Digital Commons Network^™

The Association Between Social Vulnerability And Racial Disparities In Preterm Birth, Anita Pershad, Gabby Adams, Lindsay Robbins, George Saade, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

To evaluate the association between county-level social vulnerability and preterm birth and assess whether racial disparities vary across levels of vulnerability.

Methods

This cross-sectional study utilized restricted Centers for Disease Control and Prevention natality data from 2023. We included Black or White births with singleton pregnancies across 3123 US counties from 50 US states and the District of Columbia. Participants were grouped into quartiles based on the county-level Social Vulnerability Index (SVI), with quartile 4 representing the most socially vulnerable populations. The primary outcome was preterm birth, defined as delivery before 37 weeks. Secondary outcomes included small for gestational …

Diagnosing The Discourse: How The Academy Of Breastfeeding Medicine Constructs And Constrains Treatment Of Tethered Oral Tissues, Mary E. Miller

Antioch University Dissertations & Theses

While breastfeeding is recognized as fundamental to global public health, oral restrictions that can affect infant latch, milk transfer, and feeding efficiency warrant further examination within policy frameworks. This dissertation proposes an expanded conceptualization of tethered oral tissues (TOTs) that encompasses not only anatomical frenal restrictions but also fascial tensions, neuromuscular limitations, and other conditions restricting orofacial function that may be congenital or acquired. The purpose of this study was to critically examine how this clinical guidance document shapes understandings and responses to TOTs. Using Carol Bacchi’s “What’s the Problem Represented to Be?” approach, a critical discourse analysis of the …

Emotionally Healthy Black Men: Guidelines For Supporting Mental Health Treatment For Black Men In Ohio, Eira Nichell Yates

Antioch University Dissertations & Theses

This study examines the barriers that prevent Black men in Ohio from seeking treatment for depression and other mental health conditions and explores strategies to improve engagement and outcomes. Although depression is the most prevalent mental health disorder in the United States, it remains underdiagnosed and undertreated among Black men, contributing to persistent mental health disparities. The limited body of research addressing help-seeking behaviors within this population necessitated the use of a Delphi methodology to obtain expert consensus on key challenges and promising practices. A panel of subject-matter experts in mental health, social services, and culturally responsive care participated in …

The Effects Of Abused Drugs On Ferroptosis Pathways: Potential Therapeutic Targets For Substance Use Disorders, Tamara Bouchard, Brooke Russell, Liam Liyang Guo, Tina Nguyen, Yan Cheng, Yan Y. Sanders, Ming-Lei Guo

Department of Biomedical and Translational Sciences Faculty Publications

Substance use disorders (SUDs) remain major public health concerns worldwide, particularly in developed countries. SUDs are characterized by persistent neuroinflammation and synaptic dysfunction in the brain. Despite decades of extensive investigation, the detailed mechanisms underlying SUDs remain elusive. Ferroptosis is a highly regulated cell death process deeply affected by iron metabolism, lipid peroxidation, reactive oxygen species (ROS) production, and antioxidant systems. It has been implicated in multiple neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, and ischemic stroke. Recently, emerging evidence has highlighted the role of ferroptosis in drug-induced pathological changes. Various types of abused substances including alcohol, cocaine, …

Structural Inequities, Environmental Toxicants, And Cardiometabolic Pathways In Cardiovascular Disease: Evidence From A Nationally Representative U.S. Population, Ese F. Oghaghare

Electronic Theses & Dissertations (2024 - present)

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in the United States and continues to disproportionately burden racial/ethnic minorities and socioeconomically disadvantaged populations. Traditional risk factors and behavioral explanations fail to fully account for these persistent disparities, motivating increased attention to intermediate biological pathways and environmental toxicant exposures through which structural inequities may become biologically embedded. This dissertation investigates how cardiometabolic biomarkers, diet quality, and exposure to persistent organic pollutants jointly contribute to cardiovascular disease risk in a nationally representative U.S. population.

Using data from the National Health and Nutrition Examination Survey (NHANES), three complementary studies were …

Access To Appropriate Care, Mortality, And Cost Of Inpatient Hospitalization In Infants With Omphalocele And Gastroschisis In The United States, Treeva A. Jaff

Electronic Theses & Dissertations (2024 - present)

Congenital abdominal wall defects (AWDs), including omphalocele (OM) and gastroschisis (GS), are rare but clinically significant conditions that require immediate surgical intervention and prolonged neonatal intensive care. OM is a midline defect in which abdominal organs protrude into the umbilical cord covered by a membranous sac, while GS is a full-thickness defect typically located to the right of the umbilicus through which organs protrude without protective coverage. OM is frequently associated with major co-occurring congenital anomalies and chromosomal abnormalities, while GS more commonly occurs as an isolated defect but requires more intensive surgical management. As survival rates have improved, research …

Development And Applications Of Fluorescence Microscopy Protocol To Investigate Borrelia Burgdorferi Immune Interactions In The Skin, Rebecca V. Landry

Electronic Theses & Dissertations (2024 - present)

The skin is an immunological organ that acts as the hosts’ first line of defense against infectious agents. Infectious disease vectors like ticks breach this barrier by feeding on hosts, transmitting pathogens like Borrelia burgdorferi in the process. Uncleared infection with B. burgdorferi causes Lyme disease, the most prevalent vector-borne disease in the United States. Previous research has explained many elements of Lyme disease pathogenesis and immunity including the dissemination of the spirochete, innate immune cells performing phagocytosis, the production of antibodies by the humoral response, and the impact of prophylactic treatment with monoclonal antibodies. A remaining gap in the …

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 …

Teledentistry: A Path To Minimize Emergency Department Dependency For Dental Issues, Aishwarya Joshi

Graduate Studies Theses and Dissertations 2026

Teledentistry has been promoted as a strategy to minimize emergency department (ED) visits for non-traumatic dental conditions (NTDCs). However, it remains unclear whether structural readiness or temporary policy expansion drives sustained reductions in reliance on the ED. This study integrates Andersen’s Behavioral Model of Health Services Use and Diffusion of Innovation (DOI) theory to examine determinants of Medicaid NTDC ED utilization and Tele-dentistry adoption.

Andersen’s model posits that utilization is shaped by predisposing, enabling, and need factors, whereas DOI theory emphasizes structural attributes that influence adoption, including relative advantage, compatibility, complexity, trialability, and observability. Combining these frameworks allows for a …

Puff, Puff, Pass? Examining Cannabis Use Among Black American Adults, Christopher B. Walker

Graduate Studies Theses and Dissertations 2026

In the United States, cannabis has become one of the most widely used controlled substances due to its increase in social acceptance, the growing number of states legalizing it for medical and non-medical purposes, and the expansion of consumption methods.  However, little is known about the modes of cannabis use chosen by Black American adults.  This population is of importance due to existing research suggesting their increased risk of developing cannabis use disorder compared to their White counterparts and their underrepresentation in existing literature.  The goal of this study is to examine cannabis use among Black adults in the U.S., …

Covid And The Great Retrenchment, Samuel R. Bagenstos

Articles

The past six years have seen two dramatic shifts in federal health and benefits policy. First, during the COVID pandemic, the government dramatically expanded public benefits. These expansions had incredibly positive effects, and recipients were largely satisfied with them. But after a relatively short time, Congress rolled back nearly all of the expansion. Worse, the immediate pullback set the stage for even more significant retrenchments in the second Trump Administration. Where in 2023 the United States came closest to universal health care in its history—with a record low uninsured rate of 7.7%—the Trump Administration’s Medicaid cuts and failure to extend …

Spatial Analyses Using Emergency Medical Services Data To Inform Healthcare., Jeffrey Alan Pesarsick

Graduate Theses, Dissertations, and Problem Reports (ETD)

Spatial analyses using Emergency Medical Services data to inform healthcare.

Jeffrey Pesarsick

Background

Emergency Medical Services (EMS) often serve as the initial entry point for patients into the healthcare system in the United States.  Rural health disparities, geographic isolation, socioeconomic disadvantages, and operational challenges create disparities in access to EMS services.  Disparities include prolonged response times, less resources available, and inequities in levels of care available.  The overall goal of these series of projects was to quantify the extent to which operational challenges in EMS data impact health, and how EMS data could be used to identify neighborhood level trends …

The Dual-Factor Model (Dfm) Of Mental Among Appalachian Youth, Mawyah Adel Bashatah

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background. Adolescent mental health is a critical public health concern, particularly in rural Appalachian communities where rates of depression, anxiety, and substance use exceed national averages and access to mental health resources remain severely limited. Traditional mental health frameworks rely predominantly on the identification and reduction of psychopathological symptoms, neglecting the independent contributions of positive well-being to adolescent risk and resilience. The Dual-Factor Model (DFM) of mental health offers a more comprehensive alternative by simultaneously assessing subjective well-being (SWB) and psychopathology, classifying individuals into four distinct groups: Complete mental health, Vulnerable, Symptomatic but content, and Troubled. Despite the DFM’s growing …

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 …

Longitudinal Prediction Of Bmi Using Explainable Ai: Integrating Polygenic Scores, Maternal, Early-Life And Familial Factors, Fuling Chen, Phillip E. Melton, Kevin Vinsen, Trevor Mori, Lawrence Beilin, Rae Chi Huang

Research outputs 2022 to 2026

Background/objectives: This study aimed to predict body mass index (BMI) trajectories from childhood to early adulthood using explainable artificial intelligence, integrating adult BMI polygenic scores (PGS), maternal, early-life, and familial factors to identify key predictors of obesity risk and inform prevention strategies. Subjects/methods: We analyzed longitudinal data from the Raine Study Gen2 cohort, recruiting 2868 participants. This observational study, without randomization or case-control design, collected BMI measurements at ages 8, 10, 14, 17, 20, 23, and 27 years. We applied Kolmogorov–Arnold Networks (KAN) alongside conventional machine learning models, integrating epidemiological variables (maternal and paternal anthropometrics, parental education, early-life skinfold measurements) …

Forced Oscillation Technique In Pneumothorax (Pneumofot) Study, Niranjan Ananda Setty, Carolyn J. Mcintyre, John Blakey, Yun Chor Gary Lee

Research outputs 2022 to 2026

Forced Oscillation Technique in Pneumothorax (PneumoFOT) study A single-centre prospective pilot feasibility study designed to assess the feasibility of performing FOT measurements in patients with pneumothorax. STATISTICAL ANALYSIS PLAN Version 24.05.2026

Implementation Of Risk Prediction And Stratification Approaches For Ageing Populations In Australian Healthcare: A Systematic Review, Leanne Greene, Jacob Brain, Belinda Brown, Claire V. Burley, Elissa Burton, Zhongyang Guan, Bronwyn Myers, Katherine Ride, Serena Sabatini, Mario Siervo, Abay Woday Tadesse, Eugene Yee Hing Tang, Blossom C.L. Stephan, Jennifer Dunne

Research outputs 2022 to 2026

Despite widespread development of prognostic risk stratification tools, their implementation in Australian healthcare remains poorly characterised. This review identified tools implemented for adults aged ≥40 years and examined their real-world use. Following PRISMA and SWiM guidelines, MEDLINE, EMBASE, Web of Science, PsycINFO, and CINAHL Plus were searched from inception to 20th February 2026. Eligible studies reported implementation of a risk stratification tool in Australian healthcare and health, functional, or implementation outcomes. The Mixed Methods Appraisal Tool assessed study quality. Of 7115 records screened, 21 studies were included across primary care, hospitals, residential aged care, and community services. Interventions included electronic …

The Best Practice Guide For Early Childhood Education And Care Food Environment: Module 1: Mealtime Environment And Practices (Version 1.0), Rebecca Byrne, Laine Chilman, Judith Howard, Eloise Litterbach, Merryn Netting, Ros Sambell, Sally Whitaker, Lennie Barblett, Fiona Champion, Penelope Clark, Kathy Cologon, Wendy Cook, Kirsty Elliott, Leanne Elliston, Amanda Ferguson, Ricky Gelman, Jodie Gray, Natalie Gulberti, Shae Haylen, Karen Krist, Deana Leahy, Jodie Mcgough, Ciara O’Flaherty, Aimee Sullivan, Suzanne Tamone, Sandra Vale, Jill Whelan, Amanda Devine, Audrey Elford, Lochie Clark, Connie N. Ihlein, Stacey Mckenzie, Gabrielle Orr, Asha Rojahn, Hilary Smith, Henry Tan, Helen Alexiou

Research outputs 2022 to 2026

Mealtimes in early learning settings are more than a routine to help children eat. They are important opportunities for connection, learning and development, and for supporting children’s confidence and comfort around food and eating. 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 Mealtime Environment and Practices (MEP) module has been developed to support Early Childhood Education and Care settings (ECEC), for children from birth to 5 years, to create mealtimes that are safe, calm, inclusive and responsive to each child, while reflecting …

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 …

Comparison Of Push-Pull Air Curtain To Overhead Downdraft Systems On Aerosol Containment And Distribution In Controlled Environments, Manal Mutairi

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Comparison of Push-Pull Air Curtain to Overhead Downdraft Systems on Aerosol Containment and Distribution in Controlled Environments.

This dissertation looks at the ongoing issue of tiny airborne particles created during medical and dental procedures and evaluates ways to reduce the risk of exposure for healthcare workers and patients to these particles. The first study focuses on the size, how long particles stay in the air, and how far they travel from common medical procedures that create aerosols, showing that tiny particles (less than 5 µm) can stay in the air long enough to escape basic droplet controls. As a …

Rurality, Infant Feeding Practices, And Perinatal Cardiovascular Health Behaviors, Elly Marie Marshall

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Cardiovascular diseases are a leading cause of pregnancy-related deaths in the United States, with higher rates in rural areas. While limited healthcare access contributes to this disparity, other factors remain unclear. Breastfeeding provides long-term protection against cardiovascular disease, but modern infant feeding practices are complex and may impact maternal cardiovascular health (CVH) in unexpected ways. Healthy CVH behaviors of sufficient sleep duration, adequate physical activity, a healthy diet, and nicotine avoidance can enhance protection against future cardiovascular disease risk. Therefore, the aims of this dissertation are to 1) assess associations between rurality and first trimester CVH behaviors; 2) synthesize …

Identifying And Prioritizing Essential Healthcare Services For A Private Start-Up Healthcare Hub In Laxmipasha, Bangladesh, Ferdous Ara Mostofa

Dissertations

This quantitative study identifies and prioritizes essential healthcare services for developing a private start-up healthcare hub in Laxmipasha, Bangladesh, a rural community with significant gaps in healthcare access. Using secondary data from national and international sources, the research analyzed disease burden, population characteristics, and service availability to determine the most urgent health priorities. A structured, evidence-based framework was used to evaluate services based on mortality and morbidity, service gaps, and potential health impact. The findings indicate that Maternal and Child Health (MCH), Non-Communicable Disease (NCD) management, and infectious disease control represent the most critical priorities for initial implementation. The study …

A Quantitative Analysis Of Barriers To College Students’ Seasonal Vaccination Intentions And Behaviors, Kelly S. Clemens, John Matkovic

Faculty Publications – Health Sciences

Objective
Vaccination is crucial to college student health, but quantitative analyses of barriers in this population are limited. The present study expands the work of Su and Chen to determine the relative influence of structural, psychological, and social vaccination barriers.

Participants
Participants were 650 students from a large, midwestern university during the 2024 vaccination season.

Methods
Participants were recruited from a college campus and randomized to respond to items assessing their barriers to, intentions to receive, and uptake of the COVID-19 or influenza vaccination.

Results
Structural, psychological, and social barriers were differentially important to vaccinations and to intentions vs. uptake …

Étude Multidisciplinaire Du Confort Des Bouchons D'Oreilles : Vers Une Protection Auditive Efficace En Milieu De Travail, Olivier Doutres, Franck Sgard, Alessia Negrini, Alain Berry, Chantal Gauvin

Rapports de recherche scientifique

L'utilisation de protecteurs auditifs individuels (PICB), tels que les casques ou les bouchons d’oreilles souvent recommandés comme mesure temporaire, reste souvent le seul moyen d'assurer la protection des travailleuses et travailleurs exposés quotidiennement à des niveaux de bruit dangereux. Actuellement, le choix d'un PICB est principalement basé sur des considérations liées à l’atténuation acoustique qu’il offre (et mesurée en laboratoire par des organisations certifiées), et/ou à des caractéristiques de l'environnement de travail, telles que la chaleur, l'hygiène et la compatibilité avec d'autres équipements de protection individuelle (EPI). Le port de PICB est connu pour générer de nombreux inconforts qui peuvent …

Exposition Professionnelle Aux Agents D'Infections Nosocomiales En Milieux De Soins : Mieux Comprendre Et Contrôler La Voie De Propagation Par Aérosols, Caroline Duchaine, Yves Longtin, Marc Veillette, Adriana Larotta, Bianka Paquet Bolduc

Rapports de recherche scientifique

Ce projet, mené dans le contexte de la pandémie de COVID-19, visait à mieux comprendre les risques liés à la présence de virus et de bactéries dans l’air des milieux de soins et à identifier les meilleures façons de protéger le personnel de la santé. Ce projet s’est articulé autour de trois grands volets de recherche complémentaires, menés en milieux réels et en laboratoire. Le premier volet visait à documenter la présence de virus comme le SARS-CoV-2 (responsable de la COVID-19), l’influenza ou le norovirus dans l’air d’hôpitaux et de centres de soins de longue durée. Des prélèvements dans les …

Effets Respiratoires De L'Exposition Journalière Aux Particules Respirables, Fines Et Ultrafines Dans Divers Milieux De Travail, Audrey Smargiassi, Maximilien Debia, Eva Suarthana

Rapports de recherche scientifique

De très nombreux travailleurs sont exposés quotidiennement à des niveaux de particules dans l’air ambiant qui dépassent largement les concentrations auxquelles la population générale est exposée. Néanmoins, très peu d’études ont porté sur l’influence de l’exposition quotidienne des travailleurs aux particules respirables sur la santé respiratoire. La majorité des études se sont intéressées aux effets des expositions prolongées sur le développement de maladies respiratoires. Pourtant, les associations entre l’exposition journalière aux particules respirables et l’inflammation pulmonaire et la fonction respiratoire sont bien documentées pour la population générale. Les effets des particules respirables pourraient différer pour les travailleurs parce que les …

Stakeholder Perceptions Of West Virginia’S Artificial Food Dye Ban In K–12 School Meals: Initial Year Of 2025-2026, Leah Michelle Rogers

Graduate Theses, Dissertations, and Problem Reports (ETD)

OBJECTIVES: Artificial food dyes (AFD+) are an increasing policy concern in the U.S., particularly in children’s foods. West Virginia’s House Bill 2354, the first statewide AFD+ ban implemented in K-12 schools, restricts seven AFD+ in state-funded meals. Little is known about how AFD+ bans are perceived or implemented. This study examined how the ban functioned within school food systems and the barriers and facilitators experienced by school stakeholders within the initial year of implementation during the 2025-2026 school year.

METHODS: A cross-sectional, observational mixed-methods study was conducted among implementers, enforcers, and receivers of the policy. A survey tool …

On Burden Of Diseases, Prevention, Medical Research And Health Service Delivery: Grampian Case Study, Seshadri S. Vasan, Sudarshan Anand, Miae Lee, Nicholas C. Fluck

Research outputs 2022 to 2026

Burden of diseases measured as disability-adjusted life years (DALYs) per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed to allow insightful comparisons with the national average, and to understand differences in trends between the sexes, age groups, time periods, geographic regions, and sub-regions. In this illustrative case study, we have analysed the Scottish burden of disease database to understand what ailed the population of the Grampian region before the COVID-19 pandemic. We have identified that selected cancers, ischaemic heart disease, Alzheimer’s disease and other dementias …

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.

Chronic Disease Prevalence And Modifiable Risk Factors Among Undergraduate Students At Ha’Il University: A Population-Level Cross-Sectional Study, Collins Otieno Asweto, Sehar Un Nisa Hassan, Mohamed Ali Alzain, Bandar Alsaif, Mohammed Elshiekh Saeed, Ahmed Kassar, Kamal Elbssir Mohammed Ali, Mouna Ghorbel, Rafat Zrieq, Monzer Hamed, Wei Wang

Research outputs 2022 to 2026

Background: Rising rates of chronic conditions among Saudi youth underscore the need for early prevention. Using a public‑health lens focused on demographic, academic, and lifestyle influences, this study investigates the risk and protective factors for chronic disease among students at the University of Ha’il to guide youth‑centered health policies and long‑term wellbeing initiatives. Methods: A cross-sectional survey was conducted among 10,775 undergraduate students studying in bachelor’s degree programs at Ha’il University, Saudi Arabia. Descriptive analyses were used to assess demographic characteristics, academic status, health status, and health-related lifestyles. Multiple logistic regression models were applied to determine which demographic, academic, and …