Digital Commons Network^™

Regional Differences Between Puerto Rican And Hispanic Mainland U.S. Parents’ Perceptions Of Childhood Obesity, Kasandra Blanton

Walden Dissertations and Doctoral Studies

No abstract provided.

Proactive Strategies For Catheter-Associated Urinary Tract Infection (Cauti) Reduction: Leveraging Audit Tools And Interdisciplinary Collaboration, Mica Blauw

Posters

Catheter-associated urinary tract infections (CAUTIs) are a known cause of harm to patients. Policies enforcing infection prevention measures may help minimize the risk of harm to patients, but written policies do not always translate to bedside practice. We implemented a proactive daily audit to increase awareness of, and compliance with, CAUTI prevention tactics.

Code Wet: Navigating Water Leak Mitigation And Remediation Behind The Red Line, Mica Blauw

Posters

Water leaks in the hospital setting are concerning because of the possibility of mold growthon porous materials such asdrywallthatmaylead toinfections. Water leaksbehind the line of demarcation in the surgical services suiterequire extra care during the remediation processdue to the high-risk nature of surgical patients. We navigated water leakmitigation and remediation in a surgical suite while keeping surgical operations funning safely.

Using Social Return On Investment To Evaluate Services That Support The Health Of People Experiencing Homelessness In Australia: A Scoping Review, Cate Mckenna, Christopher Rouen, Mary O'Loughlin

Research outputs 2022 to 2026

The increasing demand for homelessness services in Australia highlights the need for robust evaluation methodologies to assess their social impact. Traditional economic evaluation methods often struggle to capture the intangible social and health outcomes associated with homelessness. Social return on investment (SROI), an outcomes-based framework driven by stakeholders, offers a flexible and comprehensive approach to measuring social, economic and environmental impacts. This scoping review examines the application of SROI in evaluating services that support the health of people experiencing or at risk of homelessness in Australia. A total of 25 reports from grey literature (2010-2023) were reviewed. The findings reveal …

(Re)Claiming Homeplace: Dance As Embodied Resistance & Healing For Health & Spatial Justice, Preeya G. Kannan

University Honors Theses

This thesis argues that dance functions as both an upstream public health intervention and a form of radical spatial resistance; creating healing, agency, and belonging among historically marginalized communities. Drawing on bell hooks' concept of homeplace, Jasbir Puar's assemblage theory, Nancy Krieger's eco-social theory, and Katherine McKittrick's Black geographies, I position the body as both an ecological and political landscape shaped by histories of colonialism, racial capitalism, displacement, and resilience.

Through this community-based participatory research study, Homeplace, I explore dance as a form of social prescription that centers liberation rather than pathology. Movement is often reduced in public health discourse …

Impact Of Insurance On In-Hospital Mortality And Other Outcomes Among Patients With Acs And Cardiogenic Shock: A Nationwide Analysis From 2022., Renzo Aller, Aura Calderon

Research Symposium

Introduction: Insurance coverage may significantly affect access to timely and advanced cardiovascular therapeutic interventions within the United States. Among individuals experiencing acute myocardial infarction (AMI) accompanied by cardiogenic shock (CS), variations based on the primary payer may play a role in subsequent in-hospital outcomes. We conducted a retrospective analysis to determine whether insurance status correlates with in-hospital mortality and other outcomes among patients with AMI and CS, utilizing the NIS database.

Methods: ACS patients in the 2022 NIS were categorized as STEMI or NSTE-ACS using appropriate ICD‐10 codes. Patients with both types of ACS and cardiogenic shock were included in …

Rural–Urban Disparities In Monkeypox-Related Behaviors And Attitudes Among Men Who Have Sex With Men, Patcharaporn Krainara, Benjamas Klahan, Rungrot Jaiyong, Jitti Hanprasertpong

Journal of Health Research

Background: Monkeypox (Mpox) is a global health threat, particularly among men who have sex with men (MSM). Despite the predominance of urban cases in Thailand, rural–urban disparities in Mpox-related attitudes and behaviors remain underinvestigated. This study aimed to compare Mpox-related attitudes and preventive behaviors among urban (Chonburi) and rural (Nakhon Nayok) MSM and identify their influencing factors.

Method: This cross-sectional study was conducted between March and April 2025. A total of  842 MSM (421 urban; 421 rural) were recruited via convenience sampling. Data were collected using paper-based, self-administered Health Belief Model (HBM) questionnaires and analyzed using descriptive statistics and multivariable …

School Policy, Health Equity, And Lgbtq+ Youth: Implications Of Mahmoud V. Taylor, Anna Folta

Online/Hybrid MPH Integrative Learning Experience (capstone projects)

School-based policy functions as a critical lever for reducing health disparities among LGBTQ+ youth, who face elevated risks of suicidality, bullying, unsafe school environments, and housing instability. An extensive body of research identifies inclusive school practices—such as affirming curricula, supportive staff, and student organizations—as key protective factors that foster belonging and improve mental health outcomes. However, recent political and legal developments threaten the implementation and consistency of these protections.

Using a structured literature review and comparative policy analysis of federal, state, and district responses, this project integrates public health evidence with legal interpretation to assess how emerging parental opt-out frameworks …

Flame Retardant Metabolites In Urine Samples Associated With U.S. Consumer Dietary Behaviors, Heather Marie Holliday

Walden Dissertations and Doctoral Studies

No abstract provided.

Aid As Leverage: How Humanitarian Assistance Shapes The Health Power Dynamics In Eastern Democratic Republic Of Congo, Emmanuella K. Mbuyu

University Honors Theses

This paper examines humanitarian aid in the Eastern Democratic Republic of Congo, where it serves as both relief and a force reshaping local power dynamics within ongoing conflict. Humanitarian organizations provide essential services in contexts of state collapse, but aid delivery is deeply embedded in systems of coercion, negotiation, and external influence. Drawing on critical humanitarianism and the aid economy, this study analyzes how humanitarian access is negotiated, how donor priorities shape definitions of need, and how temporary interventions create dependency and instability. The paper explores how humanitarian action can reinforce alternative structures of authority, particularly in weak or absent …

Testing Potential Correlations Between Childhood Lead Exposure And Authoritarianism In Adulthood, Kragen Anderson

University Honors Theses

A significant body of research links lead exposure during childhood to negative effects ranging from increased impulsivity to societal level effects such as an increased likelihood of committing violent crime in adulthood. Due to exposure vectors such as lead water pipes, lead solder, lead based paints, and leaded gasoline there was significant lead exposure during childhood for large portions of the American population. This paper tested and found a statistically significant association between average population level lead exposure in childhood and likelihood of voting for candidate Trump later in life.

Healthcare Access Challenges Among Asian Americans, Phyo Theingi

University Honors Theses

Asian Americans are the fastest growing racial ethnic group in the U.S. According to the 2023 U.S. Census Bureau population estimate, Asian Americans account for 25.2 million (or 7.4%) of the nation's population. Asian Americans are not a monolith and represent a diversity of rich histories, cultures, languages and ethnicities. According to research conducted by the Pew Research Center, most Asian Americans face discrimination of some kind, including being treated as a foreigner in the U.S and being stereotyped as a model minority. They also experience health care access barriers. Research found that Asian Americans face barriers related to language …

Motherwise In Nicaragua: The Implementation Of Culturally Adapted Relationship Education For Women During Pregnancy And Postpartum, Amanda Key Correa Love

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Intimate partner violence (IPV) is a concerning public health issue of global proportions, particularly within rural and under-resourced settings. Communities in these settings face elevated risk for relationship abuse, further compounded by barriers to access culturally responsive preventive intervention programming. This qualitative study investigated participant experiences, cultural adaptation, and implementation of the MotherWise program, a healthy relationship education intervention in rural Leon, Nicaragua. Semi-structured interviews were conducted with former and current program participants as well as the program facilitator following the initial program implementation. Data were analyzed using thematic analysis to identify patterns related to participant experiences, the types of …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Understanding Moral Injury In Emergency Department Clinicians: Predictors, Outcomes, And Evidence Gaps, Rose Doering Lightspeed

University Honors Theses

Moral injury (MI) is an emerging construct for understanding clinician distress in high-acuity healthcare settings, yet its application to Emergency Department (ED) clinicians remains limited. MI refers to psychological distress resulting from exposure to, or participation in, situations that conflict with deeply held moral or ethical standards, often due to systemic or organizational constraints. Although prior research has examined MI in heterogeneous healthcare samples, the ED remains underexamined despite its unique combination of high patient acuity, throughput pressure, and resource limitations.

This review synthesizes literature on MI among healthcare workers with a focus on ED clinicians, drawing on Industrial-Organizational psychology …

The Gut Microbiome, The Gut-Brain Axis, And College Student Well-Being, Idi Mckay

University Honors Theses

This literature review examines how diet, stress, environmental exposure, and food accessibility may influence college students' mental health and academic performance through the gut microbiome and the Gut-Brain Axis (GBA). Current microbiome research often focuses on early childhood development, clinical disease populations, or older adults, while overlooking college-age students who experience significant social, environmental, and biological transitions. College students frequently face food insecurity, irregular eating patterns, chronic stress, inconsistent sleep schedules, and reduced access to nutrient-dense foods, all of which may influence microbial diversity and overall gut health.

This thesis explores how modern campus environments and lifestyle factors may contribute …

From Combustion Emissions To Neurotoxicity: Brain Health Risks Of Military Burn Pits Exposure, Katherine M. Eggers, Zoe A. Keller, Paul Barach, Julie M. Tomáška, Joshua P. Nixon, Janeen H. Trembley, Tammy A. Butterick

College of Population Health Faculty Papers

Military burn pits used during post-9/11 U.S. military deployments functioned as uncontrolled combustion systems and were widely utilized to dispose of large volumes of outdoor waste by burning. Burn pits involved heterogeneous waste materials burned under variable temperature and oxygen conditions. These combustion environments generated complex, toxic, multipollutant airborne emission mixtures that included particulate matter (PM2.5), polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs). This narrative review synthesizes epidemiologic, experimental, and mechanistic evidence linking burn pit emissions to disruption of the lung–brain axis and adverse neurological outcomes. We specifically aim to address a critical gap in understanding how combustion-derived …

When School Culture Excludes: Deficit Discourse, Microaggressions, And The Mental Health Of Marginalized Students – A Conceptual Framework With Implications For School Psychology Practice And Equity Policy, Modupe Mercy Oyewunmi

Publications

Deficit-laden language like ‘behavior problem,’ ‘not college material,’ ‘won’t fit in’, ‘not a cultural fit’, operates as a systemic form of implicit bias and microaggression in school settings. Despite decades of research on school belonging and well-being, school psychology has yet to integrate these exclusionary discursive practices into a coherent health-determinant model that also accounts for the current anti-diversity, equity, and inclusion (DEI) policy environment. This conceptual paper proposes a testable framework linking deficit discourse and school-based microaggressions to student identity suppression, academic impostor phenomenon, and educator moral injury, with downstream effects on school mental health outcomes. We situate these …

Publisher Correction: Whole Genome Sequence Analysis Of Pulmonary Function And Copd In 44,287 Multi-Ancestry Participants, Wonji Kim, Xiaowei Hu, Kangjin Kim, Sung Chun, Peter Orchard, Dandi Qiao, Ingo Ruczinski, Aabida Saferali, Francois Aguet, Lucinda Antonacci-Fulton, Pallavi P Balte, Traci M Bartz, Wardatul Jannat Anamika, Xiaobo Zhou, Junyi Duan, Jennifer A Brody, Brian E Cade, Martha L Daviglus, Harshavadran Doddapaneni, Shannon Dugan-Perez, Susan K Dutcher, Christian D Frazar, Stacey B Gabriel, Sina A Gharib, Namrata Gupta, Brian D Hobbs, Silva Kasela, Laura R Loehr, Ginger A Metcalf, Donna M Muzny, Elizabeth C Oelsner, Laura J Rasmussen-Torvik, Colleen M Sitlani, Joshua Smith, Tamar Sofer, Hanfei Xu, Bing Yu, David Zhang, John Ziniti, R Graham Barr, April P Carson, Myriam Fornage, Lifang Hou, Ravi Kalhan, Robert Kaplan, Tuuli Lappalainen, Stephanie J London, Alanna C Morrison, George T O'Connor, Bruce M Psaty, Laura M Raffield, Susan Redline, Stephen S Rich, Jerome I Rotter, Edwin K Silverman, Ani Manichaikul, Michael H Cho

Faculty, Staff and Student Publications

This corrects the article "Whole genome sequence analysis of pulmonary function and COPD in 44,287 multi-ancestry participants", 28.

The Role Of Project Managers And Pmp Principles In Improving Operational Efficiency In Healthcare Organizations, Karan Thakkar

Harrisburg University Dissertations and Theses

Healthcare organizations operate in increasingly complex, regulated, and resource-constrained environments while managing a growing volume of projects tied to digital transformation, process improvement, regulatory compliance, and infrastructure development. Despite the project-intensive nature of healthcare operations, many organizations do not formally employ trained project managers or consistently apply Project Management Professional (PMP) principles; project responsibilities are frequently absorbed by clinical or administrative leaders whose primary expertise lies outside formal project management. This qualitative study examined how the project manager role and PMP principles contribute to operational efficiency in healthcare organizations. The study was conducted as a qualitative document analysis and thematic …

How Do Us States Define Person-Centered And Family-Involved Care In Assisted Living Regulations, Paula Carder, Lindsey Smith, Jennifer N. Bunker, Cassandra L. Hua, Erh-Chi Hsu, Isabelle Boun, Olivia M. Ainsworth, Kali S. Thomas, Eric Jutkowitz

Institute on Aging Publications

Introduction: A large share of assisted living (AL) residents have a diagnosis of dementia or cognitive impairment, and these individuals can benefit from person-centered care and family-involved care. This study examines whether and how states’ AL licenses address these topics.MethodsThis research analyzed a national database of 249 unique licensing requirements that govern 35,602 ALs in all states and associated regulations, including those that govern memory care (MC) services. We reviewed each regulation for the presence of person-centered or family involved care and then used content analysis of license requirements with at least one relevant policy to identify key categories and …

Assessing Indoor Heat Vulnerability And Cooling Strategies In Three Mobile Home Communities In Boulder, Colorado, Usa, Mehdi P. Heris, Skye Niles, Alana Wilson, Megan Mccurdy, Amy Lacourse, Nick Lankau

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Extreme heat is an increasing public health and environmental threat shaped by both physical and social factors. This study assesses the vulnerability of mobile homes and their residents at three mobile home parks in Boulder, Colorado. We examined indoor temperature, housing conditions, and social and personal risk factors of the households. We monitored indoor and outdoor temperatures using 27 indoor and 5 outdoor temperature data loggers, comparing mobile homes with air conditioning, swamp coolers, and passive cooling designs. This work provides a detailed analysis of indoor temperature patterns and demonstrates how evaluating trends yields insights into the performance and effectiveness …

Feasibility Study Of A Behavioral Lifestyle Intervention For Hispanic/Latino Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease, Natalia I Heredia, Jessica P Hwang, Maria E Fernandez, Jiachen Lu, Cici X Bauer, Lorna H Mcneill

Faculty, Staff and Student Publications

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) can lead to longer-term adverse health outcomes if left unmanaged, including liver failure and liver cancer. Hispanic adults have the highest rates of MASLD of any U.S. racial/ethnic subgroup. The most effective treatment is weight loss, through healthy dietary changes and increased physical activity. This study conducted 2022-2023 aimed to assess the feasibility and acceptability (primary), as well as exploratory effectiveness outcomes, of a behavioral lifestyle intervention for Hispanic patients with MASLD.

Methods: Participants were recruited from a federally qualified health center. Self-administered questionnaires assessed demographic, psychosocial and behavioral variables. Staff measured height …

Auricular Point Acupressure Self-Management (Apa-Sm) Program For Chronic Musculoskeletal Pain Among Rural Populations: A Protocol For A Pragmatic, Randomized Controlled Trial, Jennifer Kawi, Jane Bolin, Hulin Wu, Jungkyung Min, Rupsikha Bora, Sarah Pace, Idara N Akpan, Alee Lockman, Tonychris Nnaka

Faculty, Staff and Student Publications

Introduction: Chronic musculoskeletal pain (CMP) is a leading cause of incurred personal healthcare costs and disability in the USA. It disproportionately affects rural populations, who are more likely to be uninsured, lack access to a regular healthcare provider and experience a higher prevalence of CMP. As a result of reduced access to non-pharmacological care, there is greater reliance on opioids. The Auricular Point Acupressure - Self-Management (APA-SM) program is a simple, needleless, evidence-based therapy that empowers individuals to self-manage their pain. Preliminary studies, including a recent UG3 pilot testing, demonstrated feasibility, safety and significant improvements in pain and function. Guided …

Norm Dust Intake: Comparison Of Personal Air Sampling And Bioassays, Gregory S. Hewson, Martin I. Ralph, Marcus Cattani

Research outputs 2022 to 2026

Intake of naturally occurring radioactive materials (NORM), particularly the inhalation of thorium-bearing dust in mineral sand operations, has traditionally been assessed via personal air sampling (PAS). However, data from bioassay studies suggest that the actual intake determined via PAS may be underestimated. This review integrates thorium intake estimates derived from historical bioassay datasets, such as urine, faeces, lung counting, and thoron-in-breath tests, with historical PAS data. The findings indicated that bioassay-based predictions of intake were consistently greater, with mean bioassay-to-PAS intake ratios ranging from 2.6 to 4.2. The contributing factors to this discrepancy include biokinetic model uncertainties, potential dust sampler …

Multidomain Expert Evaluation Of Leading Large Language Models As Providers Of Vaccination And Preventive Medicine Information, Marcello Di Pumpo, Leonardo Villani, Vittorio Maio, Maria Rosaria Gualano, Eleonora Marziali, Lucia De Maio, Rossella Mancini, Stefania Boccia, Walter Ricciardi, Patrizia Laurenti

College of Population Health Faculty Papers

OBJECTIVES: Vaccination is one of the most effective public health interventions. Large language models (LLMs) show great capability for providing health information. This study compared the performance of ChatGPT 3.5 (G3E), ChatGPT 4o in English (G4E), Claude 3.0 (CDE), Gemini 1.5 (GME), and ChatGPT 4o in Italian (G4I) in delivering information on vaccination and preventive medicine.

STUDY DESIGN: Mixed-method analysis evaluating large language models.

METHODS: Twenty-six expert-designed healthcare scenarios were used to evaluate each model through an adapted DISCERN-based instrument. Four experts independently rated outputs across six domains: Information Reliability, Information Quality, Medical Appropriateness, Impact on Vaccine Hesitancy, Potential for …

Extraction Of Key Themes In Online Health Discourse Using Unsupervised Learning And Large Language Models, Miranda G. Scully

Computer Science Senior Theses

Health online discussion boards are a modern platform that allow patients to interact with each other and the healthcare system as a whole, making them valuable sources of information for clinicians seeking to better anticipate treatment experiences and barriers. This study focuses on one such community, r/suboxone, a subreddit where patients using Suboxone share their experiences and ask questions. Our analysis is motivated by previous work that proposes event-based classification systems for such posts which buckets posts from r/suboxone into one or more of five high-level labels (Access Logistics, Co-Occurring Drug Usage, Medication for Opioid Use Disorder Administration, Psychophysical Effects, …

Recommendations For Disclosure Of Artificial Intelligence In Scientific Writing And Publishing: A Regional Anesthesia And Pain Medicine Modified Delphi Study, Michael R Fettiplace, Anuj Bhatia, Yian Chen, Steven L Orebaugh, Michael Gofeld, Rodney A Gabriel, Daniel I Sessler, Hannah Lonsdale, Brittani Bungart, Christopher P Cheng, Garrett W Burnett, Lichy Han, Matthew Wiles, Steve Coppens, Thomas Joseph, Kristin L Schreiber, Thomas Volk, Richard D Urman, Vesela P Kovacheva, Christopher L Wu, Edward R Mariano, Vivian H Y Ip

Faculty, Staff and Student Publications

Introduction: The use of artificial intelligence (AI) in the scientific process is advancing at a remarkable speed, thanks to continued innovations in large language models. While AI provides widespread benefits, including editing for fluency and clarity, it also has drawbacks, including fabricated content, perpetuation of bias, and lack of accountability. The editorial board of Regional Anesthesia & Pain Medicine (RAPM) therefore sought to develop best practices for AI usage and disclosure.

Methods: A steering committee from the American Society of Regional Anesthesia and Pain Medicine used a modified Delphi process to address definitions, disclosure requirements, authorship standards, and editorial oversight …

Polygenic Risk Scores, Sex, And Socioeconomic Factors As Predictors Of Age Of Onset For Major Depressive Disorder, Kaitlyn M. Nowak

USF Tampa Graduate Theses and Dissertations

Major Depressive Disorder (MDD) is a heterogeneous psychiatric condition influenced by genetic, sociodemographic, and environmental factors, yet the extent to which these factors jointly shape the timing of disease onset remains unclear. This study evaluated the effects of polygenic risk scores (PRS), sex, and socioeconomic status (SES) on age of onset for MDD across two independent cohorts: the Pharmacogenomics Research Network Antidepressant Medication Pharmacogenomics Study (PGRN-AMPS) (N = 486) and the All of Us Research Program (N = 8,014). Analyses were restricted to individuals of European genetic ancestry, and PRS were constructed using both European-ancestry (EA) and multi-ancestry (MA) genome-wide …

Longitudinal Relationship Between Income Variability And Hypertension Risk Through A Life Course Lens, Mehrnaz Siavoshi

Walden Dissertations and Doctoral Studies

No abstract provided.