Digital Commons Network^™

Knowledge, Attitudes, And Practices (Kap) Of Parents Regarding The Prevention And Control Of Childhood Iron Deficiency Anemia In Egypt: A Cross-Sectional Study, Omnia Soliman

Theses and Dissertations

Childhood Iron Deficiency Anemia (IDA) remains a major public health challenge in Egypt, where its persistently high and rising prevalence carries substantial consequences for child growth, cognitive development, immunity, and long-term health outcomes. Globally, approximately 40% of children aged 6–59 months are affected by anemia (World Health Organization, 2025), and Egypt mirrors this burden, with national data showing a worsening trend in recent years. In Egypt, national strategies have traditionally focused on biomedical interventions such as iron supplementation and food fortification, while less attention has been directed toward behavioral and household-level determinants, particularly parental knowledge, attitudes, and practices (KAP) related …

Development Of Novel Plasminogen Activators From Fragments Of Streptokinase Enzyme, Vijay G Mr

Theses and Dissertations

Thrombotic disorders such as myocardial infarction, ischemic stroke, pulmonary embolism and deep vein thrombosis remain major causes of mortality and disability worldwide, creating a continuing need for effective, safe and affordable thrombolytic therapy. Streptokinase is one of the most widely used plasminogen activators because of its activity, low cost and broad availability. However, its wider clinical utility is limited by high immunogenicity, allergic reactions, neutralizing antibody formation and poor suitability for repeat administration. This thesis aimed to develop novel streptokinase-derived plasminogen activators by identifying smaller functional fragments that retain thrombolytic activity while potentially reducing immunogenicity.

A literature-guided fragment-based strategy was …

Climate Anxiety And Nurses’ Awareness, Motivation, And Behaviors In Addressing Climate-Related Health Risks, Sarah Kaplan

Theses and Dissertations

Background: Climate anxiety, the emotional distress associated with awareness of climate change and its consequences, is an emerging mental health concern that may influence how nurses perceive and respond to climate-related health risks. Climate change is largely driven by emissions of greenhouse gases which radiate and absorb heat. Human-caused climate change is leading to higher average global temperatures and increasing risk to health through poor air quality, changes in vector borne diseases, extreme weather events, and exacerbation and development of physical and mental illnesses. This study contributes to nursing science by examining climate anxiety and climate related health practices among …

Traveling Wave Fronts For Sir Epidemic Models With Nonlocal Dispersal And Delayed Effects, Ashley Evette Embry

Theses and Dissertations

This dissertation investigates traveling wave solutions for two classes of delayed nonlocal dispersal susceptible--infected--recovered (SIR) epidemic models incorporating biologically realistic mechanisms such as delayed infectivity, delayed dispersal, nonlocal transmission, demographic turnover, and nonlinear incidence effects. These models extend classical spatial epidemic frameworks by allowing long-range population movement through nonlocal dispersal operators and incorporating temporal memory into both diffusion and transmission processes. The primary objective is to establish the existence of traveling wave solutions connecting disease-free equilibria to endemic states and to characterize threshold conditions governing epidemic propagation. The simultaneous presence of nonlocal dispersal, multiple delays, and non-monotone nonlinear incidence terms …

How Did A Pandemic Impact Park Usage Among The Older Adult Populations In Memphis, Tn?, Katherine Barlow

Theses and Dissertations

During COVID-19 older adults’ populations were a vulnerable demographic, and through a review of existing literature it was determined that there is limited research about park and outdoor space use during COVID-19 by older adults. This research seeks to address these gaps by examining how a pandemic impacted park usage among the older adult population (age 60+) in Memphis, TN at Shelby Farms Park. This study examines the comparison of park use during (2020-2023) and after (2023-present) COVID-19. A mixed methods approach was employed. Wilcoxon Signed Rank test was run to analyze the survey data and a significant statistical difference. …

Variation In The Sonographic Appearance Of The Liver In Cats With Lymphomatous Hepatic Infiltration., Charlee Sturkie

Theses and Dissertations

Lymphoma is the most diagnosed neoplasm in domestic cats, and abdominal ultrasound is often included as a component of the diagnostic plan. The aim of this study was to determine if changes in sonographic appearance of the liver as well as the presence of free fluid, lymphadenopathy, and splenic abnormalities increase the likelihood of diagnosis of lymphomatous hepatic infiltration in cats diagnosed with lymphoma. Fifty-eight cats were enrolled in this combined retrospective and prospective study, 22 with lymphomatous infiltration in the liver and 36 without. In the current population hypoechogenicity, heterogeneous echotexture, hepatomegaly, and the presence of nodules within the …

Voices From The Classroom: Elementary Teachers’ Perspectives On Teaching And Learning During The Covid-19 Pandemic – A Case Study And Autoethnography, Alicia Lopez-Hernandez

Theses and Dissertations

Guided by constructivist learning theory and sociocultural theory, this qualitative case study and autoethnography examines how bilingual educators constructed knowledge, adapted instructional practices, and utilized mediational tools within face-to-face, online and hybrid learning environments. These frameworks informed the study’s design, data analysis, and interpretation of findings related to pedagogy, technology integration, and student engagement. Data was collected through semi-structured interviews, naturalistic observations, and autoethnographic reflective journaling.

The Impact Of Nutrition On Insecticide Resistance And Gene Expression In Aedes Aegypti, Esmeralda Guadalupe Rosas

Theses and Dissertations

The development of insecticide resistance in Aedes aegypti, a major vector of dengue and Zika viruses, threatens vector control efforts, particularly in endemic regions such as South Texas. Insecticides remain widely used; however, their overuse has accelerated metabolic resistance mediated by cytochrome P450 enzymes. Environmental factors such as larval nutrition may influence mosquito physiology and resistance-associated gene expression, yet this relationship remains poorly understood. This study examines how larval nutritional conditions affect the expression of cytochrome P450 genes linked to pyrethroid resistance in Aedes aegypti. Larvae were reared under five dietary treatments differing in lipid and protein ratios, and adults …

Detection Of The Presence And Growth Of E. Coli Bacteria In A Droplet-Based Microfluidic System Using Laser Induced Fluorescence, Oshira Peiris

Theses and Dissertations

Antimicrobial resistance is a biomedical event, wherein an infectious microbe becomes non-responsive to the dosage of a particular antibiotic due to previous overuse or overexposure. Currently, agar plate disc diffusion is used as the gold standard for detecting antimicrobial resistance. The possibility of miniaturizing and speeding up detection techniques for antimicrobial resistance is investigated in this thesis. Microfabrication techniques were used in developing two droplet microfluidic systems interfaced with laser induced fluorescence detection. Microfluidic devices were manufactured with different droplet generating geometries using poly-dimethyl siloxane, soft lithography and hydrophobic surface treatment. The microfluidic devices were tested for droplet quality using …

A Holistic Assessment Of Osteopathic Medical Student Well-Being And Self-Perceived Levels Of Happiness, Stress, And Satisfaction With Life, Brittany A. Mitchell

Theses and Dissertations

The purpose of this quantitative study was to assess the well-being of medical students and identify the primary factors influencing their well-being. In this manuscript-style dissertation, the empirical article assesses the well-being of medical students through the dimensions of wellness and investigates the significance of differences between each dimension and self-perceived levels of happiness, stress, and satisfaction with life. The practitioner article provides recommendations to practitioners to further support the well-being of osteopathic medical students. The sample for this study was medical students at an osteopathic medical school in the Philadelphia region. Data was collected using seven validated survey instruments: …

Exploring Noise Induced Extreme Events In Neuronal Oscillators Networks And Machine Learning Forecasts, Hariharan S Mr

Theses and Dissertations

This doctoral dissertation comprehensively investigates the underexplored phenomenon of noise-induced extreme events (EE). The word “extreme” is accompanied by an occurring “event” when the deviation is extreme or higher than that of regular occurrences. These extreme occurrences are rare, abrupt, sudden, and irregular, often causing a profound impact on the system and its surroundings. Tsunami, earthquakes, solar flares, and tornadoes are such events that do not occur often but still significantly cause damage to mankind. This thesis particularly focuses on EE in neuronal systems where sudden synchronization can trigger seizures, tremors, and strokes which serve as classic examples of such …

Perceptions Of Healthcare Access Barriers Among Eritrean, Sudanese, And Somali Refugees And Asylum Seekers In Cairo., Ayan Musa Mohamed

Theses and Dissertations

As the world witnesses an increase in different displacements of individuals for various reasons, ranging from wars, civil conflicts, human rights violations, and natural disasters, refugees and asylum seekers, who are among those forcibly displaced, continue to face challenges in access to health care services in host countries. The topic of barriers to health care has been widely researched, with a large body of literature on refugees' interactions with health care systems. However, there is limited literature on the perceptions of Eritrean, Sudanese, and Somali refugees and asylum seekers' experience with healthcare access in host countries. Therefore, this thesis aims …

Assessing Knowledge, Attitudes, And Practices (Kap) Towards The One Health Approach In Governmental Officers In Egypt, Nour Elsersawy

Theses and Dissertations

Background: the one health (OH) approach emphasizes the interconnectedness among human, animal, and environmental health and requires multisectoral collaboration to address complex health challenges. Egypt faces significant threats at the human-animal-environment interface, including endemic and emerging zoonotic diseases, antimicrobial resistance (AMR), food safety challenges, and vector-borne diseases. Despite established coordination mechanisms and the launch of the One Health National strategic framework (2023-2027) of Egypt, the extent to which oh principles are understood, embraced, and practiced by governmental officers responsible for implementation remains incompletely understood. Objectives: this study assessed and evaluated the knowledge, attitudes, and practices (KAP) regarding the one health …

Prephiral Bacterial Infectious Agent Triggers Neuroinflammatory Responses And Neurobehavioral Impairment In Wild-Type Mice, Hadeer Atalah

Theses and Dissertations

Neurodegenerative diseases, including Alzheimer's and Parkinson's, present an increasing global challenge, with chronic neuroinflammation identified as a principal factor alongside genetic, environmental, and infectious influences (Boyd et al., 2022).  Epidemiological data associate bacterial infections with a 40% heightened risk of Parkinson's disease; however, the mechanisms—especially the direct connection between peripheral sepsis and the silent onset of central nervous system pathology absent acute meningitis—are inadequately investigated (Smeyne et al., 2021), particularly concerning common pathogens like Klebsiella pneumoniae in high-burden areas such as Egyptian ICUs, where it constitutes 30% of cases (Alkompoz et al., 2023). This study filled the gap by creating …

Global Public Health Feasibility: Digital Dentistry In Geriatric Population, Merna Amr Saleh

Theses and Dissertations

Oral health is a critical yet often overlooked determinant of well-being among older adults in Egypt, where mobility limitations, geographic barriers, and low awareness of preventive practices exacerbate dental disparities. DentalPal, a teledentistry-based mobile application, was developed to provide older adults with remote dental consultations, oral hygiene advice, and triage guidance. The platform enables users to submit oral photographs or radiographs for assessment, seek second opinions, and initiate follow-up chats directly with the healthcare provider. This flexible design allows users to access dental consultations on demand while ensuring continuity of care The question that guided this study was how older …

Mycobacteria Infection Induced Cascade Of Epigenetic Alterations Promote Training In Bystander Macrophages, Shah E. Jahan Gulzar Mr

Theses and Dissertations

Mycobacterium tuberculosis (Mtb) remodels host cell functions to support its intracellular persistence. While the effects of Mtb infection on infected macrophages are well characterized, responses of uninfected bystander cells in the same microenvironment remain poorly understood. Here, we show that Mtb infection triggers widespread epigenetic reprogramming not only in infected macrophages but also in neighbouring bystander cells. These bystander macrophages acquire active chromatin marks, exhibit distinct transcriptional changes, and display enhanced immune responsiveness, thereby increasing resistance to both homologous and heterologous infections. We identify interleukin-1 beta secreted by infected cells as a key mediator of this process. Functionally, trained bystander …

Assessing Abuse And Neglect In U.S. Nursing Homes: A Comparative Analysis Across Pre-, During, And Post-Pandemic Periods, Katherine Gane

Theses and Dissertations

Nursing homes are among the most closely regulated providers in the U.S. healthcare system, with both federal and state agencies working together to monitor care and help protect residents. The COVID-19 pandemic, however, introduced unprecedented challenges for facilities and survey agencies alike, disrupting normal operations, limiting in-person visits, and temporarily shifting regulatory priorities. The purpose of this study was to examine how these pandemic-related disruptions were reflected in the severity and reporting patterns of substantiated abuse and neglect deficiencies in U.S. nursing homes. Using publicly available data from the Centers for Medicare & Medicaid Services (CMS), this study analyzed 39,607 …

The Relationship Between K–12 School Administrators’ Adaptive Leadership Behaviors And Self-Efficacy For Crisis Management, Meg Anne Sheehan

Theses and Dissertations

This quantitative correlational study addressed the relationship between K–12 school administrators’ adaptive leadership behaviors and their self-efficacy for crisis management. Guided by Ronald Heifetz’s adaptive leadership theory and Albert Bandura’s self-efficacy theory, the study was an exploration of how adaptability, prior professional experience, and crisis-specific training influence administrators’ confidence in leading through emergencies. Participants included 51 practicing administrators from public schools, mostly located on Long Island, New York, who completed two validated instruments: the Adaptive Leadership Behavior Scale, which is an adaptation from Shams et. al, and the School Administrator Preparedness and Self-Efficacy Questionnaire, which is an adaptation of April …

Type Ii Diabetes Treatment Comparison Via Compartment Modeling, Abigail M. Collins

Theses and Dissertations

Type II diabetes mellitus affects one in ten adults worldwide, yet the effects of treatment type and adherence level on developing complications and quality of life have not been well characterized at the population level, and mathematical modeling offers a structured way to examine these dynamics. This thesis adapts the Boutayeb et al. (2004) model to incorporate dynamic treatment types and levels of adherence, producing nine scenarios in which complication development rate and complication recovery rate differed, to compare peak complications and quality of life across treatment and adherence conditions. Using a system of ordinary differential equations and compartment modeling, …

Determinants Of Routine Childhood And Adolescent Vaccine Hesitancy And Uptake Among Parents In The United States: A Scoping Review, Precious Johnson

Theses and Dissertations

Routine childhood and adolescent vaccination is an essential public health strategy for preventing disease and protecting communities. However, parental vaccine hesitancy and barriers to vaccine uptake continue to affect vaccination decisions in the United States. This scoping review examined factors associated with routine childhood and adolescent vaccine hesitancy and uptake among U.S. parents. A comprehensive literature search of PubMed and EBSCO identified peer-reviewed studies published in English between 2016 and 2026. Studies focusing on parents, guardians, or caregivers of children and adolescents in the United States were screened according to predefined eligibility criteria. Of 69 records identified, 52 remained after …

Analysis Of Risk Factors And Current Programs For Addressing Injuries In Children And Adolescents, Jahfel Nial Jones Iii

Theses and Dissertations

Unintentional injuries are a leading cause of morbidity and mortality among children and adolescents in the United States. These injuries result from various causes, including motor vehicle crashes, falls, suffocation, and poisoning. This capstone project examines the prevalence, risk factors, and prevention strategies for unintentional injuries among infants, children, and adolescents. Using a public health approach, this research explores evidence-based interventions and community-based programs that effectively reduce injury-related mortality. The project also incorporates data and insights from the Safe Kids Columbus program at Piedmont Columbus Regional, where various injury prevention initiatives have been implemented.

Findings revealed that motor vehicle crashes …

Substance Use Behaviors And Treatment Engagement In Individuals With Severe Psychopathology With And Without Comorbid Obesity, Rachel M. Madera-Arnold

Theses and Dissertations

Research has found significantly higher rates of both substance use and obesity among individuals with SMI compared to population samples which in turn can lead to worsening health outcomes. Despite this, there is limited research on the co-occurrence of obesity, substance use, and SMI and how these conditions may interact to affect patient outcomes. In addition, there are many gaps in the research regarding the relationship between substance use and body weight, appetite and/or eating behaviors. This study conducted a secondary analysis of the NSDUH 2021 survey that characterized substance use and disorders among individuals who had severe psychopathology, examined …

Absolute Quantification And Identification Of Rna From Rna-Lipid Nanoparticles Using High Resolution Mass Spectrometry, Jason C. Funderburk

Theses and Dissertations

RNA therapeutics are a rising drug category with potential use for a range of conditions encompassing infectious diseases to therapies for cancer, diseases, and genetic disorders. RNA-lipid nanoparticles (RNA-LNPs) are the prominent delivery method for these therapeutics approved products include mRNA vaccines and polyneuropathy treatments. The emergency use authorizations and orphan drug status of current RNA-LNP drugs has allowed approval without finalization of the regulatory analytical procedures for quality monitoring. The objective of the study was to develop an LC-MS assay to simultaneously measure identity and concentration of two therapeutically relevant intact RNA constructs extracted from RNA-LNPs to enhance quality …

Comorbid Psychosis In The General Population, Mariam Sankoh

Theses and Dissertations

Psychosis is a complex psychiatric phenotype characterized by substantial heterogeneity in symptom presentation, psychosis diagnosis, comorbidity patterns, and genetic architecture across diverse populations in the general population. Despite advances in psychiatric epidemiology and genomics, important gaps remain in understanding how psychosis symptoms and psychosis-related diagnoses manifest across racial and ethnic groups and how evolutionary genomic factors may contribute to disease risk and cross-ancestry genetic prediction. This dissertation, Characterizing Comorbidity in Psychosis in the General Population, integrates epidemiological, psychometric, and evolutionary genetic approaches to examine psychosis across diverse populations.

Aim 1 examined racial and ethnic differences in psychosis comorbidity patterns …

Tuberculosis In Jim Crow Virginia, 1900-1972, Elizabeth Dooley

Theses and Dissertations

Tuberculosis (TB) was a major public health concern in the United States, especially in the first half of the twentieth century. Transmission and treatment of the disease, which is spread between humans through close contact, was complicated by racial segregation laws in the South known as Jim Crow laws. Virginia subscribed to these laws, which played a role in how and where Black Virginians with TB could be treated. Segregated treatment facilities with an inadequate number of beds for the number of infected people and deaths in the state added to these complications of disease control and plan for eradication. …

Building A Cell Specific System For In Vivo Rna Imaging Of The Endogenous Actin Gene In C. Elegans, Jasmine A. Huerta Canete

Theses and Dissertations

Messenger RNA (mRNA) plays a crucial role in protein synthesis and cellular processes, important for the development of cells such as neurons. When dysregulation occurs, it can lead to outcomes such as aberrant translation, causing neurodegenerative conditions to arise. Unfortunately, the localization of mRNA in an in vivo cell specific manner is still not understood. To address this, we decided to develop a cell-specific system to image RNA in vivo, within the organism known as C. elegans with a focus on the actin gene. The Actin gene encodes for an important cytoskeleton protein expressed ubiquitously, vital for the cell …

Balancing Care And Chaos: A Phenomenological Study On The Emotional And Mental Health Challenges Of Emergency Department Nurses, Shantilee Green

Theses and Dissertations

The purpose of this qualitative, phenomenological study was to examine the experiences of emergency department nurses related to emotional and mental health challenges, coping with stress, and ways to provide them with better workplace support. Emergency department nurses are required to work 12-hour shifts in a high-stress environment with a significant patient load and an inadequate patient-to-nurse ratio. Emergency department nurses are exposed daily to patient events that can be traumatic and affect their mental and emotional health, and nurses may find it challenging to cope with the resultant stress.

The researcher created an interview protocol of 14 questions to …

Sex Disparities In Prescription Opioids Associated Cardiovascular Adverse Events, Li Ma

Theses and Dissertations

The opioid crisis in the United States has evolved from a medical response to pain into a nationwide public health emergency. The prescription opioids (POs) – associated cardiovascular adverse events (CVAEs) remain insufficiently studied, especially in relation to sex disparities. This dissertation investigates sex disparities in PO-associated cardiovascular adverse events (CVAEs) through an analytic framework integrating artificial-intelligence-assisted literature mining and real-world pharmacovigilance analytics. In the analytic framework, first, AI powered topic modeling was employed to uncover POs-associated CVAEs risks with a focus on sex differences. A total of 1,837 PubMed abstracts were analyzed using two methods, Latent Dirichlet Allocation (LDA) …

Spatiotemporal Ecology Of Mycobacterium Ulcerans And Mycolactone Functions In French Guiana And Southeastern United States Aquatic Environments, Magdalene Dogbe

Theses and Dissertations

Mycobacterium ulcerans, the causative agent of Buruli ulcer, produces mycolactone, a polyketide toxin traditionally studied for its role in human pathogenesis. This dissertation presents a comprehensive spatiotemporal analysis of M. ulcerans and mycolactone producing mycobacteria (MPM) ecology in the Americas and also reveals mycolactone's role in the environment as a microbial community regulator. Through comparative studies in French Guiana (endemic) and the southeastern United States (non-endemic), combined with experimental microcosm investigations, this research contributes to environmental pathogen ecology understanding. Environmental surveillance across 2,226 samples from French Guiana revealed complete MPM restriction to freshwater environments, with zero detections from 1,226 coastal …

Toward A Unified Network Flow Framework: From Conservation Principles To Fluid Dynamics Models, Zonghan Zhang

Theses and Dissertations

Network flows govern a wide range of critical systems, from tangible infrastructures like transportation and power grids to replicable processes such as information spread and epidemics. While tangible flows obey conservation laws and physical constraints, replicable flows, like rumors or viruses, can grow, decay, or vanish unpredictably. Despite their increasing interaction in real-world settings, these flow types are typically modeled in isolation, using disconnected mathematical frameworks. This dissertation presents a unified modeling approach that bridges the gap between conserved and replicable flows by embedding principles from fluid dynamics into graph-based propagation models. I introduce physically informed extensions to classical models, …