Digital Commons Network^™

An Analysis Of Milk Hedging Effectiveness In Madison County, Illinois, Kelsey R. Knebel

Research Papers

This study examines whether Class III and Class IV milk futures contracts can effectively hedge farm-level milk prices and reduce exposure to price volatility. The price volatility for dairy farmers is a major issue and makes it difficult for them to stay afloat. With the constant changes in input costs combined with the instability of the prices the farmers receive, the dairy industry is very difficult. Using regression analysis, the relationship between farm-level prices and futures prices was evaluated throughout multiple models, including those accounting for seasonality. The results from the regression analysis indicate that both Class III and Class …

Comparative Analysis Of Hydration Status And Microbial Quality Of Tap Water Between Urban And Rural Settings In The Ashanti Region Of Ghana, Marina A. Tandoh, Priscilla Owusu, Claire-Rush N.A. Nkrumah, Veronica Tawiah Annaful, Chris Y. Asare, Samuel Selormi Attu

Food Science Faculty Publications and Presentations

Maintaining proper hydration is crucial for human health, physiological functions, and cognitive performance. This study sought to determine the hydration status and the microbial safety of tap water in an urban setting (Kwame Nkrumah University of Science and Technology Campus) and a rural community (Adjamesu) in the Ashanti Region of Ghana. The water safety perception and hydration status of 171 study participants aged 10-61 years were assessed. Six taps were randomly selected at each site in triplicates, resulting in 36 water samples. The microbial quality of the water was assessed by testing for heterotrophic bacteria, coliforms, Staphylococcus aureus, and Salmonella. …

Delivering A Drench Using An Injector: Worksheet, Amy Papineau

UNH Cooperative Extension

No abstract provided.

Using Guided Notes To Provide Scaffolded Design As A Tool For Cognitive Efficiency And Conceptual Clarity, Ryan Schuffert

Teaching Online Pedagogical Repository

These supplemental learning materials streamline the learning process through a design that facilitates scaffolded learning by organizing focus on mastering macro-level concepts as a prerequisite to individualized details in content-dense courses.

Guided notes lead the learner on a path of discovering the depth of content while the layout encourages the development of discernment among multiple pathologies that share disease/disorder categorization.

This tool has helped students master the skill of chunked learning and has allowed them to implement this strategy, using these worksheets as a template, into multiple disciplines outside of pathophysiology.

Math Escape Room: A Virtual/Blended Problem‑Solving Adventure, Youssef Ibrahim

Teaching Online Pedagogical Repository

A narrative‑driven digital escape room turns secondary‑level mathematics review into a collaborative quest: students unlock successive “rooms” by solving algebraic, geometric, and data‑analysis challenges in Google Forms and Genially. Timers, conditional branching, and embedded hints sustain flow, while instructor analytics reveal misconceptions in real time.

Sexual Education, Sexual Self-Concept, And Behavior Of Adolescents: A Retrospective Study, Rachel Albanese

PCOM Psychology Dissertations

Adolescence is a period within the lifespan of a human where sexuality is a key component of development; therefore, it is appropriate that adolescents are provided sexual education during this time. There continues to be a debate regarding sexual education; while some studies consider specific ways to provide sexual education, they do not compare the effect of differing sexual education (i.e., how and who provided sexual education) or lack of sexual education on risky sexual behavior and sexual selfconcept during adolescence. This study retrospectively examined the impact of sexual education on risky sexual behavior and sexual self-concept. It also explored …

Exploring The Relationship Among Postpartum Depression, Cognitive Distortions, And Relationship Satisfaction, Kylie A. Hastings

PCOM Psychology Dissertations

Postpartum depression is the most prevalent psychological disorder experienced following childbirth, impairs daily functioning, negatively impacts child growth and development, and is linked to maladaptive parent-child interactions. Previous research also suggests a link among distorted thinking, depression symptoms, and interpersonal tension. The current study explores the interplay among postpartum depression symptoms, cognitive distortions, and relationship satisfaction among postpartum individuals. Researchers examined how specific thinking errors, including catastrophizing, mindreading, and labeling, are associated with depression symptoms and relational experiences in the postpartum period. Using a quantitative survey design, data were collected from 90 participants using validated instruments: the …

Fixing Mfw: Fairness And Vision In Controller Self-Dealing, Zohar Goshen, Assaf Hamdani, Dorothy S. Lund

Faculty Scholarship

The legal regime governing controlling shareholders relies on the ability of Delaware courts to police conflicted transactions under the stringent "entire fairness" standard of review. This review involves both implicit valuation – evaluating the transaction process, and explicit valuation – assessing the fairness of the transaction's financial terms. This Article reveals a critical flaw in this regime: courts cannot reliably engage in valuation when the transaction involves an entrepreneur's idiosyncratic vision for the company. As a result, there is a gaping hole in Delaware's framework for policing the fairness of controller transactions.

Delaware courts have developed guardrails to avoid judicial …

Power Training Impact On Running Ability After Traumatic Brain Injury: A Case Study, Sandra M. Tremblay Pt, Ms, Cws, Mscs

Department of Medicine

No abstract provided.

Cheshire 4-H Presents 2026 Poster Info, Extension

UNH Cooperative Extension

No abstract provided.

Defining Spine Cancer Pain Syndromes: A Systematic Review And Proposed Terminology, Markian Pahuta, Ilya Laufer, Sheng-Fu Larry Lo, Stefano Boriani, Charles Fisher, Nicolas Dea, Michael H Weber, Dean Chou, Arjun Sahgal, Laurence Rhines, Jeremy Reynolds, Aron Lazary, Alessandro Gasbarrinni, Jorrit-Jan Verlaan, Ziya Gokaslan, Chetan Bettegowda, Mohamed Sarraj, Ori Barzilai, Ao Spine Knowledge Forum Tumor

Faculty, Staff and Student Publications

STUDY DESIGN: Systematic Review.

OBJECTIVES: Formalized terminology for pain experienced by spine cancer patients is lacking. The common descriptors of spine cancer pain as mechanical or non-mechanical is not exhaustive. Misdiagnosed spinal pain may lead to ineffective treatment recommendations for cancer patients.

METHODS: We conducted a systematic review of pain terminology that may be relevant to spinal oncology patients. We provide a comprehensive and unbiased summary of the existing evidence, not limited to the spine surgery literature, and subsequently consolidate these data into a practical, clinically relevant nomenclature for spine oncologists.

RESULTS: Our literature search identified 3515 unique citations. Through …

The Influence Of The Microbiome On Radiotherapy And Dna Damage Responses, Aadil Sheikh, Michael A Curran

Faculty, Staff and Student Publications

Colorectal cancer (CRC) is one of the most prevalent cancers in terms of diagnosis and mortality. Radiotherapy (RT) remains a mainstay of CRC therapy. As RT relies on DNA damage to promote tumor cell death, the activity of cellular DNA damage repair pathways can modulate cancer sensitivity to therapy. The gut microbiome has been shown to influence intestinal health and is independently associated with CRC development, treatment responses and outcomes. The microbiome can also modulate responses to CRC RT through various mechanisms such as community structure, toxins and metabolites. In this review we explore the use of RT in the …

Patient-Reported Outcomes During Pelvic Radiation Therapy: A Secondary Analysis On Sexual Function From Nrg-Rtog 1203, Kelsey L Corrigan, Rebecca Paulus, Ann H Klopp, Lari B Wenzel, Anamaria R Yeung, J Spencer Thompson, Desiree E Doncals, Vijayananda Kundapur, Nancy H Wiggers, Dasarahally S Mohan, Sharad A Ghamande, Shannon N Westin, Kara L Schnarr, Michael L Haas, David K Gaffney, Steven E Waggoner, Pamela J Vanderwall, Noha T Jastaniyah, Stephanie L Pugh, Lisa A Kachnic

Faculty, Staff and Student Publications

Purpose: NRG-RTOG 1203 reported that intensity-modulated radiation therapy (IMRT) reduced patient-reported GI toxicities in patients with cervical/endometrial cancer receiving postoperative RT, compared with 3-dimensional conformal radiation therapy (3DRT). We conducted a secondary analysis of patient-reported sexual function (PR-SF) among treatment groups to identify factors associated with sexual dysfunction.

Methods and materials: Patients on NRG-RTOG 1203 were randomly assigned to 3DRT versus IMRT and completed Patient-Reported Outcomes (PRO)-Common Terminology Criteria for Adverse Events (CTCAE) and FACT-Cx surveys at baseline, week 5 of RT, and at 4-6 weeks, 1 year, and 3 years after RT. Patient responses to FACT-Cx sexual function questions …

Reproducibility And Repeatability Of 18f-(2s, 4r)-4-Fluoroglutamine Pet Imaging In Preclinical Oncology Models, Gregory D Ayers, Allison S Cohen, Seong-Woo Bae, Xiaoxia Wen, Alyssa Pollard, Shilpa Sharma, Trey Claus, Adria Payne, Ling Geng, Ping Zhao, Mohammed Noor Tantawy, Seth T Gammon, H Charles Manning

Faculty, Staff and Student Publications

Introduction: Measurement of repeatability and reproducibility (R&R) is necessary to realize the full potential of positron emission tomography (PET). Several studies have evaluated the reproducibility of PET using 18F-FDG, the most common PET tracer used in oncology, but similar studies using other PET tracers are scarce. Even fewer assess agreement and R&R with statistical methods designed explicitly for the task. 18F-(2S, 4R)-4-fluoro-glutamine (18F-Gln) is a PET tracer designed for imaging glutamine uptake and metabolism. This study illustrates high reproducibility and repeatability with 18F-Gln for in vivo research.

Methods: Twenty mice bearing colorectal cancer cell line xenografts were injected with ~9 …

Patterns Of Loco-Regional Progression And Patient Outcomes After Definitive-Dose Radiation Therapy For Anaplastic Thyroid Cancer, Julianna K Bronk, Alexander Augustyn, Abdallah S R Mohamed, C David Fuller, Adam S Garden, Amy C Moreno, Anna Lee, William H Morrison, Jack Phan, Jay P Reddy, David I Rosenthal, Michael T Spiotto, Steven J Frank, Ramona Dadu, Naifa Busaidy, Mark Zafereo, Jennifer R Wang, Anastasios Maniakas, Renata Ferrarotto, Priyanka C Iyer, Maria E Cabanillas, G Brandon Gunn

Faculty, Staff and Student Publications

Background: The aim of this study is to characterize the patterns of loco-regional progression (LRP) and outcomes after definitive-dose intensity modulated radiation therapy (IMRT) for anaplastic thyroid cancer (ATC) with macroscopic neck disease at the time of IMRT.

Methods: Disease/treatment characteristics and outcomes for patients with unresected or incompletely resected ATC who received IMRT (≥45 Gy) were retrospectively reviewed. For those with LRP after IMRT, progressive/recurrent gross tumor volumes (rGTV) were contoured on diagnostic CTs and co-registered with initial planning CTs using deformable image registration. rGTVs were classified based on established spatial/dosimetric criteria.

Results: Forty patients treated between 2010-2020 formed …

Selective Inhibition Of Canonical Stat3 Signaling Suppresses K-Ras Mutant Lung Tumorigenesis And Reinvigorates Anti-Tumor Immunity, Michael J Clowers, Zahraa Rahal, Sung-Nam Cho, Avantika Krishna, Bo Yuan, Leticia G Hamana Zorrilla, T Kris Eckols, Moses M Kasembeli, Samuel Liu, Stephen Peng, Marco Ramos-Castaneda, Annamarie L Thompson, Carlos Ignacio Rodriguez Reyna, Katherine E Larsen, Maria T Grimaldo, Shanshan Deng, Nastaran Karimi, Cody Chou, Walter V Velasco, Melody Zarghooni, Sayan Alekseev, Luisa M Solis Soto, Edwin J Ostrin, Humam Kadara, Suhendan Ekmekcioglu, David J Tweardy, Seyed Javad Moghaddam

Faculty, Staff and Student Publications

Introduction: K-ras mutant lung adenocarcinoma (KM-LUAD) is a difficult-to-treat cancer subtype in which chronic inflammation pervades the tumor immune microenvironment (TIME). Pro-inflammatory pathways dampen the response to treatments, including immune checkpoint inhibitors, necessitating therapies that target this inflammatory signaling network in the TIME. One of the lynchpins of chronic inflammation in KM-LUAD is signal transducer and activator of transcription 3 (STAT3).

Methods: Here, we tested the anti-tumor and early immunotherapeutic efficacy of TTI-101, a selective small-molecule inhibitor of canonical STAT3 signaling, in a K-rasG12D mutant lung cancer mouse model (CC-LR).

Results: Treatment of CC-LR mice with TTI-101 resulted in reduced …

Dedifferentiated Liposarcomas Treated With Immune Checkpoint Blockade: The Md Anderson Experience, Madeline B Torres, Cheuk Hong Leung, Marianne Zoghbi, Rossana Lazcano, Davis Ingram, Khalida Wani, Emily Z Keung, M Alejandra Zarzour, Christopher P Scally, Kelly K Hunt, Anthony Conley, Andrew J Bishop, B Ashleigh Guadagnolo, Ahsan Farooqi, Devarati Mitra, Alison K Yoder, Michael S Nakazawa, Dejka Araujo, Andrew Livingston, Ravin Ratan, Shreyaskumar Patel, Vinod Ravi, Alexander J Lazar, Christina L Roland, Neeta Somaiah, Elise F Nassif Haddad

Faculty, Staff and Student Publications

Background: Dedifferentiated liposarcoma (DDLPS) is one of the most common types of soft tissue sarcoma (STS) characterized by liposarcomatous differentiation and a predilection for the retroperitoneum. Despite the growing number of histology-specific immune checkpoint blockade (ICB) trials in STS, it is still difficult to identify the radiographic objective response rate (ORR) for DDLPS in the real world setting. This study aimed to evaluate the ORR and survival of patients with DDLPS treated with ICB at a single center.

Methods: We conducted a retrospective study of 31 patients with pathologically confirmed DDLPS treated with ICB at MD Anderson Cancer Center between …

A Plain Language Summary Of The Final Analysis Of The Griffin Study Of Daratumumab Plus Lenalidomide, Bortezomib, And Dexamethasone For People With Newly Diagnosed Multiple Myeloma, Peter M Voorhees, Douglas W Sborov, Jacob Laubach, Jonathan L Kaufman, Brandi Reeves, Cesar Rodriguez, Rebecca Silbermann, Luciano J Costa, Larry D Anderson, Nitya Nathwani, Nina Shah, Naresh Bumma, Yvonne A Efebera, Sarah A Holstein, Caitlin Costello, Andrzej Jakubowiak, Tanya M Wildes, Robert Z Orlowski, Kenneth H Shain, Andrew J Cowan, Shira Dinner, Katharine S Gries, Huiling Pei, Annelore Cortoos, Sharmila Patel, Thomas S Lin, Saad Z Usmani, Paul G Richardson

Faculty, Staff and Student Publications

No abstract provided.

Grape-Pi: Graph-Based Neural Networks For Enhanced Protein Identification In Proteomics Pipelines, Chunhui Gu, Seyyed Mahmood Ghasemi, Yining Cai, Johannes F Fahrmann, James P Long, Hiroyuki Katayama, Chong Wu, Jody Vykoukal, Jennifer B Dennison, Samir Hanash, Kim-Anh Do, Ehsan Irajizad

Faculty, Staff and Student Publications

Motivation: Protein identification via mass spectrometry (MS) is the primary method for untargeted protein detection. However, the identification process is challenging due to data complexity and the need to control false discovery rates (FDR) of protein identification. To address these challenges, we developed a graph neural network (GNN)-based model, Graph Neural Network using Protein-Protein Interaction for Enhancing Protein Identification (Grape-Pi), which is applicable to all proteomics pipelines. This model leverages protein-protein interaction (PPI) data and employs two types of message-passing layers to integrate evidence from both the target protein and its interactors, thereby improving identification accuracy.

Results: Grape-Pi achieved significant …

A Critical Assessment Of Artificial Intelligence In Magnetic Resonance Imaging Of Cancer, Chengyue Wu, Meryem Abbad Andaloussi, David A Hormuth, Ernesto A B F Lima, Guillermo Lorenzo, Casey E Stowers, Sriram Ravula, Brett Levac, Alexandros G Dimakis, Jonathan I Tamir, Kristy K Brock, Caroline Chung, Thomas E Yankeelov

Faculty, Staff and Student Publications

Given the enormous output and pace of development of artificial intelligence (AI) methods in medical imaging, it can be challenging to identify the true success stories to determine the state-of-the-art of the field. This report seeks to provide the magnetic resonance imaging (MRI) community with an initial guide into the major areas in which the methods of AI are contributing to MRI in oncology. After a general introduction to artificial intelligence, we proceed to discuss the successes and current limitations of AI in MRI when used for image acquisition, reconstruction, registration, and segmentation, as well as its utility for assisting …

Rules And Laws For Civil Actions 2026, Stella Burch Elias, Derek T. Muller, Jason Rantanen, Caroline Sheerin, Maya Steinitz

Books

Rules and Laws for Civil Actions is an open-access resource for law students containing the U.S. Constitution, Federal Rules of Civil Procedure, Federal Rules of Evidence, Federal Rules of Appellate Procedure, and selected federal and state statutes. The book was created by a team of faculty members at the University of Iowa College of Law to supplement the study of Civil Procedure, Evidence, Constitutional Law, and other law school courses. In addition to containing the official text, each legal source found in Rules and Laws for Civil Actions is accompanied by an introductory section written by an Iowa Law professor …

Book Review: Biglaw's Race Problem, Angela Onwuachi-Willig, Anthony V. Alfieri

Faculty Scholarship

Ever since the 1970s when BigLaw firms began to hire Black lawyers into their associate ranks, these firms have wrestled with problems in both recruiting and retaining Black associates. During the ensuing decades, BigLaw firms have minimally increased the low numbers of Black attorneys who have become partners, particularly equity partners, within their organizations. Numerous scholars have explored how racial bias and discrimination, both within BigLaw firms and greater society, have contributed to such failures in the recruitment, retention, and promotion of Black lawyers. In his new book The Black Ceiling: How Race Still Matters in the Elite Workplace, …

Disentangling Effects Of The Dr And Dq Isomers Encoded By The Hla Class Ii Haplotype Drb1*15:01/Dqb1*06:02 To Help Establish The True Risk Allele For Fviii Inhibitor Development In Hemophilia A, Vincent P Diego, Bernadette W Luu, Marcio A Almeida, Raja Rajalingam, Marco Hofmann, Jacob A Galan, Eron G Manusov, Jerry S Powell, Long V Dinh, Henry Mead, Huy Huynh, Anne M Verhagen, Juan M Peralta, Paul V Lehmann, Satish Kumar, Eli J Fine, Joanne E Curran, Harald H Goring, Miguel A Escobar, Sarah Williams-Blangero, Eugene Maraskovsky, John Blangero, Tom E Howard

Faculty, Staff and Student Publications

Introduction: Hemophilia A (HA) patients (HAPs) with the human leukocyte antigen (HLA)-class-II (HLAII) haplotype DRB1*15:01/DQB1*06:02, and thus antigen presenting cells which express HLAII β-polypeptide chains that form heterodimers of DR15- and DQ6-serotypes, respectively, have an increased risk of developing factor (F)VIII inhibitors (FEIs)-neutralizing antibodies against the therapeutic-FVIII-proteins (tFVIIIs) infused to prevent/arrest bleeding. As DRB1*15:01 and DQB1*06:02 exist in strong linkage disequilibrium, association analysis cannot determine which is the actual risk allele.

Methods: To establish the true risk allele of this haplotype, we analyzed the tFVIII-derived peptides (tFVIII-dPs) bound to either the DR or DQ molecules that comprise the individual HLAII …

Inhibition Of Nitric Oxide Synthase Transforms Carotid Occlusion-Mediated Benign Oligemia Into De Novo Large Cerebral Infarction, Ha Kim, Jinyong Chung, Jeong Wook Kang, Dawid Schellingerhout, Soo Ji Lee, Hee Jeong Jang, Inyeong Park, Taesu Kim, Dong-Seok Gwak, Ji Sung Lee, Sung-Ha Hong, Kang-Hoon Je, Hee-Joon Bae, Joohon Sung, Eng H Lo, James Faber, Cenk Ayata, Dong-Eog Kim

Faculty, Staff and Student Publications

No abstract provided.

A Call For Integration Of Trauma-Informed Care Into Occupational Therapy: Improving Provider Competency Through A Case Study Of A Cooking Skills Program For Survivors Of Human Trafficking, Natalie Pravinkumar

OT Doctoral Capstones

Trauma, such as abuse, neglect, and violence, has evident lasting physical and mental health effects, such as chronic illness, behavioral changes, and depression. While trauma-informed care (TIC) helps providers recognize and respond to trauma, this training is often limited to mental health and social work fields. Many survivor populations never receive interventions designed with TIC in mind, restricting outcomes leading to reduced rehabilitation and reintegration.

Occupational therapy (OT) is fundamentally client-centered and functional, making it well suited for TIC. However, while they cover many similar topics, most OT programs do not include specific curriculum on TIC.

TIC education in OT …

Trends In Contacts Made By Immigrants To The National Domestic Violence Hotline, Before And During The Covid-19 Pandemic, Sarah Treves-Kagan, Vi D Le, Liris S Berra, Colleen M Ray, Yanet Ruvalcaba, Leila Wood, Denise V D'Angelo, Tatiana M Vera, Lianne Fuino Estefan

Faculty, Staff and Student Publications

Objectives: Immigrants in the United States are more likely than nonimmigrants to experience risk factors for intimate partner violence (IPV) and problems in getting support. The COVID-19 pandemic and recent incidents of xenophobia and anti-immigrant sentiment may have exacerbated exposure to IPV risk factors. We examined immigrant experiences of IPV before and during the COVID-19 pandemic.

Methods: This study identified changes in characteristics of abuse, services used, referrals, and barriers to services among those who contacted the National Domestic Violence Hotline (NDVH) and identified as immigrants, reported immigration status as a concern, needed immigration support, and/or identified immigration status as …

Caring For Caregivers: An Occupational Therapy-Centered Mental Health And Wellness Program, Natalie Burgess

OT Doctoral Capstones

Objective: Address the mental health and wellness needs of caregivers of individuals with disabilities at Fundación Integra A.C.

Methods: Conducted a needs assessment, developed and implemented an 8-week occupational therapy-based wellness program, and evaluated outcomes using pre/post assessments and weekly feedback surveys.

Results: Caregivers showed reduced stress, improved self-reported health, and increased use of mindfulness and coping strategies.

Conclusion: Occupational therapy interventions can improve caregiver well-being and support sustainable caregiver education in community settings.

Testosterone Plus Lifestyle Therapy Improves Skeletal Muscle Glycolysis In Older Men With Obesity And Hypogonadism, Viola Viola, Marlene Aguilar, Maria Liza Duremdes Nava, Alessandra Celli, Reina Armamento-Villareal, Yoann Barnouin, Nicola Napoli, Nagireeddy Putluri, Clifford Qualls, Dennis T Villareal

Faculty, Staff and Students Publications

Objective: Weight loss in older men with obesity and hypogonadism accelerates musculoskeletal decline, yet the underlying metabolic mechanisms remain unclear. Testosterone replacement therapy (TRT), when added to lifestyle therapy (LT), mitigates this decline, but its metabolic basis has not been defined. We examined skeletal muscle metabolomic adaptations to LT with or without TRT, focusing on glycolysis, the pentose phosphate pathway (PPP), the tricarboxylic acid (TCA) cycle, and carnitine metabolism to identify dominant pathways of metabolic adaptation.

Design: Randomized, double-blind, placebo-controlled trial (LITROS).

Methods: Eighty-three men aged 65 years or older with obesity (BMI ≥30 kg/m2), hypogonadism (testosterone < 10.4 nmol/L), and frailty (Physical Performance Test score ≤31) were randomized to 26 weeks of LT plus TRT (LT+TRT) or LT plus placebo (LT+Pbo). A metabolomic substudy was performed in 44 participants, who underwent serial biopsies of the vastus lateralis for targeted LC-MS/MS analysis of intermediates in glycolysis, PPP, TCA cycle, and carnitine metabolism.

Results: Among the …

Skewed Adaptive Immune Responses Are Involved In Alpha-1 Antitrypsin Deficiency Emphysema, Joselyn Rojas-Quintero, Scott A Ochsner, Hyun-Sung Lee, Christine Cong, Alan Waich Cohen, Adrianne S Colborg, Konstantin Tsoyi, Maria C Basil, Edward Cantu, Ivan O Rosas, Neil J Mckenna, Raúl San-José Estépar, Igor Barjaktarevic, Andrew A Wilson, Francesca Polverino

Faculty, Staff and Students Publications

No abstract provided.

Advancing Narcolepsy Advocacy: Bridging Patient Narratives And Systemic Change, Ahmed Salem Bahammam, Lindsay Jesteadt, Hamza Dhafar, Amir Sharafkhaneh

Faculty, Staff and Students Publications

We introduce the Stigma-to-Structure Advocacy Framework, a novel, evidence-based model designed to transform narcolepsy advocacy by systematically bridging patient narratives with structural change. Narcolepsy remains a profoundly underdiagnosed and misunderstood neurological disorder, with persistent diagnostic delays and pervasive cultural stigma undermining patient well-being and access to care. Despite recent progress in awareness and support, advocacy efforts remain fragmented and insufficiently integrated with health policy, particularly in low- and middle-income countries. This perspective advances a strategic evolution of narcolepsy advocacy through the Stigma-to-Structure Advocacy Framework, which is anchored in three pillars: narrative-driven awareness, clinical system integration, and policy activation. Drawing on …