Digital Commons Network^™

A Mixed-Methods Research Study: Nc Health Department Directors’ Perspective On Local Impact Of Early Medicaid Expansion, Asma Warrich

MUSC Theses and Dissertations

North Carolina became the 41^st state to expand Medicaid under the Affordable Care Act. The bipartisan expansion addressed longstanding challenges; however, little is known about how Local Health Departments (LHDs) adapted to this policy change, especially in the 24 months following expansion. This study sought to fill that gap by documenting the perspectives of LHD Directors in North Carolina utilizing a ten-question REDCap survey with closed- and open-ended questions. Purposeful sampling targeted all 86 LHD Directors. Data was collected anonymously between November 2025 and January 2026. Descriptive and thematic analyses were conducted. Thirty LHD Directors completed the survey, which …

Program Development For Maternal Mental Health During The Transition To Motherhood, Lindsey A. Lindsley, Cassandra Nelson

Spring 2026 OTD Capstone Symposium

The transition to motherhood can be both rewarding and challenging, with many women experiencing increased vulnerability to postpartum depression (PPD). This capstone project focused on developing and implementing a six-week maternal mental health program designed to support postpartum women through education, occupational engagement, and peer connection. Grounded in the Model of Human Occupation (MOHO), the program used a hybrid format combining in-person and virtual sessions to improve accessibility. Program outcomes were evaluated using surveys, the Occupational Self Assessment (OSA), and participant feedback. Participants demonstrated increased knowledge of postpartum mental health, greater confidence in their maternal roles, and improved ability to …

Occupational Therapy For People With Internet Gaming Disorder: A Concept Paper, Samuel R. Bender, Steven Gerardi

Spring 2026 OTD Capstone Symposium

Internet Gaming Disorder (IGD) is associated with occupational imbalance and disrupted routines, contributing to challenges in occupational participation and performance. Due to there being a gap in occupational therapy-based research and guidance for people with IGD, this capstone project focused on the development of a concept paper informed by The Model of Human Occupation (MOHO) that frames problematic video gaming as an occupational issue. The concept paper organizes assessment strategies, identifies problems, outlines intervention ideas, and discusses potential next steps for assisting people with IGD within occupational therapy. This capstone project is intended to help current occupational therapists more effectively …

Validity And Reliability Of The Wut Hydration System When Assessed In The Afternoon, Peyton A. Hines, Rosie Perez, Rebecca Allen, Shawn Wierick, Xiujing Zhao, Corey Butts, Brendon Mcdermott

2026 Honors Symposium

The WUT (weight, urine color, and thirst) Venn diagram is recommended for individuals to self-assess their hydration status. However, current research is limited to comparisons between morning first-void markers and 24-hour markers. PURPOSE: To examine the validity and reliability of afternoon WUT scores in comparison to 24-hour hydration status. METHODS: Fifty participants (25 ± 8y, 72.2 ± 14.9kg) voluntarily participated in this study. Participants collected afternoon spot urine between 2:00 and 4:00 pm and 24-hour urine samples on three out of seven consecutive days. Body mass (BM), urine color (Ucol), urine osmolality (Uosm), urine specific gravity (USG), and thirst perception …

Paws And Practice: Overcoming Barriers To Mindfulness, Hazel Norris

2026 Awards for Excellence in Student Research and Creative Activity - Documents & Media

With the rise in chronic illnesses, healthcare professionals have sought to improve habits and behaviors to extend longevity and quality of life. However, for many people, unhealthy habits, such as smoking or binge eating, may develop as a way of coping with life stressors, which can make behavior changes harder to implement. Recently, there has been an increase in new research on whether improving mindfulness could be used to combat this problem. If mindfulness does encourage more engagement in health-promoting behaviors while protecting against risky behaviors, mindfulness-based behavior interventions could be very valuable for improving the health of college students …

Healthcare Systems & Policy Implications For Tele-Dentistry Policies On Access To Dental Care For Underserved Populations In The United States, Deeya Bhadresa

Posters - 2026

Access to dental care remains a significant public health challenge for people in rural and low-income communities. Tele dentistry has shown the ability to expand preventive services, improve care coordination, and reduce geographic barriers. However, inconsistent Medicaid coverage, limited infrastructure, and low provider participation restrict its impact. The main recommendation is standardizing Medicaid tele dentistry coverage and reimbursement across states to improve access and equity. Action is needed now to preserve post–COVID-19 telehealth gains and address persistent oral health disparities.

Healthcare Systems & Policy Implications For The Impact Of State Medicaid Reimbursement Rates On Access To Primary Care Services In Rural Communities: Turning Knowledge Into Action, Miriam Martinez

Posters - 2026

• Where a child lives can determine whether they receive care or go without it. • Access to primary care is essential for prevention, early diagnosis, and treatment, but rural areas face persistent challenges such as provider shortages and geographic isolation. • Medicaid serves as the primary source of health coverage for low-income children; however, reimbursement rates vary by state and are often lower than other forms of insurance. • This study examines how Medicaid reimbursement policy contributes to disparities in access to care for rural children and reflects broader structural inequalities within the healthcare system.

The Cost Of Affordable Healthcare: How Brazil's Sus And Generic Drug Strtegy Produce Structural Inequality And Challenge Global Pharmaceutical Rules, Elena Kössler

Posters - 2026

Affordable healthcare is often seen as a major social achievement, but maintaining low costs involves important trade-offs. Brazil’s Unified Health System (SUS) provides universal healthcare and relies heavily on generic medicines to expand access. This raises a central question: how can a system reduce the cost of healthcare while simultaneously generating new forms of inequality and tension within global pharmaceutical markets? This paper argues that Brazil’s cost-reduction strategy, particularly its reliance on generic medicines, improves affordability but also produces structural trade-offs between equitable access, quality of care, and incentives for pharmaceutical innovation.

Justice, Autonomy, Beneficence, And Non-Maleficence: The Global Failure To Heed Ethical Mandates In Birth Spaces, Julia Dees

Richard T. Schellhase Essay Prize in Ethics

Respectful and safe care in all birthing spaces has long been an ideal that global communities fail to meet. Birthing people are disrespected, physically or emotionally harmed, or left to completely fend for themselves during a period of extreme emotional and medical vulnerability. Historically, autonomy especially has been ignored in birthing spaces with medical trends like the twilight sleep, where women were drugged into a state of unconsciousness during birth (Taylor, 2023), demonstrating the desire of western medicine, in particular, to reduce birthing people to bystanders in their own birth. While birth trends and medical treatments have changed throughout time, …

Postmarketing Safety Of Bimekizumab For Hidradenitis Suppurativa: An Early Pharmacovigilance Analysis Using The United States Food And Drug Administration Adverse Event Reporting System, Simona A. Alomary, Nicole J. Baker, Temitayo Ogunleye, Susan C. Taylor

Student Papers, Posters & Projects

No abstract provided.

Music Listening While Studying And Academic Performance Among College Students With Attention Deficit And Hyperactivity Disorder, Raihan K. Khan, Md Towfiqul Alam, Madalynn Nofplot, Sojib Bin Zaman, Catherine L. Zaman

Faculty Scholarship

Evidence on whether music listening supports academic performance, particularly among students with attention deficit and hyperactivity disorder (ADHD), remains mixed. We explored associations between music listening while studying and academic performance (GPA: grade point average) among college students, and to evaluate whether the associations differed by ADHD status. We analyzed cross-sectional survey data from college students and conducted linear regression models with self-reported GPA as the dependent variable. Models were adjusted for sex, academic level, college affiliation, primary study location, weekly study hours, and preferred genre of music. A total of 541 students participated. Most of the students were at …

Volunteering: Service To Humanity Is The Best Work Of Life, William Chase Dds, Maom

The Journal of the Michigan Dental Association

Dr. William Chase reflects on a 45-year career enriched by dental volunteering and humanitarian missions. Chronicling his experiences treating patients in the Philippines and Brazil, he illustrates how altruism provides professional satisfaction that transcends financial gain. The article outlines various domestic opportunities for service, such as the MDA Foundation’s Mission of Mercy and the Donated Dental Services (DDS) program. Chase provides a checklist for interested volunteers and encourages colleagues to emerge from their comfort zones to provide life-altering care to underserved populations locally and abroad.

News You Need: Annual Session, Board Updates, And Regulatory News, David Foe

The Journal of the Michigan Dental Association

This comprehensive news section provides essential updates for Michigan dentists, including details on the 2026 Annual Session highlights and the launch of the "HERM-E" AI member assistant. It features critical regulatory reminders concerning mandated reporting for child abuse and neglect. The document also covers oral cancer prevention, dental therapy scholarship updates, and the appointment of new members to the Michigan Board of Dentistry. Additionally, it lists upcoming House of Delegates meetings and resources for donated treatment, ensuring members are informed on professional responsibilities.

Rural Health In Pike County: A Richard & Magnolia Community Health Needs Assessment, Victoria Bracey

Honors Theses

Rural communities across the United States suffer from poor health outcomes due to lack of resources and other compounding factors that make access to quality healthcare difficult. Mississippi is a predominantly rural state, and in the southwestern region of Mississippi lies the community of Magnolia and the community of Richard within Pike County. To better understand the health needs of Pike County, a community health needs assessment was conducted. This study aimed to assess the needs of Pike County in southwest Mississippi through the use of a community health needs assessment using focus groups. Two focus groups, with a total …

Navigating End-Of-Life Decisions: Cultural Considerations For Latine Patients, Michelle Carbajal Hernandez

Honors Capstones

Healthcare professionals face many challenges when communicating terminal illness prognoses for individuals. This responsibility to address a terminal prognosis is further complicated when communicating with Latine patients who may face multiple barriers within the healthcare system and whose cultural preferences influence end-of-life care planning (Carrion, 2010). For example, Latines are less likely to enroll in end-of-life (EOL) care services (e.g., hospice) (Barragan-Carrillo et al., 2022). As well as engage in end-of-life care planning than White Non-Latines (Shen et al., 2016). To understand this hesitancy towards EOL care options, this literature review aims to explore how terminally ill Latine and …

Start With What They Know: Using Motivational Interviewing To Create A Cooking Class, A Culinary Intervention For Teens (Autistic And Non-Autistic), Gwendolyn S. Tedder

LEND Trainee Presentations

Autistic teens are at greater risk for having heart disease and diabetes as adults. Food particularity, sensory issues, fixed mindset, and anxiety over trying new things can slow down their interest in preparing food for themselves. Nurturing basic cooking skills and gently encouraging trying new foods would provide more nutritional options to teens as they move into adulthood. A cooking class preceded by Motivational Interviewing (MI) developed further interest in preparing food afterward in teens, both autistic and non-autistic, and in trying new foods for autistic teens with food concerns.

The Effects Of Body Mass Index On Fertility And In Vitro Fertilization, Morgan R. Kidd

Honors College Theses

In-vitro fertilization (IVF) is the most widely used type of assisted reproductive technology for treating infertility arising from a number of conditions. As obesity rates continue to climb in the United States, infertility has been discovered to have a direct correlation. Individuals that fall below or above the healthy body mass index range are found to have disrupted regulation of the hypothalamic-pituitary-gonadal axis, resulting in diminished reproductive health. Those that are diagnosed as infertile due to conditions caused by the effects of low body mass index or high body mass index may seek assisted reproductive technologies to intervene in achieving …

Feasibility And Safety Of Intrapartum Foetal Pulse Oximetry Using A Disposable Scalp Probe: A Cross-Sectional Study, Felix Oindi, Mukaindo Mwaniki, Sikolia Wanyonyi, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background Assessment of foetal wellbeing during labour is critical for reducing adverse perinatal outcomes. While pulse oximetry is widely used in adult and paediatric medicine, its application in intrapartum foetal monitoring remains limited. This study aimed to evaluate the feasibility and safety of a foetal pulse oximeter device (OxiReed™, formerly First Touch™) for obtaining intrapartum foetal oxygen saturation (SpO₂) measurements.

Methods A cross-sectional study was conducted at a tertiary referral hospital involving 110 women in the first or second stage of labour. Eligible participants had singleton pregnancies at ≥ 34 weeks’ gestation, vertex presentation, and ruptured membranes. A disposable foetal …

A Comparative Analysis Of Group Care: Trust, Professional Identity, And Health System Structure In The United Kingdom And The Netherlands, Samantha J. Kohlmann

Senior Theses

Group prenatal care (Group Care) has been associated with improved maternal experiences and select clinical outcomes, yet less is understood about how it functions within high-resource health systems and what mechanisms underlie its impact. This study examines how Group Care is implemented in the United Kingdom and the Netherlands, with particular attention to professional roles, relational dynamics, and health system context.

I employed a qualitative, comparative design and conducted four semi-structured interviews with midwife researchers involved in Group Care implementation in both countries. Data were analyzed thematically, with attention to cross-context similarities and differences.

Findings indicate that Group Care operates …

Pelvic Inflammatory Disease: A Narrative Review Of Disparities Between Black And White Women In The United States And Strategies For Improvement, Lynne Li, Jessica Schlewitt

Journal of Patient-Centered Research and Reviews

Pelvic Inflammatory Disease (PID) is an inflammatory syndrome of the upper female reproductive organs caused by infection, most commonly via Neisseria gonorrhoeae or Chlamydia trachomatis, spreading to one or more reproductive organs. With PID responsible for many of the major morbidities of sexually transmitted infections (STIs), such as ectopic pregnancy and chronic pelvic pain, the urgency is high to mitigate the impacts of untreated PID, especially in higher-risk populations. This paper discusses the current disparities in PID diagnosis, treatment, and management between Black and white women and proposes interventions to reduce health inequalities involving PID. To conduct this narrative review, …

Co-Designing An Adolescent Perinatal Mental Health Intervention In Kenya And Mozambique: The Inspire Project, Tatiana Salisbury, Fernando Chissale, Margrette Hanselmann, Evaline Langat, Sarah Kinja, Violet Naanyu, Mark Nyalumbe, Mellan Lilumbi, Lucy Nyaga, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background Interventions to support adolescent perinatal mental health are limited and largely developed for delivery in high-income countries. This study aimed to co-design an intervention to improve mental health outcomes among pregnant and post-partum adolescent girls in Mozambique and Kenya.

Methods 159 adolescent girls (aged 15–19 years) and young women (aged 20–24 years) with experience of a pregnancy during adolescence, their partners and family members, service providers and community influencers were recruited in Kilifi County, Kenya and Moatize District, Mozambique. Those who consented took part in individual interviews, focus group discussions, observations, and workshops to identify key priorities for supporting …

Something In The Air? Uncovering The Air Quality Of St. Mary's University, Isaiah Charles, Keagan Farrell, Antonio Martinez, Andrea Realyvasquez, Kelly Swyers

Presentations - 2026

What is air quality?

Measurement of how clean or polluted the air is in a certain area. The Environmental Protection Agency uses Air Quality Index (AQI), a scale that describes the quality of air. The six major pollutants measured are: •ground- level ozone •particulate matter •carbon monoxide •sulfur dioxide •nitrogen dioxide •lead   Impacts of air pollution
•Acid rain •Climate change •Damage to plants and crops •Loss of biodiversity
•Respiratory illnesses •Cardiovascular damage •Premature death •Coughing and asthma

Cure Sound Project: Study In Silence?, Quezia Abrao, Deeya Bhadresa, Elisa Castro, Fiona Coulbourne, Carlos Flores, Lizzeth Holguin, Lazarus Maldonado, Jeremy Mares, Andrew Martini, Nicole Matthews, Katherine Montero, Mariana Reyes, Jacob Rodriguez, Julieta Ruiz, Eliana Sanchez, Gabriela Varela

Posters - 2026

Difference in sound levels in study areas across campus can affect students’ ability to work and learn efficiently 1.

According to the WHO, safe sound levels are measured to be around 70dB 2. Some study areas on campus experience sound levels exceeding the safe threshold. Unsafe sound levels are considered to be at or above 85dB 3. These unsafe and excessive noise levels negatively affect a student’s ability to concentrate and work efficiently which correlates to a decrease in class performance, attention deficits, and stress 4.

This study aims to get a base-line measurement of dB levels in common study …

Obesity In The Rio Grande Valley: Applying An Evidence-Based Public Health Approach, Erika Pineda-Horta

Posters - 2026

What structural and social determinants drive elevated adult obesity rates in the Rio Grande Valley, and what evidence-based interventions can reduce adult obesity prevalence in Hidalgo County by 5% by 2030?

Objective: This study applies an EBPH framework to (1) characterize the burden and structural determinants of adult obesity in the RGV, and (2) propose a culturally responsive, evidence-based intervention targeting adults aged 18+ in Hidalgo County.

Adult obesity is clinically defined as a Body Mass Index (BMI) ≥30 kg/m² in adults aged 18 and older (CDC, 2022). It is a chronic, multifactorial non-communicable disease shaped by structural, social, and …

Regional Inequalities In Healthcare Access And Capacity In Brazil, Elena Kossler

Posters - 2026

The Brazilian health system is one of the largest and most comprehensive universal public health systems, fully funded by the government.

Visits Related To Alcohol, Substance Use, And Mental Health In New Mexico’S Emergency Departments: Social Determinants Of Health And Discharge Disposition, 2021-2024, Samuel L. Swift, Maya Stefanovic, Dylan Pell

Population Health Research and Scholarship

No abstract provided.

Hlt 101 Introduction To Public Health, Elyse Gruttadauria

Open Educational Resources

The syllabus, created by Professor Elyse Gruttadauria as part of the CUNY OER Initiatives for HLT 101 contains a course description, course objectives, course readings divided by week and a link to four OER textbooks.

Factors Associated With Lapses In Care Among People Living With Hiv In South Carolina, Xueying Yang Ph.D., Fanghui Shi, Shujie Chen, Gavi Samuel, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Utilizing statewide electronic health records (EHR) data, this study aims to assess the factors determining the occurrence of lapses in HIV care among people with HIV (PWH) in South Carolina (SC). All adult (≥ 18 years old) PWH who were diagnosed with HIV between 2006 and 2018 with at least two HIV care encounters and at least 1-year follow-up record were included in the analysis. The outcome, a lapse in care, was defined as a repeated measure of HIV care encounter that occurs over a year following the previous visit. Generalized Estimation Equation models were employed. The study cohort had …

Aht Diagnoses: The Influences Of Clinical Presentation And Evidence Of Impact, Ruairi Smith-Dewey, Angela Bachim, Colleen Bressler, Kristine Campbell, Lori Frasier, Christopher Greeley, Danielle Horton, Nicole Johnson, Jan Leonard, Megan M Letson, Caitlin Mcnamara, Ashley Sherman, Shalon Nienow, Stuart Sommers, Joanne N Wood, James Anderst

Faculty, Staff and Students Publications

Background: The frequency of abusive head trauma (AHT) diagnoses by child abuse pediatricians (CAPs), especially regarding external evidence of head impact, has been questioned.

Objectives: To compare CAP diagnoses in subjects with subdural hemorrhage (SDH) across clinical presentations, including subgroups with and without external evidence of head impact. Additionally, we aimed to describe subjects with SDH and concomitant suspicious injuries (CSI) without evidence of head impact.

Participants and setting: Multicenter retrospective study including subjects < 24 months old with SDH.

Methods: Subjects were divided into groups based on clinical presentations: Ill SDH only, Non-ill SDH only, and SDH + CSI. Groups were subcategorized based on presence/absence …

Impact Of Cannabis And Cannabis Legalization On Us Atrial Septal Defect Rates, Albert Stuart Reece, Hulse

Research outputs 2022 to 2026

Atrial septal defect (ASD) affects 1:11.3 children in some US states; however, the antecedents of these trends are yet to be identified. A total of 1882 ASD rates (ASDRs) for 2003–2020 were sourced from the National Birth Defects Prevention Network reports. A total of 406,893 ASDs are reported. Substance (cigarettes, binge alcohol, cannabis, cannabinoids, analgesics, cocaine) exposure data were taken from the National Survey of Drug Use and Health. Income and ethnicity data were derived from the US Census. Adjustment was performed by mixed effects, survey and generalized additive regression. Causal analysis was by inverse probability weighting and E-values. Data …