Digital Commons Network^™

Reducing Sleep-Related Infant Deaths In Douglas County, Lauren J. Maskin

Capstone Experience: Master of Public Health

Douglas County, including the city of Omaha, covers 339.6 square miles along the border of the Missouri River in Nebraska with a population of 517,110 (https://www.douglascounty-ne.gov/) and is one of seven large urban counties in the state. There are approximately 8,000 infants born in Douglas County annually (Nebraska Vital Statistics Birth Dashboard). The Douglas County Health Department (DCHD), established in 1854, is one of the oldest county health departments in the state and manages multiple public health projects annually. In 2024-2025, a renewed focus for DCHD has been its infant mortality rate (IMR). In 2024, 44 infant mortalities occurred in …

Silent Cries: Analyzing The Psychological Profiles Of High School Shooters, Kayla N. Martinez

Honors Program Theses and Research Projects

Over the past two decades, school shootings have increased in frequency and severity in the United States, leaving schools, families, and communities with long-lasting trauma. Despite experiencing school shootings for more than 20 years, protocols put in place regarding school shootings seem to only be reactive rather than proactively identifying and preventing the occurrence. The purpose of this thesis was to analyze behavioral patterns high school shooters tend to exhibit using multiple factors and propose potential preventative strategies to reduce the number of incidents. This study relies on secondary data analysis in which behavioral, mental, and environmental factors were examined …

Evaluating The Impact Of Evidence-Based Guidelines On Corticosteroid Prescribing For Acute Upper Respiratory Infections In Outpatient Primary Care, Cody Allen Boyd Hyatt

Doctoral Projects

Inappropriate corticosteroid prescribing for acute upper respiratory tract infections (AURTIs) remains a prevalent issue in outpatient primary care despite limited evidence supporting their use in otherwise healthy adults. This Doctor of Nursing Practice (DNP) project aimed to reduce inappropriate corticosteroid prescribing for AURTIs by implementing an evidence-based clinical practice guideline over an eight-week period in a rural primary care setting.

The doctoral project employed pre- and post-intervention design. Providers were introduced to the corticosteroid guideline derived from the 5-Minute Clinical Consult, emphasizing appropriate use criteria for corticosteroids in AURTI cases (Unbound Medicine Inc., 2025). Educational outreach and clinical reminders …

Teaching Methods That Promote Medical Student Attendance: A Scoping Review, Jenny Mills, Sarah Keil, Pat W. Whitworth, Jamie Wiesmueller, Jeff L. Jackson

Library Faculty Scholarship

Background 

Medical student class attendance, especially traditional lectures, is on the decline. As faculty explore a variety of pedagogical approaches, understanding how to encourage attendance and engagement is critical. The purpose of this scoping review is to explore the literature to better understand the teaching methods that promote attendance.

Methods 

This scoping review was conducted as advised in the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. Five databases were systematically searched for primary studies on teaching methods that motivated undergraduate medical students to attend or not attend in-person or online synchronous class sessions. A total of 1,313 articles were …

Sustaining Community Health Through Impactful Snap-Ed Initiatives In Utah, Lacee Jimenez, Kristi Strongo, Lea Palmer, Lendel K. Narine, Heidi Leblanc

Outcomes and Impact Quarterly

Create Better Health (CBH), Utah’s SNAP-Ed program, addresses food insecurity and chronic disease prevention through nutrition education, policy, systems, and environmental (PSE) initiatives, and social media marketing. From 2024 to 2025, CBH reached over 13,500 Utahns through direct education and 81,000 through community interventions. Evaluation results showed significant improvements in nutrition behaviors, including increased fruit and vegetable intake, food resource management, and label use. Follow-up surveys showed sustained behavior change. CBH’s comprehensive approach demonstrates measurable public health impact and points to the importance of continued investment in nutrition education and food access programs to build healthier, food-secure communities.

Empower Yourself Through Self-Defense: Enhancing Personal Safety Through Self-Defense Education, Stephanie Carlson, Naomi Brower, Aaron Hunt

Outcomes and Impact Quarterly

The Empower Yourself Through Self-Defense program, developed by Utah State University faculty in 2024, builds participants’ confidence by equipping them with self-defense knowledge and skills. Participants reported reduced fear, increased preparedness, and strong interest in continued training. The program enhances personal safety by empowering individuals with practical skills for self-protection.

Covering The Care: Impacts Of Labor And Delivery Unit Closures On Maternal Health Outcomes, Bridget Green, Deborah Fournier, Susy Hawes

All Materials

In 2022, more than half of rural hospitals and one-third of urban hospitals in the United States lacked obstetric services, reflecting an escalating trend of hospital labor and delivery (L&D) unit closures across the US. Despite some large-scale studies reporting negligible impacts of L&D closures on maternal health, an analysis of the literature presents a clear net negative impact for vulnerable women, including those who identify as members of a racial or ethnic minority, those who have low-income, and those who are Medicaid members. For many families, the disappearance of local obstetric care is not merely an inconvenience but instead …

Covering The Care: Utilization Rate Trends Among Children Ages 0-18, Erica Plante, Deborah Fournier

All Materials

This data brief provides a retrospective analysis of medical claims from NH Medicaid and commercial insurers, examining trends in utilization rates for selected medical services among children ages 0–18 over a six-year period (2018–2023).1 It is the second of a three-part series of Covering the Care analytic reports exploring healthcare utilization trends in New Hampshire.

From Winans To Wallahee: Treaties, The Washington State Supreme Court, And The Pursuit Of A More Just Rule Of Law, Monte Mills

Washington Law Review

The relationship between the United States federal government, the states, and Native Nations has long been at the core of federal Indian law. From the earliest decades of its jurisprudence, for example, the United States Supreme Court struggled in its efforts to analyze and define the rights, authorities, and interactions of Native Nations within and in relation to the evolving structure of constitutional federalism. Treaties between the United States and Native Nations were central to those decisions and provided a necessary, constitutional check against state interests intent on eliminating sovereign Native Nations. Those constitutional and structural implications thus go well …

The Reasonability Rule For Medical Damages In Tort: In Defense Of Chargemaster Recovery, Avery E. Tunstill

Washington Law Review

In a personal injury suit, Washington law requires the plaintiff to prove that their medical costs are reasonable to recover damages for those costs. Tort reform proponents attempt to use this reasonability rule to limit tort damages awards. They argue that a plaintiff should only recover a portion of a hospital’s bill because most people do not pay a hospital’s sticker price—or the “chargemaster rate”—for medical care. Some reformers argue that recovery rates should instead be based on a set figure. Others argue in favor of eliminating the collateral source rule, which prohibits juries from reducing tort damages awards in …

Social Media's Impact On Female Generation Alpha's Beauty Standards And Consumer Habits, Matisen O'Brien

Theses

This study examines how social media shapes beauty standards and consumer behaviors among female Generation Alpha (ages 7–13). As the first generation fully immersed in digital culture, these young girls face early exposure to influencer marketing, algorithmic promotion, and adult beauty practices, which influence their skincare routines and product preferences. The research highlights the decline of child-centered physical spaces, intensifying their engagement with digital platforms. Using a mixed-methods approach focused on a subgroup of female gymnasts, the study combines quantitative surveys and qualitative analysis to reveal how social media affects identity formation, consumer choices, and related mental health concerns. Results …

Neurogenesis And Functional Recovery Of Murine Retinal Ganglion Cells After Glaucoma Induction Following Treatment With Pnu-282987, Samantha Luzadre

Masters Theses

Experiments were performed to demonstrate electrical recovery in glaucoma-induced adult mice after neurogenesis of retinal ganglion cells (RGCs). Newly derived RGCs were induced following eye drop treatment with a selective alpha7 nicotinic acetylcholine receptor agonist, PNU-282987. Both sexes of transgenic (RlbpCre-ER (CRE⁺) and Rosa-tdTomato (tdTomato⁺)) adult mice were utilized to trace newly generated RGCs originating from Müller glia (MG). Experimental mice were injected with hypertonic saline into the episcleral vein of anesthetized mice to significantly increase intraocular pressure (IOP) and induce glaucoma-like conditions. One month after the injection and after significant death of RGCs occurred, mice …

1st Annual Partners Meeting Of The Joint Action Research Program On Fgm In The Horn Of Africa, Population Council Kenya, Population Council

Sexual and Reproductive Health, Rights, and Choices

Funded by the German Federal Ministry for Economic Cooperation and Development (BMZ) and supported by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, the first Annual Partners Meeting of the Joint Action Research Programme on Female Genital Mutilation (FGM) in the Horn of Africa was convened from December 9-11, 2025 by the Population Council-led FGM Data Hub in Nairobi, Kenya. The meeting brought together universities and civil society organisations (CSOs) from Ethiopia, Somalia, Somaliland and Sudan to strengthen university-led action research to improve overall efforts to prevent and respond to FGM, gender-based violence (GBV) and/or related gender inequalities.

Institutional Isomorphism, Top Management Commitment, And Environmental Disclosure In Tanzania’S Construction Sector, Aulelius Lema, Siasa Issa Mzenzi

Business Management Review

This study examined the influence of institutional isomorphism on environmental disclosure (ED) in Tanzania’s construction sector and the mediating role of top management commitment (TMC). A cross-sectional design was employed, with data collected from 314 construction firms. Environmental disclosure was measured using content analysis of financial reports, and Structural Equation Modelling using the Maximum Likelihood Estimation (MLE) method was used to estimate the structural model. The findings reveal that coercive, normative, and mimetic pressures significantly impact ED. The result also indicates that TMC significantly affects ED and mediates mimetic pressure’s effect, but does not mediate coercive or normative pressures. Similarly, …

What Is The Standard Of Review For (Mixed) Constitutional Questions?, Anthony Sangiuliano, Mark Friedman

UBC Law Review

No abstract provided.

Essays On The Economics Of Farmland Valuation And Investment In U.S. Agriculture, Colson Tester

Graduate Theses and Dissertations

This dissertation presents three empirical essays that collectively advance the understanding of farmland valuation in key U.S. agricultural regions, emphasizing the critical advantages of comprehensive, transaction-based data over traditional survey methods. Farmland represents a significant portion of agricultural wealth, and its accurate valuation is crucial for farmers, investors, and policymakers, influencing everything from credit access to investment strategies. Historically, research has often relied on subjective survey data, which can suffer from biases, inaccuracies, and insufficient granularity. This dissertation addresses these limitations by leveraging extensive datasets of arm’s-length farmland transactions, offering a more precise and market-driven perspective on land values. The …

Integration Of Oral Health Assessment In Medicare Visits: A Survey Of Primary Care Physicians In Montana And Their Role In Patients Aged 65+, Cheyenne R. Smith

Dental Hygiene ETDs

The integration of oral health assessments into primary care settings has been strongly advocated to enhance access to care for elderly individuals. Medical and dental professionals recognize the critical connection between oral health and systemic health. Physicians can play a key role in enhancing oral health care by incorporating an oral health assessment into routine general health appointments, such as the Medicare Annual Wellness Visit (AWV). Physicians in Montana were invited to participate in an anonymous study to gather their opinions on conducting oral health assessments in primary care settings, identify barriers to providing these assessments, and evaluate their knowledge …

Health Workforce Issues And Recommended Practices In The Implementation Of Universal Health Coverage In The Philippines: A Qualitative Study, Veincent Christian Pepito, Arianna Maever Loreche, Ruth Shane Legaspi, Ryan Camado Guinaran, Theo Prudencio Juhani Z. Capeding, Madeline Mae A. Ong, Manuel M. Dayrit

Ateneo School of Medicine and Public Health Publications

Background

The transition towards Universal Health Coverage (UHC) in a devolved healthcare system such as the Philippines is beset by health workforce issues considering that it is among the world’s leading source countries for health workers. This study aims to document health workforce issues and recommended practices in the implementation of UHC in the Philippines.

Methods

We conducted focus group discussions and key informant interviews with health policymakers and UHC implementers in the national, regional, and local levels. Participants included local chief executives, healthcare facility administrators, and healthcare providers at tertiary, secondary, and primary levels, as well as patients. We …

Diagnostic Accuracy Of Nanopore Sequencing For Detecting Mycobacterium Tuberculosis And Drug-Resistant Strains: A Systematic Review And Meta-Analysis, Timothy Hudson David Culasino Carandang, Dianne Jaula Cunanan, Gail S. Co, John David Pilapil, Juan Ignacio Garcia, Blanca I. Restrepo, Marcel Yotebieng, Jordi B. Torrelles, Kin Israel Notarte

Ateneo School of Medicine and Public Health Publications

Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB) infection, remains a significant public health threat. The timeliness, portability, and capacity of nanopore sequencing for diagnostics can aid in early detection and drug susceptibility testing (DST), which is crucial for effective TB control. This study synthesized current evidence on the diagnostic accuracy of the nanopore sequencing technology in detecting MTB and its DST profile. A comprehensive literature search in PubMed, Scopus, MEDLINE, Cochrane, EMBASE, Web of Science, AIM, IMEMR, IMSEAR, LILACS, WPRO, HERDIN Plus, MedRxiv, and BioRxiv was performed. Quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled …

Twim #261: Overwhelming Microbial Greatness, Jenny Stoval, Briana Lanzarotta, Luke Boseman, Nicole L. Podnecky, Angela Wilson

School of Medical Diagnostics & Translational Sciences Publications

Podcast annotation TWiM #261: Overwhelming Microbial Greatness from the weekly podcast series "This Week in Microbiology" (TWiM), a podcast where experts in microbiology discuss academic papers in their field in an informal way.

Integrating Evidence Synthesis Into Doctoral Research: A Guide For Family Medicine And Primary Care, Klaus B. Von Pressentin, Jacob Shabani, Taryn Young

Family Medicine, East Africa

Given the increased complexity of healthcare needs, evidence-informed practices are needed, now more than ever. Combining the best available research evidence, the perspectives of patients and communities, and the voices of healthcare workers in guiding policy and practice is essential. All of us involved in providing and strengthening family medicine and primary care need to be good consumers (users) of research, and some will be good producers (doers) of research. In both using and doing research, a helpful starting point is evidence synthesis – a form of secondary research that collates primary research on the same research question. This short …

Exploring Synthetic Data Generation For Machine Learning And Statistical Analysis, Aditi S. Gajjar

Master's Theses

In the data-driven machine learning and statistical analysis world, real-world data availability is often constrained by privacy concerns, access restrictions, or resource limitations. To address these challenges, synthetic data provides a groundbreaking solution, enabling academics and data scientists to generate artificial datasets that mimic real-world data for model development and testing in a controlled, privacy-preserving environment. The syntheticDatasets package represents an R-based counterpart to Python's widely-used Scikit-learn dataset generators, adapted to meet the needs of statisticians, educators, and data scientists primarily working in the R programming ecosystem.

This thesis explores the design and implementation of the syntheticDatasets package, focusing on …

Performance Enhancement For Rufa: Rapid Urban Forest Assessment, Nicholas Tan

Master's Theses

Urban forests are crucial to the livability and resilience of cities, offering critical ecosystem benefits such as air quality enhancement, temperature regulation, and biodiversity. Managing said urban forests is essential to ensure their sustainability and adaptability to rapidly changing environmental and climate conditions. The Rapid Urban Forest Assessment (RUFA) tool was developed to address the need for a standardized approach to evaluating and comparing urban and community forestry programs. By analyzing and aggregating tree-specific data across California, such as canopy cover, tree counts, and diversity scores, RUFA assigns a comprehensive urban forestry score for each city. This score allows for …

An Analysis Of Neuroidal Memory Formation Within D. Melanogaster, Jerry Chang

Master's Theses

The Neuroidal model poses a neurobiologically plausible theory for modeling the brain. This symbolic network has been shown to capture realistic memorization behaviors using the JOIN algorithm. The model has also been recently improved by incorporating Watts-Strogatz small-worlds within its base structure. From the efforts of neuroscience researchers, we have access to the Drosophila melanogaster (D. melanogaster) fruit fly’s connectome, which has been found to also contain small-worlds in this thesis. By synthesizing the Ocellar Ganglion (OCG) region of Drosophila, we compare a digitized version of a real-world brain with an instance of the Neuroidal model. In this thesis, we …

Educational Methods For Fostering Sustainability Competencies: A Toolkit For Integration Of Sustainable Education In Engineering, Clara Hallgarth

Master's Theses

This thesis proposes a framework to assist in developing educational activities targeting the longitudinal growth of sustainability skills, knowledge, and attitudes (cumulatively known as competencies), contextualized in a Toolkit for engineering educators. This framework is applied to three civil engineering classes in a teaching-oriented university to demonstrate potential applications and limitations. Sustainability integration in higher education institutions has been recognized as increasingly important as complex sustainability challenges continue to develop and arise. Sustainable education, a pedagogical framework and collection of educational methods, has been shown to produce students with the key sustainability competencies needed to address sustainability challenges and promote …

Abiotic Stress Impacts On Macrophomina Root Rot And Nano-Encapsulated Citrus Oils To Control Fruit And Foliar Pathogens Of Strawberry, Marina J. Gutierrez

Master's Theses

Disease remains one of the major constraints to the productivity and economic success of the California strawberry industry. The most important soilborne pathogen is Macrophomina phaseolina, causing Macrophomina root rot (MRR). The most economically significant airborne pathogens include Botrytis cinerea, causing Botrytis fruit rot (BFR), and Podosphaera aphanis, causing powdery mildew (PM).

Disease severity of MRR is highly dependent on environmental factors. Therefore, understanding which abiotic stressors contribute most to disease development is crucial for effective management. A two-year field experiment at Cal Poly, SLO (2024 and 2025) evaluated the effects of drought stress, two elevated chloride …

Using Scenario-Based Design Activities To Explore Sociotechnical Thinking In Engineering Professionals, James M. Whealan

Master's Theses

Sociotechnical thinking is the ability to recognize the interconnectedness of both technical and non-technical dimensions such as environmental, economic, social, cultural, and political factors. Although traditional engineering curriculum often emphasizes technical knowledge and skills, research suggests that engineering work is inherently sociotechnical. While sociotechnical thinking is a critical engineering skill, relatively little is understood about the nature of it or the different aspects comprised within it. To that end, this study addresses the following research question: What sociotechnical factors do engineering professionals consider in a collaborative scenario-based design activity? To answer this question, we conducted a qualitative study of engineering …

Storage-Dependent Variability In Alzheimer Disease-Related Plasma Biomarker Results Using The Fujirebio Lumipulse G1200 Platform, Ibrahim Choucair, Tiffany L. Lee, Linda J. Van Eldik, Jeffrey L. Dage, Brian T. Gold, Erin L. Abner, Gregory A. Jicha, Peter T. Nelson

Epidemiology and Environmental Health Faculty Publications

Alzheimer disease plasma biomarkers have emerged as minimally invasive, cost-effective tools for early diagnosis and disease monitoring yet their stability under common “real world” pre-analytical conditions remains incompletely characterized. We evaluated the stability of six plasma biomarkers, Aβ40, Aβ42, pTau181, pTau217, NfL, and glial fibrillary acidic protein (GFAP) using the Fujirebio Lumipulse G1200 platform. Plasma samples were initially collected from four healthy and cognitively unimpaired volunteers. Samples were stored under four conditions: room temperature (0-4h), +4°C (1-10days), −20°C (1-3weeks), and −80°C (4-8weeks). In this pilot study, Aβ40 and Aβ42 remained generally stable. In contrast, pTau181 readings exhibited marked elevations in …

Using Low-Cost Sensors And Gps To Assess Spatiotemporal Variations In Personal Exposure To Pm2.5 In The Washington State Twin Registry, Ningrui Liu, Ally Avery, Elena Austin, John S. Meschke, Nicola K. Beck, Graeme Carvlin, Yisi Liu, Anne V. Moudon, Igor Novosselov, Jeffry H. Shirai, Glen E. Duncan, Edmund Seto

Epidemiology and Environmental Health Faculty Publications

Epidemiological studies typically rely on exposure assessments based on ambient PM_2.5 concentrations at participants' home addresses. However, these approaches neglect personal exposures indoors and across different non-residential microenvironments. To address this problem, our study combined low-cost sensors and GPS to conduct two-week personal PM_2.5 monitoring in 168 adults recruited from the Washington State Twin Registry between 2018 and 2021. PM_2.5 mass concentration, size-resolved particle number concentration, temperature, humidity, and GPS coordinates were recorded at 1-min intervals, providing 5,161,737 data points. We used GPS coordinates and a processing algorithm for automatic classification of microenvironments, including seven land use …

Discreet But Accessible, Rachel M. Marschke, April M. Young, Hannah K. Knudsen, Chelsi N. Cheatom, Hannah L.F. Cooper

Epidemiology and Environmental Health Faculty Publications

Background: Rural Appalachia has been significantly affected by drug-related harms (Hepatitis C, HIV, overdose deaths) over the past two decades, but harm reduction responses still lag behind other regions. Harm reduction vending machines (HRVMs) are an effective intervention for preventing overdose and the spread of infection, though they are newer to the US and have rarely scaled out to rural areas. Here, we report on guidance from people who use drugs (PWUD) and health department staff on how to adapt HRVMs to suit local needs in rural Appalachian Kentucky. Methods: Focus groups were conducted with local health department and syringe …