Digital Commons Network^™

Non-Diabetic Kidney Disease In A Patient With Type 2 Diabetes Mellitus: A Diagnostic Challenge, Nikhil R, Mahabaleshwar Mamadapur , Assistant Professor, Harshwardhan S Patil

Digital Journal of Clinical Medicine

Background: Diabetic kidney disease (DKD) is the most common cause of end-stage renal disease. However, non-diabetic kidney disease (NDKD) can coexist or mimic DKD, leading to misdiagnosis. Case Presentation: A 46-year-old female with type 2 diabetes presented with vomiting and abdominal pain. Physical examination revealed non-blanching erythematous papules on both lower limbs. Investigations showed uncontrolled diabetes, metabolic acidosis, and active urinary sediment. Absence of diabetic retinopathy prompted renal biopsy, which revealed immune-complex–mediated glomerulonephritis with small-vessel vasculitis. Diagnosis: Immune-complex–mediated glomerulonephritis with small-vessel vasculitis, not consistent with diabetic nephropathy. Management: Supportive care and immunosuppressive therapy were initiated with improvement in renal function. …

Geographic Variation In Adrd Prevalence And Mortality And Their Association With Social Vulnerability Across Us Counties: A Spatial Epidemiological Analysis Using Norc And Cdc Svi Data, Dean Kyne

Sociology Faculty Publications

Introduction: Geographic disparities in Alzheimer’s disease and related dementias (ADRDs) remain insufficiently understood at the national scale, limiting efforts to address inequities in dementia burden across USA communities. This study examined county-level variation in ADRD prevalence and mortality and evaluates the association between social vulnerability and these outcomes.

Methods: This cross-sectional ecological study analyzes 2020 county-level ADRD prevalence and all-cause mortality among Medicare beneficiaries from the NORC Dementia DataHub. The analytic sample included 3,108 USA counties in the contiguous USA and the District of Columbia. ADRD outcomes included (1) prevalence of highly likely ADRD and (2) prevalence of all determinations, …

Paws And Practice: Overcoming Barriers To Mindfulness, Hazel Norris

2026 Awards for Excellence in Student Research and Creative Activity - Documents & Media

With the rise in chronic illnesses, healthcare professionals have sought to improve habits and behaviors to extend longevity and quality of life. However, for many people, unhealthy habits, such as smoking or binge eating, may develop as a way of coping with life stressors, which can make behavior changes harder to implement. Recently, there has been an increase in new research on whether improving mindfulness could be used to combat this problem. If mindfulness does encourage more engagement in health-promoting behaviors while protecting against risky behaviors, mindfulness-based behavior interventions could be very valuable for improving the health of college students …

Justice, Autonomy, Beneficence, And Non-Maleficence: The Global Failure To Heed Ethical Mandates In Birth Spaces, Julia Dees

Richard T. Schellhase Essay Prize in Ethics

Respectful and safe care in all birthing spaces has long been an ideal that global communities fail to meet. Birthing people are disrespected, physically or emotionally harmed, or left to completely fend for themselves during a period of extreme emotional and medical vulnerability. Historically, autonomy especially has been ignored in birthing spaces with medical trends like the twilight sleep, where women were drugged into a state of unconsciousness during birth (Taylor, 2023), demonstrating the desire of western medicine, in particular, to reduce birthing people to bystanders in their own birth. While birth trends and medical treatments have changed throughout time, …

Exploring Adolescents’ Social, Cultural, And Health Experiences To Inform Culturally Responsive Interventions, Bria D. Singleton

Theses and Dissertations

This study examined adolescents’ perceptions of their social, cultural, and health-related experiences, assessing constructs related to identity formation, digital exposure, belonging, and safety among Generation Alpha. Using a mixed-methods design, data were collected from students aged 11 to 14 enrolled at a public middle school in South Carolina using a structured survey and qualitative group discussions. Survey findings indicated primarily positive perceptions of school safety and a sense of self-efficacy in caring for their mental health and well-being. However, qualitative findings disclosed the adolescents’ acute awareness of environmental threats, such as gun violence and school shootings, resulting in emotional dysregulation …

Vaccination Coverage And Factors Associated With Covid-19 Vaccination In The Adult African American Community In South Carolina: A Cross-Sectional Survey, Brittany Divon Smith

Theses and Dissertations

The COVID-19 pandemic has disproportionately affected African American communities, revealing longstanding disparities in healthcare access and outcomes. In South Carolina, where these inequities are particularly evident, understanding the determinants of COVID-19 vaccine uptake among African Americans is crucial for advancing health equity. This thesis examines vaccination coverage and explores social, economic, and psychological predictors of vaccine uptake in a sample of 305 African American adults through a cross-sectional survey conducted in 2023.

Vaccination status was categorized as unvaccinated, partially vaccinated, and fully vaccinated (with or without a booster). Ordinal logistic regression analyses were performed to examine associations between vaccination status …

Navigating End-Of-Life Decisions: Cultural Considerations For Latine Patients, Michelle Carbajal Hernandez

Honors Capstones

Healthcare professionals face many challenges when communicating terminal illness prognoses for individuals. This responsibility to address a terminal prognosis is further complicated when communicating with Latine patients who may face multiple barriers within the healthcare system and whose cultural preferences influence end-of-life care planning (Carrion, 2010). For example, Latines are less likely to enroll in end-of-life (EOL) care services (e.g., hospice) (Barragan-Carrillo et al., 2022). As well as engage in end-of-life care planning than White Non-Latines (Shen et al., 2016). To understand this hesitancy towards EOL care options, this literature review aims to explore how terminally ill Latine and …

A Comparative Analysis Of Group Care: Trust, Professional Identity, And Health System Structure In The United Kingdom And The Netherlands, Samantha J. Kohlmann

Senior Theses

Group prenatal care (Group Care) has been associated with improved maternal experiences and select clinical outcomes, yet less is understood about how it functions within high-resource health systems and what mechanisms underlie its impact. This study examines how Group Care is implemented in the United Kingdom and the Netherlands, with particular attention to professional roles, relational dynamics, and health system context.

I employed a qualitative, comparative design and conducted four semi-structured interviews with midwife researchers involved in Group Care implementation in both countries. Data were analyzed thematically, with attention to cross-context similarities and differences.

Findings indicate that Group Care operates …

“Recollecting The Told Story”: Storytelling, Activism, And The Black Maternal Health Emergency, Lamaya C. Williams

English Theses & Dissertations

Storytelling is a foundational component of Black knowledge creation and transmission. This dissertation centers Black women’s stories of birth and mothering—drawing on both primary source birth stories and fictional narratives—to examine the United States’ Black Maternal Health Emergency (BMHE). The BMHE is a complex and urgent issue wherein structural racism, medical bias, and intersecting social determinants disproportionately endanger the health of Black mothers. As such, Black mothers in the United States are three times more likely to die from a pregnancy-related condition compared to their white counterparts.

This study examines the birth stories of women who survived the BMHE and …

Optimizing Communication In The Periprocedural Area: Implementing Sbar: A Quality Improvement Project, Autumn Chang

Loma Linda University Electronic Theses, Dissertations & Projects

The primary aim of this project is to improve standardized nurse-to-nurse communication at the electrophysiology lab of a large Los Angeles hospital. By providing nursing education on a unit-specific, structured handoff communication framework (SBAR) and incorporating a procedure-specific handoff form for electrophysiology (EP) across pre-, intra-, and post-procedure units, this project aims to improve nurses’ perceptions of the handoff process and the effectiveness of handoff education across the periprocedural units. The project further aims to assess nursing incorporation of the training four weeks post-education and changes in patient satisfaction related to nursing teamwork and communication.

Scrub Up For Success: Transforming Infection Control In Transplant Patients Through Microlearning Video And Poster – A Quality Improvement Project, Wendy Dio

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction and Background

Healthcare-associated infections (HAIs) threaten patient safety, affecting about 1 in 25 hospitalized patients. Clostridium difficile infection (CDI) is a significant contributor, impacting both high-risk groups and the general population. Proper hand hygiene is crucial for preventing CDI transmission. In the U.S., hospital-acquired CDI costs over $1.5 billion annually and causes nearly 500,000 cases and I15,000 deaths each year. California reported 3,526 CDI cases in acute care hospitals, with Loma Linda University hospitals accounting for 16 cases, or 23% of their health system's infection rate.

Methodology

Nurses in the 6A West-Transplant Unit received a PowerPoint presentation on when …

Eating Disorder Prevention And Early Intervention In U.S. Higher Education – A Comparative Benchmarking Study, Jake R. Arcement

Senior Theses

Eating disorders (EDs), including anorexia nervosa, have the highest mortality rate of any psychiatric illness, yet remain underrecognized relative to their severity and treatment burden. Because the period of peak onset aligns with the college years, institutions of higher education are uniquely positioned to play an important role in prevention, early identification, and referral to specialized care. However, limited research has examined how colleges and universities structure ED prevention and treatment resources. This thesis applies a comparative benchmarking framework to assess current institutional practices across U.S. colleges and universities. A national survey of student health and counseling centers examined staffing, …

Preoperative Health During A Pandemic: An Observational Study Assessing Lifestyle Changes In Patients Associated With Covid-19 In Western Australia, Nadine Radin, Dana Hince, Jim Codde, Paola Chivers, Dale W. Edgar

Research outputs 2022 to 2026

Background and Aim: Healthcare service disruptions resulting from the COVID-19 pandemic led to substantial changes in surgical pathways across public hospitals in Western Australia (WA). These disruptions, compounded by restrictions and containment measures, influenced the health and lifestyle behaviours of the WA community, including patients awaiting surgery. This study aimed to assess changes in self-reported modifiable lifestyle risk factors among patients during COVID-19. Methods: This observational study analysed hospital patient data across three seasonally matched calendar periods: Period 1 (January–March 2019 vs 2020), Period 2 (March–July 2019 vs 2020), and Period 3 (July–December 2019 vs 2020). Multivariable regression models were …

Length And Framing Of Anti-Junk Food Ads Impact Inclinations To Consume Junk Food Among Normal Weight, Overweight, And Adults With Obesity, Ross C. Hollett, Brennen Mills, Stephanie L. Godrich, Julia Butt, Gina S.A. Trapp

Research outputs 2022 to 2026

Background: Unrestricted junk food advertising increases the risk of short-term junk food consumption among viewers. We aimed to estimate the impact of junk food and anti-junk food advertisements differing in length and framing on junk food consumption inclinations. Methods: Adult participants (N = 505) were exposed to a randomly selected junk food advertisement or anti-junk food advertisement and reported their immediate craving and consumption intentions. These responses were separately analysed for two groups based on Body Mass Index (BMI): participants classified as within the normal range (18.5–25), and a combined group with BMI values indicating either overweight (25+) or obesity …

Mental Health Literacy Among Perinatal Healthcare Professionals In The United Arab Emirates: A Multiphase Convergent Mixedmethods Study, Rouwida Khalil Elkhalil

Dissertations

Perinatal mental disorders (PNMDs) pose a significant public health concern due to their impact on maternal well-being, infant development, and family functioning. Effective identification and management of PNMDs depend largely on the mental health literacy (MHL) of healthcare professionals, particularly those working in perinatal settings. However, MHL among perinatal healthcare professionals in the United Arab Emirates (UAE) remains underexplored. This dissertation aimed to examine and conceptualize MHL among perinatal healthcare professionals in the UAE, explore factors influencing its application in clinical practice, and inform evidence-based improvements in perinatal mental health care. A multiphase convergent mixed-methods design was employed across four …

Beyond Parallel Programmes: A Roadmap For Operational Integration Of Family Planning And Nutrition In Low- And Middle-Income Countries, Marleen Temmerman, Samuel Ojong

Centre of Excellence in Women and Child Health

No abstract provided.

Beyond Parallel Programmes: A Roadmap For Operational Integration Of Family Planning And Nutrition In Low- And Middle-Income Countries, Marleen Temmerman, Samuel Ojong

Centre of Excellence in Women and Child Health

No abstract provided.

Caregiver Challenges And Health Access For Individuals With Developmental Disabilities In Mississippi, Kirsten Cunningham

Honors Theses

Current literature has highlighted the health disparities faced by individuals within the disability community and how it affects the care they receive. However, for many individuals with developmental disabilities, they require caregivers to make medical decisions for them. The purpose of this study is to focus on the caregiver’s perspective of caregiver stress, physical access to care, and health literacy to combat the challenges faced when getting access to healthcare resources for individuals with developmental disabilities in Mississippi. The researcher hypothesized, based on the literature review, that caregivers with higher levels of educational attainment would have less caregiver stress, more …

Advancing The Understanding Of Palliative Care In Singapore: Knowledge, Attitudes, Receptiveness, And The Moderating Role Of Media Information-Seeking Preferences, Su Lin Yeo, Angel Lee, Raymond Han Lip Ng, May O. Lwin, Yumin Lin

Research Collection Lee Kong Chian School Of Business

Introduction: Despite the growing demand for palliative care, this specialized medical care remains severely underutilized, with almost 50% of countries worldwide lacking access. Given that misperceptions and stigma continue to hinder progress in healthcare policy, this study aims to examine the relationships between palliative care knowledge, attitudes, and receptiveness to better understand how public health communication can enhance awareness and understanding of the topic in Singapore. Applying the adapted knowledge-attitude-practice (KAP) model, it further extends theory by examining the moderating role of media information-seeking between knowledge and receptiveness.Methods: Mixed-mode surveys involving 1,226 participants (926 online and 300 in-person respondents), representing …

Setting Research Priorities For The Use Of Digital Technology In The Self-Management Of Heart Health: The Results Of The James Lind Priority Setting Partnership, Lis Neubeck, Simon Nichols, Nicola Straiton, Louise J. Dunford, Amitava Banerjee, Susan Dawkes, Donna Fitzsimons, Maria Hayes, Alistair Lawson, Abigail A. Lyons, Mary Mcauley, Jill Mclaggan, Richard Mindham, Nicholas L. Mills, Rakesh Modi, Alice Pearsons, Amanda Pitkethly, Fiona E. Strachan, Coral L. Hanson

Research outputs 2022 to 2026

Aims: There are wide inequalities in access to cardiovascular care, and risk factors such as obesity, high blood pressure, and physical inactivity are often not well managed. We aim to identify the most important questions about how digital technologies can help people and their carers prevent cardiovascular disease and improve access to care. Methods and results: A priority setting partnership that aimed to generate a top 10 list of research priorities for the use of digital technology in the prevention and management of heart disease and heart conditions in the UK and Ireland, with equal input by people with lived …

Application Of The Multi-Theory Model To Determine Predictors Of Initiating And Sustaining Stress Management Behaviors In Undergraduate College Students, Bishoy T. Samuel, Joshua Mann, Michael Welsch, Manoj Sharma, Vinayak K. Nahar

Journal of Public Health in the Deep South

Background: Undergraduate college students face stress and concomitant mental health issues that can be mitigated by proper stress management behavior.

Purpose: This article examines the multi-theory model (MTM) of health behavior as a predictor of change in the primary outcomes of initiation and sustenance of relaxation-seeking behavior in undergraduate college students for the purposes of stress mitigation. The two main research hypotheses tested were that (a) participatory dialogue, behavioral confidence, and change in physical environment have statistically significant effects on initiation of behavioral change, and (b) emotional transformation, practice for change, and change in social environment have statistically significant effects …

Promoting A Culture Of Academic Integrity In The Context Of Artificial Intelligence: Lessons From One School Of Public Health In The Southeast, Gregory Pavela, Lindsay C. Aycock, Mercy Aula, Angela Sullivan, Matthew Fifolt

Journal of Public Health in the Deep South

No abstract provided.

Impact Of Tropical Cyclones On Food And Nutrition Security: A Global Scoping Review And Thematic Analysis, Patience M. Chiotha, Budi Haryanto

Jurnal Epidemiologi Kesehatan Indonesia

The increasing frequency and intensity of tropical cyclones driven by climate change pose growing threats to food and nutrition security. Globally, an estimated 80–90 tropical cyclones occur annually, affecting approximately 119 million people. Evidence regarding their impact on food systems, dietary patterns, and nutritional status remains fragmented. This scoping review aimed to map global evidence on the impacts of tropical cyclones on food and nutrition security, identify key pathways of impact, and examine affected indicators at household and individual levels. The review followed Joanna Briggs Institute guidelines and PRISMA-ScR. Searches were conducted in PubMed/MEDLINE, Web of Science, Scopus, and Google …

Analisis Disparitas Geospasial Dan Determinan Sosio-Demografis Masalah Kesehatan Jiwa Di Indonesia: Analisis Data Survei Kesehatan Indonesia (Ski) 2023, Alya Zahrah Zhafirah, Sutanto Priyo Priyo Hastono

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Kesehatan jiwa merupakan pilar utama pembangunan sumber daya manusia yang kini menjadi tantangan struktural di Indonesia. Masalah ini dipengaruhi secara signifikan oleh determinan sosio-demografi seperti tingkat pendidikan, status ekonomi dan lingkungan. Penelitian ini diinisiasi oleh urgensi untuk memetakan distribusi beban masalah kesehatan jiwa secara nasional sekaligus menginvestigasi ketidakonsistenan prevalensi antara data Riskesdas 2018 dan SKI 2023. Penelitian ini menggunakan desain potong lintang dengan menganalisis prevalensi masalah kesehatan jiwa pada penduduk Indonesia berusia ≥15 tahun, menggunakan data SKI 2023. Kondisi kesehatan jiwa dinilai menggunakan instrumen SRQ-20 untuk mengidentifikasi probabilitas masalah kesehatan jiwa. Hasil utama menunjukkan prevalensi masalah kesehatan jiwa Indonesia tahun …

Patterns Of Multimorbidity Among Low-Income Adults Who Smoke With Implications For Tailored Interventions: A Cluster Analysis Using A Mixture Of Bernoulli Model, Monique T. Cano, Michael R. Lindstrom, Oscar F. Rojas Perez, Ricardo F. Muñoz

School of Mathematical & Statistical Sciences Faculty Publications

Introduction: Smoking cigarettes remains a leading modifiable risk factor for preventable health conditions. In the United States, the health burden of smoking disproportionately impacts low-income individuals. Multimorbidity is common in this group, complicating treatment and worsening outcomes. Identifying multimorbidity clusters can support targeted, individualized interventions. This study aimed to identify multimorbidity clusters among individuals who smoke and experience economic hardship and provide clinical recommendations to enhance health outcomes.

Method: Individuals who smoke and experience economic hardship (N = 60) were recruited from the San Francisco Health Network (SFHN) and were assessed for physical and mental conditions. Cluster analysis was …

U.S. Pharmacists’ Perceptions Of Getting The Covid-19 Vaccine And How That Affects Their Interactions With The Public, Megan Boals

Walden Dissertations and Doctoral Studies

Pharmacists play a pivotal role in public health, particularly in promoting vaccination. However, vaccine hesitancy among pharmacists significantly undermines their willingness to provide effective patient counseling and to advocate for vaccination, potentially eroding public trust in vaccines. This descriptive-phenomenological study sought to understand the factors contributing to pharmacists’ COVID-19 vaccine hesitancy and how this hesitancy affected their willingness to recommend vaccines to patients. Twenty practicing pharmacists were interviewed via Zoom between September 23 and October 14, 2025. The health belief model helped interpret the study findings. Thematic analysis, as described by Braun and Clarke, was conducted to identify and interpret …

The Relationship Between Smartphone Screen Time Duration And Individual Chronotype: A Systematic Literature Review, Diego Sergio Giasia Lumbantobing, Thalia Altamilano Pramudya

Jurnal Epidemiologi Kesehatan Indonesia

The rapid increase in smartphone use over the past decade led to prolonged screen time across age groups, particularly during nighttime hours. Exposure to artificial light and pre-sleep digital activities was associated with circadian rhythm disruption and alterations in individual chronotype. This systematic literature review aimed to synthesize empirical evidence on the relationship between smartphone screen time duration and individual chronotype across all age groups and to identify key moderating factors influencing this association. The review was conducted in accordance with PRISMA 2020 guidelines. Literature searches were performed in PubMed, Scopus, and ScienceDirect for studies published between 2015 and 2025. …

Prevalence And Determinant Factors Of Depression Among Pregnant Women In Poned Health Center In Tangerang City Area, Dian Geumala Hayati, Sudijanto Kamso, Popy Yuniar, Yuli Puspita Devi

Jurnal Epidemiologi Kesehatan Indonesia

According to World Health Organization (WHO), approximately 10% of pregnant women experience mental disorders, with depression being particularly prevalent. In developing countries, this rate is was even higher, reaching 19.8% after childbirth and 15.6% during pregnancy. Various studies conducted in Indonesia show that the prevalence of depression among pregnant women ranges widely, from 21.4% to 26.2%.This study aimed to determine the prevalence and risk factors associated with depression during pregnancy in pregnant women at the PONED Community Health Center in Tangerang City Area. A facility-based cross-sectional study was conducted with 105 pregnant women attending antenatal check-ups at the 17 PONED …

Dyadic Internalized Stigma, Resilience, And Psychological Distress Among People With Hiv And Their Family Members: An Actor-Partner Interdependence Mediation Model Analysis, Fanghui Shi, Xueying Yang, Shan Qiao Ph.D., Cheuk Chi Tam Ph.D., M.S., M.A., Shuaifeng Liu, Yuejiao Zhou, Xiaoming Li Ph.D.

Faculty Publications

Despite robust evidence showing the mediation role of psychological resilience in the impacts of HIV-related stigma on psychological distress, most studies were conducted from an intrapersonal perspective. Limited studies have examined the dyadic effects of HIV-related stigma and resilience on psychological distress for people with HIV (PWH) and their family members. This study aimed to explore the actor-partner effect and the mediation role of resilience in the relationship between internalized stigma and psychological distress among PWH and family members dyads. Between October 2023 and December 2023, a total of 800 PWH-family member dyads were recruited from two urban cities and …

A Livelihood Intervention Improved Nutritional, Mental Health And Sexual Health Outcomes Among Hiv-Affected Adolescents In Western Kenya: Results From The Shamba Maisha Randomised Controlled Trial, Sheri D. Weiser, Lila Aziz Sheira, Pauline Wekesa, Jennifer Monroe Zakaras, Edward A. Frongillo Jr. Ph.D., Elly Weke, Jason M. Nagata, Amy A. Conroy, Marguerita Lightfoot, Torsten B. Neilands, Lisa M. Butler, Elizabeth A. Bukusi, Craig R. Cohen, Maricianah Atieno Onono

Faculty Publications

Introduction Interventions that address household-level factors, including food insecurity (FI) and poverty, may reduce HIV risk and improve sexual and reproductive health (SRH) among adolescent girls and young women (AGYW).

Methods This cluster randomised controlled trial in Kenya assessed AGYW living in households of adults enrolled in Shamba Maisha (SM). SM was a multisectoral agricultural livelihood intervention designed to improve HIV health. At the trial end, we used linear and logistic regressions to compare differences between the intervention and control arms in FI, and mental health among AGYW-caregiver pairs and SRH outcomes among the AGYW, accounting for clusters with robust …