Digital Commons Network^™

Optimizing Continuous Renal Replacement Therapy (Crrt) In The Icu: A Qsen-Based Framework For Nursing Decision-Making Support, Leslie Okhirkhian

Knowledge and Creativity Expo

Nurses in critical care environments must exercise precise clinical judgement to recognize patient destabilization cues while managing the complex biomedical technologies that support failing physiological systems. Continuous Renal Replacement Therapy (CRRT) is a modality for hemodynamically unstable patients requiring fluid overload management and waste removal; however, it is a complex technology that demands nurses navigate a “tightrope” between renal perfusion and hemodynamic stability. Despite its prevalence, there is no concise decision-making support for nursing care in the current literature based on the Quality and Safety Education for Nurses (QSEN) strategies. This presentation addresses this gap by proposing a QSEN-based, standardized …

Evaluating Sensory Sensitivities Among Children With Autism Spectrum Disorder In An Adaptive Gymnastics Program, Aicha Kaouss, Bradley Eppinger, Austin Ebbrecht, Kailash Ram, Kaitlin P. Hardy Md

Knowledge and Creativity Expo

Introduction: Children with autism spectrum disorder (ASD) participate in physical activity at lower rates than their neurotypical peers1. Sensory sensitivities, reported in approximately 75–95% of children with ASD, may contribute to this disparity2. Gymnastics environments involve bright lighting and loud noise, which can precipitate sensory overload. The impact of specific sensory features on participation in adaptive gymnastics remains underexplored.

Methods: A cross-sectional study recruited caregivers of children aged 3–12 years with an ASD diagnosis enrolled in the EVMS Adaptive Gymnastics Program. Caregivers completed the Sensory Experiences Questionnaire–Third Edition (SEQ-3)3 and supplemental survey items on Redcap which assessed environmental triggers and …

Bacteriophage Therapy For Antibiotic-Resistant Infections, Shiva Pariyar

Best Integrated Writing

Pariyar examines bacteriophage therapy as a promising alternative to antibiotics for treating multidrug-resistant infections, highlighting its targeted mechanism, ability to disrupt biofilms, and synergy with antibiotics. While challenges such as regulation, immune response, and limited clinical trials remain, the study argues that advances in biotechnology and global collaboration position phage therapy as a future cornerstone in combating antimicrobial resistance.

Exploring The Impact Of Education On Cardiovascular Health In Women: Sex Disparities, Symptom Recognition And Attribution, And Preventive Measures, Sydney Totten

Best Integrated Writing

Totten examines sex disparities in cardiovascular disease among women, emphasizing gaps in symptom recognition, treatment, and health education. Through a literature review and educational intervention, it demonstrates that targeted, nurse-led education can significantly improve women’s understanding of risk factors, symptoms, and disease management, ultimately supporting better health outcomes.

Dietary Inflammatory Index And Objective Disease Activity In Ibd: No Association Found, Rúbia Moresi Vianna De Oliveira, Ana Carolina Junqueira Vasques, Stefhani Andrioli Romero, Nitin Shivappa Mbbs, Mph, Ph.D., Michael David Wirth, James Hébert Scd, Glaucia Fernanda Soares Ruppert Reis, Cristiane Kibune Nagasako

Faculty Publications

Background

Inflammatory Bowel Disease (IBD) involves genetic and environmental factors, but the relationship between disease activity, adiposity, and diet remains unclear.

Objective

To investigate the association between endoscopic/radiological activity of IBD, body adiposity, and the Dietary Inflammatory Index with or without adjustment for energy density (E-DII or DII).

Method

An observational, cross-sectional study was carried out. Endoscopic activity was defined by an endoscopic Mayo score >2, Crohn’s Disease Endoscopic Index of Severity (CDEIS) > 5, and/or the presence of a deep ulcer in any intestinal segment. Body adiposity was estimated using the body mass index, waist circumference, and waist-hip ratio (WHR). …

Circulating Levels Of Insulin-Like Growth Factor I (Igf-I) And Risk Of Multiple Myeloma: An Observational And Mendelian Randomisation Study, Yolanda Benavente, Sara Hermosa, Nikos Papadimitriou, Alyssa I. Clay-Gilmour Ph.D., Elizabeth E. Brown, Jonathan N. Hofmann, Nathaniel Rothman, Qin Lan, Sonja I. Berndt, Demetrius Albanes, Mark Purdue, Mitchell J. Machiela, Stephen J. Chanock, Parveen Bhatti, Wendy Cozen, Aaron Norman, Susan L. Slager, James R. Cerhan, Vincent Rajkumar, Et. Al.

Faculty Publications

No abstract provided.

First Epidemiological Assessment: Syphilis Seroprevalence Among Asymptomatic Blood Donors In Merowe, Northern Sudan, 2022, Doaa Albagir Ahmed, Sabra Alfadil Ibrahim, Hiba Elsadig Salah, Hamad A. Albagir

Saudi Toxicology Journal

Syphilis remains a significant transfusion-transmissible infection, yet regional epidemiological data from Northern Sudan are lacking. This study aimed to establish preliminary baseline syphilis seroprevalence among asymptomatic blood donors in Merowe, Northern Sudan. A cross-sectional study was conducted in January 2022 at the Merowe blood donation center. Eighty-nine consecutive asymptomatic male blood donors were screened for anti-Treponema pallidum antibodies using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit (Fortress Diagnostics, UK). Demographic data were collected via structured questionnaire. The overall seroprevalence was 2.25% (2/89; 95% CI: 0.6–7.9%). The donor population median age was 32 years (range: 18–64). Both reactive donors were referred …

Bodies At Risk When Choice Is A Privilege: Women’S Reproductive Healthcare Accessibility And Health Outcomes Since The Dobbs (2022) Ruling, Dallas Bonnet

Undergraduate Theses

Existing literature has well-documented the disproportionate effects of abortion restrictions upon socioeconomically disadvantaged women and women of color. This thesis builds on that work by exploring the relationship between state-level abortion restrictions and women’s self-reported health, as well as state-level infant mortality rates and maternal mortality rates. This project breaks these relationships down into three separate studies: Study 1 investigates the effect that abortion restrictions have on women’s self perceptions of health. Study 2 assesses the impact of abortion restrictions on infant mortality rates. Study 3 inspects the impact of abortion restrictions on maternal mortality rates. The primary independent variable …

Depressive Symptoms, Campus Connectedness, And Campus Climate Related To Sexual Violence And Misconduct, Stephanie A. Navarro Silvera, Amanda S. Birnbaum, Eva S. Goldfarb, Ranju Mainali, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

Depression, although a consequence of sexual violence, has not been studied in the context of college students’ views of campus sexual violence climate. Depression is one of the most prevalent and impairing mental health concerns among college students and has well-established links to sexual violence victimization; therefore, it serves as a theoretically and clinically meaningful focal outcome. Therefore, we assessed perceptions of institutional climate in the context of self-reported depression. Undergraduates (n = 716) reported perceptions and experiences of campus sexual violence and misconduct, connectedness, attitude, and depressive symptoms in an online survey. More than a third of participants reported …

When To Continue, Pause, Or Stop Sglt-2 Inhibitors In Heart Failure: A Complication-Based Clinical Guide, Nicole Tesoro, Jasvin Kurundrayil Manha, Sumanth Kumar Bandaru

Journal of Community Hospital Internal Medicine Perspectives

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have become an essential part of guideline-directed medical therapy for heart failure due to their proven ability to reduce hospitalizations and improve survival, independent of diabetes status. Despite these benefits, their use can be complicated by genitourinary side effects such as genital mycotic infections, urinary tract infections, and, rarely, serious complications including urosepsis, Fournier’s gangrene, and euglycemic diabetic ketoacidosis. These events often leave clinicians uncertain about whether therapy should be continued, paused, or permanently discontinued. Current guidance remains limited and inconsistent, with most recommendations derived from case reports, expert opinion, or post-marketing surveillance. In this …

Development And Validation Of The Emergency Department Transitions Measure, Sara Beachy, Danielle M. Mccarthy, Julianna Lenoir, Alexzandra Gentsch, Richard W. Hass, Marissa Witmer, Paula Ostroff, Melissa Tupas, Lindsey Shughart, Hailey Shughart, Kristin L. Rising

Jefferson Center for Connected Care Faculty Papers

BACKGROUND: Transitions of care are high-risk periods for patient safety in the emergency department (ED), particularly for patients who are still in the diagnostic process and are discharged with diagnostic uncertainty. Care transitions must be improved for these patients, as one third of discharged ED patients have diagnostic uncertainty. Yet there are no validated measures that assess the quality of care transitions from the ED, limiting the ability to assess the impact of interventions. Thus, we developed and validated the ED Transitions (EDT) measure.

METHODS: This mixed methods study was conducted across a large healthcare system in three phases: item …

Food Insecurity’S Influence On Obesity, Hypertension, And Diabetes In Rural Vermont And Adirondack New York, Lindsay Morse

Walden Dissertations and Doctoral Studies

Food insecurity (FI) is a persistent public health challenge in the United States and disproportionately affects rural communities. Guided by syndemic theory, this quantitative cross-sectional study examined associations between FI and chronic disease outcomes among rural residents of Vermont and the Adirondack region of New York. Social determinants of health screenings and electronic medical records from 35 rural primary care sites were analyzed. Secondary data from n = 72,505 adults were used to evaluate these relationships. Binary logistic regression models assessed obesity, hypertension (HTN), and diabetes (DM), and a multinomial logistic regression model evaluated the combined presence of obesity and …

Sound, Speech, And Synapses: Rebuilding The Brain Through Neuroplasticity, Sireen Khader

The Cardinal Edge

No abstract provided.

Decision-Making At The Edges Of Capacity: Brain Science And Caregiving, Dr. Julie Yonker

University Faculty Publications and Creative Works

Keynote address at the Disabilities Resources Symposium at City Hope Church in Grand Rapids on 3/14/2026. Attached is her powerpoint.

• Describe why our brains don’t like decisions
• Understand the impact of different types of decisions
• Value suggestions for more sustained decision making
• Consider a faith perspective

Social Network Determinants Of Cigarette Forgoing And Quit-Related Conversations In A 15-Day Ecological Momentary Assessment Study In Mexico And The Us, Lizeth Cruz-Jiménez, Kevin A. Carson, Jim Thrasher Ph.D., Ma, Ms, Katia Gallegos-Carrillo, Dèsirée Vidaña-Pérez, Diego F. Leal

Faculty Publications

Introduction

Methods

Comparative Outcomes And Costs Of Robotic Assisted, Laparoscopic, And Open Partial Nephrectomy: A Contemporary Analysis Of National Inpatient Sample Data., Manisha Lin, Elizabeth Sottung, Vietbao H. Phan, Mumbi E. Kimani, Costas D. Lallas, Raegan M Davis, Scott W. Keith, Patrick Moeller, Vittorio Maio

College of Population Health Faculty Papers

PURPOSE: Partial nephrectomy is increasingly favored for small renal masses due to its renal function-preserving benefits. This study compared contemporary utilization patterns, perioperative outcomes, and hospital costs of robotic-assisted (RAPN), laparoscopic (LAPN), and open partial nephrectomy (OPN) among U.S. patients with renal cancer.

METHODS: Using the 2016–2019 National Inpatient Sample, renal cancer patients undergoing RAPN, LAPN, or OPN based on ICD-10-CM/PCS codes were identified. Patient demographics, comorbidities, hospital characteristics, length of stay (LOS), perioperative complications, and hospital costs, were summarized by surgical approach. Regression analyses adjusted for patient- and hospital-level covariates were used to compare perioperative outcomes, LOS, and costs …

Interim Estimates Of 2025-26 Seasonal Influenza Vaccine Effectiveness - United States, September 2025-February 2026., Patrick Maloney, Emily L. Reeves, Kristina Wielgosz, Ashley M. Price, Karthik Natarajan, Malini B. Desilva, Kristin Dascomb, Nicola P. Klein, Sara Y. Tartof, Stephanie A. Irving, Shaun J. Grannis, Toan C. Ong, Zachary A. Weber, Jennifer E. Schuster, Danielle M. Zerr, Marian G. Michaels, Julie A. Boom, Natasha B. Halasa, Mary A. Staat, Geoffrey A. Weinberg, Stacey L. House, Elie A. Saade, Krissy Moehling Geffel, Manjusha Gaglani, Karen J. Wernli, Vel Murugan, Emily T. Martin, Natalie A B Bontrager, Marie K. Kirby, Amanda B. Payne, Fatimah S. Dawood, Ayzsa Tannis, Heidi L. Moline, Sifang Kathy Zhao, Katherine Adams, Jennifer Decuir, Samantha M. Olson, Jessie R. Chung, Nathaniel Lewis, Brendan Flannery, Carrie Reed, Shikha Garg, Sascha Ellington, Cdc Influenza Vaccine Effectiveness Collaborators

Manuscripts, Articles, Book Chapters and Other Papers

In the United States, annual influenza vaccination has been recommended for all persons aged ≥6 months, including during the 2025-26 season. Interim influenza vaccine effectiveness (VE) estimates were calculated for patients with acute respiratory illness-associated outpatient visits and hospitalizations from three U.S. respiratory virus VE networks during the 2025-26 influenza season, using a test-negative case-control design. Among children and adolescents aged < 18 years, VE was 38%-41% against influenza outpatient visits and 41% against influenza-associated hospitalization. Among adults aged ≥18 years, VE was 22%-34% against influenza outpatient visits and 30% against influenza-associated hospitalization. Among children and adolescents, VE against influenza A ranged from 37% (against outpatient visits) to 42% (against hospitalization) across settings; among adults, VE against influenza A ranged from 30% (against hospitalization) to 34% (against outpatient visits) across settings. Among children and adolescents, VE against influenza A(H3N2)-associated outpatient visits was 35% and against influenza A(H3N2)-associated hospitalization was 38%. VE against influenza B outpatient visits ranged from 45%-71% among children and adolescents and was 63% among adults. Other estimates of VE were not statistically significant or were not reportable. Although interim influenza VE is lower during the 2025-26 influenza season than it was during recent influenza seasons, these findings demonstrate that influenza vaccination still provides protection against influenza. CDC recommends influenza vaccination; U.S. influenza vaccines remain available for persons aged ≥6 months.

Multi-Dimensional Research Appraisal: A Holistic Approach To Evidence-Informed Practice, John Damiao

Translational Science in Occupation

The field of occupational therapy (OT) and healthcare in general have made great strides in enhancing their scientific rigor through study methodologies that prioritize internal validity. However, concerns regarding reproducibility and replicability in research have cast doubt on traditional evidence-based models. This paper critically examines the limitations of an over-reliance on internal validity in evidence reviews and advocates for a multi-dimensional approach to evidence-based practice. By integrating methodological holism, contextual analysis, and a critical appraisal of external validity, this approach provides practitioners with a more nuanced and applicable framework for decision-making. The implications for research credibility and clinical confidence are …

Development And Validation Of A Life Participation Self-Assessment Tool For People Living With Obesity: The Life Participation Impact Questionnaire (Lpiq-O), Marie-Claude Touchette

Translational Science in Occupation

Purpose: Obesity is a chronic condition affecting over 40% of adults in the U.S. Given the well-documented impact of obesity on life participation, a comprehensive, population-specific assessment tool is needed. We aimed to establish the face and content validity of the Life Participation Impact Questionnaire for People with Obesity (LPIQ-O), an occupation-focused assessment tool measuring the impact of obesity on areas of life participation.

Method: This study included seven iterative phases: (a) literature review, (b) interviews, (c) synthesis of the literature review and interviews, (d) item development, (e) expert validation, (f) face validation, and (g) final expert review. Six participants …

Integration Of The Science Of Team Science (Scits) With Applied Healthcare Frameworks: Interprofessional Education Through A University-Based Head Injury Clinic, Part Ii: Mixed Methods, Emily Balog, Susan Paparella, Natalia Noce, Stephanie Hubbell, Kelly Pena

Translational Science in Occupation

Introduction: Effective healthcare delivery requires clinicians to function within high-performing, collaborative teams. To support this, interprofessional education (IPE) must provide opportunities that move beyond siloed training. This paper details the clinical application of a team science-informed educational intervention designed to prepare students for interprofessional practice (IPP) through a university-based head injury head injury clinic. Methods: The research team conducted a mixed methods case study with a convergent design to evaluate student outcomes. Eighteen graduate students from occupational therapy, physical therapy, and speech-language pathology participated in a 10-week clinic. Faculty delivered training in IPEC competencies, TeamSTEPPS® tools, and clinical processes before …

Editors' State Of The Journal: Making Academic Writing Accessible, Nicole Martino, Nancy E. Krusen, Stacy Smallfield

Translational Science in Occupation

No abstract provided.

Pedaling Through Discomfort: A Feasibility Study Of Faculty-Led Spin Classes And Their Impact On Student Engagement, Resilience, And Faculty-Student Relationships, Gabriela Baza, Elizabeth Hathaway

Pursuit - The Journal of Undergraduate Research at The University of Tennessee

This study explored the feasibility and impact of faculty-led Spin classes on college students’ engagement, well-being, and connection with faculty. Offered twice weekly at 7 AM during Fall 2024, the classes aimed to promote physical activity, resilience, and faculty-student relationships. Twenty-six students attended at least one class, with a median attendance of 4.5 sessions. Post-semester surveys (88% response rate) assessed perceived exertion, interest, enjoyment, challenge, improvement, and instructor encouragement. Students reported high levels of engagement and positive challenge (RPE = 15.3; challenge = 6.4/7). Those attending 7 or more sessions reported significantly greater perceived improvement than those attending fewer sessions …

Conjoined Twins And Abortion Restrictions: Navigating 'Ban State' Challenges, A Case Report, Beau Morgan Nrp

Pursuit - The Journal of Undergraduate Research at The University of Tennessee

This case report highlights an unusual scenario of a conjoined twin pregnancy resulting from intrauterine insemination in a state with restrictive abortion laws. Despite a diagnosis deemed not compatible with life, the patient faced legal barriers preventing termination within their home state. Forced to seek care out-of-state, the patient underwent a successful termination at ten weeks and three days after lengthy and expensive travel. This case stresses the complex challenges posed by restrictive abortion laws, impacting patient access to essential medical interventions. The case demonstrates the critical intersections between medical care, medical ethics, legal constraints, and patient outcomes in managing …

Ulk4 And Cdkn2a Polymorphisms Influence The Risk Of Developing Monoclonal Gammopathy Of Undetermined Significance, José Manuuel Sánchez-Maldonado, Angelica Macauda, Antonio José Cabrera-Serrano, Hauke Thomsen, Murat Güler, Rob Ter Horst, Bethany Van Guelpen, Pavel Vodicka, Stefano Landi, Subhayan Chattopadhyay, Pelin Ünal, Lucía Ruiz-Durán, Delphine Casabonne, Hartmut Goldschmidt, Istemi Serin, María Carretero-Fernández, Elena Cabezudo, Fernando Reyes-Zurita, Alyssa I. Clay-Gilmour, Et. Al.

Faculty Publications

Monoclonal gammopathy of undetermined significance (MGUS) is a necessary precursor condition to multiple myeloma (MM). Given the role of autophagy in modulating MM risk, we investigated whether genetic variation in autophagy-related genes influences susceptibility to MGUS. We analyzed the association of 34,042 common autophagy-related single nucleotide polymorphisms (SNPs) with MGUS across six independent cohorts, five from Europe and one from North America, comprising 2317 MGUS cases and 282,358 controls. We also assessed their impact on immune parameters, including absolute counts of 91 blood-derived immune cell subsets and 103 circulating immunological proteins. Meta-analysis revealed a genome-wide significant association between the ULK4 …

Rates And Predictors Of Intention To Get Preventive Screenings Among Individuals In Recovery From Substance Use Disorders, Afsha Hossain, Ban A. Majeed, Lia Pierson Bruner

Journal of the Georgia Public Health Association

Background: Individuals with substance use disorders (SUDs) are at greater risk for chronic disease but often face barriers to access and uptake of preventive screenings, so the aim of this study was to identify rates and predictors for intention to get preventive screenings among residents at two recovery centers.

Methods: We used a cross-sectional survey (N=95, response rate 51%) to determine previous screening rates and the intention to get recommended preventive screenings among residents of two long-term recovery programs in Athens, GA, using bivariate analysis with chi-square to look for associations with intention.

Results: Prior use of preventive health services …

Rural Georgia Hospital Covid-19 Virus Patient Outcomes, Susan P. Smith, Neeraj Dayama, Morgan E. House, Debra Flores, Sharon Hunt, April Dukes, Steven Gautney

Journal of the Georgia Public Health Association

Background: The Coronavirus disease 2019 (COVID-19) has led to over 1.2 million deaths in the United States. Given the staggering scale of the pandemic, rural hospitals faced heightened challenges due to limited resource availability and underlying patient characteristics.

Methods: In this context, we examined patient and hospital-related factors associated with inpatient mortality due to COVID-19. This study is a retrospective chart review of patient outcomes of patients who were hospitalized in a Southwest Georgia rural hospital with COVID-19 during the initial onset of the outbreak and over the following 23 months of the pandemic. Patient demographics, other characteristics, …

Health Disparities Resulted From The Relationships Between Vulnerable Patients And Providers, Matthew Maurice Bradley

Doctoral Dissertations and Projects

The study's purpose was to understand patterns of mistrust between providers and patients in vulnerable and underserved populations. The theories guiding this study were the critical theory and the critical race theory created by Max Horkheimer as it explains how people can collaborate and actively participate in rebuilding trust. The intention is to rebuild trust and reduce health disparities in the United States. The general problem is the lack of provisional resources for underserved and vulnerable communities, resulting in the population lacking trust in healthcare administration. Speicher and Francis (2022) examined how increasing physician turnover, burnout, depression, and dissatisfaction affect …

Rural–Urban Differences In Cognitive Outcomes Among Older Adults: The Roles Of Falls And Depressive Symptoms, Ayse Malatyali, Tom Cidav, Lisa A.K. Wiese, Jian Zou, Monique J. Brown Ph.D., Mph, Junfeng Ma, Breno S. Diniz, Ladda Thiamwong

Faculty Publications

Background: Older adults with Alzheimer’s Disease and Related Dementias (ADRD) experience a higher risk of falls. However, research lacks evidence on the effect of fall exposure on cognitive impairment and dementia. We investigated the association of falls and depressive symptoms with cognitive impairment and dementia in a nationally representative sample. Methods: We analyzed data from 6221 participants (age ≥ 65) in the Health and Retirement Study (HRS) from the 2018–2020 waves, using Multinomial logistic regression models. Measures included the HRS health status questionnaire, HRS cognition scale, and the Center for Epidemiological Studies Depression scale. Results: Prevalence of fall exposure across …

Rural–Urban Differences In Cognitive Outcomes Among Older Adults: The Roles Of Falls And Depressive Symptoms, Ayse Malatyali, Tom Cidav, Lisa A.K. Wiese, Jian Zou, Monique J. Brown Ph.D., Mph, Junfeng Ma, Breno S. Diniz, Ladda Thiamwong

Faculty Publications

Background: Older adults with Alzheimer’s Disease and Related Dementias (ADRD) experience a higher risk of falls. However, research lacks evidence on the effect of fall exposure on cognitive impairment and dementia. We investigated the association of falls and depressive symptoms with cognitive impairment and dementia in a nationally representative sample. Methods: We analyzed data from 6221 participants (age ≥ 65) in the Health and Retirement Study (HRS) from the 2018–2020 waves, using Multinomial logistic regression models. Measures included the HRS health status questionnaire, HRS cognition scale, and the Center for Epidemiological Studies Depression scale. Results: Prevalence of fall exposure across …

Heat And Socioeconomic Deprivation Compound To Drive Coronary Heart Disease In Los Angeles, Shutong Huo, Tessa R. Pulido, Reginald S. Archer, Joshua B. Fisher, Jason A. Douglas

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Background:

Socioeconomic deprivation and environmental heat exposure each increase cardiovascular risk, yet evidence is limited on how these stressors co-occur and jointly shape disease burden within cities. Mapping their overlap can inform equity-oriented planning and needs-based allocation of health and social protection resources.

Methods:

We conducted an ecological geospatial analysis of 2,513 census tracts in Los Angeles County. Adult coronary heart disease (CHD) prevalence was obtained from CDC Population Level Analysis and Community Estimates (2021). Socioeconomic deprivation was measured using the Social Deprivation Index (SDI), and heatwave surface heat hazard was measured using land surface temperature (LST) retrieved from the …