Digital Commons Network^™

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 – …

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.

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 …

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 …

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 …

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 …

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.

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.

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 …

Effects Of Water Stress On Herbage Quality, J R. Wilson

IGC Proceedings (1977-2023)

Uncertainty exists about whether drought is detrimental to the nutritive quality of herbage. This paper tries to resolve this uncertainty by examining the influence of soil moisture on some herbage-quality characteristics. Unpublished data from my own work and review of published literature are presented. Field plots of three tropical grasses, green panic (Panicum maximum var. trichoglume), buffelgrass (Cenchrus ciliaris), and speargrass (Heteropogon contortus), were subjected to perioqs of controlled drought, and herbage from these plots was compared with that from well-watered plots. Leaf and stem dry-matter ?igestibility of water-stressed herbage was either similar to or higher than that of unstressed …

A Descriptive Scheme For Stages Of Development In Perennial Forage Grasses, U Simon, B H. Park

IGC Proceedings (1977-2023)

A descriptive scheme of morphological stages of development in forage grasses is urgently needed for scientific investigations as well as for practical purposes. It could be used for precise timing of management measures, such as application of fertilizers and herbicides, and in harvesting with respect to a certain level of forage yield and/or quality. Existing schemes, like the Feekes scale and its modifications, were devised for cereals. They do not adequately consider the peculiar stages of development of perennial grasses grown for forage. We propose a scheme that consists of consecutive stages of the following phases of plant development: number …

Pasture Evaluation In The Desertic Zone Of Venezuela For The Development Of Goat Production, A Gallardo, A Leone

IGC Proceedings (1977-2023)

The desertic zone of Venezuela is an area of approximately 4.1 million ha that represents 4.8 % of the total national territory, on which there are two million goats. Goats represent the main, if not the only, income source for 60,000 rural families. According to UNESCO (1973), the desertic zone of the country comprises two vegetation types, evergreen scrub and deciduous scrub. In each of these zones the plant species consumed by goats were collected and, for those plant parts consumed by the animals, chemically analyzed to determine nutritive value. Forage plants from other tropical countries were also in­troduced and …

Nutritional Quality Of Leaf Proteins Prepared From Crops Containing Phenolic Compounds And Polyphenolase, T Horigome, S Uchida

IGC Proceedings (1977-2023)

Many studies have indicated that leaf protein prepared by green crop fractionation affords good potential as a protein supple­ment. It has been noted, however, that there were some marked differences between crops in the nutritional quality ofleaf pro­tein in spite of a similarity in amino-acid composition between leaf proteins made from different crops. We previously showed that brown casein, which was produced by the interaction of milk casein with phenolics undergoing enzymic oxidation, had lower nutritional value than original casein. In addition, it has been suggested that leaf proteins prepared from crops containing phenolics and polyphenolase were brown after extraction …

Physiological And Morphological Advances For Forage Improvement, J P. Cooper

IGC Proceedings (1977-2023)

Forage production basically involves the conversion of environmental inputs to provide digestible energy and other nutrients for ruminant livestock. The plant breeder needs to consider the seasonal inputs or constraints in his particular environment, the efficiency of the crop in responding to these factors, those features of the plant that contribute to this efficiency, and the degree to which those features can be modified by selection and breeding. Forage production basically involves the conversion of environmental inputs to provide digestible energy and other nutrients for ruminant livestock. The plant breeder needs to consider the seasonal inputs or constraints in his …

Potential Productivity Of Temperate And Tropical Grassland Systems, G O. Mott

IGC Proceedings (1977-2023)

Grasses of temperate regions of the world belong primarily to the subfamily Festucoideae, whereas tropical regions are populated by tribes of the Panicoideae subfamily. Temperate grasses have a C3 biochemical pathway of photosynthesis in con­trast to tropical grasses, which have a C4 photosynthetic mechan-ism. Both tropical and temperate legumes are C3 plants. Com­patible mixtures of legumes and grasses have long been successful in many temperate regions, but combining C4 grasses and C3 legumes as mixtures in the tropics has been only moderately successful. Maximum net primary productions of temperate and tropical grasslands are in the order of 25 and 80 …

Forage Quality: Assessing The Plant-Animal Complex, D J. Minson

IGC Proceedings (1977-2023)

At the VI International Grassland Congress held at Pennsylvania State College in 1952, the late Dr. C.P. McMeekan re­viewed the many problems associated with the plant-animal complex. Great stress was placed on the need to measure forage in­take accurately as a prerequisite to an under-standing of the plant-animal complex. Progress in the development of more accurate :methods of estimating the forage intake of grazing animals is reviewed, in­cluding the introduction of different methods of administering chromic oxide, the esophageal fistula for obtaining samples of selectively grazed material, the in-vitro technique for estimating the digestibility of the forage eaten, and the …

Gastrointestinal Symptoms After Sport-Related Concussion: Prevalence And Patterns In A Multi-Cohort Analysis, Emma Finnegan, Ed Daly, Katherine J. Hunzinger, Lisa Ryan

Department of Exercise Science Faculty Papers

Background/Objectives: Concussions occur across all sports globally; however, inconsistent symptom recognition continues to challenge diagnosis, management, and recovery. Although concussion effects extend beyond neurological dysfunction, gastrointestinal (GI) symptoms remain insufficiently captured within current assessment frameworks and may influence athletes’ fuelling choices and food tolerance during recovery. This study aimed to describe the prevalence and patterns of GI symptoms reported among athletes with a history of concussion and to explore whether symptom prevalence and burden differed by sex and country. Methods: A total of 401 adult athletes (225 males; mean age 32.4 ± 11.3 years) with a history of concussion were …

Assessing Impact Of Heat Waves On Pregnancy And Lactation Amidst Climate Change: A Scoping Review., Susan Anyango, Grace Nakate

School of Nursing & Midwifery, East Africa

Background: The escalation of heat waves, attributed to climate change, represents a global public health concern, with pregnant
and lactating women identified as particularly vulnerable due to Physiological and hormonal changes.

Aim: To review the existing research on the effects of heat waves on pregnancy and lactation, identifying potential health risks and outcomes.

Methods: A structured search across PubMed, Scopus, Web of Science, and Google Scholar was conducted using terms related
to heat waves, pregnancy, lactation, and climate change. Inclusion criteria focused on peer-reviewed empirical
studies in English.

Results: Heat waves are linked to increased risks of preterm labor, low …

Determination Of Pb(Ii) Ion With A Novel, Highly Efficient Immobilized Arsenazo Iii In A Polymer Matrix, Kholboeva Muyassar, Smanova Zulayho, Madatov O`Tkir, Yusupov Boburjon, Abror Nomozov, Sobirova Fotima, Jalilov Fazliddin, Daminov Oybek

Baghdad Science Journal

In this study, a novel analytical reagent based on arsenazo III immobilized on a polymer matrix composed of polyacrylonitrile, polyethylene polyamine, and dichloroethane (PPD) was developed and applied for the spectrophotometric determination of Pb(II) ions. The proposed method demonstrated standard analytical and metrological characteristics for the highly accurate determination of Pb(II) ions, as evidenced by a relative standard deviation (Sr) of 0.06 and a minimum detectable concentration (C_min) of 0.24 μ g/L. The accuracy and reproducibility of the method were evaluated using Student's t-test and Fisher's F-test. Comparison of the experimental and tabulated values (experiment=1.09; t …

Associations Among Pork Intake, Weight-Loss, And Diet Quality Outcomes In A Commercial Weight-Management Program, Ana M Palacios, Grace Anderson, Beate Henschel, Alexandra M Lee, Kelli M Richardson, Chelsie Parker, Stephanie L Dickinson, Jing X Kersey, David B Allison, Gary D Foster, Michelle I Cardel

Faculty, Staff and Students Publications

Background: Pork is a common source of high-quality protein. However, it is typically recommended in moderation due to its saturated fat content, especially as its role in weight management, weight-loss (WL) programs, and overall diet quality is not well understood. This study aimed to identify associations among pork intake, WL, and diet quality among adults with overweight or obesity participating in a weight management program (WMP).

Methods: This secondary analysis used data from a 6-month randomized controlled trial (NCT05648344) evaluating the effectiveness of a WMP on diet quality. Data were collected through online surveys and the Automated Self-Administered …