Public Health Education and Promotion Commons^™

"Health Gatekeepers": The Influence Of Women On Health Practices In Rural, Central Appalachia, Reese Lycan

Senior Theses

Women have historically assumed leadership roles in familial and community health promotion, intervention, and facilitation. While the role of women in family health is globally understood and the historical importance of female leadership has been documented, there remains a gap in knowledge regarding the role of women as “health gatekeepers”. Furthermore, when considering the Appalachian region, there are limited studies regarding women’s place in leadership as far as health is concerned. Therefore, this study employs a hermeneutic phenomenological framework to explore the lived experiences of women in relation to their family and community’s health in rural, Central Appalachia- a region …

Delta-8 Tetrahydrocannabinol Policy And Related Health Impact Among College-Aged Individuals In South Carolina: A Scoping Review, Emily K. Luoma

Senior Theses

After the 2018 Farm Bill passed, loopholes were quickly found that led to the popularization of delta-8 THC, a derivative of delta-9 THC, more commonly known as marijuana. Use of this substance became particularly high in states that criminalized marijuana, such as South Carolina. This scoping review aimed to assess South Carolina’s current delta-8 policies in the context of health-related impacts among college-aged students. Comprehensively analyzing the results of relevant studies, it was determined that there are three commonly observed threats to public health that are direct outcomes of existing policies: 1) a lack of quality control standards; 2) misleading …

Adverse Childhood Experiences And The Impact Of Resiliency On Child Behavior: A Quality Improvement Project, Macy Kraft

Graduate Theses, Dissertations, and Capstones

Background: Adverse Childhood Experiences can have a significant impact on a person’s future health and wellness. Therefore, it is necessary for healthcare professionals to increase their understanding of possible mediating factors to lessen the impact of these experiences should they occur.

Purpose: The purpose of this project was to evaluate the effectiveness of an evidence-based quality improvement initiative designed to enhance the formal behavioral assessments of pre-school children following the participation of their caregivers in an ACEs and resiliency educational intervention.

Methods: Implementation of a two-armed intervention; a brief educational session aimed at providing an introduction to ACEs and a …

Aiding Counseling Services To Increase Cultural Knowledge About Black And Lgbtq+ Populations, Brianna L. Walden

Public Health Capstone Projects

OBJECTIVES: The capstone project I would like to undertake is the creation of a quality improvement plan for the counseling and social work department of The Children’s Home to help them expand to reach vulnerable populations. A quality improvement plan, along with graphics reflecting the current data about mental health, will be delivered to The Children’s Home which they will be able to use in future projects and grant applications.

METHODS: The methods and research will be based on the 2024 Community Health Needs Assessment (CHNA) and Community Counseling Needs Assessment conducted by The Children’s Home in August 2024 to …

Fact Sheet: Fentanyl, Aaron Hunt, Gabriela Murza, Amy May, Jenna Hawks, Alyssa Ferrin

All Current Publications

This fact sheet provides essential information on fentanyl, a potent synthetic opioid increasingly found in illegal street drugs, posing significant overdose risks. It highlights how opioids affect the body, the dangers of fentanyl, and the importance of harm-reduction strategies, such as fentanyl test strips, naloxone access, and safe syringe disposal. Information on signs and symptoms and how to respond to an overdose are also included.

Awareness On Environmental Air Pollution Among Adults In Rural Mysuru, Rakesh M, Jesymol Joy, Sunil Kumar D

Digital Journal of Clinical Medicine

Introduction

Air pollution is a major environmental threat and one of the main cases of death among all risk factors known so far. Health effects also include preterm and low-birthweight, asthma as well as cognitive and neurological impairment basically having the potential to impact our whole body, way beyond our lungs. The proposed study focusses on to assess the awareness on air pollution and factors associated with it among adults in South Mysuru which can put a light on the preventive measures and policies to be taken by the individuals as well as the authorities.

Methodology

A Community-based cross-sectional study …

Your Healthiest Year Yet: Practical Tips For Mental And Physical Well-Being, Aaron Hunt

All Current Publications

As a new year begins, it’s important to prioritize our health. In a world that continues to evolve, maintaining mental and physical wellness is key to thriving in both personal and professional life. Small, intentional changes can lead to transformative results, improving not only how we feel but also how we connect, grow, and succeed. This guide presents actionable tips for fostering mental clarity, physical strength, and overall balance, all grounded in evidence-based practices. Whether you're looking to boost your fitness, reduce stress, or enhance your daily routines, these strategies will empower you to make this year your healthiest yet.

Establishing A Student-Run Mobile Clinic In Appalachian Kentucky: A Community-Based Pilot Program To Address Health Inequities, Bradley A. Firchow, John C. Cornelius

Journal of Appalachian Health

The establishment of a student-run mobile clinic in Morehead, Kentucky, led by students from the University of Kentucky College of Medicine’s (UKCOM) Rural Physician Leadership Program (RPLP), aims to address health inequities in rural Appalachian communities. This pilot program is designed to serve vulnerable populations, including the unhoused, by delivering free, accessible healthcare services directly to underserved populations. This program serves as a model for expanding access to healthcare in rural regions while promoting a collaborative, community-based approach to addressing social determinants of health.

Investigating Suicide Risk Factors Among Appalachian West Virginian Adults, Erin D. Caswell, Angela M. Dyer, Summer D. Hartley, Caroline P. Groth, Mary Christensen, Sahiti K. Tulabandu, Bryce K. Weaver, Ruchi Bhandari

Journal of Appalachian Health

Introduction: Suicide rates in the United States have increased over the past two decades, with rural areas, particularly the Appalachian Region, facing unique challenges that elevate suicide risk. These include economic hardships, social isolation, and limited access to mental health services.

Purpose: This study addresses critical gaps in understanding lifetime suicide risk in West Virginia (WV), a predominantly rural state entirely within the Appalachian Region. By identifying the factors driving urban-rural differences in suicide risk, this research seeks to inform interventions tailored to the state's distinct needs and provide insights applicable to the broader Appalachian Region

Methods: Using 2021 Mountain …

Case Report On Endocrine Induced Paralysis - " Unraveling The Impact Of Thyrotoxicosis On Potassium Homeostasis.", Srujith Pullipudi, Basava Chethan, Srinath K. M, Savitha Vijayakumar, Meghna B.S.

Digital Journal of Clinical Medicine

Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism, marked by episodes of muscle weakness and hypokalaemia. Although it predominantly affects young Asian men, it can also occur in females and individuals from non-Asian ethnic groups. TPP is a treatable form of hypokalaemic periodic paralysis and can often be the first indication of thyrotoxicosis. Triggers such as a high-carbohydrate diet, strenuous exercise, emotional stress, and steroid use can provoke TPP attacks. During an acute episode, the key diagnostic indicators are hypokalaemia along with elevated levels of thyroxine (T4) and triiodothyronine (T3). Treatment consists of two phases: promptly correcting hypokalaemia …

Mental Health Conditions Of Adults With Chronic Obstructive Pulmonary Disease And Comorbidities, Amanda M. Hinson-Enslin, Luis E. Espinoza, Jennifer L. Talleff

Journal of Social, Behavioral, and Health Sciences

Although the association is not well understood, people with COPD are likely to suffer from mental health issues such as depression and anxiety. Due to this occurrence, the aim of the present study is to better understand the mental health experience and COPD comorbidities of U.S. adults with a COPD diagnosis. The final sample comprised 1,676 U.S. adults who were surveyed in the 2019 National Health Interview Survey adult public file. Logistic and ordinal regression were used to calculate adjusted odds ratios for comorbid conditions predicting depression, anxiety, and the number of mental health issues, respectively. Depressive symptoms were more …

Investigating The Impact Of Phthalate Exposures From Personal Care Products On Uterine Fibroid Incidence And Prevalence In Us-Born Black Women, Ella Brissett

CMC Senior Theses

Uterine fibroids are benign tumors composed of smooth muscle cells and connective tissue that develop within or on the walls of the uterus. Despite being non-cancerous, they can severely affect quality of life by causing heavy bleeding, chronic pain, and reproductive complications. Fibroids are typically found in women of reproductive age, but they disproportionately affect Black women, who experience higher incidence and severity. The underlying causes of this disparity is poorly understood; however, an emerging body of research is highlighting the role of phthalates, endocrine-disrupting chemicals found in many personal care products, in exacerbating fibroid development. Through a critical analysis …

Prevalence Of Depression And Its Coping Strategies Among Rural And Urban Geriatric Population, Mohit Negi, Smitha M C

Digital Journal of Clinical Medicine

Background: Aging is a natural process, and older age is a period in which most aspects of life require support from others. Globally, Depression is a serious public health concern among elderly populations. The aim of this study was to estimate the prevalence of depression and its coping strategies among geriatric population and to evaluate the association between socio-demographic factors and level of depression.

Methods: A cross-sectional study was conducted among 410 study participants in both rural and urban areas. Geriatric Depression Scale (GDS-15) was used to measure the depression and brief-COPE (28-items) scale was used to measure the coping …

Hemifacial Spasm Due To Dolichoectasia Of Vertebral And Basilar Arteries, Meena Iyer, Shasthara Paneyala Dr.

Digital Journal of Clinical Medicine

Dolichoectasia refers to the non-focal dilatation and tortuosity of arteries, primarily affecting the vertebral and basilar arteries due to severe tunica intima degeneration. It is associated with genetic predisposition and atherosclerosis, leading to vessel wall weakening. Patients may remain asymptomatic or develop neurological deficits due to mass effect. We report a case of a 60-year-old male presenting with hemifacial spasm secondary to vertebral artery dolichoectasia. Magnetic Resonance Angiography (MRA) revealed ectatic and tortuous basilar and vertebral arteries, with the left vertebral artery compressing the left facial nerve complex. Using Smoker’s criteria, a diagnosis of dolichoectasia was confirmed. Dolichoectasia-induced hemifacial spasm …

Allergic Bronchopulmonary Aspergillosis In Pediatric Asthma : A Diagnostic Challenge Mimicking Tuberculosis, Praveen Das, Santosh Kondekar, Surbhi Rathi

Digital Journal of Clinical Medicine

Allergic bronchopulmonary aspergillosis (ABPA) is a rare hypersensitivity reaction to Aspergillus fumigatus, more commonly observed in adults and patients with cystic fibrosis. It can, however, present in pediatric asthmatics with refractory symptoms, leading to diagnostic challenges due to overlapping features with other pulmonary diseases, including tuberculosis. ABPA should be considered in children with uncontrolled asthma and atypical radiologic features, especially when unresponsive to standard therapies. Early recognition and appropriate management are critical to prevent irreversible lung damage and improve quality of life.

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Assessment Of Effectiveness And Evaluation Of Perception Among Students Towards Flipped Classroom Learning: A Prospective Study., Nagaraja Prasad Sai, Vedavathi Hanumaiah, Shreenivas Prabhakar Revankar, Shruthi S. Lingesh, Avanthi Eshwar

Digital Journal of Clinical Medicine

BACKGROUND: Flipped learning (FL) is a teaching learning approach in andragogy. In FL students are involved in self-directed learning with the teacher acting as a facilitator and a moderator. Introduction of Competency Based Medical Education led many educators to shift from traditional teaching to blended teaching learning methods. This study was conducted to assess effectiveness and evaluate students’ perception towards FL.

AIM AND OBJECTIVES: To assess effectiveness of FL teaching in improvement of student scores and to evaluate student’s perception towards FL teaching.

MATERIALS AND METHODS: Pre-class activities included study materials in the form of PowerPoint slides …

Evaluating The Efficacy Of Vertical Integration In Training Undergraduate Medical Students Under Competency Based Medical Education Curriculum, Pratham Mehta, Yashika Sharma, Kishor M, Arun M

Digital Journal of Clinical Medicine

Background: The National Medical Council in the Indian Medical Graduate guidelines to enhance learning, recommends Vertical and Horizontal Integration. Vertical integration may be defined as a curricular strategy that aligns para-clinical and clinical teaching across time with a view to enhancing relevance and application of knowledge. The present study is an attempt to test whether vertical integration of Forensic Medicine and Psychiatry is associated with greater short-term learning gains and improved student perceptions compared with conventional didactic lectures.

Methods: With Institutional and Ethics Committee clearance, a two-phase quasi-experimental study was performed across two consecutive academic cohorts (Phase 1, …

Beyond Grit: Structural Determinants Of Resilience Among College Women With Children In The U.S., Juliana Kahrs

Dissertations of Practice

This critical quantitative analysis explores how social determinants of health, including basic needs security, caregiving and work responsibilities, healthcare access, discrimination experiences, and institutional support predict resilience among U.S. college women with dependents. Using data from the Spring 2021 ACHA-NCHA III survey (n = 4,417), this study integrated the Health Equity Framework with the Social Ecological Theory of Resilience to examine multilevel influences on resilience. Descriptive analyses highlighted disproportionate burdens among single, first-generation, and racially minoritized groups. Bivariate chi-square tests revealed significant associations between resilience and sense of belonging, basic needs security, employment, healthcare utilization, and self-assessed overall health. Multinomial …

Comparison Of The Effectiveness Of Preoperative Dexmedetomidine Nebulization Versus Lignocaine Nebulization In Attenuation Of Stress Response During Direct Laryngoscopy And Endotracheal Intubation In Elective Surgeries Under General Anaesthesia: A Randomised Control Study At A Tertiary Care Hospital, Mandya, Sumayya E., Kiran A V., Santhosh M C B., Shivakumar G

Digital Journal of Clinical Medicine

Introduction: Direct laryngoscopy and tracheal intubation are known to provoke harmful stimuli that can lead to transient, unpredictable, and variable hemodynamic alterations, primarily due to heightened sympathoadrenal activity.¹ Various pharmacological agents have been explored to mitigate this stress response; however, none have emerged as optimal.²

Aim: This study aims to compare the effects of nebulized dexmedetomidine in comparison to nebulized lignocaine on the hemodynamic stress response during direct laryngoscopy and tracheal intubation, including any adverse effects in patients undergoing general endotracheal anesthesia.

Materials and Methods: Informed consent was obtained from 60 patients aged 18 to …

Myocardial Infarction Trends Following Covid-19 Vaccination: A Retrospective Investigation From India, Hema S. Pinnam, Hrithika Madhavan, Jagarlamudi Harshitha, Vikram Patil, Harshita Tiwari, Isha A. Kumthekar, Jampala Sri Mounya

Digital Journal of Clinical Medicine

Background: The relationship between COVID-19 vaccination and the incidence of myocardial infarction remains a topic of debate. The study aimed to analyze the demographic, clinical, and outcome characteristics of MI patients post-vaccination in India, focusing on differences between Covishield and Covaxin recipients.

Methods: The retrospective observational study included 303 MI patients admitted to a tertiary care center. Data were collected on demographics, comorbidities, vaccination status, ICU admissions, and outcomes. The Charlson Comorbidity Index (CCI) was used to assess disease severity. Statistical analyses evaluated the associations between vaccination status, clinical parameters, and mortality.

Results: Among the study population, 74.3% were males, …

Study Of Maternal And Fetal Outcomes In Pregnancy Complicated By Thyroid Disorders, Sindhu Kumari, Poornima M

Digital Journal of Clinical Medicine

Background:

Thyroid disorders, particularly hypothyroidism, are common during pregnancy and can significantly impact both maternal and fetal outcomes. Despite advancements in screening and treatment, thyroid dysfunction in pregnancy often remains underdiagnosed, especially in low-resource settings. This study aimed to evaluate the prevalence, outcomes and effective management strategies of thyroid dysfunction during pregnancy.

Objectives: To evaluate the prevalence and outcomes of thyroid dysfunction, including both hypothyroidism and hyperthyroidism, during pregnancy, and their associated maternal and fetal complications.

Methods: This prospective observational study included 281 pregnant women with thyroid disorders attending antenatal care at JSS Hospital, Mysuru, from August 2022 …

Felt Need For Psychiatry Clubs In Medical Colleges To Enhance Teaching-Learning, Aditya Rao, Sheryl Agarwal, Sharanya Bose, M Kishor

Digital Journal of Clinical Medicine

Mental health competence is critical for medical graduates, yet in India the treatment gap for common mental disorders remains substantial, with prevalence estimates indicating up to 80.4% of unmet need. Recent reforms under the Competency-based Medical Education (CBME) curriculum have expanded psychiatry training; however, deficiencies in applied skills, preventive psychiatry, and communication remain. Psychiatry clubs have been proposed as supplementary, student-led platforms to address these limitations. This cross-sectional study assessed the perceived need for psychiatry clubs among undergraduate medical students and explored their potential role in enhancing teaching–learning. A structured online survey was administered to 94 students across different phases …

Changing Climate, Changing Health: Perspectives From General Population In Mysuru, Lekhashree A, Manirsha P V, Paranthaman Chinnasamy, Srishti Arya, Sunil Kumar D

Digital Journal of Clinical Medicine

Background: Climate change has emerged as a major public health concern, contributing to rising morbidity and mortality worldwide. In India, increasing heat waves, unpredictable rainfall, and deteriorating air quality have intensified climate-sensitive health conditions. This study aims to assess the health impacts of climate change among the general population of Mysuru.

Methodology: A community-based cross-sectional study was conducted among 400 residents of Mysuru (April–June 2024). Participants were recruited through simple random sampling. Data were collected using a pre-tested semi-structured questionnaire via Google Forms. Analysis was performed using SPSS v26, with descriptive and inferential statistics.

Results: Among 400 participants, …

A Study Of Electrocardiogram And Echocardiography Parameters Of Post Covid – 19 Patients, Venkateswararao K, Durga Prasad Sadhupati

Digital Journal of Clinical Medicine

Background: Coronavirus Disease – 2019 [COVID-19] infection is multisystem disease not restricted to the lungs it has negative impact on Cardiovascular system by activation of ACE-2 receptors causing plaque stability, vascular inflammation and MI. ECG and 2D ECHO is a simple bed side diagnostic test can be used to assess cardiovascular disease involvement in such patients. We aimed to find out ECG and 2D ECHO abnormalities of Covid – 19 patients. To Study relation of SARS-COV-2 infection and Prevalence of Cardiovascular disease.

Methods: We perform Cross Sectional study among 500 Post Covid – 19 patients [>20 and

Results: Out …

Pregnancy-Related Delusional Beliefs In Midlife And Late-Life Women: A Case Series, Dyuksha Arora, Ashita Adarsh, Kishor M. Manohar Rao, Anand R, Soumya Rajshekar Patil, Akshatha Cj

Digital Journal of Clinical Medicine

Pseudocyesis and delusional pregnancy represent rare but clinically significant presentations across psychiatric practice. While pseudocyesis involves a false belief of pregnancy accompanied by physical manifestations, delusion of pregnancy refers to a fixed belief of being pregnant despite clear contrary evidence. Both conditions pose considerable challenges as they involve close consultation and liaison between Obstetrics & Gynaecology and Psychiatry. There are a few studies from tertiary care general hospitals in India. Here we report two case series.

Case 1: A 43-year-old married woman from a rural background with an 8-year history of recurrent depressive disorder and dysthymia, presented with 3 months …

Subclinical Myocardial Disease: The Next Frontier In Cardiovascular Prevention., Param Darpan Sheth, Chandana S., Nimrah Rehman

Digital Journal of Clinical Medicine

Subclinical myocardial disease refers to pathological cardiac changes that precede overt symptoms. It represents an emerging frontier in cardiovascular disease prevention; wherein early detection of myocardial dysfunction could allow timely intervention to avert heart failure (HF) and other outcomes. This narrative review summarizes the current and emerging tools for detecting subclinical myocardial disease, including advanced cardiac imaging and circulating biomarkers, and discusses their potential to improve risk stratification and preventive care in asymptomatic high-risk individuals. Novel echocardiographic measures such as global longitudinal strain (GLS) can unmask subtle systolic dysfunction despite preserved ejection fraction, while cardiac magnetic resonance (CMR) tissue mapping …

One Airway, One Disease In Pregnancy: A Prospective Observational Study On The Correlation Between Upper And Lower Airway Inflammation In Pregnant Women, Durga K, Yuvarajan S

Digital Journal of Clinical Medicine

Background: The well-established "One Airway, One Disease" concept recognizes the deep physiological and pathological connections between conditions affecting both the upper and lower respiratory tracts, most notably allergic rhinitis and asthma. During pregnancy, a woman's body undergoes significant immunological, hormonal, and physiological changes, which can profoundly influence and modulate existing or emerging airway inflammation.

Objective: This prospective observational study was designed with the primary objective of meticulously evaluating the correlation between upper and lower airway inflammation in pregnant women. We aimed to achieve this by assessing a range of clinical symptoms, objective functional parameters, and specific inflammatory markers.

Methods: We …

Comparision Of Buprenorphine Versus Butorphanol As An Adjuvant To Intrathecal Hyperbaric Bupivacaine For Elective Infraumbilical Surgeries : A Randomised Control Study At A Tertiary Care Hospital, Mandya, Surabhi C A, Dr. Kiran A V. Associate Professor, Dr. Shivakumar G Pofessor And Hod, Umesh N P

Digital Journal of Clinical Medicine

Introduction: Spinal anaesthesia is the most popularly performed procedure in the field of anaesthesiology. Hyperbaric bupivacaine, the local anaesthetic most commonly used, has limitation as its effect lasts only for 1.5-2 hours. Hence a lot of adjuvants have been tried to enhance the analgesic effect of bupivacaine.^[2] Opioids remain the mainstay among the various adjuvants to local anesthetics in spinal anaesthesia primarily by virtue of its various properties such as reducing the dose of local anaesthetic, minimizing side effects, and prolonging the duration of anaesthesia.^[3]

Aim: This study aims to compare the sensory and motor characteristics …

Smart Goal-Setting On Behaviors To Enhance Intrinsic Motivation For Exercise: A Pilot Study With Orangetheory Fitness Participants, Adam Relitz

Williams Honors College, Honors Research Projects

Abstract

PURPOSE: Sustaining long-term motivation for exercise remains a challenge within health and fitness, particularly when extrinsic factors like weight loss dominate motivational strategies. This study investigates the role of behavioral SMART (Specific, Measurable, Achievable, Relevant, Time-bound) goal-setting in fostering intrinsic motivation, a self-driven form of engagement, among participants in a structured fitness program. The primary aim was to evaluate the effectiveness of a SMART goal-setting curriculum in promoting intrinsic motivation and behavior-based goals over external outcomes like losing weight. METHODS: Participants (N = 24) were recruited from a fitness challenge program and selected one behavioral SMART goal from a …