Digital Commons Network^™

Failure To Rescue After Surgery For Pancreatic Cancer: A Systematic Review And Narrative Synthesis Of Risk Factors And Safety Strategies, Masashi Uramatsu, Yoshikazu Fujisawa, Paul Barach, Hiroaki Osakabe, Moe Matsumoto, Yuichi Nagakawa

College of Population Health Faculty Papers

Background: Failure to rescue (FTR), defined as death after major postoperative complications, is a critical quality indicator in pancreatic cancer surgery. Despite advances in surgical techniques and perioperative care, FTR rates remain high and vary across institutions. Methods: This systematic review uses a narrative synthesis followed by PRISMA 2020. A PubMed search (1992-2025) identified 83 studies; after screening, 52 studies (2010-2025) were included. Eligible designs were registry-based, multicenter, single-center, or prospective audits. Given substantial heterogeneity in study designs, FTR definitions, and outcome measures, a narrative synthesis was performed; no formal risk-of-bias assessment or meta-analysis was conducted. Results: …

Perceptions Of Whole Plant-Based Diets And Weight Among Hispanics In Miami, Florida, Zoraida Powell

Walden Dissertations and Doctoral Studies

Being overweight or obese poses major public health concerns and contributes to the development of chronic illnesses. While researchers have explored how a total plant-based diet impacts excess body weight or obesity, there is still a lack of clarity about how Hispanics living in Miami, FL, perceive or understand this diet concerning overweight and obesity. Using a generic qualitative approach, this study was conducted on how Hispanics in Miami, FL, understand and view a whole plant-based diet (WPBD) for preventing and reducing overweight and obesity. Through interviews with 14 diverse Hispanic participants, the study revealed that they see WPBD as …

Lived Experiences Of Obese Women In Mississippi Concerning The Role Of Psychosocial Factors In The Development Of Obesity, Temitope Olabode

Walden Dissertations and Doctoral Studies

One of the highest rates of obesity in the United States is in Mississippi, where middle- aged obese women deal with a variety of social, cultural, and personal issues, including shame, discrimination, and stigma based on weight, mental anguish, cultural norms, financial limitations, and restricted access to healthcare. This study investigated the psychosocial factors that contribute to obesity in women aged 40- 60 years, and the effects of obesity on body image, self-esteem, health behaviors, and quality of life. A qualitative phenomenological study using the social ecological model (SEM) framework looked at the individual, interpersonal, and policy levels of the …

Alternative And Traditional Schooling On Sexual Risk Behaviors Among Alaska Native Youth In The Lower Kuskokwim, Nathaniel Hebert

Walden Dissertations and Doctoral Studies

Alaska Native youth experience disproportionately high rates of sexual risk, yet disaggregated data and school-contextual analyses remain limited. Understanding how school type (alternative vs. traditional) and individual factors influence sexual risk among Alaska Native youth is essential for informing targeted, culturally responsive health interventions and addressing ongoing health disparities. This quantitative study aimed to examine the association between three behaviors (condom use, multiple sexual partners, and substance use) by school type, controlling for gender, grade level, body mass index, and afterschool activity. Guided by the social-ecological model, this cross-sectional study provided new insights into the relationship between school type and …

Household Dysfunction And Dating Violence Perpetration: The Moderating Effects Of Parental Monitoring And Closeness Among Middle School Adolescents In Southeast Texas, Ross Shegog

Faculty, Staff and Student Publications

Background: Adolescent dating violence (DV) perpetration is a significant public health issue affecting millions of adolescents in the United States. Adverse childhood experiences such as household dysfunction (HD) have been exhibited to be risk factors for DV perpetration during adolescence and adulthood. Furthermore, the literature is scant regarding how positive parent-child relationships can mitigate these risk factors and decrease HD-related consequences among sixth-grade adolescents. Thus, our study examined the moderating effects of parental monitoring and closeness regarding the association between HD and DV perpetration among middle schoolers in Southeast Texas.

Methods: In our cross-sectional study, we used the baseline data …

Determinant Factors Of Completeness Of Medical Resume Filling By Doctors At Pesawaran Regional General Hospital, Achmad Deza Farista, Aila Karyus, Abikusno Djamaluddin

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

A medical resume serves as a vital document that compiles essential information related to a patient’s clinical management. In 2019, the completeness rate of medical resume documentation at Pesawaran Regional General Hospital was only 37.4%. This study aimed to identify factors influencing the completeness of medical resume documentation by doctors through a quantitative, cross-sectional design involving 37 inpatient care doctors. Data were collected via questionnaires and direct observation, then analyzed using univariate, bivariate (Chi-Square), and multivariate (Logistic Regression) methods. Observation showed that 56.8% of medical resumes were incomplete. Questionnaire results indicated that 54.1% of respondents had negative perceptions of Standard …

The Impact Of Cooperative Extension Programs On Late Life Mental Health Outcomes: A Systematic Review, Naomi R. Meinertz, Kate Perepezko, Jeong Eun Lee, Mary E. Dozier Phd

Journal of Human Sciences and Extension

Rural-dwelling older adults have greater mental health disparities with higher rates of depression and anxiety compared to their urban counterparts; however, reaching these communities to understand and address the specific psychological needs of rural-dwelling older adults remains a barrier for gerontologists. Due to the extensive reach of the Cooperative Extension System, university Extension systems are primed to facilitate connections between researchers and rural communities to improve mental health outcomes for older adults. Despite the potential benefits of such partnerships, Extension is largely unknown and underutilized by gerontological researchers, leaving many older adults disconnected from resources available through land-grant universities that …

The Science Of Sound: Studying The Cognitive, Emotional, And Physiological Effects Of Frequency, Genre, And Music, Jett Yarborough

Senior Honors Theses

Music influences emotion, physiology, and cognition, yet little is known about how the frequency it is tuned to affects these influences. Prior research has shown that music tuned to 432 Hz can reduce stress, lower blood pressure, and improve sleep. My colleagues and I conducted two studies to investigate this. Our research found that music tuned to 432 Hz promotes a significant increase in memory retention and induces a state of focus and relaxation. These results suggest that shifting from the standard tuning frequency of 440 Hz to 432 Hz could have a profoundly positive impact on our daily lives. …

Healing Right Way: A Stepped Wedge Cluster Randomised Controlled Trial Aiming To Enhance Quality Of Life For Aboriginal Australian Survivors Of Stroke And Traumatic Brain Injury, Elizabeth Armstrong, Tapan Rai, Judith M. Katzenellenbogen, Sandra J. Thompson, Meaghan Mcallister, Natalie Ciccone, Deborah Hersh, Leon Flicker, Dominique A. Cadilhac, Erin Godecke, Graeme J. Hankey, Neil Drew, Colleen Hayward, Deborah Woods, Mel Robinson, Ivan Lin, Sanita Kratina, Jane White, Juli Coffin

Research outputs 2022 to 2026

Objective: To determine the effect of cultural security training (CST) for health professionals and access to an Aboriginal Brain Injury Coordinator (ABIC) for Aboriginal Australians with stroke or traumatic brain injury (TBI). Design: A stepped wedge cluster randomised controlled trial; the intervention package consisted of CST for hospital professionals and 6-month access to ABICs providing education, support, liaison and advocacy; the commencement order of the intervention phase was randomised. Setting: Four urban and four rural hospitals in Western Australia, 2018–2022. Participants: Aboriginal adults ≥ 18 years hospitalised with stroke or TBI. Main Outcome Measures: Primary outcome was quality of life …

Fit For Success: Exploring Physical Activity Promotion And Effects On Students At The University Of South Carolina Through A Podcast Series, Maia Schwarzmueller

Senior Theses

College students face unique challenges when trying to maintain physical activity levels, such as time constraints, stress, and lack of proper facilities. The Fit for Success podcast will explore how physical activity is a powerful tool towards enhancing self-perception, academic success, and stress management as well as delve into the specific barriers that University of South Carolina students face to physical activity. The podcast will also explore different aspects of physical activity promotion including group fitness, competition, and built environment. The goal of the podcast is to help students to see physical activity as an important component of many facets …

Determinants Of Uptake Of Breast Cancer Screening Among Women Of Reproductive Age In Makueni County, Lola Ndirangu

MSc in Advanced Practice Nursing

Background: Breast cancer is the most diagnosed cancer in all women worldwide, with women in low and middle-income countries dying of the disease in disproportionate numbers because of late diagnosis and access to screening services. Sub-Saharan Africa is an under-researched area, and the level of screening uptake in Kenya, especially in rural and semi-arid areas, including Makueni County, is low. This research assessed the factors that determine the reproductive age women's screening uptake of breast cancer in Makueni County.

Methodology: The cross-sectional design was analytical and was conducted in Makueni County Referral Hospital, where 301 randomly chosen women …

Undifferentiated Embryonal Sarcoma Of Liver In A Child : A Case Report, Neha Devendra Bhongale, Sumeet Baheti, Poonam Wade, Omkar Khandkar, Meenakshi Balasbramanian

Digital Journal of Clinical Medicine

Background: Undifferentiated Embryonal Sarcoma of liver (UESL) is a rare malignancy of liver originating from primary mesenchymal tissue with overall poor prognosis. Around 220 pediatric cases of UESL have been reported in the literature. The lack of characteristic clinical manifestations, laboratory tests and imaging studies pose a diagnostic challenge and the preoperative misdiagnosis rate is high. Historically, treatment was limited to surgical resection with poor survival rate. In recent times, combination of chemotherapy and surgical resection has improved survival.

Case Presentation: We report a case of undifferentiated embryonal sarcoma of liver in a 6 years old boy who presented …

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda Killeen

School of Podiatric Medicine Publications

Introduction: Diabetes mellitus is the 7th leading cause of death in the U.S. and 6th in Texas. South Texas counties have higher diabetes rates than state and national averages. This complex, progressive disease affects multiple body systems and can lead to serious complications, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas, predominantly Hispanic American, is disproportionately affected. This demographic faces clinical barriers due to a lack of cultural understanding, highlighting the need for culturally sensitive healthcare workers such as promotoras. This study aimed to …

Hungry Minds: Analyzing The Impact Of Food Insecurity And Food Assistance Programs On Neurocognitive Development And Childhood Mental Health, Kayla A. Davenport

Senior Theses

Introduction: Food insecurity affects millions of children in the United States and is increasingly recognized as a significant risk factor for poor nutritional intake and adverse health outcomes. However, less is known about how the experience of food insecurity disrupts healthy development and well-being, particularly among American youth. This thesis had two aims: (1) to examine the relationship between household food insecurity and children’s neurocognitive and mental health outcomes and (2) to evaluate how major food assistance programs address, or fail to address, these developmental risks.

Methods: This thesis uses a mixed-methods approach, integrating a narrative literature review, a cross-sectional …

Food Insecurity And Social Connection Of Nicaraguan Refugees And Asylum Seekers In Costa Rica: A Qualitative Study, Keren Herran

Theses and Dissertations

Background

Given the physical and mental health consequences of food insecurity, solutions should be evidence-based and seek to prioritize vulnerable populations. This qualitative study adds to limited literature on how refugees and asylum seekers use their social connections to mitigate food insecurity by investigating how Nicaraguan refugees and asylum seekers in Costa Rica foster social connections and use these connections to acquire and manage food.

Methods

In fall 2024, 35 in-depth semi-structured interviews were conducted in San José, Costa Rica. Participants were recruited through six migrant-serving nonprofit organizations. For study inclusion, participants had to: 1) be 18 or older; 2) …

Genetic Architecture Of Cerebral White Matter Hyperintensities In Diverse Hispanic/Latino Adults, Carmen R Isasi, Wassim Tarraf, Hector M Gonzalez, Charles S Decarli

Faculty, Staff and Student Publications

Background and objectives: Cerebral white matter hyperintensities (WMHs) on MRI are part of the spectrum of age-related brain vascular injury and are associated with increased risk of stroke and dementia. Genome-wide association studies (GWASs) conducted mostly in populations of European ancestry have identified several genetic loci. Although Hispanic/Latino adults have a greater burden of WMHs than their non-Hispanic White counterparts, they are vastly underrepresented in genetic studies. We sought to characterize the genetic architecture of WMHs in a Hispanic/Latino cohort by investigating the transferability of known WMH genetic loci and by leveraging Hispanic/Latino genetic diversity to map novel loci.

Methods: …

Identifying Key Influencing Factors Of Elderly Health Information Search Based On Meta-Ethnography, Zhumei Sun, Zhibing Wang

Journal of Scientific Information Research

[Purpose/significance] Health information search is an important way for elderly people to actively cope with aging. Identifying the key factors affecting of their health information searching and exploring the correlation among these factors are of positive significance for promoting the elderly proactive health ability.

[Method/process] This paper firstly integrated the original research through a meta-ethnographic approach to form a set of factors influencing the elderly health information search. The DEMATEL method was then used to analyze the interrelationships among the influencing factors and identify the key influencing factors.

[Result/conclusion] The study finds that, the influencing factors of elderly health information …

Venezuelan Migrants In Prostitution: A Personal Decision?, Yazmin Maria Lucila Cadena Camargo, Izara Maite Mondragon Moreno, Isabela Osorio Jaramillo, Paula Angélica Suárez Álvarez, Andrés Duarte Osorio, Carlos Gómez-Restrepo

Dignity: A Journal of Analysis of Exploitation and Violence

This paper explores the multifaceted experiences of Venezuelan migrant women engaged in prostitution, framed through three critical moments: the “decision to enter in prostitution,” the unique abuses faced, and the resultant consequences on mental, physical, and social health. The study highlights how socioeconomic vulnerabilities—exacerbated by migration and poverty—significantly influence the likelihood of entering prostitution. It also shows how traumatic experiences, particularly in childhood and adolescence, coupled with a lack of support networks, contribute to a heightened risk of exploitation. Eleven life stories were collected through a phenomenological approach, revealing a common narrative of abuse, poverty, and the search for survival …

“If I Can Accept My Queerness, I Can Accept My Body As It Is”: Understanding Weight-Related Perspectives And Stigma From Sexual Minority Women, Lauren A. Fowler, Yilin Wang, Catherine Wall, Allyson Velkovich, Erin N. Harrop, Melissa M. Vázquez, Janis Mensah, Annessa Flentje, Emily S. Mann Ph.D.

Faculty Publications

Introduction:

Sociocultural norms that conflate thinness with health and morality contribute to widespread weight stigma, with well-documented consequences for physical and mental health. Sexual minority women (SMW), particularly those living in larger bodies, may be especially affected due to the intersection of heterosexism, sexism, and weight stigma across their lives.

Methods:

This qualitative study utilized life history-informed semi-structured interviews with 24 cisgender SMW, ages 22–46, to explore how they experience sociocultural messages about weight, body size, and health over time, and how these experiences intersect with other aspects of structural marginalization. Interviews were audio recorded and transcripts were coded using …

Exploring Workplace Mental Health And Counseling Needs In Open University Staff: A Mixed-Methods Study, Pathanin Sangaroon, Oranuch Kanjanaprakorn, Araya Prasertchai, Worrawit Nakpan

Journal of Health Research

Background: Workplace mental health is a growing concern in higher education, especially in open and distance learning (ODL) settings, where staff face unique stressors. This study examines the mental health and counseling needs of academic and support staff at Sukhothai Thammathirat Open University (STOU), Thailand, using a biopsychosocial lens.

Methods: An explanatory sequential mixed-methods design was used. In the quantitative phase, 332 staff completed a questionnaire on mental health and biopsychosocial factors. Twelve participants then took part in interviews to explore their experiences and counseling preferences. Quantitative data were analyzed using stepwise regression, and qualitative data through thematic analysis. …

Ready Or Not? An Autoethnography Of A Midwife’S Preparedness And Readiness Journey, Kristen Graham

The Qualitative Report

This emotive autoethnography explores my experiences working as an Australian midwife in low- and middle-income countries, which led to a Doctor of Philosophy journey exploring primary care midwives' preparedness and readiness in rural and remote communities in this context. I use the midwifery tradition of storytelling to explore personal experiences of preparedness and readiness as a way towards researcher reflexivity, understanding and meaning. Emerging themes of preparation for practice, resource limitations, heartache, and emotional resilience offer insights to inform midwifery education, research, and practice.

Opportunities And Barriers To Engaging Caregivers In Firearm Suicide Prevention: Findings From Focus Groups With Caregivers Of Veterans., Katherine Macwilliams, John Marmion, Dee Blascyk, Sharon Urbina, Rachel Moyers, Gala True

School of Medicine Faculty Publications

Background: Firearms are involved in more than 70% of U.S. Veteran suicides. Caregivers, defined as family members or concerned significant others, can play an important role in firearm suicide prevention through initiating conversations about secure firearm storage with Veterans. Our objective was to explore caregivers' experiences with lethal means safety (LMS) conversations and identify perceived barriers to caregivers discussing LMS with healthcare providers and with Veterans. Methods: We conducted focus groups with 32 caregivers with experience caring for a Veteran at risk for suicide. Qualitative data were analyzed using thematic analysis. Results: We identified three primary themes: 1) caregivers recognize …

Native Hawaiian Culturally Appropriate Substance Use Disorders Formative Program Evaluation, Kelly J. Penn

Walden Dissertations and Doctoral Studies

Substance use disorders (SUDs) disproportionately affects Native Hawaiians, yet conventional treatments often overlook the cultural, spiritual, and relational foundations of well-being for Native Hawaiians. This gap represents a human services problem, as it perpetuates health disparities, limits recovery, and slows social change within Native Hawaiian communities. The purpose of this qualitative single case study was to identify culturally relevant components for an SUD treatment program tailored to Native Hawaiians. The research question guiding this study was, what are culturally appropriate components for a SUD program for Native Hawaiians. The Nā Pou Kihi framework grounded the exploration of Indigenous approaches to …

Relationship Between Alcohol Use And Obesity In Us Adults Aged 20 To 79, Chinwendu Echefu, Ramona Stone

Public Health Sciences Faculty Publications

Purpose: This is a secondary data analysis carried out to determine the asso- ciation between alcohol use and obesity (BMI) in US adults aged 20 to 79 while adjusting for confounding factors that are known to affect obesity. Methods: The 2017-2018 National Health and Nutrition Examination Survey (NHANES) was utilized to provide a weighted sample of 16,548 adults between the ages of 20 and 79 with valid information for the BMI and for the average alcohol con- sumed per day over the past 12 months. Multivariable regression was done to determine the association between obesity, measured by the Body Mass …

Examining Factors Influencing Ultra- Processed Food Consumption Among Liberty University Students Aged 18 And Older, Ginika Rosemary Muomah

Masters Theses

Ultra-processed foods (UPFs) are widely consumed among college students and are linked to adverse health outcomes including obesity, poor mental health, and cardiometabolic disease. Despite their rising prevalence, limited research has examined psychosocial and behavioral factors influencing UPF intake within Christian university settings. This study investigated demographic, behavioral, and psychosocial predictors of UPF consumption among Liberty University students, guided by the Health Belief Model (HBM). A cross-sectional survey of students aged 18 and older (N = 337) was conducted. After excluding incomplete or invalid responses, 276 cases remained. The 25-item survey assessed UPF intake, HBM constructs, and demographics. Descriptive statistics …

Comparing Ideology And Covid-19 Preferences Of Canadian Public Health Workers And The General Population, Simon Kiss, Patrick Fafard, Andrea Perrella, Ketan Shankardass, Erick Lachapelle, Matthew Arp, Joslyn Trowbridge

Laurier Institute for the Study of Public Opinion and Policy

Objectives: This study tests whether and how the Canadian public health workforce differed from the Canadian general population in their political attitudes, worldviews and policy preferences related to the COVID-19 pandemic.

Methods: Nearly identical surveys were fielded to the Canadian public health workforce in 2021 through leading public health associations and to a census-balanced sample of the general Canadian population in February and March 2021. through a consumer quota sample for a survey of the general population.

Results: The Canadian public health workforce demonstrates systematically more left-wing pro-egalitarian, anti-hierarchical, anti-individualist worldviews. Those in health promotion positions are slightly more to …

Occupational Health Equity: A Call To Consider Social-Structural Factors In Injury Prevention Research, David B Richardson

Faculty, Staff and Student Publications

Occupational health equity scholarship has been growing over the past decade, including social-structural determinants of health research that centres the voices and experiences of historically marginalised communities. In our commentary, we focus on the intersection of work-related and non-work-related factors and how they impact the health of workers, their families and their communities through community-engaged research. Case studies include the implementation of mobile clinics that are developed alongside communities, community organising to examine and reduce health disparities among racially segregated workers, the development of research instruments and measures to study racism and discrimination, and a focus on how the distribution …

Associations Between Individual And Structural Level Discrimination And Psychological And Physiological Stress Indicators During Pregnancy, Özlü Aran, Melissa Nevarez-Brewster, Kimberly D'Anna-Hernandez, Julia Dmitrieva, Curt A. Sandman, Laura M. Glynn, Elysia Poggi Davis

Psychology Faculty Articles and Research

In the United States (U.S.) pervasive health disparities in prenatal care disproportionately impact marginalized individuals. The present study investigates whether discrimination at the individual and structural levels are associated with indicators of psychological and physiological stress among pregnant Latinx people living in the U.S., including both U.S. and foreign-born individuals. Pregnant participants (n = 109) reported on birthplace, lifetime experiences of racial and ethnic discrimination, perceived levels of stress, acculturation, social support, and provided residential address data and hair samples for cortisol analysis. Regression analysis revealed that individual level discrimination was linked to higher psychological stress during pregnancy ( …

Alleviating Social And Psychological Ill-Being Research & Evaluation (Aspire) Study: Implementing An Act-Based Pathway For Patients In Primary Care, Monica C. Perez, Deepu George, Maria Hernandez, J. Garza, S. Solis

Research Colloquium

The Alleviating Social and Psychological Ill-being Research and Evaluation (ASPIRE) Study addresses a critical care gap for patients in the Rio Grande Valley by increasing access to behavioral health services within primary care. Psychosocial distress - including anxiety, depression, and lack of social support - negatively affects health outcomes and contributes to health disparities. The ASPIRE Study evaluates the impact of an Acceptance and Commitment Therapy (ACT)-based Psychological Flexibility (PF) Pathway on emotional well-being, systemic inflammation, and care engagement among patients in primary care settings.

Fortify Resilience A Multi-Level Approach To Mitigating Burnout And Promoting Well-Being In Physician Residents, Monica C. Perez, Yvette K. Cantu Cazares, M. Hernandez, Deepu George

Research Colloquium

The Fortify Resilience initiative is a multi-level program designed to cultivate and sustain a culture of well-being for Residents and Fellows (R/Fs) at The University of Texas Rio Grande Valley (UTRGV) School of Medicine’s (SOM) Graduate Medical Education (GME) residency and fellowship programs. This initiative addresses burnout and invests in well-being at individual, group, and institutional levels through three core drivers: Access Strategy, Empowerment Initiatives, and System Redesign.