Medicine and Health Sciences Commons^™

Local Government Policies Restricting Unhealthy Outdoor Food Advertising In Australia: Stakeholder Perspectives Identify Political Willingness Is Key To Overcoming Barriers, Alexia Bivoltsis, Frith Klug, Jacinta Francis, Clare Whitton, Gina S.A. Trapp, Claire E. Pulker

Research outputs 2022 to 2026

Background: Unhealthy outdoor food advertising is strongly linked to poor diet, highlighting the need for policies. Western Australian (WA) local governments (LGs) can restrict advertising on their owned infrastructure through their Public Health Plans, but limited policy action has occurred. This study aimed to explore the perspectives of WA LGs and public health organizations (PHOs) on current and potential policies restricting unhealthy outdoor food advertising on LG owned infrastructure to (1) identify barriers and enablers to the policy making process, (2) assess the current level of political willingness (i.e. political want, political can and political must) and (3) inform development …

Chlorinated Drinking Water Exposure Enriches Antimicrobial Resistance Pathways In The Infant Gut Microbiome: A Randomized Trial, Kimberley Parkin, Claus T. Christophersen, Valerie Verhasselt, Debra J. Palmer, Matthew N. Cooper, Susan L. Prescott, Desiree Silva, David Martino

Research outputs 2022 to 2026

Background: Water chlorination is essential for controlling harmful microbes in drinking water; however, the antimicrobial effects of chlorine-based disinfectants present in tap water may influence early-life gut microbial ecology.

Objective: To investigate the functional and compositional impact of chlorinated drinking water on the gut microbiome of infants.

Design: The waTer qUality and Microbiome Study (TUMS) was an Australian-based double-blinded, randomised controlled trial. Six-month-old infants (n = 197) received either de-chlorinated drinking water via benchtop filtration (treatment, n = 99), or regular chlorinated water (control, n = 98) for twelve months. Tap water and stool samples were collected at baseline and …

Free-Fall Normalised Peak Braking Velocity For Countermovement Jump Monitoring, Karol Kruczek, André Rebelo, Jason Lake, Michał Nowak

Research outputs 2022 to 2026

Background: Peak braking velocity (PBV) during the countermovement jump (CMJ) is used to describe descent strategy, but its interpretation is affected by countermovement depth. This study introduced free-fall normalised peak braking velocity (PBVFF), a dimensionless index expressing PBV relative to the displacement-specific theoretical free-fall velocity limit, and evaluated its reliability, performance associations and ranking consequences. Methods: Seventy injury-free male academy footballers (18.7 ± 1.6 years) performed three maximal hands-on-hips CMJs on dual force plates. Using retrospective observational routine monitoring data, one representative testing day per athlete was analysed. Two PBVFF variants were examined: PBVFF normalised to countermovement depth (PBVFFCMD) and …

Lessons Learned From A Randomised Controlled Trial Of A Digital Intervention Targeting Eating Disorder Symptoms In Cisgender Sexual Minoritized Men, Emma Austen, Matthew Fuller-Tyszkiewicz, Siân A. Mclean, Beth O’Gorman, Katie Bishop, Hannah K. Jarman, Susan J. Paxton, Rachel F. Rodgers, An Dang, Emily A. Harris, Felicity Angelopoulos, Wesley Grey, Suku Sukunesan, Alexandra Parker, Adrian Shatte, Long Khanh-Dao Le, Scott Griffiths

Research outputs 2022 to 2026

Background: There is an unmet need for evidence-based and accessible interventions designed to treat eating disorders in sexual minoritized men, given their heightened vulnerability to developing disordered eating. Digital interventions are a promising avenue for eating disorder treatment because of their accessibility and flexibility in delivery. Here, we present a randomised controlled trial of Seed, a 10-week treatment-focussed digital intervention for eating disorders, among sexual minoritized men.

Methods: Participants (N = 126 sexual minoritized men) with a binge-spectrum eating disorder diagnosis (e.g., bulimia nervosa, binge-eating disorder) were randomly allocated to one of three conditions: (1) a waitlist control (2) a …

In Adults Older Than 18 Years With Obesity Living In Massachusetts, Can Engaging In A Weight Loss Program Help Them Lose Weight After Insurance Stops Covering Their Weight Loss Medications?, Angel Nagawa

Capstones

Executive summary

The Problem

Obesity rates continue to rise sharply across the United States. Weight loss medications have high compliance but face major insurance restrictions. Strict clinical criteria leave many patients without accessible treatment options.

The Proposed Solution

Launch structured, lifestyle-focused clinical weight loss programs. Provide an effective, accessible alternative to restricted pharmaceutical therapies.

Supporting Evidence

Evaluated data from three distinct randomized controlled trials. Findings confirm successful long-term weight management for program participants. Results prove effective control over serious obesity-related comorbidities.

Policy recommendation

Implement structured lifestyle programs as a primary, frontline intervention modality. Improve broad-scale patient health outcomes across clinical …

Evaluation Of A No-Code Ai Model For Detecting Periapical Radiolucencies: Impact Of Anatomical Region On Diagnostic Performance, Manal Hamdan, Kevin W. Yu, Marguerite Miller, Stephanie J. Sidow, Zaid Badr, Sergio E. Uribe

School of Dentistry Faculty Research and Publications

Background

To develop a no-code artificial intelligence (AI) model for the detection of apical radiolucent lesions and to assess how lesion location influences the model’s diagnostic performance.

Methods

312 periapical radiographs were retrospectively collected, each accompanied by a corresponding cone-beam computed tomography (CBCT) scan obtained within six months and a radiology report authored by board-certified oral and maxillofacial radiologists. These reports served as the reference standard, and all findings were cross-verified by the primary investigator through CBCT review. The dataset included 181 images with at least one apical radiolucent lesion and 131 lesion-free controls. Using the no-code AI platform LandingLens …

Weathering The Divide: Social Determinants, Neighborhood Context, And Systemic Lupus Erythematosus Among African American Women, Vanessa Cl Morman

Electronic Theses and Dissertations

Background: Systemic lupus erythematosus (SLE) disproportionately affects African American women and contributes to racial health disparities in the United States. Although genetic susceptibility influences disease risk, growing evidence suggests that social determinants of health (SDOH), including neighborhood conditions, structural racism, and socioeconomic disadvantage, contribute to disease development and progression. Epigenetic mechanisms may provide a biological pathway linking adverse social conditions to chronic disease disparities. This dissertation examined the influence of SDOH on SLE disparities through evidence synthesis and empirical investigation to inform public health practice and policy.

Methods: This integrated learning experience consisted of three complementary manuscripts. Aim 1 was …

Exploring Burnout Among Ncaa Collegiate Athletes: The Impact Of Gender, Sport, Seasonal Demands, And Other Contributing Factors, Anneliese Wong

Undergraduate Honors Theses

The purpose of this study was to examine burnout among NCAA Division I student-athletes at one mid-sized University in the Rocky Mountains region of the United States and determine whether differences existed based on gender, sport type, competitive season stage, and burnout dimension. A quantitative, cross-sectional survey design was used and data was collected from 76 student-athletes across 11 varsity sports. Burnout was assessed using items adapted from the Athlete Burnout Questionnaire (ABQ; Raedeke & Smith, 2001), along with additional items assessing fatigue and seasonal experiences.

Descriptive results showed the student-athletes reported the highest mean level of physical burnout, followed …

Development Of A Standardized Evidence-Based Onboarding Process For Primary Care Providers In A Rural Health Setting, Corrie Goodier

Doctoral Scholarly Projects & Capstones

Primary care in the United States continues to face a critical provider shortage. This shortage is especially elevated in the rural regions of the country and is exacerbated by longstanding issues with subpar onboarding and high turnover rates. Failure to retain advanced practice providers in rural primary care settings further diminishes patient access to services, negatively impacts continuity of care, and complicates efforts to maintain patient trust in the nation’s delicate healthcare system.

Improved provider orientation and support processes within rural healthcare systems have the potential to increase satisfaction rates and productivity. The purpose of this DNP scholarly project was …

Improving Nurse Confidence And Perceived Readiness For Early Code Blue Response: A Quality Improvement Project, Elexia Butler, Annette Sotelo Rodriguez, Paulene Rones, Evangelyne Vue

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Improving Nurse Confidence and Perceived Readiness for Early Code Blue Response

Purpose

In many acute care units that are predominately dealing with chronic conditions, cardiac arrest is a low frequency, high stakes event. The purpose of this project is to improve early cardiac arrest response by increasing nurse confidence and perceived readiness to initiate high-quality CPR prior to Rapid Response Team (RRT) arrival.

Background

Over the past three years, there has been a significant increase in Code Blue events on the Surgical Acute Telemetry Unit. Initial management observations noted that staff response lacked clear role delineation, immediate pulse identification, and …

Impact Of School Nurse Education On Factors Influencing Hpv Vaccine Communication With Parents, Diane Santa Maria, Erika Thompson, Sanghamitra M Misra, Paula M Cuccaro

Faculty, Staff and Student Publications

Human papillomavirus (HPV) can cause six cancer types but can be prevented with timely vaccination in early adolescence. However, despite the wide availability of the HPV vaccine, uptake remains suboptimal among US adolescents. School nurses are invaluable resources to students and their families regarding adolescent immunization needs. As part of the All for Them vaccination program, we assessed the impact of the continued nurse education (CNE) intervention on school nurses’ HPV vaccine communication with parents. Seventy-two school nurses and nurse administrators in Texas participated in the study. Using a single-arm study design, we measured participants’ potential barriers to and self-efficacy …

Mtorc2-Nav1.2 Signaling Drives Early Hyperexcitability In Alzheimer’S Disease Mouse Model

Faculty, Staff and Students Publications

Hyperexcitability is a biomarker of early-stage Alzheimer’s Disease (AD) and hastens cognitive decline later in its course. Mechanistic target of rapamycin (mTOR) signaling contributes to the slope of this trajectory, as evidenced by early increased brain expression and the rescue of hyperexcitability by genetic deletion of mTOR complex 2 (mTORC2); however, a molecular mechanism directly linking mTOR signaling to membrane hyperexcitability in early-stage AD remains elusive. Here, we show that hyperactive mTOR signaling stimulates the voltage-gated Na+ channel 1.2 (Nav1.2), a previously identified downstream phosphorylation target of mTORC2 and a key regulator of membrane electrogenesis. Augmented Nav1.2 channel function induced …

Beyond Symptoms: Examining Perinatal Mental Health Care Among Black, Indigenous And People Of Color With Polyendocrine Metabolic Ovarian Syndrome, Vinaya Thomas

Electronic Theses and Dissertations

Perinatal mood and anxiety disorders (PMADs) are as a public health concern in the United States. Individuals from minoritized racial/ethnic groups face a significantly elevated risk of maternal morbidity, mortality, mental health disorders, and associated adverse outcomes. Emerging studies also reveal a higher likelihood of experiencing perinatal mental health concerns in individuals with polycystic ovarian syndrome (PCOS), currently known as polyendocrine metabolic ovarian syndrome (PMOS). People who identify as Black, Indigenous, or a person of color (BIPOC) face unique healthcare challenges given the added structural and social burdens. This online survey study aimed to 1) understand the relationship between PMOS …

An Assessment Of Accessibility And Affordability Of Inpatient Psychiatric Care In Tennessee, Kailee Havrda

Electronic Theses and Dissertations

Introduction: Access to mental health has seen changes over the past decade, but little research and attention have been given to access to inpatient psychiatric facilities. Inpatient psychiatric care is crucial for patients experiencing mental health emergencies who need immediate access to care. Gaps in spatial accessibility, affordability, and the access and assessment process were identified due to a lack of available information in the field.

Methods: Secondary data from the Tennessee Department of Health were used to assess financial accessibility through payer source charges and patient encounters, as well as through mapping of inpatient psychiatric facilities and conducting drive …

Phytochemical And In-Vitro Cytotoxic Analyses Of Flavonoid Species Isolated From Chromolaena Leivensis, Luke A. Bryant

Electronic Theses and Dissertations

As a leading cause of death worldwide, cancer and its treatments remain a primary source of interest among researchers. Modern studies are looking into bioselective cytotoxicity to create new chemotherapies that do not have the same harsh side effects as those we use today. Natural product research has a promising future for the development of such treatments. Specifically, polar flavonoids may be the key to a bioselective treatment. Such flavonoid species are native to plants, often within flower petals or within the body. A natural antioxidant, they are designed not to harm healthy cells. This study focuses on the plant …

Individual And Household Factors Associated With Tungiasis In A Marginalized Population In Karamoja, Northeastern Uganda, Lynne Elson, Abneel K. Matharu, Berrick Otieno, Hermann Feldmeier, Charles Waiswa, Amina Abubakar, Jürgen Krücken, Ulrike Fillinger, Francis Mutebi

All Peer-Reviewed Publications

Background: Tungiasis is a neglected tropical skin disease caused by adult female fleas which burrow into the skin of people and animals, causing considerable pain and itching. The distribution of the disease is heterogeneous, with Napak district, Karamoja sub-region of northeastern Uganda having the highest disease burden recorded globally. We aimed to determine the factors associated with this high prevalence to inform future intervention strategies. Methods: We conducted a cross-sectional study to identify factors associated with infection of individual children and adults, and a nested case–control study to identify factors for whole households (families). Infected children were identified through mass-screening …

Adding A Weight To Constrain The Trunk Increases Knee Joint Kinetics During Sidestep Cutting In Female Athletes, Daniel Kadlec, J. Jordan, Jacqueline Alderson, Sophia Nimphius

Research outputs 2022 to 2026

Sidestep cutting exposes the knee to high multiplanar loads that both challenge tissue capacity and provide an opportunity to develop resilience through progressive exposure. This study investigated task constraints applied at the trunk and preparatory step and changes in lower-body joint kinetics associated with ACL injury risk during sidestepping in female athletes. Twenty-one trained female athletes performed six sidestep conditions: pre-planned and unplanned sidesteps, each with and without trunk (holding ~ 5–7.5% body mass at chest level) and preparatory-step (ducking under an adjustable rope at eye height) constraints. Relative joint power at the hip, knee, and ankle was analysed using …

Co-Creating An Intervention To Prevent Injuries In Police Force Recruits: A Concept Mapping Study Of Police Force Recruits, Police Force Staff, Health Professionals, And Research Experts, Myles Murphy, Andrea B. Mosler, Garth Allen, Alex Donaldson, Clare L. Ardern, Carolyn A. Emery, Martin Hägglund, Jonathan M. Hodgson, Joanne L. Kemp, Debra Langridge, Tiffany Mcalinden, Thomas Mirco, Sophia Nimphius, Simone Radavelli-Bagatini, Kiera Staley, Vanessa Sutton, Evert Verhagen, Andrea M. Bruder

Research outputs 2022 to 2026

Objective: Police force recruits have a high musculoskeletal injury burden, which results in a substantial economic burden and can lead to attrition. The objective of this study was to identify and prioritise the strategies perceived as important and feasible to reduce the prevalence, incidence, and burden of injury in police force recruits. Design: Mixed-methods concept mapping study. Methods: Forty-eight participants were recruited from four broad groups: police force recruits/officers; police force staff; health professionals; and research experts. Participants brainstormed statements in response to a prompt (“To prevent injury and/or reduce the impact of injury on law enforcement recruit training, I …

Preventive Behaviors Associated With Fall Incidence Among Older Adults Living In Rural Communities Of Thailand: A Cross-Sectional Study, Rujira Nonsa-Ard, Sirapat Khodseewong, Kasama Wongprachum, Chaiwut Bourneow, Ploypailin Aneknan, Sumattana Glangkarn, Davina Porock

Research outputs 2022 to 2026

Background: The escalating population of older adults poses a significant challenge, particularly in lower-middle-income countries like Thailand. Falls represent a critical public health concern in this demographic. This study aimed to identify risk factors influencing fall occurrence in older adults within a specific rural community context, where the majority of participants remain engaged in farm work.

Methods: A cross-sectional study design was utilized, involving 1,256 participants recruited by the multistage random sampling approach. Data were collected via a questionnaire that included: demographic information, the Thai version of the Barthel Activities of Daily Living (ADL), the Thai Fall Risk Assessment Tool …

Primary Breast Sarcoma In Pediatric, Adolescent, And Young Adult Patients: A Single-Institution Retrospective Review, Amelie D. Perrier

Summer Research Program Abstracts

No abstract provided.

Correctional Officer Suicide: A Theory-Driven Investigation Of Acquired Capability And Suicide Behavior, Abigail R. Andersen

All-Inclusive List of Electronic Theses and Dissertations

A growing body of research suggests that correctional officers (COs) die by suicide at a significantly higher rate compared to the general population and some other public safety personnel. Despite what is known about this phenomenon, an understanding of the risk factors driving the high rate of suicide among this population remains unclear. Specifically, little attention has been paid to specific risk factors for suicide among this population and there is an overall absence of theory-driven research investigating CO suicide. The present study sought to address the gap in this area of research by investigating potential risk factors for suicide …

Medication Management And Caregiving Stress Or Benefit In Children With Medical Complexity., Casey O'Hare, Nicole Werner, Makenzie Morgen, Sophie Kooiman, James Feinstein, Michelle A. Chui, Gemma Warner, Anna Jolliff, Brittany Storhoff, Kristan Sondegren, Danielle Gerber, Jens Eickhoff, Ryan J. Coller

Manuscripts, Articles, Book Chapters and Other Papers

This study quantified medication management experiences for children with medical complexity and associations with caregiver stress or benefit. Using data from the MedS@HOME trial, involvement of professional caregivers was associated with increased caregiver benefit, and greater network collective efficacy was associated with increased caregiver benefit and decreased caregiver stress.

TRIAL REGISTRATION: ClinicalTrials.gov, ID NCT05816590.

Characterization Of Regulation Of Ace2 And Morphogenesis (Ram) Pathway Components In Aspergillus Fumigatus, Devi Naga Jyothi Bale

Theses and Dissertations (ETD)

Aspergillus fumigatus CotA is a conserved protein kinase and predicted orthologue of Cbk1, a terminal kinase of the Regulation of Ace2 and Morphogenesis (RAM) network. In our previous study, disruption of CotA resulted in carbon source dependent invasive growth with the mutant exhibiting preferential growth on glucose but severely impaired growth on alternate carbon sources. This pathway in other fungi has been implicated in the regulation of morphogenesis, stress responses, and virulence, but this study is the first one to characterize it in the pathogenic filamentous fungus.  In yeast, the RAM network includes the CotA ortholog, Cbk1, and associated proteins, …

Comparative Performance Of Physiological Vital-Sign Forecasting Under Random And Patient-Wise Splitting Using Deep Learning, Lavanya Vasavi Chittem Reddy

Theses and Dissertations

Physiological vital-sign forecasting estimates future measurements based on recent temporal patterns and can support analysis of continuously recorded monitoring data. This study comparatively evaluated deep feedforward, recurrent, bidirectional recurrent, long short-term memory, and bidirectional long short-term memory architectures for one-step-ahead forecasting of peripheral oxygen saturation, heart rate, and pulse rate. Each model received consecutive observations of peripheral oxygen saturation, heart rate, pulse rate, respiratory rate, and age, while separate single-output models predicted the next value of the selected target.

Random and patient-wise data splitting were compared using identical input definitions, preprocessing procedures, model architectures, and training hyperparameters. The strongest architecture …

Evaluating The Pulse Of Exercise Programs: Developing And Validating The Intervention Usability Scale For Exercise (Iuse) To Enhance Implementation And Adherence, Anne Inger Mørtvedt, Eva Ageberg, Steven Elmer, Kevin Trewartha, Erich Petushek

Michigan Tech Publications

Background: Adherence to exercise interventions is often suboptimal, despite numerous studies documenting barriers and facilitators. Usability may be a critical yet underexplored determinant of adherence. This study aimed to develop and assess the psychometric properties of the Intervention Usability Scale for Exercise (IUSE). Methods: Item generation and content validation involved cognitive interviews and feedback from eight exercise intervention stakeholders and ten target users from the general public. Subsequently, 526 target users from University, Qualtrics and Prolific participant panels assessed exercise programs through an online survey. Dimensionality was assessed using Principal Component Analysis (PCA), Exploratory Factor Analysis (EFA), and bifactor models. …

Smart Medical System Integrating Clinical Workflows For Robust Skin Cancer Detection Across Heterogeneous Pathologies, Ahed Abugabah, Prashant Kumar Shukla, Suchi Mishra, Abhishek Dwivedi

All Works

Skin cancer is among the most prevalent and life-threatening dermatological diseases worldwide, with melanoma responsible for a substantial proportion of skin cancer–related deaths due to delayed and unreliable diagnosis. Conventional clinical screening based on visual inspection and expert interpretation is inherently subjective and often affected by inter-observer variability, lesion heterogeneity, and imaging artifacts, highlighting the need for accurate and generalizable automated diagnostic systems. This study proposes a novel hybrid deep learning architecture for skin cancer classification that integrates an attention-guided autoencoder with a transformer-inspired global context modeling module, forming a unified and robust representation learning framework. The encoder–decoder structure is …

In-Hospital Mortality Patterns And Readmissions In Patients With Chronic Obstructive Pulmonary Disease: An Analysis Of The Role Of Pulmonary Hypertension, Saad Afzal Khan, Trishna Parikh, Adishwar Rao, Akriti Agrawal, Aarohi Parikh, Sarah Shin, Maulin Patel, Kha Dinh, Bela Patel, Bindu Akkanti

Faculty, Staff and Student Publications

Chronic obstructive pulmonary disease (COPD) may be complicated by pulmonary hypertension (PH). We aimed to understand the impact of PH on in-hospital mortality and quantify the 30-day readmission rate among patients with COPD. For this cross-sectional study, we used the Nationwide Readmissions Database from 2017-2020 to identify adults ≥18 years with COPD. Patients were stratified according to PH diagnosis. Baseline characteristics between groups were compared using the Pearson chi-square test and two-sample t-test. Predictors of in-hospital mortality were determined using multivariate logistic regression analysis adjusted for demographics and confounders. The 30-day readmission rate and prevalence of PH subgroups by baseline …

Ambulatory Blood Pressure Variability In Prediction Of Target Organ Injury: The Ship Ahoy Study, Coral D Hanevold, Jang Dong Seo, Stephen R Daniels, Bonita E Falkner, Michael A Ferguson, Joseph T Flynn, Julie R Ingelfinger, Philip R Khoury, Marc B Lande, Kevin E Meyers, Mark Mitsnefes, Joshua Samuels, Elaine M Urbina

Faculty, Staff and Student Publications

Background: Ambulatory hypertension is associated with elevated left ventricular mass index (LVMI), cardiac dysfunction, and increased arterial stiffness in adolescents. Whether the addition of measures of BP variability improves the prediction of subclinical cardiovascular target organ damage (TOD) over mean BP measures is not known.

Methods: We assessed clinic and ambulatory BP (ABP), anthropometrics, and TOD in 397 adolescents. ABP means standard deviation (SD), BP, and heart rate (HR) dipping were calculated; coefficients of variability (CV) were calculated (SD/mean) to assess ABP variabilities. Measures of TOD included LVMI, left ventricular hypertrophy (LVH), LV systolic shortening, LV diastolic function (e'/a'), and …

Acute Effects Of Accentuated Eccentric Loading On Mean Concentric Velocity During Resistance Training: A Systematic Review And Meta-Analysis, Jiahao Yang, Tsuyoshi Nagatani, Paul Comfort, Kristina L. Kendall, G. Gregory Haff

Research outputs 2022 to 2026

Background: Accentuated eccentric loading (AEL) may acutely enhance the concentric (CON) barbell velocity after the additional eccentric (ECC) load is removed, however there are inconsistent results regarding the effectiveness of this practice within the scientific literature. Objective: The aims of the present study were to: (1) examine the acute effects of applying AEL, only on the first repetition of a set, on mean barbell velocity during the CON phase of the first 3 repetitions of the set and (2) investigate the influence of the magnitude of ECC load, loading differential and exercise selection on the acute effects of AEL. Methods: …

Co-Design And Feasibility Testing Of A Midwife-Led Birth Debrief: An Implementation Science Project, Kate Buchanan, Phoebe Backhouse, Leanne Graham, Amy O’Meagher, Sara Bayes

Research outputs 2022 to 2026

Background: The period spanning pregnancy, birth and postpartum is characterised by psychosocial as well as physiological changes: many women experience new or worsening mental ill-health during the perinatal period. Midwives play a critical role in supporting and promoting psychosocial health by providing mental health education, counselling and screening. Often this includes a post-birth conversation, guided reflection, or debrief. Information about the effectiveness and experiences of specific and structured midwife-led birth debrief is scant. Aim: Our study aimed to assess the perceived effectiveness, experiences and implementability of a midwife-led birth debriefing intervention in one Australian maternity unit. Methods: A Type II …