Digital Commons Network^™

Optimizing Vitamin A Intervention: Strengthening Supplementation With Targeted Biscuit Fortification, Mayfa Yemima Simanjuntak, Nadia Amanda, Yuli Berliana Simanjuntak, Carissa Wityadarda, Lesta Livolina Simamora

Journal of Indonesian Health Policy and Administration

Vitamin A deficiency (VAD) remains a persistent public health challenge in Indonesia, particularly among children under five and breastfeeding mothers. This study aimed to analyze the distribution of vitamin A interventions and assess the potential of biscuit fortification as a complementary strategy. This study employs a literature review using the Health Policy Triangle (HPT) framework, examining policy context, content, key actors, and implementation processes related to vitamin A interventions. The analysis was conducted using secondary data from government reports, international agencies, and peer-reviewed literature published between 2018 and 2025, with comparative evidence from Vietnam, Bangladesh, and Ghana. The findings show …

Intervention Levers For Stunting Reduction In Indonesia: Evidence From The 2023 Indonesian Health Survey Data, Iwan Ariawan, Hafizah Jusril, Zahra Izza Afifa, Azka Fitri, Elmarizha Sekar Utami, Mikail Hasan, Dwi Puspasari

Kesmas

Stunting remains the largest public health challenge among macro-nutrition problems in Indonesia, affecting almost a quarter of children under five in 2023. The prevalence is considered high according to the World Health Organization standard. This study analyzed 15 aggregated provincial variables from the 2023 Indonesian Health Survey using Structural Equation Modeling (SEM), focusing on determinants of stunting among children under two to identify primary intervention levers. Findings indicated that intervention urgency should focus on the first 1,000 days, particularly the steep increase in stunting prevalence observed in the 12–24-month age range. While the highest prevalence is in Eastern provinces (e.g., …

Rewarding Risk: How Political Health Messaging Drives Virality And Controversy On X, Hiba Ali

Quantitative Social Science Undergraduate Senior Theses

No abstract provided.

Empowering Lifelong Choice: Supporting Older Individuals With Idd To Thrive At Work, Transition To Retirement With Dignity, And Maintain Community Connections, Leslie Quarles

Critical and Creative Thinking Capstones Collection

This synthesis addresses the need to support older individuals with intellectual and developmental disabilities in their engagement in continued work. The project traces the journey from an initial focus on supporting older individuals with intellectual and developmental disabilities to work as long as they wish to an eventual shift toward a phased retirement approach. It considers issues such as a reimagined visualization of the support team structure, integration of tailored job supports and Community Life Engagement (CLE). The author's familial history sparked a sense of injustice that would not stay buried, shaping a career path in disability services and access. …

The Cultivation Of Public Perception: Cultivated Meat Narratives And Misinformation On Tiktok, Anna M. Balkus

Graduate Masters Theses

Cultivated meat is an emerging tissue engineering technology that has the potential to address major issues threatening food systems, including climate change, rapid population growth, and the spread of disease. Among technical challenges, public perception remains a significant barrier for the widespread adoption of cultivated meat. While social media has transformed communication globally, it has simultaneously contributed to corrupt online environments infected with misinformation—unintentional inaccuracies that differ from disinformation, which is spread with the intent to mislead. The way the public receives and digests information regarding new food technologies, like cultivated meat, will be shaped by their social media environment. …

Role Of Technical Assistance In Pollution Prevention In Massachusetts Craft Breweries, Shubhechchhya Regmi

Graduate Masters Theses

This study aims to examine pollution from Massachusetts craft breweries, and if it can be lessened through a pollution prevention program. This study analyzed data from two assessments with the aim of analyzing the role of technical assistance in pollution prevention across eight impact categories. The first assessment was conducted on 29 MA breweries between 2022 and 2024, and 23 were assessed a second time (in summer 2024 and summer 2025). Craft breweries face several constraints in adopting pollution prevention practices the pollution prevention program known as BetterBev helps to bridge this gap by providing technical assistance, identifying inefficiency practices …

Digital Communication And The Evolution Of Ideological Narratives In Indonesia: Insights From Social Media Platforms, Tia Mariatul Kibtiah, Muhammad Fikri Fawazi

Journal of Terrorism Studies

This study examines how pro-caliphate and anti-democratic narratives are articulated and normalised within YouTube comment spaces in Indonesia. As the world’s largest Muslim-majority country with high levels of digital engagement, Indonesia provides an important context for analysing how political-religious discourses circulate through everyday digital interaction. The research analyses 1,354 YouTube comments related to the caliphate, governance, and democracy. Data were collected using Google Apps Script, manually filtered for relevance, and examined through qualitative content analysis informed by Social Network Theory (SNT) and the Radicalisation Factor Model (RFM). The findings show that 34.49% of comments endorsed ideological pro-caliphate narratives, while 35.97% …

Governance Structures And Conflict Mitigation Strategies In Food Supply Chains: Evidence From Niger State, Nigeria, Araoye Olarinkoye Ajiboye, Aminu Kandi Suleiman, Habila Daniel Diko, Tayo Moses Adebayo

Journal of Terrorism Studies

Food supply chains in fragile and semi-institutionalised economies continue to experience persistent instability driven by weak governance structures and recurring conflicts among market actors. However, despite extensive studies on food system challenges in Nigeria, there remains limited empirical understanding of how governance structures interact with conflict mitigation mechanisms to shape system stability at the local market level. Available literature tends to treat governance and conflict management as separate processes, thus overlooking their interdependent dynamics within everyday market operations. This study addresses this gap by examining governance structures and conflict mitigation strategies in food supply chains in Niger State, Nigeria. Anchored …

Culturally Competent Nurse-Led Education To Reduce Delayed Diagnosis And Increase Awareness Of Polycystic Ovary Syndrome In Reproductive-Aged South Asian Women, Madeeha Syeda

Honors College Theses

Polycystic ovary syndrome (PCOS) is a common condition that affects hormones in women, especially in their 20s and 30s. Symptoms of PCOS include irregular periods, abnormal hair growth, acne, obesity, hyperpigmentation of the skin, cysts, skin tags, thinning hair, and infertility (Newin, 2023). While the exact cause of PCOS is unknown, it is linked to insulin resistance, higher levels of androgens, and low-grade inflammation (Newin, 2023). In regards to complications, PCOS can increase risk for gestational diabetes, preeclampsia, preterm term, and C-section deliveries. In terms of treatment, there is no cure but early diagnosis is key to reducing symptoms (Newin, …

Improving Antihypertensive Medication Adherence Through Education And Follow- Up Phone Calls In A Primary Care Setting, Sarah Peterson

Doctor of Nursing Practice Final Manuscripts

Hypertension affects nearly half of adults and significantly increases the risk of stroke and cardiovascular disease; however, poor medication adherence remains a primary barrier to effective blood pressure management. The purpose of this evidence-based practice (EBP) project was to improve antihypertensive medication adherence among adult patients in a primary care setting. Guided by the Iowa Model of Evidence-Based Practice to Promote Quality Care, the project utilized a pre-test/post-test design at a private practice clinic. The sample included adults with a hypertensive diagnosis and active prescriptions. Medication adherence was defined as the Morisky Medication Adherence Scale (MMAS-8) scores, measured before and …

Reducing Preoperative Anxiety In Patients Undergoing Gynecologic-Oncology-Related Surgeries, Iman Sean Lavine-Richardson

Doctor of Nursing Practice Final Manuscripts

Elevated levels of preoperative anxiety are associated with adverse effects in the postoperative period. Evidence demonstrates the effectiveness of incorporating multimedia into preoperative education to alleviate preoperative anxiety. This project aims to decrease preoperative anxiety levels and increase satisfaction and feelings of preparedness in patients scheduled to undergo gynecologic-oncology-related procedures through the implementation of an evidence-based practice (EBP) informational video. The San Diego 8A’s EBP model was utilized to guide this project. Data was collected, anonymously, through online questionnaires which included the Anxiety Specific to Surgery Questionnaire (ASSQ) to assess anxiety levels and Likert-scale questions to assess satisfaction and feelings …

Optimizing Lactation Support: Enhancing Patient-Centered Care And Breastfeeding Self Efficacy Through Data-Driven Survey Analysis, Jessica L. Doshay

Doctor of Nursing Practice Final Manuscripts

Objective: The objective of this project was to implement evaluation of an integrated lactation support model within a multi‑site pediatric primary care organization to assess patient experience and breastfeeding confidence associated with a lactation consultation.

Background: Optimizing the patient experience is an indicator of healthcare quality. Improving breastfeeding outcomes remains a national priority. Structured lactation support delivered by International Board-Certified Lactation Consultants (IBCLCs) enhances breastfeeding outcomes, the impact of this is often undocumented in primary care settings.

Methods: This quality improvement project was conducted within the lactation department of a multicenter pediatric clinic in Southern California. Pediatric clinicians who were …

Factors Associated With The Performance Of Essential Public Health Efforts At Primary Health Centers In Jember Regency, Griselda Ardelia Hibatullah, Nuryadi Nuryadi, Yennike Tri Herawati

Journal of Indonesian Health Policy and Administration

Performance assessment of primary health centers is essential to ensure the quality of healthcare services, including the delivery of essential public health efforts. The performance target for essential public health efforts in Jember Regency is set at ≥82%. This study aimed to analyze factors associated with the performance of essential public health efforts. The study employed an analytical cross-sectional design conducted from April to May 2025, with a sample of 37 out of 50 units selected through simple random sampling. Primary data were collected using questionnaires, while secondary data were obtained from primary health center (Pusat Kesehatan Masyarakat – …

Trends Of Pediatric Psychotropic Polypharmacy In Massachusetts Before And During The Covid-19 Pandemic, Gianna D'Ambrozio

Graduate Doctoral Dissertations

Youth in the U.S. and internationally are increasingly being diagnosed with depression and related psychiatric conditions (Murthy, 2021) many of whom are being subjected to non-evidence-based, or what has been termed irrational, psychotropic polypharmacy (Barnett & Concepcion Zayas, 2019). Psychotropic polypharmacy can be defined as “the use of 2 or more psychiatric medications in the same patient,” (Zito et al., 2021) though definitions can vary. Using data from the Center for Health Information Analysis’ Massachusetts All-Payer Claims Database, this study examined the sociodemographic factors associated with high rates of polypharmacy, a hypothesized increase in pediatric psychotropic polypharmacy rates in Massachusetts …

"It's Such A Natural Fit": Integrating Reggio Emilia And Head Start For Emergent Multilinguals, Christina Bohr

Graduate Doctoral Dissertations

Early childhood education classrooms reflect the increasing cultural and linguistic diversity of the United States where many children are raised speaking more than one language. Teachers in the early education field play a critical role in supporting children’s development of language and identity. Head Start, who serves a large population of emergent multilinguals (mls), plays an essential role in offering learning environments that foster language development in both English and their home language, among many other critical skills. The Reggio Emilia philosophy is a child-centered and community-oriented approach that promotes children’s independence, exploration, and intellectual development, and is frequently integrated …

Computer-Aided Development Of Novel Antioxidants, Rita Bernadett Vlocsko

Graduate Doctoral Dissertations

Physiological redox homeostasis is a fine balance between prooxidants and antioxidants that are integrated elements of several reduction-oxidation mechanisms at molecular, organellar, cellular and tissue levels. When this equilibrium is disrupted and prooxidants become dominant, the body relies on endogenous and exogenous antioxidants to counterbalance the dysregulation and ultimately prevent the progression of oxidative stress. Reactive species (reactive oxygen species, reactive nitrogen species, or reactive sulfur species) are significant contributors to prooxidant activity. Over the years, substantial knowledge has been accumulated regarding their origin and roles in disease development, leading to the discovery and development of antioxidants that effectively target …

Pernicious Anemia Presenting As Pseudothrombotic Microangiopathy: A Case Report, Sai Sushrutha M Vemula, Shreeya Adhikari, Shreya Motkur, Alfarooq Alshaikhli, Borys Hrinczenko

School of Medicine Publications

Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening thrombotic microangiopathy (TMA) characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ dysfunction, with high untreated mortality that can be effectively reduced with timely plasma exchange (PLEX) and immunosuppressive therapy. However, several conditions can produce a clinically similar pseudo-TMA picture, among which severe vitamin B12 deficiency is an underrecognized and potentially treatable mimic that occurs due to ineffective intramedullary erythropoiesis, megaloblastic fragmentation of structurally abnormal erythrocytes, and pancytopenia in the absence of true endothelial injury or ADAMTS13 deficiency. We present a 74-year-old female patient who presented with altered mental status, bradycardia, and severe …

Towards Sustainable Agentic Artificial Intelligence In Medical Diagnosis For Autonomous Heart Disease Prediction, Thura J. Mohammed, Dhiaa M. Abed

AUIQ Humanities and Social Sciences

Diagnosis of heart disease is a procedure that requires fast, accurate predictions and conventional fixed machine learning (ML) pipelines may not fully accommodate. Although models, such as Logistic Regression and Naïve Bayes are effective on structured clinical data however they do not have self-assessment or adaptive reasoning mechanisms. In this work, we present an agentic AI framework that turns the classical models into self-evaluating diagnostic agents managed by a performance conscious supervisory component. We trained and tested the system on the UCI Heart disease dataset over three different splits (70:30, 80:20, 85:15) to test its diagnostic stability with respect to …

Making Kinship With Plants And The Multiple Meanings Of Care In Amazonian Indigenous Gardens, Ana Gabriela Morim De Lima

Tipití: Journal of the Society for the Anthropology of Lowland South America

This paper focuses on the bonds of kinship and care between humans, cultivated plants, and other-than-human beings in Indigenous gardens, myths, rituals, and shamanism, across Lowland South America. Drawing on Krahô ethnography and a review of ethnological literature, it highlights the contributions of Americanist ethnology to wider debates about multispecies relation, particularly with regard to vegetal agency. By exploring the ambivalent meanings of care- such as “caring,” “raising,” and “nurturing,” as well as “being careful,” “having respect,” and “taking precautions”- I examine how kinship relations between humans and their cultivated plants are made through care and unmade through its absence …

Impetus 2025 – The Philippine Physical Therapy Association (Ppta) National Convention: Poster Presentations, Impetus 2026

Philippine Journal of Physical Therapy

No abstract provided.

Can Behavioral Interventions Promote Health Equity In Pediatric Type 1 Diabetes? A Narrative Review Of Promising Treatments, Paul T. Enlow, Jaquelin Flores Garcia, Julia Price, Kristen A. Torres, David V. Wagner

Department of Pediatrics Faculty Papers

Purpose of review: Synthesize data on whether existing behavioral interventions can improve health equity among youth with type 1 diabetes.

Recent findings: While existing behavioral interventions demonstrated efficacy in improving health and/or psychosocial outcomes, evidence that these same interventions may improve health equity were lacking. Most interventions were evaluated using predominantly White and affluent samples and some studies did not report on racial, ethnic, or sociodemographic characteristics of their sample. Only a few interventions have been adapted for youth from minoritized backgrounds. Recent multisystemic and technology/mHealth interventions recruited samples that were sociodemographically representative of youth experiencing disparities, suggesting that these …

Navigating Trust: The Impact Of Social Media Influencers On Gen Z Health Behaviors, Abigail Stelling

Honors Thesis

Social media plays a defining role in the daily lives of Gen Z, influencing how people communicate, access information, and make decisions. More than a form of entertainment, social media is a powerful source that shapes identity, perceptions, and behaviors. As the first generation to grow up fully immersed in a digital world, Gen Z is uniquely impacted by the content and interactions that occur on social media platforms. Within this digital landscape, social media influencers have emerged as powerful figures. These individuals use large online platforms to promote lifestyles, products, and behaviors. Influencers often have the ability to shape …

Rural-Urban Differences In Hypertension Prevalence And Control In A Large Regional Health System Cohort, Yordanos M Tiruneh, Susan Mcbride, Huaxin Song, Matthew Decaro, Alaa Rihan, Theresa Byrd, Alex Baham, Jared W Magnani, Elmer V Bernstam, Jarett D Berry

Faculty, Staff and Student Publications

Background: Rural US populations bear a high burden of cardiovascular disease, with hypertension contributing to the rural-urban gap. We examined hypertension prevalence and control across the rural-urban continuum among patients in a large healthcare system in Northeast Texas.

Methods: We analyzed the electronic health record data from 363,539 patients with at least one outpatient encounter between September 2021 and April 2025. We defined hypertension using ICD-10-CM codes, antihypertensive prescriptions, or a blood pressure ≥ 130/80 mm Hg. We classified rurality using the Rural-Urban Commuting Area categories. Multivariable logistic regression models were adjusted for age, sex, race, ethnicity, insurance, and level …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Choline Counteracts Pregnancy Undernutrition-Associated Colitis In Sheep By Restoring Microbiota Driven Bile Acid Metabolism, Weibin Wu, Peng Jiao, Yamei Gu, Huizhen Lu, Caiyun Fan, Zheng Sun, Lizhuang Hao, Shengyong Mao, Jianbo Cheng, Yanfeng Xue

Faculty, Staff and Students Publications

High-fertility sheep experience undernutrition during late gestation, which induces body metabolic disruption and intestinal inflammation. Crucially, the gut microbiota-bile acid axis is a promising intestinal inflammation target, but how choline modulates this axis in livestock enteritis is unknown. This study investigated choline's protective mechanisms against undernutrition-induced intestinal inflammation in sheep, focusing on gut microbiota and bile acid regulation. Choline consistently alleviates colitis severity, restores epithelial barrier integrity, and suppresses intestinal inflammation. These protective effects are accompanied by pronounced remodeling of the colonic microbial ecosystem, characterized by the enrichment of Clostridiales bacterium to elevate bile salt hydrolase activity and regulate bile …

Assessing Growth Faltering Status After Implementation Of A Standardized Advancement Of Home Feeding Regimens Of Infants With Gastrostomy Tubes: A Quality Improvement Initiative, Michael Evers Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Fractured: Improving Screening For Metabolic Bone Disease Of Prematurity In A Level Iv Neonatal Intensive Care Unit, Victoria Aguilar Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Improving Routine Ggt Monitoring In Pediatric Inflammatory Bowel Disease, Scarlett Flaz Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Truth That Lies: How Literal Falsity Lost The Consumer And How To Restore It, Porter Alexander Tynes, Iii

Journal of Intellectual Property Law

The more deceptive the claim, the safer it becomes. Recent false advertising decisions hold that a categorical marketing promise is not literally false so long as it works for someone—even if it fails for ordinary consumers in ordinary use. Under this logic, technical accuracy immunizes practical deception, and truth is measured by theoretical possibility rather than communicative meaning.

This Note argues that this “truth for some” doctrine represents a sharp break from the Lanham Act’s consumer-protection purpose. Decisions such as BPI Sports v. ThermoLife invert the doctrine of literal falsity, transforming it from the Act’s strongest safeguard into a liability …

Using The Uniform For Views: How The Department Of Defense Can Better Protect Its Brand And Image, Maddox Rose

Journal of Intellectual Property Law

Today, the vast majority of American military servicemembers have active personal social media accounts. By creating and posting content online—particularly when in uniform—they run the risk of reflecting poorly on the image of the Department of Defense and their respective branches. Yet, the statutory and regulatory restrictions on content creation are loose and ambiguous. To combat this problem, either the Department and its branches should clarify their regulations, or Congress should amend its statutory protections. There is scholarly disagreement as to whether an entity’s right of publicity is violated when social media content is created that reflects poorly upon that …