Digital Commons Network^™

Mental Health And Art Adherence In A Multisite International Study: The Mediating Roles Of Social Support And Substance Use In People With Hiv, Joseph Awad, Wenxiu Sun, Diane Santa Maria, Rebecca Schnall, Panta Apiruknapanond, Tongyao Wang, Claudia Patricia Valencia, Christine Horvat Davey, Solymar Solis Baez, Sheila Shaibu

School of Nursing & Midwifery, East Africa

ART adherence, essential to preventing disease progression for people living with HIV (PLHIV), remains challenged by factors like poor mental health condition, insufficient social support, and substance use. This study investigates the roles of social support and substance use as mediators in the relationship between mental health and antiretroviral therapy (ART) adherence among PLHIV in a multisite, international context. Cross-sectional data from N = 1598 PLHIV across eight countries were analyzed using parallel mediation analyses in R. Results indicated that both social support and substance use independently mediated the relationship between mental health and ART adherence. Hallucinogens mediated the mental …

Formal And Informal Digital Health In Tanzania: Healthcare Workforce, Regulatory And Trust Implications Of E-Patients And Virtual Care And The Development Of The Trust Framework, Kahabi Isangula, Judith Keebisilo Leo, James Tumaini Kengia

School of Nursing & Midwifery, East Africa

Digital health and virtual care are increasingly reshaping how healthcare is organized, delivered, and experienced. In Tanzania, digital transformation is evident in national commitments to digital health governance, health information exchange, hospital information systems, digital referral and emergency transportation, telemedicine, and emerging diagnostic applications supported by artificial intelligence. At the same time, patients are increasingly using social media, mobile platforms, and other digital channels to seek health information, consultations, diagnoses, and medicines, creating new forms of digitally mediated care that often operate alongside formal healthcare systems. Using a narrative synthesis design informed by a practice-based perspective, this study reviewed policy …

Development And Application Of Lc-Ms/Ms Methods For The Determination Of Environmental Contaminants, Mawuli Wilson-Cee Macdonald

Electronic Theses and Dissertations

Environmental contaminants such as neonicotinoids and bisphenols are increasingly detected at ultratrace concentrations in environmental and consumer matrices, necessitating sensitive and efficient analytical methodologies. This dissertation presents the development, validation, and application of liquid chromatography–tandem mass spectrometry (LC–MS/MS) methods coupled with simplified sample preparation techniques. In Chapter 2, a direct aqueous injection (DAI) LC–MS/MS method was developed for the analysis of five neonicotinoids in surface water, eliminating extensive sample preparation. The method demonstrated strong linearity (R² = 0.993–0.998), with limits of detection (LOD) ranging from 0.5 to 4 ng/L and lower limits of quantification (LLOQ) of 10–50 ng/L. Accuracy (80–120%) …

Aging With A Chronic Illness: Symptom Burden, Everyday Challenges, And Quality Of Life Among Older Adults With Multiple Sclerosis, Swasati Handique

Social Work Dissertations

This three-article study examined the quality of life and everyday lived experience of older adults living with multiple sclerosis (MS). The first article is a scoping review of 14 peer-reviewed studies published between 2012 and 2025, conducted in accordance with Arksey and O’Malley’s five-stage framework and the PRISMA checklist. The second article is a cross-sectional study using the Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) Phase II data set of 60 older adults living with MS. Multiple linear regression and moderation analysis was conducted to examine the association between physical symptom burden and quality of life, and whether participation …

Called To Lead: Leadership Journeys And Workplace Experiences Of Women Presidents In Seventh-Day Adventist Institutions, Gary Thurber

Dissertations

Problem

Although women constitute more than half of Seventh-day Adventist Church membership, they remain substantially underrepresented in senior leadership roles across North America. This disparity raises important questions about the historical, theological, organizational, and gender-related factors that shape women’s access to institutional leadership within the denomination. A growing body of scholarship has examined the life experiences of women clergy in the church; however, limited research has explored the experiences of women serving in presidential leadership roles within Seventh-day Adventist institutions.

Purpose

The purpose of this study was to understand and describe the experiences of women serving in presidential leadership roles …

The Financial Effects Of Clinically Significant Readmissions In Florida Hospitals, Brian Patrick Cotton

Doctor of Business Administration Dissertations

This study examines how the financial performance of hospitals in the state of Florida impacts the quality of care. This study used data from 2017-2019 to evaluate how the number of hospital readmissions – a proxy for care quality – are associated with and vary in relation to the stability of the financial resources held by the hospital. The Hospital Readmission Reduction Program (HRRP), a Medicare value-based purchasing program, uses a mandatory pay-for-performance process that was initiated to decrease the 30-day hospital readmission rate. Hospitals with high readmissions are held accountable and financially encouraged to increase their quality of care …

Helping Nurses To ‘Get Their Good Work Out There’, Lori Grischott Msn, Rn, Nea-Bc, Npd-Bc, Rnc-Ob, Lauren Souchak Msn, Rn, Bea-Bc

Patient Care Services / Nursing

No abstract provided.

From Coverage To Care: Evaluating The Effects Of Aca Medicaid Expansion On Birth Outcomes, Bailey R. Lengfelder

Economics Honors Projects

I examine the impact of the Affordable Care Act’s Medicaid expansion on maternal and fetal health outcomes using National Center for Health Statistics Natality data from 2006 to 2023. I exploit staggered state adoption as a quasi-experiment, and the staggered differences-in-differences estimates indicate an increase in the share of Medicaid births but broadly no impact on maternal prenatal care, maternal health, and fetal health. The absence of statistically significant effects is consistent across heterogeneity groups. These null findings indicate that expanded insurance access through the Affordable Care Act may be insufficient to improve health outcomes. I do find a statistically …

Illuminating The Errors Of State V. Muñoz And The Curtailment Of Due Process Rights When A U.S. Citizen Is Married To A Noncitizen, Kavya Mahesh

Minnesota Journal of Law & Inequality

No abstract provided.

Cultivating Positive Emotion Through Gratitude: A Mixed-Methods Study Of World Language Teachers, Allyson Magrath Power

Doctor of Education (Ed.D.)

Teacher well-being is an increasingly urgent concern, particularly in shortage-area subjects such as World Languages. This study examined whether a structured gratitude intervention could support the well-being and resilience of World Language teachers. Using a convergent mixed-methods design, the study collected quantitative and qualitative data from participants who completed weekly gratitude journaling across four themes: Acknowledgment, Attention, Appreciation, and Action. Quantitative findings revealed a positive trend on the Gratitude Questionnaire, with results approaching statistical significance, suggesting a meaningful improvement in participants’ positive emotions. Qualitative analysis indicated increased emotional awareness, more intentional self-care practices, and greater reflection on supportive relationships in …

Prepregnancy Overweight And Obesity In Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Eelaf A. Husain, Maryam M.Y. Mohammad, Maryem A. Shamsah, Noor Salah Alali, Reem Sharaf-Alddin, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: This study aimed to estimate the prevalence of prepregnancy obesity and overweight, and to identify a set of sociodemographic factors that could guide weight management interventions for women prior to conception.

Design, Sample, and Measurements: Pregnant women (N = 989) were recruited in the Kuwait Birth Cohort Study during the period June 2017 to February 2020. Prepregnancy weight and height were self-reported, while current weight and height were measured in a standardized procedure. Data on sociodemographic factors were collected through face-to-face interviews conducted by a trained data collector. Multinomial logistic regression was used to investigate the association between sociodemographic …

A Cross-Sectional Study Investigating The Relationship Between The Fto Gene Polymorphism In Relation To Obesity Traits And Vitamin D Status In Adolescence, Ahmad Al-Serri, Rabeah A. Al-Temaimi, Abdullah Al-Taiar, Lemia Shaban, Reem Al-Sabah, Abdur Rahman, Ali H. Ziyab

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background and Objective: Obesity affects 18%-25% of adolescents globally and represents a major public health challenge. Genetic factors contribute to obesity susceptibility, with the FTO gene variant rs9939609 consistently associated with obesity in adults; however, evidence in adolescents is limited. This study examined the association between FTO and obesity traits in adolescents and explored potential interactions with vitamin D status.

Methods: In this cross-sectional study, 509 adolescents aged 10-15 years were genotyped for FTO rs9939609. Obesity traits, including BMI, BMI z-score, and waist circumference, were assessed. Associations with genotype were analyzed using an additive genetic model, and potential interactions with …

A Critical Perspective On The Society Of Environmental Toxicology And Chemistry's Adherence To Founding Principles— Opportunities For The Future, Barnett A. Rattner, Annegaaike Leopold, Carys L. Mitchelmore, Glenn W. Suter, Mark S. Johnson, Adriana C. Bejarano, Lawrence A. Kapustka, Niranjana Krishnan, Derek C. G. Muir, Beatrice O. Opeolu, Martha Georgina Orozco-Medina, April Reed, Bruce W. Vigon, Adam R. Wronski

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

The Society of Environmental Toxicology and Chemistry (SETAC) is a global organization whose mission is the advancement of environmental science and management through collaboration, leadership, communication and education. On SETAC's 45th anniversary, the following question was raised: Are the 1979 founding principles of SETAC, multidisciplinary approaches to solving environmental problems, multisector engagement and scientific objectivity, still useful, adequate and effective in fulfilling its mission? In a special session held at the 45th Annual Meeting in Fort Worth, Texas, United States, a critical evaluation of the founding principles was initiated by reviewing SETAC's history and ongoing activities, and recommendations were made …

Spectral Frequency And Broadband Noise Analysis Of The Firefighter Environment: Potential Implications For Cardiac Health, James Blando, Catherine Reed, Amya Turner

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Firefighters are well known to have elevated risk of adverse health outcomes across a wide range of diseases and injuries, including cancer, hearing loss, fatal cardiac events, post-traumatic stress disorder (PTSD), sleep disorders, and many other adverse outcomes. It has been speculated that the noise environment is a significant risk factor for several of these diseases. In particular, the impact of noise on cardiac outcomes has recently been identified. An environmental survey of noise that included spectral and broadband analysis was conducted across all 14 firehouses in a southeastern city in the United States as a first step to investigate …

Characteristics Of Women Who Fast During Pregnancy: Findings From The Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Reem Al Sabah, Ahmed N. Albatineh, James Blando, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Fasting during pregnancy is a widespread practice in Muslim communities, yet its health implications remain poorly understood. A lack of conceptual frameworks and limited understanding of the characteristics of women who fast during pregnancy have hindered research in this area. This study examines the differences in several nutritional biomarkers between women who fasted and those who did not and identifies factors associated with fasting behaviour. We analysed data from the Kuwait Birth Cohort in which information on fasting, sociodemographic characteristics and health behaviours was collected via structured interviews between 2017 and 2021. Clinical and laboratory data were extracted from medical …

Examining The Association Of Maternal Oral Health Experiences With Adverse Birth Outcomes: Findings From Virginia's Prams Survey, May Salama, Abdullah Al-Taiar, Denise C. Mckinney, Li-Wu Chen, Anwar T. Merchant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Preterm birth (PTB) and low birth weight (LBW) are significant public health challenges globally, contributing to neonatal morbidity, mortality, and long-term complications. Maternal oral health has been increasingly recognized as a potential contributor to PTB and LBW, yet there is inconclusive evidence about the effectiveness of dental cleaning in preventing PTB and LBW. This study examined the association between dental cleaning during pregnancy and the prevalence of PTB and LBW using data from the Virginia Pregnancy Risk Assessment Monitoring System (PRAMS).

Methods

We analyzed data from Virginia PRAMS Phases 7 and 8, spanning a 10-year period from 2012 to …

Paneugenesis: A Regenerative Systems Hypothesis For Advancing Health Promotion, Craig M. Becker, Leslie Hoglund, Beth Chaney, Joseph G. L. Lee, Michael Stellefson, Alex Davis

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Despite major advances in health promotion science, dominant approaches remain largely prevention-and risk-reduction-oriented. The prevailing orientation creates a substantial opportunity to advance generative, system-design strategies that intentionally produce well-being rather than merely prevent disease. This article proposes paneugenesis as a regenerative systems framework and a testable theoretical model for the intentional creation of net-positive outcomes, thereby extending health promotion beyond its traditional pathogenic emphasis. Paneugenesis integrates systems science, salutogenesis, behavioral science, complexity theory, and quality management principles into a unified four-function process: operationalizing idealized outcomes, identifying key precursors, optimizing processes, and continually plotting progress through feedback mechanisms. The central hypothesis …

Prevalence Of Dengue Infection In Bangladesh: A Systematic Review And Meta-Analysis, Md. Estiar Rahman, Abdullah Al-Taiar, May Salama, Michele A. Kekeh, Ahmed N. Albatineh

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective: 

To estimate the pooled prevalence of dengue infection in Bangladesh.

Methods:

Literature search was conducted across PubMed, Web of Science, and Hinari between December 2024 and April 2025, supplemented by references searching. The Joanna Briggs Institute checklist was used for evaluating study quality. A random effects meta-analysis of proportion, including subgroup analyses, was performed with R software (version 4.5.1).

Results:

Out of 2 087 records, 28 studies were included. The pooled prevalence of confirmed dengue infection among clinically suspected patients was 49.3% (95% Cl 36.1-62.6), with a significant high heterogeneity (I²=99.2%, τ²=1.81, P< 0.001). Stratified analysis showed a pooled prevalence of 47.9% (95% Cl 34.0-62.2, I2=99.1%, …

First-Job Contract Review Cheat Sheet, Johanna Jones-Morris, Ashlee Martellacci

Teaching and Learning Resources

This cheat sheet helps first-time employees understand what to review before signing an employment contract. It highlights job duties, compensation, scheduling, employment terms, benefits, restrictive clauses, worker classification, and common red flags so that individuals can ask informed questions and recognize potentially unfair or unclear terms.

Pay Stub Decoding Guide, Johanna Jones-Morris, Ashlee Martellacci

Teaching and Learning Resources

This guide explains the primary sections of a pay stub and helps employees understand how their earnings and take-home pay are calculated. Using a sample format, it reviews employee and pay-period information, regular and overtime earnings, deductions, year-to-date totals, and net pay while encouraging workers to check their records for accuracy.

Centering Community Concerns And Recommendations Amid Rapid Policy Changes: Impacts On Social Protection, Well-Being, And Health Access, Kriti Vashisht

School of Social Work Faculty Publications

Rapidly evolving policies on gender identity and expression have highlighted a wide range of public and political perspectives on whether to limit or support demands for gender identification and healthcare services for the LGBTQ+ community. Due to the rise in these pro and against narratives and incidents, there were increased protection risks for this group. Scholars and practitioners working closely with LGBTQ+ members are witnessing increased distress and concerns among them, creating further barriers to care and heightened stigma. This is why community-based scholars and educators initiated an open consultation to create a non-partisan space for dialogue, reflection, and learning …

Convergence Of Social Justice, Human Rights, And Artificial Intelligence (Ai), Sudershan Pasupuleti, Urmila Yadav, Susheelabai R. Srinivasa

School of Social Work Faculty Publications

Artificial Intelligence and large data machine learning are transforming many areas, including healthcare, economic, political, and educational social institutions, at their best. Artificial intelligence can also be offered the moral and legal potential to safeguard human rights and social justice in society. For instance, human rights organizations scan public domain images for evidence of abuse, or software uses adversarial techniques to reduce bias in training data. At best, some organizations and businesses are tackling these challenges in a proactive manner, looking for methods to make sure they avoid or identify concerns before they arise; for others, this may be a …

Parents’ Perspectives On Trajectories Of Well-Being For Immigrant Youth From Central America., Tatiana Londoño, Lauren E. Gulbas, Luis H. Zayas

School of Social Work Faculty Publications

This study explored the trajectories of well-being among immigrant youth in the United States using an ecodevelopmental and posttraumatic growth perspective. Immigrant youth were from the Northern Triangle of Central America and had recently been released from immigration family detention in the United States. Through time-ordered matrix thematic analysis of interviews with 15 mothers at baseline and follow-up (N = 30 interviews), the research revealed a complex landscape of challenges and adaptations during resettlement. While initial adverse emotional outcomes were common, these tended to improve over time as families gained stability in the United States. Family structure emerged as …

Behind The Curtain: A Literature Review Of Personal And Ecological Risk Factors And Current Multi-Level Interventions For Performing Artists, Christopher A. Robles

Social Work Theses

Performing artists experience psychological distress, including anxiety, depression, burnout, and substance use disorders, at rates significantly exceeding those of the general population. Guided by Bronfenbrenner’s Ecological Systems Theory (EST) and the Person-in-Environment (PIE) perspective, this structured literature review synthesizes research published between 2010 and 2026 to examine individual personality traits, environmental stressors across meso- and macro-systems, and existing multi-level mental health interventions for performing artists. Findings reveal that while traits such as high openness to experience, sensory processing sensitivity, and perfectionism foster artistic expression, they also heighten vulnerability to occupational stressors, financial precarity, social isolation, and venue-based substance exposure. Current …

A Multi-Case Qualitative Study Exploring Counseling Skills Courses For The Presence Of The Practice Of Counselor Reflexivity, Timothy Marlin Olsen

Graduate Research Theses & Dissertations

Counselor reflexivity is an integral component of the skill set and professional identity of the effective counselor. However, counseling skills and methods courses often do not include the teaching of this practice within their curriculum of valuable counseling techniques. Further, there also exists a gap in scholarly counseling literature about counselor reflexivity. Through this qualitative multi-case study of five counseling skills/counseling methods courses I sought to discover if counselor educators understood and subsequently taught this practice which seems to be underrepresented in such courses. First, through a review of supporting literature my study revealed no clear delineation of counselor reflexivity …

The Current State Of Behavioral Health Curriculum Within Professional Athletic Training Programs, Bethany R. Rohl

Graduate Research Theses & Dissertations

Behavioral health concerns among adolescents and young adults have increased in recent years, placing greater expectations on athletic trainers (ATs) to recognize and respond to these conditions in clinical practice. Although accreditation standards require behavioral health competencies within professional athletic training education, variability may exist in how faculty are prepared to teach this content. This study examined athletic training faculty preparation for teaching behavioral health, how programs implement and assess behavioral health content, and faculty perceptions of student satisfaction with behavioral health education.

Consensual qualitative research method was used. Eleven athletic training faculty (9 females, 2 males; age = 37.91 …

Management-Driven Shifts In The Bison Fecal Microbiome And Its Relationship To Stec Prevalence, Ritesh Ray

Graduate Research Theses & Dissertations

Contamination of meat samples from pathogens such as Shiga toxin-producing E. coli (STEC), especially in ruminants, is an ever-growing issue for the safety of global meat production. Recent studies have reported STEC in the livestock and food industry with a limited focus on wildlife. Although cattle serve as the primary reservoir for STEC, American bison (Bison bison bison) is the largest ruminant inhabiting North America, sharing similar genetics, and grazing habits, making them an ideal alternative STEC reservoir. Re-introduction for prairie conservation and meat farming has brought bison herds closer to anthropic environments than before. Recently bison meat has become …

Empowering State-Level Multilingual Education Leaders: Harnessing Generative Artificial Intelligence For Program Administration, Geqigula M. Dlamini

University of the Pacific Theses and Dissertations

This study aimed to understand how generative artificial intelligence could empower program staff at the California Department of Education (CDE) who support state-level multilingual programs by providing training and opportunities to review existing practices and identify promising use cases. With limited fiscal and personnel resources, state program staff had to rethink and intentionally consider how to enhance their own capacity to keep program momentum and support practitioners in the growth area of multilingual education.

With empowerment theory as the theoretical framework, this qualitative, participatory action research study involved 11 members of the Multilingual Support Division at the CDE. These co-researchers …

Exploring The Impact Of Social Identity-Based Support Groups On Students' Sense Of Belonging In Higher Education, Jasmine D. Patel

University of the Pacific Theses and Dissertations

Students who hold marginalized social identities report experiencing a lower sense of belonging at their institutions of higher education than their peers. A low sense of belonging has in turn been linked to lower academic performance, lower scores on mental health and well-being measures, and lower rates of degree completion. Utilizing a mixed method approach, this researcher examines the experiences of students who participated in a social identity-based support group intervention intended to improve the sense of belonging of students who hold marginalized social identities. Eight university students participated in the support group intervention over the course of one academic …

(Critical) Hope As An Arrow: A Mixed Methods Study On Student-To-School Counselor Ratios And Student Outcomes In High-Poverty School Districts, Hien Pham

University of the Pacific Theses and Dissertations

School counselors serve on the front line of student support in K-12 public school settings. However, not all school districts are adequately resourced nor require school counselors as essential members of the school team. Review of extant literature found that school counselors’ service delivery is affected by issues related to role clarity, program evaluation and existing policy. A lack of understanding of school counselors’ work and inconsistent training in program evaluation hinders the implementation of a comprehensive school counseling program, with high student-to-school counselor ratios remaining the status quo. In California, the Local Control Funding Formula (LCFF) legislation holds local …