Public Health Commons^™

Using Somatic Experiencing To Mitigate Symptoms Of Secondary Traumatic Stress In Female Helping Professionals, Jillian Christie Guinta

Doctoral Dissertations and Projects

This phenomenological and quantitative study explored the lived experiences of a dozen women within the veterinary, social work, and nursing communities and how secondary traumatic stress impacts their lives. Faced with unanticipated patient illnesses, facilitating compassionate end-of-life procedures, and rapidly moving from one emotional state to the next between patients, professionals are carrying tremendous unprocessed emotional burdens that can affect them physiologically and psychologically. Somatic Experiencing (SE) indicates tremendous promise in rehabilitating practitioners’ trauma-impacted nervous systems by offering techniques to release emotional stress and re-regulate the nervous system (Kuhfuß et al., 2023). This mixed-methods study explored the world of these …

Can The Implementation Of The Pause Decrease Death Anxiety And Poor Mental Health In Practicing Nurses?, Lilli Meyer

Undergraduate Theses

Practicing nurses are frequently exposed to patient death, placing them at increased risk for death anxiety and compromised mental health. Despite this, there remains a lack of structured, in-the-moment interventions to support emotional processing within clinical settings. This study evaluates whether the implementation of “The Pause,” a brief moment of silence following a patient’s death, may reduce death anxiety and improve mental health outcomes among practicing nurses. A quantitative survey consisting of eight questions was distributed to nurses in the Louisville, Kentucky area over a three-month period, yielding 26 responses. Findings indicated that 80.8% of participants reported no improvement or …

Is Home Birth A Choice? Racial And Geographic Differences In Unintended Home Births In The U.S., Anna De La Paz

Population Health Research Brief Series

Home births that happen without planning or medical support (i.e., unintended home births) carry a higher likelihood of adverse outcomes, such as low birth weight, preterm birth, and hypothermia. This data slice summarizes findings using data from CDC WONDER (2017–2023) on racial, regional, and metropolitan status differences in home births among women ages 15–44 in the U.S. Findings show that unintended home births are disproportionately concentrated among non-Hispanic Black women, with rates varying substantially by region and metropolitan status.

The Mommy Wine Culture: A Scoping Review Using The Person-Environment-Occupational Model., Sabina Khan

Student Dissertations

Maternal alcohol use as a coping response to parenting-related stress has received growing attention in public health and psychology but remains underexplored within occupational therapy. This gap limits understanding of how daily role demands, environmental pressures, and individual vulnerabilities combine to shape drinking as a functional coping behavior. This dissertation aimed to identify and synthesize factors associated with maternal alcohol use in the context of parenting stress and interpret these determinants using the person–environment–occupation model. A scoping review was conducted following the Arksey and O’Malley framework and reported according to PRISMA-ScR guidelines. Five databases were systematically searched without date or …

A Phenomenological Study Exploring The Role Of Religious Coping In Childhood Interpersonal Trauma Recovery Among Latinx Adults, Christina Mancebo-Torres

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study was to understand the role religious coping plays in recovery from interpersonal adverse childhood experiences (ACES) among Latinx adults attending Pentecostal churches in New Bedford, Massachusetts. The theory guiding this study was Pargament’s Theory of Religious Coping (1997), which posits that religious coping strategies are ways in which individuals attempt to understand and deal with sacred- related negative life events, including traumatic experiences (Xu, 2015). This study utilized a hermeneutic phenomenology research design. The purposive sample consisted of 12 individuals who self-identified as Latinx, 18 years of age or older, and having a …

Improving Anesthesia Provider Confidence In The Identification, Management, And Treatment Of Postoperative Delirium, Brittany M. Whistle, Charles Dustin Phelps

Scholars Week

Purpose: Postoperative Delirium (POD) is a potentially devastating complication of anesthesia that is poorly understood by clinical staff leading to poor outcomes for surgical patients. This study is meant to determine if a focused knowledge presentation accompanied by visual aids could increase anesthesia providers confidence in identifying, diagnosing, and treating Postoperative Delirium.

Methodology: Utilizing a statistical model to analyze respondents results on a standardized test administered before and after an informational presentation with visual aids on the topic of Postoperative Delirium.

Results: Results indicated a statistically significant difference between pretest and posttest scores, with a p-value of .002, t(11) = …

Intersecting Determinants Of Health: Correlating Food Insecurity And Sleep Deprivation Across Southern Adventist University Demographics*, Heaven Robles, Jesica Paralafox Ramirez, Kimberly Mongare, Joshua C. Jenkins, Melany Castillo, Philip Chen Dr, Aaron Corbit Dr

Campus Research Month

For university students, social determinants of health such as food security and sleep patterns heavily dictate both health outcomes and academic success. Using a cross-sectional study design, statistical analyses will be conducted using the Jamovi software platform to compare mean sleep durations and food access scores across multiple academic departments and ethnic demographic groups. The study evaluates four primary hypotheses: (1) Consistent food access positively correlates with sleep quality; (2) Food security and sleep metrics vary significantly across academic departments; (3) Systemic ethnic disparities exist in food accessibility; and (4) Underrepresented ethnic groups experience a compounded burden of food insecurity …

Psychosocial Mediators Of A Physical Activity And Dietary Intervention In Pregnant Women With Overweight Or Obesity, Meghan Baruth, Sarah Wilcox, Jihong Liu, Rebecca Schlaff

Faculty Publications

Background

Mediation analyses provide insight into both ‘pieces’ of the mediation chain; they allow us to look into the ‘black box’ that is behavior change. They allow researchers to better understand the ‘how’ of an intervention’s effects and/or the ‘why’ behind why an intervention worked or did not work. The lack of publications in pregnant populations highlights the need for additional studies to be conducted and published. The purpose of this study is to examine the psychosocial mediators of physical activity and dietary outcomes in a sample of pregnant women with overweight or obesity participating in the Health in Pregnancy …

Plastics, Microplastics, And The Gut Microbiome: Restoring Scientific Communication To Fight For Public Health, Benjamin Sanders '26

Honor Scholar Theses

Over the course of eight years from 2016 to 2024, a study by Nature Medicine found that the concentration of plastics in the brain increased by 50%. Even samples from patients with a documented dementia diagnosis showed a greater accumulation of microplastics (Nihart, 2025). In one of the most protected regions of our body, microplastics have made themselves known. In one of the most exposed regions of the human body, the story is no different. With the emergence of gut microbiome science and understanding, researchers are just beginning to discover the unique interplay between the microbiota of our gastrointestinal tract …

Fast-Food Consumption And Metabolic Syndrome Risk In African Children And Adolescents, Norkinsha Willis

Walden Dissertations and Doctoral Studies

Childhood obesity and excessive fast-food intake represent a significant public health concern among African American children. Grounded in the social-ecological model, this quantitative, cross-sectional study examined whether frequency of fast-food or pizza meal consumption and reliance on low-cost food was associated with total cholesterol (mg/dL) and waist circumference among African American children and adolescents aged 6–15 years while controlling for key sociodemographic factors (age, gender, parental education status, and annual household income). Secondary data from the 2017–2018 National Health and Nutrition Examination Survey were analyzed (N=184). Descriptive statistics, nonparametric analyses, and a multiple linear regression model were used to analyze …

Does What Happens In Vegas Increase Pedestrian Safety? A Longitudinal Study On The Effectiveness Of Pedestrian Bridges, Jalen Paulos, Joaquin Miguel Del Mundo, Brock Wentz, Janel Pietryga

Department of Orthopaedics Faculty Research

Urban populations continue to rise and the frequency that pedestrians are exposed to vehicular traffic continues to increase. The result is an increase in automobile versus pedestrian collisions. This study aims to determine the efficacy of pedestrian bridges in reducing the rates of automobile‒pedestrian collisions. Data for all automobile versus pedestrian collisions and injuries from July 1997 through December 2023 at four distinct intersections along Las Vegas Boulevard were retrieved from the Nevada Department of Transportation. These sites were chosen because of their historically high rates of automobile versus pedestrian incidents and the construction of pedestrian bridges at three of …

Non-Diabetic Kidney Disease In A Patient With Type 2 Diabetes Mellitus: A Diagnostic Challenge, Nikhil R, Mahabaleshwar Mamadapur , Assistant Professor, Harshwardhan S Patil

Digital Journal of Clinical Medicine

Background: Diabetic kidney disease (DKD) is the most common cause of end-stage renal disease. However, non-diabetic kidney disease (NDKD) can coexist or mimic DKD, leading to misdiagnosis. Case Presentation: A 46-year-old female with type 2 diabetes presented with vomiting and abdominal pain. Physical examination revealed non-blanching erythematous papules on both lower limbs. Investigations showed uncontrolled diabetes, metabolic acidosis, and active urinary sediment. Absence of diabetic retinopathy prompted renal biopsy, which revealed immune-complex–mediated glomerulonephritis with small-vessel vasculitis. Diagnosis: Immune-complex–mediated glomerulonephritis with small-vessel vasculitis, not consistent with diabetic nephropathy. Management: Supportive care and immunosuppressive therapy were initiated with improvement in renal function. …

Untangling Impacts Of Socioeconomic Position, Chronic Disease, And Low-Level Pm2.5 Exposure On Mortality Among Native American Medicare Beneficiaries, Judy Wendt Hess, Wenyaw Chan

Faculty, Staff and Student Publications

Ambient fine particulate matter (PM2.5) is associated with increased mortality at concentrations below current regulatory standards. Studies of low-level exposure often rely on large administrative cohorts whose geographic and demographic composition may influence observed associations. In a prior analysis, we observed an association between long-term PM2.5 and all-cause mortality among Native American Medicare beneficiaries living in zip codes within the lowest decile of PM2.5 exposure. The present study, a case-control analysis of 1,713,399 low-PM2.5-exposed beneficiaries enrolled in traditional Medicare during 2015-2016, evaluated whether this association could be explained by geographic context, socioeconomic position (SEP), or baseline health status. We used …

Hormonal Birth Control Misinformation On Tiktok: A Content Analysis Of Influencer Narratives, Sarah Bdeir, Jana Hatahet, Liselle Tungol, Khush Hussain, Rumyah Rafique, Raneem Sabbaq, Ragad Almsaddi

Medical Student Research Symposium

Background:

Hormonal birth control is the most common form of reversible contraception. In the U.S., pharmacy data show oral contraceptive pill prescriptions declined 25.6% from March 2021 to October 2023. Meanwhile, patients increasingly seek health information on social media. On TikTok, “hormone hacking” content has surged, often portraying birth control as artificial, harmful, or even carcinogenic, despite a lack of supporting evidence. While accessible information on social media can be valuable, such narratives risk spreading misinformation, fueling mistrust in women’s health.

Methods:

We conducted a qualitative content analysis of 50 TikTok videos (March and September 2025) under #birthcontrol, #hormonehealth, #birthcontroltoxicity, …

Leveling The Playing Field: Ensuring Hydration Equity For Detroit’S Student-Athletes, David Abdelnour, Noah Kos, Alqasim Elnaggar, Jack Mao, Rumyah Rafique, Julian D Johnson, Marley Sternberg, Audrey Millar, Faith Scott, Susan Lagrand, Ammar Chaudhri, Magd Boutany, Rahul Vaidya

Medical Student Research Symposium

Background:

The Detroit Public Schools Health Corps (DPSHC) provides free sideline medical coverage to Detroit Public Schools Community District (DPSCD) athletic events to address healthcare disparities in underserved communities. During 408 hours of coverage across 214 games, DPSHC volunteers observed frequent shortages of water and electrolyte drinks among teams. Given the importance of hydration in preventing heat-related illness and optimizing athletic performance, a systematic needs assessment was conducted.

Methods:

A survey was distributed to athletic coaches and administrators across DPSCD schools. Survey questions evaluated the availability of hydration resources, frequency of shortages, responsible providers, and priority needs for additional funding …

Single State Agency Licensure Requirements For Substance Use Disorder Treatment Programs In The United States: Results Of A National Survey, Brooks Yelton Ma, Lmsw, Melissa A. Westlake, Amanda J. Abraham, Colleen M. Grogan, Olivia Hinds, Christina M. Andrews

Faculty Publications

Background

Substance use disorder (SUD) remains a critical public health crisis in the United States, with high prevalence and overdose mortality rates. Despite the availability of effective treatments, including medications that significantly reduce overdose risk, fewer than 20% of Americans with active SUD receive treatment annually. Single State Agencies (SSAs), which oversee federal funding and regulate SUD treatment programs, hold significant authority to impose licensure and reporting requirements intended to promote treatment quality.

Methods

This study presents findings from a national survey of SSAs across 50 states and the District of Columbia (94% response rate) conducted between 2020 and 2021, …

Lived Experiences Of Shingles Vaccine-Hesitant Adults Over Age 50 In Riverside County, California, Michelle Beatrice Loomis

Walden Dissertations and Doctoral Studies

Shingles (herpes zoster) causes substantial morbidity, especially among adults over age 50 in the United States. There is a need to better understand the reasons behind low vaccination rates among adults over age 50 given the associated risks for infection and adverse health outcomes that can reduce their quality of life. This qualitative interpretative phenomenological study explored how individuals’ perceptions of the benefits, barriers, susceptibility, and severity of shingles influence vaccine intentions and identified what factors influence vaccine uptake. The health belief model was used to guide the study. Data were collected from one-on-one semistructured virtual interviews with eight adults …

Evaluating The Relationship Between Vitamin D Supplementation, Lifestyle, Social Determinants Of Health, Asthma, And Respiratory Tract Infections, Yun O'Donnell

Walden Dissertations and Doctoral Studies

Hypovitaminosis D is a significant public health concern in the United States associated with inadequate sunlight exposure and insufficient dietary intake. Asthma is a chronic respiratory condition that progressively worsens over time. While asthma is typically managed through individual-level treatment approaches, population-level strategies such as vitamin D supplementation and food fortification policies have not been implemented. A five-tier Public Health Impact Pyramid theoretical foundation guided this nonexperimental quantitative cross-sectional study. Data from 2013-2014 and 2017-2018 NHANES (n = 1,456) was evaluated for relationships between vitamin D supplementation, duration of sunlight exposure, and food security index, with asthma, asthma exacerbation severity, …

Geographic Variation In Adrd Prevalence And Mortality And Their Association With Social Vulnerability Across Us Counties: A Spatial Epidemiological Analysis Using Norc And Cdc Svi Data, Dean Kyne

Sociology Faculty Publications

Introduction: Geographic disparities in Alzheimer’s disease and related dementias (ADRDs) remain insufficiently understood at the national scale, limiting efforts to address inequities in dementia burden across USA communities. This study examined county-level variation in ADRD prevalence and mortality and evaluates the association between social vulnerability and these outcomes.

Methods: This cross-sectional ecological study analyzes 2020 county-level ADRD prevalence and all-cause mortality among Medicare beneficiaries from the NORC Dementia DataHub. The analytic sample included 3,108 USA counties in the contiguous USA and the District of Columbia. ADRD outcomes included (1) prevalence of highly likely ADRD and (2) prevalence of all determinations, …

The History Of Women In Neuroradiology In North America From 1990 To The Present, Vijay M. Rao

Department of Radiology Faculty Papers

From 1990 to 2024, women neuroradiologists in North America have made tremendous progress in the areas of leadership, clinical innovation, research, education, diversity, equity and inclusion, and global outreach. This chapter begins with summaries of their key accomplishments in four broad domains, followed by short biographical sketches of numerous luminaries organized by leadership roles and areas of expertise, and ending with conclusions and future directions.

The Role Of Outer Setting Health System Factors In The Use Of Hydroxyurea For Ugandan Children With Sickle Cell Anemia, Rollins Angela, Joseph Rujumba, Ruth Namazzi, Deogratius Munube, John Chandy, Russell Ware, Doreen Apolot, Andew Ssali, Henry Nancy, Robert Opoka

Paediatrics and Child Health, East Africa

Sickle cell anemia (SCA) causes childhood morbidity and mortality in Uganda and other countries in sub-Saharan Africa. Hydroxyurea is safe and effective, but not currently widely used in Uganda. We piloted a toolkit to support hydroxyurea use in two public health clinics: a regional referral hospital in a peri-urban area and a district hospital in a rural area. Implementation supports included a manual, expert training, and coaching over 2 years. We conducted key informant interviews and focus groups with national stakeholders, hospital leaders, healthcare workers, patient caregivers, and patients early in Year 1 and later in Year 2. Embedded research …

A Mixed-Methods Research Study: Nc Health Department Directors’ Perspective On Local Impact Of Early Medicaid Expansion, Asma Warrich

MUSC Theses and Dissertations

North Carolina became the 41^st state to expand Medicaid under the Affordable Care Act. The bipartisan expansion addressed longstanding challenges; however, little is known about how Local Health Departments (LHDs) adapted to this policy change, especially in the 24 months following expansion. This study sought to fill that gap by documenting the perspectives of LHD Directors in North Carolina utilizing a ten-question REDCap survey with closed- and open-ended questions. Purposeful sampling targeted all 86 LHD Directors. Data was collected anonymously between November 2025 and January 2026. Descriptive and thematic analyses were conducted. Thirty LHD Directors completed the survey, which …

Program Development For Maternal Mental Health During The Transition To Motherhood, Lindsey A. Lindsley, Cassandra Nelson

Spring 2026 OTD Capstone Symposium

The transition to motherhood can be both rewarding and challenging, with many women experiencing increased vulnerability to postpartum depression (PPD). This capstone project focused on developing and implementing a six-week maternal mental health program designed to support postpartum women through education, occupational engagement, and peer connection. Grounded in the Model of Human Occupation (MOHO), the program used a hybrid format combining in-person and virtual sessions to improve accessibility. Program outcomes were evaluated using surveys, the Occupational Self Assessment (OSA), and participant feedback. Participants demonstrated increased knowledge of postpartum mental health, greater confidence in their maternal roles, and improved ability to …

Occupational Therapy For People With Internet Gaming Disorder: A Concept Paper, Samuel R. Bender, Steven Gerardi

Spring 2026 OTD Capstone Symposium

Internet Gaming Disorder (IGD) is associated with occupational imbalance and disrupted routines, contributing to challenges in occupational participation and performance. Due to there being a gap in occupational therapy-based research and guidance for people with IGD, this capstone project focused on the development of a concept paper informed by The Model of Human Occupation (MOHO) that frames problematic video gaming as an occupational issue. The concept paper organizes assessment strategies, identifies problems, outlines intervention ideas, and discusses potential next steps for assisting people with IGD within occupational therapy. This capstone project is intended to help current occupational therapists more effectively …

Validity And Reliability Of The Wut Hydration System When Assessed In The Afternoon, Peyton A. Hines, Rosie Perez, Rebecca Allen, Shawn Wierick, Xiujing Zhao, Corey Butts, Brendon Mcdermott

2026 Honors Symposium

The WUT (weight, urine color, and thirst) Venn diagram is recommended for individuals to self-assess their hydration status. However, current research is limited to comparisons between morning first-void markers and 24-hour markers. PURPOSE: To examine the validity and reliability of afternoon WUT scores in comparison to 24-hour hydration status. METHODS: Fifty participants (25 ± 8y, 72.2 ± 14.9kg) voluntarily participated in this study. Participants collected afternoon spot urine between 2:00 and 4:00 pm and 24-hour urine samples on three out of seven consecutive days. Body mass (BM), urine color (Ucol), urine osmolality (Uosm), urine specific gravity (USG), and thirst perception …

Paws And Practice: Overcoming Barriers To Mindfulness, Hazel Norris

2026 Awards for Excellence in Student Research and Creative Activity - Documents & Media

With the rise in chronic illnesses, healthcare professionals have sought to improve habits and behaviors to extend longevity and quality of life. However, for many people, unhealthy habits, such as smoking or binge eating, may develop as a way of coping with life stressors, which can make behavior changes harder to implement. Recently, there has been an increase in new research on whether improving mindfulness could be used to combat this problem. If mindfulness does encourage more engagement in health-promoting behaviors while protecting against risky behaviors, mindfulness-based behavior interventions could be very valuable for improving the health of college students …

Preoperative Health During A Pandemic: An Observational Study Assessing Lifestyle Changes In Patients Associated With Covid-19 In Western Australia, Nadine Radin, Dana Hince, Jim Codde, Paola Chivers, Dale W. Edgar

Research outputs 2022 to 2026

Background and Aim: Healthcare service disruptions resulting from the COVID-19 pandemic led to substantial changes in surgical pathways across public hospitals in Western Australia (WA). These disruptions, compounded by restrictions and containment measures, influenced the health and lifestyle behaviours of the WA community, including patients awaiting surgery. This study aimed to assess changes in self-reported modifiable lifestyle risk factors among patients during COVID-19. Methods: This observational study analysed hospital patient data across three seasonally matched calendar periods: Period 1 (January–March 2019 vs 2020), Period 2 (March–July 2019 vs 2020), and Period 3 (July–December 2019 vs 2020). Multivariable regression models were …

Impact Of Cannabis And Cannabis Legalization On Us Atrial Septal Defect Rates, Albert Stuart Reece, Hulse

Research outputs 2022 to 2026

Atrial septal defect (ASD) affects 1:11.3 children in some US states; however, the antecedents of these trends are yet to be identified. A total of 1882 ASD rates (ASDRs) for 2003–2020 were sourced from the National Birth Defects Prevention Network reports. A total of 406,893 ASDs are reported. Substance (cigarettes, binge alcohol, cannabis, cannabinoids, analgesics, cocaine) exposure data were taken from the National Survey of Drug Use and Health. Income and ethnicity data were derived from the US Census. Adjustment was performed by mixed effects, survey and generalized additive regression. Causal analysis was by inverse probability weighting and E-values. Data …

Longitudinal Assessment Of Health-Related Quality Of Life In Adults With Ckd, Owen Ng, Teixeira-Pinto, Anh Kieu, Anita Van Zwieten, Anoushka Krishnan, Kirsten Howard, Wai H. Lim, Jeremy R. Chapman, Simon D. Roger, Michael J. Bourke, Shaundeep Sen, Steven J. Chadban, Carol A. Pollock, Allison Jaure, Jonathan C. Craig, Jean Yang, Germaine Wong

Research outputs 2022 to 2026

Key Points: Dialysis linked with poorer quality of life compared with transplant patients and patients with CKD. Quality of life trends were similar in both domain-specific and overall quality-of-life measures. Background: There are sparse data about the change in health-related quality of life (HRQoL) with the temporal progression of CKD. In this study, we assessed the association between change in CKD stages, overall and domain-specific quality of life and determined the factors that were associated with this change. Methods: Data were sourced from a multicenter study that included 1290 adult patients aged 18 years and older across six centers in …

Space-Time Analysis Of Burgeoning Us Atrial Septal Defect Rates Driven By Cannabis, Albert Stuart Reece, Kenneth Hulse

Research outputs 2022 to 2026

Atrial septal defect (ASD) has become increasingly common in the USA and now affects 1 in 11.3 children in some places, but space–time analysis has not been applied to this emerging trend. ASD rate (ASDR) data were obtained from the National Birth Defects Prevention Network 2003–2020. Substance (cigarettes, alcohol, cannabis, analgesics, cocaine) use data were obtained from the National Survey of Drug Use and Health. Income data were obtained from the US Census. Analysis was limited to the Non-Hispanic White population by technical factors. Time-sequential univariate and bivariate maps were prepared for both covariates and outcomes and their combinations. Spatial …