Digital Commons Network^™

Building The Infection Prevention Workforce: Development, Implementation And Evaluation Of Texas Epidemic Public Health Institute Infection Prevention And Control 300 Series, Kayla E Ruch, Janelle Rios

Faculty, Staff and Student Publications

Background: The Texas Epidemic Public Health Institute (TEPHI) was established to strengthen infectious disease preparedness across Texas. The Infection Prevention and Control (IPC) 300 Series represents the third year of a multi-tiered educational initiative designed to provide free, accessible, evidence-based IPC training and continuing education credits for the healthcare workforce.

Methods: Registration and attendance data were collected through Zoom™ and Microsoft Teams™. Knowledge assessments, post-module surveys, and mid- and end-of-series evaluations were administered through QuestionPro™. Module content was informed by guidance from APIC, CDC, CMS, and OSHA. Descriptive statistics and the Kirkpatrick Model of Training Evaluation were used to assess …

Safety And Efficacy Of 6% Hydroxyethyl Starch In Patients Undergoing Major Surgery: The Randomised Controlled Phoneics Trial, Wolfgang Buhre, Óscar Díaz-Cambronero, Simon Schaefer, Martin Novacek, Marina Soro Domingo, Bjorn Stessel, Aurelio Rodríguez-Pérez, Torsten Richter, Georg Rohe, Bernard Cholley, Matthias Gruenewald, Gerhardus Kuiper, Samir Jaber, Dianne De Korte, Javier Belda, Marcelo Gama De Abreu, Robert Baronica, Thomas Scheeren, Carlos Ferrando-Ortolá, Wojciech Szczeklik, Dana Tomescu, Tomas Vyzamal, Zejka Gavranovic, María Pilar Argente-Navarro, Guido Mazzinari, Sarah Thaler, Nuria García-Gregorio, Jeroen Vandenbrande, Diane Zlotnik, Jakob Wittenstein, Sonja Schmier, Susanne Rohn, Christoph Glasmacher, Martin Holler, Cornelius Jungheinrich, Ulf Niess, Daniel I Sessler, Martin Westphal

Faculty, Staff and Student Publications

Abstract

Background: Hydroxyethyl starch (HES) is often used for maintaining vascular volume during major surgery. Long-term high-dose HES in septic patients promotes renal injury, whereas meta-analyses of current HES products in surgical patients do not show such effects.

Objective: We studied if the peri-operative use of HES is noninferior to crystalloids in terms of acute kidney injury. Secondary outcome was the noninferiority of HES on worsening of renal injury and/or the incidence of a composite endpoint of major complications and mortality until postoperative day 90.

Design: Randomised double-blind trial in patients undergoing elective abdominal surgery with expected blood loss at …

Feasibility And Preliminary Outcomes Of A Remotely-Delivered Exercise Training Intervention For English-Speaking Hispanics/Latinos With Multiple Sclerosis: Results From The Ferla Ms Study, Victoria A Flores, Stephanie L Silveira, David X Marquez, Dominique Kinnett-Hopkins, Augusto Miravalle, Fabian Sierra-Morales, Robert W Motl

Faculty, Staff and Student Publications

Background: There is limited evidence on the feasibility of remotely delivered exercise interventions for English-speaking Hispanics/Latinos with MS.

Objectives: To evaluate the feasibility and exploratory efficacy of a remotely-delivered, home-based exercise program for English-speaking Hispanics/Latinos with MS and to explore associations among feasibility metrics, outcomes, and social determinants of health (SDOH).

Results: Of 340 individuals contacted, 112 were eligible (33%), 33 enrolled (9.7%), 30 randomized, and 26 completed (87% retention). Adherence averaged 81% (exercise) and 89% (control). No serious adverse events occurred. Exploratory within-group improvements were observed in the exercise group for physical activity (p = 0.03, d = …

Heart Failure Hospitalization In Patients With And Without Type 2 Diabetes: A Population-Based Retrospective Cohort Study, Allison K Shay, Wei Tao, Soumya Patnaik, Delaney K Sullivan, Angelo Nascimbene, Xueying Wang, Joseph B Mccormick, Hulin Wu

Faculty, Staff and Student Publications

Purpose: Type 2 diabetes mellitus (T2DM) is a common comorbidity among patients with heart failure (HF). This study aims to describe how T2DM relates to HF hospitalization patterns across demographic groups and HF subtypes.

Methods: We conducted a population-based retrospective cohort study using 19 years of clinical data from Cerner Health Facts®, a nationwide electronic health record (EHR) database. Adult patients hospitalized with HF were identified using ICD-9/ICD-10 diagnosis codes and HF-related medications and were stratified by T2DM status. Measures included HF-related hospitalization count, length of first HF hospitalization, and age at first HF hospitalization. Comparisons were examined across HF …

Understanding Practices Of Lactation And Infant Feeding Together With Women With Hiv: The Uplift Observational Study Protocol, Christiana Smith, Emily Anne Barr, Karen Hampanda, Mark Trumbull, Hulin Wu, Jennifer Mckinney, Sarah Buisson, Carly Hoffmann, Ciarra Brown, Angela B Hutchinson, K Rivet Amico, Ifeyinwa V Asiodu, Elizabeth J Mcfarland, Margaret A Lampe, Preetam A Cholli, Olga Varechtchouk, Allahna Esber, Athena P Kourtis, Lisa Abuogi

Faculty, Staff and Student Publications

Introduction: There is a limited understanding of infant feeding decisions, practices, and outcomes for women living with HIV (WLHIV) and their infants since U.S. guidelines were updated in 2023 to support breastfeeding for virally suppressed women on antiretroviral treatment.

Methods and analysis: The Understanding Practices of Lactation and Infant Feeding Together with women with HIV (UPLIFT) study is a convergent mixed-methods, multisite, observational study designed to address key knowledge gaps. Twelve US sites will begin enrollment in early 2026 to accomplish three core activities (CA). In CA1, we explore infant feeding decision-making and experiences via in-depth interviews with pregnant/postpartum WLHIV …

Correction: Feasibility Of Conducting A Pilot Randomized Trial Of A Mindfulness-Based Intervention Among Sheltered Young Adults Experiencing Homelessness, Diane Santa Maria, Paula Cuccaro, Erica Sibinga, Kimberly Bender, Ethel Jacko, Widumini Liyanage, Jennifer Jones, Stanley Cron

Faculty, Staff and Student Publications

This corrects the article "Feasibility of conducting a pilot randomized trial of a mindfulness-based intervention among sheltered young adults experiencing homelessness" in volume 16, 1649664.

The Law Of The Mid-Transition, Alison Gocke

Michigan Law Review

To address climate change, our energy systems need to transition from fossil fuels to clean energy resources. There is a tendency to think this transition will occur in a linear, seamless progression: We will move from the (old) fossil fuel system at Time A to a (new) clean energy system at Time B. But this belies the reality that an energy transition involves not just building a new energy system, but also unwinding an old one. Crucially, both processes will take time. That means there will be a significant period in which both energy systems coexist.

In the engineering literature, …

Algorithmic Medicine And The Duty To Disclose: Informed Consent Through The Lens Of Radiology, Lee Rodriguez

Michigan Law Review

Informed consent is the law’s mechanism for protecting patient autonomy by requiring disclosure of facts that bear on the decision to accept or refuse care. Artificial intelligence now helps decide what is medically true for patients, yet informed consent law still assumes that diagnostic judgment is rendered by a human mind whose reasoning is at least in principle communicable. Radiology has become the leading setting for this tension. AI systems triage worklists, flag suspected abnormalities, and anchor first-pass impressions in ways that guide radiologists’ attention and, in practice, can coauthor diagnostic conclusions while remaining invisible to patients. When patients are …

Understanding Motivations And Health Outcomes Of College-Aged Triathletes During Covid-19: A Mixed-Methods Study, Patrick Wilson, Eddie Hill, Justin Haegele, Xihe Zhu

Human Movement Studies & Special Education Faculty Publications

A triathlon is a multi-sport event that consists of three simultaneous events: swimming, biking, and running. This sport has experienced significant growth in the past few decades, with colleges and universities now participating. This exploratory mixed-methods study examined the motivations and perceived health benefits of college triathletes during the COVID-19 pandemic, using the Means-Ends of Recreation Scale and the Perceived Health Outcomes of Recreation Scale (N = 29), as well as semi-structured interviews (N = 4). Results indicate no difference in motives or health outcomes between male and female survey respondents. The thematic analysis of open-ended interview questions highlighted lived …

Inclusive Psychology Pedagogy Is Linked To Increased Belonging And Reduced Prejudice Toward Consensually Non-Monogamous Relationships, Rose Bern, Rachel Dinero, Kate Linenbach, Amy Moors

Psychology Faculty Articles and Research

Students enrolled in an elective psychology course entitled Relationship Science, which emphasized inclusive curricula focused on relationship diversity, completed pre- and postcourse assessments of attitudes toward consensually nonmonogamous (CNM) relationships, relationship skills (e.g., constructive communication), and classroom belonging. Given the established literature on lesbian, gay, bisexual, transgender, queer+-inclusive pedagogy, attitudes toward lesbian, gay, bisexual, transgender, queer+ individuals were also measured. Comparisons of pre- and postcourse assessments revealed significant reductions in stigma toward individuals engaged in CNM, alongside increased acceptance of CNM relationships more broadly. Students also reported increases in relationship skills and classroom belonging over the course of the …

Recent Abdominal Surgery As A Risk Factor For Unfavorable Immune-Mediated Colitis Outcomes, Rohan Ahuja, Malek Shatila, Jay Shah, Cristina Natha, Varun Vemulapalli Mdi, Nitish Mittal, Jasmine Mikal Haydel, Irene Jeong-Ah Lee, Andres Caleb Urias Rivera, Carolina Colli Cruz, Bryan Schneider, Shilpa Grover, Aliyah Pabani, Anusha S Thomas, Yinghong Wang

Faculty, Staff and Student Publications

Background and aims: Risk factors for immune checkpoint inhibitor (ICI) therapy enterocolitis (IMC) have not been greatly explored. Abdominal surgery can reduce bacterial diversity, increase the presence of pathogenic bacteria, and lead to inflammatory changes. This retrospective analysis seeks to determine if a history of recent abdominal surgery in patients who receive ICI therapy affects the severity and duration of enterocolitis.

Methods: We retrospectively reviewed patients with history of abdominal surgeries, who received ICI for cancers and then developed IMC. Clinical profiles, oncology variables, and colitis-related characteristics were reported.

Results: Seven hundred sixty-five patients met the inclusion criteria. Patients median …

Evaluating Differences In Nonsyndromic Orofacial Clefts By Infant Sex: National Birth Defects Prevention Study, 1997-2011, Victoria A Salinas, Natalie P Archer, Layla R Lustri, Katherine L Ludorf, Timothy Ihongbe, Wei Yang, Eva M Williford, Marilyn L Browne, Adrian M Michalski, Lindsay A Williams, Wendy Nembhard, Eirini Nestoridi, Gary M Shaw, Andrew F Olshan, A J Agopian, National Birth Defects Prevention Study

Faculty, Staff and Student Publications

Objective: To investigate nongenetic factors that may contribute to observed differences in nonsyndromic orofacial clefts by infant sex.

Study design: Using data for 1997-2011 deliveries from the National Birth Defects Prevention Study, a case-control study, we separately examined associations between 23 maternal factors and cleft lip with or without cleft palate (CL/P) and cleft palate alone (CP) using multivariable logistic regression stratified by infant sex.

Results: We compared 2986 infants with CL/P and 1557 with CP to 11 271 control infants without birth defects. After adjusting for maternal age at conception and education, lower odds of nonsyndromic orofacial clefts were …

An Integrated Lifestyle-, Genetic- And Metabolomics-Based Prediction Model For Mild Cognitive Aging In The Hchs/Sol, Annah B Wyss, Yana Hrytsenko, Linfeng Hu, Iris J Broce, Robert C Kaplan, Wassim Tarraf, Bing Yu, Eric Boerwinkle, Qibin Qi, Myriam Fornage, Charles Decarli, Hector M González, Tamar Sofer

Faculty, Staff and Student Publications

Prediction models for cognitive aging measures have largely evaluated demographic variables and APOE carrier status in populations of European ancestry. To comprehensively assess prediction models among Hispanic/Latinos, we considered 12 models (6 predictor sets and 2 methods) for global cognitive score change (GCSC) and mild cognitive impairment (MCI) in the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) (N = 5856). Based on the average mean squared error (MSE) for GCSC or average area under the curve (AUC) for MCI across 100 randomly split testing and training sets, performance was similar across models, but slightly better for the following models: …

Enhancing Data Compatibility In An Evolving Landscape: Medical Cannabis And Polysubstance Use Protocols In The Phenx Toolkit, Anne Buu, Johannes Thrul, Amanda Bunting, Tamara Haegerich, Wayne Huggins, Christian Hopfer, Denise Vidot, Cataia Ives, Ryan Mcneil, Sarah Zemore, Corrie Vilsaint, Elizabeth Fallon, Christine Hill, Carol Hamilton, John Kelly

Faculty, Staff and Student Publications

Introduction: With increasing legalization of medical cannabis and prevalence of polysubstance use in the United States comes the need for standard psychometrically validated measures to study these substances' health effects in the population. The PhenX (consensus measures for Phenotypes and eXposures) Toolkit (www.phenxtoolkit.org) is a freely accessible catalog of recommended measurement protocols to promote data compatibility across studies, but this extensive catalog did not include measures in these important areas.

Methods: In 2024, a PhenX Working Group of experts followed a well-established consensus process to identify and recommend measurement protocols suitable for inclusion in studies on medical cannabis and polysubstance …

Population-Based Analysis Of Synergistic Effects Of Functional Disability And Comorbidities On Retention In Hiv Care Among People With Hiv, Modupe Olajumoke Onigbogi, Osaro Mgbere, Paul Rowan, Ruosha Li, Charles Darkoh

Faculty, Staff and Student Publications

Objective: This cross-sectional study examined how types of disability and comorbidities influence retention in care (RIC) among people with HIV (PWH) in Houston/Harris County, Texas, USA.

Methods: Data from 1142 participants in the Houston Medical Monitoring Project (2015–2021) were analyzed. Descriptive statistics, bivariate analyses, and multivariable logistic regression were used to evaluate factors associated with RIC.

Results: Approximately 74.9% of participants were retained in care. Compared to PWH without specific comorbidities, those with dyslipidemia and kidney disease had higher odds of RIC (AOR: 2.66; 95% CI: 1.40–5.03 and AOR: 14.08; 95% CI: 1.44–138.12, respectively). PWH reporting only mobility disability had …

Impact Of Early Intervention On Developmental Outcomes In Young Children With Autism In Rural Communities, Libier Burgara

IdeaFest 2026

This poster examines the impact of early intervention on developmental outcomes in young children with autism in rural communities, with a focus on care delivered through a community based rural clinic and a rural federally qualified health center. Delays in diagnosis and limited access to specialized services contribute to poorer developmental trajectories in these settings.  This project highlights the importance of early screening, timely referral, and coordinated, family centered care.  Key concepts include reducing disparities, improving access to evidence based interventions, and strengthening interdisciplinary collaboration.  Outcomes demonstrate that early, consistent intervention is associated with improved communication, social functioning, and overall …

Enhancing Surgical Safety, Sarah Moxon

IdeaFest 2026

Surgical site infections (SSIs) account for 20% of hospital-acquired infections, increasing patients’ risk of disability and mortality and raising costs for hospitals. This quality improvement project, using the Model for Evidence-Based Practice Change, aims to reduce SSIs at a rural hospital by 20% within one year. Engaging key players, proven strategies will be implemented, including preoperative nasal decolonization, reducing operating room traffic, and using an SSI risk tool. These strategies will be evaluated through electronic medical record (EMR) documentation audits, tracking door openings, nasal swab cultures, and surveys assessing the SSI risk tool’s impact on clinical decision-making.

Aquatic Invertebrate Diversity Across Ponds In The Arcata Marsh, Bree Gentil-Guijosa

IdeaFest 2026

I am collecting samples across different ponds in the Arcata Marsh to compare aquatic invertebrate biodiversity and abundance. Each pond is selected due to the ponds having different management goals and different reasons for their restoration/creation in the marsh back when the city marsh was being created. I will be presenting what invertebrate orders I found, if their presence and diversity was affected based on what pond they were collected in, and what this research can be applied to in the future.

Superintendent Accountability In High Achieving School Districts: A Qualitative Multiple Case Study In The State Of Washington, Kristin Lind Jacobs

Graduate Student Theses, Dissertations, & Professional Papers

The primary goal of a school district is to promote and support student academic achievement. Superintendents of public school districts across the United States should therefore be held accountable for student performance within their districts. Establishing a successful public school district requires interconnected relationships among the superintendent, the school board, accountability structures, and evaluation processes.

The purpose of this qualitative multiple case study was to understand how superintendent accountability, in regard to student achievement, was conducted and accomplished by school boards who believe they hold the superintendent accountable for student learning. This study focused on school boards governing high-achieving school …

Cryptic Mechanisms Of Post-Fire Nitrogen Recovery In Northern Conifer Forests, Robert Edward Heumann

Graduate Student Theses, Dissertations, & Professional Papers

In recent decades, northern conifer forests have experienced larger, more frequent and more intense wildfires. Severe, stand-replacing wildfire substantially reduces forest nitrogen (N) stocks, a critical nutrient that often limits net primary productivity on land. Continued increases in wildfire activity may exacerbate forest N limitation in the future. Yet, while research shows N stocks in northern conifer forests recover following severe wildfire, the processes that contribute to rapid increases in N during post-fire regeneration are unclear. Atmospheric deposition of N and known sources of biological N fixation cannot explain the observed post-fire N accumulations. This paradox raises the question: How …

Effectiveness Of Behavioral Cough Suppression Therapy In A Closed Enrollment Group Telehealth Delivery Model And Comparison To A Rolling Enrollment, Kinsey Louise Roberts

Graduate Student Theses, Dissertations, & Professional Papers

Background:

Refractory chronic cough (RCC) is a subtype of chronic cough (CC) that persists

despite guideline-based treatment and can negatively affect quality of life. Behavioral cough

suppression therapy (BCST), typically delivered by speech-language pathologists (SLPs), is an

effective treatment for RCC. However, access to BCST remains limited due to geographic

barriers and a shortage of trained providers. Group-based telehealth may help expand access to

treatment. This study evaluated the effectiveness of BCST delivered via telehealth using

a closed enrollment group model and compared outcomes to a rolling enrollment group model.

Methods:

In this prospective sequential cohort study 32 participants attended …

Reducing Door-To-Ekg Time In The Emergency Department, Halie Dearman

IdeaFest 2026

Delayed electrocardiogram (EKG) acquisition in emergency departments (ED) represents a preventable patient safety crisis disproportionately affecting women, Black patients, older adults, and non-English-speaking patients. Using the Iowa Model of Evidence-Based Practice, this quality improvement project addresses door-to-EKG (D2E) times exceeding the ACC/AHA 10-minute benchmark in a rural northern California ED. Three evidence-based interventions are proposed: culturally tailored community education on atypical acute coronary syndrome symptoms, a standardized nurse-driven triage EKG protocol with dedicated equipment, and institutional adoption of D2E time as a formal quality metric. Evaluation includes EHR timestamp audits, demographic disparity analysis, and longitudinal mortality review. Timely EKG acquisition …

Skin Tone Inclusive Assessment To Reduce Missed Pressure Injuries, Sheena May Viste

IdeaFest 2026

Patients with high‑melanin skin are at increased risk of developing pressure injuries and experiencing more severe progression because early signs are frequently missed. This disparity is attributed to delayed PI recognition because standard visual skin assessments are biased toward light skin and fail to identify early tissue damage (Black et al., 2023; LaFond et al., 2025). Implementing the Skin Assessment for Dark Skin (SADS) technique—use of halogen light and multisensory palpation—during assessments helps nurses identify early pressure injury indicators. The overarching goal is to reduce diagnostic delays by using tools such as Skin Assessment for Dark Skin (SADS) to support …

Beyond Words: The Horse-Human Encounter In Equine-Assisted Psychotherapy For Residential Substance Use Treatment, Leah Finch Lungren

Graduate Student Theses, Dissertations, & Professional Papers

Equine-assisted psychotherapy (EAP) has emerged as a promising experiential therapeutic intervention, yet the lived experience of adults participating in EAP within residential substance use disorder (SUD) treatment settings remains underexplored. This hermeneutic phenomenological study examined the lived experience of 12 adults who participated in EAP groups during residential SUD treatment across three treatment facilities in the United States. The primary research question was: What is the lived experience of participating in EAP for adults in residential SUD treatment? Data was collected through semi-structured interviews and analyzed through iterative hermeneutic interpretation guided by van Manen’s (1990) existential framework.

Six themes emerged …

Integrating Hippotherapy Into Interprofessional Aphasia Rehabilitation: A Feasibility Pilot Study, Bethany H. Wenger

Graduate Student Theses, Dissertations, & Professional Papers

Background and Significance: Stroke remains a leading cause of disability in the United States, affecting over 2.5 million individuals annually. Stroke-related motor and communication deficits often co-occur, increasing challenges for recovery, increasing social isolation, depression, and dependency. Hippotherapy has emerged as a novel treatment approach for neurorehabilitation; however, its application within interprofessional models for individuals with stroke-related motor and communication impairments remains underexplored. This study examines the feasibility, fidelity, and acceptability of an interprofessional intervention using hippotherapy for adults with chronic post-stroke aphasia, the purpose of which is to generate methodological guidance for future controlled trials.

Methods: A non-randomized, single-group …

Instructor Created Video: Differences In Perception Of Administrative Support In Respiratory Care, Brian Daniel Cayko

Graduate Student Theses, Dissertations, & Professional Papers

Background: The recent proliferation of online education has highlighted the need to reduce transactional distance and increase the community of inquiry presence between the instructor and students and between students. This quantitative non-experimental study examined the differences in perception of administrative support for instructor-created video (ICV) between faculty and administrators within Commission on Accreditation of Respiratory Care (CoARC) higher education programs of Respiratory Care. Methodology: The Difference in Perception of Administrative Support (DPAS) survey was utilized to collect data from 93 valid participants through a snowball sampling method. Analysis was performed using an independent samples t test and Cohen's d …

Most Effective Methods For Educating Three Population Demographics At Risk Of Large-Scale Lahars Originating From Mt. Rainier, Bodhi Merrill

IdeaFest 2026

In this study I focus on the most effective ways to communicate response plans for lahars originating from Mt. Rainier to three socioeconomic groups: residents, employees, and tourists. Wood and Soulard (2009) identified these three populations in the communities surrounding Mt. Rainier as largest and most at risk to a potential large-scale lahar. I will utilize lahar hazard maps published by the United States Geological Survey in combination with peer-reviewed journal articles focusing on the most successful methods of educating specific population demographics. This work will help guide emergency planners, management agencies, and individuals to better understand what measures still …

Ensuring Safe Soil For Indigenous Food Sovereignty: Contaminant Screening For Agroecological Health, Derek Tremaine

IdeaFest 2026

Indigenous food sovereignty is a foundational component of human and environmental health. The Rou Dalagurr Food Sovereignty Lab and Traditional Ecological Knowledges Institute at Cal Poly Humboldt (FSL) foregrounds Indigenous-led approaches to land management and oversees several sites adjacent to campus infrastructure. To ensure that food and basketry materials cultivated at the FSL do not pose a risk to human health, soil samples were collected and screened for contaminants. Heavy metals, phthalate esters, and hydrocarbons were not detected at levels that would affect human health or FSL objectives. This work demonstrates how community-engaged research can inform safe land stewardship while …

A Breath Of Fresh Dust: Health Costs Of California’S Shrinking Salton Sea, Brendan Yoder

IdeaFest 2026

Literature review investigating the adverse health effects of the continued drying of the Salton Sea in Southern California.

Holy Cows: Moo-Ving The Dial On Complex Pain Management, Mary Nickell

IdeaFest 2026

In the U.S., 8.9 million people misused opioids last year (SAMHSA, 2024). Humboldt County’s overdose rate is 6% above state and national averages (DHSS, 2021). Despite high prevalence rates, many providers lack confidence in managing acute pain for patients with Opioid Use Disorder (OUD), while nursing stigma further inhibits care (Raub & Vettese, 2017). Patients with OUD report discharging against medical advice (DAMA), even with life-threatening illnesses, due to inadequate pain and withdrawal management (Babbel et al.,2024). Nurses leaders can reduce DAMA, improve health outcomes/equity through standardized screening, dedicated pain management pathways, and mandatory annual staff training.