Public Health Commons^™

The Impact Of Substance Abuse Problems And Serious Mental Illness/Serious Emotional Distress On Post-Discharge Residential Status Among Clients With Behavioral And Cognitive Disorders: Evidence From Samhsa Mh-Cld Data, Eden Moges, Norma Rochez, William Peycha, Aditya Chakraborty

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

BACKGROUND: Behavioral and cognitive disorders can undermine housing stability, a key determinant of mental health recovery, with persistent disparities across demographic and socioeconomic groups. This study examined the associations of substance abuse problems (SAP) and serious mental illness/serious emotional distress (SMISED) with residential status at discharge from mental health facilities.

METHODS: This cross-sectional study used the utilized data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Descriptive statistics were used to summarize demographic characteristics, whereas univariate and multivariable logistic regression models were employed to assess associations between the covariates and the residential outcome, adjusting for a variety of …

The Weight Of Stigma, Rebekah A. King, Michael S. Sinha

All Faculty Scholarship

Many health care providers, both implicitly and explicitly, perpetuate stigma in their treatment of patients classified as obese. While medical professionals understand that a one-size-fits-all approach to treatment is ineffective, patients classified as obese are frequently offered limited treatment options that fail to account for their unique needs. Access to a range of effective treatment options has historically been limited, but new GLP-1 receptor agonist medicines like Wegovy (semaglutide) and Zepbound (tirzepatide), have shown incredible promise in addressing the obesity crisis. Unfortunately, these transformative drugs are costly, in high demand, and not widely covered by insurance, rendering them inaccessible for …

Effet Sur La Qualité De L'Air Et La Santé Des Travailleurs Et Travailleuses Dans Les Logements Alternatifs Des Poules Pondeuses, Magali-Wen St-Germain, Valérie Létourneau, Marc Veillette, Perrine Cruaud, Candice Lemaille, Kim Robitaille, Éloïse Denis, Araceli Dalila Larios Martínez, Sébastien Fournel, Stéphane Godbout, Geneviève Dion, Andréanne Côté, Laurianne Gratton, Martine Boulianne, Caroline Duchaine

Rapports de recherche scientifique

Les oeufs de poules en liberté et les oeufs provenant « d’élevage confort » sont maintenant des produits communs dans les marchés alimentaires du Québec. Cette nouvelle variété de produits est le résultat de l’évolution des pratiques afin de concilier le bien-être des poules pondeuses et les besoins de l’industrie. En effet, d’ici l’année 2036, les logements conventionnels pour poules pondeuses (logements grillagés pour des petits groupes de poules) seront graduellement remplacés par des logements alternatifs. Les logements alternatifs pour poules pondeuses regroupent les colonies enrichies et les logements sans cages (sur plancher ou en volière). Ils ont en commun …

Évaluation De L’Exposition Aux Microorganismes Et Appréciation Du Risque Sanitaire Des Chauffeurs De Camion Et Des Éboueurs Attitrés Au Transport Des Matières Résiduelles Et Des Déchets, Geneviève Marchand, Loïc Wingert, Maximilien Debia, Carla Viegas, Susana Viegas, Liliana Caetano, Magdalena Twarużek, Nancy Lacombe, François Gouin, Delphine Lanoie, Isabelle Valois, Robert Kosicki, Marta Dias, Ewelina Soszczyńska, Julien Trépanier, Tam Nguyen, Fabiola Salambanga, Noémie Gervais

Rapports de recherche scientifique

La gestion des déchets au Québec repose sur la collecte sélective pour revaloriser les matières résiduelles et réduire l’enfouissement. Les travailleurs du secteur sont exposés aux bioaérosols contenant microorganismes et allergènes. Les risques sanitaires sont influencés par la nature des matières manipulées et les méthodes de travail employées. La manutention des déchets a déjà été mise en lien avec des inflammations respiratoires, des troubles digestifs, et des syndromes liés aux poussières organiques toxiques. L’objectif du projet visait à évaluer l’exposition des travailleurs aux microorganismes et d’en apprécier les risques pour la santé.

Dans le cadre de ce projet, 28 camions …

Allier Les Technologies Numériques À La Prévention Des Lésions Professionnelles Pour Intervenir Auprès D'Une Population Faiblement Scolarisée Se Préparant À L'Emploi, Marie Laberge, Aurélie Tondoux, Myriam Bérubé, Céline Chatigny, Denys Denis

Rapports de recherche scientifique

Ce rapport présente les résultats d’un projet de recherche visant à améliorer la santé et la sécurité au travail (SST) des élèves du Parcours de formation axée sur l’emploi (PFAE) au Québec. Ce programme accueille chaque année entre 11 000 et 13 000 élèves de 15 ans à 21 ans qui éprouvent des difficultés scolaires et risquent de quitter l’école sans diplôme. Le PFAE offre des stages d’apprentissage en milieu de travail pour des métiers semi-spécialisés, couvrant un large éventail de secteurs d’activités. Les élèves du PFAE sont particulièrement vulnérables en matière de SST puisqu’ils sont très jeunes et ont …

Politics Of A Silent Pandemic: Antimicrobial Resistance And State Capacity In India And Nigeria, Mia Kelly

CMC Senior Theses

Antimicrobial Resistance (AMR) has emerged as one of the most pressing yet widely underestimated health threats of the 21st century; this thesis explores the potentially devastating global impact of this “silent pandemic”, exposing how deeply health outcomes depend on political choices, regulatory capacity, and economic constraints. Although the danger of spreading drug-resistant pathogens is now widely acknowledged in both the scientific and political communities, states differ in their abilities to contain the issue, with low- and middle-income countries facing the greatest obstacles to national action plan implementation. This thesis investigates these disparities through a comparison of India and Nigeria, two …

Associations Between Neighborhood Physical And Social Stressors During Sensitive Developmental Periods And Substance Use In Early Adulthood, Abigail M. Ulofoshio

Electronic Theses & Dissertations (2024 - present)

Background

Substance use is a major public health problem. Neighborhood disadvantage and related stressors have been linked to increased substance use in adolescence and early adulthood, although findings are mixed. No studies have explored whether the timing or accumulation of neighborhood stressors in childhood and adolescence impact substance use in early adulthood. This study aims to investigate to what extent physical and social neighborhood stress during sensitive developmental periods influence substance use dependency and illicit substance use in early adulthood.

Methods

We analyzed an imputed sample (n = 7,494) from the Avon Longitudinal Study of Parents and Children (ALSPAC), a …

Assessing And Advancing Pandemic Emergency Preparedness In New York City's Hospitals: A Strategic Management Toolkit Integrating Policy Analysis, Risk Assessment, And Stakeholder Insight, Irrem Jamal

College of Graduate Studies: Theses & Dissertations

This dissertation examines pandemic emergency preparedness in New York City hospitals, which were severely strained during COVID-19, revealing critical gaps between documented plans and operational readiness. Using a multimethod approach combining a survey of 20 stakeholders across city hospitals, semi-structured interviews, and document analysis of policy frameworks and after-action reports, the study identifies a persistent "documentation-execution paradox": while 80% of respondents confirmed clear pandemic plans, only 45% expressed confidence in staffing adequacy, 55% in surge planning realism, and just 45% confirmed regular drills. Qualitative analysis revealed workforce as the single greatest yet most underinvested vulnerability, supply chain fragility rooted in …

Exploring Psychological Safety And Workforce Experiences Among Employees In Recovery Community Organizations In The Southern United States: A Qualitative Study, Claire-Lorentz Ugo-Ike

College of Graduate Studies: Theses & Dissertations

This qualitative study explored how employees in Recovery Community Organizations (RCOs) in the Southern United States experience psychological safety and how these experiences shape employee well-being and their intentions to stay or leave their organizations. Guided by Edmondson’s Psychological Safety Theory and the Job Demands-Resources (JD-R) model, the study examined how leadership practices, workplace culture, and the emotional demands of recovery support work shape employees’ perception of safety, support, and sustainability in the workforce. Semi-structured interviews were conducted with 19 RCO employees working in various peer support roles. Thematic analysis identified five major themes: (1) leadership behaviors shape psychological safety …

Anti-Sars-Cov-2 Nucleoprotein Iga Is Associated With Worse Disease Severity In Critically Ill Covid-19 Pneumonia Patients, David Brett-Major, Dylan S. George, Eric D. Morrell, Carmen Mikacenic, Julie Carstens, Laura E. Evans, Mark M. Wurfel, Pavan K. Bhatraju, M. Jana Broadhurst

Journal Articles: Epidemiology

While humoral responses to vaccination and infection have largely focused on IgG, there is an evolving literature on ways in which IgA may drive neutrophil activity in lung injury secondary to viral infections, including COVID-19. We evaluated 238 immune-naïve, critically ill patients in the first year of the COVID-19 pandemic. Employing a laboratory-developed, multiplexed antibody testing, clinical history, medical record, and machine learning, we pursued relationships between systemic IgA and disease severity. Individuals with elevated anti-N IgA had 4-fold odds of more severe disease. This work emphasizes the importance of continued work to understand how different elements of the immune …

Development Of A Semi-Mechanistic Population Pharmacokinetic Model For Predicting Tenofovir Disoproxil Fumarate And Tenofovir Alafenamide Exposure In Plasma And Cellular Matrices During Pregnancy And Postpartum, Yifan Yu, Kristina M. Brooks, Gustavo F. Doncel, Brookie M. Best, Mark A. Marzinke, Mark Mirochnick, Peter Anderson, Landon Myer, Connie Celum, Renee Heffron, Jenell Coleman, Dvora Joseph Davey, Craig W. Hendrix, Jeremiah D. Momper, Robert Bies, Rachel K. Scott

CONRAD Publications

Background and Objective

Tenofovir (TFV)-based regimens are backbones of both HIV treatment and pre-exposure prophylaxis during pregnancy. Multiple studies have shown up to one-third decreases in dried blood spot tenofovir-diphosphate concentrations during pregnancy among participants taking tenofovir disoproxil fumarate (TDF). Currently, there are no mechanism-based models describing the pharmacokinetics of tenofovir diphosphate (the active anabolite) in peripheral blood mononuclear cells (PBMCs) of pregnant individuals receiving TDF or tenofovir alafenamide (TAF), and the mechanisms behind observed differences between dried blood spots and PBMCs remain unclear.

Methods

To address this gap, we developed a semi-mechanistic model to simultaneously describe the pharmacokinetics of …

Photovoice Exploration Of Afghan Refugee Background Women's Food-Related Well-Being, Eileen C. Lindemann

Graduate Research Theses & Dissertations

More than 117,000 Afghans have been relocated to the United States following the U.S. military withdrawal in August 2021. Research indicates that Afghan refugees resettled in the U.S. are at increased risk of psychological distress, with Afghan women particularly susceptible compared with Afghan men, and diet-related chronic disease. However, research also shows that traditional food and eating customs foster cultural identity, social support, integration, and well-being. The purpose of this study was to collaboratively explore the food-related well-being and daily life contexts of resettled refugee participants through the photovoice method, a participatory research strategy in which participants photograph aspects of …

Air Quality Risks In Public Housing, Brynn Sheehan, Carolyn Caraballo Velez, Vaughan W. Rees, Miasha T. O'Neal, Kristen E. Moore, Katie M. Jones, Jessica Meadows, Sarah Gehlert, Richard Grucza, Andrew Plunk, Kelli J. England

Department Psychiatry & Behavioral Science Faculty Publications

Importance Public housing residents face elevated environmental health risks, yet indoor air quality in these settings remains underexamined. OBJECTIVE: To evaluate indoor air quality in public housing 5 years after implementation of the federal smoke-free housing policy and compare it with outdoor air quality in the same regions.

Design, Setting, and Participants A 1-year cohort study of indoor air quality (particulate matter ≤2.5 μm in diameter [PM2.5]) across 12 multifamily public housing communities in southeastern Virgina for individuals 65 years and older or persons with disability in cities with the highest rated outdoor air quality. Indoor PM2.5 was continuously measured …

Medical Image Feature Extraction And Selection Based On Inception V3 And Gini Index For Cervical Cancer Cells Identification, Rachida Assawab, Mounir Ouzir, Badreddine Benyacoub, Abderrahim Electrochemical Sensor For Tenofovir Allati, Ismail El Moudden

Research and Infrastructure Service Enterprise (RISE) Faculty Publications

Background: Cervical cancer remains the fourth most common cancer in women globally, with 604,000 new cases annually. Early detection through cytological screening is critical, but manual interpretation suffers from high false negative rates and requires expert pathologists often unavailable in resource-limited settings.

Methods: We developed a novel hybrid framework combining InceptionV3-based deep feature extraction with Gini Index feature selection for automated cervical cancer cell classification. Using the Herlev dataset (917 Pap smear images: 242 normal, 675 abnormal), we extracted 2048 deep features and applied systematic feature selection to identify optimal discriminative subsets. Comprehensive clustering analysis (K-means, K-medoid, Fuzzy clustering) validated …

Neurotensin Drives Theca Cell Migration During Ovulation In Primates, Jessica S. Miller, Megan A. G. Sage, Thomas E. Curry Jr., Diane M. Duffy

Department of Biomedical and Translational Sciences Faculty Publications

Theca cells are a critical steroidogenic cell type of the ovarian follicle and corpus luteum. The ovulatory luteinizing hormone (LH) surge (or human chorionic gonadotropin (hCG)) stimulates theca cell relocation from the stroma surrounding the dominant follicle to full integration into the developing corpus luteum. Luteinizing hormone/human chorionic gonadotropin also stimulates granulosa cells to produce local mediators of ovulation, including the peptide neurotensin (NTS). To determine if hCG-stimulated NTS regulates theca cell relocation within the ovulatory follicle, vehicle or an NTS receptor antagonist was injected into a macaque dominant follicle, and ovaries were removed 48 h after hCG administration. Additional …

Skeletal Muscle Myofiber Development In Non-Human Primate Offspring Deprived Of Estrogen In Utero, Phillip J. Gauronskas, Terrie J. Lynch, Eugene D. Albrecht, Gerald J. Pepe

Department of Biomedical and Translational Sciences Faculty Publications

Introduction: We previously showed that baboon offspring born to mothers deprived of estrogen during the second half of gestation exhibited insulin resistance prior to and after the onset of puberty. Moreover, the size of skeletal muscle myofibers and the number of microvessels important for delivery of insulin/glucose to myofibers were lower in near-term fetuses deprived of estrogen during pregnancy, and myofiber capillarization remained reduced in post-pubertal offspring deprived of estrogen in utero. However, it remains to be determined whether skeletal muscle size is restored to normal in animals deprived of estrogen in utero after the onset of puberty/gonadal estrogen production. …

Hu308, A Selective Cannabinoid Type-2 Receptor Agonist, Mitigates Sars-Cov-2 Spike Protein-Induced Acute Lung Injury In Mice, Janette Lockett, Gregory Nicholson, Nicholas Richards, Ryan Washington, Nagaraja Nagre

Department of Biomedical and Translational Sciences Faculty Publications

Introduction

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to pose major health challenges despite effective vaccination efforts. The sustained occurrence of breakthrough infections and emerging variants of the virus highlights the need for additional therapeutic strategies. Given the anti-inflammatory role of the cannabinoid type 2 receptor (CB2R), we examined the effect of CB2R activation in SARS-CoV-2 spike protein subunit 1 (S1SP)-induced acute lung injury (ALI).

Methods

ALI was induced in mice by intratracheal (i.t.) administration of S1SP, followed by treatment with the CB2R agonist HU308 (5 mg/kg, intraperitoneal: i.p.) 1 h …

Aging With A Chronic Illness: Symptom Burden, Everyday Challenges, And Quality Of Life Among Older Adults With Multiple Sclerosis, Swasati Handique

Social Work Dissertations

This three-article study examined the quality of life and everyday lived experience of older adults living with multiple sclerosis (MS). The first article is a scoping review of 14 peer-reviewed studies published between 2012 and 2025, conducted in accordance with Arksey and O’Malley’s five-stage framework and the PRISMA checklist. The second article is a cross-sectional study using the Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) Phase II data set of 60 older adults living with MS. Multiple linear regression and moderation analysis was conducted to examine the association between physical symptom burden and quality of life, and whether participation …

From Coverage To Care: Evaluating The Effects Of Aca Medicaid Expansion On Birth Outcomes, Bailey R. Lengfelder

Economics Honors Projects

I examine the impact of the Affordable Care Act’s Medicaid expansion on maternal and fetal health outcomes using National Center for Health Statistics Natality data from 2006 to 2023. I exploit staggered state adoption as a quasi-experiment, and the staggered differences-in-differences estimates indicate an increase in the share of Medicaid births but broadly no impact on maternal prenatal care, maternal health, and fetal health. The absence of statistically significant effects is consistent across heterogeneity groups. These null findings indicate that expanded insurance access through the Affordable Care Act may be insufficient to improve health outcomes. I do find a statistically …

Prepregnancy Overweight And Obesity In Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Eelaf A. Husain, Maryam M.Y. Mohammad, Maryem A. Shamsah, Noor Salah Alali, Reem Sharaf-Alddin, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: This study aimed to estimate the prevalence of prepregnancy obesity and overweight, and to identify a set of sociodemographic factors that could guide weight management interventions for women prior to conception.

Design, Sample, and Measurements: Pregnant women (N = 989) were recruited in the Kuwait Birth Cohort Study during the period June 2017 to February 2020. Prepregnancy weight and height were self-reported, while current weight and height were measured in a standardized procedure. Data on sociodemographic factors were collected through face-to-face interviews conducted by a trained data collector. Multinomial logistic regression was used to investigate the association between sociodemographic …

A Cross-Sectional Study Investigating The Relationship Between The Fto Gene Polymorphism In Relation To Obesity Traits And Vitamin D Status In Adolescence, Ahmad Al-Serri, Rabeah A. Al-Temaimi, Abdullah Al-Taiar, Lemia Shaban, Reem Al-Sabah, Abdur Rahman, Ali H. Ziyab

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background and Objective: Obesity affects 18%-25% of adolescents globally and represents a major public health challenge. Genetic factors contribute to obesity susceptibility, with the FTO gene variant rs9939609 consistently associated with obesity in adults; however, evidence in adolescents is limited. This study examined the association between FTO and obesity traits in adolescents and explored potential interactions with vitamin D status.

Methods: In this cross-sectional study, 509 adolescents aged 10-15 years were genotyped for FTO rs9939609. Obesity traits, including BMI, BMI z-score, and waist circumference, were assessed. Associations with genotype were analyzed using an additive genetic model, and potential interactions with …

Spectral Frequency And Broadband Noise Analysis Of The Firefighter Environment: Potential Implications For Cardiac Health, James Blando, Catherine Reed, Amya Turner

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Firefighters are well known to have elevated risk of adverse health outcomes across a wide range of diseases and injuries, including cancer, hearing loss, fatal cardiac events, post-traumatic stress disorder (PTSD), sleep disorders, and many other adverse outcomes. It has been speculated that the noise environment is a significant risk factor for several of these diseases. In particular, the impact of noise on cardiac outcomes has recently been identified. An environmental survey of noise that included spectral and broadband analysis was conducted across all 14 firehouses in a southeastern city in the United States as a first step to investigate …

Characteristics Of Women Who Fast During Pregnancy: Findings From The Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Reem Al Sabah, Ahmed N. Albatineh, James Blando, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Fasting during pregnancy is a widespread practice in Muslim communities, yet its health implications remain poorly understood. A lack of conceptual frameworks and limited understanding of the characteristics of women who fast during pregnancy have hindered research in this area. This study examines the differences in several nutritional biomarkers between women who fasted and those who did not and identifies factors associated with fasting behaviour. We analysed data from the Kuwait Birth Cohort in which information on fasting, sociodemographic characteristics and health behaviours was collected via structured interviews between 2017 and 2021. Clinical and laboratory data were extracted from medical …

Examining The Association Of Maternal Oral Health Experiences With Adverse Birth Outcomes: Findings From Virginia's Prams Survey, May Salama, Abdullah Al-Taiar, Denise C. Mckinney, Li-Wu Chen, Anwar T. Merchant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Preterm birth (PTB) and low birth weight (LBW) are significant public health challenges globally, contributing to neonatal morbidity, mortality, and long-term complications. Maternal oral health has been increasingly recognized as a potential contributor to PTB and LBW, yet there is inconclusive evidence about the effectiveness of dental cleaning in preventing PTB and LBW. This study examined the association between dental cleaning during pregnancy and the prevalence of PTB and LBW using data from the Virginia Pregnancy Risk Assessment Monitoring System (PRAMS).

Methods

We analyzed data from Virginia PRAMS Phases 7 and 8, spanning a 10-year period from 2012 to …

Paneugenesis: A Regenerative Systems Hypothesis For Advancing Health Promotion, Craig M. Becker, Leslie Hoglund, Beth Chaney, Joseph G. L. Lee, Michael Stellefson, Alex Davis

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Despite major advances in health promotion science, dominant approaches remain largely prevention-and risk-reduction-oriented. The prevailing orientation creates a substantial opportunity to advance generative, system-design strategies that intentionally produce well-being rather than merely prevent disease. This article proposes paneugenesis as a regenerative systems framework and a testable theoretical model for the intentional creation of net-positive outcomes, thereby extending health promotion beyond its traditional pathogenic emphasis. Paneugenesis integrates systems science, salutogenesis, behavioral science, complexity theory, and quality management principles into a unified four-function process: operationalizing idealized outcomes, identifying key precursors, optimizing processes, and continually plotting progress through feedback mechanisms. The central hypothesis …

Prevalence Of Dengue Infection In Bangladesh: A Systematic Review And Meta-Analysis, Md. Estiar Rahman, Abdullah Al-Taiar, May Salama, Michele A. Kekeh, Ahmed N. Albatineh

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective: 

To estimate the pooled prevalence of dengue infection in Bangladesh.

Methods:

Literature search was conducted across PubMed, Web of Science, and Hinari between December 2024 and April 2025, supplemented by references searching. The Joanna Briggs Institute checklist was used for evaluating study quality. A random effects meta-analysis of proportion, including subgroup analyses, was performed with R software (version 4.5.1).

Results:

Out of 2 087 records, 28 studies were included. The pooled prevalence of confirmed dengue infection among clinically suspected patients was 49.3% (95% Cl 36.1-62.6), with a significant high heterogeneity (I²=99.2%, τ²=1.81, P< 0.001). Stratified analysis showed a pooled prevalence of 47.9% (95% Cl 34.0-62.2, I2=99.1%, …

Management-Driven Shifts In The Bison Fecal Microbiome And Its Relationship To Stec Prevalence, Ritesh Ray

Graduate Research Theses & Dissertations

Contamination of meat samples from pathogens such as Shiga toxin-producing E. coli (STEC), especially in ruminants, is an ever-growing issue for the safety of global meat production. Recent studies have reported STEC in the livestock and food industry with a limited focus on wildlife. Although cattle serve as the primary reservoir for STEC, American bison (Bison bison bison) is the largest ruminant inhabiting North America, sharing similar genetics, and grazing habits, making them an ideal alternative STEC reservoir. Re-introduction for prairie conservation and meat farming has brought bison herds closer to anthropic environments than before. Recently bison meat has become …

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

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

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

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

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

Graduate Theses, Dissertations, and Problem Reports (ETD)

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

Community Resilience Drives Change, Andrew Thomas Solt

Graduate Theses, Dissertations, and Problem Reports (ETD)

The opioid crisis has impacted many Americans. From 1999 to 2023, approximately 800,000 people have died due to opioid overdose (CDC, 2025). What began as overprescriptions of painkillers has quickly evolved into a complex social health issue that is now further worsened by stronger synthetic drugs like fentanyl. Fentanyl and fentanyl analogs (synthetic opioids that are very similar chemically to fentanyl) are often found in illegal drug supplies and in counterfeit pills (CDC, 2025). Thus, individuals who might have been initially overprescribed painkillers might now be pushed towards illegally produced drugs that are significantly more potent than what they were …