Digital Commons Network^™

Advanced Interactions Of Directed Energy With Retinal Pigment Epithelial Cells And Their Photochemical And Photothermal Responses, Jin B. Ha

Theses & Dissertations

Excess optical radiation can injure the retina through either rapid heat deposition (photothermal damage) or cumulative photo‑oxidative stress (photochemical damage), yet current laser‑safety limits treat these mechanisms as independent. To test that assumption, this dissertation integrated systematic wavelength, duration and temperature‑controlled laser exposures with live/dead fluorescence imaging in a melanin‑loaded hTERT‑RPE1 monolayer model. First, concurrent 447 nm (blue) and 2 µm (infra‑red) beams delivered for 200 s demonstrated a strong thermal–photochemical synergy: each beam alone was sub‑threshold (≤25 % lethality) but together produced 100 % RPE death without exceeding 50 °C, proving that modest heating markedly lowers the photon dose …

Application Of Machine Learning In Early Childhood Development Research: A Scoping Review, Faith Benson, Daisy Chelangat, Willie Brink, Patrick Mwangala, Akbar Waljee, Cheryl Moyer, Amina Abubakar

Institute for Human Development, East Africa

Background: Early childhood development (ECD) lays the foundation for lifelong health, academic success and social well-being, yet over 250 million children in low- and middle-income countries are at risk of not reaching their developmental potential. Traditional measures fail to fully capture the risks associated with a child’s development outcomes. Artificial intelligence techniques, particularly machine learning (ML), offer an innovative approach by analysing complex datasets to detect subtle developmental patterns.

Objective: To map the existing literature on the use of ML in ECD research, including its geographical distribution, to identify research gaps and inform future directions. The review focuses on …

Social Cohesion, Trust, And Utilisation Of Maternal Health Services Among Refugee And Host Community Women In Bangladesh And Kenya, Haeun Lee, Ryan Rego, Neyat Fiseha, Ashok Barman, Nimo Sharif, Peninah Wachira, Joe Kolars, Akbar Waljee, Rubhana Raqib, Amina Abubakar

Institute for Human Development, East Africa

The global refugee crisis places significant pressure on host communities, particularly in low- and middle-income countries. Social cohesion and trust between refugee and host communities are critical for maternal health service utilisation. This study explores the relationship between host–refugee trust, social cohesion, and maternal health service use in Bangladesh and Kenya, focusing on facility-based delivery, antenatal care visits, and postnatal care attendance. To do so, a cross-sectional survey was administered among 649 refugee/displaced women and 371 host community women in the two locations. The results show high trust levels in both groups, while social cohesion is greater among refugee/displaced women. …

Evaluating What Works: A Comparison Of Five Diabetes Prevention Programs For Latino Children, Ruchi Patel

Doctor of Nursing Practice Final Project Abstract

Background: Children in the Rio Grande Valley (RGV) are at increased risk of diabetes due to limited access to effective, culturally appropriate prevention programs. Existing programs are often time-intensive, require transportation, and lack cultural relevance, reducing participation and impacting outcomes. This project aimed to evaluate diabetes prevention programs (DPPs) in the literature and identify five that may benefit children in the RGV by reducing diabetes risk.

Methodology: The Eightfold Path policy analysis approach guided this project. A literature review identified DPPs for children, and the Critical Appraisal Skills Programme (CASP) was used to assess study quality. Limitations included difficulty finding …

A Global Movement Takes Shape – Physical Activity, Health, And The New Era Of Responsibility: “Global Alliance For Promotion Of Physical Activity”, J. M. Steinacker, W. Van Mechelen, C. Joisten, S. Zanuso, C. A. Jaworski, Y. P. Pitsiladis

Research outputs 2022 to 2026

No abstract provided.

Digital Tools To Promote Or Measure Health Literacy In Children Aged 3–5 Years: Scoping Review, Caron Molster, Jennifer Irvine, Amanda Devine, Ruth Wallace, Lennie Barblett, Leesa Costello

Research outputs 2022 to 2026

Health literacy is a determinant of health that should be promoted and measured in early childhood. In the era of digitalization, this could involve digital platforms. However, little knowledge exists on the extent, range, and nature of literature on digital tools for promoting or measuring young children’s health literacy. Addressing this gap, a scoping review was undertaken to explore what digital health literacy tools for children aged 3–5 years could be identified in the literature, what their key features were, how they were designed, whether children were codesigners, and whether the tools had been evaluated. Eligibility criteria included the literature …

The Impact Of Culture And Language On Internal Communication And Patient Care In Small To Medium-Sized Black Immigrant-Owned Healthcare Practices In Texas., Chisom Nwosu

Dissertations

This qualitative phenomenological study explored how cultural competency in small to medium-sized Black immigrant-owned healthcare practices in Texas affects internal communication and patient care. Through semi-structured interviews with nine clinical and administrative leaders in Dallas and Houston, five themes emerged: culturally competent leadership, intentional communication structures, language and interpretation practices, patient-centered cultural sensitivity, and the use of technology for adaptation. Findings suggest that culturally aware leadership and inclusive communication strategies foster team cohesion and improve patient trust and care. Participants reported adapting workflows to meet religious, language, and communication needs through human and technological tools. The study underscores embedding cultural …

Adolescent E-Cigarette Expectancies: Measure Development And Preliminary Validity Of The Electronic Nicotine Vaping Outcomes Measure For Youth, Paul T. Harrell, Kelli J. England, Tracey E. Barnett, Vani N. Simmons, Richard W. Handel, Amy C. Paulson

Department of Pediatrics Faculty Publications

BACKGROUND: Electronic nicotine delivery systems (“e-cigarettes”) are the nicotine product most commonly used by adolescents. Research, treatment, and policy could benefit from measures of adolescent e-cigarette beliefs about outcomes of use (ie, expectancies). In the current study, we developed and tested an adolescent electronic nicotine vaping expectancy measure.

METHODS: A focus group with adolescents evaluated potential e-cigarette expectancy items. A panel of national experts assisted in revision of these items. Finally, items were administered to a sample of adolescents 14-17 years old (N = 267, Mean age 15.6, SD = 1.1, 50.9% Female, 50.2% Non-Hispanic White, 22.5% Non-Hispanic Black, 14.2% …

Adolescent Online Leisure, Media Literacy, Online Victimization, And Multifaceted Well-Being During Covid-19: The Role Of Parental Support, Yunqi Wang

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

The rapid advancement of the internet and digital technology has provided opportunities for adolescents to conduct leisure activities online on a daily basis. However, research on adolescent technology use and mental health often highlights negative effects without carefully examining the specific mechanisms, which overlooks the complexity of effects of online behaviors on adolescent well-being and the importance of developing adolescents’ media literacy skills. Moreover, despite the crucial role of family dynamics in adolescent development, research on how parental support and involvement might affect adolescent technology use and well-being is still limited. The current study retrieved data from Programme for International …

Resilience Of Interdependent Transportation And Healthcare Systems: A Simulation-Driven Framework Incorporating Social Equity And Facility Optimization, S. Yasaman Ahmadi

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

The overarching goal of this dissertation is to develop an integrated, simulation-driven framework to assess and enhance the resilience of interdependent transportation and healthcare systems before, during, and after natural hazards. By examining how spatial disruptions, social vulnerability, operational constraints, and infrastructure interdependencies affect access to and functionality of hospitals, this research offers a multifaceted evaluation of system performance under stress. This dissertation examines the impact of natural hazards, particularly floods, on the interdependent transportation and healthcare systems. The proposed approach combines and advances GIS-based network analysis, graph-theoretical modeling, and discrete-event simulation to evaluate system performance under different scenarios. The …

Bilingual Budget-Friendly Hispanic Cookbook And Resource Guide For Food Pantries In San Bernardino County, Anasofia Garay Guzman

Electronic Theses, Projects, and Dissertations

San Bernardino County is faced with a significant issue of food insecurity with its residents relying on food pantries to meet their food and nutritional needs. However, the food items offered at food pantries are often limited in quantities and the variety is inconsistent, which makes it a challenge for families wanting to prepare healthier budget friendly meals while maintaining its cultural relevance. This project consists of two main key components: a bilingual, culturally relevant budget-friendly Hispanic cookbook and a comprehensive resource guide about ways and ingredient substitutions adaptable to the recipe based on what is available.

The cookbook included …

Medical Surveillance In Custodial Jsas: Preventing Bloodborne Pathogen Exposure, Kiara Gadea

Electronic Theses, Projects, and Dissertations

Custodians play an important role in maintaining our surroundings safe and sanitary. However, in doing so, they are their exposure to health hazards that put them at risk, yet these exposures are often overlooked. One major risk they face is contact with bloodborne pathogens, which put custodial staff at risk for infections such as hepatitis B. While Job Safety Analyses (JSA’s) outline various protective measures, many fail to incorporate medical surveillance as part of their risk management program. Overlooking this important detail leaves custodians vulnerable to health risks that can be prevented.

Adding a medical surveillance section to custodial JSA’s, …

Identifying And Breaking Barriers: Addressing Disparities In The Care Of Patients With Gynecologic Cancers, Bhavana Pothuri, Michele Muir, Jean Hurteau, John Farley, Michelle D. Lightfoot, Summer Dewdney, Tara Castellano, John K. Chan, Sharad Ghamande, Al Asante-Facey, Marina Stasenko, B J. Rimel, Electra D. Paskett

School of Medicine Faculty Publications

BACKGROUND: Significant disparities exist in the care of patients with gynecologic malignancies. Higher incidences of gynecologic malignancies among underrepresented subpopulations (eg, racial, ethnic, and/or LGBTQAI+) and lack of representative enrollment within clinical trials have highlighted the need to improve healthcare equity. We aimed to identify barriers to equitable health care and clinical trial participation for specific diverse populations of patients with gynecologic malignancies and to identify potential solutions for overcoming these barriers. METHODS: A series of 4 live and 3 asynchronous advisory boards facilitated by GSK was conducted between January 2023 and July 2024; live advisory boards were population specific. …

Simulating The Blood Transfusion System In Kenya: Modelling Methods And Exploratory Analyses, Yiqi Tian, Bo Zeng, Jana Macleod, Gatwiri Murithi, Cindy Makanga, Hillary Barmasai, Linda Barnes, Rahul Bidanda, Tecla Chelagat, Carolyne Njoki

Anaesthesiology, East Africa

The process of collecting blood from donors and making it available for transfusion requires a complex series of operations involving multiple actors and different resources at each step. Ensuring hospitals receive adequate and safe blood for transfusion is a common challenge across low- and middle-income countries, but is rarely addressed from a system level. This paper presents the first use of discrete event simulation to study the blood system in Kenya and to explore the effect of variations and perturbations at different steps of the system on meeting blood demand at patient level. A process map of the Kenyan blood …

Do Finances Determine Our Fate?: Understanding The Relationships Between Socioeconomic Status, Inflammation, And Cancer Recurrence Risk, Faith Wilbourne

Master's Theses

Individuals of a low socioeconomic status (SES) are more likely to experience a cancer recurrence relative to individuals with a higher SES. This may be partially explained by the stressors of living with a low SES. These stressors can increase inflammatory markers known to elevate the risk of cancer development. Health-promoting behaviors such as exercise, adequate sleep, and a healthy diet can reduce systemic inflammation. Health behaviors may therefore moderate any potential relationship between SES and cancer recurrence risk. This study explored associations between SES (income, educational attainment) and inflammatory markers related to cancer recurrence while seeking to determine if …

A Tale Of Two Toxicants: Investigating The Interaction Between Hexavalent Chromium And Perfluorooctane Sulfonic Acid., Morgan Elizabeth Delnicki

Electronic Theses and Dissertations

Hexavalent chromium [Cr(VI)] and per- and polyfluoroalkyl substances (PFAS) are environmental contaminants of major public health concern. Despite commonly being found together in contaminated drinking water, no studies have considered the concomitant health effects of Cr(VI) and PFAS, specifically perfluorooctane sulfonic acid (PFOS). In vitro studies using CHO cells assessed the cytotoxicity and genotoxicity of Cr(VI) and PFAS both individually and in combination. Intracellular and extracellular Cr levels were measured with Atomic Absorption Spectrometry. PFOS was found to exacerbate Cr(VI) induced cytotoxicity and genotoxicity. Additionally, a novel in vivo model of studying the hepatotoxicity of Cr(VI) was established. Adult Hartley …

Exploring Hexavalent Chromium Exposure And Lipid Accumulation In Liver Disease., Gabrielle Celine Griffin

Electronic Theses and Dissertations

The prevalence of MASLD has doubled over the past 20 years and continues to rise. Hexavalent chromium [Cr(VI)], a top chemical hazard in U.S. drinking water, is emerging as potential risk factor for liver disease. To study the impact of Cr(VI) and high-fat diet on MASLD, we developed an in vivo model using Sprague-Dawley rats exposed to Cr(VI) in drinking water (0, 0.05, or 0.1 mg/L) and fed normal or high-fat diet for 90 days. High-fat diet significantly increased body mass, plasma lipoproteins, cholesterol, liver injury, and hepatic triglycerides, which were exacerbated by Cr(VI) exposure. Cr(VI) alone increased hepatic chromium …

Intergenerational Family Dynamics Among Caregivers And Children’S Social-Emotional Development In China, Weiman Xu

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

The early years of a child’s life are pivotal for social-emotional development. While extensive research has explored the role of family settings in fostering children's social-emotional development (Bornstein, 2005), the impact of grandparental involvement, particularly the caregiving dynamics between generations, remains less well understood. This study aims to fill this gap by examining two critical aspects of intergenerational dynamics among caregivers (i.e. parent-grandparent coparenting and parent-grandparent relationship quality) and their associations with children’s social-emotional development (i.e. social skills and problem behaviors). Two specific aims were delineated: 1) examine the unique contribution of parent-grandparent coparenting, especially the power and authority domain …

The Tree That Would Not Fall: An Educator’S Autoethnographic Journey Of Healing Through Words, Raeanna Marie Carlson

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

To say the world has changed since the 2020 COVID-19 shut down is to minimize the micro and macro social changes that infiltrated the school system. In the wake of it all, we find a landscape marred by a both rising teacher attrition and struggling student motivation. This autoethnographic dissertation explores the deeply personal experience tethered to a deeply problematic system that contributes to not only teacher burnout but what I came to know as teacher demoralization. Personal traumas of teachers profoundly impact their experience in the classroom, and as I examined my own near departure from the classroom, I …

If Alcohol Consumption Were Eliminated, Which Us Counties Would Still Experience High Rates Of Breast Cancer Among Women?, Hina Javed

Boise State University Theses and Dissertations

Background

Breast cancer is the most prevalent cancer among women in the United States, accounting for roughly one-third of all newly diagnosed female cancers (American Cancer Society, 2024). The risk factors for breast cancer include both non-modifiable and modifiable factors. Non-modifiable factors include age at menarche, early menstrual cycles and late menopause. Modifiable factors include smoking, diabetes, obesity and environmental factors such as air pollution. The interplay between lifestyle factors and environmental exposures in cancer development has long been debated. While alcohol consumption is widely recognized as a major breast cancer risk factor, the role of environmental exposure such as …

The Relationship Between Total Serum Cholesterol And Hypertensive Outcomes Among Women 50-60 Years Old: Findings From The Framingham Heart Study, Sierra Smith

Capstone Experience: Master of Public Health

Objective: To assess whether total serum cholesterol (TSC) among middle-aged women is associated with subsequent hypertension while accounting for potential confounders.

Methods: A sample of 853 adults who identify as women, aged 50-60, from the Framingham Heart Study 1948-1972 cohort was selected for this study. Participants' TSC was measured at baseline, and they were followed for 24 years for cardiovascular disease outcomes or death. The outcome of interest in this study was hypertension. A multivariable logistic regression was used to analyze the relationship between TSC and hypertension while controlling for age, glucose, systolic, and diastolic blood pressure.

Results: Compared to …

Analysis Of The Clinical, Socioeconomic, And Sociodemographic Characteristics Of Virally Unsuppressed Children Aged 2-14 Living With Hiv/Aids In The Region Of Abidjan 2 – Côte D’Ivoire (Region Supported By Usaid), Maman Fathim Kamagate

Capstone Experience: Master of Public Health

Background: Viral suppression among children living with HIV (CLHIV) remains suboptimal in Côte d’Ivoire. This study assessed clinical, socioeconomic, and demographic characteristics associated with viral non-suppression among CLHIV aged 2–14 years in Abidjan 2 to inform targeted interventions under the U.S. Agency for International Development (USAID)-supported Reaching Impact, Saturation, and Epidemic Control (RISE) project.

Methods: A retrospective analysis was conducted using routine program data from 1,203 CLHIV across 73 health facilities. Descriptive, bivariate, and multivariate analyses were performed to examine associations with viral load suppression status. Findings guided the development of a multi-level implementation plan using Kotter’s Change Management Framework, …

The Real Story Of “The Happy Mother”: A Narrative Inquiry Exploring The Construction Of Motherhood And Postpartum Depression, Elizabeth Erin Falconer

Seton Hall University Dissertations and Theses (ETDs)

The transition to motherhood is a complex and challenging period, during which mothers undergo a considerable number of biological, hormonal, and identity changes. The first six to eight weeks following childbirth is a time of great susceptibility to postpartum depression for mothers. Despite its prevalence, there is a lack of research beyond the biological understanding of the experience. Prior literature has examined the biological aspects of postpartum depression and its societal influences on motherhood. However, no prior study has explored how postpartum depression impacts mothers’ construction and understanding of motherhood through investigating their subjective, lived experiences. This study fills that …

Water Fluoridation: A Personal Perspective On The Effectiveness Of Community Water Fluoridation, William Chase Dds, Maom

The Journal of the Michigan Dental Association

This article offers Dr. William R. Chase's personal insights into community water fluoridation, emphasizing its effectiveness in preventing dental caries. It traces the discovery of fluoride's benefits back to Frederick McKay's 1901 observations and highlights the pivotal 1945 Grand Rapids Study, which demonstrated significant caries reduction, especially in younger age groups. Despite long-standing support from the American Dental Association, controversies regarding fluoride's safety persist, leading to recent state-level bans. Dr. Chase's experiences in countries without fluoridated water, where he observed severe decay and life-threatening cellulitis, underscore his belief in fluoride as a "miracle supplement" when properly utilized. The Michigan Dental …

Did California's Mental Health Services Act Improve Mental Health? Evidence From Self-Reported Data, Bennett Rider

All Theses

This analysis evaluates the impact of California’s Mental Health Services Act (MHSA), which was implemented in 2006 to increase access and improve quality of mental health care for Californians. Difference-in-differences analyses were applied to evaluate the impact of the MHSA on the number of poor mental health days in the past month (PMHDs) that survey respondents had self-reported, relative to a control group with similar pre-policy trends. Using survey data from the Behavioral Risk Factor Surveillance System (BRFSS), this study found that the MHSA’s full implementation is associated with California respondents reporting 0.118 fewer poor mental health days in the …

What Is Clinical Excellence, And How Do Healthcare Companies Achieve It?, Lorena R. Muller

Electronic Theses, Projects, and Dissertations

Clinical excellence is the benchmark for quality in modern healthcare organizations, encompassing safe, effective, patient-centered, timely, efficient, and equitable care. For organizations to develop excellent care facilities, they must clearly define the roles and responsibilities of their healthcare teams. These necessities include strong leadership, a structured staff, a functioning clinical support system, and finally, a focus and strategy to help their community's population health needs. By examining existing programs and developing them in response to the needs of healthcare organizations and communities, this article explores various ways to achieve excellence.

Evaluation Of The Psychometric Properties Of The Social Communication Questionnaire In Rural Kenya, Patricia Kipkemoi, Jeanne Savage, Joseph Gona, Kenneth Rimba, Martha Kombe, Paul Mwangi, Collins Kipkoech, Danielle Posthuma, Charles Newton, Amina Abubakar

Institute for Human Development, East Africa

Children can be reliably diagnosed with autism as early as 3 years of age, and early interventions are initiated. There is often a significant gap between the age of onset of symptoms (2–3 years) and diagnosis (8–10 years) in Africa. We conducted a study to validate the Social Communication Questionnaire (SCQ) as a screening instrument in a rural setting in Kenya. The study was conducted along the Kenyan Coast. Study participants included 172 children with a neurodevelopmental disorder (NDD) diagnosis (84 of which were autism) and 112 controls. Internal consistency was evaluated through the use of Cronbach’s alpha, confirmatory factor …

Evaluating The Impact Of Medicaid Expansion On Non-Small Cell Lung Cancer Care And Health Disparities, Marvin Idoteyin Okon

All Dissertations

Persistent disparities in non-small cell lung cancer (NSCLC) outcomes reflect broader structural inequities shaped by race, place, and socioeconomic conditions. This dissertation examined trends in NSCLC outcomes over the past two decades and evaluated the impact of Medicaid Expansion (ME) under the Affordable Care Act on improving outcomes and reducing disparities, especially in marginalized communities.

Using nationally representative datasets, three interrelated studies were conducted. The first assessed trends in NSCLC incidence, early-stage diagnosis, and 3-year survival from 2002-2021, stratified by metropolitan status, deprivation (Social Deprivation Index), and segregation (Index of Concentration at the Extremes). While incidence declined and early-stage diagnosis …

Evaluating Covid-19, Influenza, And Rsv Vaccine Effectiveness, Iromi N. Jayawardena

All Dissertations

Respiratory infectious diseases, including COVID-19, influenza, and RSV, pose significant public health challenges, especially during the respiratory virus season. Vaccination remains the primary intervention to mitigate morbidity and mortality associated with these diseases. Vaccine effectiveness (VE) can vary between seasons and populations, necessitating continuous evaluation. This study aims to evaluate the effectiveness of the 2024-2025 COVID-19 mRNA vaccine, 2024-2025 seasonal influenza vaccine, and single-dose RSV vaccine over two seasons.

Utilizing electronic health records (EHRs) from the Prisma Health healthcare system, this dissertation emulated target trials to assess the vaccine effectiveness of each vaccine. Risk set propensity matching was used to …

Europe–Africa Collaboration: Working Together To Strengthen Health Research, Implementation, And Equitable Systems, Lara Pandya, Irene Norstedt, Martin Seychell, Emer Cooke, Isabel Barranco, Niklas Blomberg, Marleen Temmerman, Michael Makanga

Centre of Excellence in Women and Child Health

No abstract provided.