Digital Commons Network^™

Transition To Home Guideline For Patients With Diabetes, Kathleen R. Burgner

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Diabetes is a leading contributor to preventable hospital readmissions. These hospital readmissions often result from fragmented discharge planning, poor care coordination, and limited post-discharge support. At a 915-bed academic medical center in Southern California, the diabetes-related readmission rate was 13.3%, compared with 11.4% among patients without diabetes. This project aimed to develop an evidence-based Transition-to-Home (TTH) guideline for hospitalized patients with diabetes and evaluate the strength of its recommendations through multidisciplinary stakeholder review.

Methods: An evidence-based guideline development project was conducted over 8 weeks. A comprehensive literature search in CINAHL, MEDLINE, PubMed, and ScienceDirect identified current evidence on transitional …

Technological Interventions For Reducing Climate Change Impacts On Health: An Overview Of Future Possibilities, Sujatha Alla, Vijay Kumar Chattu, Bawa Singh

Engineering Management & Systems Engineering Faculty Publications

Globally, over five million deaths annually are attributed to extreme weather events exacerbated by climate change, such as heatwaves, hurricanes, wildfires, droughts, and floods, which create health crises and economic losses. The 2015 Paris Declaration emphasized climate technology mechanisms, including research and development, to enhance resilience and reduce greenhouse gas emissions. Biotechnological advancements have mitigated about 20% of economic losses since the 1960s, highlighting technology’s potential to address climate-induced health risks.

Meta-Analysis Of The Health Effects Of Gas Cooking In Homes, P. Jacob Bueno De Mesquita, Núria Casquero-Modrego, Erik Pontes

Arts & Sciences Faculty Publications

Background: Given existing evidence linking indoor gas combustion with potential health effects, we aimed to quantify from epidemiologic field studies the health impacts associated with residential gas cooking and unvented heating.

Methods: We evaluated and synthesized results from peer-reviewed epidemiologic studies that isolated associations between exposure to residential gas cooking and/or unvented heating and an unrestricted range of health outcomes. We focused on studies conducted since 2000 that cited at least one of five, well-regarded studies. We evaluated relevant studies and computed pooled effect estimates, where at least three studies contributed data, using random effect meta-analysis models with inverse-variance weighting. …

A Framework For Digital Energy Modulation And Translation In Projectional X-Ray Imaging, Richard R. Wargo

Theses and Dissertations

In projectional X-ray imaging, acquisition energy fundamentally influences subject contrast, image noise, and radiation dose. While dual-energy techniques exploit spectral differences to optimize contrast and enable material separation, acquiring multiple images of the same anatomy often requires additional exposures and increased system complexity.

This dissertation presents a framework for digital energy modulation (DEM), in which computational models are trained to translate projection images between energy domains without requiring additional X-ray acquisitions. DEM is conceived as a generalizable strategy for controlled contrast modulation in projection imaging, with potential applications in image optimization, radiation therapy alignment, and dual-energy applications.

The framework was …

Embracing Imperfection And Stress As The Foundation For Growth, Excellence, And Well-Being In Dentistry, John W. Claytor Jr., Dds, Magd-Llsr, Facd

Journal of the American College of Dentists

Studies reveal that stress in dentistry begins early in training and may progress throughout a dentist’s career. Fear of managing patient dissatisfaction, demanding schedules, time constraints, staff issues, and the stressors of clinical dentistry all contribute to professional strain. Difficulties associated with perfectionistic tendencies, burnout, and mental health concerns remain ever-present challenges within the profession. This article discusses evidence-based strategies, coping skills, organizational approaches, and professional resources that may help mitigate the effects of stress in dentistry. Particular emphasis is placed on reducing stigma surrounding mental health care and supporting initiatives such as the Lorna Breen Heroes Foundation’s “Safe Haven” …

Examining The Barriers To Healthcare Among Native Hawaiian And Pacific Islander Populations Living In Hawaii, Gracie L. Kaye

Honors Undergraduate Theses

The state of Hawaii was annexed by the United States in 1898, and served as a starting point from which the U.S. influenced Hawaii's socioeconomic conditions and healthcare access. The literature review examines healthcare views and outcomes among Native Hawaiian and Pacific Islander residents, utilizing various tools and resources to investigate how these factors have impacted overall health statistics and the reasons behind these trends. Results found that the western colonization of the island and the disease outbreaks led to an initial mistrust of “western ideas.” Additionally, due to long-standing cultural beliefs, there is a natural preference for traditional cultural …

The Knowledge, Experiences, And Attitudes Of Nurses Regarding Trauma-Informed Care For Sexually Abused Intrapartum Patients, Kayleigh Mcgraw

Honors Undergraduate Theses

Labor and delivery nurses care for women from diverse backgrounds who are preparing for a life-changing event, often marked by fear, excitement, sadness, and joy. However, 1 in 5 women in the United States have experienced rape or attempted rape, and for these survivors, labor can become re-traumatizing. Many report flashbacks, dissociation, and a sense of “being back in the rape” during childbirth. Research further links prior sexual assault to unplanned cesareans, traumatic births, and childbirth-related PTSD. Trauma-informed care (TIC) provides a framework to reduce these risks by encouraging providers to understand trauma, recognize signs of distress, and act to …

Timelines Of Care: Analyzing Treatment Access For Women With Ongoing Reproductive Health Needs, Nyla M. Keith

Honors Undergraduate Theses

Mandates in the United States created pressure on an already strained healthcare system post-COVID-19 pandemic. With new regulations placed upon abortion care forcing the closing of low-cost health clinics such as Planned Parenthood, legislation that has made health insurance more expensive, and rising pharmaceutical prices, women’s OB/GYN care in America has struggled to meet patient needs. A cross-sectional survey was developed and distributed to four clinics in the Orlando area to assess patients' perceived access to care and identify barriers to receiving OB/GYN care. The survey took approximately 10 – 15 minutes to complete, was available in print and online …

The Role Of Resistance Training In Managing Menopause-Related Changes, Alyson K. Strauss

Honors Undergraduate Theses

Resistance training serves as a critical non-pharmacological strategy for mitigating the physiological and psychological declines associated with the menopausal transition. This natural biological phase, marked by declining estrogen levels, typically leads to accelerated bone mineral density loss, sarcopenia, metabolic regulation disturbance, and heightened mood disturbances. To evaluate the efficacy of targeted exercise interventions, a systematic review was conducted following PRISMA guidelines. From an initial pool of 60 relevant articles, 13 studies met the specific inclusion criteria, focusing on structured resistance training protocols for perimenopausal, menopausal, and postmenopausal cohorts.

The synthesis of these studies indicates that resistance training is a highly …

Oral Health Access Among Ethnic Minority Older Adults In The United States, Jasleen K. Sodhi

Honors Undergraduate Theses

Oral healthcare is a critical yet often overlooked component of overall health among U.S. adults. Ethnic minorities for older adults face heightened risks of poor oral health and related health conditions, while experiencing disparities in access to care. This study aimed to systematically examine and synthesize existing literature to assess the extent to which oral health disparities exist among ethnic minority older adults in the U.S. and explore the roles of socioeconomic factors on these disparities. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, we conducted a systematic review of peer-reviewed articles published in English …

The Impact Of Parental Influence On The Sexual Health Of College Students In South Florida, Lauren Barthel

Honors Undergraduate Theses

College students account for some of the highest rates of sexually transmitted infections (STIs) annually in America. Interventions aimed at reducing the number of cases in this emerging population are needed. This study utilized a secondary data analysis of an online survey administered to college students from August 2018 to December 2022 to examine their sexual literacy and overall sexual health. The objective of this study was to explore the relationship between parental influence and the sexual health of college students by exploring variables such as parent-child communication, race/ethnicity, and parental background. Using IBM SPSS Statistics 30, results indicated that …

A Qualitative Analysis Of Youtube-Based Dietary Messaging On Type 2 Diabetes For South Asians, Sukhmani K. Dhaliwal

Honors Undergraduate Theses

While South Asians experience a disproportionately high risk of Type 2 Diabetes Mellitus (T2DM), culturally tailored dietary guidance remains limited within healthcare settings. As digital platforms increasingly serve as sources of health information, YouTube has grown as a prominent space for the publishing and consumption of dietary advice. This study examines how diet-related messaging about T2DM is communicated in YouTube videos directed at South Asian populations.

Using qualitative thematic analysis, 21 videos published between 2016 and 2025 by influencers with a wide reach were analyzed. Videos were selected based on relevance to South Asian audiences, focus on dietary management of …

Healthcare Access And Community Nursing Outreach Effectiveness In Underserved Zip Codes In Central Florida, Miah Sanchez

Honors Undergraduate Theses

Access to healthcare depends on more than whether healthcare services are available. A person’s ZIP code, income, education, transportation options, health literacy, and neighborhood resources can all affect whether care is reached at the right time and in an appropriate setting. This literature review examines healthcare access and the role of community nursing outreach in underserved ZIP codes across Central Florida. The review synthesizes current literature on social determinants of health, geographic disparities, medically underserved populations, and community-based nursing interventions to better understand how these factors shape access to care. Across the literature, poverty, limited transportation, lower educational attainment, neighborhood …

Building Ai Literacy To Redesign Graduate Public Health Courses: A Case Study Of Pubh 520, Darren Liu

2026 Scholarly Teaching Conference: Concurrent Session Papers

As artificial intelligence (AI) becomes increasingly embedded in public health practice, graduate education must move beyond ad hoc responses to AI toward intentional, ethically grounded instructional design. This conference paper presents a case study of the redesign of PUBH 520, a graduate-level public health course, to explicitly integrate AI literacy within course outcomes, assessments, and learning activities. Guided by higher-education AI literacy frameworks, the redesign foregrounded faculty AI literacy as a prerequisite for responsible AI integration, emphasizing ethical reasoning, technical understanding, pedagogical alignment, and reflective assessment practices. Findings suggest that the redesigned course improved coherence among learning outcomes, assessment integrity, …

Geographic Clusters Of Human Papillomavirus-Associated Cancer Incidence In The Us, 2008–2022, Todd Burus, Krystle A. Lang Kuhs, Ashish A. Deshmukh, Haluk Damgacioglu

Markey Cancer Center Faculty Publications

Objective: Despite known state and regional differences, United States (US) county-level patterns of human papillomavirus (HPV)-associated cancer incidence remain unexplored. Methods: In this cross-sectional study, we analyzed US county-level HPV-associated cancer incidence rates from 2008 to 2022 using the US Cancer Statistics Incidence Analytic Database to identify geographic clusters of high and low incidence. Clusters were identified using the Getis-Ord Gi* statistic and assessed for differences in cluster-level sociodemographic characteristics and sex-and-site-specific incidence. Results: We found 373 hot spot and 409 cold spot counties, with median incidence rates of 16.14 and 10.62 per 100,000, respectively. Hot spot counties were particularly …

Colorectal Cancer Screening In Carceral Settings: Barriers And Opportunities To Improve Early Detection Among Incarcerated Individuals, Daven K. Sarikonda Ba, Elijah Marquez Bs, Alexander Seidel Ba, Christine Larrea Bs, Jack S. Gurwin Bs, Maria Karla Bermúdez Piñero Ba, Suraj Suresh M.D., Laura Benjamins Md, Mph, Faap, Aahivs

Population, Patient, Physician and Professionalism Projects

Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related death in the United States, with screening shown to significantly reduce mortality. However, incarcerated individuals experience substantially lower CRC screening rates and often present with more advanced disease than non-incarcerated individuals. Our project’s objective was to review the state of CRC screening in U.S. carceral settings, along with exploring possible alternatives to address the substantial disparity in CRC screening rates experienced by the incarcerated population.

Edible Cannabis Product Information Captured Within Patient Poison Center Records, G. Fulkerson, B. J. Holstege, R. Farah, A. Zmuda, C. P. Holstege

Department Psychiatry & Behavioral Science Faculty Publications

Introduction

United States poison centers are encountering increasing numbers of calls pertaining to edible cannabis exposed patients following state decriminalization. The emergence of these edible products has led to numerous emergency department visits in both adults and children following exposure. The capturing of specific data associated with the product type is imperative as state government regulators attempt to control cannabis products emerging on the market as a growing public health issue.

Objectives

This study was performed to determine if the exact products involved with edible cannabis exposure were being captured in the electronic medicial records and to delineate those specific …

Implementing A Standardized App-Led Multidisciplinary Medication Review And Reconciliation To Improve Medication Safety Before Systemic Cancer Therapy: An Ambulatory Oncology Quality Improvement Initiative, Sarah R. Hines

DNP Projects

Background

Adult patients initiating systemic cancer therapy frequently present with pre-existing polypharmacy related to chronic comorbidities and cancer-related symptom management. The addition of anticancer therapies and supportive care medications further increases medication burden and the risk of medication-related harm. Although national organizations and institutional policies recommend comprehensive medication review before treatment initiation, implementation remains inconsistent in ambulatory oncology practice.

Purpose

To implement and evaluate a standardized Advanced Practice Provider (APP)-led multidisciplinary medication review and reconciliation process designed to identify medication medication-related safety risks before initiation of systemic cancer therapy in adult oncology patients receiving care in an ambulatory infusion center. …

Improving Nursing Compliance With Pain Reassessment Documentation After Analgesic Administration, Dorcas Okunola

Doctor of Nursing Practice Final Project Abstract

Improving Nursing Compliance with Pain Reassessment Documentation After Analgesic Administration

PURPOSE: This quality improvement project aimed to increase registered nurse (RN) compliance with documenting pain reassessment within 30–60 minutes after analgesic administration in an adult medical–surgical trauma unit at a large academic medical center.

BACKGROUND: Timely pain reassessment is essential for evaluating treatment effectiveness and ensuring safe, patient-centered care. Baseline audits showed inconsistent documentation and compliance below institutional expectations. Evidence supports the use of electronic health record (EHR) prompts combined with targeted nursing education to improve adherence.

METHODOLOGY: A 12-week quality improvement initiative was conducted to reinforce adherence to the …

The Impact Of Substance Abuse Problems And Serious Mental Illness/Serious Emotional Distress On Post-Discharge Residential Status Among Clients With Behavioral And Cognitive Disorders: Evidence From Samhsa Mh-Cld Data, Eden Moges, Norma Rochez, William Peycha, Aditya Chakraborty

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

BACKGROUND: Behavioral and cognitive disorders can undermine housing stability, a key determinant of mental health recovery, with persistent disparities across demographic and socioeconomic groups. This study examined the associations of substance abuse problems (SAP) and serious mental illness/serious emotional distress (SMISED) with residential status at discharge from mental health facilities.

METHODS: This cross-sectional study used the utilized data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Descriptive statistics were used to summarize demographic characteristics, whereas univariate and multivariable logistic regression models were employed to assess associations between the covariates and the residential outcome, adjusting for a variety of …

The Weight Of Stigma, Rebekah A. King, Michael S. Sinha

All Faculty Scholarship

Many health care providers, both implicitly and explicitly, perpetuate stigma in their treatment of patients classified as obese. While medical professionals understand that a one-size-fits-all approach to treatment is ineffective, patients classified as obese are frequently offered limited treatment options that fail to account for their unique needs. Access to a range of effective treatment options has historically been limited, but new GLP-1 receptor agonist medicines like Wegovy (semaglutide) and Zepbound (tirzepatide), have shown incredible promise in addressing the obesity crisis. Unfortunately, these transformative drugs are costly, in high demand, and not widely covered by insurance, rendering them inaccessible for …

Effet Sur La Qualité De L'Air Et La Santé Des Travailleurs Et Travailleuses Dans Les Logements Alternatifs Des Poules Pondeuses, Magali-Wen St-Germain, Valérie Létourneau, Marc Veillette, Perrine Cruaud, Candice Lemaille, Kim Robitaille, Éloïse Denis, Araceli Dalila Larios Martínez, Sébastien Fournel, Stéphane Godbout, Geneviève Dion, Andréanne Côté, Laurianne Gratton, Martine Boulianne, Caroline Duchaine

Rapports de recherche scientifique

Les oeufs de poules en liberté et les oeufs provenant « d’élevage confort » sont maintenant des produits communs dans les marchés alimentaires du Québec. Cette nouvelle variété de produits est le résultat de l’évolution des pratiques afin de concilier le bien-être des poules pondeuses et les besoins de l’industrie. En effet, d’ici l’année 2036, les logements conventionnels pour poules pondeuses (logements grillagés pour des petits groupes de poules) seront graduellement remplacés par des logements alternatifs. Les logements alternatifs pour poules pondeuses regroupent les colonies enrichies et les logements sans cages (sur plancher ou en volière). Ils ont en commun …

Évaluation De L’Exposition Aux Microorganismes Et Appréciation Du Risque Sanitaire Des Chauffeurs De Camion Et Des Éboueurs Attitrés Au Transport Des Matières Résiduelles Et Des Déchets, Geneviève Marchand, Loïc Wingert, Maximilien Debia, Carla Viegas, Susana Viegas, Liliana Caetano, Magdalena Twarużek, Nancy Lacombe, François Gouin, Delphine Lanoie, Isabelle Valois, Robert Kosicki, Marta Dias, Ewelina Soszczyńska, Julien Trépanier, Tam Nguyen, Fabiola Salambanga, Noémie Gervais

Rapports de recherche scientifique

La gestion des déchets au Québec repose sur la collecte sélective pour revaloriser les matières résiduelles et réduire l’enfouissement. Les travailleurs du secteur sont exposés aux bioaérosols contenant microorganismes et allergènes. Les risques sanitaires sont influencés par la nature des matières manipulées et les méthodes de travail employées. La manutention des déchets a déjà été mise en lien avec des inflammations respiratoires, des troubles digestifs, et des syndromes liés aux poussières organiques toxiques. L’objectif du projet visait à évaluer l’exposition des travailleurs aux microorganismes et d’en apprécier les risques pour la santé.

Dans le cadre de ce projet, 28 camions …

Allier Les Technologies Numériques À La Prévention Des Lésions Professionnelles Pour Intervenir Auprès D'Une Population Faiblement Scolarisée Se Préparant À L'Emploi, Marie Laberge, Aurélie Tondoux, Myriam Bérubé, Céline Chatigny, Denys Denis

Rapports de recherche scientifique

Ce rapport présente les résultats d’un projet de recherche visant à améliorer la santé et la sécurité au travail (SST) des élèves du Parcours de formation axée sur l’emploi (PFAE) au Québec. Ce programme accueille chaque année entre 11 000 et 13 000 élèves de 15 ans à 21 ans qui éprouvent des difficultés scolaires et risquent de quitter l’école sans diplôme. Le PFAE offre des stages d’apprentissage en milieu de travail pour des métiers semi-spécialisés, couvrant un large éventail de secteurs d’activités. Les élèves du PFAE sont particulièrement vulnérables en matière de SST puisqu’ils sont très jeunes et ont …

Politics Of A Silent Pandemic: Antimicrobial Resistance And State Capacity In India And Nigeria, Mia Kelly

CMC Senior Theses

Antimicrobial Resistance (AMR) has emerged as one of the most pressing yet widely underestimated health threats of the 21st century; this thesis explores the potentially devastating global impact of this “silent pandemic”, exposing how deeply health outcomes depend on political choices, regulatory capacity, and economic constraints. Although the danger of spreading drug-resistant pathogens is now widely acknowledged in both the scientific and political communities, states differ in their abilities to contain the issue, with low- and middle-income countries facing the greatest obstacles to national action plan implementation. This thesis investigates these disparities through a comparison of India and Nigeria, two …

Anti-Sars-Cov-2 Nucleoprotein Iga Is Associated With Worse Disease Severity In Critically Ill Covid-19 Pneumonia Patients, David Brett-Major, Dylan S. George, Eric D. Morrell, Carmen Mikacenic, Julie Carstens, Laura E. Evans, Mark M. Wurfel, Pavan K. Bhatraju, M. Jana Broadhurst

Journal Articles: Epidemiology

While humoral responses to vaccination and infection have largely focused on IgG, there is an evolving literature on ways in which IgA may drive neutrophil activity in lung injury secondary to viral infections, including COVID-19. We evaluated 238 immune-naïve, critically ill patients in the first year of the COVID-19 pandemic. Employing a laboratory-developed, multiplexed antibody testing, clinical history, medical record, and machine learning, we pursued relationships between systemic IgA and disease severity. Individuals with elevated anti-N IgA had 4-fold odds of more severe disease. This work emphasizes the importance of continued work to understand how different elements of the immune …

Development Of A Semi-Mechanistic Population Pharmacokinetic Model For Predicting Tenofovir Disoproxil Fumarate And Tenofovir Alafenamide Exposure In Plasma And Cellular Matrices During Pregnancy And Postpartum, Yifan Yu, Kristina M. Brooks, Gustavo F. Doncel, Brookie M. Best, Mark A. Marzinke, Mark Mirochnick, Peter Anderson, Landon Myer, Connie Celum, Renee Heffron, Jenell Coleman, Dvora Joseph Davey, Craig W. Hendrix, Jeremiah D. Momper, Robert Bies, Rachel K. Scott

CONRAD Publications

Background and Objective

Tenofovir (TFV)-based regimens are backbones of both HIV treatment and pre-exposure prophylaxis during pregnancy. Multiple studies have shown up to one-third decreases in dried blood spot tenofovir-diphosphate concentrations during pregnancy among participants taking tenofovir disoproxil fumarate (TDF). Currently, there are no mechanism-based models describing the pharmacokinetics of tenofovir diphosphate (the active anabolite) in peripheral blood mononuclear cells (PBMCs) of pregnant individuals receiving TDF or tenofovir alafenamide (TAF), and the mechanisms behind observed differences between dried blood spots and PBMCs remain unclear.

Methods

To address this gap, we developed a semi-mechanistic model to simultaneously describe the pharmacokinetics of …

Photovoice Exploration Of Afghan Refugee Background Women's Food-Related Well-Being, Eileen C. Lindemann

Graduate Research Theses & Dissertations

More than 117,000 Afghans have been relocated to the United States following the U.S. military withdrawal in August 2021. Research indicates that Afghan refugees resettled in the U.S. are at increased risk of psychological distress, with Afghan women particularly susceptible compared with Afghan men, and diet-related chronic disease. However, research also shows that traditional food and eating customs foster cultural identity, social support, integration, and well-being. The purpose of this study was to collaboratively explore the food-related well-being and daily life contexts of resettled refugee participants through the photovoice method, a participatory research strategy in which participants photograph aspects of …

Air Quality Risks In Public Housing, Brynn Sheehan, Carolyn Caraballo Velez, Vaughan W. Rees, Miasha T. O'Neal, Kristen E. Moore, Katie M. Jones, Jessica Meadows, Sarah Gehlert, Richard Grucza, Andrew Plunk, Kelli J. England

Department Psychiatry & Behavioral Science Faculty Publications

Importance Public housing residents face elevated environmental health risks, yet indoor air quality in these settings remains underexamined. OBJECTIVE: To evaluate indoor air quality in public housing 5 years after implementation of the federal smoke-free housing policy and compare it with outdoor air quality in the same regions.

Design, Setting, and Participants A 1-year cohort study of indoor air quality (particulate matter ≤2.5 μm in diameter [PM2.5]) across 12 multifamily public housing communities in southeastern Virgina for individuals 65 years and older or persons with disability in cities with the highest rated outdoor air quality. Indoor PM2.5 was continuously measured …

Medical Image Feature Extraction And Selection Based On Inception V3 And Gini Index For Cervical Cancer Cells Identification, Rachida Assawab, Mounir Ouzir, Badreddine Benyacoub, Abderrahim Electrochemical Sensor For Tenofovir Allati, Ismail El Moudden

Research and Infrastructure Service Enterprise (RISE) Faculty Publications

Background: Cervical cancer remains the fourth most common cancer in women globally, with 604,000 new cases annually. Early detection through cytological screening is critical, but manual interpretation suffers from high false negative rates and requires expert pathologists often unavailable in resource-limited settings.

Methods: We developed a novel hybrid framework combining InceptionV3-based deep feature extraction with Gini Index feature selection for automated cervical cancer cell classification. Using the Herlev dataset (917 Pap smear images: 242 normal, 675 abnormal), we extracted 2048 deep features and applied systematic feature selection to identify optimal discriminative subsets. Comprehensive clustering analysis (K-means, K-medoid, Fuzzy clustering) validated …