Digital Commons Network^™

Exploring The Association Between Social Media Use Frequency And Violence-Related Behaviors Among U.S. High School Students: A Cross-Sectional Analysis Of The 2023 Youth Risk Behavior Survey, Luma Hammoudi

ETDs from 2020-2029

Youth violence remains a major public health concern in the United States (U.S.), with firearm injuries now the leading cause of death among children and adolescents. At the same time, social media use has become nearly universal among youth, raising concerns about how online interactions may influence violence-related behaviors. Social media platforms can facilitate peer conflict, electronic bullying, and public exposure to aggressive behaviors, which may extend into offline environments such as schools and communities. However, the relationship between social media use frequency and youth violence remains understudied. This study examined the relationship between frequency of social media use and …

Electrophysiological Retinal Changes In Aging And Its Implication In Alzheimer’S Disease, Samuel Jacob Haskins

ETDs from 2020-2029

Alzheimer’s disease remains one of the most expensive and fatal diseases facing medical practitioners to this day. According to the CDC, statistics show that it is the seventh leading cause of death worldwide. In addition to fatalities, there is a tremendous financial and emotional cost of dementia to the patient and surrounding caregivers. Improved screening techniques and new treatments for this disease are a priority of several institutes within the NIH. Early detection and early intervention are critical to improve the outcomes of patients worldwide. Amyloid beta plaques and neurofibrillary tangles (NFT) are two of the most important protein aggregates …

Ambulatory Blood Pressure Monitoring Phenotypes And Circadian Blood Pressure Patterns Among Adults Referred For Diagnostic Evaluation At Aga Khan University Hospital, Nairobi, Kenya: A Retrospective Cross-Sectional Study, Nadeem Kassam, Mzee Ngunga, James Orwa, Alisa Bhojani, Mohamed Varwani, Swaffiya Salim, Yvonne Oketch, Salim Surani, Anthony Ochola, Barbara Karau, Jeilan Mohamed, Etienne Amendezo

Internal Medicine, East Africa

Introduction: hypertension represents the primary modifiable risk factor for cardiovascular disease and poses a public health challenge in sub-Saharan regions, with Kenya experiencing particularly low detection and control rates. Traditional office-based blood pressure measurements often fail to detect key phenotypes, such as white-coat and masked hypertension. Ambulatory Blood Pressure Monitoring (ABPM) offers a comprehensive 24-hour profile that excludes white-coat hypertension and allows for the evaluation of circadian patterns, including nocturnal hypertension and non-dipping status, both of which are recognized as high-risk phenotypes strongly linked to adverse cardiovascular events. This study evaluated ABPM data from Aga Khan University Hospital, Nairobi …

Advance Care Planning In Metastatic Lung Cancer Patients: A Quality Improvement Initiative, Khanh H. Thai

Student Theses

Background: Advance care planning (ACP) is essential in achieving goal-concordant care for patients with metastatic lung cancer (MLC), yet it remains underutilized.

Local problem: Despite its benefits, ACP has been inconsistently integrated into outpatient oncology settings, and a baseline evaluation at the project site revealed that only 11% of patients with MLC had ACP documented in the outpatient care clinic.

Methods: This Quality Improvement initiative implemented a formal, Nurse Practitioner (NP)-led intervention into routine oncology care. Using a quasi-experimental nonrandomized design, 13 eligible patients diagnosed with MLC without prior ACP documentation were enrolled in a four-week study. These participants were …

Increasing Lead (Pb) Screening Participation Rates In The Pediatric Patient Population At The Philadelphia College Of Osteopathic Medicine Lancaster Avenue Community Healthcare Center, Jacob Varrato

PCOM Biomedical Studies Student Scholarship

Elevated blood lead levels (EBLLs) are an ongoing public health crisis predominantly affecting children under six in low-income communities located in major cities across the United States (Zartarian et al. 2024). Chronic lead exposure due to outdated housing, polluted water, and contaminated soil is especially harmful in early childhood. Frequent hand to mouth contact at this age increases the risk of ingesting particulate matter containing lead (CDC). EBLLs can predispose children to neurocognitive deficits, cardiovascular disease, and epigenetic modifications to gene expression patterns (Collin et al. 2022). While precautionary measures and timely screening protocols greatly reduce the risk of developing …

The Dermatologic Effects Of Climate Change On Skin Of Color Populations: A Comprehensive Review, Grace Ugwueke, Simona A. Alomary, Nicole J. Baker, Susan C. Taylor Md, Nada Elbuluk Md

Student Papers, Posters & Projects

Background: Climate change contributes to rising temperatures, worsening air pollution, increasing UV exposure, and more frequent extreme weather events with downstream consequences for dermatologic conditions. However, limited research has examined how these climate-related effects can impact skin of color (SOC) populations, who often face disproportionate environmental exposures and structural inequities. Objective: To summarize the dermatologic implications of climate and environmental stressors on SOC populations. Methods: A literature search of PubMed and Embase (2000-2025) identified studies assessing dermatologic outcomes related to climate change or environmental exposures. Of 1254 records screened, 133 duplicates were removed, leaving 1121 studies for evaluation. Twenty-three studies …

Neuroinflammation And Neuropathology In A Novel Tau, Amyloid-Beta And Alpha-Synuclein Co-Pathology Model, Jhodi Mickayla Webster

ETDs from 2020-2029

Neurodegenerative diseases including Alzheimer’s disease (AD) and Parkinson disease (PD) often present with overlapping proteinopathies rather than aggregated proteins in isolation. Amyloid-β (Aβ) and phosphorylated tau are found in a substantial proportion of idiopathic PD cases, while α-synuclein (α-syn) pathology is present in over half of AD cases. The presence of these co-pathologies is associated with accelerated cognitive decline and increase mortality in these patients. In parallel, neurodegenerative diseases are increasingly recognized as being shaped by interactions between central nervous system (CNS) pathology and the immune system. Despite this, most experimental animal models of neurodegenerative disease examine single pathologies in …

The Healthcare Transition Experiences Of Emerging Adults With Congenital Adrenal Hyperplasia, Leslie Noojin Pitts

ETDs from 2020-2029

Congenital adrenal hyperplasia (CAH) is a group of disorders characterized by enzyme deficiencies impairing adrenal hormone production and requiring lifelong management. Individuals with CAH experience increased morbidity and mortality due to the underlying condition, steroid exposure, and inadequate preventative care. Despite clinical guidelines recommending a structured healthcare transition (HCT), little is known about the HCT experiences of emerging adults with CAH. Understanding these experiences is critical for identifying practice gaps and developing interventions to improve health outcomes. This qualitative descriptive study explored the HCT experiences, challenges, and outcomes of emerging adults with CAH, as guided by the refined Social Ecological …

Retrospective Chart Review Of Immobilized Lipase Cartridge Use In Children With Short Bowel Syndrome., Elizaveta Khenner, Jennifer Morton, Laura Green, Ashlee Yoder, Kayla Paul, Ann E. Remmers, William San Pablo

Manuscripts, Articles, Book Chapters and Other Papers

This retrospective, single-center chart review studied the use of an in-line, immobilized lipase cartridge (ILC) in children with short bowel syndrome (SBS) at Children's Mercy Hospital. For parenteral nutrition (PN)-dependent patients, the primary endpoint was enteral feeding progression, evaluated by comparing monthly change from baseline in PN and enteral nutrition (EN) after the start of ILC use. For patients with enteral autonomy, changes from baseline in growth measure z-scores were evaluated. In 9 PN-dependent patients (with Type II or III SBS), mean PN use decreased 10.6 kcal/kg/day (15.5%) and mean EN use increased by 6.0 kcal/kg/day (39.9%) after 3.8 to …

Incidental Colorectal Adenomas In Adolescents: Clinical Management, Genetic Evaluation, And Surveillance., Brett J. Hoskins, Shlomi Cohen, Colleen B. Flahive, Isabel Rojas, Aparajita Singh, Thomas M. Attard

Manuscripts, Articles, Book Chapters and Other Papers

The rising incidence of early-onset colorectal cancer has renewed attention to colorectal adenomas in adolescents and young adults (AYA), although these lesions remain rare and poorly characterized in adolescents. Lack of age-specific guidance creates uncertainty regarding genetic evaluation, surveillance intervals, and long-term management when these lesions are identified in adolescents. This narrative review synthesizes current evidence and expert perspective on epidemiology, evaluation, endoscopic management, surveillance, genetic considerations, and psychosocial implications of incidentally identified colorectal adenomas across the AYA spectrum, with emphasis on adolescents as a distinct clinical population. Available data largely derive from adults aged 20-49 years but suggest that …

Prevalence And Aetiology Of Cerebral Palsy Among Nigerian Children: A Systematic Review And Meta-Analysis., Udochukwu Michael Diala, Aderonke O. Uhunmwangho-Courage, Fatima Abdullahi, Paul Ikhurionan, Caitlin Bakker, Duke Appiah, David Danjuma Shwe, Rose N. Gelineau-Morel, Kabiru Gurama, Olugbenga Akinyemi Ofakunrin, Angela Mcgillivray, Gabriel E. Ofovwe, Tina Slusher

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Nigeria is among the leading countries contributing to the burden of cerebral palsy. Cerebral palsy (CP) is the commonest physical disability in childhood, accounting for 16.2% of child neurology referrals. Many cases of CP are preventable with simple interventions such as neonatal resuscitation and effective phototherapy. Lack of reliable data on the burden of disease limits comprehensive national policy directed to the prevention, holistic care and rehabilitation of patients with cerebral palsy in Nigeria. Therefore, to effectively address this problem, this study aimed to describe the pooled prevalence of CP in Nigeria, its potential causes and types.

METHODS: This …

Infection Prevention And Control Of Candida Auris In Pediatric Settings, Thomas S. Murray, Hana Hakim, Christelle Ilboudo, Lynn Ramírez-Ávila, Jana Shaw, Terri Stillwell, Patricia Budo, Bernard Ebruke, Noa Fleiss, Amanda Green, Matthew Linam, Roshni Mathew, April Mcdougal, Natalie Neu, Zoi Dorothea Pana, Karen Ravin, Ayelet Rosenthal, Jane D. Siegel, Katlyn Steimel, Amy Valencia, Carol Vance, Lars F. Westblade, Lisa Saiman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Candida auris (also referred to as Candidozyma auris) is an emerging multidrug-resistant fungal pathogen associated with high morbidity and mortality. Existing infection prevention and control (IPC) guidance has largely focused on adult populations, with limited recommendations for pediatric healthcare and non-healthcare settings.

METHODS: The Society for Healthcare Epidemiology of America (SHEA) convened a multidisciplinary expert panel to develop IPC recommendations for C. auris. The panel developed recommendations using a structured, iterative Delphi consensus process with rounds of discussion, refinement, and anonymous electronic voting with predefined consensus thresholds. Panelists reviewed relevant peer-reviewed and gray literature integrated with expert …

Initial Injury Type And Violent Reinjury, Nicholas Szoko, Daphne Lew, Taylor Kaser, Zoe M Miller, Matt Vogel, Michael A Mancini, Lindsay M Kranker, Christopher Behr, Vicki Moran, Rachel Ancona, Kristen Mueller

2020-Current year OA Pubs

IMPORTANCE: Violent injuries are the leading cause of death among children and young adults in the United States. Violent injury may increase the risk of subsequent injury (ie, violent reinjury), but it is unclear how this risk varies across different injury types (eg, blunt assault, stabbing, firearm).

OBJECTIVE: To describe patterns of violent reinjury across different injury types to inform tailored prevention strategies.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter cohort study included patients who presented with violent injuries to 2 adult and 2 pediatric level I trauma centers in St Louis, Missouri, from January 2016 to December 2023.

EXPOSURES: Violent …

Investigation Of Warfarin–Human Serum Albumin Binding By Ultrafast Affinity Extraction Using Single- And Dual-Column Affinity Microcolumn Systems, Samiul Alim

Department of Chemistry: Dissertations, Theses, and Student Research

This dissertation examined the interaction of warfarin with human serum albumin (HSA) by using affinity chromatography, with particular emphasis on ultrafast affinity extraction (UAE) and affinity microcolumns. HSA affinity supports were prepared by immobilizing HSA onto diol-bonded silica via Schiff base chemistry and used to prepare affinity microcolumns for chromatographic studies under physiological-like conditions at pH 7.4 and 37.0 °C. UAE studies were performed to investigate the effects of residence time, flow rate, and column configuration on the measured apparent free fraction of warfarin and on the calculated apparent binding parameters. The results showed that the measured apparent free fraction …

Personal And High-Intensity Gait Factors Associated With Balance And Walking Improvement With Outpatient Stroke Rehabilitation: A Retrospective Study, Heather Staal

Dissertations

Objective: The purpose of this study is to examine the relationships between personal factors and High-Intensity Gait variables and balance and walking improvement in an outpatient stroke population.

Background: Stroke is a leading cause of long-term disability, with persistent gait and balance impairments commonly limiting independence and participation. High-intensity gait training (HIGT) is an evidence-based rehabilitation approach that improves walking outcomes following stroke; however, guidance on how specific training variables are applied in outpatient physical therapy settings remains broad.

Methods: This retrospective observational study analyzes clinical data from outpatient physical therapy episodes in which HIGT is a …

A Word From The Writing Team (June 2026), Pam Walter, Mfa, Laura Deloretta, Phd

A Word From the Writing Team (Newsletter)

No abstract provided.

The Effects Of Bone Health And Variation On Saw Mark Signatures, Lily Ambrose

PCOM Biomedical Studies Student Scholarship

Bone health and structural variation are multifactorial. Population, environment, age, diet, and health influence the overall functional morphology of bone and its response to stressors. Reduced cortical porosity, trabecular thinning, and low bone mass are common indicators of age-related and pathological changes, affecting a significant portion of the population. Because of this, bones encountered in medicolegal investigations often differ from what is considered “normal.” The structural integrity of bone needs to be considered because density influences mechanical strength and response to external forces. In criminal dismemberment cases, forensic scientists analyze saw marks to identify tool class and reconstruct events. While …

Co-Designed Interventions Package For Enhancing Women's Resilience In Reproductive And Child Health Through Income-Generating Associations: A Human-Centered Design Study In Tanzania, Kahabi Isangula, Aminieli Itaeli Usiri, Eunice Pallangyo

School of Nursing & Midwifery, East Africa

Background: Maternal and under-five mortality remain major public health concerns in many low- and middle-income countries, including Tanzania. Despite their widespread use in strengthening economic resilience, income-generating associations (IGAs) have not fully utilized their potential as platforms for addressing reproductive and child health (RCH) challenges.

Objective: This study aimed to co-design an intervention package with women participating in income-generating associations to enhance their preparedness and resilience in addressing RCH challenges in Tanzania.

Methods: A qualitative descriptive study guided by a Human-Centered Design (HCD) framework was conducted in the Arusha and Shinyanga regions of Tanzania. The study followed …

Optimizing Cochlear Implant Follow Up: An Analysis Of Mstb 3 Proposed Timeline Changes, Alexandra Parbery-Clark, Dylan Severson, Sachin Gupta, Nadav Brumer, Elizabeth Elkins, Chantel Hazlewood, Jake Hillyer

All Poster Presentations

No abstract provided.

Marshall University 2026 College Of Health Professions Student Research Day, Cohp Research Committee

Appalachian Student Healthcare Research Review

Marshall University

2026 College of Health Professions Student Research Day

April 16, 2026

Student Oral Presentations

1. Validity of Using Smartphone Cameras and Pose Estimation Algorithms for Quantitative Analysis of Human Dynamic Movements

Flanders B, Wolfe T, Saines J, Liang H: School of Physical Therapy

2. Effects of Creatine Supplementation on Anaerobic Capacity and Body Composition in Novice Rock Climbers

George LG, Jones BJ: School of Health and Movement Sciences

3. Relationship Between Musculoskeletal Injuries and Mental Health

Rice C, Konz S: School of Health and Movement Sciences

Student Poster Presentations

4. Effects of Bright Light Therapy on Depression

Adams, …

Development And Validation Of The Lifetime Sense Of Safety Scale In Kenyan Adults, Karen Blackmon, Anne Nyambura, Anne Gitere, Levi Muyela, Catherine Onyancha, Kendi Muchungi, Catherine Ajalo, Litha Musili, Rachel Maina, Edna Bosire, Lukoye Atwoli, Zul Merali, Chinedu Momoh

Brain and Mind Institute

Background. Safety supports psychological wellbeing and potentially shapes brain aging yet existing scales overlook cumulative lifespan safety experiences.

Methods. To address this gap, we developed and validated the Lifetime Sense of Safety (LSS) scale in Kenyan adults. The LSS uses visual analog scaling with a red-to-green color gradient to retrospectively rate felt safety across life stages and settings. We evaluated scale psychometrics and associations with social determinants of health and indicators of brain health.

Results. The LSS shows adequate internal consistency and test-retest reliability, with two distinct but correlated factors representing childhood and adulthood safety. Women and …

Breaking Barriers: Harnessing Collaboration Between Individuals With Disabilities And Emergency Management In New Jersey, Daniel Wrinn

Master of Science in Emergency & Disaster Management Capstones

No abstract provided.

Geographic And Systemic Disparities In Maternal Health: A Systems Analysis Of Prenatal Care Access Across Rural Oregon, Cecelia Petrik

University Honors Theses

Objectives: In Oregon, 51% of hospitals providing labor and delivery services are located in rural areas. Consolidation of these hospitals and provider shortages has created severe geographic and systemic disparities in maternal healthcare. This thesis explores how geographic isolation and inadequate prenatal care access contribute to widening disparities in severe maternal morbidity (SMM) and mortality across Oregon's rural and frontier counties.

Methods: This study utilizes data from the Oregon Health Authority (OHA) Center for Health Statistics (2024) and analyzes spatial correlations across all 36 Oregon counties. A bivariate choropleth map was constructed to examine the structural intersection between health infrastructure …

Exploring Psychosocial Risk Factors For Disordered Eating Among Future Healthcare Professionals: A Cross-Sectional Analysis, Ayron Walker, Manan Roy, Jenna Warnock, Karlee Prater, Alisha Farris, Danielle Nunnery

Appalachian Student Healthcare Research Review

Background. The prevalence of disordered eating (DE) patterns is significantly higher among college-aged students and health-related majors. This study explored associations between DE behaviors and psychosocial risk factors, including adverse childhood experiences (ACEs), food insecurity, weight stigma, fat phobia, and family ‘fat talk’, among health science students at a large, rural U.S university, using an anonymous online survey.

Method. An anonymous online survey was distributed to a randomly selected, cross-sectional sample of 3,000 health science students. Participant responses (n = 550; 18.3% response rate) were analyzed using Pearson’s correlation, and multiple linear regression.

Results. The sample was …

New Graduate Nurses' Experiences Of Leaving The Emergency Department, Gemma John

Walden Dissertations and Doctoral Studies

No abstract provided.

Reflections And Revisionism: Rethinking The U.S. Response To Covid-19, Wendy E. Parmet

Michigan Law Review

A review of In Covid’s Wake: How Our Politics Failed Us. By Stephen Macedo and Frances Lee.

Socio-Ecological Models As A Framework For 21st-Century Genetic Counseling, Shana L. Merrill, Rebecca Mueller

College of Life Sciences Faculty Papers

Socio-ecological models and the related concepts of micro-, meso-, and macro-level practice are commonly used in the fields of social work and public health yet have not been thoroughly conceptualized for application to genetic counseling practice, research, and training. The field of genetic counseling is currently undergoing significant expansion with more genetic counseling training programs, greater variation in genetic counselor job roles, and genetic counselors practicing in more globally dispersed regions. It is therefore a critical time to conceptualize and tailor relevant theoretical frameworks to unify and guide the evolving field of genetic counseling. In this paper, we posit that …

Evaluation Of Neuroplastic Changes In Psychological Intervention And Contemporary Treatments Of Depression, Taylor Severance

Dissertations

Major depressive disorder is one of the most prevalent mental health disorders worldwide. There is a vast range of treatment options for depression, with varying levels of effectiveness. Recent treatments for depression have expanded, increasing alternative treatments, and it is unknown which treatments have the largest impact on depression. This research was designed to examine the treatments of depression, with a focus on psychotherapy and contemporary treatments such as ketamine, psilocybin, and transcranial magnetic stimulation. A literature review was conducted to assess treatment outcomes and neuroplastic changes in these interventions, as well as combinations of the interventions. Data were evaluated …

From Evidence To Action: Case For Further Investment In Family Planning For Faster Fertility Decline, Population Council Pakistan

Sexual and Reproductive Health, Rights, and Choices

For over three decades, the Population Council Pakistan has generated evidence and supported governments in designing innovative approaches to address population and reproductive health challenges. Building on evidence around fertility transition, reproductive health, and the nationally endorsed Tawazun (balance) narrative, the Population Council supported the Government of Punjab through the FCDO-funded Delivering Accelerated Family Planning in Pakistan (DAFPAK) initiative and other strategic partnerships to implement scalable solutions for strengthening family planning services. This brief outlines five high-impact, proven interventions ready for institutional scale-up and provides an actionable path forward to transform routine health encounters into sustainable health system reforms.

June 2026, Swosu Rural Health Center

RURAL ROCKS

Rural Rocks

Second Generation Antipsychotics in the Treatment of Depression

Dr. Debra L. Stevens, Pharm.D., BCPP 

Major depressive disorder (MDD), also known as depression, affects 1 in 5 individuals in their lifetime.¹ Worldwide approximately 246 to 286 million individuals are afflicted with MDD.² MDD may cause significant morbidity and disability. The World Health Organization estimates that MDD will be one of the leading causes of disease burden by 2030.²

A significant number of patients diagnosed with MDD do not respond adequately despite appropriate treatment with antidepressants.² Treatment resistance may occur in up to one-third of patients …