Digital Commons Network^™

Exposing The Disaster Disparities And Experiences On College Campuses, Deleanor Kirkpatrick Murray

All-Inclusive List of Electronic Theses and Dissertations

Challenges in higher education continue to arise, providing administrators with insights into how prepared—or unprepared—their institutions may be for future crises. The purpose of the study is to examine how mid-level leadership, staff, and students perceived the disaster response to Hurricane Ida during the 2021–2022 academic year. Using the theoretical frameworks of the Four-Frame Model (Bolman & Deal, 2021), Critical Race Theory (Delgado & Stefancic, 2017), and Institutional Theory (Manning, 2018), this case study employed interviews with 8 participants. Data analysis resulted in the emergence of 7 major themes and 11 sub-themes. The findings from the study suggest that participants …

The Benefits Of Telehealth Among Disadvantaged Communities, Anoosh Arshad

Honor’s College Freeman Research Journal

This study aims to understand how the widespread integration of telehealth services affects underserved communities, helping reduce health disparities in this group. Telemedicine includes various technologies and applications, supported by extensive research, public health, administrative, and patient-care benefits, to adapt to different fields. It involves clinical applications that focus on patient care, like making health decisions, and nonclinical applications like arranging board meetings. Telehealth is a health platform that uses communication technologies that allow doctors and patients to meet online through video and telephone visits, ensuring that patients receive high-quality care. It increases access to healthcare by removing geographical and …

A Replication Study — Suicidal Thoughts And Behaviors Among High School Students — Youth Risk Behavior Survey, United States, 2021, Mallory Hays

Capstone Experience: Master of Public Health

Suicidal thoughts and behaviors among adolescents are critical public health concerns in the United States, with suicide being the third leading cause of death among high school-aged youths (14-18 years). This study replicates and extends the findings of the 2021 Youth Risk Behavior Survey (YRBS) conducted by Gaylor et al., which analyzed data from 13,677 students in 2019 and 17,232 students in 2021. The original study revealed alarming increases in suicidal ideation and behaviors, particularly among female students, and highlighted disparities across demographic groups. Using raw YRBS datasets, this replication involved a pure replication of the original findings, followed by …

Promoting Adolescent Mental And Physical Health: Initiatives Focused On Connecting Public Health And Social Services To The Health Sector In Nebraska, Theresa Nguyen

Capstone Experience: Master of Public Health

This capstone focuses on the second recommendation of improving access to comprehensive, coordinated health services from the National Academies of Sciences, Engineering, and Medicine report The Promise of Adolescence: Realizing Opportunity for All Youth (2019). This proposal uses secondary data from the research project, Moving Evidence-Based Recommendations to Practice to Strengthen the Health Care System in Nebraska. Key stakeholders (n=28) were interviewed from the health care, public health, social services, and policy sectors. Each subject was asked to participate in a semi-structured interview by a trained interviewer. The interview was 1 hour long and conducted via phone call or Zoom. …

The Association Between Systolic Blood Pressure And Coronary Heart Disease In The Framingham Heart Study: A Long-Term Prospective Cohort Study, Alexandrea M. Welch

Capstone Experience: Master of Public Health

Coronary heart disease (CHD) is a leading cause of morbidity and mortality worldwide, with systolic blood pressure (SBP) as a critical risk factor. This study utilized data from the Framingham Heart Study to assess the association between SBP and CHD among participants. Univariate, bivariate, and multivariable logistic regression was used to explore this association as well as the association with other key covariates. We found a significant positive association between elevated SBP and the risk of CHD (adjusted OR: 1.69, 95% CI: 1.41-2.01, p < 0.0001). Age, sex, current blood pressure medication use, and body mass index (BMI) were significantly associated with CHD. Our findings support the need for blood pressure management to prevent cardiac events and reduce CHD burden.

Closing Gaps To Address Lifespan Health: Considerations For Developing A Preconception Healthcare Training For Community Health Workers, Jaclyn R. Vancamp

Capstone Experience: Master of Public Health

Community health workers (CHWs) are frontline public health workers who are embedded in their own communities and as linkages to care, decreasing health disparities for underserved individuals. The goal of this capstone project was to identify Michigan CHWs' knowledge gaps in the area of preconception healthcare. Through administering a training needs assessment to a sample of community health workers, the goal was to characterize knowledge gaps and make recommendations about what type of training would be most useful to them. The results of this needs assessment showed that the general state of self-reported knowledge about preconcept health among Michigan community …

Dietary And Physical Activity Behaviors In 2021 And Changes From 2019 To 2021 Among High School Students: A Replication Study, Jamila Nasir

Capstone Experience: Master of Public Health

Shannon L. Michael et al. conducted the study “Dietary and Physical Activity Behaviors in 2021 and Changes from 2019 to 2021 Among High School Students” to compare the prevalences of specific dietary and exercise behaviors among high-school students between 2019 and 2021, in order to examine how the COVID-19 pandemic affected these behaviors and to identify disparities in these effects.

This replication of the study focuses on exercise behaviors. The study data, drawn from the CDC’s YRBS in 2019 and 2021, had been selected using a three-stage cluster sampling method in which the clusters in the third stage were selected …

Association Between Cigarette Smoking And Angina Pectoris Among Middle-Aged Adults: Findings From The Framingham Cohort Study, Lauren M. Hron

Capstone Experience: Master of Public Health

Objectives: This study investigates the relationship between current cigarette smoking at baseline and the occurrence of angina pectoris during follow-up among middle-aged adults (30-70 years), adjusting for age, sex, BMI, diabetes status, education, and number of cigarettes smoked per day.

Methods: Using the Framingham Heart Study cohort (N=4,434), logistic regression analyses were performed. A backward selection approach identified confounders and explored effect modification.

Results: Angina prevalence was 16.4%, with higher odds observed in males, older individuals, and those with obesity or diabetes. Smoking status showed a non-significant association with angina in multivariable models (aOR:0.86, 95% CI: 0.73-1.01). However, age and …

Cybersecurity Vulnerabilities And Considerations In U.S. Healthcare Facilities: A Scoping Review, Rebecca J. Campbell

Capstone Experience: Master of Public Health

Robust cybersecurity measures are essential for business continuity of U.S. healthcare institutions which is to maintain care standards for all patients. Hackers seek to disrupt healthcare delivery for financial and political means, to disrupt services in retaliation, or simply for malicious intent (Wasserman & Wasserman, 2022). The COVID-19 pandemic further accelerated innovation and digitization in healthcare, including wearable and implanted medical devices, telehealth care delivery options, artificial intelligence, and cloud-based data management (Kioskli, Fotis, & Mouratidis, 2021). This progress in innovation continues today but also brings new vulnerabilities and challenges to stay ahead of cybersecurity threats.

Given that cyberattacks have …

Understanding And Mitigating The Potential Effects Of Postpartum Depression On Fathers And Male Support Persons, Rachel Norton-Turk

Capstone Experience: Master of Public Health

Background. During the postpartum period, best practices dictate that medical professionals screen new mothers or birthing persons for anxiety and depression and direct them to the appropriate resources and services they may need. This qualitative study explored the steps being taken to identify depression and anxiety concerns in male support partners during the postpartum period and to understand what resources are being brought to their attention if depression and anxiety are identified. Methods. A convenience sample of male support persons participated in semi-structured, one-on-one interviews either in-person or over Zoom between September and October 2024. Interviews were recorded, transcribed, …

A Cohort Study Examining The Risk Of Smoking On The Likelihood Of Developing Angina Among Women Under Age 65, Sarah Ward

Capstone Experience: Master of Public Health

Objective:

To determine if current smoking status is a risk factor for angina among women under the age of 65.

Methods:

A subset of participants from the Framingham Heart Studywere used to complete a cohort study. The analyses evaluated population means and characteristics, followed by bivariate and multivariable logistic regression, to determine the association of smoking and other key factors with angina.

Results:

Smoking status had a significant association to angina(OR 0.67, 95% CI: 0.52, 0.86, p-value= 0.0015). Age as a categorical variable had a significant relationship with angina (OR 0.97, 95% CI: 0.617, 1.520, p-value=

Conclusions:

Smoking had a …

Beryllium Work Area And Tank Waste, Angelica Zarate

Capstone Experience: Master of Public Health

My capstone was conducted at the Hanford site in Richland, Washington. It was once a location that produced weapons-grade plutonium, but now its mission is to clean up the radioactive waste that was left behind. My project focused on beryllium and how much is present in the 56 million gallons of waste that needs to be disposed of. I evaluated the OSHA regulations for beryllium work areas, medical surveillance, and beryllium exposure's environmental and health implications. The purpose was to determine if the concentrations present meet the requirements to continue to be considered a beryllium work area.

Comparative Study Of Coronary Heart Disease Incidence In Smokers Vs. Non Smokers: A Longitudinal Cohort Analysis From The Framingham Heart Study, Mona Melvin Periera

Capstone Experience: Master of Public Health

Objective: To evaluate the association between smoking and coronary heart disease (CHD) incidence while adjusting for potential confounding factors, including age, education level, systolic blood pressure, BMI, serum cholesterol, and diabetes, using data from the Framingham Heart Study.

Methods: A cohort of 4,434 participants aged 32–70 years, free of CHD at baseline, was analyzed. Smoking status (current vs. non-current smokers) was the primary exposure, and CHD incidence was the outcome. Adjustments were made for confounders using multivariable logistic regression models. Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

Results: CHD was diagnosed in 27.96% of …

The Role Of Serum Total Cholesterol In Coronary Heart Disease: A Prospective Cohort Analysis From The Framingham Heart Study, Sanish Maharjan

Capstone Experience: Master of Public Health

Objective: To investigate the association between serum total cholesterol and coronary heart disease (CHD), accounting for key risk factors in adults aged 32–70 years.

Methods: We analyzed data from 4,382 participants of the Framingham Heart Study, a prospective cohort study with 24 years of follow-up. Multivariable logistic regression was used to assess the relationship between serum cholesterol and CHD, adjusting for age, sex, smoking status, systolic blood pressure, BMI, diabetes, and heart rate.

Results: Individuals with high (aOR = 1.87; 95% CI = 1.52 - 2.32; p<.0001) and borderline high (aOR = 1.40; 95% CI = 1.13 - 1.75; p = 0.0024) cholesterol levels have significantly higher odds of developing CHD than those with normal cholesterol. Older (aOR=1.03; 95% CI=1.03–1.05), male (aOR=2.16; 95% CI=1.86–2.51), current smokers (aOR=1.20; 95% CI=1.03–1.39), hypertensive (aOR=1.88; 95% CI=1.55–2.26), obese (aOR=3.03; 95% CI=1.24–7.43), and diabetic individuals (aOR=2.41; 95% CI=1.63–3.56), had significantly higher CHD risk.

Conclusions: Elevated serum cholesterol significantly increases CHD risk, emphasizing …

Prevalence And Risk Factors Of Obesity Among Undergraduate Student Population In Ghana: An Evaluation Study Of Body Composition Indices, Christian Obirikorang, Evans A. Adu, Enoch O. Anto, Anthony A. A. Awuah, Angela N. B. Fynn, George Osei-Somuah, Patience N. Ansong, Alexander O. Boakye, Ivy Ofori-Boadu, Yaa Obirikorang, Austin G. Adobasom-Anane, Eric N. Y. Nyarko, Lois Balmer

Research outputs 2022 to 2026

Background: Obesity is a classified risk factor for several of the world’s leading causes of death. In this study, we combined information contained in body mass index (BMI), total percentage body fat (TPBF) and relative fat mass (RFM) to estimate obesity prevalence and examine the risk factors associated with obesity. Methods: The study recruited 1027 undergraduate students aged between 16 and 25 years using a cross-sectional study design and two-stage stratified random sampling between January and April 2019 from the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Demographic, lifestyle, and family history of chronic disease data, were collected …

Associations Of Metabolic Changes And Polygenic Risk Scores With Cardiovascular Outcomes And All-Cause Mortality Across Bmi Categories: A Prospective Cohort Study, Cancan Li, Xiaoni Meng, Jie Zhang, Haotian Wang, Huimin Lu, Meiling Cao, Shengzhi Sun, Youxin Wang

Research outputs 2022 to 2026

Background: Associations between metabolic status and metabolic changes with the risk of cardiovascular outcomes have been reported. However, the role of genetic susceptibility underlying these associations remains unexplored. We aimed to examine how metabolic status, metabolic transitions, and genetic susceptibility collectively impact cardiovascular outcomes and all-cause mortality across diverse body mass index (BMI) categories. Methods: In our analysis of the UK Biobank, we included a total of 481,576 participants (mean age: 56.55; male: 45.9%) at baseline. Metabolically healthy (MH) status was defined by the presence of < 3 abnormal components (waist circumstance, blood pressure, blood glucose, triglycerides, and high-density lipoprotein cholesterol). Normal weight, overweight, and obesity were defined as 18.5 ≤ BMI < 25 kg/m2, 25 ≤ BMI < 30 kg/m2, and BMI ≥ 30 kg/m2, respectively. Genetic predisposition was estimated using the polygenic risk score (PRS). Cox regressions were performed to evaluate the associations of metabolic status, metabolic transitions, and PRS with cardiovascular outcomes and all-cause mortality across BMI categories. Results: During a median follow-up of 14.38 years, 31,883 (7.3%) all-cause deaths, 8133 (1.8%) cardiovascular disease (CVD) deaths, and 67,260 (14.8%) CVD cases were documented. Among those with a high PRS, individuals classified as metabolically healthy overweight had the lowest risk of all-cause mortality (hazard ratios [HR] 0.70; 95% confidence interval [CI] 0.65, 0.76) and CVD mortality (HR 0.57; 95% CI 0.50, 0.64) compared to those who were metabolically unhealthy obesity, with the beneficial associations appearing to be greater in the moderate and low PRS groups. Individuals who were metabolically healthy normal weight had the lowest risk of CVD morbidity (HR 0.54; 95% CI 0.51, 0.57). Furthermore, the inverse associations of metabolic status and PRS with cardiovascular outcomes and all-cause mortality across BMI categories were more pronounced among individuals younger than 65 years (Pinteraction < 0.05). Additionally, the combined protective effects of metabolic transitions and PRS on these outcomes among BMI categories were observed. Conclusions: MH status and a low PRS are associated with a lower risk of adverse cardiovascular outcomes and all-cause mortality across all BMI categories. This protective effect is particularly pronounced in individuals younger than 65 years. Further research is required to confirm these findings in diverse populations and to investigate the underlying mechanisms involved. Graphical abstract: (Figure presented.)

Exploring Drivers Of Women’S Well-Being In Hospitals: Mapping The Landscape, Mitra Faghihi, Aliasghar Farshad, Nasim Salehi, Dean Whitehead, Masoud Motalebi Ghayen, Bahar Izadi, Morteza Mansourian

Research outputs 2022 to 2026

Background and purpose: The workplace plays a key role in impacting the health and well-being of employees at various levels, including physical, psychological, and social aspects of health. This study aims to identify the drivers of a healthy environment that promotes the well-being of women employed in hospitals. Materials & methods: This qualitative study used purposive sampling to recruit a total of 48 working women across a diverse range of participants with different job categories and socio-demographic statuses. These include clinical health (e.g., nurse, head nurse, practical nurse, supervisor, physicians); allied health (e.g., diagnostic services); public health (e.g., health promotion …

Co-Design Of A Personalised Digital Intervention To Improve Vegetable Intake In Adults Living In Australian Rural Communities, Katherine M. Livingstone, Jonathan C. Rawstorn, Laura Alston, Stephanie R. Partridge, Amber Bastian, Kate Dullaghan, Sarah A. Mcnaughton, Gilly A. Hendrie, Lauren C. Blekkenhorst, Ralph Maddison, Yuxin Zhang, Scott Barnett, John C. Mathers, Stephanie L. Godrich

Research outputs 2022 to 2026

Background: Diets low in vegetables are a main contributor to the health burden experienced by Australians living in rural communities. Given the ubiquity of smartphones and access to the Internet, digital interventions may offer an accessible delivery model for a dietary intervention in rural communities. However, no digital interventions to address low vegetable intake have been co-designed with adults living in rural areas. This paper describes the co-design of a digital intervention to improve vegetable intake with rural community members and research partners. Methods: Active participants in the co-design process were adults ≥ 18 years living in three rural Australian …

Cohort Profile: The Origins Pregnancy And Birth Cohort, Jacqueline Davis, Zenobia Talati, Sarah Whalan, Wesley Billingham, Nina D'Vaz, Lisa Gibson, Susan L. Prescott, Desiree T. Silva

Research outputs 2022 to 2026

No abstract provided.

Personal Protective Equipment For Minoritized U.S. Agricultural Farmworkers: Community-Based Efforts During The Pandemic & Implications For Extension, Helen Trejo

Journal of Human Sciences and Extension

There are an estimated 2 million farmworkers who are essential to the food system in the United States; however, they are exposed to hazardous environmental conditions with limited access and/or use of Personal Protective Equipment (PPE). The primary purpose of this research is to evaluate community-based organizational efforts to provide farmworkers with apparel-textile basic needs, such as face masks. A primary goal is to address the research gap regarding common environmental factors that impact farmworkers, including pesticides and the pandemic, their use of available PPE, and community-based efforts to improve access to face masks as basic PPE. We consider the …

Engaging Fathers(To-Be): A Pilot Study On The Adaptation And Programme Experience Of Sms4baba Intervention In Kenya’S Informal Settlements, Vibian Angweny, Richard Fletcher, Paul Mwangi, Margaret Kabue, Rachel Odhiambo, Stephen Mulupi, Emmanuel Obulemire, Eunice Njoroge, Eunice Ombech, Mercy Mokaya, Moses Wesala, Joyce Marangu, Amina Abubakar

Institute for Human Development, East Africa

Background Engaging fathers(to-be) can improve maternal, newborn, and child health outcomes. However, father-focused interventions in low-resource settings are under-researched. As part of an integrated early childhood development pilot cluster randomised trial in Nairobi’s informal settlements, this study aimed to test the feasibility of a text-only intervention for fathers (SMS4baba) adapted from one developed in Australia (SMS4dads).

Methods A multi-phased mixed-methods study, which included an exploratory qualitative phase and pre-post evaluation of the adapted SMS4baba text-only intervention was conducted between 2019 and 2022. Three focusgroup discussions (FGDs) with 19 fathers were conducted at inception to inform SMS4baba content development; two post-pilot …

High Yield Of Congenital Hypothyroidism Among Infants Attending Children Hospital, Nairobi, Kenya. Facility Based Study In The Absence Of Newborn Screening, Menbere Kahssay, Thomas Ngwiri

Paediatrics and Child Health, East Africa

Objectives: Congenital hypothyroidism (CHT) is a treatable cause of intellectual disability. Late diagnosis and delayed initiation of treatment leads to irreversible neurodevelopmental and intellectual disability. Thus, newborn screening is crucial. However, 71 % of babies are born in an area with no established newborn screening program and Kenya is not an exception. We aimed to determine the incidence of CHT, developmental outcomes of patients in the absence of newborn screening.

Methods: A retrospective data of subjects who met the inclusion criteria, newborn and infants from 3 days to 2 years whose thyroid function test (TFT) was undertaken during well baby …

Metagenomic Sequencing For Early Detection Of Future Engineered Pandemics: Foreshadowing The Privacy Challenge, Nir Eyal, Bridget Williams, Kevin M. Esvelt, Jane R. Bambauer

UF Law Faculty Publications

In this commentary, we imagine how a global system of metagenomic sequencing could be governed in order to reap the benefits and manage the risks. Global institutional engineers and their academic partners would need to develop a new governance model to ensure that all partners involved in a global metagenomic surveillance system cooperate as needed.

Chronic Illness Education 2024: Incremental Diet And Activity Changes To Improve Cardiovascular Health, Carter Dunaway, Jonah Kornbluh, Kit Tran, Naya Pabla, Olivia Jeakle, Zaid Saadeh

Patient Education Projects

No abstract provided.

Lgbtq+ College Students’ Willingness To Access Campus Health Services At A Midsized, Urban Christian University: A Study On Disparities, Samual J. Piatt, Christian Williams, Frecia Gonzalez

SPARK Symposium Presentations

Introduction

LGBTQ+ college students face inequitable health outcomes in both mental health and physical health versus non-LGBTQ+ counterparts (The Trevor Project, 2023), (Brittain et Dinger, 2015). LGBTQ+ students experience higher unwillingness and disparities in care access due to negative perceptions of and experiences with UHS providers (Hood et al, 2019). Research indicates that better provider LGBTQ+ cultural awareness contributes to a more affirming space which in turn benefits LGBTQ+ healthcare (Parmenter et al, 2020), (Prasad et al, 2023).

Methods

A 2024 cross-sectional study assessed the comfort levels of LGBTQ+ college students in accessing student health services, explore how affirming healthcare …

Integrated Child Nutrition, Parenting, And Health Intervention In Rural Liberia: A Mixed-Methods Feasibility Study, Sejla Isanovic, Musa Sanoe, Shelbie Wooten, Edward A. Frongillo Ph.D., Aisha K. Yousafzai, Christine E. Blake Ph.D., Rd, Mufaro Kanyangarara Ph.D., Melanie Swan, Nicole Rodger, Miriam Murray, Leila M. Larson Ph.D., Mph

Faculty Publications

In Liberia, children are exposed to multiple forms of adversity which can negatively impact their health and development. Research is needed to examine the feasibility and benefits of integrated interventions that can be incorporated into existing health delivery programs to simultaneously address low responsive stimulation, undernutrition, and infection. This study assessed the feasibility of an integrated intervention promoting psychosocial stimulation and improved child feeding by the provision of eggs and fish. The integrated intervention was incorporated into an existing government health program. Thirty female caregiver-child dyads were randomly selected from two rural communities in Liberia. Participants received fortnightly group parenting …

An Innovative Community‐Led Education And Recruitment Program To Increase Clinical Research Participation Among Black Americans, Bahar Niknejad, Ethlyn Mcqueen Gibson, Travonia Brown-Hughes, Katie Mcdonough, Ebony Andrews, Deborah Hudson, Hamid Okhravi

Glennan Center for Geriatrics and Gerontology Faculty Publications

Background: Previous studies attest to a lack of awareness about Alzheimer’s Disease (AD) and limited participation of Black Americans in AD clinical trials. The AHEAD Study is a multicenter trial focused on preventing AD by evaluating the effectiveness and safety of Lecanemab in individuals with preclinical AD. The study aims to recruit at least 15% from underrepresented populations, including Black Americans. To achieve this goal, our study site utilizes a community-based participatory research (CBPR) approach and developed a Community Education and Recruitment Program (CERP) designed to increase the participation of Black individuals in the AHEAD Study.

Method: In a collaborative …

Understanding And Intervening In Children's Tick Risk Perceptions And Protective Behaviors: A Grounded Theory, Ariel Dawdy

Department of Entomology: Dissertations, Theses, and Student Research

Children, ages 8 years and younger, are at a particularly high risk of contracting a tick-borne disease. This is partially due to the misconceptions spread about tick protective behavior and a poor understanding of how antibiotic treatment can help. Because most communities and families believe that tick control is the individual’s responsibility, looking at the interaction between ticks and human children is essential to understanding the individual’s motivations to protect themselves. To help alleviate the number of individuals contracting tick-borne diseases, misconceptions must be addressed, intervention programs implemented, and a behavioral change must occur. This study used a qualitative research …

Taking A Closer Look At Tpack: Examining Teacher Perspectives Of The Knowledge, Competencies, And Context Needed For Improved Remote Education In Grades 4-8, Jennifer Christine Buth Bell

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Though wrought with challenges, the COVID-19 Pandemic, which led to the closure of schools worldwide and forced educators into a rapid transition from traditional to Emergency Remote Teaching (ERT), held some promise for furthering the integration of digital technology in schools. But now, years following the crisis, policymakers, administrators, and teachers continue to grapple with how best to incorporate lessons learned and improve the future of teaching and learning in both traditional and remote settings. This mixed-methods study (n = 21; n = 6) followed an explanatory sequential design to collect and analyze data from a sample of 4th-8th …

Domestic Violence And Mental Health In Pregnant Women, Arabella M. Co

Nursing | Student Research Posters

Background: Domestic violence can include verbal, emotional, and physical abuse, which can lead to long-term mental health disorders such as stress, anxiety, or post-traumatic stress disorder. Purpose: This research includes a literature review, as well as a proposed research design to examine the significance of intimate partner violence in relation to mental health by implementing screening methods and interventions. Method: Participants will be recruited from prenatal clinics around the Bay Area. A quantitative, randomized, controlled-trial cohort study will investigate the effectiveness of the Pregnancy Risk Assessment Monitoring Systems (PRAMS). A screening tool used in determining intimate partner violence within the …