Digital Commons Network^™

A Scoping Review Of Maternal Active Smoking During Pregnancy And Low-Birth Weight, Naomi Sondang, Nindi Oktavia, Qorinah Estiningtyas Sakilah Adnani, Lani Gumilang, Hadi Susiarno, Victor Abiola Adepoju

Journal of Asian Midwives (JAM)

Background: Low-birth weight (LBW; < 2.5 kg) infants are at increased risk of early mortality, impaired growth, neuro-developmental delay and chronic disease later in life. Maternal behavior, especially cigarette smoking, remains one of the most modifiable determinants of birth weight. We therefore synthesized recent evidence on the association between active maternal smoking during pregnancy and LBW.
Methods: Following PRISMA guidance, we systematically searched PubMed, Scopus and ScienceDirect for the period January 2020 to 31 January 2025 for English-language observational studies that quantified the relationship between active prenatal smoking and LBW. Risk of bias was appraised, and findings were summarized narratively.
Results: In total 26,650 papers were found and eight eligible studies (four cohort, three cross-sectional, one case-control) from Asia, Europe and the Middle East were included. Across all designs and exposure metrics—self-report, exhaled carbon-monoxide, urinary cotinine, and cord-blood DNA-methylation, active smoking was consistently associated with …

A Prevalence Study Of Iron Deficiency Anemia Among Children In Elbasan, Albania: Directions For Health Care Policy, Artilda Lala

All Dissertations

Iron deficiency anemia (IDA) is one of the most prevalent disorders worldwide, especially in children from low-income and underdeveloped countries. In Albania, anemia is a major public health concern with many unstudied regions (prefectures and rural municipalities). Childhood IDA can impair cognitive development, immunity and overall well-being, so early diagnosis and prevention of anemia is critical. This study examined the prevalence of IDA in children aged 0-10 years in the district of Elbasan, Albania. The data were additionally analyzed for relationships with demographic (age, gender, education, parental education and child academic performance) and nutrition variables.

A cross-sectional study design was …

Mpox Insights: From Structure To Human Cell Interaction, Md. S. Zaman, Robert C. Sizemore, Draven Rodriguez, Emilio Lopez, S. M. Golam Alam, Suleyman Tufa, Juan C Lopez Alvarenga, Nuraly S. Akimbekov, Mohammed S. Razzaque

School of Medicine Publications

Mpox, a zoonotic viral disease, has emerged as a global concern due to outbreaks in both endemic and non-endemic regions in 2022. Rodents, including African squirrels and Gambian pouched rats, are suspected key reservoirs, with human infections occurring through direct contact with infected animals or bushmeat consumption. Previously confined to rural Africa, mpox has spread via international travel and the exotic pet trade. Human-to-human transmission occurs mainly via respiratory droplets and direct contact with bodily fluids or lesions. The virus has a double-stranded DNA genome within a lipid envelope. Despite lower mutation rates in DNA viruses, mpox has developed mutations, …

Unvaccinated By Doubt: How Covid-19 Governance Sparked A Measles Outbreak, Ellen Black

Law Faculty Scholarship

This Article examines how the erosion of public trust in government and public health institutions during the COVID-19 pandemic has contributed to the resurgence of measles in the United States. It argues that pandemic-era governance—marked by inconsistent scientific messaging, politically charged public health mandates, and the federal government’s coordination with social media platforms to suppress dissenting viewpoints—generated widespread skepticism that continues to undermine vaccination uptake. Through a detailed analysis of lockdown policies, vaccine and mask mandates, and the subsequent revelations regarding governmental influence over online content moderation, the Article demonstrates how conflicting guidance and perceived censorship fostered long-lasting public doubt. …

Book Review Of The Art And Science Of Connection By Kasley Killam, Harit Agroia

Journal of Social, Behavioral, and Health Sciences

The Art and Science of Social Connection by Kasley Killam presents a case for better understanding individual health by ensuring that the social aspect is considered as a significant component of health in addition to the physical and mental aspects. Killam states that social health consists of an individual’s sense of belonging, the strength of relationships, and meaningful connections. By drawing from years of evidence building, Killam argues that social health is fundamental for one to truly flourish and prosper in their life as people who have stronger social health are shown to have higher quality of life, emotional resilience, …

The Hidden Link Between Hiv And Cardiomyopathy: Unraveling Hiv's Impact On The Heart, Toluwalase Awoyemi, Oluwaremilekun Zeth Tolu-Akinnawo, Andrew Greek, Oluwakemi Adenuga, Chukwuebuka Asogwa, Isaac Ekundayo, Olamide Odusola, Oyinlola Fasehun, Mercy Ajayi, Onyinye Ugoala, Luther-King Fasehun, Adeleke Oluwaseun Dorcas, Michael Angarone

Student Publications

This comprehensive review examines the complex relationship between human immunodeficiency virus (HIV) and cardiomyopathy, focusing on the underlying molecular mechanisms, clinical manifestations, diagnostic approaches, and treatment strategies. It highlights the significant global health burden posed by HIV and its potential to cause long-term cardiovascular complications. The review investigates the pathogenesis of HIV-associated cardiomyopathy. It elucidates the intricate cellular and molecular pathways involved, including the actions of neutrophils, monocytes, macrophages, and lymphocytes in cardiac inflammation. Key signaling pathways such as TNF-NF-κB and the caspase-1 inflammasome are detailed, as they contribute to cardiac infection and injury. The clinical manifestations of HIV-associated cardiomyopathy …

The Hidden Link Between Hiv And Cardiomyopathy: Unraveling Hiv's Impact On The Heart, Toluwalase Awoyemi, Oluwaremilekun Zeth Tolu-Akinnawo, Andrew Greek, Oluwakemi Adenuga, Chukwuebuka Asogwa, Isaac Ekundayo, Olamide Odusola, Oyinlola O. Fasehun, Mercy Ajayi, Onyinye Ugoala

School of Medicine Publications

This comprehensive review examines the complex relationship between human immunodeficiency virus (HIV) and cardiomyopathy, focusing on the underlying molecular mechanisms, clinical manifestations, diagnostic approaches, and treatment strategies. It highlights the significant global health burden posed by HIV and its potential to cause long-term cardiovascular complications. The review investigates the pathogenesis of HIV-associated cardiomyopathy. It elucidates the intricate cellular and molecular pathways involved, including the actions of neutrophils, monocytes, macrophages, and lymphocytes in cardiac inflammation. Key signaling pathways such as TNF-NF-κB and the caspase-1 inflammasome are detailed, as they contribute to cardiac infection and injury. The clinical manifestations of HIV-associated cardiomyopathy …

Medical Surveillance In Custodial Jsas: Preventing Bloodborne Pathogen Exposure, Kiara Gadea

Electronic Theses, Projects, and Dissertations

Custodians play an important role in maintaining our surroundings safe and sanitary. However, in doing so, they are their exposure to health hazards that put them at risk, yet these exposures are often overlooked. One major risk they face is contact with bloodborne pathogens, which put custodial staff at risk for infections such as hepatitis B. While Job Safety Analyses (JSA’s) outline various protective measures, many fail to incorporate medical surveillance as part of their risk management program. Overlooking this important detail leaves custodians vulnerable to health risks that can be prevented.

Adding a medical surveillance section to custodial JSA’s, …

Understanding The Experiences And Perceptions Of Faculty Supporting Undergraduate Students With Mental Health Challenges, Jenna Ranee Parbati Jamieson

Dissertations

College is a big adjustment for students, and it doesn't come without its challenges, including being in a new place with new responsibilities. This is a stressful time that presents new obstacles and frustrations that can lead to increased stress, anxiety, depression, and mental health challenges that may cause faculty to engage and support undergraduate students with mental health challenges. As students adjust and transition to college, it is vital for university faculty to feel confident and comfortable supporting students from diverse backgrounds with varying levels of distress. By interviewing faculty, a better understanding of their lived experiences and perceptions …

Visceral, Neural, And Immunotoxicity Of Per- And Polyfluoroalkyl Substances: A Mini Review, Pietro Martano, Samira Mahdi, Tong Zhou, Yasmin Barazandegan, Rebecca Iha, Hannah Do, Joel Burken, Paul Ki-Souk Nam, Qingbo Yang, Ruipu Mu

Chemistry Faculty Research & Creative Works

Per- and polyfluoroalkyl substances (PFASs) have gained significant attention due to their widespread distribution in the environment and potential adverse health effects. While ingestion, especially through contaminated drinking water, is considered the primary route of human exposure, recent research suggests that other pathways, such as inhalation and dermal absorption, also play a significant role. This review provides a concise overview of the toxicological impacts of both legacy and emerging PFASs, such as GenX and perfluoro butane sulfonic acid (PFBS), with a particular focus on their effects on the liver, kidneys, and immune and nervous systems, based on findings from recent …

Diverse Diagnostic And Management Approaches For Acute Rheumatic Fever In Australia And New Zealand: Findings Of A Prospective Clinical Study, Ruwani Peiris, Rachel Webb, Julie Bennett, Jennifer Yan, Joshua Reginald Francis, Bo Remenyi, Florina Chan Mow, Rachel Burgess, Nigel J. Wilson, Alicia Stanley, Laura Francis, Rhonda Holloway, Roxanne Westbury, Shirley Lawrence, Yolanda Hernandez-Gomez, David Broadhurst, Nicole J. Moreland, Reuben Mcgregor, Caroline Motteram, Glenn Pearson, Mark Mayo, Anna P. Ralph, Jonathan R. Carapetis

Research outputs 2022 to 2026

Objectives To describe diagnostic and management characteristics of acute rheumatic fever (ARF) among participants in the € Searching for a Technology-Driven Acute Rheumatic Fever Test' study, in order to answer clinical questions and determine epidemiological and practice differences in different settings. Design Multisite, prospective cohort study. Setting One hospital in northern Australia and two hospitals in New Zealand, 2018-2021. Participants 143 episodes of definite, probable or possible ARF among 141 participants (median age 10 years, range 5-23; 98% Indigenous). Primary and secondary outcome measures Participant characteristics, clinical, biochemical and echocardiographic data were explored using descriptive data. Associations with length of …

Bibliometric Analysis Of Congenital Toxoplasmosis: A Ten-Year (2013-2023) Review Of Research Publications, Festus Mulakoli, Horatius Musembi, Ann Kimani

School of Nursing & Midwifery, East Africa

Background:Toxoplasma gondii, an obligate intracellular protozoan, infects more than one-third of the global population and causes toxoplasmosis, which can lead to severe fetal complications in pregnant women. The global prevalence of latent toxoplasmosis in pregnant women is 33.8%, with regional variations and risk factors, including the consumption of undercooked meat, exposure to cat feces, and consumption of contaminated water. Pregnant women lack sufficient awareness of these risk factors, necessitating enhanced education, regular screening, and counseling during antenatal care for early detection and management.

Aim: This study performed a comprehensive bibliometric analysis of research on congenital toxoplasmosis published between 2013 …

The Impact Of Adverse Childhood Experiences And Living With Hiv On Cardiovascular Health And Cardiometabolic Disorders In An African Population: An Analysis Of The Indepth Community In Rural South Africa, Samuel Gavi

Theses and Dissertations

Background: Adverse Childhood Experiences (ACEs) have been shown to be associated with cardiometabolic disorders (CMDs) and poor CVH; however, in Africa, this has not been well studied. Cardiovascular health (CVH) is an important measure of risk for cardiovascular diseases (CVD) developed by the American Heart Association (AHA). With the increasing prevalence of CVD in Africa, CVH is a potential upstream prevention approach. Africa also has the highest prevalence of HIV, and an increasing prevalence of comorbidities associated with it. Various mechanisms have been investigated to explain the relationship between CVD and chronic HIV infection. This study explores the potential relationship …

Evaluating Impacts Of Improved Flooring On Enteric And Parasitic Infections In Rural Households In Kenya: Study Protocol For A Cluster-Randomised Controlled Trial, Katherine E. Halliday, Stella Kepha, Hugo Legge, Elizabeth Allen, Robert Dreibelbis, Lynne Elson, Beatrice K. Kakoi, Carlos Mcharo, Sharon Muli, Jacinta Mwongeli, Doris Njomo, Margaret M. Njoroge, Victoria Ochwal, William E. Oswald, Martin Rono, Tuva K. Safari, Ulrike Filinger, James Wambua Kaluli, Charles S. Mwandawiro, Rachel L. Pullan

All Peer-Reviewed Publications

Introduction Earthen floors are often damp or dusty and difficult to clean, providing an ideal environment for faecal pathogens and parasites. Observational studies have revealed associations between household flooring and health outcomes, but robust experimental evidence is scant. This study will evaluate the impact of an improved household flooring intervention on enteric infections, soil-transmitted helminth (STH) infections and tungiasis through implementation of a cluster-randomised trial in two rural settings in Kwale and Bungoma Counties, Kenya. Methods and analyses 440 clusters (households) across both sites are allocated to control or intervention group, in which a low-cost, sealed, washable, cement-based floor is …

Vaccination Mandates And Civil Liberties, Sophia Choti

Florida Atlantic University Undergraduate Law Journal

Vaccination mandates in the United States sit at the crossroads of public health and individual freedoms, a complex and often controversial intersection. The enforcement of immunization policies has a long history of legal and ethical scrutiny, balancing the state's responsibility to protect its citizens with the constitutional rights individuals hold dear. The COVID-19 pandemic reignited this debate, amplifying existing tensions and presenting new challenges. This analysis argues that while vaccination mandates are constitutionally valid and essential for safeguarding public health, they must be designed with care to respect individual liberties and address modern challenges such as misinformation, inequities, and public …

Covid-19 & Healthcare (Re)Privatization? A Comparative Analysis Of High And Medium Per Capita Gdp Countries, Kristina Donders, Kaitlyn Matthews, Brittany Reyes, Frank. H. Rizzo

Working Papers Series

This paper examines whether the COVID-19 pandemic accelerated healthcare privatization in high- and medium-GDP countries. Drawing on political economy theories of path dependence and privatization, we analyze changes in public and private healthcare expenditures in eight countries: Canada, Chile, Denmark, Georgia, Luxembourg, Norway, the Philippines, and South Korea—comparing data from 2019 and 2022. Using World Bank indicators on healthcare financing, GDP, aging populations, and food insecurity, we find that although healthcare expenditures generally increased during the pandemic, this increase was primarily in public, not private, spending. Case studies of Georgia and South Korea reveal that local economic and demographic pressures, …

Investigating Social Network Peer Effects On Hiv Care Engagement Using A Fuzzy-Like Matching Approach: Cross-Sectional Secondary Analysis Of The N2 Cohort Study, Cho-Hee Shrader, Dustin T Duncan, Redd Driver, Juan G Arroyo-Flores, Makella S Coudray, Raymond Moody, Yen-Tyng Chen, Britt Skaathun, Lindsay Young, Natascha Del Vecchio, Kayo Fujimoto, Justin R Knox, Mariano Kanamori, John A Schneider

Faculty, Staff and Student Publications

BACKGROUND: Social network data are essential and informative for public health research and implementation as they provide details on individuals and their social context. For example, health information and behaviors, such as HIV-related prevention and care, may disseminate within a network or across society. By harmonizing egocentric and digital networks, researchers may construct a sociocentric-like "fuzzy" network based on a subgroup of the population.

OBJECTIVE: We aimed to generate a more complete sociocentric-like "fuzzy" network by harmonizing alternative sources of egocentric and digital network data to examine relationships between participants in the Neighborhoods and Networks (N2) cohort study. Further, we …

Addressing Late Latent Syphilis In Pregnancy: A Case Study Emphasizing Interdisciplinary Communication And Public Health Collaboration, Mustafa I. Ansari, Audrey Arona

Research Day

Introduction: Congenital syphilis has re-emerged as a significant public health concern, despite being preventable through timely diagnosis and treatment during pregnancy. Late latent syphilis, particularly in high-risk populations, poses serious risks to both mother and fetus, with non-compliance to treatment exacerbating these dangers. Effective management requires coordinated efforts between healthcare providers and public health officials to ensure proper intervention and follow-up.

Objective: The objective of this study is to assess the impact of interdisciplinary communication and public health collaboration in the management of late latent syphilis during pregnancy, focusing on how coordinated care can address challenges such as patient non-compliance …

Conflict, Human Development, And Neonatal Health: A Regional Analysis Of The Eastern Mediterranean, Zynub A. Al-Sherri

Honors Theses

Background. The effects of war and conflict on a population are direct and indirect in nature. One of the most devastating consequences is the destruction of healthcare infrastructure, which severely disrupts access to essential services and impedes long-term socioeconomic development. Among those most affected are newborns, as the neonatal period represents the most vulnerable stage of a child’s life and serves as a sensitive indicator of a society’s overall health and socioeconomic conditions. Given the persistent instability in the Eastern Mediterranean Region (EMR), this study aimed to explore how conflict and human development are associated with neonatal health outcomes …

Frontier Healthscapes: Competing Narratives Of Disease, Environment, And Wellbeing In Early Minnesota, Aidan Reynolds

Geography Honors Projects

Across settler societies, health narratives were shaped by evolving tensions between lay and expert knowledge, frameworks of disease causation, and perceptions of the environment as both a source of health and a threat. In the decades following Euro-American settlement (1860-1900), Minnesota became a focal point for these debates, with its landscape fostering complex and competing narratives on health, wellbeing, and disease. This paper explores how public health discourse developed in Minnesota through the perspectives of institutions, the public, and economic interests. Combining environmental history with critical discourse analysis of archival materials, this study examines shifts within the Minnesota State Board …

Arthroscopy And The Future Of Surgery: Personal And Public Health Benefits, Preston T. Koski

Honors Thesis

Arthroscopy focuses on operating on the body using probes and working through keyhole incisions on the skin. This rapidly evolving field has seen many innovations in its technology, aided by advances in optical and surgical capabilities. Moreover, it presents many advantages over traditional surgery that directly impact the patient. Shorter recovery time and lessened scarring, reduced postoperative pain and opioid dependence, and less risk of infection are key benefits over open surgery. These benefits can also be applied to areas of public health. Minimizing the burden on hospital resources, reducing the environmental impact of surgery, and improving cost-effectiveness in healthcare …

Administrative Law And The Pandemic, Gillian E. Metzger

Faculty Scholarship

American administrative law’s relationship to change is, as they say, compli­cated. On the one hand, continual evolution has been an endemic feature of American administrative law. Doctrines such as Chevron deference to agency statutory interpretations were born, grew, and declined in just the period from the 1980s to today. On the other, the United States (US) Supreme Court regularly rejects such common law development in administrative law as illegitimate and insists that federal judges must adhere to the original terms of the 1946 Administrative Procedure Act (APA) and other statutes, unless the Constitution requires otherwise. And to this day scholars …

Restoring Trust In Public Health: An Analysis Of The Lasting Implications Of The Covid-19 Pandemic Response On Community Trust In Public Health In Nebraska, Kerri Dittrich

Capstone Experience: Master of Public Health

Background and Significance

Public trust is essential for effective public health efforts. In Nebraska, as in many regions, the pandemic response exposed strengths and vulnerabilities in the public health system. Misinformation, political discourse, inconsistent messaging, and poor communication contributed to growing mistrust, threatening the long-term success of public health programs and initiatives. While national trends have been studied, Nebraska-specific research remains limited.

Methods

An original descriptive survey was designed and administered to public health professionals in Nebraska to assess their perceptions of public trust in the local public health system before and after the COVID-19 pandemic. The survey also explored …

Genomic Diversity Of Salmonella Enterica Serotype Braenderup In New York State, Nicole Zac Soligno

Biological Sciences

The Gram-negative Salmonella enterica (family Enterobacteriaceae) is a common foodborne pathogen mainly isolated from foods of animal origin. Salmonella can be transmitted to humans, causing diverse symptoms, from self-limiting gastrointestinal diseases to more fatal typhoid fever. The young, elderly, and Individuals with weakened immune systems are especially at risk from salmonellosis. Salmonella is a concern to public health and the food industry throughout the world, and its severity depends largely on its serotype, a classification based on the unique combination of surface antigens. In this study, I aimed to elucidate the population structure and antimicrobial resistance determinants of S. enterica …

Knowledge, Attitudes, And Practices Regarding Antimicrobial Resistance And Antimicrobial Stewardship Among Healthcare Workers In Outpatient Medical Centers In Kenya: A Qualitative Study, Mary Kaniu, Wahu Gitakah, Rupali Jain, Ann Munyare, Rodney Adam, Aliza Monroe Wise

Paediatrics and Child Health, East Africa

Objective: Antimicrobial resistance (AMR) is a major global health threat with a projected 10 million deaths globally by 2050. Antimicrobial stewardship (AMS) programs are coordinated efforts involving doctors, nurses, pharmacists, and other healthcare providers. Understanding knowledge, attitudes, and practices of health providers is pivotal for implementing strategies to curb the spread of AMR. The aim of this study was to evaluate knowledge, attitudes, and practices surrounding AMR and AMS among healthcare workers in Kenya.

Design: A qualitative study using in-depth semi-structured interviews

Setting: 12 private outpatient clinics in Kenya.

Participants: Healthcare workers including administrators and clinicians. …

Navigating Travel Therapy: Balancing Benefits And Risks For Optimal Wellness, Fangli Hu, Jun Wen, Wei Wang

Research outputs 2022 to 2026

This research note examines travel therapy as a novel healthcare approach in which positive travel experiences serve to promote well-being. It emphasizes the need for a balanced assessment of the benefits and risks associated with travel therapy, offering insights into this practice's evolving roles in the health and wellness domains.

Revitalizing Passenger Rail: A Sustainable Solution To Environmental And Public Health Challenges In South Carolina, Benjamin Cochran

Theses and Dissertations

South Carolina, a historic leader in passenger rail, has become a heavily vehicle-dependent state. As the population rapidly grows, so does the number of vehicles, vehicle miles traveled, and vehicle emissions, including the greenhouse gas pollutants carbon dioxide (CO2), nitrous oxide (N2O), and particulate matter (PM2.5), significantly contributing to air pollution and deteriorating health and environmental outcomes. Despite this, mass transit is nonexistent for the three largest cities in South Carolina, Charleston, Columbia, and Greenville, forcing residents and travelers to drive. This study evaluates the feasibility and the environmental, public health, environmental justice, and economic implications of a passenger rail …

Strengthening The Paediatric Clinical Trial Ecosystem To Better Inform Policy And Programmes, James A. Berkley, Judd L. Walson, Glenda Gray, Fiona Russell, Zulfiqar Ahmed Bhutta, Per Ashorn, Shane A. Norris, Ebunoluwa A. Adejuyigbe, Rebecca Grais, Bernhards Ogutu

Institute for Global Health and Development

The first WHO Global Clinical Trials Forum was convened in November, 2023 to develop a shared vision of an effective global clinical trial infrastructure. The Paediatric Clinical Trials Working Group was formed to provide perspectives, identify challenges, and propose solutions to strengthen the paediatric clinical trials ecosystem. Participants represented paediatric disciplines, including infectious diseases, nutrition, neonatology, pharmacology, oncology, neurodevelopment, public health, and policy. Childhood diseases have profound lifelong effects on health, livelihoods, and societies. Investment in early childhood results in highly cost-effective changes to lifelong health, productivity, and human capital returns. Yet, there remain substantial gaps in knowledge on the …

An Environmental Vulnerability Index Framework Supporting Targeted Public Health Interventions At The Census Tracts Level., Lauren B. Anderson, Rochelle Holm, Caison Black, Donald J. Biddle, Weihsueh A. Chiu, Aruni Bhatnagar, Ted Smith

Faculty and Staff Scholarship

Abstract

Background

Analyzing and visualizing disparities in environmental risks can help assess place-based vulnerabilities and provide civic leaders and community members with essential data for promoting health equity and informing public health strategies.

Objective

We investigated the adaptation of a previously developed environmental vulnerability index to evaluate the cumulative impact of diverse stressors in Louisville Metro-Jefferson County, KY, with the goal of supporting multi-faceted targeted public health interventions at the census tract level.

Methods

We assessed countywide vulnerability variability using the Toxicological Prioritization Index interface across five domains with 32 publicly available data indicators, and modeled the effects of theoretical …

The Importance Of Public Health In College Populations: Why Vaccines Are Important, Kashish Poore

Honors Program: Senior Projects (Public)

This paper examines the importance of vaccines in college populations, where high-density living environments create unique vulnerabilities to infectious disease outbreaks. Despite vaccine mandates at most institutions, research indicates that many college students possess incomplete understanding of vaccine mechanisms and importance. The paper addresses three interconnected aspects: the biological foundations of vaccine-induced immunity, the significance of vaccination in collegiate settings, and the current state of vaccine literacy among students. Historical outbreaks on campuses, including meningitis at Princeton and mumps across several institutions, highlight the consequences of undervaccination. Social media misinformation has contributed significantly to vaccine hesitancy, particularly since COVID-19. The …