Medicine and Health Sciences Commons^™

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

School of Nursing & Midwifery, East Africa

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

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

Social Work Dissertations

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

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

Doctor of Business Administration Dissertations

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

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

Economics Honors Projects

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

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

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

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

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

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

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

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

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

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

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

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

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

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

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

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

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

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

Methods

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

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

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

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

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

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective: 

To estimate the pooled prevalence of dengue infection in Bangladesh.

Methods:

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

Results:

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

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

Teaching and Learning Resources

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

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

Graduate Research Theses & Dissertations

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

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

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

Graduate Research Theses & Dissertations

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

Reflux Micro-Aspiration: Natural History, Pathophysiology, Clinical Presentation And Treatment, Oleksandr Khoma

Theses

Background

The accurate diagnosis of gastro-oesophageal reflux pulmonary micro-aspiration has only become possible recently with the introduction of a novel technique of reflux micro-aspiration scintigraphy study combined with single photon emission computed tomography (SPECT) combined with x-ray tomography (CT) in a hybrid instrument (1-3). This has allowed the accurate diagnosis of pulmonary and airway contamination with refluxate. Previously only patients with large volume symptomatic reflux aspiration were diagnosed clinically (Mendelson syndrome) or by 2-dimentional barium meal or an older plantar (2 dimensional) technique of scintigraphic aspiration studies. The concept of reflux micro-aspiration has been implicated in multiple pulmonary diseases but …

Cross-Cue Reactivity Of Nicotine And Cannabis Vaping Products, Madeline Smith

Graduate Theses, Dissertations, and Problem Reports (ETD)

SIGNIFICANCE. The rewarding properties of nicotine increase when administration is paired with external stimuli, or “cues”, including those related to vaping products. Given the visual similarity between nicotine vaping products (NVPs) and THC vaping products (TVPs), exposure to one product may elicit reactivity (e.g., craving, urge to use) to the other. The present study aimed to develop a set of cues capable of differentiating NVPs from TVPs to inform investigations of cross-cue reactivity. METHODS. Images (n=61 NVPs; n=64 TVPs; 7=unspecified) were obtained via an online search using both generic (“vape”, “vape pen”) and product-specific (e.g., “nicotine vape”, “dab pen”) keywords …

Comparison Of Push-Pull Air Curtain To Overhead Downdraft Systems On Aerosol Containment And Distribution In Controlled Environments, Manal Mutairi

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Comparison of Push-Pull Air Curtain to Overhead Downdraft Systems on Aerosol Containment and Distribution in Controlled Environments.

This dissertation looks at the ongoing issue of tiny airborne particles created during medical and dental procedures and evaluates ways to reduce the risk of exposure for healthcare workers and patients to these particles. The first study focuses on the size, how long particles stay in the air, and how far they travel from common medical procedures that create aerosols, showing that tiny particles (less than 5 µm) can stay in the air long enough to escape basic droplet controls. As a …

Evaluation Of Finger-Tightening Torque Applied To Implant Healing Abutments By Dental Providers With Varying Experience And Physical Characteristics: An In-Vitro Study., Bayan Abuhalimeh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Evaluation of Finger-Tightening Torque Applied to Implant Healing Abutments by Dental Providers with Varying Experience and Physical Characteristics: An In-vitro Study

Bayan Abuhalimeh, D.D.S

Aim: The primary objective of this project is to measure the actual torque applied by dental providers when finger-tightening a healing abutment and assess the variability among individuals. A secondary objective is to analyze the correlation between applied torque and: provider experience level (residents, general dentist, specialist); gender; age; and, physical attributes (e.g., grip strength, hand size, and dominant hand used for tightening). The null hypothesis is that there is no difference in the mean finger-tightening …

Self-Leadership And Perceptions Of Artificial Intelligence: A Single-Case Study, Patrik Garren

Graduate Theses, Dissertations, and Problem Reports (ETD)

The purpose of this single-case qualitative project is to uncover how self-leadership’s behavioral and cognitive strategies influence perceptions of Artificial Intelligence (AI) and AI adoption. While existing literature acknowledges that there is an association between self-leadership, technology’s perceived usefulness and ease of use, as well as comfort with AI preparedness and its professional impact, there is limited research on how self-leadership shapes perceptions of AI and AI adoption in real-life contexts. To fill this gap in contemporary literature, this project analyzes qualitative semi-structured interviews with 25 healthcare professionals involved in the implementation of ‘AI Model 1’ at their mid-sized United …

Rurality, Infant Feeding Practices, And Perinatal Cardiovascular Health Behaviors, Elly Marie Marshall

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Cardiovascular diseases are a leading cause of pregnancy-related deaths in the United States, with higher rates in rural areas. While limited healthcare access contributes to this disparity, other factors remain unclear. Breastfeeding provides long-term protection against cardiovascular disease, but modern infant feeding practices are complex and may impact maternal cardiovascular health (CVH) in unexpected ways. Healthy CVH behaviors of sufficient sleep duration, adequate physical activity, a healthy diet, and nicotine avoidance can enhance protection against future cardiovascular disease risk. Therefore, the aims of this dissertation are to 1) assess associations between rurality and first trimester CVH behaviors; 2) synthesize …

Facial Aesthetics And The Esthetic Plane: Effects Of Modern Lip Trends, Allison Paige Fritz

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background and Objectives: The objective of this study is to evaluate whether there is a difference in aesthetic preferences of lip position between dental professionals and the general public, which we will refer to throughout the paper as lay people. In addition, age and gender differences will be determined to evaluate whether there is a need to re-evaluate the accepted normative values for lips to Esthetic plane (E-plane).

Experimental Design and Methods: A cross sectional, observational study design was used. The study aim was to evaluate the perception and opinions regarding lip position and fullness of both lay people …

Comparison Of Three Methods In Diagnosing Maxillary Transverse Discrepancy, Madison Hull Smith

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Comparison of Three Methods in Diagnosing Maxillary Transverse Discrepancy

Thesis by Madison Smith, D.D.S.

Introduction

There are several different methods in determining the maxillary transverse discrepancy (MTD). In specific, MTD can be determined with the help of a cone beam computer tomography (CBCT), 3D scan and models, or simply a 2D occlusogram.  Do they provide the same MTD values for diagnosing transverse discrepancies? A patient may need a certain amount of skeletal and dental expansion based on a diagnosis of MTD, but this amount may vary depending on the diagnosis method used. There is a lack of knowledge in …

Bridging The Sensory Gap With Occupational Therapy: Program Development For Sensory Integration In Inpatient Rehabilitation For Adults With Central Nervous System Injuries, Callie Marie Honaker

Graduate Theses, Dissertations, and Problem Reports (ETD)

Objectives: This project aimed to identify sensory processing deficits in adults with central nervous system injuries and to inform the development of sensory-informed program components in an inpatient rehabilitation setting. Participants: A total of 76 adults admitted with diagnoses including cerebrovascular accident, brain injury, and spinal cord injury were included. Methods: A structured sensory screening and mental health questionnaire were administered and compared to prescreening admission documentation and PHQ-9 scores. Descriptive statistics and inferential analyses were conducted. Results: Sensory impairments were highly prevalent, with participants demonstrating an average of three impairments across the sensory domains. Proprioceptive, tactile, and visual deficits …

Community Resilience Drives Change, Andrew Thomas Solt

Graduate Theses, Dissertations, and Problem Reports (ETD)

The opioid crisis has impacted many Americans. From 1999 to 2023, approximately 800,000 people have died due to opioid overdose (CDC, 2025). What began as overprescriptions of painkillers has quickly evolved into a complex social health issue that is now further worsened by stronger synthetic drugs like fentanyl. Fentanyl and fentanyl analogs (synthetic opioids that are very similar chemically to fentanyl) are often found in illegal drug supplies and in counterfeit pills (CDC, 2025). Thus, individuals who might have been initially overprescribed painkillers might now be pushed towards illegally produced drugs that are significantly more potent than what they were …

Comparative Evaluation Of Bending Resistance And Retentive Torque Stability Of Zest Locator® And Straumann Novaloc® Abutments: An In Vitro Study, Hammad Ul Haq

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Comparative Evaluation of Bending Resistance and Retentive Torque Stability of Zest Locator® and Straumann Novaloc® Abutments: An In Vitro Study

Hammad Ul Haq B.D.S.

Objective: To compare the mechanical performance of Locator® (Zest Anchors) and Novaloc® (Straumann) implant overdenture attachment systems connected to Straumann Bone Level Conical (BLC) implants under standardized cyclic and static off-axis loading conditions.

Materials and Methods: Ten Straumann BLC implants were divided into two groups (n = 5): Group 1 received Locator® abutments and Group 2 received Novaloc® abutments. All abutments were tightened to 35 N·cm and retightened after 10 minutes. Baseline removal torque values …

Hyperglycemia Detection From Sigle - Lead Ecg Using A Hybrid Cnn & Transformer Model, Adam Ayomikun Ogunjembola

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract
Hyperglycemia Detection from Single-Lead ECG using a Hybrid CNN & Transformer Model
Adam Ogunjembola

Diabetes Mellitus is known as high blood glucose. This high blood glucose level happens when the body has a problem with producing or using insulin. Insulin is a very important hormone that the pancreas makes to control how much glucose gets into the bloodstream and cells. Diabetes Mellitus has an effect on the body if it is not treated, such as damaging the blood vessels and nerves which can lead to stroke, kidney failure, heart attack and permanent loss of vision. Since people with diabetes …

Exploring The Role Of Occupational Therapy In A Pediatric Specialty Care Office, Sierra Leigh Hays

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: The role of OT in primary and specialty care clinics is a rising area of interest in the field. There are also many multidisciplinary clinics that OTs can be or are apart of. This study aims to evaluate the consulting role of OT in primary and specialty care clinics, as well as to evaluate data collected by an OT in a pediatric brachial plexus and peripheral nerve clinic. Methods: The first objective was focused on analyzing functional outcomes, using the Active Movement Scale (AMS), of children following neurosurgery or onabotulinum toxin A injections. This was a retrospective study with …

Caring For The Caregiver: Implementing An Occupational Therapy-Tailored Educational Program To Alleviate Caregiver Burden, Lura Elizabeth Simons

Graduate Theses, Dissertations, and Problem Reports (ETD)

Caregivers of traumatic brain injury (TBI) survivors experience caregiver burden, which is a prevalent issue. The most significant concern is for symptoms of burden affecting mental health and sleep quality. This doctoral capstone project addressed the knowledge gap regarding programs that alleviate these signs and symptoms through evidence-based interventions. The objective was to create an educational program with modules that demonstrated improvement in satisfaction and content understanding through in-person sessions and individualized interviews with staff members. This project aimed to reduce perceived burden by conducting in-person sessions to implement interventions through an occupational therapy (OT) lens and by using educational …

Examining Preoperative Health And Lifestyle Risk Factors In Patients Awaiting Surgery During Covid-19 In Western Australia, Nadine Radin

Theses

This study investigated the prevalence of modifiable preoperative lifestyle risk factors among patients undergoing upper gastrointestinal and colorectal surgery at a metropolitan hospital in Perth, Western Australia (WA). It aimed to characterise behaviours such as smoking, alcohol and drug use, nutritional risk, physical fitness, frailty, and body mass index (BMI), and to examine whether these changed during the early phase of the COVID-19 pandemic in 2020 compared to 2019.

A retrospective audit of 2,340 patient medical records was conducted, with data extracted from routinely collected preadmission documentation. Regression models compared the prevalence of risk factors across matched calendar periods, adjusting …

Velocity Based Training In Athletic Development, Ross Martin Sangalang

Graduate Student Theses, Dissertations, & Professional Papers

The foundation of high-level sport performance is the ability to produce and express force rapidly across the task-specific temporal demands of sport. Traditional percentage-based prescription methods have long been used to develop hypertrophy, maximal strength, and power; however, fixed %1RM prescriptions fail to account for daily undulations in athlete readiness, accumulated fatigue, and changes in neuromuscular capacity. Velocity based training (VBT) offers a practical framework to regulate training through measurement of concentric velocity, allowing coaches to more accurately prescribe loads, stringently monitor repetition quality, and precisely regulate fatigue. This review discusses the neuromuscular qualities underpinning success in athletic endeavors, limitations …