Digital Commons Network^™

Health Disparities In Pediatric Epilepsy: A Narrative Review Of Barriers To Equitable Care, Nikhila Archakam, Akhila Archakam, Wesley Kim, Harshal Parmar

Rowan-Virtua Research Day

Epilepsy affects approximately 1% of children in the United States, representing over 456,000 pediatric patients with active seizure disorders. Despite advances in antiseizure medications and surgical interventions, the benefits of these developments are not distributed equally across racial, socioeconomic, and geographic groups. A narrative review of the literature was conducted using PubMed, Scopus, Embase, and Medline using search terms including "pediatric epilepsy," "health disparities," "health equity," "social determinants of health," "race," "socioeconomic status," and "access to care." Articles were included if they focused on pediatric populations aged 0 to 17, addressed at least one disparity domain, and were published between …

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

CISLA Senior Integrative Projects

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

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

Trends And Disparities In Mortality Involving Epilepsy And Aspiration Pneumonia Among Older Adults In The United States, 1999–2020, Pranaya Gade, Jarvish Shah, Daarsh Goradia, Nishant Patel, Jamir Pitton Rissardo Md, Ana Leticia Fornari Caprara Md

Rowan-Virtua Research Day

Introduction: Epilepsy in older adults is frequently complicated by swallowing dysfunction, increasing the risk of aspiration pneumonia. Despite its clinical relevance, national trends and demographic disparities in deaths involving these conditions remain poorly characterized. Methods: We analyzed death certificate data from the CDC WONDER Multiple Cause of Death database (1999–2020) for individuals aged ≥65 years with epilepsy (ICD-10 G40, G41) and aspiration pneumonia (J69) listed as causes. Age-adjusted mortality rates (AAMRs) per 100,000 and annual percentage changes (APCs) with 95% confidence intervals were calculated using Joinpoint Regression. Analyses were stratified by sex, race/ethnicity, census region, and state. Results: From 1999 …

From Lists To Landscapes And Locations: Spatial Memory And Schema Formation (Memory Palace Adaptation) As A Neurobiologically Informed Strategy For Teaching Environmental And Toxicology Emergencies Ite And Board Review In Emergency Medicine Residency, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background:

Most emergency medicine board domains inherit spatial scaffolding from foundational anatomy education (e.g., neuroanatomy, gastrointestinal tract, cardiopulmonary structures). Environmental emergencies lack an inherent anatomic anchor and are frequently taught as disconnected lists, increasing cognitive load and impairing schema formation. Similarly, toxicology crosses age, and specialty without an inherent anatomic structural anchor.

Objective:

To describe a scene-based, learner-generated landscape model designed to reintroduce spatial structure into environmental emergency education and to situate the model within contemporary neurobiology and learning science.

Educational Innovation:

Residents construct a large-format landscape diagram (sun–water–mountain schema) during live instruction. Environmental conditions are spatially anchored in ecologically …

Designing Patient Update Intervals In The Emergency Department: A Queueing-Theory And Operational Science Model Of Patient Updates And Progress Signaling To Improve Patient Experience, James Espinosa, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Background Patients in the Emergency Department (ED) frequently experience uncertainty while awaiting diagnostic results, reassessment, and disposition. Even when clinical processes are progressing, prolonged informational silence may create the perception of that those processes are not advancing.

Objective To develop a conceptual and operational mathematical, queuing-theory based  model linking bedside communication, conversational time, and informational silence to patient experience.

Methods A back-of-the-envelope operational model was constructed to estimate the time required for bedside update communication during a typical physician shift. A queueing-theory framework was applied to examine how intervals between informational updates influence perceived waiting burden. Concepts from queueing theory …

Barriers To Palliative Care Access In Rural South Dakota: A Policy And System-Level Analysis, Harshavardhan Kadarkaraisamy

Honors Thesis

Palliative care improves the quality of life for people living with serious illness. It helps by addressing symptoms, improving communication, and providing mental, physical, and spiritual support. However, in South Dakota access to palliative care is limited in rural areas. These challenges include geographic isolation, workforce shortages, healthcare infrastructure, reimbursement, and misunderstandings about palliative care. This thesis examines the key policy barriers that limit access to palliative care in rural South Dakota. This work involves engaging with South Dakota-specific literature, rural health research, policy sources, community education, telehealth expansion, and policy reform. By focusing on the rural context of South …

Ai×Life 2026: Advances In Computational Biology Across Scales For Life & Health Sciences, Suma Mohan S., Devika N. T., Pranavathiyani G.

Conference Proceedings

Book of Abstracts of the International Conference, AIxLife 2026: Advances in Computational Biology Across Scales for Life & Health Sciences, held on 17–18 April 2026, SASTRA Deemed to be University, Thanjavur, Tamil Nadu, INDIA 

About the Conference

Conventional computational biology laid the foundation for biological data analysis through statistical models, algorithms, and curated databases, enabling insights into genes, proteins, and pathways. Today, the integration of artificial intelligence, spanning machine learning, deep learning, and large language models (LLMs) is driving a transformative shift across biological scales, from atomic and molecular interactions to pathways, cellular systems, organisms, and populations.

AI-powered approaches …

Building Dental Workforce Pathways In A Rural State Without A Dental School, Rashid Ahmad, Shawnda Schroeder

Indigenous Health Posters and Presentations

In North Dakota, workforce shortages are shaped by geography, training pathways, and weak return incentives.

• Statewide Dental Health Professional Shortage Area designation
• No in-state dental school
• Workforce shortages function as a structural driver of inequity • Oral health disparities among children, low-income populations, and Indigenous communities

Exploring Policy Change To Support Early Diagnosis Of Congenital Heart Defects (Chd) In New Mexico, Kelsey Carson Leibenhaut

Doctor of Nursing Practice Scholarly Projects

Congenital heart disease (CHD) is not a new or rare problem; it has likely always been a leading cause of childhood morbidity and mortality and clocks in today as the most frequently occurring birth defect, affecting an estimated 1 in 100 newborns (CDC, 2025). Prior to the middle of the 20th century, there was little to be done about CHD, as no treatments existed. Everything changed with the advancement of options for surgical repair of CHDs, significantly prolonging lifespans and improving quality of life for affected individuals. Despite these incredible advancements, babies are born with CHD every day, leading to …

Utilizing The Indian Self Determination Act To Enhance And Improve Health Outcomes In A Tribal Communities, Adriann Ricker, Shawnda Schroeder

Indigenous Health Faculty Publications

The Indian Self-Determination and Education Assistance Act (PL 93-638) serves as a critical policy mechanism enabling Tribes to exercise sovereignty and self-determination in health care delivery. American Indian and Alaska Native (AI/AN) communities face significant disparities in oral health outcomes, driven by systemic and structural racism, geographic isolation, and inadequate access to health care professionals. This policy paper examines the historical context and implementation of PL 93-638 and explores how the law empowers Tribes to address health inequities on their own terms. Drawing on case studies and insights from the Fort Peck Assiniboine and Sioux Tribes, this paper highlights how …

Cultivating Connection: A Culturally Responsive Mental Wellbeing Curriculum For Latine Youth In Santa Cruz County, Suzzy Landeros

Capstone Projects and Master's Theses

Latine adolescents experience high rates of stress, depression, and stigma surrounding mental health, in part due to limited access to culturally responsive support and safe spaces for connection. The purpose of this internship project was to develop and implement a trauma-informed, culturally responsive, mental wellbeing curriculum to address barriers related to stigma, limited culturally responsive support, and disconnection, while supporting emotional awareness, connection, and use of grounding strategies among youth. The project was implemented through United Way Santa Cruz County in partnership with Watsonville High School and Soquel High School and served high school-aged youth. Development of the curriculum included …

Systemic Barriers To Educational And Employment Attainment Among Individuals With Substance Use Disorders, Mollie B. Mccann Poblocki

Creativity and Change Leadership Graduate Student Master's Projects

Substance use disorders (SUDs) and opioid use disorder (OUD) represent one of the most pressing yet poorly understood public health crises in the United States. Despite decades of clinical intervention, recovery outcomes remain deeply unequal, not because individuals lack motivation, but because the structural systems surrounding them are fundamentally broken. This project explored that reality through a comprehensive literature review examining how systemic barriers across educational systems, labor markets, poverty dynamics, and healthcare infrastructure shape vulnerability, treatment access, and recovery outcomes for individuals with SUDs. Major findings revealed a consistent socioeconomic gradient of harm: individuals with lower educational attainment, unstable …

Exploring Policy Change To Support Early Diagnosis Of Congenital Heart Disease (Chd) In New Mexico, Kelsey Carson Leibenhaut

Doctor of Nursing Practice Posters and Presentations

Congenital heart disease (CHD) is not a new or rare problem; it has likely always been a leading cause of childhood morbidity and mortality and clocks in today as the most frequently occurring birth defect, affecting an estimated 1 in 100 newborns (CDC, 2025). Prior to the middle of the 20th century, there was little to be done about CHD, as no treatments existed. Everything changed with the advancement of options for surgical repair of CHDs, significantly prolonging lifespans and improving quality of life for affected individuals. Despite these incredible advancements, babies are born with CHD every day, leading to …

The Birthing Ground Podcast: Assessing The Impact Of Shared Doula Experiences On New Doula Confidence, Arrieanna D. Martinez

Capstone Projects and Master's Theses

There are too few confident, experienced doulas available in Monterey County to meet the needs of birthing families. Community-based maternal health programs face challenges related to limited confidence and experience among newly trained doulas, which affect the quality and consistency of care provided to families. This project addressed the needs of new doulas serving Medi-Cal–eligible families in Monterey County. The purpose of this capstone project was to increase confidence and preparedness among new doulas through a mentorship-based learning intervention. The project was implemented at the Parenting Connection of Monterey County and included new doulas and experienced mentor doulas. Key activities …

Chemical Variability In The Unregulated Opioid Supply In The South Bronx, Yeireline Rodriguez

Student Theses

The unregulated drug supply in the United States has become increasingly unpredictable, contributing to persistently high overdose mortality, particularly in structurally marginalized communities such as the South Bronx. While drug adulteration has long been present in illicit markets, the number and pharmacological diversity of adulterants remained limited for much of the twentieth century. Over the past decade, however, the drug supply has undergone a significant transformation marked by the proliferation of potent synthetic opioids such as fentanyl and its analogues, frequently combined with novel sedatives and chemically diverse adulterants. These shifts have introduced increasing chemical complexity into the street drug …

Factors Affecting Pedestrian-Vehicle Conflicts: An Empirical Analysis, Christo D. Jamo

Honors Scholar Theses

The number of pedestrian deaths increased by 78% between 2009 and 2023, while other motor vehicle crash deaths increased by 13% in the same period [1]. To identify potential pedestrian safety measures, this study analyzed the effects of location-based demographics, pedestrian phasing type, and other physical infrastructure and behavior variables on the probability of pedestrian-vehicle conflicts at signalized intersections, which is a surrogate measure of crash risk. Data were collected from 55 intersections in Connecticut, and the pedestrian-vehicle interactions were classified by severity based on the Swedish Traffic Conflict Technique: undisturbed passage, potential conflict, minor conflict, or serious conflict. Because …

Halo Effect Of Prescribing Guidelines For Opioid Naive Patients Translates To Opioid Non-Naive Patients Undergoing Lumbar Decompression: A Michigan Spine Surgery Improvement Collaborative (Mssic) Study, Anisse Chaker, Geoff Kahn, Michael Melhem, Jian-Hui Hu, Kari Jarabek, Heegook Yeo, Jawad Saad, Abdullah Al-Tekreeti, Kenneth Easton, Jad Khalil, Richard Easton, Doirs Tong, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, David Nerenz, Victor Chang

Conference Presentation Abstracts

Introduction: Chronic opioid dependency in spine surgery is an ongoing concern given the ongoing opioid epidemic. We have previously reported on our cohort of opioid-naıve patients, however the literature has shown that patients with opioid use at baseline are at higher risk of less favorable outcomes. Starting in 2022, MSSIC instituted state-wide prescribing guidelines for opioid naıve patients undergoing one- or two-level lumbar decompression surgery (laminectomy, laminotomy, foraminotomy, microdiscectomy) with performance goals of 80% compliance. The goal of this study was to evaluate whether there would be a form of a “halo” effect on prescribing patterns for patients with baseline …

Challenging Myths In Speech-Language Pathology: A Scientific Review Of Augmentative And Alternative Communication (Aac) Use, Bilingualism, And Late Talking, Mariah Morris

Undergraduate Honors Capstone Projects

Persistent myths within the field of speech-language pathology continue to influence clinical decision-making and contribute to biases experienced by both providers and clients. This scientific review examines common misconceptions surrounding late talking, bilingualism, and augmentative and alternative communication (AAC) by evaluating current evidence-based research. Specifically, this review addresses three central questions: Do children outgrow late talking? Does bilingualism cause language delay in children? Does AAC hinder speech development? 

An analysis of multiple peer-reviewed studies revealed little statistical support for the belief that bilingualism or AAC use causes language delays. Instead, research indicates that factors such as limited access to language-rich …

Observation And Reflection Of Neighborhood And Community 2026: Education Access/Quality, Economic Stability, Built Environment/Infrastructure And Team Reflection, Alan Carbajo, Samiollah Mohammad, Muhammed Zahriyeh, Grace Drexel, Aster Disbrow, Reagan Recchia

Patient Education Projects

No abstract provided.

Seroprevalence Of Helicobacter Pylori Infection Among Asymptomatic Patients Served By A Safety-Net Healthcare System, Aaron P Thrift, Peyman Dinarvand, Luis Juarez, Jourdan Brown, Daniel Avila, Jennifer Mistica Zafiro Garcia-Villanueva, Lisa C Danek, Hammad Mahmood, Thomas Porter, Ann Gotschall, Noreen F Pirzada, Jaime J Rueda, Lee B Lu, Afroze Ali, Ijeoma Anyakorah, Sanjana J Bhattarai, Anees Fatima, Jessica Garcia, Hung V Nguyen, Bharat Joshi, Malvika Juneja, Misba S Lateef, Najda Mujtaba, Preethi V Nambi, Jay S Orr, Huma Rahman, Stephanie Nguyen, Amna Waqar, Yanyan Chen, David Y Graham, Hashem B El-Serag, Mimi C Tan

Faculty, Staff and Students Publications

Background & aims: Helicobacter pylori screening and eradication is a cost-effective strategy for primary gastric cancer prevention in high-risk populations outside the United States. There is a paucity of population-based H pylori seroprevalence data available in high-risk U.S. groups, particularly data for low-income, uninsured patient populations.

Methods: We used data from a cross-sectional study of a largely underserved, immigrant, and minority patient population. Inclusion criteria included asymptomatic individuals 30-65 years of age without prior H pylori testing or treatment. Consented patients completed a study survey and a blood draw to screen for H pylori using IgG serology. We calculated seroprevalence …

The Role Of Dollar Store Proliferation In Influencing Diabetes And Obesity Rates In West Virginia, Kelli L. Keith

Walden Dissertations and Doctoral Studies

Dollar stores are the fastest growing food retail format and are highly concentrated in rural, low-income communities including West Virginia, where diabetes and obesity prevalence rank among the highest in the United States. Although these retailers increase physical access to food, concerns remain about their limited healthier food options and potential contribution to chronic disease disparities. Guided by the socioecological model, this three-manuscript dissertation examined how dollar store density and healthier food availability related to county-level diabetes and obesity prevalence in West Virginia. Manuscript 1 used a cross-sectional ecological design with all 55 West Virginia counties, using data from USDA, …

The Association Between Racial Discrimination And Pregnancy-Related Hypertension Among Department Of Health And Human Services Regions Between 2016 And 2022, Emily Chew

Walden Dissertations and Doctoral Studies

This quantitative study examined the association between racial discrimination and pregnancy-related hypertension among women age 18–40 in the United States, and how this relationship is modified by age and the Department of Health and Human Services (HHS) regions (states). Guided by the social ecological model, this research measured whether race, place, and lived experiences of discrimination contributed to disparities in maternal health outcomes. The study utilized the Centers for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System data set (2016–2022) which represented 81% of United States live births (n=249,970). The independent variable was self-reported racial discrimination during pregnancy, delivery, …

Supporting Families Of Children With Craniosynostosis: A Qualitative Exploration Of Parental Usage Of Online Forums, Elisha L. Rea, Rachel M. Roberts, Amanda J. Osborn

Patient Experience Journal

Objective: Craniosynostosis is characterised by the early fusion of cranial sutures, resulting in an abnormal head shape. This study examines the psychosocial impact of a child's craniosynostosis diagnosis on families, by analysing online forum discussions. While surgery is often needed to address appearance-related and neuropsychological concerns, parents face challenges navigating their child's diagnosis. Many seek support through online forums, yet research on their experiences remains limited. This study aims to understand parental needs and experiences by analysing forum discussions. Method: Online forums were analysed using reflexive thematic analysis. Significant features of the data were systematically coded and themes reflecting …

Comparison Of Clinical Outcome Of Mushroom Poisonings With And Without Specific Treatment: A 5-Year Retrospective Analysis, Kamil Deveci, Necmi Baykan, Baycan Kus, Fatma Ünlü, Ömer Salt, Serhat Koyuncu

Saudi Medical Journal

Objectives: To determine the demographic and clinical characteristics, potential specific antidote treatments, clinical outcomes, and organ failure (morbidity) rates of patients with mushroom poisoning admitted to our center. Methods: We included 425 patients admitted to the emergency department of Kayseri City Hospital complaining of mushroom poisoning, between May 2018 and December 2023, who met the study criteria. Results: The median age of the 425 patients admitted was 51 years (34–63); 49.5% were female (n = 211), and 75% (n = 319) were admitted by ambulance. According to the Poisoning Severity Score, 70.3% (n = 299) of cases were mild, 21.9% …

The Secretary Of Alienation: Metaphor And Metapsychology, Anna Kreienberg

Middle Voices

Commentary

Spatial Distribution Patterns Of Determinants Of Hypertension In West Java In 2023, Meirina Nur Asih Susanti, Wahyu Septiono

Preventia: The Indonesian Journal of Public Health

Hypertension is a public health issue that is unevenly distributed across regions. The high prevalence in West Java (34.4%) with a large population makes the management of hypertension crucial. Differences in economic and environmental conditions are thought to influence the distribution of hypertension, thus requiring spatial analysis. This study used an ecological approach by analyzing data from districts/cities in West Java in 2023. Secondary data were used to measure hypertension prevalence and to assess socioeconomic and environmental factors. The analysis was conducted using univariate Moran's Index, Local Indicators of Spatial Association (LISA), and the Spatial Autoregressive Model (SAR). The prevalence …

Association Between Maternal Factors And Stunting Based On The Indonesia Family Life Survey 5 (Ifls-5), Charissa Otniel Sukamto, Siti Nur Fatimah, Noormarina Indraswari

Makara Journal of Health Research

Background: Stunting remains a major issue in Indonesia. Maternal factors during pregnancy are one of the key determinants in preventing stunting. This study aimed to analyze the association between maternal history during pregnancy (age, height, parity, and inter-pregnancy interval) and stunting, with a comparison between urban and rural areas.

Methods: This analytical cross-sectional study used data from 3,639 children aged 1-5 years old from the household survey of Indonesia Family Life Survey 5, conducted between late October 2014 and August 2015 within 13 provinces in Indonesia. Data was analyzed using chi-square and binary logistic regression methods.

Results: …

Canndor Herbarium: A Comprehensive Herbarium Resource For Cannabis Identity, Diversity, And Botanical Research, Nick Batora, Laura Klein, Kerin Law, Eleanor Kuntz

Oxford ICSB

Decades of cannabis prohibition have created major gaps in our understanding of cannabis biology, especially with regard to the genomic, phenotypic, and germplasm resources that are standard in other agriculturally and medicinally important crops. Herbarium collections, which serve as archival specimens that preserve plant material for long term study, are no exception. Although herbarium specimens are meant to document plant diversity, most collections contain only a narrow sampling of cannabis and do not reflect the extensive variation present in commerce or this species at large. To address this need, the Canndor Herbarium was established in 2016 as the first dedicated …

Frankincense (Boswellia Spp.) Essential Oils: Chemistry-Driven Authentication, Chemotype Discovery, And Sustainability Insights Across My Published Studies, Prabodh Satyal

Oxford ICSB

Frankincense, which comes from the oleo-gum resins of Boswellia species, is one of the most important botanicals in global trade. However, its essential oils often face issues like variations in chemical makeup, mislabeling, and adulteration. This presentation summarizes findings from ten peer-reviewed studies conducted between 2016 and 2023. These studies create a chemistry-based framework for authenticating frankincense and ensuring sustainable sourcing.  Research on various Boswellia species, including B. sacra, B. carteri, B. papyrifera, B. frereana, B. occulta, B. ogadensis, and B. rivae, shows strong patterns in volatile profiles at both the species and tree levels. This supports distinguishing between species …

Using Geospatial Environmental And Income Variables As Predictors Of Diabetes In Appalachia, John Kunicki Huth

Walden Dissertations and Doctoral Studies

Diabetes remains disproportionately prevalent in Appalachia, and macroenvironmental contributors remain poorly understood. Guided by spatial epidemiology, this quantitative, cross-sectional ecological study examined whether county-level environmental factors including distance to mine, distance to landfill, distance to water, mean annual precipitation, mean annual temperature, forest classification, distance to impervious surface, and median income were independently and collectively associated with diabetes cases per capita in West Virginia, used as a surrogate for Appalachia. Research questions addressed environmental predictors of diabetes cases per capita with and without controlling for median income. Publicly available county-level data from 53 West Virginia counties representing adults aged 20 …