Digital Commons Network^™

Association Of State Cannabis Legalization With Cannabis Use Disorder And Cannabis Poisoning, Jayani Jayawardhana, Jialin Hou, Patricia Freeman, Jeffery C. Talbert

Health Management and Policy Faculty Publications

IMPORTANCE Whether state implementation of medical and recreational cannabis laws is associated with increased cannabis use disorder (CUD) and/or cannabis poisoning among adults is not evident.

OBJECTIVE To examine state-level medical and recreational cannabis laws’ associations with CUD and cannabis poisoning, overall and by sex and age subgroups.

DESIGN, SETTING, AND PARTICIPANTS In this longitudinal cohort study, state-level CUD and cannabis poisoning diagnoses from January 2011 to December 2021 were examined across all 50 US states and the District of Columbia before and after the implementation of medical and recreational cannabis laws (MCLs and RCLs, respectively) using a staggered adoption …

Demographic Variation In Continuous Glucose Monitoring Utilisation Among Patients With Type 1 Diabetes From A Us Regional Academic Medical Centre: A Retrospective Cohort Study, 2018–2021, Omer Atac, Kory R. Heier, Daniela Moga, John L. Fowlkes, Min-Woong Sohn, Aaron J. Kruse-Diehr, Teresa M. Waters, Mary E. Lacy

Health Management and Policy Faculty Publications

Objective: While continuous glucose monitoring (CGM) utilisation has been increasing among patients with type 1 diabetes (T1D), few studies have examined patterns of use across age, race/ethnicity and insurance status together. In this study, we examine CGM utilisation among patients with T1D from a regional academic medical centre across all insurance types.

Design and Setting: This is a retrospective cohort study including both paediatric and adult patients with T1D who visited a regional academic medical centre between 1 January 2018 and 31 December 2021.

Methods: Patients were followed from the date of their first T1D encounter during the study period …

Rural Hospital Closure And Medicaid Expansion, Jason White

Theses, Dissertations and Capstones

Introduction: In the United States, hospitals in rural areas have been under financial pressure and have been closing at an increasing rate.  This reduces access to care for rural citizens.  The Affordable Care Act of 2010 was passed in order to increase access to medical care, partially through an optional expansion of Medicaid coverage to a larger percentage of the population.  As some states adopted the expansion and some states did not, an opportunity was created to examine the policy’s effect on rural hospital stability.

Purpose of the Study:  This study was designed to examine the effect of …

Effect Of Wildfire Smoke Pm2.5 On Preterm Birth Outcomes: A Generalized Synthetic Control Analysis Of Preterm Births In The Contiguous United States From 2006 To 2020, Alexandra Maria Nechaev

Public Health Theses

Wildfire activity has intensified across the United States due to climate change, contributing to rising levels of smoke-attributable fine particulate matter (PM2.5) in ambient air. Wildfire-specific PM2.5 is linked to adverse health outcomes, including increased risk of preterm birth, a leading cause of infant morbidity and mortality. Despite growing concern, few studies have applied quasi-experimental methods to evaluate the causal effects of wildfire-attributable PM2.5 on preterm birth across large, diverse populations and geographical areas. This study estimated the effect of wildfire-specific PM2.5 exposure on preterm birth rates across all counties in the contiguous United States from 2006 to 2020 using …

Social Media Influences On Youth Substance Use, Sexual Health, And Mental Health In Paterson, New Jersey: A Rapid Qualitative Analysis, Nimisha Srikanth

Public Health Theses

Introduction: Social media use among youth has become a topic of concern among public health professionals and policymakers. Youth have grown to rely on social media for communication and entertainment, but are exposed to negative health behaviors with the potential to model them in their lives. In this study, we investigated youth’s perspectives on social media content and the impact it has on their health and lives.Methods: We conducted a rapid qualitative analysis of individual interviews of youth from Paterson, New Jersey. Among the sample (n=20), the mean age was 16 years, 80% identified as male, and 30% were justice-involved. …

The Role Of Climate Change In The Pandemic Agreement Negotiations, Cristina Arnes Sanz

Public Health Theses

Introduction: For over three years, Member States of the World Health Organization (WHO) have been negotiating a treaty to prevent, prepare for, and respond to future pandemics. The Pandemic Agreement is anticipated to be adopted at the World Health Assembly in May 2025. Growing scientific evidence underscores the effects of climate change on infectious diseases, including those that could lead to pandemics. This thesis examines how climate change has been addressed in the drafting and negotiations of the Pandemic Agreement.

Methods: All the references related to climate change in the transcripts of the publicly broadcast Intergovernmental Negotiating Body (INB) meetings …

Exploring The Link Between Low-Income Communities And Increased Cancer Risk From Nitrate Contamination In Drinking Water: A Review, Anna Wiggins, Rena Phillips, Michael L. Phillips, Wei-Hsiung Yang

South Atlantic Division GME Research Day 2025

No abstract provided.

Ambient Air Pollution And Survival Among Black Women With Epithelial Ovarian Cancer Across Diverse Geographical Regions Of The United States, Ekaterina Chirikova, Courtney E. Johnson, Anke Huels, Pushkar P. Inamdar, Elisa V. Bandera, Lawrence H. Kushi, Jennifer A. Doherty, Joellen M. Schildkraut, Hari S. Iyer, Melissa Bondy, Edward S. Peters, Kendra L. Ratnapradipa, Jeffrey Marks, Christopher Pierson, Theresa Hastert, Kristin Haller, Grace Christensen, Salma Shariff-Marco, Scarlett L. Gomez, Andrew Lawson

Journal Articles: Epidemiology

Background: Ovarian cancer is a leading cause of gynecologic cancer mortality, with Black women experiencing 5-year survival rates of only 41%. Disproportionate air pollution exposure may impact survival. We evaluated associations of fine particulate matter (PM_2.5) and nitrogen dioxide (NO₂) exposure with survival among Black women with epithelial ovarian cancer using data from the California Cancer Registry (CCR, n = 540) and the multi-state African American Cancer Epidemiology Study (AACES, n = 766).

Methods: Annual PM_2.5 and NO₂ levels were estimated at a 1 km resolution using well-validated ensemble-based prediction models derived from the …

Building Place-Based Experiential Learning Into The Honors Curriculum At Ohio University, Geoffrey L. Buckley, Nicole Finnicum, Michelle O'Malley, Jennifer Bowie, Yolonda Youngs

Honors in Practice Online Archive

Observing the demand for interdisciplinary experiential learning opportunities post-COVID, authors present a place-based curriculum in honors. Workshop-style special topics classes provide students with an immersive and flexible learning environment, energize faculty, and engage alumni and community partners. Coursework, fieldwork, internships, and study abroad opportunities all contribute to the development of an informed and engaged citizenry. Authors address challenges in funding, access, and equity, and they suggest ways these challenges might be met.

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 …

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 …

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 …

Prevalence Of Depression Among Type 2 Diabetes Mellitus Patients In Urban Mysuru – A Cross-Sectional Study, Jesymol Joy, Renuka M, Chiranjeevi G S

Digital Journal of Clinical Medicine

Background: Depression is a significant comorbidity among individuals with Type 2 Diabetes Mellitus (T2DM) adversely affecting disease management and overall quality of life. Diabetes and depression have a bidirectional relationship, where poorly managed diabetes increases the risk of depression, and depression exacerbates diabetes-related complications. Depression contributes to poor glycemic control, decreased adherence to treatment, increased risk of diabetes-related complications, and higher healthcare utilization.

Objectives: To determine the prevalence of depression and its associated factors among Type 2 Diabetes Mellitus patients in urban Mysuru.

Methods: A community-based cross-sectional study was conducted among 300 Type 2 Diabetes mellitus patients >18 years of …

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.

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 …

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 …

How To Create A Self-Sustaining Meditation Garden, Heather Salazar, Lydia Barrett-Miller, Kaitlyn Parisan

Honors in Practice Online Archive

This essay presents the creation and maintenance of a campus meditation garden as an outgrowth of four successive philosophy classes in honors. The authors describe the garden’s inception, execution, curricular advantages, and administration, with specific examples of the impact on student health and well-being. The authors observe the ways in which honors students attained skills in transformational leadership by collaborating to develop projects and lead events, suggesting that a meditation garden may be appropriate for any learning environment emphasizing cooperation, creativity, mindfulness, and well-being.

Engaging The Community, Providing Hopes, Mackenzie Peeke, Margaret West, Alyssa Wilkinson, Matthew Serrata, Michael Baroody, Conner Tembe, Chrisney Yerena

HOPES Free Clinic Publications

Founded in the 1970s as a grassroots effort to provide care to the underserved population of Hampton Roads, Eastern Virginia Medical School (EVMS) has long been committed to community-centered care. The HOPES Free Clinic is a manifestation of that mission. Launched in 2011 as a student-run phone triage service, the Health Outreach Partnership of EVMS Students (HOPES) later transitioned to provide direct clinical services—becoming the first student-run free clinic in the Commonwealth of Virginia. In 2014, HOPES integrated into Community Engaged Learning to enhance and solidify its efforts. Since its inception, medical and health professions students have partnered with volunteer …

Systemic Therapy Targeting Psoriatic Inflammation Is Associated With Decreased Incidence Of Dementia: An Observational Retrospective Cohort Study, Madison P. Olexson, Ana Ormaza Vera, Chunghwan Ro, Clinton W. Enos

Department Dermatology Faculty Publications

[Introduction] To the Editor: Psoriasis, an immune-mediated chronic inflammatory skin disorder, has been implicated in cognitive impairment and dementia.1, 2, 3 Emerging evidence suggests that systemic inflammation contributes to neuroinflammation and resultant cytokine-driven neurodegeneration, although findings remain inconclusive.1, 2, 3 While systemic therapies such as biologics and conventional disease-modifying antirheumatic drugs are routinely used in psoriasis management, their role in modulating dementia in this population remains underexplored, with research yielding mixed results.1, 2, 3 We conducted a large-scale, retrospective cohort study to investigate the relationship between psoriasis and dementia and whether systemic treatments for psoriasis impact this association.

Strategies To Enhance Gme Program Coordinator Job Satisfaction And Well-Being, Stuart Slavin, Julie Beckerdale, April L. Mcguire, Linda Ortiz Morrison, Melanie Pigott, Carrie L. Racsumberger, Evangelina Rangel, Bret Stevens, Ramona Tirado, Cynthia D. Thompson, Latoya Wright

Department Dermatology Faculty Publications

[Introduction] Program and institutional coordinators in graduate medical education (GME) have very complex jobs that are often highly pressured and demanding, requiring a diverse skill set to manage effectively. While these positions can be immensely gratifying, the demands and pressures inherent in the roles pose threats to job satisfaction as well as risks to mental health and well-being. A national survey of 6372 coordinators found that 20.4% reported being dissatisfied or very dissatisfied with work, and 27.9% reported being likely or very likely to leave their job in the next year. ¹ Of the coordinators surveyed 36.3% screened positive for …

Summary Of Eco Groups Learning Evaluation, Claire Devine, Abby Bush, Lisa Angus

Articles, Abstracts, and Reports

No abstract provided.

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 …

Targeted Deletion Of Cxcl1 In Mscs Regulates Osteogenesis And Suppresses Bone-Metastatic Prostate Cancer, Catherine S. Johnson, Diane L. Costanzo-Garvey, Julio C. Valencia, Sanjana Rajgopal, Theodore Reed, Emma R. Brannon, Jeremy S. Frieling, Deanna Mosley, Todd A. Wyatt, Elijah F. Edmondson, Kabhilan Mohan, Grinu Mathew, Leah M. Cook

Journal Articles: Environmental, Agricultural & Occupational Health

Bone metastasis continues to be the greatest challenge in treating patients with prostate cancer despite ongoing research. In bone, prostate cancer tumors hijack normal bone remodeling processes to drive cancer progression. However, it is unclear how these interactions drive bone-metastatic prostate cancer growth in the bone environment. To understand the mechanisms associated with bone-metastatic prostate cancer regulation of mesenchymal stem cells (MSC), we previously identified that bone-metastatic prostate cancer induces MSC expression of the pro-inflammatory chemokine CXCL8 and its mouse functional homologue Cxcl1. To date, there has been little to no information about the role of CXCL1/8 in MSC biology …

Estimating Per-Infection Cost And Burden For Dengue And Zika As A Function Of Antibody-Dependent Enhancement, Christopher M. Kribs

Mathematics Faculty Publications - Archive

The complex immune interactions produced by the tetravalent dengue vaccine Dengvaxia have foregrounded the important role of antibody-dependent enhancement (ADE) in dengue infection. Some evidence exists that ADE may extend beyond the four dengue serotypes to Zika, a closely related flavivirus transmitted by the same mosquito species as dengue, and may also account for the increased severity of some cases. Estimates of the public health impact of dengue vaccination may then need to include its effects on the transmission of Zika in addition to dengue. This study gathers primary references to build estimates of per-case economic cost and disease burden …

Pedestrian Safety South Of Brigham Young University Campus, Emma Mayo, Alisha H. Redelfs

Library/Life Sciences Undergraduate Poster Competition 2025

8,500 crossings happen on 800 North every day. In Provo last year, 57 car crashes involved pedestrians. A pedestrian’s view of the road is obstructed by cars parked on the right hand side of the road causing them to walk in the crosswalk to see if there is a car coming. Sidewalks on connecting streets are uneven and cracked. Multiple blocks on 800 North without a stop sign to slow drivers down. Currently no posted speed limit signs on 800 North. Drivers can’t see pedestrians crossing on 200, 300, 400, or 500 East because of inadequate lighting. Cars obstruct areas …

Maternal Health Predictors In Ohio, Sritha Donepudi, Humza Khan

Scholarship in Medicine - All Papers

Background: Ohio has continued to have a maternal mortality rate higher than the average which has posed the question of how geographic location, socioeconomic status, and demographics affect these rates.
Objective: This paper aims to investigate the relationship between variables affecting maternal mortality rates in Ohio such as teen birth rates and primary care physician access with where one lives between Rural and Urban areas and their household income in order to provide more information for future research.
Methods: This paper utilized County Health Rankings and statistical and correlation analysis with SPSS to analyze rates across counties in Ohio.
Results: …

The Impact Of Health Promotion Home Visits On Loneliness In An Older Adult Population, Jean M. Herb

West Chester University Doctoral Projects

Loneliness among older adults is a significant public health concern associated with adverse physical, emotional, and cognitive outcomes. Despite widespread recognition of the issue, effective interventions remain limited in clinical practice. This Doctor of Nursing Practice (DNP) project implemented and evaluated a Health Promotion Home Visit (HPHV) intervention designed to reduce loneliness in community-dwelling adults aged 65 and older. A quality improvement initiative using a pre-post design was conducted at a community outreach division of a home health agency. Patients received HPHV every other week over an eight-week period. The UCLA Loneliness Scale (Version 3) was used to assess loneliness …

Institute Of Public Health Newsletter, January - December 2025, Institute Of Public Health (Iph)

Institute of Public Health Newsletter (IPHNL) and Other Publications

No abstract provided.

A Parent's Guide To Success, Marina D. Bucciarelli

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2025

A Parent’s Guide to Success, a doctoral capstone project, explored occupational therapy’s (OT) role in family-centered practice (FCP). The project focused on areas of education, advocacy, and program development which were informed by the completion of a scoping review. This capstone project was developed as a primary prevention resource for parents and caregivers of children from birth to three years. It was designed to prepare, inform, and support new parents and caregivers with educational videos and resources that depict the skills, knowledge, and support needed for optimized family outcomes. Education was also a valuable aspect of this project as the …