Digital Commons Network^™

Money Matters: Investigating The Emotional, Cognitive, And Biological Pathways Connecting Maternal Early Life Financial Insecurity And Parenting Quality, Elise Power, Stacey N. Doan

CMC Senior Theses

Early life adversity has been shown to have a variety of negative effects on adult functioning, including parenting quality, with implications for child wellbeing. Adverse early life experiences including poverty have been linked to long-term disruptions in emotional, cognitive, and physiological functioning that compromise the ability to provide sensitive, nurturing care. The present study investigated whether emotional regulation difficulties, physiological regulation, and cognitive function mediate the relationship between early life financial insecurity and parenting quality. A sample of 132 mother-child dyads completed self-report measures, biological samples, and cognitive assessments. A multiple mediation model ran in SPSS, revealed a significant indirect …

A Case Study In Program Evaluation, Kaitlyn E. Lee

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This capstone project evaluates a fictious online MRSA education program developed by the Lexington-Fayette County Health Department and Fayette County Public Schools after a suspected outbreak among student athletes. Using the CDC’s 6-Step Framework for Program Evaluation, the project focuses on how stakeholders were engaged, how the program was described and mapped, how the evaluation questions were developed, what evidence was collected, and how conclusions were formed. The goal of the evaluation is to understand whether the program’s structure, delivery, and implementation support clear infection-control education for the different school personnel who use it. This project emphasizes the overall evaluation …

Tort Liability For Failure To Age Gate: A Promising Regulatory Response To Digital Public Health Hazards, Matthew B. Lawrence, Brett Frischmann, Avi Sholkoff

Faculty Articles

Tort liability for failure to “age gate” is a promising legal response to the public health hazards of AI, social media, sports gambling, and other digital spaces. Tort liability for failure to “age gate” hinges liability for harms to minors on an app’s failure to take reasonable steps to prevent minors from gaining access or otherwise to apply appropriate governance rules, such as privacy-protective default settings or ensuring genuine parental consent. While no one legal response is a panacea, tort liability for failure to age gate carries several distinctive advantages that make it a particularly promising option at this stage …

Exploration Of The Mechanisms Of Benjakul’S Anti-Rheumatoid Arthritis Actions Through Network Pharmacology, Hongxiang Duan

Chulalongkorn University Theses and Dissertations (Chula ETD)

Rheumatoid arthritis (RA) is driven by chronic inflammation and matrix degradation; traditional Thai formula Benjakul (BJK) is empirically used for inflammatory conditions, but its mechanisms are not well defined. To assess the antioxidant capacity of BJK and to elucidate potential anti-inflammatory targets and signaling pathways relevant to RA. BJK and its five constituent herbs were extracted with 99% ethanol and evaluated for TPC, TFC, FRAP, and DPPH assays. LC–MS/MS was used to profile key bioactive compounds, which were further filtered by SwissADME and subjected to target prediction using SwissTargetPrediction. Overlapping targets with RA-related genes were analyzed by GO and KEGG. …

Association Between Knowledge, Attitude, Risk Perception, Expectancies And Cannabis Use Among International University Students In Thailand : A Cross-Sectional Study, Yueting Liu

Chulalongkorn University Theses and Dissertations (Chula ETD)

The global increase in cannabis use, particularly among young individuals, poses a serious public health risk. Thailand decriminalized cannabis in 2022, under this situation, international students are experiencing changes in social attitudes toward cannabis use and have increasing access to sources of cannabis. There is currently lack of research on cannabis use among this group in Thailand. This study aimed to analyze the associations between knowledge, attitudes, risk perceptions, and expectancies and cannabis use among international university students in Thailand. This cross-sectional study was conducted among international university students aged 18 years and older in Thailand. Participants were collected through …

Cause Of Death? -- It's Probably Not What's Reported On The Death Certificate, Lauren R. Roth

Lewis & Clark Law Review

In the age of big data, this country has a data problem—inaccurate and incomplete information in death certificates. The problem has long been hidden by the numbers reported—as have the people whose deaths go uncounted, but the COVID-19 pandemic unveiled the scope of the issue. Since the beginning of the pandemic, “excess deaths” (i.e., any deaths above the number predicted by existing mortality models) have increased significantly. Most of these excess deaths are likely attributable to COVID-19 because the decedent was never tested for COVID-19 or it was one of multiple factors contributing to their death. Other deaths are uncounted …

How Sleep Disorders And Sleep Duration Impact Memory, Alexandria J. Sims

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

INTRODUCTION: Sleep duration and sleep disorders can cause changes in memory function as populations age. Previous studies have shown that disordered sleep is associated with increased risk of cognitive dysfunction and long and short sleep durations can cause memory impairment. This study studies aims to find if there is an association between sleep disorders and sleep duration and the impacts on memory.

METHODS: In this study, 3,478 participants aged 60 year and older from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 dataset were included in adjusted and unadjusted models, comparing the sleep disorders and sleep duration exposures to …

Epidemiology Of Recurrent Herpes Labialis Among Dentistry Students: A Cross-Sectional Survey In Egypt, Sara Abdelwahed, Dalia Ghalwash, Al Hassan Diab

Dentistry

Aim: Recurrent herpes labialis (RHL) is a common viral infection with significant psychosocial and clinical implications. Dental students are particularly vulnerable due to stress and frequent patient contact, yet data on their epidemiology in Egyptian cohorts are scarce. The study aimed to determine the prevalence, recurrence patterns, and associated risk factors of RHL among dentistry students in Egypt. Materials and Methods: A cross-sectional survey was conducted among 559 dentistry students at the British University in Egypt. A structured, self-administered questionnaire captured sociodemographic data, history of RHL episodes, frequency, severity, and triggering factors. Data were analyzed using descriptive statistics and Chi-square …

Facilitated Group Care For Maternal And Child Health Model Fidelity: A Scoping Review, Ashley Gresh, Phoebe Parker, Anne Batchelder, Jalana Lazar, Christina X. Marea, Camilla Bjelland, Rohan D. Jeremiah, Giovanna Cristina Machado-Kayzuka, Hayden Geibel, Dhruvi R. Patel, Esnath Kapito, Kathleen F. Norr, Crystal L. Patil

Department of Pediatrics Faculty Publications

Group care is a transformative model of prenatal, postnatal, and well-child care. The Centering-based group care model has three core components: health care, interactive learning, and community building. It has been implemented in 33 countries with associated improved maternal and child health outcomes. Maintaining fidelity to the model is essential for its effectiveness. However, to date no standardised measure of fidelity to the group care model exists. This review aimed to explore how fidelity is measured in group care and identify common themes to understand what is essential to maintain fidelity. We used the scoping review framework by Arksey & …

Patterns Of Exclusive, Dual And Poly Tobacco Products Use Among Cancer Survivors In The United States, Ateeqa Ijaz, Miranda E. Gehris, Paul T. Harrell, Aditya Chakraborty, Rime Jebai, Wei Li, Olatokunbo Osibogun, Seyedeh Yasaman Alemohammad, Ziyad Ben Taleb, Ebbie Kalan

Department of Pediatrics Faculty Publications

Purpose

Identifying tobacco products use (TPU) patterns among cancer survivors (CSs) is critical to optimize survivorship care. This study examines exclusive cigarette/e-cigarette, dual (two tobacco-products) and poly (≥ 3 tobacco-products) use among CSs (vs. no cancer history) and its sub-types: smoking-related-cancers (SRCs) vs. non-smoking-related cancers (NSRCs) while also exploring socio-demographic factors.

Methods

The study analyzed 86,551 adults from the 2021–2023 National Health Interview Survey, including 10,846 (9.7%) CSs. Participants were categorized and analyzed based on their CSs status and TPU patterns. Weighted logistic regression models assessed the relationship between TPU and CSs status while adjusting for socio-demographic characteristics.

Results

CSs …

Air Pollution Exposures And Cognitive Function Among Older Americans, Clarisse Nyondo Okoma

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: New findings indicate that environmental factors, such as air pollution, could contribute to cognitive decline among older adults. Nonetheless, extensive longitudinal studies in the U.S. investigating this connection are few and far between.

Objective: This study assessed the relationship between long-term exposure to ambient air pollutants and cognitive function in older adults in the United States.

Methods: We examined data from the Health and Retirement Study (2010-2018), which included 234,250 observations from adults aged 50 and older. Cognitive performance was evaluated based on immediate and delayed word recall, a 27-point cognitive summary score, backward from 20, and …

Rct Pre-Post Training Analysis Of The Vipcorps Maternal Mortality Prevention Course With A Focus On Intimate Partner Violence (Ipv), Rose A. Wood

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Maternal mortality rates rob families across the U.S. of a mother figure, and each death is preventable. The U.S. has the highest maternal mortality rate of high-earning countries. This study assesses the effects of the VIPCorps program, a course on the top 3 risk factors of maternal mortality, on improving knowledge and attitudes towards victims of IPV. Students in helping professions at the University of Kentucky (n = 223) were recruited via on campus advertising and remotely allocated to either the VIPCorps program or a mock maternal mortality training control. Generalized linear modeling was used to estimate the difference in …

Exploring The Role Of Bingocize® Workshops In Enhancing Health And Well-Being In Older Adults, Kaitlyn Gray

Mahurin Honors College Capstone Experience/Thesis Projects

As the population of older adults grows, the need for better health and well-being also grows, making it necessary to implement effective strategies for healthy aging to improve the length and quality of life of older adults (CDC, 2024). This study evaluates the effectiveness of a Bingocize^® Workshop in improving the physical health of older adults. Bingocize^®, a unique program combining bingo with exercise, is designed to increase physical activity. Eleven (11) participants aged 68.55 ± 6.235 attended a ten-week workshop, two times per week focusing on physical exercises tailored to their abilities. The primary objective was …

Pathogen Surveillance Of Viruses And Antimicrobial Resistance Through Wastewater Based Epidemiology, William Strike

Theses and Dissertations--Biomedical Engineering

Pandemic surveillance is a cornerstone in public health safety, as it enables identification of pathogens circulating within a community before they become widespread outbreaks. Wastewater based epidemiology has blossomed in recent years due to its success in the SARS-CoV-2 pandemic, but this form of public health surveillance has a global equity problem. A large majority of the wastewater-based surveillance work has been done in large metropolitan cities with access to advanced testing infrastructure, which poses a challenge as we consider where pandemics have historically emerged. Therefore, there is a need to identify, adapt, and develop workflows to meet the needs …

Understanding The Impact Of The Medicaid Expansion On Hospital Length Of Stay And Emergency Department Use In Kentucky, Cameron Bushling

Theses and Dissertations--Epidemiology and Biostatistics

Three related analyses were performed to try to understand the immediate effects of Medicaid expansion on hospital systems in Kentucky. Medicaid expansion led to a large, sudden increase in the number of individuals eligible for various health care needs. This sudden increase in demand for health services lead to initial hypotheses regarding hospitals’ ability to handle this demand. The first analysis examined hospital average length of stay (LOS) using a linear mixed-effects model. Length of stay was modeled longitudinally between 2013 and 2015 to determine if significant changes in the slope of LOS could be detected after expansion (2014). Separate …

Changes In Cancer Diagnosis And Survival In The United States During The Covid-19 Pandemic, Justin T. Burus

Theses and Dissertations--Epidemiology and Biostatistics

The COVID-19 Pandemic led to global societal disruptions as political leaders and public health authorities attempted to control the spread of the newly discovered SARS- CoV-2 virus. While these measures were designed to lessen morbidity and mortality from a novel pathogen, their impact was also felt in many other, often unintended ways. The purpose of this dissertation is to use cancer surveillance research methods to examine the association between COVID-19 Pandemic-related disruptions and changes in the normal diagnosis and care of cancer in the United States.

The first two studies of this dissertation analyzed reductions in cancer diagnoses in the …

Enhancing Public Health Surveillance: Development And Validation Of Machine Learning Models For Suspected Opioid Overdose Detection In Emergency Medical Services Data, Peter J. Rock

Theses and Dissertations--Clinical and Translational Science

The ongoing opioid overdose crisis in the United States requires timely and accurate surveillance systems to inform public health responses. Traditional public health surveillance methods rely on hospital discharge data and death certificates, which suffer from significant reporting delays and miss cases where patients refuse hospital transportation. Emergency Medical Services (EMS) data presents a promising alternative with advantages in timeliness and case ascertainment but lacks validated definitions for suspected opioid overdose (SOO).

This dissertation addresses this critical gap through the development, validation, and fairness assessment of machine learning models with natural language processing (ML-NLP) for identifying SOOs in EMS data. …

Comparing Patency Of Pulmonary Stent Implantation And Balloon Angioplasty In Pulmonary Vein Stenosis: A Systematic Review And Meta-Analysis, Izza Batool, Muhammad K. Khan, Muhammad Zohaib, Ibrahim A. Khan, Syed A. A. Bukhari, Shreeja Shah, Khaled Harmouch, Hussam Al Hennawi, Bruce D. Klugherz

Abington Jefferson Health Papers

Pulmonary vein stenosis (PVS) is an insidious diagnosis associated with morbidity and mortality. Pharmacologic therapy may suffice initially, but advanced stages demand mechanical intervention. Pulmonary stent implantation (PSI) and pulmonary balloon angioplasty (PBA) are common strategies, both carrying restenosis risks. This meta‐analysis compares PSI and PBA to determine the superior revascularization strategy. We systematically searched databases until November 2023, identifying 11 studies with 780 patients. Studies, including those involving patients undergoing balloon angioplasty (BA) or stent angioplasty (SA) for PVS, were selected. Case reports, editorials, and cross‐sectional studies were omitted. Primary outcomes included restenosis requiring reintervention, 5‐year freedom from restenosis, …

Why A Healthy Diet Is Important For Women's Health, Halley Doster

Theses and Dissertations

Nutrition plays a critical role in women’s reproductive health, yet many women face barriers to maintaining a balanced diet. This study aimed to examine the relationship between nutritional intake and reproductive health outcomes among women of reproductive age, as well as to assess their knowledge and challenges related to healthy eating. Using a cross-sectional survey design, data were collected from 50 women at a community health center and analyzed using SPSS to generate descriptive statistics and explore patterns through chi-square and regression analyses. Findings revealed that most participants had moderate to low fruit and vegetable intake, and fewer than half …

Real-World Clinical And Cost Effectiveness Of Osteoporotic Treatments In Men, Yu Ren

Open Access Dissertations

Osteoporosis is a condition characterized by the loss of bone mass, which increases the risk of fractures. In 2017-2018, the age-adjusted prevalence of osteoporosis among adults aged 50 and over was 12.6%, with 19.6% in women and 4.4% in men. Untreated osteoporosis can lead to a cycle of recurrent fractures that severely impact quality of life and place significant emotional, physical, and financial strain on patients, families, and healthcare resources. Approximately 50% of women and 20% of men will experience at least one fracture in their lifetime. In the United States, an estimated 1.5 million osteoporotic fractures occur each year, …

An Analysis Of Covid-19 Vaccine Hesitancy In The U.S., Hieu Trung Bui, Sandra Eksioglu, Ruben Proano, Sarah Nurre Pinkley

Industrial Engineering Faculty Publications and Presentations

Reluctance or refusal to get vaccinated, commonly known as Vaccine Hesitancy (VH), poses a significant challenge to COVID-19 vaccination campaigns. Understanding the factors contributing to VH is essential for shaping effective public health strategies. This study proposes a novel framework for combining machine learning with publicly available data to generate a proxy metric that evaluates the dynamics of VH faster than the currently used survey methods. The metric is input to descriptive classification models that analyze a wide array of data, aiming to identify key factors associated with VH at the county level in the U.S. during the COVID-19 pandemic …

Mercury Concentrations, Health, And Marine Food Consumption Across Four Eastern Caribbean Populations: Insights From A Novel Community-Based Study, Russell Fielding, Catherine Brown, Jessica Dutton, Martin S. Forde, Heather Harewood, Lisa Hunt, Catherine Macdonald, Cameron Mewhirter, Vincent Reid, Madison Smith, Holly Taylor, Katelyn Zimmerman

Gulf and Caribbean Research

Mercury (Hg), as an environmental pollutant, can have harmful effects on human health. A common way that people are exposed to Hg is through seafood consumption. This project was designed to investigate Hg exposure through seafood consumption and its health effects among adults in 4 Caribbean countries: Barbados (n = 117), Grenada (n = 90), St. Lucia (n = 126), and St. Vincent & the Grenadines (n = 77). We applied a novel, community—based method, which involved recruiting and paying local barbers and hairstylists to collect hair samples from their clients who consented to join the project as participants. Participants …

The Association Between Pain Sensitivity And Low Energy Availability, Sleep, Mental Health, And Stress In Female Endurance Athletes, Taylor R. Moler

Honors Undergraduate Theses

The disruption of certain physiological functions due to low energy availability (LEA) in female endurance athletes is a prominent concern. This condition resulting from LEA has been described as Relative Energy Deficiency in Sport (RED-S), which can include alterations in metabolism, menstrual function, bone deposition and resorption, mental well-being, and more. The goal of this study was to determine whether pain sensitivity was associated with LEA, sleep, mental health, and stress in female endurance athletes. Participants completed a demographic survey, the Low Energy Availability in Females Questionnaire (LEAF-Q), the Pittsburgh Sleep Quality Index (PSQI), the Patient Health Questionnaire (PHQ-4), and …

Associations Between Perceived Discrimination And Sleep Health: Results From The Future Of Families And Child Wellbeing Young Adult Sleep Study, Angel I.M. Collie, Adwoa Dadzie, David A. Reichenberger, Lindsay A. Master, Gina M. Mathew, Lauren E. Hale, Anne-Marie Chang, Orfeu M. Buston

Department of Preventive Medicine Faculty Publications

Objectives. We investigated cross-sectional associations between perceived discrimination and actigraphic sleep health among young adults.

Methods. Data from the age 22 wave (mean±SD age=22.1±0.4 years) of the Future of Families and Child Wellbeing Young Adult Sleep Study, a national birth cohort originally drawn from 20 U.S. cities, included young adults (n=334; 68.9% Black, 14.7% Hispanic/Latino) who self-reported experiences of discrimination. Wrist-worn actigraphy was collected across ~2 weeks from 2020-2024 and measures included sleep duration, onset, midpoint, maintenance efficiency (SMeff), and wake after sleep onset (WASO). Multiple linear regression models examined the association between experiencing a specific type of …

Detecting Sars-Cov-2 In Ct Scans Using Vision Transformer And Graph Neural Network, Kamorudeen Amuda, Almustapha Wakili, Tomilade Amoo, Lukman Agbetu, Qianlong Wang, Jinjuan Feng

Electrical & Computer Engineering Faculty Publications

The COVID-19 pandemic has presented significant challenges to global healthcare, bringing out the urgent need for reliable diagnostic tools. Computed Tomography (CT) scans have proven instrumental in detecting COVID-19-induced lung abnormalities. This study introduces Convolutional Neural Network, Graph Neural Network, and Vision Transformer (ViTGNN), an advanced hybrid model designed to enhance SARS-CoV-2 detection by combining Graph Neural Networks (GNNs) for feature extraction with Vision Transformers (ViTs) for classification. Using the strength of CNN and GNN to capture complex relational structures and the ViT capacity to classify global contexts, ViTGNN achieves a comprehensive representation of CT scan data. The model was …

How To Approach Medical Education Research, Stefanie Attardi, Jeff Cross, Sarah Lerchenfeldt

Books and Book Chapters

Medical education research blends two of the core functions of academic medicine: teaching and scholarship. Its value is increasingly recognized in promotion and tenure decisions, and in the number of funding sources available. Similar to other types of research, it starts with a well-crafted question and a thorough review of the literature. For a successful project, it is critical to select the research design that can best answer the research question, keeping in mind its advantages and limitations. Because the research design must also adhere to ethical principles, working closely with the local Institutional Review Board prior to starting the …

Relative Energy Deficiency In Sport: Risk Assessment In Collegiate Female Athletes Using The Reds Cat2 Tool, Kelsea Elizabeth Nunes

All Master's Theses

Context: Alterations in energy intake (EI) and high exercise energy expenditure (EEE) may increase the risk of low energy availability (LEA) in Division II female collegiate ball sport athletes. Furthermore, chronic LEA can transition to problematic LEA, leading to Relative Energy Deficiency in Sport (REDs).

Objective: The purpose of this study was to assess the current severity and prevalence of REDs using the REDs CAT2 Tool and the Female Athlete Triad using the FAT CRA in Division II collegiate female volleyball, basketball, soccer, and rugby athletes.

Design: Cross-sectional design.

Setting: Research laboratory.

Patients or Other Participants …

The Use Of Motivational Interviewing In Preventing Dental Caries Among Young Children, Denise C. Mckinney, Melissa L. Sullivan, Futun Alkhalifah

Dental Hygiene Faculty Publications

Dental caries is a complex, preventable disease that remains a global health burden. The burden of this disease has been shown to impact young children before the age of 6 years. Discussing dental caries prevention with the mother/caregiver(s) prior to childbirth is an ideal time to influence positive oral health behaviors. Motivational interviewing (MI) is a person-centered, goal-oriented, collaborative communication style that has been used to help individuals modify behaviors. The interrelated principles of partnership, acceptance, compassion, and evocation underpin the MI approach while utilizing communication skills such as asking open-ended questions, affirmation, reflective listening, and summarizing (OARS) to engage …

'I Did Not Know We Could Exercise This Small Premature Baby': Challenges Experienced By Parents While Implementing Early Intervention For Their Preterm Infants-A Qualitative Perspective, Manasa Kolibylu Raghupathy, Selim Jahangir, Sonia Khurana, Leslie Edward S. Lewis, Bhamini Krishna Rao

Rehabilitation Sciences Faculty Publications

Background

Preterm birth is a highly stressful experience for both parents and infants. Parental participation in care enhances developmental outcomes, fosters parent-infant interactions and builds parental confidence. However, low parental adherence has always been a challenge in the successful implementation of intervention programs both in the NICU and at home. It is imperative to understand parents' perspectives and view the challenges that they experience through their lens while providing early intervention to their infants born preterm. This study is aimed at identifying new parents' challenges when implementing early intervention programs for their infants during the transition from hospital to home. …

Supports For Mental Well-Being Valued By Healthcare Workers: Qualitative Analysis Of Data From A Canadian Cohort Of Healthcare Workers During The Covid-19 Pandemic, Shannon Marie Ruzycki, Anil Adisesh, Quentin Durand-Moreau, France Labrèche, Tanis Zadunayski, Erica Stroud, Nicola Cherry

Études primaires

A prospective cohort of 4964 HCWs from four Canadian provinces was established early in the COVID-19 pandemic. Participants were invited to comment about workplace mental health supports at three time points. We performed a thematic content analysis of responses from 1738 participants using the Social Support Behaviour Code framework to categorize barriers to support as informational, tangible, emotional, social, or expressing esteem. Themes were synthesized into suggestions for healthcare organizations to prepare for future crises. Formal and informal peer support, workplace mental health supports, and one-on-one counseling were most often mentioned as valued. Analysis suggested that workplace social networks as …