Digital Commons Network^™

The Basis For Recommending The Selection Of Samplers In Determining Occupational Exposures To Aerosols, Martin Harper, Pieter Bertier, Marcus Cattani, Karen Galea, Darrah Sleeth, Steven Verpaele

Research outputs 2022 to 2026

Measurements are considered to be the basis of exposure assessments used to determine risks to workers. Inhalation exposure poses the greatest risk for most airborne chemicals, and measurements are based on collecting (sampling) and analyzing air samples. Samplers have been developed for more than 120 years. Each new design has been intended to address flaws perceived in earlier designs. Users are faced with a varied array of samplers from which to choose. Comparisons are difficult to make because tests of sampler performance were not standardized until recently and have not been applied consistently. The existing large body of work does …

The Best Practice Guide For Early Childhood Education And Care Food Environment: Module 4: Staff And Family Engagement (Version 1.0), Ros Sambell, Audrey Elford, Connie N. Ihlein, Lochie Clark, Amanda Devine, Helen Helen Alexiou, Lennie Barblett, Fiona Champion, Penelope Clark, Kathy Cologon, Wendy Cook, Katie Dix, Kirsty Elliott, Leanne Elliston, Amanda Ferguson, Yuna Ribeiro Ferreira Alves, Ricky Gelman, Jodie Gray, Natalie Gulberti, Lena Harle, Jill Whelan, Karen Krist, Ashton Leach, Deana Leahy, Stacey Mckenzie, Lauren Moore, Merryn Netting, Ciara O’Flaherty, Asha Rojahn, Blake Stewart, Aimee Sullivan, Suzanne Tamone, Henry Tan, Courtney Trezona, Sandra Vale, Kathy Cologon

Research outputs 2022 to 2026

Engaging with families is a core responsibility of ECEC services and staff. By building positive, personal relationships with families, ECEC staff are able to share concerns or queries about the children in their care in a sensitive way.

One of the more sensitive topics that can come up is food – what they are eating, how much they are eating, their eating behaviours and skills, and everything in between. Through quick conversations at drop-off or via formal communication platforms, services can share a range of information about a child’s eating patterns and behaviours, and also gather information from families to …

Pharmacist-Led Educational Intervention To Improve Knowledge, Medication Adherence, And Asthma Control Among Asthma Patients At Ayder Comprehensive Specialized Hospital: A Protocol For Randomized Controlled Trial, Mekuriaw Dereje Tekele, Goitom Belay Kassa, Yainu Welegerima Welekidane, Derbew Fikadu Berhe, Abadi Kahsu Gebre, Afewerki Gebremeskel Tsadik

Research outputs 2022 to 2026

Objective: To evaluate the effect of a pharmacist-led educational intervention on medication knowledge, adherence, and asthma control among adult asthma patients at Ayder Comprehensive Specialized Hospital, Ethiopia.

Methods: A single-blind, parallel-group randomized controlled trial will be conducted. All eligible adult asthma patients on active follow-up at the chest clinic of Ayder Comprehensive Specialized Hospital will be included. Participants will be randomly assigned via a computer-generated sequence to an intervention group (structured pharmacist-led education using teach-back, illustrated pamphlets, a follow-up phone call and SMS) or a control group (routine care). Outcome assessors will be blinded to group allocation. Outcomes will be …

Factors That Impede Women's Contraceptive Care Needs During And Immediately After Incarceration In New South Wales, Australian. Qualitative Perspectives Of Professional Staff Working With Incarcerated Women, Helene Smith, Mandy Wilson, Basil Donovan, Jocelyn Jones, Tony Butler, Paul Simpson

Research outputs 2022 to 2026

Introduction: Women with a history of incarceration report higher rates of pregnancy and abortion, lower contraception use and poorer birth outcomes compared to other women in the community. This suggests family-planning and reproductive-health needs that are not well served by current models of care. Despite this, little is known about how contraception is provided within Australian carceral settings, or the structural barriers experienced by professional staff working in these environments. We report findings from a qualitative study conducted in New South Wales (NSW), Australia, describing professional staff's views of factors that support or impede women's contraceptive care needs both during …

Restricting Outdoor Advertising Of Unhealthy Food: Feasibility Of Using A Nutrition Classification System In Australia, Claire E. Pulker, Frith Klug, Georgina S.A. Trapp, Ainslie Sartori, Michelle Mcintosh, Alexia Bivoltsis, Catrina Mcstay, Clare Whitton

Research outputs 2022 to 2026

Objective: Exposure to food advertising is associated with consumption. Globally, most outdoor food advertisements feature unhealthy foods or beverages. As Australian local government areas (LGAs) begin developing restriction policies, the feasibility of applying nutrient-based Nutrition Classification Systems to outdoor advertising requires evaluation.

Design: Observational study on 1) types of food business advertisements outdoors and 2) availability of quantitative nutrition and/or ingredient information for featured products. 178 outdoor advertisements were analysed, from a 500m audit around schools in 16 stratified LGAs (2019), along with bus shelter audits in four LGAs (2022). Advertisements were categorised as featuring ‘branded packaged products’, ‘food service …

Multi-Omics Integration Reveals Vaccine-Specific Molecular Signatures And Temporal Dynamics Of Covid-19 Immune Responses, Anne H. Klein, David J. Beale, Thao V. Nquyen, Jian-Wei Liu, Petrus Jansen Van Vuren, Nagendrakumar B. Singanallur, Carol Lee, Andrew C. Boomer, Jennifer A. Juno, Stephen J. Kent, Adam K. Wheatley, Gough G. Au, Seshadri S. Vasan, Laurence Wilson, Alexander J. Mcauley

Research outputs 2022 to 2026

Vaccination elicits systemic immune responses that extend beyond antibody and lymphocyte activation, engaging coordinated metabolic and lipid pathways that modulate immune function. Nevertheless, how systemic molecular responses differ across COVID-19 vaccine platforms, including closely related mRNA platforms, remains poorly understood. Here, we performed integrated plasma proteomic, lipidomic, and metabolomic profiling of 53 SARS-CoV-2–naïve adults vaccinated with Pfizer-BioNTech, Moderna, or AstraZeneca COVID-19 vaccines. Samples were analysed across multiple timepoints using differential analysis and DIABLO-based multi-omics integration. Our findings reveal distinct platform-associated multi-omic molecular signatures not captured by unsupervised analyses alone. Pfizer-BioNTech vaccination was associated with widespread increases in immunoglobulin and complement …

Overview Of Aboriginal And Torres Strait Islander Health Status 2025, Australian Indigenous Healthinfonet

Research outputs 2022 to 2026

This Overview provides a summary of the most recent indicators of the health and wellbeing of Aboriginal and Torres Strait Islander people (of all ages, where data are available). The topics included in the Overview cover chronic health conditions which are featured on the HealthInfoNet website. Over the years as additional funding has been obtained and in consultation with HealthInfoNet networks, more topics have been covered on the website and are now included in the Overview. The topics aim to reflect the status of Aboriginal and Torres Strait Islander health over this period and going forward.

Chronic Disease Prevalence And Modifiable Risk Factors Among Undergraduate Students At Ha’Il University: A Population-Level Cross-Sectional Study, Collins Otieno Asweto, Sehar Un Nisa Hassan, Mohamed Ali Alzain, Bandar Alsaif, Mohammed Elshiekh Saeed, Ahmed Kassar, Kamal Elbssir Mohammed Ali, Mouna Ghorbel, Rafat Zrieq, Monzer Hamed, Wei Wang

Research outputs 2022 to 2026

Background: Rising rates of chronic conditions among Saudi youth underscore the need for early prevention. Using a public‑health lens focused on demographic, academic, and lifestyle influences, this study investigates the risk and protective factors for chronic disease among students at the University of Ha’il to guide youth‑centered health policies and long‑term wellbeing initiatives. Methods: A cross-sectional survey was conducted among 10,775 undergraduate students studying in bachelor’s degree programs at Ha’il University, Saudi Arabia. Descriptive analyses were used to assess demographic characteristics, academic status, health status, and health-related lifestyles. Multiple logistic regression models were applied to determine which demographic, academic, and …

Diagnosing The Discourse: How The Academy Of Breastfeeding Medicine Constructs And Constrains Treatment Of Tethered Oral Tissues, Mary E. Miller

Antioch University Dissertations & Theses

While breastfeeding is recognized as fundamental to global public health, oral restrictions that can affect infant latch, milk transfer, and feeding efficiency warrant further examination within policy frameworks. This dissertation proposes an expanded conceptualization of tethered oral tissues (TOTs) that encompasses not only anatomical frenal restrictions but also fascial tensions, neuromuscular limitations, and other conditions restricting orofacial function that may be congenital or acquired. The purpose of this study was to critically examine how this clinical guidance document shapes understandings and responses to TOTs. Using Carol Bacchi’s “What’s the Problem Represented to Be?” approach, a critical discourse analysis of the …

Emotionally Healthy Black Men: Guidelines For Supporting Mental Health Treatment For Black Men In Ohio, Eira Nichell Yates

Antioch University Dissertations & Theses

This study examines the barriers that prevent Black men in Ohio from seeking treatment for depression and other mental health conditions and explores strategies to improve engagement and outcomes. Although depression is the most prevalent mental health disorder in the United States, it remains underdiagnosed and undertreated among Black men, contributing to persistent mental health disparities. The limited body of research addressing help-seeking behaviors within this population necessitated the use of a Delphi methodology to obtain expert consensus on key challenges and promising practices. A panel of subject-matter experts in mental health, social services, and culturally responsive care participated in …

An Evaluation Of Programmatic Assessment Across Health Professions Education Using Contribution Analysis, Janica Jamieson, Claire Palermo, Margaret Hay, Rachel Bacon, Janna Lutze, Simone Gibson

Research outputs 2022 to 2026

Programmatic assessment is gaining traction in health professions education. Despite this popularity, educators continue to grapple with complex contextual factors that impact implementation and outcome attainment. We used contribution analysis, a theory-informed evaluation method, to understand the mechanisms underpinning successful implementation. Applying the six steps of contribution analysis, we developed a postulated theory of change (ToC) and then conducted a qualitative study with programmatic assessment stakeholders (graduates n = 15, supervisors n = 32, faculty n = 19) from four Australian dietetic programs. These data were analysed using the Framework Analysis method and integrated with data derived from a literature …

Contextualizing The Aspe Standards Of Best Practice: Reflecting On The Past, Present, And Future Of Sp Methodology, Amelia M. Wallace, Cory Krebsbach, Janice Radway, Lou Clark

EVMS School of Health Professions Faculty Publications

As we celebrate the publication of the Association of SP Educators Standards of Best Practice (ASPE SOBP) for Physical Exam Teaching Associates (PETAs) and corresponding literature review, we, elected leaders of ASPE, offer reflections on SP methodology history, current practices, and future opportunities. Our aim is to contextualize this addition to what is now the third SOBP publication [1, 2] that guides the global simulation community on best practices of simulated participant (SP) methodology.

Thank you to the ASPE members and SP Educators who made time to share their expertise as authors on these new standards- in addition to their …

Thorium Lung Burdens Of Norm Workers Revisited, Gregory S. Hewson, Martin I. Ralph, Marcus Cattani

Research outputs 2022 to 2026

Historical thorium bioassay data collected from Australian mine workers in the 1990s, including in vivo lung counting and thoron-in-breath (TIB) measurements, were re-evaluated using current dosimetric and biokinetic models. Revised daily thorium intakes from bioassay were compared with previous estimates to assess changes in the dose profile and potential implications for contemporary operations. Reanalysis revealed lower estimates of annual dose, including the number of workers assessed as exceeding 20 mSv. However, it was found that intakes derived from industry personal air sampling (PAS) underestimated intake by up to three-fold. This study determined that sensitive bioassay techniques, such as TIB using …

Forced Oscillation Technique In Pneumothorax (Pneumofot) Study, Niranjan Ananda Setty, Carolyn J. Mcintyre, John Blakey, Yun Chor Gary Lee

Research outputs 2022 to 2026

Forced Oscillation Technique in Pneumothorax (PneumoFOT) study A single-centre prospective pilot feasibility study designed to assess the feasibility of performing FOT measurements in patients with pneumothorax. STATISTICAL ANALYSIS PLAN Version 24.05.2026

On Burden Of Diseases, Prevention, Medical Research And Health Service Delivery: Grampian Case Study, Seshadri S. Vasan, Sudarshan Anand, Miae Lee, Nicholas C. Fluck

Research outputs 2022 to 2026

Burden of diseases measured as disability-adjusted life years (DALYs) per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed to allow insightful comparisons with the national average, and to understand differences in trends between the sexes, age groups, time periods, geographic regions, and sub-regions. In this illustrative case study, we have analysed the Scottish burden of disease database to understand what ailed the population of the Grampian region before the COVID-19 pandemic. We have identified that selected cancers, ischaemic heart disease, Alzheimer’s disease and other dementias …

Exploring Psychological Safety And Workforce Experiences Among Employees In Recovery Community Organizations In The Southern United States: A Qualitative Study, Claire-Lorentz Ugo-Ike

College of Graduate Studies: Theses & Dissertations

This qualitative study explored how employees in Recovery Community Organizations (RCOs) in the Southern United States experience psychological safety and how these experiences shape employee well-being and their intentions to stay or leave their organizations. Guided by Edmondson’s Psychological Safety Theory and the Job Demands-Resources (JD-R) model, the study examined how leadership practices, workplace culture, and the emotional demands of recovery support work shape employees’ perception of safety, support, and sustainability in the workforce. Semi-structured interviews were conducted with 19 RCO employees working in various peer support roles. Thematic analysis identified five major themes: (1) leadership behaviors shape psychological safety …

Understanding The Syphilis Resurgence Among Females Of Childbearing Age: Informing Prevention Efforts In New York State, Salvatore Currenti

Electronic Theses & Dissertations (2024 - present)

Syphilis is caused by Treponema pallidum and transmitted through direct contact with infected mucosal lesions and via vertical transmission during pregnancy (i.e., congenital). Transmission of syphilis to an infant during pregnancy (i.e., congenital syphilis [CS]) can lead to early fetal death, stillbirth, neonatal death, preterm birth, low birthweight, and congenital infection in infants. The United States (U.S.) is experiencing epidemic increases in both females of reproductive age with syphilis and infants with CS. In New York State (NYS), these trends have also occurred, especially after COVID-19 emergence, and increases in reported cases and incidence rates are comparable to national statistics. …

Neighborhood Socioeconomic Deprivation And Physical Activity Associate With Extracellular Vesicle Size And Cargo In A Community-Based Cohort Of Women, Yvonne Baumer, Elizabeth M. Aquino Peterson, Matthew R. Bavuso, Noel Miller, Cristhian A. Gutierrez-Huerta, Nithya P. Vijayakumar, Sam J. Neally, Kaveri Curlin, Valerie M. Mitchell, Billy S. Collins, Neelam R. Redekar, Subrata Paul, Anca D. Dobrian, Tiffany M. Powell-Wiley

Department of Biomedical and Translational Sciences Faculty Publications

African American (AA) women face disproportionate cardiovascular disease (CVD) risk due to adverse social determinants of health (SDoH), including lower socioeconomic status (SES). Physical activity (PA) and plasma extracellular vesicles (EVs) modulate CVD risk, but their relationships with SDoH remain unclear. This study examines associations between SDoH, PA, and plasma EVs in a Washington, DC-based cohort of at-risk AA women. Participants (N = 24, Age: 57 ± 12, BMI: 35 ± 6, ASCVD: 9 ± 5) joined the Step It Up Community-Engaged, Digital Health Physical Activity Intervention pilot study. EVs were isolated from fasting plasma samples. Multivariable regression, adjusted for …

Evolving Trends In Organ Donation, Recovery, And Utilization In The United States: A Decade Of Change And The Impact Of Covid-19, Nirmay H. Rokad, Ohm Tripathi

UROP Posters

Evolving Trends in Organ Donation, Recovery, and Utilization in the United States: A Decade of Change and the Impact of COVID-19 Background: Over the past decade, organ donation and transplantation in the U.S. have undergone substantial changes, influenced by evolving donor practices and the COVID-19 pandemic. We examined national trends in donor types, organ recovery, utilization, and discard rates between 2012 and 2023. Methods: We analyzed SRTR/OPTN registry from 2012–2023, including total deaths, DBD (donation after brain death); DCD( donation after circulatory death); NRP (normothermic regional perfusion), organ authorization, recovery, transplantation, and discard rates. Pre-COVID (2016–2019) was compared with post-COVID …

Proof-Of-Concept Development And Preclinical Evaluation Of A Microarray Patch Platform For Codelivery Of Multiple Broadly Neutralizing Antibodies For Hiv Prevention, M. Melissa Peet, Vivek Agrahari, Parbeen Singh, Lam Luong Hoai Nguyen, Louise A. Ouattara, Eun Sung Yang, Carolina Herrera, Amarendra Pegu, Theodore C. Pierson, Thanh D. Nguyen, Gustavo F. Doncel

CONRAD Publications

Broadly neutralizing antibodies (bnAbs) are advancing as a preventative or treatment option for HIV infection, but currently must be administered parenterally, typically as a large injection or infusion, an invasive method of delivery, especially for the pediatric population. Here, we present proof-of-concept data on a minimally invasive microneedle (MN) patch platform codelivering three bnAbs, PGT121, VRC07-523LS, and PGDM1400LS, from separate MN patch units or pixels. Each 1 cm² patch pixel, fabricated via solvent casting, contained ∼2 mg of one bnAb. In ex vivo porcine skin tests, the MNs effectively penetrated the skin. When tested in vitro in PBS buffer, MNs …

Proof-Of-Concept Development And Preclinical Evaluation Of A Microarray Patch Platform For Codelivery Of Multiple Broadly Neutralizing Antibodies For Hiv Prevention, M. Melissa Peet, Vivek Agrahari, Parbeen Singh, Lam Luong Hoai Nguyen, Louise A. Ouattara, Eun Sung Yang, Carolina Herrera, Amarendra Pegu, Theodore C. Pierson, Thanh D. Nguyen, Gustavo F. Doncel

CONRAD Publications

Broadly neutralizing antibodies (bnAbs) are advancing as a preventative or treatment option for HIV infection, but currently must be administered parenterally, typically as a large injection or infusion, an invasive method of delivery, especially for the pediatric population. Here, we present proof-of-concept data on a minimally invasive microneedle (MN) patch platform codelivering three bnAbs, PGT121, VRC07-523LS, and PGDM1400LS, from separate MN patch units or pixels. Each 1 cm² patch pixel, fabricated via solvent casting, contained similar to 2 mg of one bnAb. In ex vivo porcine skin tests, the MNs effectively penetrated the skin. When tested in vitro in PBS …

Antiviral Activity And Mucosal Safety Of Novel Human-Milk-Inspired Antimicrobial Peptides, Nazita Yousefieh, Louise A. Ouattara, Maimoona Bhutta, Ishita M. Shah, Carolina Herrera, Gustavo F. Doncel

CONRAD Publications

Background: Sexually transmitted infections (STIs) remain a major global health concern, with over one million new curable cases reported daily and limited long-term treatment options. Additionally, there are limited treatment options for women with bacterial vaginosis (BV), a dysbiotic condition predisposing them to STIs. Computationally designed human-milk-inspired antimicrobial peptides (AMPs) are promising candidates for novel antiviral and antibacterial therapies. This study evaluated the cervicovaginal mucosal safety and antiviral activity of three human-milk-inspired AMPs (MAT-006, UCD-MAT-001, and UCD-MAT-002) previously shown to exhibit antimicrobial activity against BV-causing pathogens. Methods: AMP cytotoxicity and inflammatory responses were assessed in relevant genital tract cell lines …

Predicting Oral Hiv Pre-Exposure Prophylaxis Efficacy In Cisgender Women Across Pregnancy And Postpartum, Yifan Yu, Kristina M. Brooks, Gustavo F. Doncel, Brookie M. Best, Mark A. Marzinke, Mark Mirochnick, Peter L. Anderson, Landon Myer, Connie Celum, Renee Heffron, Jenell Coleman, Dvora L. Joseph Davey, Lanxin Zhang, Max Von Kleist, Craig W. Hendrix, Jeremiah D. Momper, Robert Bies, Rachel K. Scott

CONRAD Publications

Cisgender women face an increased risk of HIV acquisition during pregnancy and postpartum. Oral pre-exposure prophylaxis (PrEP) with emtricitabine and tenofovir disoproxil fumarate (F/TDF) is recommended in pregnancy despite limited published pharmacokinetic (PK) and efficacy data during pregnancy. Altered PK during pregnancy may reduce prophylactic efficacy and necessitate higher adherence. Tenofovir alafenamide (TAF) is a newer tenofovir prodrug with higher tenofovir diphosphate (TFV-DP) exposure in peripheral blood mononuclear cells (PBMCs), but the prophylactic efficacy of F/TAF across different reproductive stages in women is understudied. We adapted a multiscale modeling framework to predict the prophylactic efficacy of F/TDF and F/TAF across …

Comparison Of Push-Pull Air Curtain To Overhead Downdraft Systems On Aerosol Containment And Distribution In Controlled Environments, Manal Mutairi

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Comparison of Push-Pull Air Curtain to Overhead Downdraft Systems on Aerosol Containment and Distribution in Controlled Environments.

This dissertation looks at the ongoing issue of tiny airborne particles created during medical and dental procedures and evaluates ways to reduce the risk of exposure for healthcare workers and patients to these particles. The first study focuses on the size, how long particles stay in the air, and how far they travel from common medical procedures that create aerosols, showing that tiny particles (less than 5 µm) can stay in the air long enough to escape basic droplet controls. As a …

Increasing Documentation Of Endotracheal Tube Cuff Pressures: A Quality Improvement Initiative For Flight Crew Providers, Matthew D. Noss

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: There was a lack of documentation of endotracheal tube (ETT) cuff pressures (CPs) by flight crew providers at Base 1 of HealthNet Aeromedical Services. A three-month pre-intervention data collection showed 1.8% of patients had initial CPs documented. Inadequate documentation and monitoring of ETT CPs can lead to patient complications such as tracheal injury and aspiration making this an important area for quality improvement.

Purpose: To increase documentation of ETT CPs through education and evidence-based interventions.

Intervention: This project implemented an educational in-service on ETT cuff syringe manometry for flight crew providers. The educational intervention consisted of …

The Dual-Factor Model (Dfm) Of Mental Among Appalachian Youth, Mawyah Adel Bashatah

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background. Adolescent mental health is a critical public health concern, particularly in rural Appalachian communities where rates of depression, anxiety, and substance use exceed national averages and access to mental health resources remain severely limited. Traditional mental health frameworks rely predominantly on the identification and reduction of psychopathological symptoms, neglecting the independent contributions of positive well-being to adolescent risk and resilience. The Dual-Factor Model (DFM) of mental health offers a more comprehensive alternative by simultaneously assessing subjective well-being (SWB) and psychopathology, classifying individuals into four distinct groups: Complete mental health, Vulnerable, Symptomatic but content, and Troubled. Despite the DFM’s growing …

Spatial Analyses Using Emergency Medical Services Data To Inform Healthcare., Jeffrey Alan Pesarsick

Graduate Theses, Dissertations, and Problem Reports (ETD)

Spatial analyses using Emergency Medical Services data to inform healthcare.

Jeffrey Pesarsick

Background

Emergency Medical Services (EMS) often serve as the initial entry point for patients into the healthcare system in the United States.  Rural health disparities, geographic isolation, socioeconomic disadvantages, and operational challenges create disparities in access to EMS services.  Disparities include prolonged response times, less resources available, and inequities in levels of care available.  The overall goal of these series of projects was to quantify the extent to which operational challenges in EMS data impact health, and how EMS data could be used to identify neighborhood level trends …

Microplastics Suppress Copepod Grazing Of The Harmful Algal Bloom-Forming Dinoflagellate, Alexandrium Catenella, Megan Ladds, Christopher Gobler

OES Faculty Publications

While harmful algal blooms (HABs) are prominent occurrences in coastal zones where microplastic concentrations are maximal, the manner in which microplastics may influence food webs and HABs is poorly understood. This study explored how polystyrene microplastics affected copepod grazing of the saxitoxin-synthesizing harmful dinoflagellate, Alexandrium catenella, as well as a non-toxic dinoflagellate, Gymnodinium aureolum. Experiments were performed using multiple densities of microplastics (250 – 10,000 mL^–¹) of differing sizes (4 and 10 µm), as well as multiple densities of microalgae in microplates. The addition of 10 µm microplastics at densities of 1000 – 10,000 beads mL^{– …}

Advancing Interoperability Through Governance And Sustainability: A Qualitative Comparative Case Study Of State Health Information Exchanges In The United States, Karterria Finkley

College of Graduate Studies: Theses & Dissertations

This study presents a comprehensive comparative analysis of state-level Health Information Exchanges (HIEs) across all 50 U.S. states and the District of Columbia, examining how governance structures, consent frameworks, funding models, and technical infrastructure influence interoperability maturity, sustainability, and adoption. Guided by Systems Theory and Donabedian’s Structure Process Outcome framework, the research employs a mixed-methods comparative case design integrating systematic documentary review, qualitative thematic analysis, and a policy-anchored analytic scoring methodology. Structural and policy characteristics were operationalized through standardized ordinal (1-5) metrics and aggregated into composite indices representing governance capacity, consent inclusivity, financial sustainability, and technical readiness. This approach enabled …

Assessing And Advancing Pandemic Emergency Preparedness In New York City's Hospitals: A Strategic Management Toolkit Integrating Policy Analysis, Risk Assessment, And Stakeholder Insight, Irrem Jamal

College of Graduate Studies: Theses & Dissertations

This dissertation examines pandemic emergency preparedness in New York City hospitals, which were severely strained during COVID-19, revealing critical gaps between documented plans and operational readiness. Using a multimethod approach combining a survey of 20 stakeholders across city hospitals, semi-structured interviews, and document analysis of policy frameworks and after-action reports, the study identifies a persistent "documentation-execution paradox": while 80% of respondents confirmed clear pandemic plans, only 45% expressed confidence in staffing adequacy, 55% in surge planning realism, and just 45% confirmed regular drills. Qualitative analysis revealed workforce as the single greatest yet most underinvested vulnerability, supply chain fragility rooted in …