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 …

The Relationship Between Socioeconomic Factors And Low Birth Rates In Ohio, Ryan Gora, Hannah Amin

Scholarship in Medicine - All Papers

Background: The incidence of low birth weight (LBW) has not substantially fallen over time despite advances in medical interventions. LBW has been linked to several chronic diseases in adulthood including type 2 diabetes (T2DM) and cardiovascular disease (CVD), making it a particularly salient public health issue.
Objective: To examine socioeconomic factors and diseases associated with LBW in Ohio between 2016-2022.
Methods: Using data from County Health Rankings, we identified socioeconomic factors predictive of LBW in Ohio between 2016-2022. We also examined the relationship between LBW and incidence of T2DM as well as food insecurity (FI). In addition, we investigated how …

Food And Mood, Angelina Gentilin, Patrick Tawil

Scholarship in Medicine - All Papers

Depression and mental illnesses are on the rise in the United States alongside other chronic illnesses like obesity. Preliminary research indicates that diets of individuals and obesity can have profound roles in mental health status. Alongside the consummatory behavior of eating, drinking alcohol is associated with mental illnesses like depression and could potentially play a role in mental health and poor diet. The authors analyzed the public health county data in Ohio of adults between the years of 2016 and 2022 to investigate any differences in the population’s health rates. This study found that diet plays an influencing role in …

Examining Intersectional Factors In Infant Mortality: The Role Of Race, Geography, And Socioeconomic Status In Ohio, Catherine Tran, Rebekah Murray

Scholarship in Medicine - All Papers

Background: Aspects of a mother’s identity such as race, socioeconomic status, and geographical location can impact healthcare access and outcomes, especially infant mortality.
Objective: The aim of this study is to identify how different variables relating to a mother’s identity intersect with one another to impact infant mortality rate in Ohio.
Methods: Data for infant mortality rate, racial residential segregation index, patient race by percentage, and median household income was collected from County Health Rankings, and data was analyzed using IBM SPSS Statistics.
Results: A linear regression found that the best fitting model including median household income and percent Black …

The Opioid Crisis: Analyzing Access To Resources, Mental Health And The Influence On Overdose Deaths In Urban And Rural Communities, Katharina Johnson, Maggie Obourn

Scholarship in Medicine - All Papers

Background: Opioid use contributes significantly to deaths throughout the United States. Opioid overdose deaths have increased in recent years and the opioid crisis has far reaching effects on many communities. There are several factors that contribute to opioid overuse and death, including access to resources and social factors.
Objective: In this study we aimed to assess how social factors affect overdoses by examining the differences between rural and urban communities over time.
Methods: We utilized data from County Health Rankings and conducted a retrospective review of data from 2016 and 2023 to compare several factors that we hypothesized affected opioid …

Access To Exercise Opportunities And Food Security: Mediators In The Prevalence Of Chronic Diseases In Ohio, Anidya Soni, Lisa Victor

Scholarship in Medicine - All Papers

Background: Obesity remains a leading public health issue in the United States, with 40.3% of adults classified as overweight, underscoring the need to understanding the environmental and social determinants of health1. The neighborhood food environment, including access to healthy food and recreational spaces in one's community, plays a critical role in shaping dietary behaviors and physical activity levels.

Objective: This study examines the relationship between neighborhood food environments including access to healthy food and exercise opportunities, socioeconomic factors, and health outcomes like obesity, and diabetes in Ohio from two-time points: 2016 to 2023 using data from the County Health Rankings …

Customary Corruption, Ani B. Satz, Liza Vertinsky

Faculty Articles

For over a hundred years, it has been well-accepted among tort scholars that physicians—as one of the legally recognized professions— determine their own customary practices. Within tort law, and medical malpractice more specifically, customary practice establishes whether physicians breach or uphold the required standard of care toward their patients. The results of our hand-coded examination of decided cases and statutes show a more complex picture. While some states have endeavored to shift the standard away from professional custom, it continues to play a critical, and in many cases a determinative, role in establishing physician liability in most states.

Using illustrative …

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 …

Constitutionalizing Climate Rights, Mark P. Nevitt

Faculty Articles

This Essay proceeds in three Parts. In Part I, I describe and analyze which states have climate and environmental amendments within their state constitutions. Here, I focus on three states (Hawaii, Montana, and Pennsylvania) that have comparably strong Green Amendments and have experienced litigation in recent years enforcing these constitutional provisions. I describe and analyze three cases: Navahine F. v. Hawaii Department of Transportation (Hawaii), Held v. Montana (Montana), and Robinson Township (Pennsylvania). I argue that these three decisions—all of which enjoyed varying degrees of success—will spur greater efforts to constitutionalize state environmental rights. Indeed, there are grassroot efforts within …

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 …

A Qualitative Study Of End-Stage Liver Disease And Liver Transplant Referral Practices Among Primary Care Providers In Nonurban America, Vashisht Madabhushi, Matthew Wright, Gabriel Orozco, Allison Murphy, Antonio R. Garcia, Natalie D. Pope, Xiaonan Mei, Alexandra Cocca, Roberto Gedaly, Meera Gupta

Surgery Faculty Publications

Purpose: In rural America, the road to obtaining a liver transplant (LTX) often starts at the primary care provider’s (PCP’s) office. Patients with end-stage liver disease (ESLD) in rural communities experience lower rates of wait-listing and higher mortality. This study identifies issues related to the knowledge and perceptions of ESLD and LTX referral among PCPs in rural Kentucky (KY).

Methods: The study protocol involved relying upon a semistructured outline to explore the knowledge, attitude, and perceptions of PCPs toward ESLD and LTX referral among PCPs in rural KY. Inductive thematic analysis was utilized to identify, analyze, and report themes.

Findings: …

Blood Biomarkers In Down Syndrome: Facilitating Alzheimer’S Disease Detection And Monitoring, Melissa E. Petersen, Lisi Flores-Aguilar, Elizabeth Head, Laia Montoliu-Gaya, Andre Strydom, Sarah E. Pape, Juan Fortea, Nicholas J. Ashton, Chinedu Udeh-Momoh, Sid E. O’Bryant, Dwight German, Florin Despa, Mark Mapstone, Henrik Zetterberg

Neurology Faculty Publications

Blood-based biomarkers continue to be explored for disease detection, monitoring of progression, and therapeutic outcomes as the diagnostic determination of Alzheimer’s Disease in Down Syndrome (DS-AD) remains challenging in clinical settings. This perspective highlights the current status of this effort. Overall, amyloid (A), tau (T), and neurodegeneration (AT[N]) blood-based biomarkers have been shown to increase with disease pathology for individuals with DS. Phosphorylated tau biomarkers (p-tau217, p-tau181) have been consistently shown to track disease progression for DS-AD and are likely good candidates for use in clinical settings. Biomarkers of inflammation (glial fibrillary acidic protein) also show promise; however, additional work …

Bones And Brains: The Association Between Osteoporosis And Depression, Mason Taylor

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

Introduction: Osteoporosis and depression are two public health problems that are increasing in prevalence. Previous studies have found a positive association between the two variables in women and men and women together, but there is a gap when looking at men. Therefore, it was important to investigate the odds of depression in men, women, and men and women together to make comparisons by sex.

Methods: 1,602 participants aged 65 and older were included in the study from the National Health and Nutrition Examination Survey (NHANES) 2017 – March 2020 Pre-Pandemic dataset. One unadjusted and seven adjusted models were created for …

Evaluation Of The Bourbon County Health Department Physical Activity Program, Walker S. Hancock

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

Bourbon County has a low physical activity rate. A program has been implemented to increase rates of physical activity. An evaluation has been performed using the CDC’s 6-step program evaluation process framework.

According the the framework, two recommendations were made. The first one is to increase access to parks or exercise facilities for those outside of Paris city limits. The second one is to increase the number of indoor facilities for people to use during the cold, winter months.

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 …

Environmental And Behavioral Determinants Of Congenital Defects: An Ecologic Study In Kentucky, Amelia G. Floyd

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

Congenital defects are a significant contributor to infant morbidity and mortality. The multifactorial etiology of such defects presents complex challenges for public health. This ecologic study investigates the association between environmental and behavioral exposures and congenital defects rates at the county level in Kentucky from 2010 to 2019. The Kentucky Department for Public Health, Office of Vital Statistics, provided all relevant defect data. County-level exposure data was collected from multiple sources.

Descriptive and geospatial analyses revealed substantial geographic variability, with notable high defect rates in northeastern Kentucky. Negative binomial regression models identified behavioral and socioeconomic factors to be the strongest …

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 …

Evaluation Of Lyte’S Pilot Health And Wellness Coach Training Program, Lauren Allyson Von Lawn

CGU Theses & Dissertations

Breast cancer survivorship presents ongoing physical, emotional, and social challenges that often extend beyond clinical treatment. While survival rates continue to improve, many survivors lack adequate post-treatment support, particularly in underserved communities. The Living Your Truth Empowered (LYTE) Foundation developed and piloted a Health and Wellness Coach Training Program to address these gaps by preparing individuals—including survivors, advocates, and community members—to provide evidence-based, holistic support. This 16-week cohort-based program, funded through a City of Hope Healthy Living Community Benefits Grant, integrates the National Board of Health and Wellness Coaching (NBHWC) standards with curriculum content focused on: behavior change, cultural humility, …

Birthing While Black: The Color Of Care And Black Women’S Lived Experiences Giving Birth In The United States, Portia Cowlings

Theses and Dissertations

Black women in the United States face disproportionate maternal health outcomes during pregnancy, childbirth, and postpartum compared to other racial and ethnic groups. Despite advancements in healthcare, the United States continues to report the highest maternal mortality rates among high-income developed nations, with Black women experiencing rates up to three times higher than their White counterparts. This phenomenological study explores the lived experiences of Black women in the United States to understand how they navigate the continuum of maternal healthcare, from preconception through postpartum. Guided by the social determinants of health (SDOH) theoretical framework, childbirth was examined through four interconnected …

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 & …

Therapy-Based Strategies To Support Tummy Time In Infants Post-Hospital Discharge: A Scoping Review Protocol, Ketaki Inamdar, Sonia Khurana

Rehabilitation Sciences Faculty Publications

Tummy time is essential for infant development, yet many caregivers face significant challenges with adherence due to behavioral and contextual barriers. While numerous tummy time interventions exist, a limited understanding of their behavioral components hinders effective replication and implementation. This scoping review aims to identify multidisciplinary interventions used to promote tummy time in infants aged 0–12 months, evaluate their impact on adherence, developmental and health outcomes, and examine the behavior change techniques employed using the Theoretical Domains Framework (TDF). Following the Joanna Briggs Institute (JBI) methodology, a comprehensive search will be conducted in MEDLINE (PubMed), Web of Science Core Collection, …

Culturally Sensitive Nursing Care And Its Impact On Abuse Disclosure Among Immigrant-Origin Populations​, Jaspal Uppal

Nursing | Student Research Posters

Background: Immigrant-origin patients often face many systemic barriers when accessing healthcare. Factors such as language barriers, fear of deportation, limited trust in healthcare providers, and lack of culturally sensitive care make it hard for patients to disclose abuse. These challenges contribute to poor health amongst vulnerable populations which highlights the importance of using culturally sensitive and trauma-informed care. Objective: This research aims to test whether culturally adapted, trauma-informed nursing care improves disclosure of abuse and access to support services. The objective is to strengthen safety and trust between healthcare providers and patients through culturally sensitive care. Method: A quantitative quasi-experimental …

Educating Nurses On Culturally Competent Intimate Partner Violence Care, Nicole Lee

Nursing | Student Research Posters

No abstract provided.

Empowering Birth: Comparing Nurse-Led Holistic And Pharmacologic Pain Relief Approaches​, Jessica C. Moore

Nursing | Student Research Posters

Childbirth is often described as one of the most meaningful experiences in a woman’s life. During this time, effective pain management is essential not only for reducing discomfort, but also for improving maternal satisfaction and minimizing unnecessary obstetric interventions. While childbirth is frequently approached as a purely physical process, it is inherently holistic, influenced by cultural, social, psychological, and emotional factors.

Growing evidence highlights the value of incorporating and educating patients and providers on non-pharmacologic strategies such as breathing techniques, massage, aromatherapy, hydrotherapy, positioning ,ambulation, and continuous emotional support.

For example, a study in Sweden that found that a group …

The Impacts Of Dietary And Educational Intervention In Addressing Adult Obesity In The Mexican Population, Matthew C. Servin

CMC Senior Theses

Mexico’s obesity epidemic has been an ongoing issue for the past few decades, with multiple studies attributing this to the disparities in accessing healthy food and health education. Designing a solution to Mexico’s adult obesity crisis will focus on studying the effects of an intervention plan that addresses these obesogenic factors. This proposed study will assess how a token system and health education sessions may impact the risk of obesity in the adult Mexican population. This study also will consider any limitations that arise when only one of the two intervention methods are used. As these interventions are implemented over …

Adapting A Mobile Health Intervention To Improve Prep Adherence Among Young Black Msm In Fulton County, Georgia, Kassidy Maust

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

Young Black men who have sex with men (YBMSM) in the southern United States, particularly in Fulton County, Georgia, face disproportionately high rates of HIV and unique structural barriers to pre-exposure prophylaxis (PrEP) uptake and adherence. Sustained adherence among YBMSM remains low due to intersecting structural, social, and behavioral barriers. To address these disparities, this paper presents an adapted implementation of the evidence-based M-Cubed (Mobile Messaging for Men) mHealth intervention. Prior studies of M-Cubed and similar mHealth interventions have shown promising outcomes in increasing PrEP adherence among Black MSM populations. The adapted intervention integrates culturally tailored messaging specific to behaviors …

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 …

Reducing Stress Related To Injection Therapy: A Zen Bundle Approach, Valoree Bowen

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Needle fear and stress are common barriers preventing adults from seeking necessary medical treatments, including intramuscular (IM) injection therapy. Research highlights the need for evidence-based interventions to mitigate this fear and improve patient experience.

Objective: This evidence-based pilot project included a Zen Bundle—an intervention incorporating shared decision-making, aromatherapy, and distraction—to evaluate the impact on stress reduction and patient satisfaction in a retail vitamin shop in North Texas.

Methods: The project utilized a pre-and post-intervention design over eight weeks. Participants completed pre-surveys assessing stress levels using a Visual Analog Scale before choosing an intervention (aromatherapy, distraction, or both) during IM …

Bundled Approach To Improve Colorectal Cancer In Primary Care, Elizabeth Reddiar

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in the United States, despite being preventable through timely screening. National guidelines recommend regular screening for adults aged 45 to 75; (American cancer Society (ACS), 2025) however, screening rates remain suboptimal, particularly in primary care settings serving diverse and high-volume populations. Local Problem: At the project site, a community-oriented primary care clinic in North Texas, baseline data revealed CRC screening completion rates were below benchmarks set by the organization. Barriers included limited patient awareness, inconsistent provider reminders, and workflow challenges in distributing and tracking fecal immunochemical test …