Digital Commons Network^™

Abortion Politics And Policy: Stigma And Access In The Silver State, Celene Fuller

Lincy Institute Events

In the aftermath of the Supreme Court’s Dobbs v. Jackson Women’s Health Organization (2022) overturning Roe V. Wade, states have taken divergent paths in regulating access to abortion services. In 2024, Nevada voters overwhelmingly passed Question 6 proposing to codify abortion rights into the state constitution. In November 2026, Question 6 will again be on the ballot for final confirmation. If it passes, these rights will be protected from future legislative action.

Despite Nevadans’ strong support for abortion rights, the state’s dearth of abortion providers limits access to these services. As this lecture explores, both providers and individuals seeking abortions, …

Charity Pharmacies: An Integrative Overview Of Operations: A Continuing Education Program For Pharmacists, Stella Bertram

Honors Theses

PROGRAM DESCRIPTION

The goal of this activity is to educate pharmacists about Charity Pharmacies by creating an integrative overview of their purpose, laws and regulations, processes and procedures, eligibility, and opportunities for involvement. This course will ensure pharmacists are competent in the operations involved in volunteering or working within a charitable pharmacy.

Additionally, the information provided supports pharmacists in understanding their roles as well as roles of volunteers. They will understand the importance of their role in the community and the depth of their service within Charity Pharmacies.

A Phenomenological Study On The Lived Experiences Of Military Spouses With Secondary Traumatic Stress Who Are Married To Veterans Diagnosed With Ptsd, Trisha R. Perry

Doctoral Dissertations and Projects

The purpose of this hermeneutical phenomenological study was to understand the lived experiences of Secondary Traumatic Stress (STS) in military spouses whose partners have Post-Traumatic Stress Disorder (PTSD). The theory guiding this study was Lazarus and Folkman’s Transactional Model of Stress and Coping (TMSC). The central research question was: What are the lived experiences of STS in spouses married to a service member with PTSD? Additional sub-questions addressed changes in worldview, marital satisfaction, and daily functioning. Criterion and snowball sampling were used to select participants who were married to service members with PTSD for the study. Following the hermeneutical phenomenological …

Middle East Bifurcation Club Consensus Document On Percutaneous Revascularization Of Bifurcation Lesions In Association With The National Heart Center – Saudi Health Council, Khaled Al-Shaibi, Mirvat Alasnag, Haitham Amin, Ali Nazmi Calik, Ali Almasood, Abdullah Alenezi, Nouf Alanazi, Abdulrahman Almoghairi, Hadi Abu-Hantash, Khaled Almerri

Saudi Medical Journal

Bifurcation lesions are among the most challenging in percutaneous coronary intervention (PCI), with outcomes affected by anatomy, side-branch disease, and procedural variability. Existing European definitions and strategies require adaptation for Middle Eastern populations, where diabetes, obesity, and hypertension are highly prevalent and present earlier. The Middle East Bifurcation Club (MEBC), with the National Heart Center, used the Nominal Group Technique to standardize bifurcation PCI terminology, techniques, and treatment pathways tailored to regional demographics. The consensus provides evidence-based recommendations on imaging, provisional and 2-stent strategies, POT, and left main versus non-left main bifurcations, alongside practical algorithms and heart team guidance, highlighting …

Ethnic Background As A Determinant Of Thyroid Cancer Risk: A Decade-Long National Cohort Study Reveals Divergent Epidemics In Saudi Arabia, Nizar A. Khamjan

Saudi Medical Journal

Objectives: To analyze and compare temporal trends, demographic characteristics, and stage at diagnosis for thyroid cancer (TC) between Saudi and non-Saudi populations in order to identify potential population-specific etiological drivers. Methods: We conducted a national retrospective cohort study of TC cases in Saudi Arabia from 2013–2022. To assess population-level trends, we computed age-standardized incidence rates (ASIRs) and multivariable Poisson regression alongside piecewise regression models for comparative analysis. Results: Among 14,159 total cases, TC incidence increased disproportionately in Saudi nationals, rising from 884 to 1,677 (90%), significantly outpacing the 184 to 275 (49%) increase observed in non-Saudis. The incidence rate ratio …

Tumor-Associated Neutrophils In Advanced Non-Small Cell Lung Cancer Patients Predicted By Clinicopathologic Characteristics And Peripheral Blood Markers, Weiwei Hong, Xie Xiong, Chen Fang, Chuanhong Luo, Xiaoying Qian, Xinyuan Yao, Xin Ye, Biao Yu, Bingbiao Zhou, Dengying Chen, Chengsi Shu, Yong Wang, Yong Li

Saudi Medical Journal

Objectives: The process of analyzing tumor-associated neutrophils (TANs) types is complex. This study explored the relationships among clinicopathological characteristics, peripheral blood markers, and TANs. Methods: Clinical information was retrospective gathered for 115 patients in our hospital from May 2019 to May 2021, and multiplex immunofluorescence staining was utilized to access the expression of TANs and analyze the potential relationship between TANs and clinicopathological features or peripheral blood markers. Results: Among the 115 patients, the proportion of female patients within the neutrophils (N1)-low group was notably greater compared to the N1-high group (87.5% vs. 12.5%, p = 0.022). In nonsmoking patients, …

Concurrent Appendectomy In Patients Undergoing Surgery For Gynecological Malignancies: A Retrospective Analysis From A Tertiary Referral Center, Gazi Güner, Can Tercan, Emrah Dağdeviren, Ali Selçuk Yeniocak, Ceylin Elbistanli, Sure Nur Erdoğmuş, Ayşe Hazirbulan, Yiğit Mert Bayrak, Neçirvan Çağdaş Çaltek, Gözde Şahin, Ergun Tercan, Figen Efe Çamili, Nazlıaylin Vural, Hüseyin Karatay, Saniye Merve Gül Kara, İlkbal Temel Yüksel

Saudi Medical Journal

Objectives: To evaluate appendectomy specimen findings and their association with tumor type and stage. Concurrent appendectomy is frequently performed during gynecologic oncology surgery to prevent postoperative appendicitis and detect occult pathology, yet its value remains debated. Methods: In this study, we reviewed the medical records of 300 women who underwent gynecologic oncologic surgery accompanied by appendectomy at Başakşehir Çam and Sakura City Hospital (Istanbul, Türkiye) over the period from July 2020 to April 2025. Clinical, surgical, andhistopathologic data were collected. Appendiceal pathologies were categorized as reactive hyperplasia, chronic inflammation, benign neoplasms, metastatic tumors, or primary. Statistical analyses included chi-square, t-test, …

Integrative Approaches To Gut Microbiota: Biomarkers, Dysbiosis, And Therapeutic Potential, Zeyad M. Alharbi

Saudi Medical Journal

The human gut contains bacteria, viruses, and archaea that influence health depending on age, diet, and location. An individual harbours about 150 bacterial species. An imbalance of these microorganisms, known as dysbiosis, can negatively impact health. Commensal bacteria maintain microbial homeostasis by building short chain fatty acids. The 2-way communication channel that connects the gut and the brain is referred to as the gut-brain axis. Dysbiosis of the gut leads to some autoimmune diseases. A decline of beneficial bacteria causes the progression of rheumatoid arthritis. Gut dysbiosis increases intestinal permeability, allowing toxins and cytokines to enter the bloodstream and damage …

An Ethics Of Listening: The Rupture Of Delusion And The Offer Of A New Freedom, Bret Fimiani

Middle Voices

This paper will focus on the topic of listening as an ‘analytic act’ by the analyst (but also by the analysand) and its relation to ethics and the position of the analyst in the field of psychosis. Is the analyst listening for something in particular? The prospect of listening for something supposes that the analyst holds a specific idea of what distinguishes the ‘structure of the address’ in psychosis (versus neurosis). Typically, we say that the analyst is listening for the unconscious, or for the ‘subject’ (of the unconscious). As we are trying to find our bearings in the field …

What Are Elementary Phenomena? An Introduction To A Lacanian Conceptualization, Derek Hook Ph.D.

Middle Voices

What do Lacanians mean when they refer to the notion of elementary phenomena? This idea, crucial to Lacan’s (1993) theorizations of psychosis in Seminar III, refers back to the psychiatric conceptualizations of the late 19th and early 20th century. However, even while citing the influence of others when utilizing the concept, Lacan—characteristically enough— described the concept in his own distinctively psychoanalytic way. The term is particularly important to Lacan in terms of how he thinks about the development of delusions and related psychotic symptoms in relation to the initial onset of psychosis. In this short paper, I aim simply to …

The Wager Of Speech, And The Maneuver Of The Dream In The Clinic Of Psychosis, Christopher Meyer

Middle Voices

Psychoanalysis, especially in the clinic of psychosis and extreme states, requires a wager on the part of the analyst. This wager welcomes the speech of the analysand regarding a censored unconscious. In the clinic of psychosis, the analyst’s reference to the dream in the establishment of the frame of the treatment is a maneuver that creates a working space that reveals the subjective history of the analysand. This history concerns key moments of trauma in which the speaking being found themselves without resort or resource to speech or language to represent their experience. The discourse of the delusion arises in …

The Secretary Of Alienation: Metaphor And Metapsychology, Anna Kreienberg

Middle Voices

Commentary

Prenatal Care Access And Pregnancy Outcomes Among Black Women Ages 15–44 In Cook County, Illinois, Deandrea Heggins

Walden Dissertations and Doctoral Studies

Maternal health disparities affecting Black women in the United States remain a persistent public health concern due to inequities in prenatal care access and adverse birth outcomes. Prior research has shown that socioeconomic conditions, insurance coverage, and systemic barriers influence prenatal care utilization and maternal outcomes; however, limited research has examined how Medicaid coverage, household income, preterm birth, and birth weight are collectively associated with prenatal care access among Black women in Cook County, Illinois. The purpose of this quantitative correlational study was to examine the relationships among these factors and access to prenatal care among Black women ages 15–44 …

Quality Improvement Project Reducing Attrition Rates In Nursing Students: Evaluating The Enhanced Student Success Program, Jason Grigg

Doctor of Nursing Practice Projects

The high attrition rate in the Associate of Applied Science in Nursing (AASN) program created an opportunity to develop the enhanced Student Success Program (eSSP). This is a faculty-based quality improvement project designed to increase support for students at risk of withdrawal from the AASN program. The aim of eSSP is to reduce attrition rates, however, this project evaluated only short-term changes in faculty confidence. Using Lewin's Change Model and the Theory of Planned Behavior as a guide, this QI implemented a one-group pre-post experimental design to determine whether a short eSSP training program, combined with a 5-week implementation period, …

Quality Improvement Project : Educating Critical Care Nurses On Braden Scale And Sskin Care Bundle To Impact Pressure Injuries, Andrea Garrett

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries (HAPIs) increase patients' risk of infection, prolonged hospitalization, death, and healthcare costs. The Agency for Health Research and Quality (AHRQ) has shown that implementing a standardized skin assessment process and a care bundle helps prevent skin injuries. A critical care unit (CCU) at an acute care 339-bed hospital in Southaven, MS, has seen an increase in HAPIs. This quality improvement project aimed to educate CCU nurses about the Braden Scale and the SSKIN care bundle to impact pressure injuries in the CCU within 8 weeks. Education on the Braden Scale and the Skin, Sensory, Keep Moving, Incontinence, …

Thinking With The Feet In The Clinic Of Psychosis, Jed Wilson

Middle Voices

In his later work, Lacan makes occasional reference to the idea of “thinking with the feet.” An equivocal formulation, it first seems to suggest that thought and language can be regarded as physical processes—not occurring in some homunculan disembodied brain or mind, but in the real of the body. Equally, it can call to mind the idea of thinking “on” one’s feet, in the manner of adaptive improvisation. Going further, could we not also say that it points to the possibility of setting something in motion (as in walking, dancing, going somewhere—all the things we do with the feet) as …

Quality Improvement Project: Gpt Prompts As Tools For Cultural Competence In Undergraduate Nursing Education, Elizabeth K. Hobbs

Doctor of Nursing Practice Projects

In rural nursing programs, student exposure to diverse cultures is limited, which can hinder development of cultural competence. Artificial intelligence (AI) simulation is an evidence-based strategy to improve cultural competence and clinical decision-making, a practice gap exists due to lack of structured, accessible tools. This quality improvement project evaluated whether Generative Pre-trained Transformer (GPT)–based structured prompts would increase culturally inclusive simulation activities and improve faculty perceptions of usefulness and ease of use at a rural community college. The guiding PICOT asked: Among nursing faculty, how does the use of GPT-based structured prompts, compared to an unstructured approach, impact perceived usefulness, …

Do-Not-Resuscitate Orders In The Perioperative Period: A Quality Improvement Project, Brooke Popejoy, Connor Lebsack, Rena Bish

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Management of do-not-resuscitate (DNR) orders during the perioperative period presents ongoing ethical and clinical challenges. Variability in provider knowledge and documentation can compromise patient autonomy and safety. Despite institutional policies, such as Barnes-Jewish Hospital’s “Goals of Care Directive,” inconsistent adherence remains common.

Review of Literature Findings: Evidence reveals that limited provider education contributes to uncertainty in managing perioperative DNRs. Studies by Baumann et al. (2017), Chappell et al. (2023), and Crowe and Marsh (2023) support targeted educational interventions to improve provider competence and consistency with national guidelines regarding required reconsideration.

Methods: Preintervention and postintervention surveys will be …

Associations Between Smoking Habits And Weight-Related Behaviors Among People Who Smoke In The United Arab Emirates: A Cross-Sectional Study, Sharifa Alblooshi, Maryam Hassan Dawood, Dana N. Abdelrahim, Marika Lo Monaco, Falak Zeb

All Works

Background: Smoking is one of the leading global public health problems, and is complicated by multiple reasons for its prevalence and associated health problems. An understanding of the influence of smoking activity on weight management is essential to formulate successful health programs. Aim: The objective of the present study was the investigation of the association between smoking habits and weight management among adult people who smoke in the UAE. Methods: A cross-sectional study was conducted with 232 participants who completed a 36-item questionnaire assessing their smoking habits and weight management practices. Results: The sample consisted mostly of males (75.4%) aged …

Risk Of Alzheimer Dementia After High-Dose Vs Standard-Dose Influenza Vaccination, Avram Samuel Bukhbinder, Yaobin Ling, Lauren Jhin, Elizabeth He, Kristofer Harris, Mya Rodriguez, Jenna Thomas, Gabriela Cruz, Kamal Phelps, Yejin Kim, Luyao Chen, Xiaoqian Jiang, Paul E Schulz

Faculty, Staff and Student Publications

Background and objectives: Previous studies, including large cohort analyses comparing vaccinated and unvaccinated adults, suggest that routine immunizations such as inactivated influenza vaccines (IIVs) may reduce Alzheimer dementia (AD) risk. Whether AD risk differs after high-dose IIV (H-IIV) vs standard-dose IIV (S-IIV) remains unexamined. We hypothesized that AD risk would be lower among adults ≥65 years after H-IIV compared with S-IIV.

Methods: This retrospective cohort study analyzed data spanning 2014-2019 from IQVIA PharMetrics Plus for Academics, a US health care claims database. Eligible participants were ≥65 years with ≥2 years of continuous medical and pharmaceutical coverage and no previous diagnostic …

Yap Induces A Prorenewal Metabolic State In Cardiomyocytes, Lin Liu, Jeffrey D Steimle, Chang-Ru Tsai, Fansen Meng, Yuka Morikawa, Yi Zhao, Sandra Carmichael, Xiao Li, James F Martin

Faculty, Staff and Students Publications

BACKGROUND: Cardiomyocytes, as highly specialized and differentiated somatic cells, possess a limited capacity for renewal. Neonatal rodents possess the ability to regenerate cardiomyocytes after injury; however, this regenerative capacity declines rapidly with cardiomyocyte maturation, suggesting an inhibitory network between cellular maturation and cardiomyocyte proliferation. Maturing cardiomyocytes undergo a metabolic shift from predominantly glycolysis in the neonatal state to increased fatty acid oxidation in the mature state, which poses a barrier to cardiomyocyte proliferation and cardiac regenerative repair. YAP, a transcriptional cofactor regulated by the Hippo signaling pathway, promotes cardiac regenerative repair. We investigated the role of YAP in mediating metabolic …

Beyond Symptoms: A Narrative Counseling Interpretation Of First-Year Student Anxiety In Indonesian Higher Education, Azizah Abdullah, Rizky Andana Pohan, Ramtia Darma Putri, Triyono Triyono, Marimbun Marimbun, Rahmi Dwi Febriani

Buletin Konseling Inovatif

The transition to higher education is a critical period in which first-year students face new academic demands, financial pressures, social adjustment challenges, and uncertainty about the future. However, limited research has examined how freshmen make sense of and narrate their anxiety, particularly in the Indonesian context. This study aimed to explore the main domains of anxiety among first-semester students in Indonesian public universities and to interpret these experiences through a narrative counseling lens. The study employed a qualitative online survey design with an interpretivist orientation. Data were collected from 199 first-semester students through open-ended questions addressing anxiety-provoking situations, sources of …

Examining Nurse Burnout During The Covid-19 Pandemic: Causes And Mitigation Strategies, Melanie Sena

Honors Projects

Nurse burnout is a multidimensional occupational syndrome that predates the COVID-19 pandemic, yet the pandemic served as a catalyst that intensified its scope and severity in ways that the healthcare system was profoundly ill-equipped to manage. Characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, burnout among nurses accelerated dramatically between 2020 and 2022 as clinical workloads surged, personal protective equipment remained scarce, and moral distress became a near-universal experience across care settings. This review examines the primary systemic and individual contributors to nurse burnout during COVID-19, explores the consequences of burnout for both nurses and patients, …

Assessment Of Health And Medical Students' Awareness, Attitude, And Preventive Practices Toward Monkeypox Outbreak, Haneen Qahtan, Taher M. Al-Fahham, Sameerah Mohammed Saeed

Preventia: The Indonesian Journal of Public Health

Monkeypox is an infectious disease caused by the monkeypox virus, which is a primarily endemic disease in Western and Central Africa. Monkeypox infections among humans have been on the rise in certain areas of Africa in recent times, leading to its identification as a major health hazard. It is important for medical college students, who will become future healthcare professionals, to actively participate in educating the general population about this illness. Their readiness and capacity to properly handle such health emergencies are strongly influenced by their knowledge, attitudes, and preventive measures regarding newly emerging infectious diseases such as monkeypox. This …

Association Between The Combined Herbal Medicines And Risk Of Dental Diseases In Patients With Rheumatoid Arthritis: Insight From A Nationwide Database, Chiu-Hui Ling, Wei-Jen Chen, Ying-To Hsu, Hanoch Livneh, Ming-Chi Lu, Tzung-Yi Tsai

Leadership, Learning and Counseling Faculty Publications and Presentations

Background and Objectives:

Patients with rheumatoid arthritis (RA) are found to have a higher risk of dental diseases. Although herbal medicines (HMs) have long been used to treat various conditions, few studies focus on its impact on dental diseases. In this longitudinal cohort study, we assessed the correlation between HM use and risk of dental diseases in RA groups.

Materials and Methods:

A total of 2359 persons with RA aged 20–80 who were free of dental diseases between 2001 and 2010 were retrospectively enrolled from nationwide register-based data. They were then classified into HMs and non-HMs groups based on whether …

High-Precision Automated Bone Age: A Clinically Useful Tool In Monitoring Of Treatment Effects In Children And Adolescents, Hans Henrik Thodberg, Lise Aksglaede, Anders Juul, Shanlee M. Davis, Judith L. Ross

Department of Pediatrics Faculty Papers

The clinical value of serial bone age (BA) determinations in children during growth is limited by the manual rater variability (precision 0.63 years). The objective of this work was to determine the precision of automated bone age and bone health index (BHI) measurements by BoneXpert and to establish the time interval at which the automated method can detect a significant treatment effect. The data were from a case-control trial (oxandrolone/placebo) following 90 boys with Klinefelter syndrome (KS) with five visits over 2 years, recording X-rays of both hands. The precision of BA was 0.08 years [0.07; 0.09] 95% CI, leading …

Autoantibody Reactivity In Hidradenitis Suppurativa: Characterizing Keratinocyte And Apocrine Gland Targets Across Disease Progression And Anti-Tnf-Α Treatment, Talla Hamouche

Student Theses and Dissertations

Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory skin disease associated with impaired quality of life, representing one of the highest burdens among dermatological conditions. This debilitating disorder primarily affects apocrine-gland-bearing and flexural skin areas, most commonly the axillae, breast, buttocks, and groin. As lesions recur and new sites emerge, surgical excision does not guarantee prevention of disease reestablishment. Despite its substantial burden, HS remains among the least understood and most treatment-resistant inflammatory diseases. The mechanisms underlying this chronicity and the frequent failure of conventional anti-inflammatory therapies remain unresolved. An underappreciated autoimmune dimension may contribute to HS pathogenesis: the clonal …

2026 - The Thirtieth Annual Symposium Of Student Scholars

Symposium of Student Scholars Program Books

The full program book from the 30th Annual Symposium of Student Scholars, held on April 22-24, 2026. Includes abstracts from the presentations and posters.

Organizational Governance Capacity And Organizational Resilience In Hospitals: A Cross-Sectional Study, Leyla Afşar, Selim Yazıcı

Makara Journal of Health Research

Background: This study aims to examine the relationship between organizational governance capacity (OGC) and organizational resilience (OR) in hospitals, with a focus on cross-institutional differences.

Methods: A cross-sectional study was conducted among 1,143 employees from six hospital types in Istanbul, including university, Ministry of Health (state, training and research, and city), and private hospitals. Validated scales were used to measure OGC and OR. Data were analyzed using descriptive statistics, nonparametric tests, and structural equation modeling (SEM) to assess the relationships between these dimensions.

Results: Private hospitals demonstrated the highest levels of both OGC and OR (70%), followed …

Questionnaire For Eudaimonic Well-Being: Psychometric Validation Among Malaysian Youth, Mohd Ahsani A. Malek, Nurulwahida Saad, Suzana Mohd. Hoesni, Muhamad Ariff Ibrahim, Nurul Shafira Adi, Mohd Nazir Mohd Nazori

Makara Journal of Health Research

Background: The rising prevalence of mental illness underscores the need to understand how individuals can live and flourish under such conditions. In Malaysia, research has largely emphasized diagnosis and treatment, with limited focus on positive psychology and few validated instruments. This study aimed to translate and validate the questionnaire for eudaimonic well-being (QEWB) among Malaysian youth.

Methods: The QEWB was translated into Malay using back-to-back translation and administered to undergraduates from four public universities through a cross-sectional survey design. Convenience quota sampling was used, resulting in 229 respondents completing the online form to measure sociodemographic characteristics, eudaimonic well-being, …