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Examining The Relationship Of Work Stressors And Resilience Among Inpatient Oncology Nurses: A Cross-Sectional Study:, Blanca Melida Vasquez-Clarfield Apr 2026

Examining The Relationship Of Work Stressors And Resilience Among Inpatient Oncology Nurses: A Cross-Sectional Study:, Blanca Melida Vasquez-Clarfield

Theses & Dissertations

Burnout among inpatient oncology nurses remains a concern in a specialty marked by high patient acuity, complex care regimens, emotional intensity, and repeated exposure to suffering and death. Resilience is often discussed as a protective resource in nursing, yet less is known about how personal resilience and work resilience relate to work stress and burnout within inpatient oncology practice. This study examined the relationships among perceived work stress, personal resilience, work resilience, and burnout among registered nurses working in inpatient oncology units. It also explored whether selected nurse characteristics were associated with these variables and how nurses described workplace stressors, …


A Market Of Care Skills: Profiting From Professional Education And Practice, Yasmin Y. Ortiga Apr 2026

A Market Of Care Skills: Profiting From Professional Education And Practice, Yasmin Y. Ortiga

Research Collection School of Social Sciences

Who profits from the commodification of care and how does such accumulation occur? Focusing on the case of the nursing care market, this paper shows how professional schools and local hospitals within source nations like the Philippines profit from nurses seeking the credentials to qualify for jobs overseas. While existing studies show how nursing skills are exploited and undervalued, this paper argues that it is the process of skilling itself that allows for the accumulation of profit, regardless of whether nurses leave their origin countries to work abroad. This study reveals how global care economies are tightly linked to local …


Eagle-Winged Worms: Seeing Contingent Faculty Through Currere, Nicholas Hayes Apr 2026

Eagle-Winged Worms: Seeing Contingent Faculty Through Currere, Nicholas Hayes

Theses and Dissertations from DePaul University

This currere explores my experiences as part-time contingent faculty working at multiple institutions (a so-called freeway flyer). Covering the years from 2005-2015, the regressive mode draws from my experiences teaching writing composition and literature at a community college, arts college, and three religious universities. A central impetus for this exploration is a desire to understand the ways I was socialized by these institutions and how that socialization shaped my understanding of my identity within and through my status as contingent faculty. Higher education (especially first-year writing programs) has become dependent on contingent faculty. The increased reliance on part-time contingent faculty …


The Unspoken Struggles And Unseen Strength: An Autoethnographic Exploration Of Single Motherhood In Higher Education, Alexis Summer Gunartt Apr 2026

The Unspoken Struggles And Unseen Strength: An Autoethnographic Exploration Of Single Motherhood In Higher Education, Alexis Summer Gunartt

Theses and Dissertations from DePaul University

Despite the social, economic, and generational benefits of degree attainment, single mothers remain underrepresented in higher education. This autoethnographic research explores the lived experiences of single mothers as they navigate higher education. Guided by feminist theory and critical perspectives on higher education, this study examines how power, gendered expectations, and institutional structures shape single mothers’ academic experiences and persistence. As a single mother myself, I draw from personal narrative along with narrative interviews from other single mothers engaged in higher education, this study examines how financial strain, childcare challenges, institutional inflexibility, and cultural norms shape educational persistence. Using autoethnography as …


The Perceptions Of Early Adolescents: Academic Stressors Within Under-Resourced Schools, Problem Solving, And Important Adults, Aliyah White Apr 2026

The Perceptions Of Early Adolescents: Academic Stressors Within Under-Resourced Schools, Problem Solving, And Important Adults, Aliyah White

Theses and Dissertations from DePaul University

Early adolescence is marked by increasing academic demands and the growing need for effective coping strategies. The present study examined early adolescents’ perceptions of academic stressors, use of primary control coping mechanisms, and identification of important related and unrelated adults within their lives. Participants included 96 youth ages 10-14 recruited from Chicago Public Schools in under-resourced South Side communities. Results indicated that youth reported substantial exposure to academic stressors, including teachers yelling, difficulties understanding coursework, and pressure to perform well academically. Findings revealed a significant decrease in the use of primary control coping strategies over time, despite increasing academic stress. …


A Descriptive Survey Of Reef Fish Biodiversity At The Erojacks Artificial Reef, Dania Beach, Florida, Daniella Michelle Acosta Reyes Apr 2026

A Descriptive Survey Of Reef Fish Biodiversity At The Erojacks Artificial Reef, Dania Beach, Florida, Daniella Michelle Acosta Reyes

Undergraduate Student Symposium

South Florida has one of the highest biodiversity's of reef-associated fish species in the United States. Reef systems play a crucial role in sustaining regional biodiversity. Ongoing declines in natural coral reef systems caused by climate change, coastal development, and other anthropogenic factors have increased the reliance on artificial reefs as alternative structures for coral and fish communities to aggregate. Artificial reefs play an important role in maintaining marine biodiversity and provide habitat for reef-associated fishes. The Erojacks Reef, an artificial reef system located off the coast of Dania Beach, South Florida acts as a gathering site for reef fishes. …


A Review Of Reproductive Cycling In Batoid Dentition Morphology With New Data On Two Dasyatid Stingrays From The Western North Atlantic, Lacey Adamik Apr 2026

A Review Of Reproductive Cycling In Batoid Dentition Morphology With New Data On Two Dasyatid Stingrays From The Western North Atlantic, Lacey Adamik

Undergraduate Student Symposium

Elasmobranchs continuously replace their teeth throughout their lifespan, allowing changes in tooth morphology associated with feeding and reproduction to occur. In many batoid species, males will bite females during pre-copulatory behavior, placing male dentition under selective pressure to meet the demands of both diet and grasping of females. Previous research has documented sexual dimorphism and seasonal dentition changes in several species of batoids, suggesting that this phenomenon is widespread. Much of this research is observation-based, and quantitative studies of dentition are limited, particularly in pelagic species. Pelagic Stingray (Pteroplatytrygon violacea) specimens were previously collected by commercial fishermen, and …


Transcranial Magnetic Stimulation For Substance Use Disorder, Sarah Defrant Apr 2026

Transcranial Magnetic Stimulation For Substance Use Disorder, Sarah Defrant

Undergraduate Student Symposium

This review evaluates transcranial magnetic stimulation (TMS) as a supplemental intervention for decreasing substance use disorder (SUD) relapse rates by synthesizing understandings of neurobiological mechanisms and clinical outcomes. TMS stimulates the activity of neural cells in the dorsolateral prefrontal cortex (DLPFC), a small portion of the prefrontal cortex that houses impulse control and decision-making skills. This leads to improved neuroplasticity and dopamine regulation, both of which are disrupted by unregulated substance use. Although TMS is not FDA-approved for substance use disorder, the neurobiological similarities between SUD and its comorbidities like major depressive disorder or anxiety highlight TMS's theoretical potential to …


Disease-Modifying Therapies Targeting Neuroinflammation In Alzheimer's Disease: Evaluation Of Ongoing Clinical Trials, Shree Diora, Reagan Colavita, Christa Torchia Apr 2026

Disease-Modifying Therapies Targeting Neuroinflammation In Alzheimer's Disease: Evaluation Of Ongoing Clinical Trials, Shree Diora, Reagan Colavita, Christa Torchia

Undergraduate Student Symposium

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and behavioral changes. While traditionally associated with amyloid-β plaques and tau tangles, growing evidence implicates neuroinflammation as a key driver of disease progression. Microglial, astrocytic, and mast cell activation, along with elevated pro-inflammatory mediators, contribute to synaptic dysfunction and neuronal loss. Targeting these pathways offers promising therapeutic avenues beyond amyloid and tau-centric strategies. This study evaluates the emerging disease-modifying therapies in clinical trials that target neuroinflammation in AD, focusing on mechanisms, trial phases, and emerging clinical findings. The clinical trial website was accessed to find drug therapies under …


Bone Mineral Density, Mechanical Loading, And Mediterranean Diet Adherence In University Runners: A Pilot Study, Sathvi Gandra, Kiana Medina, Auston Hsieh Apr 2026

Bone Mineral Density, Mechanical Loading, And Mediterranean Diet Adherence In University Runners: A Pilot Study, Sathvi Gandra, Kiana Medina, Auston Hsieh

Undergraduate Student Symposium

Bone mineral density (BMD) is influenced by both mechanical loading and dietary patterns and is a determinant of skeletal health in distance runners. This exploratory study examined descriptive relationships among Mediterranean diet adherence, running biomechanics, and BMD in a pilot sample of competitive distance runners. Seven university runners, (18-21 years; 5 female, 2 male) completed dual-energy X-ray absorptiometry to assess total and segmental BMD, and a running biomechanical analysis on an instrumented treadmill. Biomechanical variables included peak vertical ground reaction force (vGRF), hip and knee joint reaction forces (JRF), ground contact time (GCT), and vertical stiffness(kvert). Dietary patterns …


Time-Lapse Microscopy To Characterize Astrocyte Precursor Cells Migration Using A Double Reporter Mouse Line, Megan Hilliard, Sravika Chirla, Maria Ramirez Apr 2026

Time-Lapse Microscopy To Characterize Astrocyte Precursor Cells Migration Using A Double Reporter Mouse Line, Megan Hilliard, Sravika Chirla, Maria Ramirez

Undergraduate Student Symposium

Astrocytes, the most abundant non-neuronal cell type in the brain, are a diverse population of cells that play a central role in regulating synaptic activity, supporting neuronal energy demands, and modulating interactions among neurons, glia, and blood vessels. Astrocytes originate from astrocyte precursor cells (APCs) in the subventricular zone, from where they migrate to the cortex postnatally. Once in the cortex, APCs continue to proliferate and then undergo morphological and functional maturation. Using a double reporter mouse line engineered to express enhanced green fluorescent protein (eGFP) under the control of the entire glutamate transporter 1 (GLT1) gene and tdTomato (tdT) …


Epigenetic Upregulation Of P21 Via Mdm2 And Dnmt Inhibition Induces Cell Death In Neuroblastoma Cells, Helen Le, Sruthika Talanki, Shyam Jaganathan, Umamaheswari Natarajan Apr 2026

Epigenetic Upregulation Of P21 Via Mdm2 And Dnmt Inhibition Induces Cell Death In Neuroblastoma Cells, Helen Le, Sruthika Talanki, Shyam Jaganathan, Umamaheswari Natarajan

Undergraduate Student Symposium

Neuroblastoma is a childhood cancer that primarily impacts children, mostly under five years of age, that originates from neuroblast cells. It's located in the adrenal glands, neck, or thorax. Experimental evidence indicates that epigenetic modifications influencing cell cycle arrest and programmed cell death (PCD), including apoptosis, may provide an effective treatment strategy for enhancing neuroblastoma that is resistant to conventional therapies. This study explored MDM2 and DNMT pathways that might suppress DNA methylation leading to the upregulation of TET enzymes and p21, which trigger cell cycle arrest and apoptotic in IMR-32 cells were treated with RG-7388, CM-272, and SGI-1027 for …


Does A Competitive Season Alter Elastic Bounce Mechanics In University Distance Runners?, Marcus Marek Tortorella Apr 2026

Does A Competitive Season Alter Elastic Bounce Mechanics In University Distance Runners?, Marcus Marek Tortorella

Undergraduate Student Symposium

The spring-mass model (SMM) describes the body's center of mass oscillation during running as a bouncing system, where energy is absorbed and released, producing two asymmetries that represent muscle-tendon elastic function: (1) landing-takeoff (LTO; % relative difference propulsion to braking time), and (2) rebound (REB; % relative difference effective aerial to contact time). Additional SMM-derived variables, such as vertical stiffness(kvert) and step frequency (SF) may provide insight into the influence of a competitive season on running elastic bounce mechanics in university distance runners. The purpose of this study was to examine the impact of a competitive cross-country season …


Genetic Diversity Of Invasive Grey-Headed Swamphens In Florida Compared To Native Gallinules, Monica Maurer Apr 2026

Genetic Diversity Of Invasive Grey-Headed Swamphens In Florida Compared To Native Gallinules, Monica Maurer

Undergraduate Student Symposium

Invasive species outcompete native ones and threaten ecosystem stability. The grey-headed swamphen (Porphyrio poliocephalus), established in southeast Florida since 1996, continues to expand into the northern Everglades and Lake Okeechobee despite prior eradication attempts. This study is comparing the genetic diversity of invasive grey-headed swamphens to the genetic diversity of native purple (P. martinica) and common (Gallinula galeata) gallinules to better understand invasion history, competitive potential, and ecosystem impacts. Muscle tissue samples of P. porphyrio collected by the Florida Museum of Natural History from 1999-2023 and the Florida Fish and Wildlife Conservation Commission (FWC) …


Implementing Video Analysis And Titleist Performance Institute Level 1 Screening To Assess Sway In Collegiate Golfers, Sydney Mazur Apr 2026

Implementing Video Analysis And Titleist Performance Institute Level 1 Screening To Assess Sway In Collegiate Golfers, Sydney Mazur

Undergraduate Student Symposium

Golf swing mechanics are fundamental for proper performance and sustainability in the sport. Understanding the complexities of the golf swing as well are crucial in proper performance and prevent injury. Sway is a common swing fault that occurs in golfers because of improper swing fundamental mechanics. The Titleist Performance Institute (TPI) Level 1 screen is used in conjunction with video analyses to better understand swing mechanics. The purpose of this study is to better understand these specific components of the golf swing mechanics to prevent injury and improve performance for collegiate golfers. A total of 16 National Collegiate Athletic Association …


What Genograms Can Tell Us About Family Dynamics That Quantitative Data Cannot, Connor Mccarville, Jessica Frye, Maegan Mcdonough Apr 2026

What Genograms Can Tell Us About Family Dynamics That Quantitative Data Cannot, Connor Mccarville, Jessica Frye, Maegan Mcdonough

Undergraduate Student Symposium

Genograms are an important clinical tool that is used to visually represent family relationships and their dynamics, but their effectiveness in empirical research remains limited. This mix-methods study examined the alignment between qualitative genogram visualizations and quantitative assessments of family dysfunctionality among individuals who exhibited high levels of risky sexual behavior. Based on preliminary data, currently with seven individuals with a high level of risky sexual behavior, we created genograms through interviews with young adult participants who described the emotional quality of each family relationship. Quantitative data on risky sexual behavior and whole family functioning were collected using the Family …


Tissue-Specific Stable Isotope Fractionation In Subarctic Pinniped Species, Morgan Michalek Apr 2026

Tissue-Specific Stable Isotope Fractionation In Subarctic Pinniped Species, Morgan Michalek

Undergraduate Student Symposium

Stable carbon (δ13C) and nitrogen (δ15N) isotope ratios are widely used to evaluate marine mammal diet, trophic position, and nutrient assimilation. However, interpretation is often confounded by tissue-specific isotopic discrimination, which alters isotope ratios during nutrient assimilation and tissue synthesis. Quantifying these offsets is essential for ensuring accurate trophic reconstructions across multiple tissues with different biochemical compositions. This study measured δ13 and δ15N values in muscle, blood, blubber, brain, collagen, kidney, liver, skin, fur, and vibrissae of Steller sea lions (Eumentopias jubatus), harbor seals (Phoca vitulina), and northern fur …


Is Left Ventricular Dysfunction Associated With Increased Risk Of Alzheimer's Disease Independent Of Classical Vascular Dementia Pathways?, Priyanshi Patel Apr 2026

Is Left Ventricular Dysfunction Associated With Increased Risk Of Alzheimer's Disease Independent Of Classical Vascular Dementia Pathways?, Priyanshi Patel

Undergraduate Student Symposium

This poster examines the potential connection between left ventricular dysfunction and the risk of Alzheimer's disease in older adults. Studies suggest that reduced heart function may affect brain health by limiting blood flow to the brain, increasing inflammation, and interfering with the brain's ability to clear harmful proteins such as amyloid-β and tau. These processes resemble changes commonly seen in Alzheimer's disease. In population-based studies, individuals with heart failure or structural abnormalities of the left ventricle appear to have a higher risk of developing dementia, including Alzheimer's disease, even after accounting for major risk factors such as hypertension and clinical …


Analysis Of Conserved Domains In Promoters Of Differentially Expressed Genes In Rice, Mahalaxmi Some, Eimaan Ahmad, Emalynn Tobias Apr 2026

Analysis Of Conserved Domains In Promoters Of Differentially Expressed Genes In Rice, Mahalaxmi Some, Eimaan Ahmad, Emalynn Tobias

Undergraduate Student Symposium

Plant responses to stress involve changes in gene expression, and understanding these changes is key to improving crop resilience. A critical step in this process is identifying "conserved domains" in the promoters of Differentially Expressed Genes (DEGs), as these domains often provide binding sites for transcription factors. In this study, we aim to identify the Cis-Regulatory Elements (CREs) in the promoters of DEGs associated with heat stress. Previously, we identified 149 DEGs from transcriptomic analyses of two rice varieties, Cypress (heat-tolerant) and LaGrue (heat-sensitive), both exposed to high night temperatures (HNT; 82.4 ± 1°F or 28 ± 1°C). We hypothesize …


Effects Of Renin-Angiotensin System Targeting Drugs On Cerebral Amyloid Angiopathy And Related Neuropathology, Anna Maria Weber, Ariana Hernandez, Chana Vogel, Victoria Pulido-Correa, Maria Agustina Paiz, Shaina Binu, Sonakshi Kose, Aayush Doshi, Dylan Kuni, Sylvia Yousef Apr 2026

Effects Of Renin-Angiotensin System Targeting Drugs On Cerebral Amyloid Angiopathy And Related Neuropathology, Anna Maria Weber, Ariana Hernandez, Chana Vogel, Victoria Pulido-Correa, Maria Agustina Paiz, Shaina Binu, Sonakshi Kose, Aayush Doshi, Dylan Kuni, Sylvia Yousef

Undergraduate Student Symposium

Cerebral amyloid angiopathy (CAA) is a common cerebrovascular disease characterized by beta-amyloid (Aβ) accumulation in the cerebral vasculature, resulting in vascular cognitive impairment and dementia (VCID) along with other neuropathologies such as inflammation. Given that medications approved to treat CAA currently do not exist, this highlights that there is a pressing need for more innovative approaches to drug discovery. In this study, classical renin-angiotensin system (RAS)-inhibiting antihypertensive drugs were repurposed to investigate their efficacy for mitigating CAA-associated neuropathology and cognitive decline, while additionally evaluating for sex-specific outcomes. Male and female Tg-SwDI mice were treated for 4 months with non-hypotensive doses …


Colon Cancer Findings And A Community Solution, Brintia Wright Apr 2026

Colon Cancer Findings And A Community Solution, Brintia Wright

Undergraduate Student Symposium

Colorectal cancer remains a significant public health concern due to its high incidence, mortality, and persistent demographic disparities. The primary goal of this project was to develop an evidence-based community resource guide for the South Florida region to support early detection and equitable screening for colon cancer. The resource guide was informed by a structured review of current screening guidelines, peer-reviewed literature, and population-level data from the Surveillance, Epidemiology, and End Results (SEER) program. SEER incidence, stage at diagnosis, and survival data for individuals aged 25-84 years diagnosed with colon cancer between 2000 and 2022 were synthesized to identify high-risk …


Black Equality In Ocd Neurogenomics (Belong): Study Protocol, Iasha J Williams, Dalia Y Marquez, Kara E Lopez-Lengowski, Malini Bommiasamy, Ogechi Cynthia Onyeka, Slayton J Underwood, Juliana E Avery, Jacob Gluckman, Thariana Pichardo, Rhea Chandler, Yulu Brown, Katie Mangen, Emma Grace Choplin, Black Equality In Ocd Neurogenomics (Belong) Study Team, Sonyia C Richardson, Joseph D Buxbaum, Eric A Storch, James J Crowley, Sidney H Hankerson, Dorothy E Grice Apr 2026

Black Equality In Ocd Neurogenomics (Belong): Study Protocol, Iasha J Williams, Dalia Y Marquez, Kara E Lopez-Lengowski, Malini Bommiasamy, Ogechi Cynthia Onyeka, Slayton J Underwood, Juliana E Avery, Jacob Gluckman, Thariana Pichardo, Rhea Chandler, Yulu Brown, Katie Mangen, Emma Grace Choplin, Black Equality In Ocd Neurogenomics (Belong) Study Team, Sonyia C Richardson, Joseph D Buxbaum, Eric A Storch, James J Crowley, Sidney H Hankerson, Dorothy E Grice

Faculty, Staff and Students Publications

Obsessive-compulsive disorder (OCD) is a chronic, serious psychiatric disorder that affects 2%-3% of the population and is associated with high personal and societal costs. Genetic factors are estimated to explain roughly half the risk of developing OCD, and genomic studies are just beginning to identify common and rare genetic variants mediating this risk. A major goal of genomic studies is to yield insights into the etiology of OCD and identify molecular targets for the development of novel therapeutics. However, the overwhelming majority of subjects in existing genetic studies are of European ancestry, limiting the generalizability of these findings. To address …


Coordinated School Health 2024-25 Annual Report, Tennessee. Department Of Education. Mar 2026

Coordinated School Health 2024-25 Annual Report, Tennessee. Department Of Education.

Coordinated School Health

No abstract provided.


Child Welfare Upholds Black Family Separation While Denying Essential Constitutional Protections, Samantha Nichol Mar 2026

Child Welfare Upholds Black Family Separation While Denying Essential Constitutional Protections, Samantha Nichol

UC Law Journal of Race and Economic Justice

This note examines the refusal to expand constitutional protections to include proceedings concerning child welfare. A system that largely mirrors and works in tandem with the criminal system, which enjoys robust constitutional safeguards. Important to the analysis of the rejection of these protections is an acknowledgement that child welfare, or welfare more broadly, is a system that upholds racial power structures and a tradition of family separation. Just as the overincarceration of Black people has been acknowledged by legal scholars to be a particular badge and incident of slavery, the child welfare system should also be critiqued as a system …


Operating Fund Budget/ Expenditure Summary Report 3rd Quarter 2025-26, Csusb Budget Office Mar 2026

Operating Fund Budget/ Expenditure Summary Report 3rd Quarter 2025-26, Csusb Budget Office

University Budget Office records

No abstract provided.


Approved Programs 3-31-26, Angela Brock Mar 2026

Approved Programs 3-31-26, Angela Brock

Programs Committee (PC)

No abstract provided.


Program Agenda 3-31-26, Angela Brock Mar 2026

Program Agenda 3-31-26, Angela Brock

Programs Committee (PC)

No abstract provided.


Food For Health: Nourishing Transitions, Kamryn Pfenning, Grace Beauchamp, Shauntel Nutile, Morgan Brummels, Melanie Menning Mar 2026

Food For Health: Nourishing Transitions, Kamryn Pfenning, Grace Beauchamp, Shauntel Nutile, Morgan Brummels, Melanie Menning

Innovations in Health Sciences Education Journal

This is an abstract from the Spotlight on Scholarship event in 2026.


Meet The Team: Exploring Health Professional Roles And Responsibilities In An Introductory Interprofessional Course, Elizabeth W. Blake, Kimberly A. Taylor, Beverly Baliko, Teri Browne, Donna D. Ray, Abbas Tavakoli Drph, Mph, Me Mar 2026

Meet The Team: Exploring Health Professional Roles And Responsibilities In An Introductory Interprofessional Course, Elizabeth W. Blake, Kimberly A. Taylor, Beverly Baliko, Teri Browne, Donna D. Ray, Abbas Tavakoli Drph, Mph, Me

Publications

Introduction: Health professional academic programs require interprofessional education (IPE) to meet accreditation standards and better prepare students for collaborative patient care. The Interprofessional Education Collaborative (IPEC) includes the roles and responsibilities of the health professions as a key domain of IPE curricula. A learning module focusing on this domain was developed for an interprofessional introductory course involving 12 health professions. Adaptations to this module over time aimed to enhance content and student knowledge. Methods: Students were assigned to small interprofessional teams throughout the course and completed modules aligned with the IPEC core competencies. The first module highlighted roles and responsibilities. …


Food For Health: Nourishing Transitions, Kamryn Pfenning, Grace Beauchamp, Shauntel Nutile, Morgan Brummels, Melanie Menning Mar 2026

Food For Health: Nourishing Transitions, Kamryn Pfenning, Grace Beauchamp, Shauntel Nutile, Morgan Brummels, Melanie Menning

Interprofessional Academy of Educators Spotlight on Scholarship

In 2023, 13.5% of U.S. households and 12.9% of Nebraska households experienced food insecurity. The negative effect of food insecurity on the health of patients is well known and includes decreased intake of nutritious foods, increased intake of carbohydrate‑dense foods, and having to choose between paying for food versus other health needs. Food insecurity has also been associated with multiple chronic conditions (asthma, bronchitis, COPD, chronic pain, diabetes, kidney disease, sleep disorders) and lower overall health status. While food insecurity is a major problem faced by many in our community and has been highly associated with poor health outcomes. Despite …