Preventive Medicine Commons^™

Small Cell Lung Cancer In A Never-Smoking Patient: A Case Highlighting Diagnostic And Screening Gaps In Primary Care, Edward Hamilton, Alexandra She, Francis Jenney

The Journal of Integrated Primary Care

Small cell lung cancer (SCLC) is best known in relation to tobacco exposure and tends to be seen in advanced disease. Contemporary guidelines in lung cancer screening demonstrate a strong emphasis on smoking exposure, which may serve as a barrier to recognition in never-smokers who lack conventional risk factors. As a result, SCLC in never-smokers remains an important but underrecognized consideration in general and primary care settings. The current case involves a 65-year-old African American man who has never been a smoker but who presented with progressive thoracic pain, shortness of breath, and unintended weight loss, leading to the discovery …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

Care Coordination In Pediatric Primary Care, Alyssa K. Durzo

Dissertations

No central documentation of care plans exists for children with special healthcare needs (CSHCN) in the electronic health record (EHR). Providers of a large pediatric primary care office in St. Louis Missouri were asked to identify CSHCN in the practice. Clinic nurses completed a comprehensive chart review of the patients identified and constructed care coordination documents using a pre-established smart-text phrase. Subsequently, these were documented centrally in the EHR under the Problem List.

Likert score data was obtained from providers on the acceptability, appropriateness, and feasibility of the intervention through the verified tools: Acceptability of Intervention Measure (AIM), Intervention Appropriateness …

Development Of Preventive Dental Guidelines In The Primary Healthcare Setting In Egypt: A Delphi Method, Basant Mehriz

Theses and Dissertations

This study addresses the critical need for standardized preventive dental care guidelines within Egypt's primary healthcare system amid the rising burden of oral diseases. Through a systematic two-phase methodology combining a comprehensive literature review and a Delphi consensus-building process engaging 35 dental professionals, the research established priorities for contextually appropriate preventive measures. The consensus framework revealed strong support for clinical interventions (mean of 83% agreement), particularly fluoride-based prevention; community initiatives (mean of 83%), especially school-based programs; policy measures (mean of 77%) such as workforce and educational development, though with variable support for taxation and social determinants approaches. Statistical analysis demonstrated …

Integrating Positive Psychology And Spirituality To Foster Meaning And Well-Being In Older Adults, Crystal Morris

Adultspan Journal

This perspective article explores the integration of positive psychology interventions (PPIs) and spirituality in therapy to foster meaning and well-being in older adults. It highlights exercises such as the positive introduction, positive legacy, character strengths, mindfulness, mindful-based yoga, and a manifestation prayer journaling. The interventions presented are tools to support older adults that may experience depression, difficult life transitions, and the search for renewed meaning. Therapists who integrate PPIs and spirituality into therapy can promote a holistic, non-pathological approach to treatment.

A Systematic Review Of Weight Loss Interventions Among Black Postpartum Women, Jhelma Velveder Perez

Honors Scholar Theses

Cardiovascular disease is a leading contributor to maternal mortality, which remains disproportionately high among Black women. Obesity and postpartum weight retention exacerbate cardiovascular disease risk and increase the likelihood of complications in future pregnancies. Weight loss during the postpartum period may reduce long-term chronic health risks and mortality for Black women. This systematic review aimed to understand the weight-related health needs of Black postpartum women by evaluating behavioral weight loss interventions within the first year after childbirth. A comprehensive search of the PubMed database identified 3 randomized controlled trials that met inclusion criteria. These studies evaluated home-based programs, mobile health …

Heart To Heart: Exploring Why Cardiovascular Risk Is Higher In South Asians, Jasjeet Kaur Dhaliwal

Rowan-Virtua Research Day

Cardiovascular disease (CVD) is a leading global cause of mortality, but South Asians experience a disproportionately high burden of disease, often developing CVD at younger ages and with lower body mass indices compared to other populations. This project explores the underlying genetic and lifestyle factors contributing to elevated cardiovascular risk in South Asians, aiming to highlight the need for targeted prevention strategies and policy reforms.

A literature review was conducted using peer-reviewed studies, meta-analyses, and reviews published between 2007 and 2024. After screening 47 initial articles, 18 were selected for analysis based on their relevance to genetic and lifestyle risk …

Exercise As An Intervention For Postpartum Depression (Ppd), Kylie P. Mistretta

Honors Scholar Theses

Objective: To illustrate the applications of exercise for preventing the development of postpartum depression (PPD) and addressing associated risk factors identified in the literature. Data Sources: PubMed and EBSCO: Academic Search Premier were accessed using the search terms exercise OR physical activity OR yoga AND postpartum depression OR postnatal depression. A secondary search of PubMed was conducted using the search terms exercise AND pregnancy AND depression OR gestational diabetes OR weight gain OR sleep quality.

Study Selection: Studies selected for inclusion were peer-reviewed, published after January 2012, written in English, and relevant to the PPD risk factors examined. Only clinical …

The Impact Of An Iron-Rich Diet On Fatigue In Menstruating Women With Non-Anemic Iron Deficiency, Meagan Seraydar, Lauren Latimer, Sam Miragliatto

Department of Nutrition Student Projects

Fatigue without diagnosed anemia is prevalent in menstruating women, with iron deficiency being a potential contributor. While iron supplementation is a standard intervention, dietary sources of iron may offer a sustainable alternative. This study aims to assess the impact of an iron-rich diet on fatigue levels in menstruating women. A 12-week randomized controlled trial (RCT) will be conducted, assigning participants to either an iron-rich diet group or a control group following their usual diet without specific iron recommendations. Fatigue will be measured using the Fatigue Severity Scale (FSS) at baseline, six weeks, and twelve weeks, alongside iron status biomarkers, including …

Perceived Risk And Hpv Vaccination Awareness Among Women In Rural And Underserved Communities In The State Of Louisiana, Deborah Gurgel Smith, Emily M. Dantes, Robbie Beyl, Yanna X. De Koter, Margaret Bourg, Corey D. Smith, Gelinia Jackson, Justin Brown, Jerry W. Mclarty

School of Nursing Faculty Publications

Despite the availability of effective preventive measures, women in rural and underserved communities of Louisiana face health disparities regarding human papillomavirus infections. This study explores how perceived risk and socioeconomic factors, such as income, influence HPV vaccine awareness and attitudes toward HPV risk. A cross-sectional study was conducted among women in rural and underserved areas of Louisiana from November 2022 to December 2023. Participants were eligible to be included in the study if they were adult females aged 25 to 64 with no history of hysterectomy and no history of cervical cancer. We used convenience sampling through a mobile health …

"Health Gatekeepers": The Influence Of Women On Health Practices In Rural, Central Appalachia, Reese Lycan

Senior Theses

Women have historically assumed leadership roles in familial and community health promotion, intervention, and facilitation. While the role of women in family health is globally understood and the historical importance of female leadership has been documented, there remains a gap in knowledge regarding the role of women as “health gatekeepers”. Furthermore, when considering the Appalachian region, there are limited studies regarding women’s place in leadership as far as health is concerned. Therefore, this study employs a hermeneutic phenomenological framework to explore the lived experiences of women in relation to their family and community’s health in rural, Central Appalachia- a region …

Are Maternal Adverse Childhood Experiences (Aces) And Resilience Associated With Breastfeeding Rates And Neonatal Growth?, Lily Zheng, Krystal Hunter, Hsiao-Wei M. Banks, Leslie Abraham, Alla Kushnir

Cooper Rowan Medical Journal

Background: Adverse childhood experiences (ACEs) have shown to have a negative impact on health outcomes. There is evidence of how negative childhood events adversely affect self-esteem in adulthood. Not only do ACEs have an impact on one's own life, but maternal ACEs have shown to have consequences on infants’ development as well, indicating a negative intergenerational impact.

Objectives: To analyze the relationship between maternal ACEs on infant outcomes, breastfeeding adherence, and maternal self-perception

Design/Methods: Between 2020 and 2023, 120 mother-infant pairs from a New Jersey urban hospital were approached between their 2nd trimester and the 2-month well …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Transdisciplinary Collaboration Of Healthcare Professionals And The Emotional Connectedness With Working With Patients Coping With Death And Dying, Princess Nguyen, Lindsay Gietzen

Pacific Journal of Health

Abstract

Purpose: This study explores how an integrated approach to care for patients and families by transdisciplinary healthcare teams provides opportunities for a patient-centered care approach to support quality of life throughout one's chronic illness and at the end-of-life. Discussions and conversations about impending death or dying are often challenging and a complex task for healthcare professionals in whatever settings. While there is an understanding of aspects of collaborative care and transitions and processes to support patients and families about how to cope and communicate about death and dying, it is essential to recognize how best to support end-of-life care …

Comprehensive Community Medicine, Alexander Walther

Capstone Projects and Master's Theses

Comprehensive Community Medicine (CCM) is a theoretical framework designed to address the complex needs of individuals with dual diagnoses of mental illness and substance use disorders (SUDs). Dual diagnosis is highly prevalent, particularly among populations experiencing homelessness, and is associated with poorer health outcomes and increased healthcare service utilization. Structural inequities, including a fractured healthcare system, exacerbate the challenges faced by this vulnerable group. Research indicates that effective care for dually diagnosed individuals requires a layered approach addressing clinical, systemic, legal, and housing barriers.

The development of CCM has been informed by interviews with local stakeholders, including County EMS board …

Laboratory Literacy: Surveying Lab Result Interpretations Of A Local Patient Population, Jordan Franco, Mark K. Fung

Patient Experience Journal

A patient's independent interpretation of their medical laboratory data has become an unspoken prerequisite in the current age of medicine. In the outpatient setting, it is anecdotally commonplace for patients to receive their lab results before their physicians, resulting in patients often relying on self-interpretations of their results. This study analyzed the degree to which patients are comfortable interpreting lab results and sought to shed light on the question: How are patients interpreting their laboratory reports? A survey was constructed to include the items from a validated health literacy screening tool, followed by items inquiring about the respondent's experience and …

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

Reclaiming Healing Spaces: A Phenomenological Study On The Transformative Power Of Outdoor Therapy From The Lived Experiences Of Black Clinicians Working With Black Clients, Lynn Murphy

Dissertations

This phenomenological study involved assessing the experiences of Black therapists who engaged Black clients in outdoor therapeutic contexts. The study was founded on the existing literature that shows the quality of the therapeutic relationship is pivotal for client retention and the Western standards that have historically favored treatment within indoor environments. To contextualize this research, a comprehensive literature review was commenced, covering topics such as the decolonization of therapy, the historical and present-day relationship between Blacks and the outdoors in the United States, sedentary lifestyles, the psychological benefits of time spent in nature, various types of outdoor therapy, and the …

Supporting South Korea’S Aging Population: How Ai And Iot Acceptance Connects The Young And Old, Bobby Im

Master's Projects and Capstones

In 2024, South Korea surpassed every other nation by becoming the country with the lowest fertility rate (below 0.7%). Population decline will hinder future ability to care for their aging population and although the government and private corporations are investing millions of dollars on developing Artificial Intelligence-Internet of Things (AI-IoT) devices to support the aging, the acceptance levels and the amount of family support required is undervalued. By examining AI-IoT’s current use and role in South Korea’s public health system this paper shows how intergenerational support helps optimize existing procedures and equipment, increases the level of acceptance and use, and …

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Unveiling The Impact: Structural Racism And Childhood Lead Exposure's Health Consequences In Philadelphia, Mahhum Naqvi, Mahrukh Naqvi, Justin Stout, Colton Spencer

Rowan-Virtua Research Day

Childhood lead exposure poses a significant risk to health and well-being, adversely affecting brain function, nervous system development, and behavioral patterns. This study examines the health disparities and inequities associated with childhood lead exposure in Philadelphia, focusing on structural racism and residential segregation as crucial lenses for analysis. By delving into the sociocultural context of lead exposure, this study underscores the imperative of collaborative efforts among stakeholders to safeguard Philadelphia's most vulnerable populations. Healthcare professionals and policymakers play pivotal roles in enhancing funding and prevention strategies. Addressing this issue through the prism of structural racism allows for the identification and …

Sunscreen Cost And Its Effect On Skin Cancer In Low-Income Communities: A Systemic Review, John Sauer

Rowan-Virtua Research Day

This research examines the pivotal connection between sunscreen affordability and its impact on skin cancer prevalence, especially in low-income communities. Despite universal dermatological recommendations for daily sunscreen use, stringent criteria contribute to elevated prices, averaging around $10 for a 6 oz unit. This financial strain is compounded for families adhering to recommended application rates, leading to significant economic burdens. Outdoor laborers, less likely to follow guidelines, face heightened risks. Government programs' excluding sunscreen costs further exacerbate challenges for low-income communities, contributing to increased skin cancer incidence. This review aims to establish a correlation between sunscreen cost and skin cancer rates, …

Barriers To Healthcare Access Between English And Spanish Speakers In An Underserved Population, Adeena Javed, Dale Johnson, Gerardo J. Rivera-Colón, Nathaniel J. Byrnes, Kristin Bertsch, Anne C. Jones

Rowan-Virtua Research Day

• According to the NJ State Department of Health, Atlantic County has higher rates of smoking, respiratory disease, hypercholesterolemia, as well as death rates due to coronary heart disease, HIV, and all cancers compared to the NJ state average1,2.

• With over 20% of Atlantic County's population identifying as Hispanic, Spanish speakers encounter greater obstacles compared to their English-speaking counterparts in accessing healthcare services and improving health outcomes1,2 .

• Existing research indicates that various factors, including health insurance coverage, proximity to healthcare facilities, transportation options, health literacy levels, and trust in the medical profession, significantly influence access to healthcare …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

The Unequal Distribution Of Social Risk For Black Men Across The Life-Span. A Novel Framework., Waleed Y. Sami

Adultspan Journal

This conceptual overview offers a comprehensive overview of systemic pathways that negatively impact the mental health of Black Men throughout their lives. Our argument highlights the importance for counselors and mental health professionals to utilize a thorough social risk assessment that considers these pathways in order to effectively address the mental health needs of Black Men while fostering positive working relationships. This overview strongly advocates for the use of context and structural determinants when evaluating mental health symptoms. Without an appropriate understanding of social risk and determinants, counselors may inadvertently perpetuate disparities by decontextualizing symptomology, and reproducing racist discourse.

Addressing Healthcare Disparities Faced By Aging Down Syndrome Populations, Rhea Mistry

Pitzer Senior Theses

Down syndrome (DS) is a chromosomal genetic condition that impacts the development of the body and brain. The life expectancy of individuals with DS has drastically improved over the decades, increasing from 9 years in 1929 to 25 years in 1983 and further reaching 60 years by 2002. Individuals with DS face a variety of prominent co-occurring health conditions that are subject to change over time, including cognitive, visual, and hearing impairments, sleep apnea, cardiovascular defects, Down syndrome regression disorder, and dementia. Despite this increase in life span, DS is still most familiar to pediatric care providers, resulting in healthcare …

Understanding Guardian Perceptions Of Whole-Foods Plant-Based Diets As Interventions In Pediatric Medicine, Vijay R. Luthra

Honors Undergraduate Theses

The obesity epidemic is widespread in American society, often affecting children who bear its consequences innocently. Due to a lack of nutrition knowledge, children rely on caregivers to meet their nutritional needs and instill healthy habits. This study examines parents' attitudes, knowledge, and behaviors, as well as perceived barriers to adopting a whole-foods plant-based diet (WFPD) for their children. Using a modified survey instrument by Morton et al., this study focused on parents and children regarding dietary choices. Participants were recruited from the waiting area of a pediatric clinic at the Medical College of Georgia between April and May 2023. …

My Happy Baby Is Back: Zero Balancing, Craniosacral Therapy And A Baby’S Journey To Becoming Mobile, Veronica Quarry

Journal of Transformative Touch

Alison began receiving ZB and CST at 13 months of age due to gross motor delays: at that age she was only able to sit somewhat rigidly. After the first session, Alison changed` from being very unhappy and seemingly frustrated to being happy and more calm. Within one month of weekly sessions, Alison was able to be on her tummy, began to crawl, became more agile in seated play, was squatting and standing and took her first steps.