Digital Commons Network^™

The Effect Of Hunger On The Likelihood Of Glucose Excursions In Adults With Overweight Or Obesity: Continuous Glucose Monitoring And Ecological Momentary Assessment Observational Study, Byunggul Lim, Phrashiah Githinji, Yue Liao, Jacob Szeszulski, Alexandra L Macmillan Uribe, Rebecca A Seguin-Fowler, Jane Anderson, Chad D Rethorst

Faculty, Staff and Students Publications

Background: Maintaining stable glucose levels is important for metabolic health. Glucose excursions (GEs), which are marked increases in glucose following food intake, have been associated with a higher risk for cardiovascular disease and metabolic dysfunction. Individuals with overweight or obesity who do not have diabetes may still show impaired glucose regulation, as reflected in increased glucose variability. Hunger, as a real-time physiological cue, may be associated with subsequent glucose changes and represents a potential target for just-in-time adaptive interventions.

Objective: This study aimed to investigate the temporal relationship between self-reported hunger and subsequent glucose dynamics, including the likelihood of GE …

Prevalence And Risk Factors Of Surgical Site Infections In Hospitals Across Al Madinah Al Munawwarah, Saudi Arabia: A Retrospective Cohort Study, Atheer M. Aljohani, Danah O. Sandaqji, Rana A. Alahmadi, Raha Z. Ishqi, Manal A. Alanazi, Shouq N. Aloufi, Husain I. Sandugji

Saudi Medical Journal

Objectives: To determine the prevalence of surgical site infection (SSI) and identify associated risk factors in hospitals in Al Madinah Al Munawwarah, Saudi Arabia.

Methods: We conducted a retrospective cohort study of 363 adult surgical patients from major hospitals in Madinah between 2023 and 2024. We analyzed medical records using descriptive statistics, bivariate analysis, and multivariable logistic regression.

Results: The overall SSI rate was 5.2% (95% confidence interval [CI]: 3.3–7.9%). Infection types comprised superficial incisional (57.9%), deep incisional (36.8%), and organ/space infections (5.3%). Significant risk factors included younger age (adjusted odds ratio [aOR] = 0.94 per year, p = 0.014), …

Comparison Of The Effects Of Incubator And Radiant Environments On Physiological Criteria And Pain-Stress Levels During Heel Lance In Neonates In The Neonatal Intensive Care Unit: A Randomized Controlled Trial, Sezin Gürsu, Birsen Karaca Saydam, Oğuzhan Kalkanl\I

Saudi Medical Journal

Objectives: To compare the effects of incubator and radiant heat on physiological criteria and pain-stress levels during heel prick procedures in newborns in the neonatal intensive care unit (NICU).

Methods: This randomized controlled quasi-experimental study was conducted between June and December 2023 with newborns diagnosed with IHB hospitalized at a NICU in Turkey. Prior to the heel prick procedure, 72 newborns (gestational age: 37–41 weeks) were randomly and equally assigned to either a radiant heater or an incubator setting. Physiological parameters (temperature, SpO₂, heart rate [HR]) and pain-stress scores of the newborns were measured and compared in both …

The Impact Of Exercise Intervention On Pulmonary And Physical Function In Patients With Cystic Fibrosis: A Comprehensive Systematic Review, Abdullilah Alghamdi, Muroj Al-Attas, Abrar Radhi, Amnah Alfaqih, Bashair Aljabri, Rawan Alharbi, Sumayyah Alsubaie, Raneem Aljawaied, Sarah Alenazi, Ahlam Mazi, Ebtehal Qulisy

Saudi Medical Journal

Objective: To evaluate the effect of various exercise interventions on lung function, specifically forced expiratory volume in 1 second (FEV₁), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP), as well as on cardiorespiratory fitness (peak oxygen uptake [VO₂peak]), and muscle strength (handgrip strength). The review also considers factors such as patient adherence, follow-up duration, and statistical significance to inform clinical practice.

Methods: This systematic review followed preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines and was prospectively registered in international prospective register of systematic reviews. PubMed, Google Scholar, OVID, and Web of Science …

Pharmacovigilance For Health Management: A National Profile Of Methylphenidate Adverse Events In Thailand Using National Databases, Suwapat Sukthas, Pornpan Soontorntham, Surasak Saokaew

Journal of Health Research

Background: Methylphenidate, a Schedule II psychostimulant, is indicated for ADHD in children ≥6 years when other measures fail, with unclear adult indications beyond narcolepsy. Global use increases necessitate robust pharmacovigilance, especially in low/middle-income countries like Thailand where safety data is sparse. This study characterized methylphenidate-associated adverse events (AEs) in Thailand, analyzing product types and patient factors.

Methods: Spontaneous Thai Vigibase™ reports (2005-2024) were analyzed alongside national distribution data. AEs were MedDRA-coded and stratified by age, sex, indication, formulation (original/generic; immediate/extended-release), allergy history, and comorbidities. Reporting Odds Ratios (RORs) identified safety signals. Serious AEs followed WHO criteria.

Results: Among 424 patients …

A Text Message Health Intervention For Cervical Cancer And Hpv Education And Behavioral Intentions Related To Screening And Vaccination, Carla G. Mercer

Electronic Theses and Dissertations Archive

This study examined the effectiveness of a technology-based educational intervention delivered exclusively through text messaging to increase knowledge of cervical cancer and HPV infection and behavioral intentions to obtain Pap test screening and HPV vaccination. A two-arm randomized controlled trial with a pretest-posttest structure was administered to 33 enrolled college students ages 18–26 years, with 29 participants completing both assessments and included in the final analysis. Participants were randomly assigned to a treatment group, which received a one-week text message-based health intervention, or a control group, which received no intervention. Pretest and posttest surveys evaluated knowledge regarding cervical cancer and …

Best Strategies To Teach Nutrition Courses In Graduate Programs: A Systematic Review, Zeina Hojeij, Suzan Haidar, Rana Rizk, Nadine Mahboub

All Works

Introduction – Graduate-level nutrition education requires innovative teaching strategies that foster advanced clinical competence, professional communication, cultural responsiveness, and self-directed learning. Methods – This systematic review synthesized evidence from fifteen peer-reviewed studies examining diverse teaching strategies in graduate nutrition programs. Results – Most interventions employed simulation-based learning, experiential placements, or flipped classrooms, often incorporating technology such as virtual simulations and online collaborative platforms. Simulation and experiential approaches improved clinical competence, communication skills, empathy, and self-efficacy by providing realistic, hands-on experiences that bridged theoretical knowledge with professional practice. Flipped classrooms, though less frequently implemented, promoted teamwork, problem-solving, and reflective learning, while …

Psychogastroenterology: An Introduction For Behavioral Health And Healthcare Professionals, Jerrod Brown Ph.D., M.A., M.S., M.S., M.S., M.S., M.S., Jeremiah B. Schimp Phd, Ma, Lpcc, Leanne Skehan Dcn, Msacn, Mph, Mba, Cns, Ches, Shelley Mydra Dmft, Lmft, Jonathan Ward Dc, Phd(C), Ms, Dibcn, Tiffany Flaten Cns, Ldn

Nutritional Neurocriminology Today

Although often difficult to discuss with clients, gastrointestinal (GI) issues affect an estimated 60 to 70 million Americans (American Gastroenterological Association, 2022). Yet only about 25% of those experiencing these conditions receive treatment. This is troubling because GI issues frequently co-occur with clinically significant consequences for physical health, psychological well-being, daily functioning, and overall quality of life. Designed for behavioral health and healthcare professionals, this brief article introduces the field of psychogastroenterology, with emphasis on symptoms, stigma, diagnosis, and treatment. Key topics include the gut-brain axis, common digestive health conditions, and the mental health implications associated with gastrointestinal disorders.

Acute And Inpatient Occupational Therapy Practice For People With Chronic Conditions Who Are Experiencing Homelessness, Emily K. Simpson, Anne K. Mokate, Elizabeth A. Gibbs, Nina K. Duric

Internet Journal of Allied Health Sciences and Practice

Purpose: Despite having high rates of chronic illness, people experiencing homelessness (PEH) in the United States face barriers to healthcare access that result in unmet health needs and poor health outcomes.  The objective of the study was to identify the barriers to service experienced by occupational therapy practitioners (OTPs) in acute and inpatient settings in providing services to PEH and to describe education strategies to reduce those barriers. Methods: Researchers employed a cross-sectional design with OTPs (n=292) with experience treating PEH. Results: Barriers to treatment for OTP included lack of education, need to prioritize acute concerns, and inadequate institutional resources. …

Learning From Inexperienced Users’ Early Engagement With Food Tracking, Isil Oygur, Saadet Tikac Andic

DRS Biennial Conference Series

Current food tracking applications are largely designed to support behaviour change among users who track their food intake to meet predefined goals. As a result, individuals who are curious about food tracking but do not have specific goals remain underserved, limiting the potential of these tools for preventive care. To address this gap, we conducted a three-phase interview study using an existing food journaling application as a probe to reimagine food tracking experiences for inexperienced users. Thirty-one participants used the app for 14 days and discussed their views on healthy eating, food practices, and their tracking experiences. Our analysis identified …

Measuring Service-Related Subjective Wellbeing In Paediatric Oncology, Valentina Marques Da Rosa, Priscila Goergen Brust-Renck, Flavio Sanson Fogliatto, Leandro Miletto Tonetto

DRS Biennial Conference Series

Children’s hospitalisation affects more than physical health; it shapes children’s subjective wellbeing (SWB). Yet design researchers rarely systematically capture SWB. This study introduces the Subjective Wellbeing Questionnaire for Hospitalised Children (SWBQ-HC), a tool that measures children’s perceptions of themselves, hospital services, and spaces. Developed by combining validated psychological scales with service- and space-specific items, the tool was piloted with 19 paediatric patients (aged 4–13) and 35 parents. Factor analysis revealed four dimensions: Positive and Negative Feelings about Self, and Feelings about Hospital Services and Spaces. The results highlight the interplay between relational and environmental factors in shaping SWB and reveal …

Exploring How Llms Shape Collaborative Decision-Making In Service Design, Yaoqi Li, Hyunyim Park

DRS Biennial Conference Series

The increasing integration of Large Language Models (LLMs) into design workflows is reshaping how designers make decisions. This study examines the influence of LLMs on design decision-making during the early stages of service design, through a diary study with service design practitioners. By analysing usage logs and conducting post-intervention focus group interviews, we examine collaborative decision-making across three interaction dimensions: designer–designer, designer–LLM, and LLM–LLM. The findings reveal that LLMs reshape the internal decision logic and collaboration mode within service design teams. Across different stages of collaborative decision-making with human, LLMs take on varying roles as apprentice, collaborator, advisor, expert, co-creator, …

More Than Weeds: Thickening Designer-Plant Relations In The Sonoran Desert, Andrew James Whitcomb, Marysol Ortega Pallanez

DRS Biennial Conference Series

Affective relations among humans and more-than-humans are full of shifts, subtleties, and complexities. Yet, design research often treats feelings as stable instruments to utilize for making sustainable climate futures. Through reflection-on-practice, we untangle impressions and gestures in the field during a design research project in the Sonoran Desert titled Gifts for Tempe. Our reflections focus on shifts in our attention and attachments with an ‘invasive’ plant commonly known as Stinknet. The impressions and gestures reveal designer-researchers’ thick tensions in designing for climate futures. By showing how affective relations with more-than-humans change over time, we identify that climate futuring involves learning …

Designing For Self-Tailoring In Adolescent Health Behavior Change, Timothy A. Houtman, Froukje Sleeswijk Visser, Ece Şekerli, Valentijn Visch

DRS Biennial Conference Series

Digital behavior change tools increasingly use system-driven tailoring to guide users toward healthier choices. While well-intentioned, such approaches may undermine autonomous behavior change by removing users from decision-making processes and limiting opportunities to develop self-knowledge: a practical understanding of what works for oneself that can help regulate current and future behaviors. This is particularly consequential for adolescents, who are developing personal autonomy at a time when the health behaviors they establish can have long-term consequences. We propose that self-tailoring can enhance autonomy by actively involving users in constructing and adapting approaches to their own contexts. Through two studies, we investigated …

Educating Inclusive Human Augmentation By Design: A Triadic Definitional Framework And Pedagogical Validation, Keren Zhang, Huiyi Zhang, Ka Wing Tsang, Yijia Jiang, Shiyu Liu, Kin Wai Michael Siu

DRS Biennial Conference Series

Advances in AI, wearables, exoskeletons, and BCIs are driving human augmentation (HA) into everyday use, yet education lacks a design-focused definition, a practical positioning language, and awareness of ethics. This study asks: How should HA be defined for design, and how can a critical, inclusive approach be taught and validated? Based on systematic reviews, we propose a three-part toolkit: a Human–Machine–Environment paradigm that redefines objects and boundaries; a map of design possibilities (dimensions, categories, intervention levels); and ethical dimensions spanning the thing, the human, the environment, and society. We validated the toolkit through three 8–11 week speculative workshops (n=45). Four …

Tangible Conversations For Uncertain Futures: A Design-Led Approach With Families Affected By Multiple Sclerosis, Alison Thomson, Hannah Scott, Ruth Dobson

DRS Biennial Conference Series

Neurological prevention science is gaining traction, with implications for people at raised familial risk of Multiple Sclerosis (MS). We examine how design can intervene in this emerging prevention space through Digesting Science (DS), a co-designed public engagement project that brings families affected by MS together through events and playful, hands-on activities in community settings. We analyse post-event open-ended evaluation forms and a follow up study using auto-photo-elicitation with semi-structured interviews with children and parents. Findings show that DS makes MS discussable without increasing anxiety, embodied activities create shared reference points and language for talking about symptoms, science and uncertainty. We …

Becoming Humus: Embodied Ecological Literacy Through Designing, Ines Weigand

DRS Biennial Conference Series

This paper employs environmental humanities theories through design, translating them into a more-than-human experiential pedagogy. Drawing on Haraway’s (2016) concept of humans as “humus” and Braidotti’s (2013) notion of the subject as embodied and embedded, it presents an approach that uses the human body to cultivate ecological literacy and make ecological relations tangible through personal involvement. In two public workshops, participants produced phosphate fertiliser from their urine, revealing connections between bodily and planetary metabolisms. This linked the biogeochemical flow of phosphorus within the Planetary Boundaries framework (Rockström et al., 2009) to everyday routines, reframing urine from taboo to resource. The …

Contextualising Soil To Soil Textile Production In Aotearoa, Genevieve Rae, Gina Russell, Seonaid Burnie, Ngaio Cowell

DRS Biennial Conference Series

Regenerative textile design begins in the soil, and ends in the oneone (soil). In this paper oneone is described and articulated by Papahoa Fibreworks (Papahoa or the organisation) as their context and guide for designing a textile production system in Aotearoa. The kaupapa (purpose, foundational approach) of context based design, alongside Hua Parakore has led Papahoa to offer organically grown linen, dye plants, and dye services for the local fashion industry. As a case study, Papahoa demonstrates both soil to oneone textile processes in Waitaha (Canterbury) historically, and looks into the future of how fibre production could be remodeled in …

Design For Mending The Rift: Rethinking Sustainable Design From An Eco-Marxist Perspective, Yan Yang, Zhaoyu Wang, Jia Ren, Tie Ji, Han Meng

DRS Biennial Conference Series

Despite the advancement of sustainable design, a critical paradox persists: many practices remain embedded in industrial paradigms, failing to address deep-seated socio-natural contradictions. Grounded in the Eco-Marxist "metabolic rift" framework and informed by recent Agricultural Innovation Design (AID) research, this study proposes a key path for mending these rifts. The research offers a systemic framework for intervening in complex social-ecological systems. The primary conclusions are: (1) metabolic rifts are fundamentally rooted in relational alienation, characterized by the disruption of healthy and reciprocal metabolic relationships between society and nature; (2) structural sustainability requires reshaping metabolic relationships across social, ecological, and intergenerational …

Supporting Mental Health And Wellbeing Through A Staff Home Food-Growing Project, Laura Maclean, Andrew Wodehouse, Frederike Garbe, Mia Shepherd, Sarah Bowyer

DRS Biennial Conference Series

This paper presents a co-designed, nature-based intervention supporting NHS staff wellbeing through food growing. The NHS Home Growing Group (HGG) was collaboratively developed by DesignHOPES, NHS24, and a community garden. Home growing was identified as a feasible and meaningful activity compatible with shift work, with the potential of improving mental wellbeing in line with the NHS’s Five Steps to mental wellbeing model: connect, be active, keep learning, give, and take notice. Following a feasibility study, the 12-week intervention (April–July 2025) engaged 60 NHS staff using windowsill-growing kits designed for flexibility, autonomy, and asynchronous participation. Kits were sustainably sourced through recycled …

Designing Hospitality Through Sensory Workshops For Autistic People With Eating Disordered Behaviour, Sarah Kettley, Kyle Buchan, Abi Pickard, Ellen Maloney, Rebecca Allen, Callum Glasgow, Karri Gillespie-Smith

DRS Biennial Conference Series

We report on a series of sensory workshops and research interview training conducted with young Autistic people with lived experience of eating disordered behaviour. This under-researched co-occurence has been explored by a collaborative of clinical psychologists, peer researchers and participants through creative methods novel in this domain, led by a participatory design researcher. The paper outlines the design of the workshops, and discusses the insights generated around the key themes of environment, eating utensils and foods. It proposes a set of recommendations and creative opportunities for the hospitality industry to explore a range of approaches including ‘Autism-friendly days’ that may …

Should Sustainability Come Second? Artifact Analysis Toward More Positive Outcomes Through Design, Michael C. Kowalski, Jungkyoon Yoon

DRS Biennial Conference Series

While academic research on design for sustainability and design for subjective well-being has grown for decades, application of these perspectives in professional practice remains underdeveloped. Professional designers often struggle to translate these objectives into their work due to conflicting demands, including tight project timelines, cost targets, and manufacturing constraints. Tools and methods developed in academic contexts have faced criticism for failing to consider these practical concerns, resulting in limited professional adoption. Studies indicate professional designers could benefit from concrete case-studies for existing products and systems that clearly demonstrate both processes and outcomes. This paper addresses this need through an artifact-analysis …

Unmaking Ai’S Classificatory Ontologies: Situated Annotation As Design Inquiry In Human–Ai Assemblages, Antonella Autuori

DRS Biennial Conference Series

This paper examines how design research can unmake AI's classificatory ontologies through situated and embodied annotation practices. Drawing on feminist, queer, and critical data epistemologies, it reframes bias not as a technical flaw but as a generative condition that reveals how knowledge is produced and negotiated within human–AI assemblages. An autotheoretical experiment grounds the inquiry. The researcher creates and annotates a dataset of self-representations using subjective, affective, and relational labels, training a small-scale model to probe classification as an interpretive encounter shaped by embodiment, ambiguity, and positionality. Building on the shift from debiasing toward reflexive data practices in design and …

Food Morphology: Food Forms Matter, Pedro Reissig

DRS Biennial Conference Series

This research is guided by the general question: Why do foods have the forms they do, and what is the best form for a particular food? The possible answers are multiple and complex, and involve a mix of factors, starting with ingredients and their transformative technologies, immersed in geographical and cultural contexts, informed by the customs, needs, tastes, and food functions of each place and time. These factors, and the interactions between them, constitute the determinants of a particular food's shape or form. Food morphology is defined by the author as the study of the generation, transformation and reading of …

Cuia Colab: Toward A Design Across Species, Worlds And Relations, Andrea Bandoni

DRS Biennial Conference Series

Cuia Colab emerged from a design research project seeking to explore whether biodesign practices in the Amazon could foster equitable exchanges between traditional knowledge and contemporary design. The research combined theoretical and empirical methods, beginning with a literature review and a case study focused on the cuias of Santarém. Subsequent stages involved active field investigation through observation, collaboration with traditional cuia artisans, biodesign experiments integrating living organisms, and a co-created exhibition. Grounded in a situated, multispecies, and pluriversal approach, Cuia Colab revealed both the challenges and possibilities of establishing ethical and reciprocal relations between design and the Amazonian context. The …

More-Than-Human Self-Tracking: An Uncertain Account Of Urine Monitoring, Protein Excess And Ecological Entanglements, Anton Poikolainen Rosén

DRS Biennial Conference Series

This paper explores self-tracking technologies through a more-than-human lens, focusing on the entanglements between protein consumption, urine monitoring, and environmental care. Using autoethnography, I reflect on the practices of measuring protein and nitrogen in urine as a means to interrogate how personal health data intersect with ecological concerns, particularly nitrogen runoff and its contribution to overfertilization of the Baltic Sea. The account highlights tensions between the precision promised by digital health apps and the uncertainty, messiness, and environmental costs of measuring itself. By mapping nitrogen metabolism across bodies, infrastructures, and the environment, the paper identifies potential points of intervention: dietary …

Inter-Poly-Creation (Ipc): Unifying Mass Customisation And Co-Creation, Hoi Wah Chan, Christopher J. Parker, Darren J. Southee

DRS Biennial Conference Series

To innovate stakeholder value, designers, business strategists, and marketers rely on shared understanding to co-create value. While co-creation is established in strategic design, practitioners use related terms interchangeably, including co-creation and Mass Customisation (MC). While conflicting terminology enables stakeholder participation, resources and knowledge are fragmented, obstructing a unified practice and limiting shared understanding of value creation. This paper clarifies co-creation and MC terms, explains why practitioners interchange terminology, and examines how stakeholder value and disciplinary perspectives shape their usage. We analysed 828 academic papers across the design, business, and innovation disciplines, focusing on commonly confused lexicons. We reveal that designers, …

Age-Ready Suburbia: Designing Distributed Care And Housing Transitions For Longevity, Kaicheng Zhuang, Minghao Du

DRS Biennial Conference Series

This thesis reimagines the aging U.S. suburb as a site of transition, where single-family housing can evolve into distributed care infrastructure supporting longevity and community well-being. Through onsite research in Sacramento and collaboration with local care providers, the project develops a scalable framework for retrofitting suburban homes into neighborhood-based care hubs connected by shared food, mobility, and caregiver networks. Integrating architectural transformation, service design, and participatory co-design methods, it proposes a systemic approach that bridges individual housing adaptation with urban-scale resilience. Rather than pursuing technological “smartness,” the model advances a human-centered LongevityTech vision,where design mediates between housing, health, and social …

The Intrusive Sounds Of Resilence., Andrea Cera, Georgios Loupas, Eleftheria Lagiokapa, Nefeli Valeria Georgakopoulou, Sotiris Diplaris, Stefanos Vrochidis, Eleonora Ceccaldi, Nicola Corbellini, Simone Ghisio, Antonio Camurri

DRS Biennial Conference Series

In a ReSilence (S+T+Arts) residency dedicated to the consequences of urban soundscapes on human movement, 36 sound-files and their spectral analyses were considered as examples of auditory intrusiveness (intended as a pre-conscious effect, anticipating conscious behaviors). These 36 sounds were used in three modules: a pilot experiment to study the influence of auditory intrusiveness on human movement; an installation, where the sound-files were triggered by the participants' movement qualities – moreover, their spectral analyses served as prompts to an image-generating GAN network; in the design of a smartphone app, where the 36 analyses allowed to study the spectral features to …

Designing For Food System Transformation: Navigating Cultural Complexity In Cross-Regional Platform Design, Margherita Motta, Sebastian Baez-Lugo, Luis Rodriguez Aguayo, Laura Deschl, Nicolas Henchoz, Emily Groves

DRS Biennial Conference Series

This paper examines the design of a digital platform supporting sustainable food transformation across six European regional Hubs. Through multi-phase participatory evaluation involving contextual inquiry across culturally diverse contexts, responsive redesign, and formal usability testing, we identify a fundamental tension between technical standardization and cultural adaptation. While formal metrics demonstrated strong usability and aesthetic appeal of our platform design, Hub-based evaluation revealed that participants' requests for regional adaptation such as representing traditional production methods, biodiversity, and place-specific sustainability logics challenged fundamental platform assumptions about capturing food knowledge in standardized structures. We articulate emergent design principles including minimizing barriers while maintaining …