Digital Commons Network^™

Review Of Current Research Describing The Influence Of Non-Health Care Drivers Of Health In Rural And Urban Populations, Katie Youngen, Julia Cecil, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Social determinants of health (SDOH) (also called social drivers of health) are the conditions of the environment where people live, learn, work, and play that are known to affect health outcomes.¹ The primary objective of this literature review is to summarize the most recent literature related to the Healthy People 2030 domains of a) economic stability, b) education access and quality, c) neighborhood and built environment, and d) social and community context.² Our particular focus is on non-health care drivers of health. The secondary objective is to identify gaps in literature applied to rural populations.

Felt Ambivalence Weakens The Attitude-Intention Pathway For Regular Leisure-Time Physical Activity In Chinese Adolescents: A Three-Wavee Prospective Study, Yaogang Han, Yubing Wang, Pan Li, Guohua Zheng

Human Movement Studies & Special Education Faculty Publications

Background: Favorable attitudes toward regular leisure-time physical activity may not always translate into intention if adolescents feel ambivalent about the behavior. This study tested whether felt ambivalence weakens the prospective attitude–intention association and the indirect effect of attitude on later behavior through intention. Methods: Chinese adolescents (N = 1714; Grades 7–12; mean age = 15.0 years) completed a three-wave survey at approximately two-week intervals. Wave 1 assessed attitudes toward regular leisure-time moderate-to-vigorous physical activity, felt ambivalence, and physical activity habit; Wave 2 assessed intention; and Wave 3 assessed leisure-time physical activity. Moderated mediation was tested in a structural equation model …

Chronic Dislocations And Pain In A College Athlete, Rachel Joseph, Trina Walker, University Of Wisconsin - Madison, Rebecca Kronk, Karen J. Whitt, Deborah O. Himes

Faculty Publications and Presentations

This diagnostic case study describes an 18-year-old woman and competitive gymnast who presents with recurrent joint dislocations, chronic musculoskeletal pain, and dermatologic findings suggestive of a heritable connective tissue disorder. Early recognition of connective tissue disorders is essential for accurate diagnosis, genetic evaluation, injury prevention, and long-term management planning.

Digital Diplomacy And Activism: Sustaining Institutional Legacy Through State-Proxy Discursive Competition In The Aftermath Of The Usaid 2025 Suspension, Maryam Alaa Elprince

Capstone and Graduation Projects

This study examines how the 2025 suspension of the United States Agency for International Development (USAID) transformed the arena of U.S. foreign-aid diplomacy by eliminating the agency’s operational capacity and erasing its digital presence, thereby redistributing discursive authority across a fragmented communicative field. The research aims to determine how diplomacy adapts when a bilateral institution central to American soft power is dismantled through top-down decision, and whether discursive power exercised online can extend institutional relevance and legitimacy beyond structural collapse. Using an interpretivist qualitative design that combines digital-forensic reconstruction, document-based content analysis, and elite interviews  with top ranking officials, the …

Netchoice V. Wilson, District Of South Carolina

Historical and Topical Legal Documents

No abstract provided.

The Effect Of Automated Self-Monitoring On The Behavior Of Individuals Diagnosed With Pre-Diabetes Or Type 2 Diabetes, Leti Phillips Armenta

Cal Poly Humboldt theses and projects

Type 2 diabetes (T2D) and prediabetes affect millions of individuals in the United States and require effective self-management strategies to reduce glucose variability and improve health outcomes. This study evaluated the effects of automated self-monitoring using the Dexcom G7 continuous glucose monitor (CGM) on glucose management and health-related behaviors among adults diagnosed with prediabetes or at risk for T2D. A repeated-measures design was used to asses’ participants across two distinct 10-day periods. Data included CGM glucose readings, self-report questionnaires, and social validity measures. Results indicated that participants demonstrated reduced glucose variability, fewer prolonged glucose spikes, and increased engagement in health-related …

Increasing Uptake Of Diabetes Self-Management Education And Support (Dsmes) In Rural Kentucky Primary Care Clinics, Mary E. Lacy, Jessica Elliott, Vance Drakeford, Laura Wright, Brent Mckune, Key C. Douthitt, Aaron J. Kruse-Diehr, James W. Keck

Epidemiology and Environmental Health Faculty Publications

Background: Diabetes self-management education and support (DSMES) is an evidence-based intervention that improves outcomes for people with diabetes, but uptake is <10%. We conducted a pilot pragmatic trial to increase DSMES in rural primary care clinics that integrated health information technology with a quality improvement (QI) learning collaborative. Methods: Two healthcare systems from rural Kentucky participated in the study. Within each system, 2 clinics received the intervention and 1 clinic served as a control (N = 6 clinics). Each intervention clinic identified a QI team (5-6 individuals) who participated in a 9-month QI learning collaborative followed by 5 months of follow-up. Our primary outcome was DSMES referrals; secondary outcomes were DSMES attendance and percentage with A1c >9%. Results: The 6 study clinics served 1,803 patients with diabetes; n = 1083 (60.1%) from 4 intervention clinics and n = 720 (39.9%) from 2 control clinics. DSMES referrals significantly increased in the intervention clinics compared to the control clinics (31.7% vs 0.1%, P < .001) and continued to increase throughout 5-month follow-up (40.0% vs 0.1%, P < .001). Conclusions: A structured QI intervention can significantly increase DSMES referral rates in primary care clinics. Findings highlight the potential of systems-level approaches to address persistent gaps in diabetes care delivery in rural settings. Clinical Trial Registry: Using Practice Facilitation and Operationalizing Referral Information Technology to Increase DSMES Utilization (Clinicaltrials.gov registration number no. NCT05472142). Clinicaltrials.gov URL (https://clinicaltrials.gov/study/NCT05472142).

The Association Between Human Papillomavirus Type 16 E6 Seroprevalence And Degrees Of Anal Disease Among Men With Hiv, Krystle A.Lang Kuhs, Christopher Otieno, Staci Sudenga, Tim Waterboer, Weiqun Tong, Dorothy Wiley, Jay H. Bream, Steven Wolinsky, Jeremy Martinson, Gypsyamber D’Souza

Epidemiology and Environmental Health Faculty Publications

Introduction: Human papillomavirus type 16 (HPV16) E6 antibodies may be an early biomarker of anal cancer. We cross-sectionally evaluated when in the course of anal disease, HPV16 antibodies are induced. Methods: A nested case-control study of 846 men who have sex with men (MSM) was conducted within a prospective study of men with and without HIV. Cases of anal HPV16 (N=262), biopsy-confirmed high-grade squamous intraepithelial lesion (HSIL;N=140), and anal cancer (N=21) were individually matched to controls (N=423) on HIV status, study-participation duration, and age. Serum samples closest to diagnosis underwent HPV serologic testing; prediagnostic serial samples were tested for anal …

Association Between Educational Attainment And Discharge Disposition Following Incident Stroke Hospitalization, Ning Li, Erin L. Abner, Silvia Koton, Lena Mathews, Kunihiro Matsushita, Anna Kucharska-Newton

Epidemiology and Environmental Health Faculty Publications

Background – The relationship between educational attainment and discharge disposition after stroke hospitalization remains unclear. This study examined whether educational attainment is associated with discharge disposition after incident stroke and whether stroke severity modifies this association. Methods – The study included Atherosclerosis Risk in Communities (ARIC) participants with an incident stroke hospitalization from 1991 to 2020 who were enrolled in fee-for-service (FFS) Medicare at discharge. Discharge disposition was obtained from hospitalization claims. Educational attainment was categorized as “less than high school” vs. “high school or more.” Multivariable logistic regression models were used to estimate associations between educational attainment and discharge …

Decreased Exercise-Induced Pulmonary Capillary Recruitment In Pulmonary Arterial Hypertension, David Langleben, Stylianos E. Orfanos, Benjamin D. Fox, Michele Giovinazzo, Magali Kaddis, John D. Catravas

Bioelectrics Publications

The human lung normally accommodates exercise-induced cardiac output increases mainly via recruitment of non-concomitantly perfused pulmonary capillaries. Recruitment is detectable by measuring the first-pass transpulmonary metabolism of ³H-benzoyl-Phe-Ala-Pro, providing an estimate of functional capillary surface area (FCSA). Pulmonary arterial hypertension (PAH) results from luminal narrowing of small precapillary arterioles, reducing downstream perfused FCSA. We hypothesized that exercising PAH patients would not be able to recruit FCSA normally. We studied two patients with severe PAH. Despite exercising to maximal dyspnea, neither could recruit FCSA. These limited data are the first direct measurements of FCSA in exercising PAH patients.

Navigating Liminality: Building Resources For And With Undocumented Students, Yaneyry Delfin Martinez

Cal Poly Humboldt theses and projects

Rooted in Community-Based Participatory Research (CBPR) and Liberation Sociology, this project outlines an institutional blueprint for the resources and support systems needed to address the lived realities of undocumented students at Cal Poly Humboldt (CPH). Conducted during the second Trump Administration amidst escalating hostility towards immigrants and attacks on DEI initiatives, this work documents both the structural conditions shaping undocumented students’ lives and the collective resistance that emerged in response. Furthermore, it examines how immigration policy, access to and restrictions on federal and state aid, geographic conditions, and on-campus barriers reproduce and maintain legal liminality within higher education. Grounded in …

Nourishing Roots: Supporting Indigenous Food Education In School Gardens, Tatiana Marina Patino Madriaga

Cal Poly Humboldt theses and projects

This project asked: How can a school garden at Hoopa Valley Elementary support Indigenous food education, student well-being, and relational learning? To explore this question, I designed and implemented a garden classroom and facilitated hands-on garden and culinary workshops with students.

The garden was planned in September, built in October, and had plants in the ground by November. Over the course of the project, I facilitated four workshops, one Earth Day community event, and weekly garden classes. Approximately 350 students participated in the garden in some capacity, reflecting broad, school-wide engagement.

Methods included participant observation, documentation of student engagement, and …

Bacterial Community Function In Pitcher Plant Leaves As An Experimental And Mathematical Model Of Functional Dynamics, Amelia Jackson

Cal Poly Humboldt theses and projects

This work looks at two different sites with differing abiotic factors in measures of altitude, temperature and precipitation. The site with higher altitude, larger temperature range, and lower precipitation, located in Plumas National Forest (Quincy, CA), had a flat BEF trend that suggests functional redundancy The site with lower altitude, more moderate temperatures, and higher precipitation located in Six Rivers National Forest (Gasquet, CA), also had a flat BEF trend. These abiotic factors could correlate to the significantly different bacterial compositions between sites. The second portion of this work is modeling the host antagonist relationship between Eyxra moths and their …

Endocranial Lesions: A Paleopathological Study Of Late Medieval Skeletal Remains From Żelewo Poland, Francesca Aleen Meyer

Cal Poly Humboldt theses and projects

The site of Żelewo is located in a rural area of northwestern Poland, a region historically known as Pomerania. Skeletal remains from the cemetery associated with the archaeological site Żelewo 1-3, dating mostly to the 13th-15th centuries, are likely associated with a nearby Cistercian monastery. Numerous individuals from this site show evidence of endocranial lesions. To evaluate potential factors associated with the lesions, a differential diagnosis was performed based on macroscopic observations of endocranial lesion morphology and distribution. This study takes into account estimated age at death, biological sex, and other signs of pathology in the body. Potential confounding factors, …

Nutrient-Driven Transcription Factor-Dna Interactions And Their Signaling Mechanisms In Metabolic Disease, Evelyn A. Bates

Theses and Dissertations--Nutritional Sciences

Metabolic homeostasis is maintained through tightly coordinated signaling networks that integrate diverse physiological inputs. Central to this regulation are transcription factors, which sense nutrient, hormonal, and vitamin-derived signals and translate them into coordinated gene expression programs. Transcription factor activity is governed by DNA binding, recruitment of coregulatory proteins, and interactions with specific response elements in gene promoters, which allows them to selectively modulate diverse metabolic pathways. Owing to their multifactorial and tunable nature, transcription factors have emerged as promising targets for the treatment and diagnosis of metabolic diseases, including metabolic dysfunction-associated steatotic liver disease (MASLD). This dissertation explores the molecular …

Vegetation Species And Bed Position May Drive Epifaunal But Not Nekton Habitat Use In Estuarine Submerged Vegetation In The Mobile-Tensaw River Delta, Alabama, Steven Vroljik, Kathryn O'Shaughnessy, Ashley Mcdonald, Zoey Hendrickson, Bethany Kiley, Anna Reimer, Sierra Robertson, Samantha Smith, Edward Sullivan, Charles Martin

Gulf and Caribbean Research

Submerged aquatic vegetation (SAV) supports nekton and epifaunal macroinvertebrates, sustaining food webs and ecosystem services in estuaries. Invasive SAV can alter these dynamics by displacing native vegetation and restructuring communities. In Alabama’s Mobile-Tensaw Delta (MTD), Eurasian milfoil (Myriophyllum spicatum) is rapidly expanding and outcompeting native wild celery (Vallisneria americana). This study compared nekton and epifaunal assemblages between M. spicatum and V. americana, focusing on edge versus interior positions. Nekton surveys identified 22 taxa (M. spicatum, n = 13; V. americana, n = 18), but assemblages did not differ significantly between vegetation types …

Impact Of Powdered Tart Cherry Supplementation On Performance Recovery Following Repeated Sprint Exercise, Anthony M. Hagele, Kyle S. Levers, Kevin F. Holley, Alex C. Schrautemeier, Joesi M. Krieger, Joshua M. Iannotti, Connor J. Gaige, Ralf Jäger, Chad Kerksick

Faculty Scholarship

Background: Due to its high polyphenol content and purported capability to mitigate post-exercise muscle soreness and promote recovery, tart cherry (TC) supplementation has been proposed to enhance recovery and athletic performance. This study examined the effects of powdered TC supplementation on various recovery and performance metrics following a repeated sprint exercise protocol in physically active young adults.

Methods: 40 (18 M, 22 F) healthy, active participants (24.6 ± 5.5 yrs, 171.5 ± 11 cm, 71.7 ± 14.5 kg, 24.2 ± 3.1 kg·m−2) participated in this randomized, double-blind, placebo-controlled, parallel study design. Placebo (PLA) or powdered TC supplementation (500 …

Aging On The Fringes: Understanding Inequities Among Older Adults Impacted By Poverty, Mental Health Challenges, And Drug Use, William O’Leary, David Howson-Jan, Marjorie Knight, Soo Chan Carusone

Lyle S. Hallman Social Work Faculty Publications

This report provides an overview of government reports and academic literature examining aging and its intersection with poverty, homelessness, drug use, and mental health challenges. It pairs national and Ontario trends with data from Waterloo Region to illustrate how aging on the fringes is unfolding locally.

Throughout the report, “Local Lens: Waterloo Region” callouts highlight key regional indicators and their implications for programs and policy. The purpose of this report is to support discussion and action to advance equity-informed research and advocacy for people aging on the fringes. It is written for community members, service providers, and organizations seeking to …

Prevention Beyond Deterrence, Benjamin A. Barsky

Emory Law Journal

This Article reconceptualizes preventive justice—the public safety paradigm that seeks to prevent harm before it occurs. Scholars have long documented how cities have advanced this paradigm through largely punitive measures, notably variants of broken windows policing, which posit that aggressive misdemeanor enforcement deters more serious crime. Yet in the aftermath of the 2020 George Floyd protests, and as underscored recently in City of Grants Pass v. Johnson, these measures have faced a legitimacy crisis—prompting calls for nonpunitive responses to nonviolent incidents.

This Article establishes a preventive justice approach that advances health and safety without emphasizing crime deterrence. It draws …

Lunch Shaming And The Right To Privacy, Ira P. Robbins

Emory Law Journal

Lunch shaming is the practice of penalizing students who cannot afford to pay for their meals, resulting in them being denied food, served alternative meals, or publicly identified. The origins of lunch shaming can be traced to the financial pressures faced by school districts that struggle to balance tight budgets with the mandate to provide free or reduced-price meals to eligible students. Despite legislative efforts and advocacy campaigns aimed at mitigating the problems associated with lunch shaming, the practice persists, exacerbated by rising food costs and the expiration of pandemic-era food programs.

Many law journal and other articles have correctly …

Beyond Ssris: Omega-3 Fatty Acids And The Neurobiology Of Impulsivity In Borderline Personality Disorder, Sujean Doo

Scripps Senior Theses

Impulsivity is a central and clinically significant dimension of Borderline Personality Disorder (BPD), and is strongly associated with self-harm, aggression, and suicide risk. Despite its prognostic importance, pharmacologic management of impulsivity in BPD remains inconsistent. Selective serotonin reuptake inhibitors (SSRIs) are frequently prescribed; however, randomized controlled trials demonstrate limited efficacy for impulsive-aggression, and some patients experience a paradoxical behavioral activation. Meta-analytic and systematic reviews further suggest that mood stabilizers and second-generation antipsychotics may outperform antidepressants, yet no specific medication is indicated to target impulsive behavioral dyscontrol.

This thesis synthesizes findings from systematic reviews, randomized trials, and neuroimaging research to evaluate …

The Effects Of The Opioid Crisis On Contraceptive Decisions And Fertility In Pakistan, Simren R. Khan

Scripps Senior Theses

This paper examines how the opioid epidemic influences household fertility behavior in Pakistan by analyzing contraceptive use and fertility outcomes across regions with differing levels of opioid prevalence. Using household-level data from the 2017–18 Pakistan Demographic and Health Survey (DHS) and estimating OLS regression models, the study compares households in high-prevalence regions with those in low-prevalence regions. The results show that exposure to high-opioid regions is associated with lower fertility outcomes and a higher likelihood of respondents wanting their last child. These patterns suggest that households may respond to opioid-related economic and caregiving burdens by limiting family size and treating …

An Analysis Of Eating Disorders As A Comorbidity Of Autoimmune Diseases, Madeleine Shore

Scripps Senior Theses

For many autoimmune disease patients, psychiatric conditions are a common comorbidity. Although there are many shared mechanisms between autoimmune disease and psychiatric conditions, current research surrounding mental health among autoimmune disease patients often focuses on mood disorders rather than eating disorders. Despite the high risk for developing psychiatric conditions, most autoimmune disease patients are not screened for eating disorders. This lack of screening is significant, because if an eating disorder is missed by a healthcare provider, the autoimmune or eating disorder condition could be exacerbated, resulting in severe illness or even fatality. Given an existing link between comorbid psychiatric disorders, …

Justice For One, Injustice For All: The Consequences Of The Legal Services Corporation’S Class Action Restriction, Elizabeth J. Lattner

Case Western Reserve Law Review

No abstract provided.

The Effect Of Sleep Environment On Sleep Quality And Behavior In Firefighters: A Cross-Sectional Study, Jacquelyn N. Zera, Erica Esper, Anna Peluso Simonson, Ashley N. Clausen, Serena Paterno

2026 Faculty Bibliography

Firefighters face high-stress occupational demands and irregular shift work that negatively impact sleep quality, which is intrinsically linked to long-term physical and psychological health. This cross-sectional study examines how the physical sleep environment (home vs. work) and station sleeping arrangements (bunk-style vs. individual dorm-style quarters) influence subjective sleep quality in this population. Sixty-six career firefighters (Age = 40.89 ± 11.05 years), completed the Pittsburgh Sleep Quality Index (PSQI) to assess their sleep in both home and fire station environments, with data analyzed using Wilcoxon Signed Ranks and Mann–Whitney U tests. The results reveal significant differences (p < 0.001), with sleep duration, efficiency, subjective quality, and global PSQI scores all performing significantly better at home than at work. Notably, no significant differences were found between bunk-style and dorm-style sleeping quarters at the station. These findings suggest that firefighters experience poorer sleep while on duty regardless of room design, indicating that operational stressors like call volume and nocturnal arousal may be more influential on sleep quality than the physical arrangement of sleeping quarters, and could inform organizational policies and wellness programs aimed at reducing occupational fatigue.

Dietary Intake And Predictors Of Healthy Eating In Midwestern American College Students: An Observational Study †, Anna Peluso Simonson, Jacquelyn N. Zera, Gregory S. Farnell

2026 Faculty Bibliography

College students often maintain poor dietary habits, notably low fruit and vegetable intake. Commonbarriers include limited time, cost, and lack of nutritional knowledge. This study examined dietary behaviors, barriers, and factors influencing Healthy Eating Scores (HES) amongcollege students. Participants (N = 224; age = 20.3 ± 2.5 years, BMI = 23.9 ± 4.1 kg/m2, 78.9% female, and 91.3% white) completed an online survey. Results indicate meat overconsumption with underconsumption of water, fruits, and vegetables. Limited time and healthy options were the primary perceived barriers. Tests of between-subject effects identified gender (F = 4.38, p = 0.04) and living situation (F …

Parent And Family Guide, 2026-2027, Illinois State University, Dean Of Students Office, Parent And Family Services

Parent and Family Guide

Campus guide prepared by the Illinois State University Dean of Students Office's Parent and Family Services Department

"It's A Dance": Examining Midwives As Choreographers Of Reproduction In Maine, Annie Goldstein

Honors Theses

This thesis examines the contemporary work of community-based Maine midwives through the theoretical framework of choreography. In the context of this work, choreography can be understood as the well-thought-out, purposeful undertaking of a process during which negotiation, coordination, and improvisation are required to adapt to constantly changing circumstances. Using choreography, this thesis attempts to understand how Maine midwives navigate global market processes and practice under authoritative forms of biomedicine, ultimately linking them to other midwives across various global sites. Situated within Maine’s maternal health landscape that is characterized by the ongoing closure of labor and delivery units and rural hospitals, …

Ultra-Processed Or Ultra-Addictive? A Demand-Based Redefinition Of Ultra-Processed Foods, Braden Jondro

Honors Theses

Ultra-processed foods now comprise the majority of the U.S. food supply and have been directly associated with 32 chronic diseases including obesity, cardiovascular disease, cancer, and diabetes. Current classification systems such as NOVA provide a useful framework for identifying food processing, but rely on broad and subjective categorizations that may not capture the mechanisms most closely associated with promoting persistent overconsumption. In particular, existing classification systems remain limited in their ability to evaluate addiction-like behaviors associated with highly processed foods, including persistent purchasing patterns, reinforcement effects, and substitution responses. This paper introduces the Ultra-Processed Food Intensity (UPFI) index, an objective, …

Why Stay? A Qualitative Case Study Of Parents Who Choose Local Public Schools Over Alternative Options, Michael Antonio Scott

Theses and Dissertations

Public schools face challenges that directly impact the quality of education and educational programming. Declining student enrollment trends affect school funding and resource allocation for school improvement. This qualitative case study identified key factors influencing parents' perceptions of school quality and explored how these perceptions shaped school choice decision-making. Guided by Rational Choice Theory, the study examined how individuals make enrollment decisions by weighing perceived costs, benefits, constraints, and available resources to achieve desired educational outcomes. Semi-structured interviews, an open-ended survey, and archival school performance data were used to explore the perspectives of parents with children enrolled in public high …