Digital Commons Network^™

Perceptions Of The Effects Of Launch Control Center Environmental Exposures And Alert Schedules Among Missile Operations Officers: A Mixed Methods Phenomenological Study, Dawnie Rae Ramie

Doctoral Dissertations and Projects

This mixed methods hermeneutic phenomenological study focused on an investigation of the perceptions of missile operations alert duty and the effects on health and sleep hygiene among Air Force missile operations officers. Questionnaires, interviews, and surveys were all used to gather data on subjects’ experiences and perspectives, including methods to mitigate the effects of poor sleep. Driving questions of research included how missile alert schedules affect sleep habits, as well as how missileers perceived alert duties may impact their health. Data was collected through a web-based Qualtrics Likert questionnaire (N=139), open-ended interviews with purposively selected subjects (N=17), and web-based Qualtrics …

Inadequate Access To Healthcare In Low-Income Hispanic Communities In Brooklyn, Joanna Marie Garcia

Doctoral Dissertations and Projects

The purpose of this qualitative research was to understand healthcare disparities using the Solar and Irwin conceptual framework and to shed light on healthcare disparities as the reason low-income Hispanic patients, male and female, from the ages of 20-90 in Brooklyn, New York, received inadequate access to healthcare. Healthcare disparities represented a critical issue in providing adequate patient care for adult Hispanic patients within the United States healthcare system. Research into healthcare disparities has been conducted; however, detailed information about the causes of the disparities was lacking, especially concerning inadequate access to healthcare in low-income Hispanic communities. This qualitative research …

Factors Associated With Vaping Frequency Among University Students, Oluwatosin Marylyn Oduneye

Masters Theses

Electronic cigarette use among university students is a growing public health concern, with approximately 20-25% reporting current use. Despite extensive research on vaping initiation, factors associated with vaping frequency among established users remain understudied. This study examined stress-coping mechanisms, peer influence, and health risk perceptions as predictors of vaping frequency, guided by Bandura's Social Cognitive Theory (SCT). A quantitative cross-sectional survey was administered via Microsoft Forms to 399 university students aged 21-25 with recent vaping experience, recruited nationally through campus flyers and online platforms. Multiple linear regression was conducted in SAS OnDemand for Academics, with stress-coping, peer influence, and health …

Examining The Link Between Adenomas And Early-Onset Colorectal Cancer In Adults Aged 20–44, Ijeoma F. Erondu

Doctoral Dissertations and Projects

Early-onset colorectal cancer (EOCRC) has increased among adults younger than 50 years, raising concerns regarding risk identification and screening practices in younger populations. This study examined the association between colorectal adenomas and EOCRC among adults aged 20–44 years in the United States and evaluated whether this relationship was influenced by selected demographic and behavioral factors. A cross-sectional analytic design was used to examine medical claims data from the Optum Partner Health database. The study population included 186,790 individuals aged 20–44 years who underwent colonoscopy procedures. Demographic variables included age group, sex, race/ethnicity, and body mass index (BMI). Smoking status was …

Beyond Crisis: Patient Access And Sustainability, Miguel A. Mendoza

Doctoral Dissertations and Projects

Critical systems underwent drastic workflow adaptations during the COVID-19 pandemic. Many of these operational alterations persist today, while others have been reduced or eliminated. This is a qualitative study on the operational, technological, and human-centered challenges experienced by healthcare organizations providing primary care services in Southwest Ohio during and immediately after the pandemic. This flexible research design implements in-depth, semi-structured interviews with healthcare professionals leading primary care operations to capture a longitudinal perspective on pandemic-era service delivery, and the legacy systems still in place today. Thematic analysis revealed seven themes that determine the effectiveness of care delivery models. Social Determinants …

Beyond Stabilization: Biological Healing, Structural Exclusion, And The Recovery Gap After Border-Fall Trauma At The U.S.-Mexico Border, Julia Robinson

Undergraduate Honors Theses

This honors thesis examines the biochemical, ethical, and public health consequences of insufficient post-operative follow-up care for undocumented immigrants injured in border falls. Discussing pathways of inflammation resolution, wound healing, and bone remodeling, this thesis argues that recovery depends on tightly regulated molecular and cellular processes that are highly vulnerable to disruption without continued monitoring and rehabilitation (Loi et al., 2016; Maruyama et al., 2020). When follow-up care is absent, these processes can be predicted to derail, leading to infection, impaired healing, and permanent disability (Chung & Sohn, 2025; Howard et al., 2020; Kruidenier et al., 2018). Framed through principles …

Managing Maternal Anemia In Pregnancy: The Role Of Iron-Rich Foods And Supplementation, Carli Dibler

InnovateHER Meeting 2026

Anemia during pregnancy is a large public health concern, which often leads to independent risk factors for fetal and maternal outcomes including postpartum hemorrhaging, cesarean sections, blood transfusions during and after the labor process, hysterectomies, preterm birth, and infectious diseases. Six level I-III studies were analyzed using the John Hopkins nursing evidence-based practice model. Findings showed that by using a combined approach of dietary intake and supplementation overall leads to better fetal and maternal outcomes compared to supplementation alone.

Prenatal Care, Pregnancy Risk, Birth Outcomes And The Role Of Neighborhood Characteristics, Monica Garcia-Perez Phd, Randy Huard Phd, Christopher Thoms Phd, David Tilstra Md

InnovateHER Meeting 2026

This study links 2024 CentraCare Health birth records with neighborhood census tract conditions from the National Neighborhood Data Archive (NaNDA, 2020/2021) to examine how place, prenatal care, and clinical risks influence birth outcomes in Central Minnesota. Neighborhood factors are standardized and paired with measures of prenatal-care adequacy and pregnancy-risk indicators in a series of multivariate linear models to explore their effect on birth outcomes. Analyses adjust for maternal demographics and clinical risks to identify independent neighborhood effects. A privacy-preserving, tract-linked dataset is also created to help local partners target high-need prevention areas.

Utilizing Remote Patient Monitoring With Dnp Students To Provide Pre-Natal Care, Sara Mccumber

InnovateHER Meeting 2026

This educational project introduced Nurse Practitioners to the use of RPM during pre-natal care for a patient with pre-natal hypertension. Hypertension is a risk factor in 16% of pregnancies and 5-8% of US births are impacted by hypertensive disorders and preeclampsia (CDC, 2023).

Identification and effective management of hypertension in pregnancy recently was an initiative of the Minnesota Perinatal Quality Collaborative (MPQC, 2022).

Cognitive Behavioral Therapy-Based Psychosocial Interventions To Reduce Anxiety After Social Isolation In Adolescent Females, Bailey E. Noble

InnovateHER Meeting 2026

• COVID-19 social isolation linked with higher anxiety risk in adolescents, especially females
• Review examined whether CBT-based psychosocial interventions reduce anxiety after pandemic-related loneliness/social isolation
• Across 6 studies, remote and internet-delivered CBT linked with anxiety improvement 
• Strongest outcomes seen with therapist-assisted CBT
• Common barriers: privacy, motivation, scheduling, and digital access
• Nursing relevance: early screening, referral, and support for treatment participation

Advocateai: A Human-In-The-Loop Artificial Intelligence Platform To Improve Diagnostic Trajectories And Patient Empowerment In Chronic Pelvic Pain, Gayatri Bhanot, Ashley Kochans

InnovateHER Meeting 2026

Chronic pelvic pain (CPP) affects up to 27% of women globally^1, yet diagnosis takes 4 – 12 years on average² — a crisis driven by healthcare fragmentation, systemic gender bias, and a 62% rate of symptom dismissal by healthcare providers³. AdvocateAI is a human-in-the-loop AI platform designed to empower patients to accelerate their own diagnostic journey. By synthesizing fragmented medical records and patient-reported symptoms, the tool creates structured clinical summaries and personalized advocacy scripts. Here, we present our findings from discovery, including a landscape analysis of available CPP treatments, a prototype co-designed by patients, and custom …

Health-Seeking Behaviors Of Ethiopian Women In The United States: A Pilot Qualitative Study, Hanna Belay, Felicia Leammuda, Ahmed Ugbad, Beamlak Kebede

InnovateHER Meeting 2026

This study explores how Ethiopian immigrant women understand health and navigate healthcare in the United States. Using qualitative interviews with two participants, findings show that health is viewed holistically, with strong reliance on traditional remedies. Participants engage with the U.S. healthcare system selectively, often seeking care only when symptoms become severe. Barriers such as system complexity, fear, and time delays influence healthcare decisions.

When Faced With Persistent Crying, Will Adults Follow The Advice To Take A Break?, Lauren J. Duplessis, Remington K. Asta, Benjamin N. Witts

InnovateHER Meeting 2026

Inconsolable crying in early infancy can have detrimental effects on caregiver mental health, the caregiver-infant relationship, and infant safety. Professionals often advise caregivers to walk away and take a break. This study used n-of-1 methodology to examine how frequently undergraduate students will follow this advice when tasked with calming a simulated inconsolable infant. Results are mixed, but suggest active training prior to the baby’s arrival might yield promising outcomes

Awareness And Attitudes Toward Female Genital Mutilation At A Mid-Sized Midwestern University, Kaafiya Salad

InnovateHER Meeting 2026

This study utilized a confidential survey to examine awareness, knowledge, and attitudes toward Female Genital Mutilation (FGM) among the Saint Cloud State University community. Participants were recruited through campus outreach methods, and responses were collected voluntarily. The survey included questions assessing familiarity with FGM, sources of information, knowledge of associated health risks, and perceptions of the importance of awareness and public education.

Advancing Exclusive Breastfeeding Through Prenatal Education, Emr Optimization, And Community Partnership: A Champs National Quality Improvement Initiative, Heather Klein, Hannah Koepp

InnovateHER Meeting 2026

CHAMPS National is a CDC-funded quality improvement initiative focused on improving exclusive breastfeeding rates, strengthening maternity care practices, and reducing racial disparities. This project implemented culturally responsive prenatal education, optimized EMR workflows, and strengthened community partnerships to support informed infant feeding decisions and improve breastfeeding equity.

Empowering Women: Understanding Neurological Changes In The Aging Brain, Joy Mckenzie

InnovateHER Meeting 2026

Women tend to have more neurological changes than men as they age starting in their mid-30s (Mosconi, 2024). While aging is a natural process, the neurological changes can impact a woman’s personal and professional quality of life (Faubion et al., 2023; Gravini, 2023). For years, women’s neurological symptoms have been ignored by being told that their experiences are normal and just a part of life (Haver, 2025). That narrative is starting to shift with the increased awareness of changes specific to women. There are resources to assess cognitive changes such as memory, processing speed, and word finding and strategies to …

Improving Hormone Therapy Replacement Use Through Provider Education, Caitlin Schmidt, Jennifer Peterson

InnovateHER Meeting 2026

Menopausal symptoms significantly affect quality of life, yet hormone therapy (HRT) remains underutilized in primary care settings. This quality improvement project assessed whether a brief educational intervention could improve provider knowledge and prescribing confidence. A pre–post survey design revealed increased knowledge, greater guideline awareness, and heightened willingness to prescribe HRT following a 10–15 minute educational module.

Global Health Financing Of Diagonal Interventions: Building Resilient And Sustainable Health Systems In Sub-Saharan Africa, Lucy Kim

Master in Public Policy Theses

Background: Global health financing has historically prioritized disease-specific “vertical” programs over broader “horizontal” strengthening of general health systems. Vertical programs in HIV have led to unprecedented reductions in mortality worldwide, but HIV remains a significant public health threat in sub-Saharan Africa, where vertical strategies have long been criticized for creating fragmented health systems. In response, global health strategies have shifted towards combining vertical investments with broader horizontal activities, commonly referred to as “diagonal” programming. While evidence suggests that diagonal programming has the potential to create more resilient and sustainable health systems, evaluating its value for money is challenging due to …

Beyond The Ban: Chhaupadi Abolition And The Governance Of Menstrual Autonomy In Western Nepal, Nikita Paudel

Master in Public Policy Theses

This thesis examines how two decades of efforts to abolish chhaupadi have shaped the everyday conditions under which women and girls experience menstruation in western Nepal. Chhaupadi, commonly understood as menstrual seclusion, has been addressed through Supreme Court directives, national policy, criminal law, municipal implementation instruments, hut demolition campaigns, public health programming, and rights-based advocacy. Yet the practice has persisted, adapted, and in some cases moved into less visible spaces. Rather than treating this as a simple gap between law and practice, this thesis asks how abolition efforts themselves have become part of the regulatory regime through which menstruation is …

Measuring Treatment Burden With The Treatment Burden Questionnaire (Tbq): A Narrative Literature Review And Implications For Geriatric Research And Clinical Practice, Jennifer Li-Wang, Sophia Hernandez, Sahana Ramasamy, Lawrence Qu, Jack Banks, Rafael Samper-Ternent, Holly Holmes, Aanand Naik, Dana Giza

Faculty, Staff and Student Publications

Background: Treatment burden refers to the demands that healthcare places on a patient's daily life, including managing appointments, medications, and lifestyle adjustments. It is a critical concern for older adults, particularly those with multiple chronic conditions. High treatment burden has been associated with poorer treatment adherence, increased disruptions in care, and diminished quality of care. The Treatment Burden Questionnaire (TBQ) is a validated tool that has been successfully used to measure treatment burden in a variety of geographic, clinical, and research settings.

Methods: We conducted a narrative literature review to identify studies that have applied the TBQ in older adult …

Comparison Of Selected Supply Chain Management Practices Of Three Major Regional/Metropolitan Hospitals, Alan D. Smith

Atlantic Marketing Association Proceedings

No abstract provided.

Tiktok And The Brain: Neuropsychological Correlates Of Short-Form Video Consumption, Caty Enders

Psychology ETDs

Short-form video platforms like TikTok have quickly become the fastest growing segment of social media, thanks to powerful algorithms serving up personalized content driven by large quantities of user data. This study investigates the neuropsychological correlates of digital media use, with a particular focus on TikTok and smartphone screen time among young adults. Combining correlational analyses and an experimental design (n = 49; n = 44 included in final sample), we examined the relationship between digital media use and cognitive and emotional functioning across multiple domains. Objective measures of digital media consumption (daily average screen time and time on TikTok) …

From Cranes To Clinics: Genomic Epidemiology At The Human-Animal Interface, Sarah Shrum

Biology ETDs

Emerging infectious diseases represent a significant, increasing threat to human life, economic stability, and global security. The One Health framework, which promotes human health and wellness through the understanding that animal, environmental, and human health are interwoven, is critical to understanding pathogen emergence and transmission. This is underscored by the fact that roughly 60% of all human pathogens and 75% of emerging infectious disease are zoonotic, meaning they are transmitted from animals to humans.

The work presented in this dissertation integrates genomic epidemiology, ecological analysis, and One Health Surveillance approaches to characterize cross-species circulation of opportunistic yeast pathogens (Candida …

Birth Control Use Alters Memory For A Stressful Experience, Julia N. Gross, Kristie Payment, Boyd R. Rorabaugh, Phillip R. Zoladz

Aurora

Hormonal birth control methods are widely used; however, some users suffer considerable side effects. Previous research suggests oral contraceptive users exhibit a blunted cortisol response to psychosocial stressors and alterations in emotional memory, including differential recall of emotional images and details of emotional stories. However, no studies have examined how birth control influences memory for a stressful experience.

The present study analyzes data previously collected from female undergraduate students. In this study, participants reported contraceptive use, then underwent a modified version of the Trier Social Stress Test (TSST) or the friendly-TSST (f-TSST). The TSST required participants to deliver a ten-minute, …

Conflict, Climate, And Child Health: Evidence From Sub-Saharan Africa, Brian C. Thiede, Nigel C. James

Health Studies Faculty Publications

Many parts of the world are experiencing social and political instability, as well as ongoing climatic changes that are expected to accelerate in the years ahead. These changes can undermine children's health through multiple pathways, and the growing frequency of sociopolitical and environmental stressors increases the likelihood that individuals are exposed to multiple risks simultaneously. Few studies have quantified the effects of such concurrent shocks despite conceptual motivations for doing so. We address this gap by measuring the independent and compounding effects of conflict and climate exposures on the weight-for-height of 0–23 month-old children across 32 countries in sub-Saharan Africa. …

Poly(Adp-Ribose) Polymerase Inhibitor Maintenance Therapy In Ovarian Cancer: A Single-Center Retrospective Study., Sydney Pence, Kayla Dyson, Kristen Waters, John O Elliott, Kellie Rath, Stuart Pierce, Amy Harper, Corinne Calo, Aine E Clements

OhioHealth Research Institute Articles

OBJECTIVE: To determine the effectiveness and tolerability of PARPi maintenance in a real-world patient population. Specifically, to assess duration of PARPi, the rate of secondary malignancies, rate of side effects, and survival.

METHODS: A retrospective review of patients with ovarian, fallopian tube, and primary peritoneal cancer at OhioHealth Riverside Methodist Hospital in Columbus, Ohio was performed. All patients diagnosed since March 2015 were reviewed for eligibility. Data was collected via EMR query and stored in REDCap. Charts were reviewed for multiple data points, including duration of PARPi use, side effects, secondary malignancies, survival, and recurrence. Data were reported descriptively with …

Level Of Comfort And Barriers To Pediatric Vaccination Among Pharmacy-Based Immunizers In California, Laressa Bethishou, Karl Hess, Richard Beuttler, Jeffery Goad

Pharmacy Faculty Articles and Research

Background

Pharmacists are increasingly recognized as accessible immunizers, yet pediatric vaccination rates in community pharmacies remain lower than those for adults, likely due to unique barriers. This study aimed to assess the comfort level of pharmacy-based immunizers in California with administering vaccines to pediatric patients and to identify barriers limiting their participation in pediatric immunization.

Methods

An IRB-approved, cross-sectional survey was distributed electronically to pharmacists, student pharmacists, and pharmacy technicians administering vaccines in California community pharmacies between November 2022 and February 2023. The survey measured comfort with vaccinating pediatric age groups, perceived barriers, and collected demographic data. Data analysis included …

Exploring Direct Support Professionals' (Dsps) Attitudes Regarding Trauma Informed Care And Its Impact On Turnover Intention, Lorraine D'Sylva-Lee

Seton Hall University Dissertations and Theses (ETDs)

The relationship between Direct Support Professionals’ (DSPs’) attitudes toward trauma-informed care (TIC) and their turnover intention has remained empirically untested, despite DSPs’ exposure to primary and secondary trauma. An estimated 8.38 million Americans with intellectual and developmental disabilities (IDD) depend on this workforce, yet 2024 turnover rates reach 53.7%. This convergent mixed methods study examined TIC attitudes, turnover intention, and their relationship among 109 DSPs in IDD provider agencies in New Jersey. Grounded in the Theory of Planned Behavior (TPB), the cross-sectional design used the ARTIC-10, TIS-6, and two open-ended items. DSPs with more favorable TIC attitudes were significantly less …

Unknowing Sacrifices: Public Health And Radiation Illness In New Mexico And Nevada, 1940s-1960s, Beatriz Avila-Marquez

UNLV Theses, Dissertations, Professional Papers, and Capstones

The detonation of the first atomic bomb in the early morning of July 16, 1945, in New Mexico welcomed the atomic age that forever changed the world. After that day, thousands of lives were lost due to nuclear weapons, and hundreds of thousands more continued to suffer from the effects of atomic testing. The Atomic Energy Commission, fueled by the arms race of the Cold War, chose Nevada to continue the United States’ nuclear weapons testing. Knowledge of the dangers of radiation exposure, the effects of radiation, and techniques to prevent exposure are now available in part due to the …

Establishing A Comprehensive Framework For Sfrt Lattice Treatments: Optimization, Planning, And Clinical Evaluation, Gregory M. Gill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Spatially fractionated radiation therapy (SFRT) using lattice radiotherapy (LRT) has emerged as a promising treatment technique for bulky, nonresectable tumors by delivering spatially heterogeneous dose distributions consisting of high-dose vertices embedded within lower-dose regions. Although early clinical experiences have demonstrated potential therapeutic benefit, widespread clinical implementation of LRT remains limited due to the absence of standardized treatment planning workflows, consistent optimization strategies, and clearly defined evaluation metrics for heterogeneous dose distributions. The objective of this study is to develop and evaluate a structured framework to support efficient, reproducible, and safe clinical implementation of LRT.

To address these challenges, a comprehensive …