Digital Commons Network^™

Teledentistry: A Path To Minimize Emergency Department Dependency For Dental Issues, Aishwarya Joshi

Graduate Studies Theses and Dissertations 2026

Teledentistry has been promoted as a strategy to minimize emergency department (ED) visits for non-traumatic dental conditions (NTDCs). However, it remains unclear whether structural readiness or temporary policy expansion drives sustained reductions in reliance on the ED. This study integrates Andersen’s Behavioral Model of Health Services Use and Diffusion of Innovation (DOI) theory to examine determinants of Medicaid NTDC ED utilization and Tele-dentistry adoption.

Andersen’s model posits that utilization is shaped by predisposing, enabling, and need factors, whereas DOI theory emphasizes structural attributes that influence adoption, including relative advantage, compatibility, complexity, trialability, and observability. Combining these frameworks allows for a …

Puff, Puff, Pass? Examining Cannabis Use Among Black American Adults, Christopher B. Walker

Graduate Studies Theses and Dissertations 2026

In the United States, cannabis has become one of the most widely used controlled substances due to its increase in social acceptance, the growing number of states legalizing it for medical and non-medical purposes, and the expansion of consumption methods.  However, little is known about the modes of cannabis use chosen by Black American adults.  This population is of importance due to existing research suggesting their increased risk of developing cannabis use disorder compared to their White counterparts and their underrepresentation in existing literature.  The goal of this study is to examine cannabis use among Black adults in the U.S., …

The Development And Pilot Evaluation Of An Out-Of-Hospital Immersive Birthing Simulation Training Application For Paramedics And Ambulance Officers Using Virtual-Reality Technology, Michella Hill

Theses: Doctorates and Masters

Out-of-hospital births (OOHBs) are births which occur outside a hospital setting. This includes planned home births attended by midwives, or unplanned OOHBs where the intention was to birth in a hospital or maternity centre, however, occurs in an unintended location. Prehospital clinicians, inclusive of registered paramedics and volunteer ambulance officers (VAOs) infrequently attend OOHBs, as most births occur in maternity wards as anticipated. OOHBs comprises < 1% of emergency ambulance requests and requires specialised skills for prehospital clinicians to competently manage birthing and potential complications. As exposure to birthing is so rare, these specialised skills and knowledge are underutilised and subject to rapid decay. Compounding the problem, obstetrics is infrequently taught across undergraduate education, in-service training, or within individual clinician’s continuing professional development. Placements shadowing midwives are scarce due to nursing and medical students receiving priority. Previous research regarding OOHBs is limited, nonetheless suggests prehospital clinicians are underprepared to manage an OOHB, which has serious patient safety implications. The present research sought to explore prehospital clinicians’ preparedness and confidence in managing OOHBs. It also investigates whether a digital training solution such as virtual reality (VR) simulation may reduce the theory-practice gap and assist in competency retention.

Publication one provides a comprehensive methodology outline which is applied to Study One; a scoping review of prehospital clinician and birth parent experiences with OOHBs. Risk factors, complications and interventions provided by prehospital clinicians, as …

Associations Between Neighborhood Physical And Social Stressors During Sensitive Developmental Periods And Substance Use In Early Adulthood, Abigail M. Ulofoshio

Electronic Theses & Dissertations (2024 - present)

Background

Substance use is a major public health problem. Neighborhood disadvantage and related stressors have been linked to increased substance use in adolescence and early adulthood, although findings are mixed. No studies have explored whether the timing or accumulation of neighborhood stressors in childhood and adolescence impact substance use in early adulthood. This study aims to investigate to what extent physical and social neighborhood stress during sensitive developmental periods influence substance use dependency and illicit substance use in early adulthood.

Methods

We analyzed an imputed sample (n = 7,494) from the Avon Longitudinal Study of Parents and Children (ALSPAC), a …

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

Electronic Theses & Dissertations (2024 - present)

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

Combating Antibiotic Resistance With Plasmid-Dependent Phages, Rhiannon T. Mariano

Electronic Theses & Dissertations (2024 - present)

The alarming rise of carbapenem-resistant bacteria poses an urgent global health threat, driven in large part by the horizontal spread of carbapenemase-encoding plasmids (Ma et al., 2023). These plasmids are often highly mobile and transmissible, enabling rapid dissemination of resistance genes across diverse bacterial populations. Their mobility is largely mediated by conjugation, a process dependent on the formation of pili, which serve as physical bridges for plasmid transfer between cells (Murray et al. 2022; San Millan and MacLean 2017; Virolle et al. 2020). Beyond their role in gene exchange, these pili also act as entry points for a unique class …

Development And Applications Of Fluorescence Microscopy Protocol To Investigate Borrelia Burgdorferi Immune Interactions In The Skin, Rebecca V. Landry

Electronic Theses & Dissertations (2024 - present)

The skin is an immunological organ that acts as the hosts’ first line of defense against infectious agents. Infectious disease vectors like ticks breach this barrier by feeding on hosts, transmitting pathogens like Borrelia burgdorferi in the process. Uncleared infection with B. burgdorferi causes Lyme disease, the most prevalent vector-borne disease in the United States. Previous research has explained many elements of Lyme disease pathogenesis and immunity including the dissemination of the spirochete, innate immune cells performing phagocytosis, the production of antibodies by the humoral response, and the impact of prophylactic treatment with monoclonal antibodies. A remaining gap in the …

Hepatitis C Among Persons Who Inject Drugs In New York State: Progress Towards Elimination, Meredith A. Barranco

Electronic Theses & Dissertations (2024 - present)

Background: Hepatitis C virus (HCV) infection is one of the leading causes of liver disease in the United States (US) and worldwide. In the United States today, HCV is transmitted primarily through injection drug use (IDU) and therefore disproportionately impacts persons who inject drugs (PWID), a population with a range of complex social and health needs. HCV is not vaccine-preventable but can be cured in over 90% of cases with an 8–12-week course of daily direct-acting antiviral (DAA) medication. Since approval of curative medications in 2014, various jurisdictions have developed plans to eliminate HCV. In 2021, the New York State …

Regulating For Birth Justice, Jamille Fields Allsbrook

Lewis & Clark Law Review

Impacted persons have shared accounts of traumatic birthing experiences, and advocates have raised the alarm on the urgent need to advance birth justice. Despite this raised awareness, women and birthing people are still dying and suffering unnecessarily. Even more, systems are still structured to impede birthing choices, particularly those from marginalized communities such as Black and Indigenous women. Notably, over 80% of U.S. maternal deaths are preventable, according to federal government data. Ironically, the same laws and systems that have created, perpetuated, and tolerated birth injustices can be leveraged to move the country towards birth justice. On the national level, …

Do Fair Schedules Matter? Work-Home Conflict And Justice In Emergency Medicine, Maresca J. Brand

Graduate Studies Theses and Dissertations 2026

Emergency physicians work in a high-demand environment requiring irregular, around-the-clock schedules, which can contribute to elevated work-home conflict and burnout. While previous research has focused on objective schedule characteristics such as length of shift or time of day worked, less attention has been given to how emergency physicians perceive the fairness of the scheduling process itself. Drawing on Work-Home Resources Theory and Personal Resource Allocation Theory, this study examines whether perceptions of schedule justice influence work-home conflict via schedule satisfaction. I propose that perceived fairness in schedule creation functions as a contextual resource that shapes whether a schedule is experienced …

Assessing Access To Orthopaedic Care For Patients With Osteogenesis Imperfecta, Annemarie K. Leonard, Kara Ayers, Lauren Faokunla, Kaeli Samson, Erika Carter, Tracy Hart, Maegen Wallace

Graduate Medical Education Research Journal

Background. Osteogenesis Imperfecta (OI) is a rare disorder caused by variations in collagen. Clinical manifestations include multiple fractures, short stature, scoliosis, blue sclera, hearing loss, and opalescent teeth. Patients often need many different medical providers frequently, which may place financial burdens on families. This study sought to identify and understand barriers to care for children with OI.

Methods. We utilized an Institutional Review Board (IRB)-approved survey for primary caregivers of children with OI. Questions included demographic data, type of health insurance, history of and reasons for insurance denials, access to multidisciplinary OI care, and travel to receive OI care. The …

Translating Evidence Into Action: Understanding How Community- Based Practitioners Make Intervention Implementation Decisions In Practice, Kristin C. Bennett

Dissertations and Theses (Open Access)

This study examined how community-based practitioners implement public health interventions in practice settings to identify gaps between existing implementation frameworks and real-world practice. Six farmers' markets in Southeast Texas served as cases to understand implementation decision-making by community-based practitioners addressing food access challenges. A qualitative case study approach was employed, using semi-structured interviews with program adopters and key stakeholders to examine how practitioners addressed food access problems, selected interventions, and navigated implementation decisions. This methodology captured the contextual nature of implementation decision-making in community settings. The findings revealed that program adopters recognized health problems through lived experience rather than formal …

Associations Between Health-Seeking Behaviors And Social Support For Adult Black Women In The United States, Patricia Saint Cyr-Hager

Walden Dissertations and Doctoral Studies

A persistent gap exists involving health outcomes for Black women in the United States, regardless of socioeconomic status when compared to Black men and White women. This qualitative case study involved exploring the influence of social support on health-seeking behaviors among Black women. Sixteen participants, between ages 22 to 49 from nine states, were recruited. Data was collected using semi-structured interviews based on the social support theory. An analysis of the network composition showed that family members (including mothers, fathers, sisters, and partners), friends, community support groups not connected to social media, and online community support groups were the most …

The Association Between E-Cigarette Use And Community Mattering Among Adolescents In Maine, April Hughes

Walden Dissertations and Doctoral Studies

E-cigarette use among U.S. high school students is a significant public health issue. Factors such as mattering, sexual orientation, and gender identity (SOGI) influence e-cigarette use among adolescents, yet few studies have explored the relationship between mattering and e-cigarette use when considering SOGI. This quantitative study explored the association between past 30-day e-cigarette use and mattering among Maine high schoolers while controlling for SOGI and grade level. This correlational cross-sectional study used the 2023 Maine Integrated Youth Health Survey data, and the socioecological model served as the theoretical foundation. A multivariate binary logistic regression analysis indicated a significant association between …

Health Risk Assessment (Hra) In Home-Based Ironing Businesses: Risk Identification, Intervention, And Evaluation In Johar Baru District, Central Jakarta, Heru Alfares, Irawadi Darmaputra, Marsen Isbayuputra, Muhammad Ilyas

Occupational and Environmental Medicine Journal of Indonesia

Background Home-based ironing businesses in Johar Baru District, Central Jakarta, are part of the informal sector, vulnerable to health risks due to suboptimal working conditions. This study aims to identify, assess, and control health risks through a Health Risk Assessment (HRA) approach.

Methods Research methods include direct observation, interviews, environmental measurements, health screenings, and ergonomic surveys using the BRIEF (Baseline Risk Identification of Ergonomic Factor) instrument.

Results The results indicate that the temperature in the ironing area reaches 33°C, exceeding the comfort standard, and that 80% of workers have dark yellow urine, indicating a high risk of dehydration. Risk assessment …

Returning To Work On Chef With Graves’ Disease: A Case Report, Izzatul Abadiyah, Dewi Sumaryani Soemarko

Occupational and Environmental Medicine Journal of Indonesia

Background Graves’ disease has adverse effects on quality of life, because of somatic psychiatric symptoms and an inability to work. Chefs face many occupational hazards that can aggravate certain medical conditions, worsen the disease, and pose safety risks at work. This case report aims to assess the returning-to-work evaluation and program for a chef with Graves’ disease.

Case Description A forty-seven-year-old Indonesian male who was diagnosed with Graves’ disease from characteristic clinical features and biochemical abnormalities was admitted to the hospital with shortness of breath. TSH concentration was 0.001mU/L, FT4 concentration was 2.85 ng/dL, hemoglobin level was 10.6 g/dL, and …

Burden Of Musculoskeletal Disorders, Associated Risk Factors And Perceptions On Prevention Among Airport Baggage Handlers, Ashish A. Trivedi Md, Alice Lai, Mahmud Tasim, Nik Tuah

Occupational and Environmental Medicine Journal of Indonesia

Background Airport baggage handlers are involved in manual handling of heavy loads, predisposing them to the risk of developing work-related musculoskeletal disorders (MSDs). This study aimed to determine the burden of self-reported MSDs and their associated factors among airport baggage handlers in Brunei Darussalam.

Methods In this cross-sectional study, we used a self-administered questionnaire to collect demographic and work profile data. We also incorporated the Nordic Musculoskeletal Questionnaire to assess body-part MSD symptoms over a 12-month period. Baggage handlers’ perceptions of the likelihood of specific work tasks related to MSDs and of preventative measures were also sought.  The data were …

Comparative Analysis Of Groundwater Quality Based On Chemical Parameters Around Final Disposal Sites Using Open Dumping And Sanitary Landfill Methods, Shiesil Rizqia Amadia, Mika Vernicia Humairo

Preventia: The Indonesian Journal of Public Health

The main environmental issue at landfill sites is the seepage of leachate into the ground, which contaminates surrounding aquifers. Communities residing within one kilometer of landfill sites are at high risk of environmental pollution. This study aimed to analyze differences in groundwater quality around landfills applying open dumping and sanitary landfill methods, and to compare groundwater quality at safe and unsafe distances from these sites. The research was conducted around the Cipayung landfill in Depok (open dumping) and the Talangagung landfill in Kepanjen (sanitary landfill). The study adopted an analytical observational approach using a cross-sectional design. The independent variables included …

Analysis Of Demand And Supply Of Radiotherapy Services At Dr.M.Djamil General Hospital Padang, Viola Shinta Dewi, Catur Suharinto, Zarni Zamzahar, Yulhaini Yulhaini

Preventia: The Indonesian Journal of Public Health

Around 10 million cases of cancer are discovered in the world per year, and it will continue to increase. Half of cancer cases require radiotherapy as treatment therapy. Dr. M. Djamil General Hospital, Padang, in 2021, has only 1 Cobalt radiotherapy. This study aimed to analyze the demand and supply of radiotherapy services at Dr. M. Djamil General Hospital, Padang. This descriptive study was conducted at Dr. M. Djamil General Hospital, Padang from May to December 2022. Data were analyzed using univariate analysis to describe the variables studied. This study reported that 241 patients were registered and received radiotherapy services. …

The Role Of Climate And Population Density In The Spread Of Dengue Fever: A Spatial Analysis Of Padang City 2022–2024, Nailul Hikmi, Aria Gusti

Preventia: The Indonesian Journal of Public Health

In 2023, Padang city had a dengue fever incidence rate of 46.5 per 100,000 population, an increase compared to the previous year. Climate change, with the transition from the dry to the rainy season, contributed to a surge in dengue fever cases. This study aims to determine the relationship between environmental factors and the incidence of dengue fever in Padang City from 2022 to 2024. This study uses an ecological study design with a sample of all dengue fever cases recorded by the Padang City Health Office. Climate data was obtained from the Indonesian Agency for Meteorological, Climatological, and Geophysical …

From Medical Check-Ups To Risk-Based Health Governance: Reframing Fitness-For-Work And Preventive Health In Modern Health Systems, Kasyunnil Kamal, Iqbal Mochtar

Occupational and Environmental Medicine Journal of Indonesia

-

Food Apartheid And The Retail Food Environment In The Bronx, Aissatou Barry

CUNY Mexican Studies Institute

This project examines the structural mechanisms that contribute to unequal food access, both historical and ongoing, in the South Bronx, and applies the food apartheid framework created by Bronx food activist Karen Washington. This paper applies the framework to two food retail initiatives in NYC: the New York State Regional Hub and the New York City FRESH food program to assess whether their policies address the structural mechanisms that contribute to food inequality. I ask: How does the unequal distribution of healthy food access in the Bronx reflect broader patterns of racial and economic exclusion? To what extent do current …

Family Dementia Caregivers’ Disaster Preparedness In Chinese American Communities In New York City, Weiyu Mao, Bei Wu, Yaolin Pei, Zhen Cong

Health Sciences and Kinesiology Faculty Articles

Disaster preparedness is a significant public health concern. Disasters manifest in different forms and often lead to disruption of daily life. This is especially challenging for family dementia caregivers and their care recipients in the community. There remains much unknown regarding dementia caregiver disaster preparedness, especially in ethnic and racial communities. Guided by Protection Motivation Theory, with the backdrop of Hurricane Ida, this study explored the association between caregiving-related characteristics, cognitive appraisals, and disaster preparedness among caregivers in Chinese American communities. Data came from a pilot study on Chinese American family dementia caregivers in New York City between November 2021 …

Analysis And Numerical Investigation Of A Breast Cancer Treatment Model Incorporating Ketogenic Diet And Immune Boosters Via Optimal Control Theory, Kunnisai Muniroh, Ummu Habibah, Wuryansari Muharini Kusumawinahyu, Nur’Izzati Hamdan

Mathematical Modelling and Numerical Simulation with Applications

This paper develops a mathematical model to investigate breast cancer dynamics by incorporating tumor–immune interactions, ketogenic diet effects, and medical treatment. The model is formulated as a system of nonlinear ordinary differential equations and analyzed within an optimal control framework. Time-dependent control variables are introduced to represent treatment strategies aimed at minimizing tumor progression while reducing therapeutic costs. The model’s well-posedness is established through positivity and boundedness analysis. The necessary conditions for optimality are derived using Pontryagin’s Minimum Principle, resulting in a coupled system of state and adjoint equations. Numerical solutions are obtained using the fourth-order Runge–Kutta method combined with …

Us Drug Policy Does Not Align With Experts' Rankings Of Drug Harms: A Multi-Criteria Decision Analysis, Michael Broman, Alan K. Davis, Stacey Armstrong, Adam Levin, Kaltum Ahmed, Gustavo A. Angarita, Brooke J. Arterberry, Cecilia Bergeria, Mitch Earleywine, Kathryn S. Gex, Tom Gregoire, Jamey J. Lister, David S. Mathai, Nicky J. Mehtani, Nathan Menke, Charles D. Nichols, Hillary Shaub, Alayna P. Tackett, Brandon Weiss, Nefize Yalin, Lawrence D. Phillips

School of Medicine Faculty Publications

Background United States drug policy is primarily based on the Controlled Substances Act of 1970 and largely contradicts scientific evidence about how to mitigate drugs' harms. Expert consensus on drug harms could inform policy that improves the health of people who use drugs while reducing negative societal impacts of drug use. Therefore, this study adapted and extended the relevant 2010 United Kingdom multi-criteria decision analysis, rating drug harms by criteria comprising health and social impacts to people who use drugs and their families, communities, and society.Methods Seventeen experts on drug use in the US, including three with lived experience of …

Causal Functional Mediation Analysis With An Application To Functional Magnetic Resonance Imaging Data, Yi Zhao, Xi Luo, Michael E Sobel, Martin A Lindquist, Brian S Caffo

Faculty, Staff and Student Publications

A primary goal of task-based functional magnetic resonance imaging (fMRI) studies is to quantify the effective connectivity between brain regions when stimuli are presented. Assessing the dynamics of effective connectivity has attracted increasing attention. Causal mediation analysis serves as a widely implemented tool aiming to delineate the mechanism between task stimuli and brain activations. However, the case, where the treatment, mediator, and outcome are continuous functions, has not been studied. Causal mediation analysis for functional data is considered. Semiparametric functional linear structural equation models are introduced and causal assumptions are discussed. The proposed models allow for the estimation of individual …

Uji Kelayakan Teknis Dan Performa Auvest: Rompi Pendingin Otomatis Berbasis Wearable Thermoelectric Cooler Untuk Mitigasi Risiko Heat Stress, Muchammad Adam Wildan, Amelia Avril Rayhana, Nadia Hanifan Nabila, Bian Shabri Putri Irwanto

National Journal of Occupational Health and Safety

Heat stress is a serious threat to construction workers that can reduce productivity and even threaten lives. Existing cooling vest innovations still have limitations, such as weight, manual systems, and the risk of leakage. This study aims to analyze the effectiveness of the Automatic Vest (AUVEST), an automatic cooling vest based on Wearable Thermoelectric Cooler and the Internet of Things (IoT), in preventing the risk of heat stress. The method used is experimental with trials on one construction worker in indoor and outdoor environments. AUVEST is equipped with temperature sensors (DS18B20, TMP102) and humidity (DHT11), whose data is processed by …

Occupational Resilience (Part 2): Toward A Cross-Culturally Relevant Measure Of A Novel Construct, Bernard A. Muriithi, Milan Bimali

Occupational Therapy Faculty Scholarship

Occupational resilience (OR) refers to an individual’s ability to persist in performing an occupation, with the duration and intensity of engagement determining resilience for each occupation. It is a key determinant of both the manner and the extent to which occupations influence health; therefore, it is a promising construct with several potential applications. There are currently no validated OR measures; which problematizes its application. Three considerations were made in designing the Occupational Resilience Measure (ORM 1.0) and evaluating its potential as a cross-culturally relevant measure of OR: 1) the findings of a published study of lived experiences of refugees from …

Optimalisasi Rekam Medis Elektronik Berbasis Artificial Intelligence, Ikhwan Rinaldi, Wahyu Sulistiadi

Jurnal Penyakit Dalam Indonesia

Electronic medical records (EMRs) are essential to modern healthcare systems, yet their implementation continues to face challenges such as disruption of doctor–patient communication, administrative burden, and documentation structures misaligned with clinicians’ clinical reasoning processes. This narrative review aims to assess the limitations of conventional EMRs and examine the potential of artificial intelligence (AI) to improve documentation efficiency, accuracy, and overall clinical performance. The literature indicates that AI technologies, including machine learning, deep learning, and natural language processing, can automate documentation, streamline workflows, enhance decision support, and reduce physician burnout, thereby allowing clinicians to devote more attention to patient care. Nevertheless, …

A Study Of Perceptions, Readiness, Benefits, And Barriers Related To Exoskeleton Adoption In New Jersey’S Warehousing Sector, Terry Asante

Theses

The warehousing industry in New Jersey remains a vital component of the region's logistics network, employing more than 200,000 workers who routinely engage in lifting, bending, overhead reaching, and other physically demanding activities. These exposures contribute to musculoskeletal disorder (MSD) rates that exceed national averages, particularly affecting the low back and shoulders. Nationally, MSDs account for an estimated $420 billion in combined direct and indirect costs each year, underscoring the need for interventions that can effectively reduce biomechanical strain. Industrial exoskeletons have emerged as a potential solution, with prior research demonstrating reductions in muscle activation, perceived exertion, and fatigue during …