Digital Commons Network^™

Longitudinal Associations Between Maternal And Child Screen Use At 1 Year Of Age And Child Behavior And Development At 3 Years Of Age, Stephanie Sim, Juliana Zabatiero, Natasha Bear, Amber Beynon, George Thomas, Ravisha Srinivasjois, Brad Jongeling, Desiree Silva, Leon Straker

Research outputs 2022 to 2026

Background: Young children are increasingly exposed to evolving screen technology. International guidelines recommend no screen use for children under the age of 2 years, due to the potential for detrimental effects on behaviour and development. However, evidence for these guidelines is limited by inadequate consideration of device-specific effects (TV and mobile phone/tablet computer), maternal screen use, confounders such as maternal mental health and importance of effect sizes. Our aim was to investigate longitudinal associations of device-specific maternal and child technology use and covariates (including maternal mental health) with behavioural and developmental outcomes, to guide adults on screen use behaviours by …

Midwife-Led Birth Debrief: A Concept Analysis, Kate Buchanan, Elliesha O'Reilly, Georgia Wilcox, Sara Bayes, Lauren Kearney, Linda Sweet, Hazel Keedle

Research outputs 2022 to 2026

Background: Psychological birth trauma (PBT) affects approximately 19 % of postnatal women, making its prevention a global priority. Midwives are responsible for providing psychosocial care during the postnatal period to foster the mother-infant relationship, provide education and screening and support positive transitions to parenting. However, the specific attributes of a birth debrief and the role of the midwife in a supporting a woman to review their birth experience is less well documented in regulatory frameworks or scientific literature. This has created significant ambiguity in both clinical practice among health professionals and in research contexts. The lack of a clear understanding …

Periodizing Exercise Medicine Prescription For Patients With Cancer: A Narrative Opinion, Francesco Bettariga, Robert U. Newton, Chris Bishop, Luca Maestroni, Anita Borsati, Alice Avancini, Sara Pilotto, Dennis R. Taaffe, Daniel A. Galvão, G. Gregory Haff

Research outputs 2022 to 2026

Exercise has emerged as an effective therapeutic strategy in cancer management. Long-term supervised exercise programs, including resistance training and aerobic training, can improve body composition and physical fitness, modulate circulating factors (e.g., hormones, cytokines), enhance treatment tolerance, and reduce side effects, potentially influencing cancer progression and reducing mortality risk. Despite advancements in exercise oncology, opportunities remain to refine exercise prescription through the integration of advanced methodologies such as periodization and autoregulatory programming strategies. Periodization, a systematic approach to organizing training over time, has demonstrated benefits in general fitness and clinical populations but is underexplored in cancer care. Emerging evidence suggests …

Rac1 In Gastric Cancer: A Molecular Driver Of Invasion, Emt, And Therapeutic Resistance, Jianwen Li, Yahong Zhu, Ruifeng Duan, Yueli Tian, Xingang Li, Ying Song

Research outputs 2022 to 2026

Gastric cancer (GC) ranks as the fifth most common cancer worldwide and is the third main cause of cancer-related mortality, posing a substantial burden to global public health. Research suggests that targeted therapy and immunotherapy may become more effective treatment options for advanced, unresectable, or metastatic gastric cancer. Ras-related C3 botulinum toxin substrate 1 (Rac1), a small GTP-binding protein within the Rac subfamily of the Rho GTPase family, is a critical molecule that promotes cancer cell invasion and metastasis by regulating signal transmission and promoting cell polarity. It has emerged as a key driver of tumor development and metastasis in …

Trends And Determinants Of Early Neonatal Mortality In Ethiopia: Evidence From The Ethiopian Demographic And Health Survey Data, Tsion Mulat Tebeje, Beminate Lemma Seifu, Yordanos Sisay Asgedom, Kusse Urmale Mare, Zufan Alamrie Asmare, Hiwot Altaye Asebe, Abdu Hailu Shibeshi, Afework Alemu Lombebo, Kebede Gemeda Sabo, Bezawit Melak Fente, Bizunesh Fantahun Kase

Research outputs 2022 to 2026

Background: Early neonatal mortality (ENM) accounts for three-fourths of all neonatal deaths and one-third of overall child mortality. While previous studies have primarily focused on neonatal and under-five mortality, ENM has received comparatively less attention. This study aims to address this gap by analyzing trends and identifying factors associated with ENM in Ethiopia. Methods: Data from the Ethiopian Demographic and Health Survey (EDHS) conducted between 2005 and 2016 were analyzed, comprising a total weighted sample of 22,310 participants. To account for the hierarchical structure of the EDHS data, a mixed-effects binary logistic regression model was applied to identify associated factors. …

Incidence Of Health Problems In Australian Mixed Martial Arts And Muay Thai Competitors: A 14-Month Study Of 26 Combat Sports Events, Colin S. Doherty, Oliver R. Barley, Lauren V. Fortington

Research outputs 2022 to 2026

Background: Mixed martial arts (MMA) and Muay Thai (MT) are widely practiced combat sports, yet research on the full spectrum of competition-related health problems (HPs) remains limited, particularly for MT. Existing studies in both sports primarily focus on retrospective analyses of severe injuries, often estimating time lost from training or competition. This study describes the incidence of all competition HPs reported seven days after MMA and MT contests, and determines the number of days impacted by tracking athletes’ self-identified worst HPs until resolution. Methods: Data on competition HPs were collected using an online questionnaire completed seven days after each MMA …

Trajectories Of Plant-Based Dietary Patterns And Their Sex-Specific Associations With Cardiometabolic Health Among Young Australian Adults, Laura E. Marchese, Sarah A. Mcnaughton, Gilly A. Hendrie, Priscila P. Machado, Therese A. O’Sullivan, Lawrence J. Beilin, Trevor A. Mori, Kacie M. Dickinson, Katherine M. Livingstone

Research outputs 2022 to 2026

Background: Plant-based diets are associated with favourable cardiovascular health markers. Although increasingly consumed among younger demographics, it is unclear how plant-based diet quality tracks from adolescence to young adulthood, and how this impacts cardiovascular health later in life. Thus, this study aimed to explore trajectories of plant-based dietary patterns from adolescence to young adulthood and investigate associations with cardiometabolic health markers in young Australian adults. Methods: Longitudinal data from 417 participants from the Raine Study were included. Semi-quantitative food frequency questionnaires conducted at 14, 20, and 27 years of were used to derive three plant-based diet quality index scores: an …

The First Year Of Assisted Dying In New Zealand Through The Lens Of Healthcare Professionals Not Directly Involved In The Process, Waqas Arshad, Aida Dehkhoda, Melissa Carey, David B. Menkes, Nicholas Hoeh, Frederick Sundram, Rosemary Frey, Gary Cheung

Research outputs 2022 to 2026

Background: New Zealand’s End of Life Choice Act 2019 was enacted in 2021, allowing terminally ill people experiencing unbearable suffering to request assisted dying if they are expected to die within six months. Healthcare professionals not directly involved in assisted dying provision may have unique perspectives on implementation, yet this remains under-explored. Methods: This qualitative study was conducted between June and November 2022. We used purposive and snowball sampling to recruit potential participants through various sources, including the Ministry of Health’s assisted dying training and communication email list. A multidisciplinary research team developed a semi-structured interview guide. The individual interviews …

As Effective As You Perceive It: The Relationship Between Chatgpt’S Perceived Effectiveness And Mental Health Stigma, Scott N. Hannah, Deirdre Drake, Christopher D. Huntley, Joanne M. Dickson

Research outputs 2022 to 2026

Individuals are increasingly using artificial intelligence chatbots, such as ChatGPT, to seek conversational support for their personal mental health difficulties. Heightened concerns about mental health stigma may make anonymous, on-demand chatbot interactions more appealing for some than traditional face-to-face support. This study examined if using ChatGPT-4 for personal mental health difficulties is associated with two distinct forms of stigma, anticipated stigma and self-stigma. Our main aim was to investigate if the perceived effectiveness of ChatGPT use for mental health issues mediates the relationship between ChatGPT usage and anticipated stigma and self-stigma. The sample comprised 73 participants, mostly undergraduate psychology students. …

False Narratives And Fierce Hope: Recentering Appalachian Rhetorics Of Place And Health, Sarah G. Cardwell

Honors Theses

This research seeks to analyze the rhetorical dimensions of how health is discussed in Appalachia, focusing specifically on Letcher County, Kentucky. In Letcher County, as in many Appalachian communities, rhetorics of healthcare and poverty are inextricably linked, largely due to media portrayals. One of the most impactful of these media portrayals is the 1964 CBS special entitled Christmas in Appalachia. In this special, host Charles Kuralt visits Letcher County and makes a pointed effort to speak to families who are living in poverty, asking them questions about their daily lives and if they “want better” for their children than their …

Influence Of Depressive Symptomatology On Vocal Production, Olivia Taylor

Honors Theses

Language has been widely recognized as a crucial form of social connection, providing both contextual and semantic information, including intonation, pitch, rate of speech, and pauses. As mental health conditions begin to rise while mental health providers begin to decrease, research in psychology has focused on investigating other factors that may aid in the diagnosis of mental health disorders. Research has indicated that physiological factors, including vocal production, may highlight specific shifts in speech patterns or vocal characteristics. Limited research has been conducted to investigate the possible implications for the emerging adult population, despite the group obtaining the highest prevalence …

Transcription Factors And Regulatory Proteins In The Control Of Eukaryotic Gene Expression, Maya M. Minkara

Honors Theses

Transcription factors (TFs) function as precision switches that integrate signaling inputs, chromatin state, and protein homeostasis to control gene expression. This thesis unites three interconnected research themes: (1) mechanistic studies of the ubiquitin-proteasome system (UPS) in regulating eukaryotic TFs, focusing on polymerase-associated Factor 1 (Paf1) and TATA-box binding protein-associated factor 2 (Taf2); (2) identification of biomarker genes within odor-related TF networks; and (3) integration of published undergraduate research linking molecular regulation, bioinformatics, and synthetic biology. These themes are purposefully structured so that mechanistic insight into TF control sets up network-level discovery and, in turn, motivates applied and translational directions. In …

Determinants Of Mental Health-Seeking Behaviour Among Upgrading Nursing Students At The Aga Khan University, Kenya, Cecilia Wanjiru Ndungu

MSc in Advanced Practice Nursing

Background: Mental health challenges are increasingly recognised, and nursing students often report higher stress and anxiety than other peers.Working nurses in upgrading programmes face additional pressure from balancing work, study and family,yet remain under-studied. At Aga Khan University in Kenya, the determinants influencing mental health-seeking behaviour among upgrading nursing students have not been documented, which is critical for addressing mental health needs. This study aimed to investigate the biological, psychological, and sociological factors influencing mental health-seeking behavior in this cohort.

Methodology: A descriptive cross-sectional study was conducted among 106 upgrading nursing students at AKU, utilizing structured questionnaires to …

Determinants Of Utilization Of Skilled Birth Attendant Among Women Of Reproductive Age In Habeswein Ward, Wajir County, Kenya, Suada Hassan

MSc in Advanced Practice Midwifery

Background: Maternal care provided by a skilled birth attendant (SBA) during pregnancy, at delivery, childbirth, and the postpartum period is vital for reducing maternal and neonatal mortality. In sub-Saharan Africa, the overall prevalence of usage of SBA in a 2021 study was 63%. Tanzania recorded the lowest rate at 13.8%, while Kenya registered 89.3% in 2023. However, disparities exist within Kenyan counties, for instance, in Wajir County only 57% of births were assisted by skilled health providers, a disparity that could be due to socio-cultural differences.

Aim: This study aimed to determine the factors influencing the utilization of skilled …

Perceived Stress And Coping Mechanisms Among Nurses Working In Oncology Inpatient Units At Kenyatta National Hospital, Bole Ado

MSc in Advanced Practice Nursing

Introduction: Cancer is the second leading cause of death globally and the third leading cause of death in Kenya. Nurses in oncology units often experience stress because of the emotionally demanding nature of providing care for patients diagnosed with cancer. Global studies show that nurses in the oncology unit reported experiencing moderate to extreme work-related stress, with a prevalence of work stress globally varying between 9.2% to 68% globally. Many nurses experience stress, and because of ineffective coping mechanisms, this affects their psychological well-being and negatively impacts the quality of their care as well as patients’ outcomes.

Objective of the …

Codification In Mississippi: Nineteenth Century Efforts For A Mississippi Civil Code, Milton J. Hernandez Iv

MC Law Review

No abstract provided.

The Relationship Between The Development Of Tourism Special Economic Zones (Sezs) And Local Tax Revenue, Ibnati Misbha Hussudurri, Riatu Mariatul Qibthiyyah

Economics and Finance in Indonesia

This study employs dynamic two-way fixed effect (TWFE) event regressions to analyze the direct impact of SEZ policies, specifically focusing on tourism SEZs in 6 districts across Indonesia and neighbouring districts within the same province. By examining data from 2010 to 2022, the research aims to evaluate how tourism SEZ development influences local tax revenue. Our estimation results show no evidence that Tourism SEZs affect aggregate local tax revenues. However, by type of local taxes, we found that Tourism SEZs have increased hotel tax and entertainment tax but not restaurant tax revenues.

Cultural Adaptation Of An Innovative Reproductive Health Assessment Tool For Dementia Research In Africa: Insights From The Fember-Africa Study, Alice Moraa Ondieki, Anne Njogu, Cynthia I Sabel Smith, Edna Bosire, Karen Blackmon, Harrison Kaleli, Jasmit Shah, Rachel Maina, Sheila Waa, Chinedu Momoh

Brain and Mind Institute

Background: Dementia research accounts for only 0.1% of all research in Africa,making it the lowest among all low- and middle-income country (LMIC) regions. Thedevelopment and adaptation of biological and psychosocial measures in ethnicallyand culturally diverse populations remain limited but are essential for culturallyinformed research. This is particularly critical for examining sex- and gender-basedvulnerabilities to Alzheimer’s disease and related dementias (ADRD), including factorssuch as reproductive health and fertility.

Method: We conducted a thorough review of our clinical and health questionnaires forcultural relevance and sensitivity through a series (n = 3) of focus groups discussions.These focus groups included a diverse range of …

Vitality Tracking In Kenyan Adults Using Wearable Devices And Ecological Momentary Assessments, Karen Blackmon, Benard Alaka, Catherine Onyancha, Litha Musili, Raechel Kamau, Cyprian Mostert, Mansoor Saleh, Zul Merali, Chinedu Momoh, Thomas Thesen

Brain and Mind Institute

Background: Vitality is essential to healthy aging but is elusive to define and measure.Dynamic capture of fluctuations in vitality can uncover abnormal trajectories thatcould be a harbinger of frailty in older adults. Yet, these fluctuations are missed bystatic and/or sparse sampling strategies. To address the need for dynamic and high-density capture of vitality in older adults, we developed a passive sensing and activeprobing digital platform using wearable devices and smartphones. We deployed thisparadigm in older Kenyan adults and evaluated its potential for use in research on thedynamics of accelerated aging.

Method: Cognitively unimpaired (CU) Kenyan adults ≥ 35 years of …

Predicting Accelerated And Delayed Aging In Global Settings: Biobehavioral Age Gaps And The Role Of Global Exposomes, Hernan Hernandez, Hernando Santamaria-Garcia, Sebastian Moguilne, Agustina Legaz, Pavel Prado, Jhosmary Cuadros, Liset Gonzalez, Cyprian Mostert, Chinedu Momoh, Zul Merali

Brain and Mind Institute

Background: Global health challenges like aging and dementia are shaped bysocioeconomic disparities, environmental factors, and social determinants of health.We developed a behavioral age gap (BAG), measuring the difference between expectedbehavioral age and chronological age

Method: We utilized a cross-sectional sample (n = 161,981) comprising countriesfrom Latin America, Europe, Asia, and Africa. Behavioral age was estimated usinga Gradient Boosting Regressor with 10-fold cross-validation, incorporating multiplerisk factors (hypertension, diabetes, heart disease, female sex, visual impairment andhearing impairment) and protective factors (cognition, functional ability, education)associated with healthy aging. BAG was calculated as the difference between predictedand chronological age, and adjusted gaps were derived …

Avaren-Fc's Effects On Lymphoma Cells., Jacob Hahn

Electronic Theses and Dissertations

This thesis investigates the therapeutic potential of Avaren-Fc (AvFc), a novel lectin fusion protein that integrates the Fc region of human IgG1 with the engineered lectin Avaren, specifically targeting lymphoma. The study delineates the in vitro binding capabilities of Avaren-Fc with a human B-cell lymphoma cell line, a canine B-cell lymphoma cell line, healthy canine peripheral blood mononuclear cells (PBMCs), and healthy human PBMCs. AvFc was shown to exhibit significant binding to human lymphoma cells. Furthermore, the direct cytotoxicity of Avaren-Fc against canine lymphoma cells, canine lymphoma cells and healthy canine PBMCs was assessed. It was found that there is …

Examing Fear Conditioning/Extinction And The Role Of The Amygdala In Human Neuroimaging., Olivia Cook

Electronic Theses and Dissertations

Fear plays a crucial role in survival but can lead to psychological disorders when dysregulated. Fears can be innate due to evolutionary relevance or learned through associative processes, where predictive accuracy of threat is pivotal. Disruptions in fear neurocircuitry contribute to anxiety disorders, characterized by heightened activation and impaired learning. Fear conditioning and extinction paradigms based on classical Pavlovian conditioning have been used to study mechanisms underlying fear learning. Using this experimental model, fear networks in rodents have been described in detail with clear distinction between conditioning and extinction neural functioning. Yet, there is no consensus on the neurobiological processes …

Experiences Of Title Ix Hearing Panel Members., Amanda Gage Stonecipher

Electronic Theses and Dissertations

The number of allegations of sexual misconduct on college campuses has been increasing over the past decade and higher education institutions are charged with addressing the misconduct. Addressing student behavior on college campuses through a conduct process is woven into the fabric of higher education, and many institutions use a hearing panel model to determine if institutional policies were violated. My research aims to explore how student conduct hearing panel members process the tension between the emotional management required when hearing intimate and traumatic details of a sexual misconduct case. The data for this research were collected via semi structured …

The Role Of Law Enforcement In Sexual Assault Kit Submissions: A Statewide Analysis Of Decision-Making Processes & Focal Concerns In Kentucky., Rychelle Elizabeth Wilks

Electronic Theses and Dissertations

Sexual assault case attrition persists throughout the criminal justice system, partly due to inconsistent Sexual Assault Kit (SAK) submission decisions. This dissertation examines factors influencing police officers' decisions to submit SAKs for forensic testing, applying the focal concerns perspective to understand how legal and extra-legal characteristics shape these decisions. Using statewide Kentucky data from July 2007 to March 2018, this study analyzed 2,194 adult sexual assault cases from 192 law enforcement agencies. Of these cases, 1,520 (69.3%) resulted in SAK submission. Logistic regression analyses examined the full sample, as well as four subsamples. Results provide mixed support for focal concerns …

Characterizing The Ethanol Sensitivity Of The Planar Cell Polarity Pathway In Endoderm Morphogenesis And Jaw Development., Raéden Omneil C. C. Rolle Gray

Electronic Theses and Dissertations

Fetal Alcohol Spectrum Disorders (FASD) describes a large range of developmental defects due to prenatal alcohol exposure. It is characterized by neural and facial defects, including jaw hypoplasia. Many factors contribute to the susceptibility of ethanol-induced facial defects, including genetics, yet the genes involved, and the cell events they regulate, are poorly understood. Zebrafish have a large number of tools for genetic manipulation available, share 70% of genes with humans, are fertilized externally and are translucent during embryogenesis, making them great models to study FASD. Previous studies show that two members of the Planar Cell Polarity (PCP) pathway, zebrafish vangl2 …

Safety Evaluation Of Epicertin, An Oral Biotherapeutic Candidate For Treating Ulcerative Colitis: A 28-Day Repeated Dose Toxicity Study., Jimmy Fernando Cifuentes Jimenez

Electronic Theses and Dissertations

Ulcerative colitis (UC) is an inflammatory bowel disease characterized by chronic, relapsing inflammation of the colon and rectum with limited treatment options. Among them, immunosuppressive agents have a high rate of adverse side effects and do not cure the disease. EPICERTIN (EPT), a recombinant variant of the cholera toxin B subunit (CTB) with a C-terminal hexapeptide extension consisting of a KDEL endoplasmic reticulum (ER) retention motif, is a promising oral biotherapeutic candidate for the treatment of UC. EPT has demonstrated mucosal healing activity in mouse models of colitis and human colonic explants. EPT's mechanism of action involves binding to GM1 …

Congolese Mothers' Beliefs That Influence Health-Seeking Behaviors For Their Infants., Shawn Meiman

Electronic Theses and Dissertations

In 2024, approximately 100,000 refugees were admitted to the United States, with 20% coming from the DRC, while Kentucky continues to rank fourth in the country for refugee resettlement. The increasing number of Congolese refugee children in the United States and Kentucky necessitates a greater understanding of these beliefs and practices to ensure equitable, quality, and culturally informed health services. The purpose of this study was to explore Congolese refugee mothers’ culturally and socially situated beliefs, perceptions, practices, and resources related to health care that may influence their views and practices of preventive well-child health care for their infants in …

The Role Of Psychological Capital And Case Management Intensity In Patient Activation In Permanent Supportive Housing Residents., Sarah J. Carter

Electronic Theses and Dissertations

This dissertation explores patient engagement with health, or patient activation, in the formerly homeless population housed in Permanent Supportive Housing (PSH) and receiving case management support. Research is limited on patient activation in PSH residents; consequently, there is minimal understanding of factors contributing to one’s attitudes and behavior towards health care in this group. Psychological Capital refers to the components of hope, self-efficacy, resilience, and optimism. Research in other marginalized groups indicates increasing psychological capital may improve health behaviors. Case management provides support to PSH residents and forms of social support have been associated with improved health outcomes. Applying the …

Reducing Operating Room Turnover Times Through Standardized Workflow, Trinity H. Darnell

Doctor of Nursing Practice Final Project Abstract

Prolonged operating room (OR) turnover times (TOTs) contribute to surgical delays, decreased case volume, and inefficiencies that negatively affect patient care and hospital operations. Lack of coordination in turnover processes and communication among staff are common contributors to extended TOTs. The purpose of this project was to reduce turnover times by implementing a standardized workflow carried out by efficiency teams composed of OR float staff. This project took place in the surgical department of a hospital in Sugar Land, Texas, using a single group pretest-posttest design. Baseline data was collected for 12-weeks prior to implementation and compared to 12-weeks of …

An Objective Structured Clinical Examination For Cervical Plexus Block Utilizing Ultrasound Guidance And Landmark Technique, Morgan Sollie, Cathrine Warren

Doctoral Projects

Regional blocks have become an increasingly important part of anesthesia practice. Anesthetists have developed many of these regional blocks in recent years, and because of this, some certified registered nurse anesthetists (CRNAs) have not received training specific to each kind of block during their education. An example of a block that current CRNAs who graduated in earlier years may have yet to receive specific training on is a cervical plexus block. Developing a learning tool such as an objective structured clinical examination (OSCE) will address this knowledge gap.

An OSCE will allow CRNAs to take advantage of hands-on learning stepwise, …