Digital Commons Network^™

Combating Antibiotic Resistance With Plasmid-Dependent Phages, Rhiannon T. Mariano

Electronic Theses & Dissertations (2024 - present)

The alarming rise of carbapenem-resistant bacteria poses an urgent global health threat, driven in large part by the horizontal spread of carbapenemase-encoding plasmids (Ma et al., 2023). These plasmids are often highly mobile and transmissible, enabling rapid dissemination of resistance genes across diverse bacterial populations. Their mobility is largely mediated by conjugation, a process dependent on the formation of pili, which serve as physical bridges for plasmid transfer between cells (Murray et al. 2022; San Millan and MacLean 2017; Virolle et al. 2020). Beyond their role in gene exchange, these pili also act as entry points for a unique class …

Identifying The Physical Activity Promotion Practices Of Obstetricians And Gynecologists: Patients With Endometriosis And Polycystic Ovary Syndrome, Allison P. Herman

Theses and Dissertations (Comprehensive)

Despite efforts to promote physical activity, many females in Canada do not meet recommended physical activity guidelines. For individuals with gynecological conditions such as endometriosis and polycystic ovary syndrome (PCOS), physical activity may aid in symptom management and improve daily functioning. Healthcare settings, including obstetrics and gynecology, represent an area of opportunity to promote physical activity among this population. This thesis aims to understand the physical activity promotion practices of Ontario-based Obstetricians and Gynecologists (OBGYNs) to patients with endometriosis and/or PCOS. A cross-sectional online survey was conducted to explore OBGYNs promotional practices and perceived factors influencing their engagement in physical …

Modeling Accreditation Standards And Evaluation Methods To Inform Strategic Planning In Public Health Education, Debra Rich

College of Graduate Studies: Theses & Dissertations

Public health has long benefited from the relationship between postsecondary education, accreditation, and government employment. Assessment and accreditation are important tools in postsecondary education to ensure fiscal responsibility, professional competencies, and quality assurance. The competency standards implemented in post-secondary education are not under the direct control of the federal government; however, policy amendments aimed at specific accreditation criteria could result in changes to public health curriculum and create eligibility barriers for students who rely on federal financial support. The Central Washington University Public Health program has provided educational support in professional public health for decades, and there is an increased …

Exploring Acculturation And Its Role In Substance Abuse Behaviors Among Refugee Populations In Bowling Green, Ky: An Interactive Learning Experience Through Provider’S Perspectives., Aishwarya Potluri

College of Graduate Studies: Theses & Dissertations

Substance use among refugee populations is an emerging public health concern shaped/influenced by cultural, social, and structural factors associated with resettlement. This qualitative study explored providers’ perspectives on substance use behaviors among refugees in Bowling Green, Kentucky. Using Health Behavior Theory with acculturation as a contextual construct, semi-structured interviews were conducted with 10 providers working with refugee-serving organizations. Data collected through the interviews was analyzed using thematic analysis in NVivo. The findings indicate that substance use is being influenced by peer exposure, occupational stress, and the increased availability of substances in the United States. Providers identified cultural stigma surrounding mental …

Sociodemographic Differences In Sepsis-Related Medicare Hospitalizations: A State-Level Analysis Of Diagnosis-Related Groups For Severe Sepsis In 2019 And 2022, Alba Kuqi

College of Graduate Studies: Theses & Dissertations

Introduction: This state-level ecological repeated cross-sectional study examined sociodemographic differences in sepsis-related Medicare hospitalizations assigned to Medicare Severity Diagnosis-Related Groups (MS-DRGs) 871 and 872 in 2019 and 2022.

Objective: The study focused on three outcomes: changes in sepsis-related Medicare discharge volume, changes in average Medicare payment per sepsis discharge, and changes in the proportion of MS-DRG 871 discharges relative to MS-DRG 872 discharges.

Methods: Publicly available Medicare inpatient hospital data and state-level demographic data were used to evaluate whether age, race, gender composition, and median household income were associated with these changes across the 50 U.S. states and …

Assessing And Advancing Pandemic Emergency Preparedness In New York City's Hospitals: A Strategic Management Toolkit Integrating Policy Analysis, Risk Assessment, And Stakeholder Insight, Irrem Jamal

College of Graduate Studies: Theses & Dissertations

This dissertation examines pandemic emergency preparedness in New York City hospitals, which were severely strained during COVID-19, revealing critical gaps between documented plans and operational readiness. Using a multimethod approach combining a survey of 20 stakeholders across city hospitals, semi-structured interviews, and document analysis of policy frameworks and after-action reports, the study identifies a persistent "documentation-execution paradox": while 80% of respondents confirmed clear pandemic plans, only 45% expressed confidence in staffing adequacy, 55% in surge planning realism, and just 45% confirmed regular drills. Qualitative analysis revealed workforce as the single greatest yet most underinvested vulnerability, supply chain fragility rooted in …

Exploring Psychological Safety And Workforce Experiences Among Employees In Recovery Community Organizations In The Southern United States: A Qualitative Study, Claire-Lorentz Ugo-Ike

College of Graduate Studies: Theses & Dissertations

This qualitative study explored how employees in Recovery Community Organizations (RCOs) in the Southern United States experience psychological safety and how these experiences shape employee well-being and their intentions to stay or leave their organizations. Guided by Edmondson’s Psychological Safety Theory and the Job Demands-Resources (JD-R) model, the study examined how leadership practices, workplace culture, and the emotional demands of recovery support work shape employees’ perception of safety, support, and sustainability in the workforce. Semi-structured interviews were conducted with 19 RCO employees working in various peer support roles. Thematic analysis identified five major themes: (1) leadership behaviors shape psychological safety …

Promoting The Concept Healthy Ageing For Use In Gerontological Health And Social Care Policy And Practice, Claire Donnellan

Research outputs 2022 to 2026

Aims: The concept of healthy or successful ageing dates back to the 1960s, where its goal is more realistic in today's ageing society as a result of effective interventions to control and reduce disability and health risks. The aim of this paper is to outline the importance of defining ageing, the semantics and indicators used, and to identify common challenges for health professionals' understanding and application of a healthy ageing approach in their everyday clinical practice. Design and Methods: This discursive paper demonstrates how realistic ageing indicators are for highlighting the variation and impact of challenges associated with ageing. It …

Sexuality Education In An Age Of Resistance: Reflections At The Nexus Of Education, Health And Rights, Sarah Vrankovich, Katrina Marson, Giselle Woodley, Jordina Quain, Hanna Saltis

Research outputs 2022 to 2026

Comprehensive sexuality education (CSE) is internationally recognised as essential to public health and young people’s rights. Yet its implementation in Australia and globally is increasingly undermined by conservative backlash, moral panic and political interference. This paper offers a critical reflection on the current landscape of CSE, drawing on insights from a panel discussion at the 2025 World Association for Sexual Health congress, and collaborative analysis. As early-career researchers, sexologists and practitioners working across education, communications, public health and sexual violence prevention, we utilise our collective experience to examine how various influences shape and constrain the delivery of CSE. We map …

The Best Practice Guide For Early Childhood Education And Care Food Environment: Module 5: Sustainable Food Practices (Version 1.0), Ros Sambell, Audrey Elford, Connie N. Ihlein, Lochie Clark, Amanda Devine, Helen Alexiou, Lennie Barblett, Caterina Benati, Fiona Champion, Bek Clancy, Penelope Clark, Kathy Cologon, Wendy Cook, Katie Dix, Kirsty Elliott, Leanne Elliston, Amanda Ferguson, Ricky Gelman, Jodie Gray, Natalie Gulberti, Lorraine Hingston, Karen Krist, Deana Leahy, Rebecca Lindberg, Stacey Mckenzie, Merryn Netting, Ciara O’Flaherty, Asha Rojahn, Blake Stewart, Leah Stuart-Douglas, Aimee Sullivan, Suzanne Tamone, Henry Tan, Sandra Vale, Jill Whelan

Research outputs 2022 to 2026

ECEC food environments are uniquely positioned to support sustainability by implementing practices that can reduce environmental impacts while creating meaningful opportunities for children to experience and explore the interconnections between people, animals, plants, lands and water through food.

The Early Years Learning Framework (EYLF) (Version 2.0) recognises sustainability as an important consideration for children’s learning and development and that educators and children have active roles to play in contributing to more sustainable communities.1 Through the food provided, mealtimes, and food education, ECEC services can provide meaningful opportunities for children to experience and engage with sustainable food practices.

This Sustainable Food …

The Best Practice Guide For Early Childhood Education And Care Food Environment: Module 4: Staff And Family Engagement (Version 1.0), Ros Sambell, Audrey Elford, Connie N. Ihlein, Lochie Clark, Amanda Devine, Helen Helen Alexiou, Lennie Barblett, Fiona Champion, Penelope Clark, Kathy Cologon, Wendy Cook, Katie Dix, Kirsty Elliott, Leanne Elliston, Amanda Ferguson, Yuna Ribeiro Ferreira Alves, Ricky Gelman, Jodie Gray, Natalie Gulberti, Lena Harle, Jill Whelan, Karen Krist, Ashton Leach, Deana Leahy, Stacey Mckenzie, Lauren Moore, Merryn Netting, Ciara O’Flaherty, Asha Rojahn, Blake Stewart, Aimee Sullivan, Suzanne Tamone, Henry Tan, Courtney Trezona, Sandra Vale, Kathy Cologon

Research outputs 2022 to 2026

Engaging with families is a core responsibility of ECEC services and staff. By building positive, personal relationships with families, ECEC staff are able to share concerns or queries about the children in their care in a sensitive way.

One of the more sensitive topics that can come up is food – what they are eating, how much they are eating, their eating behaviours and skills, and everything in between. Through quick conversations at drop-off or via formal communication platforms, services can share a range of information about a child’s eating patterns and behaviours, and also gather information from families to …

Predictors Of Quality Of Family Planning Counselling In Ethiopia: Multilevel Analysis Of The Spa Survey 2021/22, Kalayu Brhane Mruts, Tesfay Brhane Gebremariam, Amanuel Tesfay Gebremedhin

Research outputs 2022 to 2026

Background: High-quality family planning (FP) counselling is essential for informed contraceptive choice, reducing discontinuation, and improving reproductive health. However, many women in sub-Saharan Africa continue to face barriers. This study examined client-, provider-, and facility-level determinants of FP counselling quality in Ethiopia using nationally representative, multi-source data. Methods: We analysed data from the 2021/22 Ethiopia Service Provision Assessment, including 2,224 women who received or were prescribed injectables, pills, or implants. Counselling quality was assessed using a 15-item checklist derived from direct observations and client exit interviews. Multilevel ordinal logistic regression was applied to identify predictors at the client-, provider-, and …

Una Nueva Herramienta Para Estimar El Volumen Muscular Independientemente De La Edad, El Sexo Y El Nivel De Actividad Física, José J. Rivera-Sánchez, Laura P. Burgos-Morelos, Daniel Castillo-Castillo, Gerardo Méndez-Suárez, Juan C. Lopez-Alvarenga, Damián Carrillo-Ruíz

School of Medicine Publications

Antecedentes: Actualmente, la evaluación del volumen muscular requiere técnicas invasivas o de imagen, lo que aumenta los costos y retrasa la evaluación, y las mediciones antropométricas con frecuencia son inexactas.

Objetivo: Desarrollar una fórmula matemática para estimar el volumen del cuádriceps.

Material y métodos: Se evaluaron 127 sujetos: 40 adultos sedentarios de 20 a 35 años, 47 atletas adultos de 20 a 45 años y 40 adultos sedentarios de 70 a 94 años. Se dividieron en grupos de desarrollo y de validación. Se realizaron mediciones de variables antropométricas y fuerza de agarre, y se desarrolló la fórmula de predicción del …

Engineering Osteo-Mucosal Constructs: A Review Of Adhesion Mechanisms And Innovations, Sanaz Mihandoust, Ali Seyed-Monir, Mehrsima Ghavami-Lahiji, Keyvan Moharamzadeh, Lobat Tayebi

Electrical & Computer Engineering Faculty Publications

Developing a laboratory-grown construct integrating viable bone and oral mucosal tissues with strong adhesion between the hard and soft tissue layers presents a significant challenge. This engineered tissue construct holds promise as a versatile graft material for diverse oral surgeries and as an in vitro model for evaluating dental materials, dental implants, and oral healthcare products, potentially replacing the need for in vivo studies. Additionally, it offers a valuable tool for investigating various aspects of oral diseases and evaluating the efficacy of different treatments, eliminating the need for animal models. The success of such osteo-mucosal constructs depends on achieving proper …

Associations Between Modifiable Lifestyle Risk Factors And Abdominal Aortic Calcification In The Uk Biobank Imaging Study, Nicola P. Bondonno, Abadi K. Gebre, Benjamin H. Parmenter, Jonathan Hodgson, Lauren C. Blekkenhorst, Catherine P. Bondonno, Richard Woodman, John P. Kemp, James Webster, Carl Schultz, Cassandra Smith, Afsah Saleem, Syed Zulqarnain Gilani, Emma L. Duncan, Joseph Hung, Wai H. Lim, Parminder Raina, John T. Schousboe, Nicholas C. Harvey, Marc Sim, Joshua R. Lewis

Research outputs 2022 to 2026

Background and aims: Abdominal aortic calcification (AAC) reflects subclinical atherosclerotic cardiovascular disease (ASCVD), but its lifestyle determinants remain uncertain. We investigated how a Healthy Lifestyle Score (HLS) relates to AAC and whether AAC mediates the HLS-ASCVD association. Methods and results: Participants from the UK Biobank Imaging study were assessed for AAC from DXA images. A Healthy Lifestyle Score (HLS), based on smoking, physical activity, diet quality, alcohol consumption, sleep, and BMI was developed, and categorised as low, moderate and high. Cross-sectional associations with (i) any AAC (AAC≥1) and (ii) high AAC (AAC≥6) were analysed using multivariable-adjusted logistic regression models. The …

The Ihs Strategic Plan: Improving The Health Of American Indian And Alaska Native People Through Collaboration And Innovation, Indian Health Service

Native Health Database Full Text

The IHS Strategic plan entails four goals: Build Healthy Communities, Achieve Parity in Access by 2010, Provide Compassionate Quality Health Care, and Embrace Innovation. Each of these goals are outlined alongside their respective strategies for accomplishment.

Sugar Consumption In Aboriginal Children Explored From A Social Practice Perspective, Amy Budrikis, Angela Durey, Dan Mcaullay, Paul Ward, Hanny Calache, Thierry Ng, Roma Winmar, Linda Slack-Smith

Research outputs 2022 to 2026

Australian Aboriginal children have higher sugar intake and are disproportionately affected by sugar-related diseases such as obesity, diabetes and dental caries than non-Aboriginal children. The intention of this paper was to highlight the need for approaches that can capture the complexity of health practices without reducing them to either individual choice or structural determination. We explore sugar consumption in Aboriginal children from a social practice perspective. Here, the unit of analysis is the practice, not the individual, where the elements of a social practice (competence, materials and meanings) are integrated into its performance. We conducted qualitative research using elements of …

The Best Practice Guide For Early Childhood Education And Care Food Environment: Module 3: Food Education (Version 1.0), Ros Sambell, Connie N. Ihlein, Audrey Elford, Lochie Clark, Amanda Devine, Helen Alexiou, Lennie Barblett, Fiona Champion, Penelope Clark, Kathy Cologon, Wendy Cook, Katie Dix, Leanne Elliston, Amanda Ferguson, Ricky Gelman, Jodie Gray, Natalie Gulberti, Debbie Jordan, Karen Krist, Deana Leahy, Stacey Mckenzie, Sandra Murphy, Merryn Netting, Ciara O’Flaherty, Asha Rojahn, Blake Stewart, Aimee Sullivan, Suzanne Tamone, Henry Tan, Sandra Vale, Danielle Waterson, Jill Whelan

Research outputs 2022 to 2026

Food education (FE) in early learning settings is more than cooking – it is an opportunity to experience food in ways that include cooking but go far beyond. Food education gives children the opportunity for exploration, experimentation, learning, teamwork, skill building and much more. At the same time, services must balance safety, regulatory requirements, diverse developmental and cultural needs, family expectations and practical constraints such as time and staffing.

The FE module has been developed to support Early Childhood Education and Care settings (ECEC), for children from birth to 5 years, to create food experiences that are safe, engaging, inclusive …

Machine Learning Prediction Of Incident Hypertension In Australian Men: Integrating Survey, Pharmaceutical And Healthcare Utilisation Data From The Ten To Men Cohort, Ebenezer Afrifa-Yamoah, Emmanuel Peprah-Yamoah, Victor Opoku-Yamoah, Eric Adua

Research outputs 2022 to 2026

Background: Hypertension is a leading modifiable contributor to cardiovascular disease. We developed and evaluated machine learning models to predict incident hypertension in Australian men using baseline survey data linked to pharmaceutical (PBS) and healthcare utilisation (MBS) administrative records from the Ten to Men cohort.

Methods: Among 13,519 men free of hypertension at baseline (2014), incident hypertension over 10 years was ascertained from PBS antihypertensive dispensing. Twenty-five baseline features spanning sociodemographic, anthropometric, lifestyle, clinical and administrative domains were used to train logistic regression, random forest, gradient boosting and XGBoost models, evaluated by five-fold cross-validation with out-of-fold prediction. Discrimination, calibration and threshold-based …

Precision Prevention For Health: The Global Alliance Framework For The Promotion Of Physical Activity, Jürgen M. Steinacker, Willem Van Mechelen, Lars Engebretsen, Evert Verhagen, Mats Börjesson, Marcela González-Gross, Mark R. Hutchinson, Petra Zupet, Herbert Löllgen, Dina C. Janse Van Rensburg, Norbert Bachl, Sergio Migliorini, Pieter D‘Hooghe, Christian Schneider, Jiao Jiao, Ka Ki Wong, Jeroen Swart, Leigh Gordon, Victoria Badtieva, Borja Muniz-Pardos, Tony Lei Shi, Li Xiangchen, Feng Qiang, Guoping Li, Minhao Xie, Xia Zhang, Uğur Erdener, Federica Fagnani, Fabio Pigozzi, Chiara Fossati, Luigi Di Luigi, Francisco Arroyo, Jean-François Kaux, Camille Tooth, Shulin Cheng, Xiuqiang Wang, Emin Ergen, Bülent Ülkar, Frederic Dutheil, Ruediger Reer, Theodora Papadopoulou, Clea Papaellina, Demitri Constantinou, Jason Constantinou, Merling Phaswana, Mamosilo Lichaba, Philippe Gradidge, Mandisa Simamane, Georgia Torres, Natalia Neophytou, Elelwani D. Nevhufumba, Bernhard Schwaab, José Antonio Casajús Mallen, Martin Halle, Martine Duclos, Daniel Neunhaeuserer, Andrea Ermolao, Francesca Battista, Federica Duregon, Julio Motta-Pensabene, Yiannis Koutedakis, Wilhelm Bloch, Nicolaas P. Pronk, Anastasia Fischer, Lisset Pantoja-Arévalo, Ana V. Cintrón, Adewale S. Adebero, Jill Borresen, Johannes Zwerver, Diana M. Ramos-Caballero, Erica M. Mancera-Soto, Pedro Manonelles, Benedict Tan, Ingrid Burrowes, Carl Ward, Kim R. Quimby, Christina Howitt, Robert Clive Landis, Hans Hauner, Mikio Hiura, Luz Divina De La Cruz Lastre, Gunnar Treff, Fotini Tsofliou, José Kawazoe Lazzoli, Umutcan Kayıkçı, Mourad Ghrairi, Vincent Onywera, Robert Ojiambo, Robert Sallis, Sophia Papamichalopoulos, Maher Zahar, Christine Joisten, Bernd Wolfarth, Sandra Rozenstoka, Hashel Al Tunaiji, Kiera Wason, Felix Drummond, Wolfgang Schobersberger, Vahur Ööpik, Eve Unt, Anna Jegier, Stéphane Doutreleau, Seung Hoon Han, Jörg F. Debatin, Nils Schumacher, Luís B. Sardinha, Lenka Dienstbach-Wech, Tuba Melekoğlu, Sheng Zeng, Maurizio Casasco, Kristy Howells, Eva-Maria Klinkisch, James Bilzon, Gregory Heath, Thomas Horstmann, Eduardo H. De Rose, Nick Webborn, Klaus-Michael Braumann, Li Jing, Xiao Xu, Elizabeth Moxley, Yi Zheng, Alison V. September, Malcolm Collins, Olena Andrieieva, Svitlana Drozdovska, Andreas Michael Nieß, Rikke Helene Moe, Carolin Knoke, Silvano Zanuso, Francesco Zanatta, Veronika Všetíčková, Spyridon Zormpas, Christoforos D. Giannaki, Brian P. Carson, Matthew P. Herring, Ciara Mccormack, Marco Vecchiato, Thomas Yvert, Makro Korenjak, Benjamin Billet, Andréia Lópes Azevedo, Naama Constantini, Sigmund Loland, Aaron Leigh Baggish, Luis Monteiro, Nuray Yazihan, Yannis P. Pitsiladis

Research outputs 2022 to 2026

This conceptual, implementation-oriented paper proposes a framework for precision prevention centred on physical activity promotion and early risk mitigation, aiming to support a shift from reactive disease management toward proactive prevention. The proposed framework focuses on the early identification of risk trajectories by integrating biological, environmental, and social determinants of health through systems thinking, multi-omics technologies, digital health, and behavioural science. It aims to inform tailored, context-sensitive interventions that will help to mitigate chronic non-communicable diseases (NCDs), while supporting lifelong resilience. Within this framework, physical activity is positioned as the central, modifiable anchor behaviour through which personalised prevention strategies may …

The Role Of Participant–Clinician Relationality And Intervention Source In A Violence Reduction Trial: A Qualitative Study, Paul Leslie Simpson, Freya Stephenson, Patricia Morgan, Emaediong I. Akpanekpo, Jocelyn Jones, Peter William Schofield, Lee Knight, Tony Butler

Research outputs 2022 to 2026

Violence and domestic violence are global public health problems with prevention programs showing limited effectiveness. The form of delivery of such programs can influence their utility yet delivery characteristics are often poorly described. We analysed interviews with clinicians (n = 5) and participants (n = 12) involved in ReINVEST, a violence reduction clinical trial, to identify key elements of delivery. Three themes were identified: (1) clinician accessibility; (2) clinicians as participant advocates; and (3) humane care, reflecting participant–clinician ‘relationality’ as a central component of program delivery. We propose that this relationality is more likely to emerge in interventions delivered independently …

Improving The Continuity Of Care For Opioid Use Disorder: Investigating Fentanyl Overdose Outcomes And Pharmacy-Level Buprenorphine Access, Lyn Yuen Choo

Graduate Theses, Dissertations, and Problem Reports (ETD)

Opioid overdose (OD) deaths remain a leading cause of injury-related death in the United States (US) and approximately 76,516 drug OD deaths were predicted in the past year prior to April 2025. While previous research has focused on fatal opioid ODs, less is known about outcomes following non-fatal opioid ODs (NFOO) involving fentanyl. Patients who experienced a fentanyl OD may develop significant morbidity and inpatient mortality due to fentanyl’s high potency, rapid onset of action, and decreased response to naloxone. Research efforts to improve continuity of care for opioid use disorder (OUD) are highly needed to ensure appropriate follow-up care …

Effectiveness Of Occupational Therapy-Inspired Educational Sessions For Mothers Accessing Women, Infants, And Children (Wic) Services, Samantha Annette Merew

Graduate Theses, Dissertations, and Problem Reports (ETD)

This doctoral capstone project examined the effectiveness of occupational therapy (OT)-inspired group and one-on-one educational sessions designed to support the emotional, mental, and social well-being of pregnant and postpartum mothers accessing Women, Infants, and Children (WIC) services in Onslow County, North Carolina. Grounded in the Model of Human Occupation and Cognitive Behavioral Frame of Reference, the program aimed to address gaps in holistic maternal health support, particularly among low-income and at-risk populations. Eight structured group sessions and five one-on-one sessions were developed, implemented, and evaluated, focusing on topics such as stress management, emotional regulation, self-care, role transition, and self-advocacy. A …

Risk Of Gestational Diabetes By Aerobic And Resistance Exercise During The First And Second Trimesters, Takaki Tanamoto, George Saade, Leryn J. Reynolds, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

While some studies have shown that exercise reduces the incidence of gestational diabetes mellitus (GDM), there is limited evidence on whether aerobic or resistance exercise is more beneficial. This study aimed to examine the rate of GDM according to the type of exercise during early pregnancy.

Study design

We analyzed data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b), a prospective cohort of individuals enrolled during the first and second trimesters. We excluded participants with pregestational diabetes or delivery < 20 weeks. The primary exposure was either aerobic or resistance exercises in the first or second trimester. For each trimester, the metabolic equivalent of task hours per week (MET-h/week) was calculated for each exercise. Participants were grouped as follows: "Aerobic exercise" (≥7.5 MET-h/week from aerobic exercises), "Resistance exercise" (≥2 times/week from resistance exercises), "Both types of exercise" (≥7.5 MET-h/week from aerobic exercise and ≥2 times/week from resistance exercises), and "Insufficient exercise" (≤7.5 MET-h/week from aerobic exercise and ≤2 times/week from resistance exercises). Our primary outcome was GDM. Adjusted relative risks (aRRs) with 95% confidence intervals (95% CIs) were calculated using modified Poisson regression, adjusting for potential confounders.

Results

In both the first and second trimesters, analyses included 9049 individuals. In the first trimester, individuals who performed …

Differential Impact Of Admission Type And Clinical Complexity On Diabetes Hospitalization Costs Among African American And Hispanic Patients In Southeastern Virginia, Ismail El Moudden, Asra Amidi, Reem Sharaf-Alddin, Michael C. Bittner, Qi Zhang

Department of Obstetrics & Gynecology Faculty Publications

Background

Diabetes mellitus (DM) imposes substantial healthcare costs with documented disparities among African Americans and Hispanic patients. To inform care delivery and resource allocation, this study identified hospitalization cost predictors among African American and Hispanic patients with diabetes in Southeastern Virginia.

Methods

We analyzed 6,011 hospital discharges from the Virginia Health Information database (2016-2020) for adults aged 18-85 with diabetes. Discharges were classified by Medicare Severity Diagnosis-Related Groups: DM with complications/comorbidities (DCC, n = 3,328), DM with major complications/comorbidities (DMCC, n = 1,518), and DM without major complications/comorbidities (DWO, n = 1,165). Because cost distributions were right-skewed (skewness 3.5-8.24), we …

Contribution Of Comorbidities And Pregnancy Complications To Severe Maternal Morbidity In The United States, Tetsuya Kawakita, Sora A. Jones, Natsume Furukawa, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective: To quantify the extent to which rising rates of severe maternal morbidity (SMM) in the United States from 2016 to 2022 are attributable to increasing prevalence of maternal risk factors, including advanced maternal age, obesity, pregestational diabetes mellitus, gestational diabetes, chronic hypertension, and hypertensive disorders of pregnancy (HDP).

Methods: We conducted a retrospective cohort study using the Nationwide Readmissions Database from 2016 to 2022, representing more than 25 million weighted delivery hospitalizations. The primary outcome of SMM was identified with the Centers for Disease Control and Prevention's 21-condition algorithm; a secondary outcome excluded transfusion to improve specificity. Temporal trends …

Hardin Health Link: A Community-Integrated Paramedicine (Cip) Program In Hardin County, Kentucky, Samantha Jones

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

Rural and mixed rural–urban communities face persistent disparities in access to timely emergency medical services (EMS), contributing to preventable morbidity and mortality from time-sensitive conditions such as cardiovascular disease, stroke, and injury. Hardin County, Kentucky, reflects these challenges due to its geographically dispersed population, high burden of chronic disease, and variability in EMS response times. This capstone proposes Hardin Health Link, a Community-Integrated Paramedicine (CIP) program designed to expand the traditional role of EMS providers through in-home health assessments, chronic disease monitoring, post-discharge follow-up, medication reconciliation, and connection to clinical and social services.

Guided by an evidence-informed framework, the program …

Momentum For Healthy Births-Hardin County, Ky, Brittany R. Jackson

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

Maternal and infant health disparities in Hardin County, Kentucky, reflect persistent gaps in timely access to care, particularly among rural and underserved populations. Structural barriers, including transportation limitations and unmet social needs, contribute to delayed prenatal care initiation and low postpartum follow-up, increasing the risk of adverse outcomes. This capstone project proposes the MOMentum (Maternal Outreach and Monitoring for Mothers) Program, an integrated care model designed to strengthen access, improve care coordination, and enhance continuity across the prenatal and postpartum period.

The program combines a Community Health Worker (CHW)-led navigation model with enhanced postpartum care supported by telehealth services and …

Overview Of Aboriginal And Torres Strait Islander Health Status 2025, Australian Indigenous Healthinfonet

Research outputs 2022 to 2026

This Overview provides a summary of the most recent indicators of the health and wellbeing of Aboriginal and Torres Strait Islander people (of all ages, where data are available). The topics included in the Overview cover chronic health conditions which are featured on the HealthInfoNet website. Over the years as additional funding has been obtained and in consultation with HealthInfoNet networks, more topics have been covered on the website and are now included in the Overview. The topics aim to reflect the status of Aboriginal and Torres Strait Islander health over this period and going forward.

Sex Differences In Sleep, Circadian Rhythms, And Alzheimer’S Disease Pathology In The Appxps1 Mutant Knock-In Mouse, Carrie E. Johnson

University of Kentucky Doctoral Dissertations

Decades of research have demonstrated that sleep and circadian rhythm disruptions increase with age and are associated with increased Alzheimer’s Disease (AD) risk. Women experience more sleep and circadian disruptions with age, especially throughout the menopausal transition, and more women than men have AD. The molecular mechanisms underlying biological sex, sleep and circadian disruptions, and AD are largely unknown. Most research has focused on the build-up of toxic amyloid-beta (Aβ) in the brain [which is a cleavage fragment of the full-length amyloid beta precursor protein (APP)] alongside of loss of circulating gonadal hormones. To investigate these possibilities and others, we …