pandemic across six countries—China, Italy, the Netherlands, Sweden, the United Kingdom (UK), and the United States (US)—using three SES indicators: education level, income, and work status.

Methods

Between April and June 2020, individuals aged 18–75 years old completed a web-based survey. HRQoL was measured using the EQ-5D-5L Level Sum Score (LSS), where higher scores indicate poorer health. Country-specific differences in LSS across SES groups …

Family Planning Exemplar Country Selection Methodology: Time Lag And Trends Analysis, Zahid Memon, Abeer Mian, Ira Martopullo, Narjis Hussain, Zeba Sathar, Ali Mohammad Mir, Michael Mbizvo, Marleen Temmerman, Jen Drake, Zulfiqar Bhutta

Centre of Excellence in Women and Child Health

Introduction While many countries achieved notable gains in contraceptive use levels after the 1994 International Conference on Population and Development which redefined family planning (FP) as a human right, there was a long period of 15 years when contraceptive use levels did not receive due attention. It was only later that its subsequent inclusion in the Sustainable Development Goals and the 2012 London Summit on FP renewed global commitment and a focus towards FP. This paper aims to select countries that identify as ‘exemplar’ low-middle-income countries that have achieved exceptional progress in FP. Examining these outliers can uncover actionable drivers …

The Impact Of Economic Stability On Diagnostic Timing Of Autism Spectrum Disorder In Children, Leslie Box Simms

ETDs from 2020-2029

Diagnosis of neurodevelopmental delays in children, including autism spectrum disorder, is an often lengthy and burdensome process, potentially placing children with economic instability at risk for diagnostic delay. The first aim of this dissertation was to explore the impact of economic stability on diagnostic timing of autism spectrum disorder via a scoping review of the literature. Papers were summarized by study design, data sourcing, handling of variables, statistical methodology, and the effect of economic stability factors on diagnostic timing of autism. Income and healthcare insurance were the most frequently employed measures of economic stability, with transportation, housing, and food security …

Exploring Racial And Ethnic Diversity Trajectories And Diabetes Prevalence In The United States, Jiue-An Yang, Calvin P Tribby, Anna Dmowska, Qian Xiao, Marta M Jankowska

Faculty, Staff and Student Publications

This study investigates whether long-term changes in neighborhood racial and ethnic diversity are associated with adult diabetes prevalence across the contiguous United States. We calculated diversity indexes for US census tracts (n = 72,033) using decennial census data from 1990 to 2020. Five diversity trajectory clusters were identified using K-means clustering. Diabetes prevalence in 2019 was obtained from the CDC's PLACES dataset. Linear mixed models (LMMs) assessed global associations between diversity trajectories and diabetes prevalence, adjusting for age, sex, poverty, marital status, and public insurance. Geographically weighted regression (GWR) examined local variations in these associations. Compared to the reference group …

Trust In Cancer Information Sources And Awareness Of Human Papillomavirus As A Cause Of Cervical Cancer Among Us Adults, Olajumoke Ope Oladoyin, Paula Cuccaro, Lara S Savas, Robert Yu, Joel Fokom Domgue, Sheryl Mccurdy, Sanjay Shete

Faculty, Staff and Student Publications

Importance: Religiosity, trust in physicians, and trust in government health agencies influence individual decision-making and behavior toward public health programs. However, trust in information about cancer from these sources and their association with public awareness of human papillomavirus (HPV) as a cause of cervical cancer remain understudied.

Objective: To assess the association of trust in cancer information sources with awareness that HPV causes cervical cancer among US adults.

Design, setting, and participants: This cross-sectional study used the nationally representative 2022 Health Information National Trends Survey (HINTS) data on noninstitutionalized US adults aged 18 years or older collected between March 7 …

Association Of Insulin Resistance And Fracture Risk In The Osteoporotic Fractures In Men (Mros) Cohort, Jeonghoon Ha, Li-Yung Lui, Kristine Ensrud, Qian Xiao, Andrew R Hoffman, Joy Y Wu

Faculty, Staff and Student Publications

Context: Insulin resistance (IR) is more prevalent in men than in women, but evidence directly linking IR to fracture risk in older men remains limited.

Objective: To evaluate the association between insulin resistance (IR), estimated using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and the triglyceride-glucose (TyG) index, and fracture risk in older men.

Methods: Data from 5994 men (≥65 years) in the MrOS cohort were analyzed. A total of 5416 participants were included in the HOMA-IR analysis and 5384 in the TyG index analysis. Fractures were self-reported and confirmed radiographically. Participants were grouped into quartiles based on IR …

The Life Study: A Cross-Sectional Study Protocol For Lifestyle Risk Factors For Chronic Disease Across The Stages Of Reproductive Ageing, Laura E. Pernoud, Jamie L. Noll, Paul A. Gardiner, Melinda Dean, Kathryn M. Broadhouse, Meegan Anne Walker, Hattie H. Wright, Anthony Villani, Joseph Scott, Alexandra P. Metse, Mia A. Schaumberg

Research outputs 2022 to 2026

Introduction: The dynamic physiological and hormonal changes through the menopause transition predispose women to an increased risk of chronic diseases including cardiovascular disease, metabolic disease, depression and dementia. The underlying mechanisms remain unclear, yet it is thought that chronic systemic inflammation and changes to lifestyle behaviours play important roles. The LIfestyle risk Factors for chronic disease across the stagEs of reproductive ageing (LIFE study) is a cross-sectional study aimed to characterise how hormonal and lifestyle (physical activity, diet and sleep) differences across pre, peri and postmenopause influence chronic systemic inflammation, visceral adiposity, cognitive function and sleep health. Methods and analysis: …

Moving Beyond Traditional Cost Containment For Glp-1 Coverage Within Oregon's Proposed Universal Health Plan, Manoj Rajesh

University Honors Theses

In 2022, Oregon voters passed Measure 111, constitutionally mandating access to affordable health care. As the Universal Health Plan Governance Board (UHPGB) designs the state's proposed single-payer system, it faces an unprecedented financial vulnerability: the clinical demand for GLP-1 receptor agonists. These high-cost, indefinite-use medications for obesity and metabolic syndrome threaten to overwhelm fixed public budgets. Historically, both the Oregon Health Plan's Medicaid framework and commercial private insurers have relied on static cost-containment models—categorical exclusions, step therapy, and aggressive utilization management—that achieve short-term fiscal solvency at the expense of comprehensive preventative care. This thesis argues that to fulfill the mandate …

Enhancing Emergency Department Preparedness For Amniotic Fluid Embolism Through Evidence-Based Simulation Training, Olivia M. Smoak

Doctor of Nursing Practice Final Manuscripts

Maternal mortality in the United States remains a significant and worsening public health concern, with increasing reliance on emergency departments (EDs) as access points for maternal care. Emergency clinicians are therefore more likely to encounter high-acuity obstetric emergencies, including maternal cardiac arrest and amniotic fluid embolism (AFE), yet often receive limited formal training in these conditions. Simulation-based education, interdisciplinary training, and cognitive aids have been identified as effective strategies to improve performance in high-risk, low-frequency events.

The purpose of the evidence-based practice project was to evaluate whether an interdisciplinary simulation with obstetric-led debrief and introduction of the AFE checklist improves …

The Effects Of Osha State Plans And State Gdp On Occupational Injuries And Illnesses In The United States, Ahmad Abdel Rahman Mohammad Amoorah

Theses

Workplace safety in the United States is governed by a system in which some states operate under federal OSHA oversight, while others administer their own OSHA-approved safety and health plans. This duality raises questions about whether state-level control leads to variation in safety and health outcomes. Economic conditions have also been shown to influence workplace injury rates, yet the interaction between safety and health regulations and local economies remains underexplored. Understanding these relationships is critical to protecting workers in occupational settings. The effects of OSHA state-plan status and state-level economic activity on occupational injury and illness rates across the United …