Digital Commons Network^™

Identification And Preclinical Assessment Of Novel Therapeutic Modalities In Environmental Exposure-Induced Lung Disease, Aaron D. Schwab

Theses & Dissertations

Environmental lung diseases are preventable respiratory conditions either caused or made worse by inhaled environmental exposures. Contemporarily, environmental lung diseases are most associated with workplace exposures given specific occupational processes aerosolize inflammatory agents that can be inhaled at high concentrations. Although a considerable amount is known regarding immunoglobulin (Ig)E-mediated responses to environmental exposures, little is known about non-IgE mediated respiratory conditions resulting from lipopolysaccharide (LPS)-enriched organic dust exposure(s). Chronic respiratory diseases such as asthma, hypersensitivity pneumonitis, chronic obstructive pulmonary disease (COPD), and pulmonary fibrosis have all been identified as environmental lung diseases caused or exacerbated by such environmental dusts. Therapeutic …

Let-7 Restrains An Epigenetic Circuit In At2 Cells To Prevent Fibrogenic Intermediates In Pulmonary Fibrosis, Matthew J Seasock, Md Shafiquzzaman, Maria E Ruiz-Echartea, Rupa S Kanchi, Brandon T Tran, Lukas M Simon, Matthew D Meyer, Phillip A Erice, Shivani L Lotlikar, Stephanie C Wenlock, Scott A Ochsner, Anton Enright, Alex F Carisey, Freddy Romero, Ivan O Rosas, Katherine Y King, Neil J Mckenna, Cristian Coarfa, Antony Rodriguez

Faculty, Staff and Students Publications

MicroRNA-mediated post-transcriptional regulation of lung alveolar type 2 (AT2) and AT1 cell differentiation remains understudied. Here, we demonstrate that the let-7 miRNA family plays a homeostatic role in AT2 quiescence by preventing the uncontrolled accumulation of AT2 transitional cells and promoting AT1 differentiation. Using mouse and organoid models, we show that genetic ablation of let-7a1/let-7f1/let-7d cluster (let-7afd) in AT2 cells prevents AT1 differentiation and leads to KRT8 transitional cell accumulation in progressive pulmonary fibrosis. Integration of AGO2-eCLIP with RNA-sequencing identified direct let-7 targets within an oncogene feed-forward regulatory network, including BACH1/EZH2/MYC, which drives an aberrant fibrotic cascade. Additional CUT&RUN-sequencing analyses …

Integrating Positive Psychology And Spirituality To Foster Meaning And Well-Being In Older Adults, Crystal Morris

Adultspan Journal

This perspective article explores the integration of positive psychology interventions (PPIs) and spirituality in therapy to foster meaning and well-being in older adults. It highlights exercises such as the positive introduction, positive legacy, character strengths, mindfulness, mindful-based yoga, and a manifestation prayer journaling. The interventions presented are tools to support older adults that may experience depression, difficult life transitions, and the search for renewed meaning. Therapists who integrate PPIs and spirituality into therapy can promote a holistic, non-pathological approach to treatment.

How Does Snap Access Prior To Pregnancy Affect Maternal And Infant Health Outcomes?, Sarah Hamersma, Mitch Mcfarlane

Center for Policy Research

Consistent access to healthy food even before pregnancy can play a role in maternal and child health. The Supplemental Nutrition Assistance Program (SNAP) provides food assistance to low-income individuals, including those who do not yet have children (often classified as Able-Bodied Adults Without Dependents, or ABAWDs). Our study uses ABAWD work requirement waivers – which vary within and across counties over a 15-year-period – as a measure of SNAP access for childless women. We use this variation to investigate pre-pregnancy SNAP access and the health of mothers and their infants. Using rich, population-wide Vital Statistics data combined with county-level SNAP …

Characterizing Spatial Epidemiology In A Heterogeneous Transmission Landscape Using The Spatial Transmission Count Statistic, Leke Lyu, Gabriella Veytsel, Guppy Stott, Spencer Fox, Cody Dailey, Lambodhar Damodaran, Kayo Fujimoto, Pamela Brown, Roger Sealy, Armand Brown, Magdy Alabady, Justin Bahl

Faculty, Staff and Student Publications

Background: Viral genomes contain records of geographic movements and cross-scale transmission dynamics. However, the impact of regional heterogeneity, particularly among rural and urban centers, on viral spread and epidemic trajectory has been less explored due to limited data availability. Intensive and widespread efforts to collect and sequence SARS-CoV-2 viral samples have enabled the development of comparative genomic approaches to reconstruct spatial transmission history and understand viral transmission across different scales.

Methods: We proposed the spatial transmission count statistic that efficiently summarizes the geographic transmission patterns imprinted in viral phylogenies. Guided by a time-scaled tree with ancestral trait states, we identified …

Building Community Through Food And Health: Student Initiatives To Address Food Insecurity In Mississippi, Sarah E. Sawaya

Honors Theses

This thesis explores food insecurity in Oxford and Lafayette County, Mississippi, within the broader context of state, national, and global challenges. Over a four-year period, student-led and community organizations collaborated to design programs that addressed both food access and chronic illness prevention through education, outreach, and direct service. Community input was gathered through health screenings, campus engagement, and informal interviews with residents, which guided the development of practical tools like recipe kits, QR code-based cookbooks, and on-site health education. These efforts were rooted in local partnerships and shaped by the lived experiences of those most affected. This project demonstrates that …

Investigating Social Network Peer Effects On Hiv Care Engagement Using A Fuzzy-Like Matching Approach: Cross-Sectional Secondary Analysis Of The N2 Cohort Study, Cho-Hee Shrader, Dustin T Duncan, Redd Driver, Juan G Arroyo-Flores, Makella S Coudray, Raymond Moody, Yen-Tyng Chen, Britt Skaathun, Lindsay Young, Natascha Del Vecchio, Kayo Fujimoto, Justin R Knox, Mariano Kanamori, John A Schneider

Faculty, Staff and Student Publications

BACKGROUND: Social network data are essential and informative for public health research and implementation as they provide details on individuals and their social context. For example, health information and behaviors, such as HIV-related prevention and care, may disseminate within a network or across society. By harmonizing egocentric and digital networks, researchers may construct a sociocentric-like "fuzzy" network based on a subgroup of the population.

OBJECTIVE: We aimed to generate a more complete sociocentric-like "fuzzy" network by harmonizing alternative sources of egocentric and digital network data to examine relationships between participants in the Neighborhoods and Networks (N2) cohort study. Further, we …

Over-The-Counter Cold Medication Usage Self-Efficacy Among Undergraduate Students In The United States, Ray Goodwin

Honors Theses

Background

This study looks at the trends in over-the-counter medication usage and self-efficacy among undergraduate college students in the United States. Over-the-counter (OTC) medications serve as the most easily accessible and commonly purchased medications and can be used as a basis to determine this demographic’s attitudes and behaviors towards self-medication. In addition, undergraduates represent a diverse population for analyzing differences among demographic groups.

Methods

A Qualtrics survey was sent out to undergraduates across the US via a panel, and the team received 403 useable responses. As part of a larger study, the survey presented participants with four different scenarios at …

A Local Assessment Of Glp-1 Use For Weight Loss: An Interview Study, Maci Bradley

Honors Theses

Glucagon-like peptide-1 (GLP-1) receptor agonists are a novel class of medications used primarily for the treatment of type 2 diabetes, as well as for chronic weight management. The first GLP-1 medication, exenatide, was FDA-approved in April of 2005 for glycemic control, however, it was not until December of 2014 when liraglutide became the first GLP-1 FDA-approved for weight loss. There are now eight FDA-approved GLP-1s, only two of which are approved for weight loss. GLP-1 use has become increasingly popular in recent years, even extending to the college-aged population. The purpose of this study is to examine the trends in …

Tackling Social Stigma: An Ethical Obligation In Healthcare Intervention To Involuntary Childlessness, Persis Naumann

Electronic Theses and Dissertations

The stigma associated with involuntary childlessness has negatively affected health and well-being for several decades. This situation is particularly exacerbated for women within the Tamil socio-cultural context, resulting in feelings of shame, neglect, denial, isolation, and constituting a significant barrier to long-term access to healthcare services. Although advancements have been made in the provision of biomedical care, the psychosocial support remains inadequately addressed. Moreover, there are currently no healthcare interventions that specifically target the stigma associated with this issue, which hinders open communication with healthcare providers, delays necessary treatments, and adversely impacts overall health outcomes. The central thesis of this …

Fall Incidences, Risk Factors, And Health Effects Among Early- And Middle-Aged Elderly People In Rural Areas Of Border Provinces In Southern Thailand, Phnom Sukchan, Tapanan Prateepko, Arinda Ma-A-Lee, Kruawan Hounkong, Penporn Sujiwattanarat, Gornganok Piboonpol

Journal of Health Research

Background: Elderly individuals with physical and psychological challenges face a high risk of falls. This study aimed to assess the incidence, health effects of, and risk factors for falls among those aged 60-79 years old in Thailand's three southern border provinces.

Methods: A community cross-sectional study was conducted between October 2021 and September 2022. Questionnaires were administered though verbal face-to-face conversations. Descriptive statistics, the Chi-square test, Fisher’s exact test, and logistic regression were used.

Results: A total of 419 elderly participants were recruited, while 374 participated in the study. The incidence of falls was 37.4% with an average of 1.7 …

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Recurrent Urinary Tract Infections In The Urgent Care Clinic, Stephanie Krol

Evidence-Based Practice Project Reports

Nearly 60% of women will suffer from a urinary tract infection (UTI) in their lifetime, with 20- 40% of them suffering from multiple (Anger et al., 2022). The primary purpose of this evidence-based project was to implement a multi-modal intervention to improve identification of women who suffer from recurrent urinary tract infections (rUTIs) and to assist in the prevention and treatment of future UTIs. Additionally, the project aimed to increase the number of referrals to urology for better management of these patients. This project was implemented at an Urgent Care Clinic (UCC) in northwest Indiana. Eligible participants who presented with …

Experience Of Coparents/Partners Of African American Mothers Participating In Breastfeeding Education, Samantha Hickson

Walden Dissertations and Doctoral Studies

Coparents and partners of African American mothers are critical in the initiation and continuation of breastfeeding and influence a woman’s decision to breastfeed. The purpose of this qualitative study was to explore the experience of coparents/partners of African American mothers participating in breastfeeding education and its impact on the support they provide. Bandura’s social cognitive theory provided the theoretical foundation for this study. Data were collected via semi-structured interviews with 11 participants. Data analysis followed the traditional seven steps of interpretative phenomenological analysis. Findings showed that while coparents and partners of African American breastfeeding mothers found breastfeeding education to be …

Examination Of Eating Disorder Risks And Body Image Dissatisfaction Among Division Iii Student-Athletes, Maddie Wisener

Masters Theses/Capstone Projects

Eating disorders (ED) and pathogenic behaviors are prevalent concerns among collegiate athletes due to performance pressures and body image expectations. This cross-sectional study examined the risk of ED among 243 student-athletes (Males: 54.9%, Females: 44.3%, Non-Binary: 0.4%) at a private institution in the Midwest. The convenience sample included student-athletes from baseball, basketball, cheerleading, cross country, football, golf, lacrosse, soccer, softball, tennis, track, volleyball, and wrestling teams. The participants were given a demographic survey, the Eating Attitudes Test-26, and Sex-Specific Figural Stimuli Silhouettes to assess eating behaviors and perceived and desired body images. Overall, 22.1% of participants were at risk for …

Preserving What Matters: A Multimodal Approach To Maintaining Fat-Free Mass During Anti-Obesity Medication Based Weight Loss, Sarah Gore

Evidence-Based Practice Project Reports

Weight loss is often associated with reductions in fat-free mass (FFM), which can negatively impact metabolic rate, thermoregulation, bone density, functional capacity, and overall quality of life (Roth et al., 2022; Sedlmeier et al., 2021). This Evidence-Based Practice project aimed to reduce FFM loss in adults prescribed anti-obesity medications (AOMs) for weight management through a targeted, multimodal intervention. Twenty-two patients beginning AOM treatment at a family practice in northwest Indiana were invited to participate, with 19 consenting to enroll. Each participant received personalized guidance, including tailored calorie and protein intake goals to support a hypocaloric, high-protein diet, alongside evidence-based aerobic …

Impact Of Implementing An Updated Cervical Cancer Screening Protocol In The Primary Care Setting, Teri A. Koch

Evidence-Based Practice Project Reports

Cervical cancer is one of the most common types of cancer among women globally. Current screening methods by clinicians include cytology sampling, high-risk human papillomavirus sampling, or co-testing with both methods. These tests may detect cell changes before they become cancerous, yet the uptake of these methods has decreased in recent years (Aginga, 2022; Office of Disease Prevention and Health Promotion, 2023; Popalis et al., 2022; Sung et al., 2021). The primary purpose of this evidence-based practice project was to determine if the implementation of an updated cervical screening protocol improved the linkage of abnormal results to appropriate clinical follow-up …

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Early Childhood Caries In The Primary Care Setting, Rieley M. Hull

Evidence-Based Practice Project Reports

Early childhood caries (ECC) is the most prevalent chronic childhood disease and, if untreated, can lead to significant long-term health and social consequences, posing a substantial healthcare burden (AAPD, 2023; ADA, 2023; USPSTF, 2021; WHO, 2022). This evidence-based practice (EBP) project aimed to implement a multi-modal intervention to reduce ECC risk factors, prevent new dental caries, and halt the progression of existing dental caries. Conducted in a pediatric primary care setting in West Michigan, the project included patients five and under who received an oral examination and dental caries risk assessment following the AAP’s guidelines. Based on their oral health …

Out From Under: Stories Of Endometriosis, Prisca Edwards

Theses and Dissertations

Six individuals. One diagnosis. In Out From Under, people living with endometriosis gather for an art-centered workshop. Through collage and conversation, they transform isolating medical experiences into paths of connection and collective healing.

Endometriosis affects approximately one in ten women of reproductive age, yet diagnosis is often delayed by nearly a decade. During this time, many suffer from debilitating symptoms without adequate care or accessible treatment. Out From Under explores the lived experience of endometriosis through the lens of socially engaged documentary filmmaking. Participants share their medical histories, emotions, and frustrations in a structured yet open environment designed for intimacy, …

Dnp Final Report: Improving Adherence With Cms Sep-1 Sepsis Bundle In The Emergency Department, Emmanuel Bernards

DNP Final Reports

Adherence to the CMS SEP-1 Sepsis bundles is critical to sepsis management and leads to lower sepsis mortality, lower incidence of readmission, reduced length of hospital stay, and improved patient outcomes. This medical center has struggled to meet the required 71% adherence rate set by the Center for Medicaid and Medicare, representing the benchmark of acceptable care of sepsis patients. Therefore, the following PICOT question arises: among the hospitals’ ED physicians and nursing staff (P), how does a multimodal approach consisting of education, visual reminders, and audit and feedback (I) compared to a single approach (education) (C) affect adherence to …

Evaluation Of Engagement And Collaboration Among Hospitals In The Maine Rural Maternity & Obstetrics Management Strategies (Rmoms) Network, Molly Volt, Lori Travis, Caroline Zimmerman, Erica Swan, Katherine Crothers, Anna Gilbert, Kate Allerding

Costas T. Lambrew Research Retreat 2025

Introduction

• Maine RMOMS Network: Grant awarded to Maine in 2022, 16 rural birthing hospitals & 5 state partners

• Network Goal: Improve access to maternity and obstetrics care for rural communities

• A qualitative Network Health Evaluation was conducted to diagnose strengths and areas of growth regarding engagement and collaboration

Conflict, Human Development, And Neonatal Health: A Regional Analysis Of The Eastern Mediterranean, Zynub A. Al-Sherri

Honors Theses

Background. The effects of war and conflict on a population are direct and indirect in nature. One of the most devastating consequences is the destruction of healthcare infrastructure, which severely disrupts access to essential services and impedes long-term socioeconomic development. Among those most affected are newborns, as the neonatal period represents the most vulnerable stage of a child’s life and serves as a sensitive indicator of a society’s overall health and socioeconomic conditions. Given the persistent instability in the Eastern Mediterranean Region (EMR), this study aimed to explore how conflict and human development are associated with neonatal health outcomes …

Parental Vaccine Hesitancy And The Decision To Vaccinate Children Against Covid-19, Jessica Mckee

Walden Dissertations and Doctoral Studies

While there is a significant body of literature regarding vaccine hesitancy, there is a gap in the literature on its impact to parents’ decisions to vaccinate their children against a pandemic pathogen. The purpose of this study was to examine the relationship between parental vaccine hesitancy, measured using the health belief model (HBM) theoretical framework constructs of the Vaccine Hesitancy Scale (VHS; the degree to which an individual trusts in vaccine efficacy, safety, the reliability and trustworthiness of vaccine programs, community impact, perceived risks, and the importance of childhood vaccinations), and parents’ decision to vaccinate their children against COVID-19 with …

Impact Wv: Adapting Patient Navigation Models Of Care To Improve Services To Caregivers Of Infants Exposed To Substances In Utero, Charlotte S. Workman Bsms, Ccrp, Lesley Cottrell, Mawyah Bashatah, Aisha Hashmi, Kayla Richard, Poornima Murthy, Susan Harrison, Ashleigh Mckinsey, Amy Bott, Sydney Leary, Cody Smith, Melina Danko

Journal of Appalachian Health

Patient navigation (PN) is a healthcare service delivery model designed to partner clients with service providers to reduce challenges to health care, as well as to improve access to care by identifying opportunities to coordinate services for clients. The IMPACT WV project at the West Virginia University Center for Excellence in Disabilities (WVU CED) implemented PN models of care for caregivers of infants exposed to substances in utero. The purpose of this program was to reduce burden for potentially at-risk families and improve caregiver and infant outcomes as a result. To understand the processes that influence the implementation of PN …

Patient-Clinician Communication In The Appalachian Region: A Scoping Review, Kawther Al Ksir, Hadii M. Mamudu, Chidiebube J. Ugwu, Emily K. Flores, Tracy Fasolino, Holly Wei, Rick L. Wallace, Florence M. Weierbach

Journal of Appalachian Health

Introduction: Effective communication between patients and clinicians is a critical component of quality health care, influencing disease prevention, management, and outcomes. In regions with unique socioeconomic and geographic challenges, communication barriers can further exacerbate health disparities. Understanding the factors that facilitate or hinder patient-clinician communication is essential for developing targeted interventions that improve health care delivery.

Purpose: This review explores the existing literature on patient-clinician communication concerning cardiovascular disease (CVD) in the Appalachian Region with the aim to understand existing gaps and interventions.

Methods: PubMed and Web of Science databases were utilized to conduct a systematic search. The Population, Concept, …

Determinants Of Willingness To Share Wearable Health Data With Health Care Providers In Appalachian Populations: An Exploratory Study, Gilbert Munoz Cornejo, Joonghee Lee

Journal of Appalachian Health

Background: Wearable health devices capture metrics (e.g., physical activity, ECG, sleep) that can enhance care when shared with providers. Yet, willingness to share wearable data may differ in Appalachia, where chronic disease burdens, mistrust, and limited infrastructure pose unique challenges.

Objective: This study explored (1) which sociodemographic, health, and digital behaviors correlate with willingness to share wearable data and (2) how these insights can guide region-specific interventions in Appalachia.

Methods: We analyzed 320 Appalachian respondents from the Health Information National Trends Survey (HINTS 6). Descriptive statistics and logistic regression models examined willingness to share wearable data. Because of small cell …

Improving Hospital Discharges Before Noon: Implementation Of A Vida (Very Important Discharge Appointment), Nadia Paul

Evidence-Based Practice Project Reports

Delays in hospital discharge can negatively affect hospital throughput and bed capacity, resulting in increased length of stay and boarding of patients in off-unit locations which causes concerns for patient safety and potential harm (Rutherford et al., 2017). The purpose of this DNP project was to determine if the implementation of a very important discharge appointment (VIDA) would increase the number of hospital discharges occurring before noon (DBN) each day. This project was implemented at a 350-bed academic medical center in East Central Indiana. A 25-bed, adult medical unit served as the pilot unit. In total, 538 patients were included …

Breaking Barriers: Exploring The Impact Of Social Media On Women's Behaviors, Attitudes, And Barriers In The Free-Weights Room, Kate Jensen

Master's Theses

The purpose of this study was to determine social media’s impact on women’s habits and attitudes on the weight-room area of a college recreation center. Using non-experimental quantitative methods, the frequency and type of weightroom use by women was measured, as well as the type and frequency of fitness-focused social media use.

Frontier Healthscapes: Competing Narratives Of Disease, Environment, And Wellbeing In Early Minnesota, Aidan Reynolds

Geography Honors Projects

Across settler societies, health narratives were shaped by evolving tensions between lay and expert knowledge, frameworks of disease causation, and perceptions of the environment as both a source of health and a threat. In the decades following Euro-American settlement (1860-1900), Minnesota became a focal point for these debates, with its landscape fostering complex and competing narratives on health, wellbeing, and disease. This paper explores how public health discourse developed in Minnesota through the perspectives of institutions, the public, and economic interests. Combining environmental history with critical discourse analysis of archival materials, this study examines shifts within the Minnesota State Board …

Promotion Of Women’S Preventative Health Behaviors For Breast And Cervical Cancer, Shelby Lopez

Doctor of Nursing Practice Scholarly Project

Women’s health prevention is typically not a significant topic for discussion. Health prevention measures are often discussed after a new diagnosis, rather than being a proactive approach toward improving women’s health. Breast and cervical cancer continue to be prevalent today and, to decrease the number of women diagnosed with late-stage cancer, this scholarly project will focus on improving the participation in prevention behaviors among women 18-45 years of age, but also acknowledge the role self-efficacy and perception of health behaviors has on the participation in prevention measures. Pender’s Health Promotion Model will help acknowledge how social-behavioral factors affect prevention behaviors. …

Promoting Increased Consumption Of Fruits And Vegetables In Older Adults Through Self-Efficacy And Social Cohesion, Ashley Lynn Nelson

Doctor of Nursing Practice Scholarly Project

The purpose of this scholarly project was to design and offer a nutrition education program on fruit and vegetable consumption to a group of rural adults aged 65 and older. It was hypothesized that the nutrition program would directly motivate older adults to increase dietary consumption of fruits and vegetables. The project utilized the Health Promotion Model as the theoretical framework. To incorporate this project into a quantitative design, the methodological design that was applied is a non-experimental or observational design. This project included a four-week educational program in the Spring of 2023 that provided information on the importance of …