Public Health Commons^™

Reducing Stress Through Low-Carbohydrate Nutrition Education In Emergency Department Staff – A Quality Improvement Project, Hassan Oman Gomar

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction and Background

Emergency department staff often face job-related stress, which can lead to burnout, reduced compassion satisfaction, and adverse effects on patient care. Loma Linda University Health (LLUH) offers support programs, including Care for the Caregiver (C4C) and the Living Whole Employee Wellness program, that provide emotional and general wellness resources. While these programs are helpful, they do not offer practical solutions for everyday stress. There is a need for simple, lasting, and food-based ways to help staff manage stress and perform better. Recent research shows that eating patterns, especially high intake of processed carbohydrates, can alter energy and …

Urban-Rural Differences In The Association Between Physical Activity And Overweight/Obesity Among Indonesian Adolescents: A Cross-Sectional Study, Wahyu Wulandari, Mufti As Siddiq M. Irzal, Lady Farah Fatmawati

Jurnal Epidemiologi Kesehatan Indonesia

Adolescent overweight/obesity is an increasing public health concern and contributes to the risk of non-communicable diseases later in life. Physical activity plays an important role in weight regulation. However, its association with overweight/obesity may vary according to residential setting. This study aimed to examine the association between physical activity and overweight/obesity among adolescents living in rural and urban areas of Indonesia. A cross-sectional study was conducted using data from the 2023 Indonesian Health Survey. The study included 115,372 adolescents aged 10–18 years. Physical activity was classified based on total Metabolic Equivalent of Task (MET)-minutes per week (≥600 MET-minutes/week), while nutritional …

Analysis Of Priority Vaccine-Preventable Diseases Using The Paho-Adapted Hanlon Method In Bogor City In 2024, Sonia Annisa Br Ketaren, Tri Yunis Miko Wahyono, Bai Kusnadi

Jurnal Epidemiologi Kesehatan Indonesia

Vaccine-preventable diseases (VPDs) remain a major public health challenge despite substantial progress in immunization programs. In Indonesia, routine immunization coverage has shown a post-pandemic recovery trend; however, disparities in access to health services and surveillance quality persist across regions. This study aimed to determine priority VPD problems in Bogor City and identify factors contributing to the highest-ranked disease. A mixed-methods study was conducted in Bogor City from October 2024 to January 2025. Quantitative prioritization was performed using the Pan American Health Organization (PAHO)-adapted Hanlon method across eight VPDs. Qualitative data were collected through in-depth interviews with key informants and analyzed …

Association Of Household Economic Status And Birth Order With Stunting Among Children Aged 24-35 Months: Malawi Mics 2019–20, Sibongire B. Ngoma, Asri C. Adisasmita, Renti Mahkota, Septyana Choirunisa, Melisa Nyamukondiwa

Jurnal Epidemiologi Kesehatan Indonesia

Stunting remains a major public health concern in Malawi, with a national prevalence of 35.5% among children under five. However, evidence on the independent and combined effects of household economic status and birth order on stunting among Malawian children aged 24-35 months remains limited. This study aimed to examine the independent and combined association of household economic status and birth order with stunting among children aged 24-35 months in Malawi. A secondary data analysis of a cross-sectional 2019-20 Malawi Multiple Indicator Cluster Survey (MICS) was conducted, and the final sample comprised 2,764 children aged 24-35 months with complete data. Stunting …

Air Pollution And Public Health: Global Evidence And Implications, Mohammed Obaid Al-Mansoori

Al-Bahir

Globally, the issue of air pollution keep being one of most serious challenges that affecting environment and human health, coming from emissions of industries, transport, agriculture and also from the fuel people use in homes, in addition to natural events that make the situation worse. This review try to bring together the available evidences about the sources, types, and the health impacts of the main air pollutants, including the gaseous ones like SO₂, O₃, NO₂, and CO, and the particulate matter (PM₁₀, PM₂.₅). Exposure for short or long time to these pollutants is linked with many harmful outcomes, such as …

Epidemiology And Ultrasonographic Observations Of Urogenital Schistosomiasis Related Urinary Tract Morbidity In Itilima District, Simiyu Region, Tanzania, Coletha Yohana, Bruno A. Nyundo, Jared S. Bakuza, Peter F. Rambau, Safari M. Kinung’Hi

Tanzania Journal of Science

Chronic infection of urogenital schistosomiasis in humans is a major cause of urinary tract morbidity in endemic areas. However, information on the prevalence of schistosomiasisrelated urinary tract morbidity is lacking in most endemic countries including Tanzania. This study was conducted to determine the prevalence of schistosomiasis-related urinary tract morbidity in schoolchildren and adults in Itilima District. Urine samples from 682 residents were examined for Schistosoma haematobium infection using urine filtration technique. Urinary tract morbidity was examined by ultrasound. The prevalence of S. haematobium infection was 16.4% (112/682) and varied significantly between villages (range 3.2% to 29.5%, χ2 = 48.467, p < 0.001). There was no significant variation of S. haematobium infection between male and female (8.3 % vs 8.1%, χ2 = 0.679, p = 0.410). Majority (93.8%) had light infections (

(Re)Claiming Homeplace: Dance As Embodied Resistance & Healing For Health & Spatial Justice, Preeya G. Kannan

University Honors Theses

This thesis argues that dance functions as both an upstream public health intervention and a form of radical spatial resistance; creating healing, agency, and belonging among historically marginalized communities. Drawing on bell hooks' concept of homeplace, Jasbir Puar's assemblage theory, Nancy Krieger's eco-social theory, and Katherine McKittrick's Black geographies, I position the body as both an ecological and political landscape shaped by histories of colonialism, racial capitalism, displacement, and resilience.

Through this community-based participatory research study, Homeplace, I explore dance as a form of social prescription that centers liberation rather than pathology. Movement is often reduced in public health discourse …

The Gut Microbiome, The Gut-Brain Axis, And College Student Well-Being, Idi Mckay

University Honors Theses

This literature review examines how diet, stress, environmental exposure, and food accessibility may influence college students' mental health and academic performance through the gut microbiome and the Gut-Brain Axis (GBA). Current microbiome research often focuses on early childhood development, clinical disease populations, or older adults, while overlooking college-age students who experience significant social, environmental, and biological transitions. College students frequently face food insecurity, irregular eating patterns, chronic stress, inconsistent sleep schedules, and reduced access to nutrient-dense foods, all of which may influence microbial diversity and overall gut health.

This thesis explores how modern campus environments and lifestyle factors may contribute …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Polygenic Risk Scores, Sex, And Socioeconomic Factors As Predictors Of Age Of Onset For Major Depressive Disorder, Kaitlyn M. Nowak

USF Tampa Graduate Theses and Dissertations

Major Depressive Disorder (MDD) is a heterogeneous psychiatric condition influenced by genetic, sociodemographic, and environmental factors, yet the extent to which these factors jointly shape the timing of disease onset remains unclear. This study evaluated the effects of polygenic risk scores (PRS), sex, and socioeconomic status (SES) on age of onset for MDD across two independent cohorts: the Pharmacogenomics Research Network Antidepressant Medication Pharmacogenomics Study (PGRN-AMPS) (N = 486) and the All of Us Research Program (N = 8,014). Analyses were restricted to individuals of European genetic ancestry, and PRS were constructed using both European-ancestry (EA) and multi-ancestry (MA) genome-wide …

A Predictive Coding Account Of Spatial Working Memory Following Prophylactic Levetiracetam Administration Prior To Traumatic Brain Injury, Omeima Mutwali

Dissertations, Theses, and Capstone Projects

Traumatic brain injury (TBI) symptom prevention and remediation is an important area of research that would benefit vulnerable groups, including active-duty and veteran soldiers. These patients can sustain penetrative forces in fields of combat or in training, which result in focal lesions that trigger inflammatory and degenerative processes in the brain. Both primary and secondary injuries are associated with changes to cognition, behavior and affective state. This disease poses increased risk of epileptogenesis, as well. Given these outcomes, prior research has evaluated levetiracetam (LEV) as a prophylactic treatment for seizures, cognitive deficits and negative emotionality. LEV acts as a presynaptic …

Intervention Levers For Stunting Reduction In Indonesia: Evidence From The 2023 Indonesian Health Survey Data, Iwan Ariawan, Hafizah Jusril, Zahra Izza Afifa, Azka Fitri, Elmarizha Sekar Utami, Mikail Hasan, Dwi Puspasari

Kesmas

Stunting remains the largest public health challenge among macro-nutrition problems in Indonesia, affecting almost a quarter of children under five in 2023. The prevalence is considered high according to the World Health Organization standard. This study analyzed 15 aggregated provincial variables from the 2023 Indonesian Health Survey using Structural Equation Modeling (SEM), focusing on determinants of stunting among children under two to identify primary intervention levers. Findings indicated that intervention urgency should focus on the first 1,000 days, particularly the steep increase in stunting prevalence observed in the 12–24-month age range. While the highest prevalence is in Eastern provinces (e.g., …

Slouching Towards Inefficiency? The Cardiometabolic And Cognitive Costs Of Poor Posture, Ava Mae Fitzenrider

Honors Projects

Posture affects all of our lives. It is both static and dynamic, adapting continuously to environmental demands. One postural alteration frequently observed in occupational settings is hyperkyphosis, which can be induced by sitting position. During computer use, individuals commonly adopt a slouched posture, which can exacerbate hyperkyphosis, and contribute to dis-ease within the body. Previous research has demonstrated that such postural deviations can negatively affect pulmonary function, as well as other bodily functions. Despite these findings, the effects of acute hyperkyphosis (“slouching”) on cardiometabolic function and cognition remain largely unexplored. Therefore, the purpose of this study was to examine the …

Somatic Prosthetics For Planetary Resonance, Disha Dharesh Kumar R

Masters Theses

This thesis investigates how industrial design can transcend extractive technological paradigms in favor of relational interfaces that foster planetary attunement. Framing the climate crisis as a 'crisis of imagination', the research challenges the Western bifurcation of nature and culture by drawing on Indic cosmologies- which recognize stones, plants, and ecosystems as conscious at different levels and participants in a shared cosmic field. By synthesizing research in Biosemiotics, Quantum Information Pansycishm, and Neuroscience, the project redefines intelligence as a distributed, more-than-human phenomenon.

The research materializes as a speculative design artifact: a device that functions as a somatic prosthetic for planetary resonance. …

Environmental Mercury Alters Immune Pathways Linked To Autoimmune Risk In Mice Mirroring Humans, Maurgan Lee, Paul Stemmer, Randall Gill, Allen Rosenspire, Anil Aranha, Heather Gibson

Medical Student Research Symposium

Background and Purpose: Mercury is a pervasive environmental contaminant, and human epidemiologic studies have linked chronic low-level exposure to increased autoimmune disease-risk. Dysregulated lymphocyte activation and impaired signaling tolerance are central mechanisms in human autoimmunity. Protein phosphorylation governs lymphocyte differentiation and function, alterations in phosphoproteomic networks may represent a signature of immune disruption. This study evaluates how low dose mercury exposure modifies B and T cell abundance and intracellular signaling patterns in BALB/c and Diversity Outbred (DO) mice.

Methods: BALB/c and DO mice were exposed to low dose HgCl2 in their water for two weeks or provided standard water controls. …

Beyond Stabilization: Biological Healing, Structural Exclusion, And The Recovery Gap After Border-Fall Trauma At The U.S.-Mexico Border, Julia Robinson

Undergraduate Honors Theses

This honors thesis examines the biochemical, ethical, and public health consequences of insufficient post-operative follow-up care for undocumented immigrants injured in border falls. Discussing pathways of inflammation resolution, wound healing, and bone remodeling, this thesis argues that recovery depends on tightly regulated molecular and cellular processes that are highly vulnerable to disruption without continued monitoring and rehabilitation (Loi et al., 2016; Maruyama et al., 2020). When follow-up care is absent, these processes can be predicted to derail, leading to infection, impaired healing, and permanent disability (Chung & Sohn, 2025; Howard et al., 2020; Kruidenier et al., 2018). Framed through principles …

Managing Maternal Anemia In Pregnancy: The Role Of Iron-Rich Foods And Supplementation, Carli Dibler

InnovateHER Meeting 2026

Anemia during pregnancy is a large public health concern, which often leads to independent risk factors for fetal and maternal outcomes including postpartum hemorrhaging, cesarean sections, blood transfusions during and after the labor process, hysterectomies, preterm birth, and infectious diseases. Six level I-III studies were analyzed using the John Hopkins nursing evidence-based practice model. Findings showed that by using a combined approach of dietary intake and supplementation overall leads to better fetal and maternal outcomes compared to supplementation alone.

When Faced With Persistent Crying, Will Adults Follow The Advice To Take A Break?, Lauren J. Duplessis, Remington K. Asta, Benjamin N. Witts

InnovateHER Meeting 2026

Inconsolable crying in early infancy can have detrimental effects on caregiver mental health, the caregiver-infant relationship, and infant safety. Professionals often advise caregivers to walk away and take a break. This study used n-of-1 methodology to examine how frequently undergraduate students will follow this advice when tasked with calming a simulated inconsolable infant. Results are mixed, but suggest active training prior to the baby’s arrival might yield promising outcomes

Empowering Women: Understanding Neurological Changes In The Aging Brain, Joy Mckenzie

InnovateHER Meeting 2026

Women tend to have more neurological changes than men as they age starting in their mid-30s (Mosconi, 2024). While aging is a natural process, the neurological changes can impact a woman’s personal and professional quality of life (Faubion et al., 2023; Gravini, 2023). For years, women’s neurological symptoms have been ignored by being told that their experiences are normal and just a part of life (Haver, 2025). That narrative is starting to shift with the increased awareness of changes specific to women. There are resources to assess cognitive changes such as memory, processing speed, and word finding and strategies to …

Global Health Financing Of Diagonal Interventions: Building Resilient And Sustainable Health Systems In Sub-Saharan Africa, Lucy Kim

Master in Public Policy Theses

Background: Global health financing has historically prioritized disease-specific “vertical” programs over broader “horizontal” strengthening of general health systems. Vertical programs in HIV have led to unprecedented reductions in mortality worldwide, but HIV remains a significant public health threat in sub-Saharan Africa, where vertical strategies have long been criticized for creating fragmented health systems. In response, global health strategies have shifted towards combining vertical investments with broader horizontal activities, commonly referred to as “diagonal” programming. While evidence suggests that diagonal programming has the potential to create more resilient and sustainable health systems, evaluating its value for money is challenging due to …

From Cranes To Clinics: Genomic Epidemiology At The Human-Animal Interface, Sarah Shrum

Biology ETDs

Emerging infectious diseases represent a significant, increasing threat to human life, economic stability, and global security. The One Health framework, which promotes human health and wellness through the understanding that animal, environmental, and human health are interwoven, is critical to understanding pathogen emergence and transmission. This is underscored by the fact that roughly 60% of all human pathogens and 75% of emerging infectious disease are zoonotic, meaning they are transmitted from animals to humans.

The work presented in this dissertation integrates genomic epidemiology, ecological analysis, and One Health Surveillance approaches to characterize cross-species circulation of opportunistic yeast pathogens (Candida …

Unknowing Sacrifices: Public Health And Radiation Illness In New Mexico And Nevada, 1940s-1960s, Beatriz Avila-Marquez

UNLV Theses, Dissertations, Professional Papers, and Capstones

The detonation of the first atomic bomb in the early morning of July 16, 1945, in New Mexico welcomed the atomic age that forever changed the world. After that day, thousands of lives were lost due to nuclear weapons, and hundreds of thousands more continued to suffer from the effects of atomic testing. The Atomic Energy Commission, fueled by the arms race of the Cold War, chose Nevada to continue the United States’ nuclear weapons testing. Knowledge of the dangers of radiation exposure, the effects of radiation, and techniques to prevent exposure are now available in part due to the …

Behavioral Science Applications In Collegiate Athlete Nutrition And Sleep: A Scoping Review, Maryam Yuhas, Katherine M. Kidwell, Olivia Moskuna, Rajib Mandal, Jessica L. Garay

Nutrition - All Scholarship

Nutrition and sleep are key health behaviors supporting athletic performance. Collegiate athletes in the United States (U.S.) are at high risk of insufficient dietary intake and nightly sleep given the competing demands of elite sports and academics. Researchers have developed interventions to improve collegiate athletes’ sleep and nutrition, either individually or collectively. However, progress in understanding how best to create sustained behavior change in this population has been slow. This may be due to the lack of application of behavioral science principles such as lack of a guiding theory, effective strategies, and consideration of implementation contexts. This scoping review takes …

Leveraging Mobile Health To Prevent Coronary Artery Disease Through Physical Activity Promotion Among Underserved Youth, Alina Yang, Jessh M. Mavoungou, Matthew C. Miller, Zarmina Amin, Zan Gao

International Journal of Physical Activity and Health

Coronary artery disease (CAD) develops earlier than often recognized, with underserved youth facing disproportionate cardiometabolic risk. Low participation in moderate-to-vigorous physical activity (PA) is a key driver. This viewpoint explores how mobile health (mHealth) technologies can serve as tools to increase PA engagement among underserved youth, guided by a combined Self-Determination Theory and RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. It highlights current barriers to mHealth adoption, limited cultural relevance, engagement challenges, and accessibility gaps, and presents key considerations for designing culturally informed, age-tailored, and youth-centered mHealth interventions. Overall, the paper calls for a more inclusive and targeted approach …

The Mediating Effect Of Physical Activity On Mental Health Among Sexual Minority Adolescents During Covid-19, You Fu, Ryan D. Burns, Hayley Almes, Xiangren Yi, Nora Constantino

International Journal of Physical Activity and Health

Purpose: Adolescents identifying as a sexual minority frequently experience mental health issues exacerbated by the COVID-19 pandemic. Physical activity (PA) has numerous benefits for mental health and emotional development. The purpose of this study was to examine the mediating effect of PA on the association between sexual minority status and mental health among adolescents during COVID-19. Methods: A sample of adolescents (grades 9-12) completed the online Adolescent Behaviors and Experiences Survey (ABES; N = 7677; 49.6% male) in 2021. The independent variable in this study was a recorded binary response item asking about sexual orientation. The dependent variable was a …

The Influence Of Prosthetic Obturators On Quality Of Life In Individuals With Maxillectomy Defects, Minseok Kim

Oral Health

Abstract

Introduction: In recent years, there has been a growing focus on understanding the impact of oral cancer on patients' quality of life. Prosthetic rehabilitation techniques, such as maxillary obturators, often in conjunction with reconstructive surgery, have emerged as interventions to address the challenges posed by post-maxillectomy abnormalities.

Objective: This study aims to systematically review and evaluate the effectiveness of maxillofacial prosthetic rehabilitation using obturators in enhancing the quality of life of patients following maxillectomy.

Methodology: Systematic review of identified literature spanning the timeframe from 2000 to 2020 was used. The comprehensive search encompassed widely recognized databases including PubMed, …

Development Of Water-Soluble Nanofibrous Poly(Vinyl Alcohol) Collectors For Bioaerosol Sampling And Environmental Surface Microbial Detection, Kevin Crown

Theses & Dissertations

Environmental surveillance for pathogenic microorganisms requires sampling technologies capable of efficiently collecting biological particles from air and surfaces for downstream detection.  Current environmental sampling materials, such as fibrous aerosol filters and surface sampling swabs, are designed to capture particles effectively but often retain a portion of the collected material during extraction.  Incomplete recovery reduces the sensitivity of microbiological and molecular detection, particularly in situations where microbiological concentrations are low, such as in environmental monitoring and clearance sampling following biological contamination events.  This dissertation describes the development and evaluation of water-soluble nanofibrous sampling materials designed to improve microbial recovery while maintaining …

The Legacy Of Lead: Lead Exposure's Harmful Effects And Its Concentration In Poc Communities, Layla Sophronia Barber

Student Theses 2015-Present

This thesis examines the disproportionate burden of lead exposure carried by low income, POC communities. The systemic nature of this problem is a symptom of a longstanding legacy of environmental injustice in the United States. Decades of federal neglect are reflected in the higher statistics of lead exposure and poisoning in predominantly black communities. While it is understood that lead exposure poses a serious threat to physical health and early cognitive development, there is a discouraging lack of urgency to remove the toxin from non-wealthy communities. The material covered by this thesis aims to identify and correct the discriminatory social …

Bio 340 Final Project: Rural Population Structure And Food Production Interact To Shape Global Undernourishment, Ava Ripanti

Biology Student Scholarship

Ava Ripanti - Environmental Biology '27

Undernourishment remains a major global public health challenge, reflecting the proportion of a population lacking sufficient dietary energy intake. While food availability is central to food security, undernourishment is also shaped by structural and socioeconomic factors such as population distribution and access to resources. Although rural populations are closely tied to agriculture, they often experience higher food insecurity due to limited infrastructure, market access, and healthcare. Prior research emphasizes that broader determinants, particularly inequality and development, are stronger predictors of undernourishment than agricultural output alone, that food insecurity exists in both rural and urban …

Invisible Shipwrecks And Neurological Endangerment: The Trade-Off In Seeking Asylum - Reframing The Neurobiological Cost Of Forced Migration, Eisha Giran

CISLA Senior Integrative Projects

Forced migration along the Spain–Morocco route represents one of the most visible humanitarian crises of the twenty-first century, yet its neurological dimensions remain insufficiently examined. This paper investigates how prolonged displacement and trauma reshape neural systems involved in stress regulation, memory, and emotional processing. It introduces the concept of neurological endangerment, defined as a condition of prolonged and inescapable threat exposure during forced migration in which stress-response systems remain chronically activated, opportunities for recovery are structurally constrained, and cumulative neurobiological risk persists beyond the period of immediate danger.

To address the gap between biological measurement and lived experience, this paper …