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Articles 4741 - 4770 of 15190
Full-Text Articles in Medicine and Health Sciences
Lifestyle And Activity Patterns Of The Classic Period Maya From Chac Balam And San Juan, Ambergris Caye, Belize, Abigail L. Hornbeck
Lifestyle And Activity Patterns Of The Classic Period Maya From Chac Balam And San Juan, Ambergris Caye, Belize, Abigail L. Hornbeck
Honors Theses
Bioarchaeological research often uses skeletal remains to reconstruct patterns of activity and labor in past populations. This study examines potential sex-based differences in long bone morphology among individuals from the Classic Maya sites of Chac Balam and San Juan on Ambergris Caye, Belize. These coastal communities participated in maritime trade networks, and daily activities such as cargo transport, canoe travel, and fishing may have placed distinctive mechanical stresses on the skeleton. The goal of this study was to evaluate whether measurable differences in bone structure between males and females reflect differences in habitual activity patterns.
Two complementary methods were used …
Mapping Information Literary To The Medical Curriculum, Ella Hu, David Stewart
Mapping Information Literary To The Medical Curriculum, Ella Hu, David Stewart
Posters
Medical school accreditation by the Liaison Committee on Medical Education (LCME) requires library staff to be responsive to educational needs. Despite a move toward integrated learning, library instruction is often limited to single sessions early in the curriculum. Curriculum mapping addresses this by providing a systematic analysis of program courses to visualize teaching priorities and the student experience. This strategic tool enables librarians to shift from reactive service to proactive engagement, finding high-impact courses through syllabus analysis. Furthermore, aligning the ACRL Framework with medical education standards, such as AAMC Core EPAs and ACGME requirements, is essential for identifying instructional gaps …
Not All Health Problems Are Medical, Lisa George, Jennifer Hartke, Linda Caurdy-Bess, Karen Glorio
Not All Health Problems Are Medical, Lisa George, Jennifer Hartke, Linda Caurdy-Bess, Karen Glorio
Posters
Medical Legal Partnership (MLP) started in 1993 in Boston. Currently MLP’s have been established in over 450 health care institutions in 49 states. Patient Legal Support (PLS) began in August 2009 and is a collaborative effort between Corewell Health East (then Beaumont Health system) and Lakeshore Legal Aid. Modeled after Boston Medical Center’s Family Advocacy Program, PLS provides educational training to health care providers, helping them recognize legal issues that affect the health of their patients, refer patients with legal problems, and improve their own advocacy skills.
How Medical Education Reframes Perceptions Of Substance Use Disorder: A Study Of Evolving Student Attitudes, Eva Neueunschwander, Cameron Davidson
How Medical Education Reframes Perceptions Of Substance Use Disorder: A Study Of Evolving Student Attitudes, Eva Neueunschwander, Cameron Davidson
Posters
According to the Substance Abuse Mental Health Services Administration (SAMHSA), in 2022 about 50 million people had experienced a substance use disorder (SUD) in the past year.1 Despite the alarming prevalence of SUD, stigma remains a major barrier to seeking and obtaining high quality treatment. Understanding how medical students view SUD and how perceptions change across their educational journey is essential for improving patient care. While previous studies have investigated SUD stigma among medical students, the effect of study year on attitudes remains largely mixed and unclear.2 This project compares attitudes across educational levels to understand how medical training influences …
The Library As A Partner In Wellness: A Curated Resource Collection For Medical Students, David Stewart
The Library As A Partner In Wellness: A Curated Resource Collection For Medical Students, David Stewart
Posters
Medical education involves intense stress; 82% of students experience high distress, facing higher rates of burnout and mental illness than the general population2,3. This is often attributed to a medical culture prioritizing technical efficiency over humanistic care1 . Medical libraries are uniquely positioned to bridge this gap, as students perceive them as safe, confidential communal spaces2 . Despite this, only 18% of U.S. medical libraries currently offer dedicated wellness resources2 . To address this, Narrative Medicine, the engagement with patient stories, has emerged as one way to foster narrative competence1 . These interventions improve clinical connections and self-perspective, helping students …
Reframing Inclusion Through Scholarship & Equity (Rise) Equity Project 2026, Tonya Bailey, Brandon Harris, Abhinav Krishnan, Trini Mathew, Amita Pai, Julie Zaituna, Tracey Taylor
Reframing Inclusion Through Scholarship & Equity (Rise) Equity Project 2026, Tonya Bailey, Brandon Harris, Abhinav Krishnan, Trini Mathew, Amita Pai, Julie Zaituna, Tracey Taylor
Posters
The OUWB RISE program is a faculty development educational initiative, and this poster disseminates both clinical and foundation faculty scholars’ year-long, project-based learning focused on advancing inclusive and equitable medical education.
Staff Education To Improve Appointment Adherence In Outpatient Behavioral Health, Yvonne Joseph
Staff Education To Improve Appointment Adherence In Outpatient Behavioral Health, Yvonne Joseph
Walden Dissertations and Doctoral Studies
No abstract provided.
Reducing Emergency Department Overuse Through Patient Education, Maddie Pieper, Joshua Heuertz
Reducing Emergency Department Overuse Through Patient Education, Maddie Pieper, Joshua Heuertz
Doctor of Nursing Practice Projects: College of Nursing
Background/Introduction
Emergency departments (EDs) are designed to provide rapid evaluation and management of acute, life-threatening, and time-sensitive conditions. However, EDs are frequently used for nonemergent or low-acuity concerns that could be managed in primary care or urgent care settings. This overuse contributes to rising healthcare costs, resource strain, longer wait times, and overcrowding. Underserved populations may rely more heavily on ED services because of barriers such as limited primary care access, language differences, low health literacy, restrictive work schedules, transportation challenges, and difficulty navigating the healthcare system. These factors can make the ED seem the most accessible source of care. …
The Ethical Imperative Of Public Health Institutions To Protect The Reproductive Autonomy Of Vulnerable Populations, Kennethea Wilson
The Ethical Imperative Of Public Health Institutions To Protect The Reproductive Autonomy Of Vulnerable Populations, Kennethea Wilson
Electronic Theses and Dissertations
This dissertation establishes the ethical responsibility of public health institutions to safeguard reproductive autonomy, especially among vulnerable populations. While reproductive decision-making is traditionally framed within individual clinical encounters, this work contends that reproductive autonomy is fundamentally a matter of public health ethics. Socioecological determinants, including social, legal, environmental, and structural factors, often constrain individuals’ ability to make meaningful reproductive choices, leading to preventable harm.
Reproductive autonomy is defined as the capacity to make informed decisions about whether and when to conceive, as well as how to parent. The dissertation critiques the sufficiency of clinical ethics frameworks, such as informed consent …
Agenda (Pdf), Department Of Surgery
Agenda (Pdf), Department Of Surgery
Surgery Research Symposium
Agenda for the 4th Annual Surgery Research Symposium held May 7, 2026.
Genetic Analysis Of The X-Linked Adrenoleukodystrophy Gene Abcd1 In Drosophila Uncovers A Conserved Phenotype, Joshua Manor, Sharayu V Jangam, Hyung-Lok Chung, Pranjali Bhagwat, Jonathan C Andrews, Hillary Chester, Shu Kondo, Saurabh Srivastav, Juan Botas, Ann B Moser, Suzette M Huguenin, Michael F Wangler
Genetic Analysis Of The X-Linked Adrenoleukodystrophy Gene Abcd1 In Drosophila Uncovers A Conserved Phenotype, Joshua Manor, Sharayu V Jangam, Hyung-Lok Chung, Pranjali Bhagwat, Jonathan C Andrews, Hillary Chester, Shu Kondo, Saurabh Srivastav, Juan Botas, Ann B Moser, Suzette M Huguenin, Michael F Wangler
Duncan NRI Faculty and Staff Publications
X-linked adrenoleukodystrophy (X-ALD) is a progressive neurodegenerative disorder caused by a loss-of-function (LOF) mutation in the ATP-binding cassette subfamily D member 1 (ABCD1) gene, leading to the accumulation of very long-chain fatty acids (VLCFAs). This disorder exhibits striking heterogeneity; some male patients develop an early childhood neuroinflammatory demyelination disorder, while other patients, including adult males and most affected female carriers, experience a chronic progressive myelopathy. Adrenocortical failure is observed in almost all male patients, with the age of onset varying, sometimes being the first diagnostic finding. The gene underlying this spectrum of disease encodes an ATP-binding cassette (ABC) transporter that …
Pharmacogenomic-Guided Prescribing And Polypharmacy Across Age Groups In Obsessive-Compulsive Disorder: A Retrospective Study, Sheldon R Garrison, Matthew W Boyer, Anthony W Zoghbi, Rachel A Schwartz, Nicolette Weisensel, Martin E Franklin, Madeline M Hartig, Maharaj Singh, Sreya Vadapalli
Pharmacogenomic-Guided Prescribing And Polypharmacy Across Age Groups In Obsessive-Compulsive Disorder: A Retrospective Study, Sheldon R Garrison, Matthew W Boyer, Anthony W Zoghbi, Rachel A Schwartz, Nicolette Weisensel, Martin E Franklin, Madeline M Hartig, Maharaj Singh, Sreya Vadapalli
Faculty, Staff and Students Publications
Background: This study evaluated medication utilization in children, adolescents, and adults with obsessive-compulsive disorder (OCD), a chronic psychiatric condition characterized by intrusive thoughts and repetitive behaviors. Although first-line treatments include selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT), the heterogeneous biological underpinnings contribute to suboptimal outcomes, with 40-60% of individuals not responding to SSRIs. This complex phenotype often leads to psychotropic polypharmacy, which may be mitigated by incorporating combinatorial pharmacogenomic (PGx) testing into protocol-based care to identify potential gene-drug interactions.
Methods: A retrospective review was conducted of individuals with OCD aged 8 to 65 years who received either …
Gut Microbiota Modulation Of Regulatory Dna Elements Revealed By Massively Parallel Functional Characterization, Chadmirah Zaratiana, Adheet Ganesh, Yang E Li, Et Al.
Gut Microbiota Modulation Of Regulatory Dna Elements Revealed By Massively Parallel Functional Characterization, Chadmirah Zaratiana, Adheet Ganesh, Yang E Li, Et Al.
2020-Current year OA Pubs
Cis-regulatory elements (CREs) are central to dynamic gene regulation in hepatocytes, yet most functional annotations derive from in vitro models that poorly capture physiological regulation. We systematically profiled 109,386 human liver-derived CREs using massively parallel reporter assays in hepatocytes under matched in vitro and in vivo conditions. In vivo-active functional CREs (fCREs) were enriched for H3K27ac and chromatin accessibility and were regulated by diverse transcription factors in the human liver. We further demonstrate that gut microbiota-derived signals modulate fCRE activity and target gene expression in vivo, in part via the KEAP1/NFE2L2 antioxidant pathway. Specific microbial metabolites directly altered the activity …
Mind Over Measure: The Role Of Self-Care Practices In Mitigating Mental Health Strain Among K-12 Educators, Jerry Burkett, Ryan Hulla
Mind Over Measure: The Role Of Self-Care Practices In Mitigating Mental Health Strain Among K-12 Educators, Jerry Burkett, Ryan Hulla
School Leadership Review
Teacher mental health is a critical concern in K-12 education, with high rates of burnout demanding effective protective strategies. This study investigated the relationship between five dimensions of teacher self-care (Physical, Psychological, Emotional, Spiritual, and Professional) and overall mental health outcomes, while specifically exploring differences between elementary (K-5) and high school (9-12) educators. A sample of K-12 teachers completed the Mental Health Inventory (MHI-5) and the Self-Care Inventory. Correlational analysis found that all five self-care dimensions were significantly and positively associated with mental health, with Professional Self-Care demonstrating the strongest link (r=.48, p
Screening Novel Secreted Proteins For Their Effects On Pancreatic Islet Function Using Qpcr-Based Gene Expression Analysis, Deepti Agarwal, Neha Mishra, Marcus Seldin
Screening Novel Secreted Proteins For Their Effects On Pancreatic Islet Function Using Qpcr-Based Gene Expression Analysis, Deepti Agarwal, Neha Mishra, Marcus Seldin
Cumberland Medica
Type 2 diabetes (T2D) involves progressive dysfunction of pancreatic β-cells and systemic insulin resistance. Although a handful of secreted factors acting on pancreatic islet have emerged as important therapeutic targets, many additional signaling processes remain unknown. The identification of such mediators can make a new contribution to the regulation of islet biology and serve as another approach for disease treatment. This study aimed to investigate whether three novel peptides could modulate islet-specific gene expression in vivo. Methods: Male C57BL/6J mice were injected with proteins then pancreatic tissues were collected six hours post-treatment. Total RNA was isolated, converted to cDNA, and …
Comparative Analysis Of Antegrade And Retrograde Nailing For Proximal, Shaft, And Distal Femur Fractures, Saahil Noupada
Comparative Analysis Of Antegrade And Retrograde Nailing For Proximal, Shaft, And Distal Femur Fractures, Saahil Noupada
Rowan-Virtua Research Day
Background:
Antegrade and retrograde intramedullary nailing are widely used for femoral fractures, yet their relative advantages across fracture locations remain debated. This study compares union rates, time to union, malunion, and functional outcomes between approaches, stratified by AO/OTA classification.
Methods:
A systematic review of PubMed, Embase, Cochrane Library, Web of Science, and Scopus (2015 to 2025) was performed. Studies reporting outcomes of antegrade and/or retrograde nailing for proximal (31), diaphyseal (32), and distal (33) femoral fractures were included. Data on demographics, fracture classification, fixation method, and outcomes were extracted. Risk of bias was assessed using ROBINS-I. Pooled estimates were calculated …
Medical Providers’ Perspective On Barriers Faced By Intellectual And Developmental Disabled (Idd) Patients From Medically Underserved Backgrounds, Mayra A. Flores
Medical Providers’ Perspective On Barriers Faced By Intellectual And Developmental Disabled (Idd) Patients From Medically Underserved Backgrounds, Mayra A. Flores
Rowan-Virtua Research Day
•Complexities of obtaining healthcare access can be difficult for all patients across the board, so much so that it’s viewed as a maze. Studies have shown that these challenges are added on for medically underserved communities.2-3 Some of these challenges include insurance, language barriers, appointment availability, stigma, financial limitations and lack of transportation.2 •Identify the barriers that patients with intellectual and developmental disabilities (IDD) from medically underserved backgrounds face in healthcare access. •Intellectually and developmentally disabled patients from medically underserved communities face exacerbated barriers in healthcare access. •Participating medical providers from the Regional Integrated Special Needs Center (RISN) – Sewell …
Management Of Libman-Sacks Endocarditis: The Role Of Anticoagulation And Immunosuppressive Therapy, Klaudia Matanaj, Demi Poulathas, David Altimore
Management Of Libman-Sacks Endocarditis: The Role Of Anticoagulation And Immunosuppressive Therapy, Klaudia Matanaj, Demi Poulathas, David Altimore
Rowan-Virtua Research Day
Background: Libman-Sacks endocarditis (LSE) is a nonbacterial thrombotic endocarditis detected in 10-40% of patients with systemic lupus erythematosus (SLE), depending on imaging modality. LSE is strongly associated with antiphospholipid syndrome (APS). The condition significantly increases the risk of cerebrovascular accidents and inpatient mortality compared to SLE without cardiac involvement. Despite these serious complications, optimal management remains uncertain. Objective: To review the current evidence on the pathophysiology and management of LSE. Methods: A literature review was conducted using 12 peer-reviewed articles addressing LSE pathophysiology, clinical outcomes, and treatment strategies. Results: Combination anti-inflammatory and antithrombotic therapy achieved 76% …
Age And Genotype-Dependent Baseline Characterization Of Spatial Learning And Memory In App/Ps1 Rats Using The Morris Water Maze, Thomas George, Mohammadreza Arbab, Nathanael Ricardo Alicea, Mahdie Kerdari, Christopher Janson
Age And Genotype-Dependent Baseline Characterization Of Spatial Learning And Memory In App/Ps1 Rats Using The Morris Water Maze, Thomas George, Mohammadreza Arbab, Nathanael Ricardo Alicea, Mahdie Kerdari, Christopher Janson
Rowan-Virtua Research Day
Background: Alzheimer’s disease (AD) is characterized by progressive cognitive decline. Transgenic APP/PS1 rat models offer improved translational relevance compared to mouse models due to closer similarity to human neurobiology.
Objective: To establish a baseline profile of spatial learning and memory across age and genotype in rate model.
Methods: The Morris Water Maze (MWM) was used to assess four groups of rats: young Wild Type (WT), young APP/PS1 (AD), middle-aged WT, and middle-aged AD. Spatial learning was evaluated during acquisition (Day 1–4) using cumulative proximity and escape latency. Memory was assessed using probe trials (Day 2–4). Swim velocity …
Involuntary Medication Administration Review: A Historical Look At New Jersey Psychiatric Law And Its Significance, Casey Burke, Joon Min Chun D.O., Ramya Kommidi D.O., Salvatore Montana Messina D.O.
Involuntary Medication Administration Review: A Historical Look At New Jersey Psychiatric Law And Its Significance, Casey Burke, Joon Min Chun D.O., Ramya Kommidi D.O., Salvatore Montana Messina D.O.
Rowan-Virtua Research Day
The legal and ethical evolution of involuntary psychiatric medication in New Jersey has been shaped through the landmark legal cases Rennie v. Klein and Brandt v. Monte. To this effect, this poster explores how each case shaped state hospital policy and the balance between patient autonomy and clinical judgment. Rennie v. Klein (1978) established a constitutional right for involuntarily committed patients to refuse psychotropic medication, except in emergencies or with due process safeguards. Decades later, Brandt v. Monte (2006) exposed flaws in New Jersey’s administrative procedures—particularly Administrative Bulletin 78-3—which permitted coercive practices under the guise of emergency treatment and lacked …
Behind The Screen: The Effect Of Screen Time On The Pediatric Population, Arthi Rameshkumar, Tanvi Shah, Liam Courtney, Talia Hartman, Tanya Kadrmas-Iannuzzi
Behind The Screen: The Effect Of Screen Time On The Pediatric Population, Arthi Rameshkumar, Tanvi Shah, Liam Courtney, Talia Hartman, Tanya Kadrmas-Iannuzzi
Rowan-Virtua Research Day
No abstract provided.
Tat-Beclin 1 And Exercise: Investigating Their Potential Synergy In Improving Sarcopenia-Related Muscle Changes In A Mouse Model, Shreya Krishnan, Thuan Thien Tchen, Kleiton Silva, Gabryel Sales Nascimento
Tat-Beclin 1 And Exercise: Investigating Their Potential Synergy In Improving Sarcopenia-Related Muscle Changes In A Mouse Model, Shreya Krishnan, Thuan Thien Tchen, Kleiton Silva, Gabryel Sales Nascimento
Rowan-Virtua Research Day
No abstract provided.
Improving Adherence To Comprehensive Gynecological Assessments In Female Rectal Cancer Patients Prior To Rectal Cancer Treatment, Rachael Smith, Eleanor Williams, Emily Young
Improving Adherence To Comprehensive Gynecological Assessments In Female Rectal Cancer Patients Prior To Rectal Cancer Treatment, Rachael Smith, Eleanor Williams, Emily Young
Rowan-Virtua Research Day
Background: A retrospective chart review of 139 female patients with Stage I-III rectal cancer treated at our institution (2017-2022) revealed only 32.6% (n=45) had documented age-appropriate gynecologic screenings prior to surgical intervention. These findings were disseminated to colorectal surgeons, medical oncologists, and radiation oncologists through departmental meetings and tumor boards. This follow-up study evaluates the impact of that educational initiative on gynecologic referral patterns.
Hypothesis: Targeted education of colorectal surgeons, medical oncologists, and radiation oncologists would significantly increase gynecologic referral rates for female rectal cancer patients.
Methods: This pre-post quality improvement study compared gynecologic referral rates among female patients with …
Understanding The Immune Responses Of Macrophages And Neutrophils In Synovial Fluid And Post-Operative Joint Environments, Allison Noelle Snyder
Understanding The Immune Responses Of Macrophages And Neutrophils In Synovial Fluid And Post-Operative Joint Environments, Allison Noelle Snyder
Rowan-Virtua Research Day
Periprosthetic joint infections (PJI) are devastating complications of total joint replacement (TJA). Even with aggressive antibiotic treatments, PJI recurrence rates are >17%, and 5-year survival is only 87.3%. Understanding the levels of inflammatory markers and cell types present at different timepoints is crucial in maximizing antimicrobial therapy and preventing adverse outcomes following TJA. This study tests the hypothesis that the synovial fluid environment of PJI induces immunosuppression in human macrophages, thereby hindering their ability to kill bacteria.
How Do Adverse Social Determinants Of Health Influence 30-Day Hospital Readmission Rates Among Patients With Heart Failure?, Noor Baig
Rowan-Virtua Research Day
Heart failure is one of the leading causes of hospitalization in the United States, with nearly 1 in 4 patients readmitted within 30 days of discharge. Clinical severity largely accounts for this risk, but social determinants of health (SDOH), including income, housing stability, transportation access, and health literacy, also play a role in post-discharge outcomes. This review synthesized seven cohort, observational, and qualitative studies from PubMed (2018–2025) examining the relationship between SDOH and 30-day readmission in heart failure patients.
Several patterns emerged across the literature. Neighborhood socioeconomic disadvantage, measured through ADI and SDI, was independently associated with higher readmission and …
Premenstrual Disorders In Females With Neurodevelopmental Conditions: A Systematic Review, Akhila Archakam, Nikhila Archakam, Harshal Parmar, Wesley Kim
Premenstrual Disorders In Females With Neurodevelopmental Conditions: A Systematic Review, Akhila Archakam, Nikhila Archakam, Harshal Parmar, Wesley Kim
Rowan-Virtua Research Day
Background: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are prevalent conditions associated with substantial functional impairment and psychiatric morbidity. Symptoms are driven by heightened sensitivity to cyclical fluctuations in estrogen and progesterone rather than absolute hormone levels. Individuals with neurodevelopmental conditions, particularly attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), may exhibit altered neurobiological and emotional regulation pathways that increase vulnerability to these hormonal changes; however, this relationship has not been systematically synthesized.
Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Embase, and Cochrane CENTRAL were searched from 2000–2026 for studies evaluating associations between ADHD, …
Psychiatry Meets Ai: Are Residents Ready?, Jacob De Castro, John Case
Psychiatry Meets Ai: Are Residents Ready?, Jacob De Castro, John Case
Rowan-Virtua Research Day
Artificial intelligence (AI) use is increasing in healthcare, but psychiatry residency training remains unstructured. In a 20-resident pilot survey, AI was frequently used for literature review and clinical support, with limited confidence and institutional guidance. We found most residents desired formal training and would use AI more if institutionally supported. Findings highlight a gap between rapid adoption and structured education.
Health Outcomes In Heat-Intense Areas In Response To Socioeconomic Status, Victoria Zheng, Chandni Patel, Emily Fried, Jayanth Ambat, Lincoln Opara, Rohan Gupta
Health Outcomes In Heat-Intense Areas In Response To Socioeconomic Status, Victoria Zheng, Chandni Patel, Emily Fried, Jayanth Ambat, Lincoln Opara, Rohan Gupta
Rowan-Virtua Research Day
Background: As ambient temperature rises, regions experiencing extreme heat face serious health concerns. This disproportionately affects lower socioeconomic status (SES) individuals in urban areas. This review examines how these “heat islands” affect the health outcomes for those in different socioeconomic statuses.
Methods: The databases used were PubMed, Embase, and Medline, and were searched with keywords such as “heat islands”, “social inequality”, “SES”, and “health outcomes”. After compiling, articles were screened using the inclusion criteria of ages, gender, peer-reviewed and English-written publications, from any location, social determinants as a primary outcome, and directly compared heat with social determinants of health. Articles …
Evaluation Of Possible Suicide Attempt And Treatment Of Chronic Serotonin Syndrome: A Case Report, Lalitya Karra, Colin Villarin
Evaluation Of Possible Suicide Attempt And Treatment Of Chronic Serotonin Syndrome: A Case Report, Lalitya Karra, Colin Villarin
Rowan-Virtua Research Day
No abstract provided.
Challenges For Older Veterans In Disaster-Prone Rural Areas, Umayma Saifuddin, Joshua Ehrenberg, Elizabeth Tran Phung
Challenges For Older Veterans In Disaster-Prone Rural Areas, Umayma Saifuddin, Joshua Ehrenberg, Elizabeth Tran Phung
Rowan-Virtua Research Day
Purpose: To describe a case in which an elderly veteran was unable to receive necessary health services due to environmental factors and routine natural disaster in his rural coastal town. Methods: A case report is presented. Results: A 95 year-old WWII veteran with a complex medical history and numerous disabilities including hearing impairment, visual impairment, and chronic pain struggles to receive proper care as he lives in a small coastal town. The patient’s son lives an hour away and this area is prone to flooding, making accessing health services extremely challenging. In order to respect the patient’s wishes to remain …