Mental and Social Health Commons^™

Advance Care Planning Utilization Among Non-White Individuals With Heart Disease And Cancer Using Health Retirement Study (Hrs) Data, Trizah M. Njoroge

Nursing Dissertations - Archive

Advance Care Planning (ACP) is a critical component of patient-centered care, yet its utilization remains disproportionately low among Non-White populations in the United States, particularly among individuals with chronic illnesses such as heart disease and cancer. This article explores racial disparities in ACP engagement using secondary analysis of the 2018 and 2020 waves data from the Health and Retirement Study (HRS), guided by Bandura’s self-efficacy theory (SET). The study examines how race, disease type, comorbidity, and survey year predict ACP service utilization, defined as completing five key ACP components: a legal will, a medical care discussion, surrogate assignment (DPOA), a …

Ketamine Infusion Treatment For Depression, Isabella Schwing

Capstone Showcase

Depression remains a significant public health challenge in the U.S., affecting millions of adults and contributing to both psychological and financial burdens. Major depressive disorder impacts approximately 14.5 million U.S. adults, with about 30% of cases classified as treatment-resistant depression. Traditional antidepressant therapies, including selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, often have delayed onset and limited efficacy, leaving a substantial portion of patients without adequate relief. Given these limitations, there is an urgent need for alternative treatment options.

Recent research has highlighted ketamine as a promising intervention for Major Depressive Disorder and Treatment Resistant Depression. Initially identified as …

Multidisciplinary Lethal Means Safety Counseling Design And Implementation: Training And Identifying Barriers In A Children's Hospital, Cassandra L. Stegall, Brendon Carnell, Jaime M. Golden, Rupa Kapoor, John H. Fanton, Paul C. Mullan, Alexandra P. Leader

Department of Pediatrics Faculty Publications

Background

Access to lethal means contributes significantly to suicide completion. Lethal means safety counseling (LMSC) is an injury prevention strategy to limit access to firearms, medications, and other means of injury. Not previously evaluated in the trauma setting, this study aims to design and implement a standardized LMSC protocol for pediatric patient discharge education in emergency (ED), trauma, and inpatient psychiatry settings.

Methods

A single-center quality improvement study at an academic pediatric urban tertiary Level-one trauma center was performed from July 2023 to February 2024. Protocol was implemented for pediatric patients discharged from three departments: ED, surgery trauma service, and …

The Quality-Of-Life Benefits And Risk Of Isotretinoin (Accutane) In Acne Treatment: A Systematic Review, Noelia Valencia Zuniga

Honors Undergraduate Theses

Acne vulgaris is a prevalent dermatological condition, particularly affecting adolescents and young adults. While often treated as a cosmetic issue, acne can significantly impair a patient's mental health and overall quality of life (QoL). Isotretinoin, commonly known as Accutane, is widely regarded as the most effective treatment for severe and persistent acne. However, its use is controversial due to a range of potential side effects, including psychiatric symptoms, teratogenicity, and other systemic complications. To better understand the risk-benefit profile of isotretinoin in acne treatment, we conducted a systematic review, focusing on the QoL benefits and risks associated with its use. …

The Role Of Social Isolation In Shaping Health Outcomes In Older Adults: A Regional Analysis, Vince Falco, Lynn Wiles, Jonathan Romero, Leorey Saligan

Ellmer School of Nursing Faculty Publications

Social isolation is a critical public health concern in older adults and is linked to a range of adverse health outcomes across diverse sociodemographic groups. This study investigated the associations between social isolation with physical and mental health of older adults residing in Hampton Roads, a racially diverse region in Southeastern Virginia, home to a large population of senior military veterans. Secondarily, the study explored how social determinants of health (SDoH) and comorbid medical conditions influenced the relationship of social isolation with physical and mental health of these seniors. Physical and mental health were measured using the Patient-Reported Outcomes Measurement …

Opioid Usage And Non-Opioid Alternatives In Septorhinoplasty: A Narrative Review, Robert M. Frederick, Eric Dobratz

Department of Otolaryngology (ENT) Faculty Publications

Background and Objective: Opioids are routinely prescribed following septorhinoplasty and oftentimes surgeons prescribe a larger number of tablets than patients require. Considering the high risk of developing opioid dependence and risk of diversion, it is imperative that surgeons practice safer, evidence-based prescribing habits. This review is intended to detail the current state of opioid usage after septorhinoplasty, focusing on articles that show pertinent and practice-altering findings. This will allow surgeons to reflect on their prescribing patterns and make evidence-based decisions to improve them.

Methods: A literature search was performed in November 20, 2024 via PubMed using keywords such as ‘opioid …

Study Of Maternal And Fetal Outcomes In Pregnancy Complicated By Thyroid Disorders, Sindhu Kumari, Poornima M

Digital Journal of Clinical Medicine

Background:

Thyroid disorders, particularly hypothyroidism, are common during pregnancy and can significantly impact both maternal and fetal outcomes. Despite advancements in screening and treatment, thyroid dysfunction in pregnancy often remains underdiagnosed, especially in low-resource settings. This study aimed to evaluate the prevalence, outcomes and effective management strategies of thyroid dysfunction during pregnancy.

Objectives: To evaluate the prevalence and outcomes of thyroid dysfunction, including both hypothyroidism and hyperthyroidism, during pregnancy, and their associated maternal and fetal complications.

Methods: This prospective observational study included 281 pregnant women with thyroid disorders attending antenatal care at JSS Hospital, Mysuru, from August 2022 …

Isapa 2025: Program Guide, Catherine Carty, Gerard Masdeu Yelamos

Publications

ISAPA 2025 is a landmark international event that brings together global leaders, researchers, practitioners, and advocates in Adapted Physical Activity to ignite systemic change under the unifying theme “Shifting the Dial: From Awareness to Transformation.” Hosted in Kerry, Ireland, under the patronage of UNESCO, the symposium integrates five major events into one dynamic platform.

The program reflects IFAPA’s mission to advance inclusion, research, professional excellence, and international cooperation, while also contributing meaningfully to the implementation of global frameworks such as the UN Convention on the Rights of Persons with Disabilities (CRPD), the Sustainable Development Goals (SDGs), the Paris 2024 Call …

Screening For The Unseen: Depression Detection Through Phq-9 And Provider Education In Pain Management, Veronica Shaw

DNP Projects

Background: Depression leads to significant economic and health burdens, causing 200 million lost workdays and costing employers $17 to $44 billion annually (CDC, 2022). It accounts for 4.3% of the global disease burden and is a leading cause of disability worldwide (WHO, 2021). Chronic pain, affecting 20.9% of United States adults, often exacerbates depression, creating a vicious cycle of physical and emotional suffering (Rikard et al., 2023). Despite the availability of effective treatments, depression is frequently missed in primary care settings, with 50% of cases undiagnosed (Hawkes, 2019). Addressing both depression and chronic pain through improved screening and holistic care …

Introducing An Eating Disorder Protocol In The Pediatric Primary Care Setting, Brandi Bozarth

DNP Projects

Background: The incidence of eating disorders has been on the rise, often beginning in adolescence and continuing well into adulthood. Consequences of untreated disrupted eating patterns can affect multiple body systems and are responsible for thousands of deaths annually. Despite these facts, research and data regarding eating disorders in adolescent patients are severely deficient. There is also a lack of standardization regarding assessing eating disorders in the pediatric primary care setting, as there are no specific guidelines or screening processes recommended by the American Academy of Pediatrics for the detection of eating disorders.

Purpose: The purpose of this project is …

Prevalence Of Depression And Its Coping Strategies Among Rural And Urban Geriatric Population, Mohit Negi, Smitha M C

Digital Journal of Clinical Medicine

Background: Aging is a natural process, and older age is a period in which most aspects of life require support from others. Globally, Depression is a serious public health concern among elderly populations. The aim of this study was to estimate the prevalence of depression and its coping strategies among geriatric population and to evaluate the association between socio-demographic factors and level of depression.

Methods: A cross-sectional study was conducted among 410 study participants in both rural and urban areas. Geriatric Depression Scale (GDS-15) was used to measure the depression and brief-COPE (28-items) scale was used to measure the coping …

Myocardial Infarction Trends Following Covid-19 Vaccination: A Retrospective Investigation From India, Hema S. Pinnam, Hrithika Madhavan, Jagarlamudi Harshitha, Vikram Patil, Harshita Tiwari, Isha A. Kumthekar, Jampala Sri Mounya

Digital Journal of Clinical Medicine

Background: The relationship between COVID-19 vaccination and the incidence of myocardial infarction remains a topic of debate. The study aimed to analyze the demographic, clinical, and outcome characteristics of MI patients post-vaccination in India, focusing on differences between Covishield and Covaxin recipients.

Methods: The retrospective observational study included 303 MI patients admitted to a tertiary care center. Data were collected on demographics, comorbidities, vaccination status, ICU admissions, and outcomes. The Charlson Comorbidity Index (CCI) was used to assess disease severity. Statistical analyses evaluated the associations between vaccination status, clinical parameters, and mortality.

Results: Among the study population, 74.3% were males, …

Establishing Psychiatry Clubs: Novel Approach To Enhance Psychiatry Teaching Learning In India, Akuti Khanna, Kishor M

Digital Journal of Clinical Medicine

Despite the fact that over 150 million Indians suffer from psychiatric disorders, the country faces a severe shortage of mental health professionals, with less than 1,300 psychiatrists graduating annually. One such solution is the establishment of Psychiatry Clubs in medical colleges, which can significantly enhance awareness, education, and community engagement in mental health. The Psychiatry Club at JSS Medical College, Mysuru, established on October 10, 2023, aims to promote mental well-being, provide peer support, as well as foster professional development through workshops, seminars, and collaborations with other mental health professionals and other student led organisations. These clubs offer a sustainable …

Assessment Of Effectiveness And Evaluation Of Perception Among Students Towards Flipped Classroom Learning: A Prospective Study., Nagaraja Prasad Sai, Vedavathi Hanumaiah, Shreenivas Prabhakar Revankar, Shruthi S. Lingesh, Avanthi Eshwar

Digital Journal of Clinical Medicine

BACKGROUND: Flipped learning (FL) is a teaching learning approach in andragogy. In FL students are involved in self-directed learning with the teacher acting as a facilitator and a moderator. Introduction of Competency Based Medical Education led many educators to shift from traditional teaching to blended teaching learning methods. This study was conducted to assess effectiveness and evaluate students’ perception towards FL.

AIM AND OBJECTIVES: To assess effectiveness of FL teaching in improvement of student scores and to evaluate student’s perception towards FL teaching.

MATERIALS AND METHODS: Pre-class activities included study materials in the form of PowerPoint slides …

Changing Climate, Changing Health: Perspectives From General Population In Mysuru, Lekhashree A, Manirsha P V, Paranthaman Chinnasamy, Srishti Arya, Sunil Kumar D

Digital Journal of Clinical Medicine

Background: Climate change has emerged as a major public health concern, contributing to rising morbidity and mortality worldwide. In India, increasing heat waves, unpredictable rainfall, and deteriorating air quality have intensified climate-sensitive health conditions. This study aims to assess the health impacts of climate change among the general population of Mysuru.

Methodology: A community-based cross-sectional study was conducted among 400 residents of Mysuru (April–June 2024). Participants were recruited through simple random sampling. Data were collected using a pre-tested semi-structured questionnaire via Google Forms. Analysis was performed using SPSS v26, with descriptive and inferential statistics.

Results: Among 400 participants, …

A Cross-Sectional Study Of The Correlation Between Working Models, Work-Life Balance And Psychological Distress In It Professionals In An Urban Setting., Neeharika Krishna Kumar, Ponnammal Sundar Lakshmi, Vathsalya S. Gowda, Kshamaa Haradanahalli Giriprakash, Manju Aswath

Digital Journal of Clinical Medicine

Background: India makes up more than 19% of the global Information Technology (IT) Market. The health and well-being of the population employed in this sector will affect their productivity at work and, in turn, the economic outcome. Changes in working models and altered work-life balance can lead to increased distress in IT Professionals, hence the current study.

Methodology: The current cross-sectional descriptive study assessed 247 IT professionals. A semi-structured questionnaire was used for socio-demographic details, working models and work-life balance. Kessler Psychological Distress Scale (K10) Plus was used to assess psychological distress. Statistics and correlations were done using SPSS 20. …

A Study Of Electrocardiogram And Echocardiography Parameters Of Post Covid – 19 Patients, Venkateswararao K, Durga Prasad Sadhupati

Digital Journal of Clinical Medicine

Background: Coronavirus Disease – 2019 [COVID-19] infection is multisystem disease not restricted to the lungs it has negative impact on Cardiovascular system by activation of ACE-2 receptors causing plaque stability, vascular inflammation and MI. ECG and 2D ECHO is a simple bed side diagnostic test can be used to assess cardiovascular disease involvement in such patients. We aimed to find out ECG and 2D ECHO abnormalities of Covid – 19 patients. To Study relation of SARS-COV-2 infection and Prevalence of Cardiovascular disease.

Methods: We perform Cross Sectional study among 500 Post Covid – 19 patients [>20 and

Results: Out …

Subclinical Myocardial Disease: The Next Frontier In Cardiovascular Prevention., Param Darpan Sheth, Chandana S., Nimrah Rehman

Digital Journal of Clinical Medicine

Subclinical myocardial disease refers to pathological cardiac changes that precede overt symptoms. It represents an emerging frontier in cardiovascular disease prevention; wherein early detection of myocardial dysfunction could allow timely intervention to avert heart failure (HF) and other outcomes. This narrative review summarizes the current and emerging tools for detecting subclinical myocardial disease, including advanced cardiac imaging and circulating biomarkers, and discusses their potential to improve risk stratification and preventive care in asymptomatic high-risk individuals. Novel echocardiographic measures such as global longitudinal strain (GLS) can unmask subtle systolic dysfunction despite preserved ejection fraction, while cardiac magnetic resonance (CMR) tissue mapping …

Comparison Of Transversus Abdominis Plane Block Versus Intrathecal Clonidine In Lower Segment Caesarean Section - A Prospective Observational Study, Christy Maria Paul, Dr Somsundar R G Associate Professor, Dr Archana B N Assistant Professor, Dr. Shivakumar G Pofessor And Hod

Digital Journal of Clinical Medicine

Comparison of Transversus Abdominis Plane Block versus Intrathecal Clonidine in Lower Segment Caesarean Section - A Prospective Observational Study

Background and Objective: In the majority of abdominal procedures, transverse abdominis plane block, one of the fascial plane blocks, has been used extensively to treat post-operative pain. Ultrasound has gained popularity in the management of cesarean patients due to its ease of use and reduced adverse effects.To assess the effectiveness of ultrasound guided transverse abdominus plane block with intrathecal clonidine for post surgical pain control in lower segment cesarean patients.

Material and Methods: This prospective observational study was done in …

Association Between Trust In The Incumbent President And Covid-19 Preventive Behaviors During The Pandemic In Four Latin American Countries, Juliana Mejía-Grueso, Gloria Isabel Niño-Cruz, Javiera Alarcón-Aguilar, Pablo Roa-Urrutia, Sergio Mauricio Moreno-López, Adriano Akira Ferreira Hino, Alexandre Augusto De Paula Da Silva, Fernando López, Deborah Salvo, Rodrigo Siqueira Reis, Guillermo Rosas, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

The COVID-19 pandemic revealed disparities in policy responses in Latin America. We examined the association between trust in the president and COVID-19 preventive behaviors in Brazil, Chile, Colombia, and Mexico. We used data from the Collaborative COVID-19 Response Survey by the McDonnell Academy at Washington University in St. Louis (United States), from September 2020 to March 2021. Nonprobabilistic sampling included adult citizens from the four countries. Multivariate negative binomial regression models were applied. The study included 8,125 participants, with Brazil showing the lowest adherence to preventive behaviors (65.5%). Increased adoption of preventive behaviors was linked with ages 18-26 (aIRR = …

My Body My Choice: A Qualitative Study Of Volitional Female Sterilization In The U. S. Latina And Hispanic Female Population, Heather Morris Tuip

Antioch University Dissertations & Theses

This qualitative study, utilizing an interpretative phenomenological analysis methodology, elucidates the experience of Latina and Hispanic women living in the United States who have volitionally undergone sterilization or have sought the procedure out for birth control. Understanding the rich, contextual, lived experience of Latina and Hispanic women through an intersectional framework highlights how cultural influences and contemporary policies on reproductive rights informed their personal choice to undergo a female sterilization procedure. The participants of this study shared how they made meaning of their experiences. Within a homogenous sampling of study participants who share ethnicities and genders, six group experiential themes …

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 …

Havana Syndrome: A Scientific Review Of An Unresolved Medical Mystery, Aishik Dutta

Digital Journal of Clinical Medicine

Background

Since 2016, U.S. and Canadian officials have reported Anomalous Health Incidents (AHIs), or "Havana Syndrome," characterised by a strange sensory experience followed by chronic neurological, cognitive, and vestibular issues. The cause is intensely debated, with primary hypotheses pointing to either psychosocial factors or a directed-energy weapon, creating a significant medical and geopolitical puzzle.

Methods

This review critically assesses the current evidence by analysing peer-reviewed clinical studies and major institutional reports.

Results

The findings are deeply contradictory. A 2020 NASEM report identified directed, pulsed radiofrequency energy as the most plausible mechanism for a core set of symptoms. Conversely, comprehensive 2024 …

Self-Inflicted, Non-Sexual, Non-Masturbatory Penile Fracture Case Report - An Atypical Presentation, Sajan Sehgal, Vijayakumar R, Sachin Dharwadkar, Amruthraj G. Gowda

Digital Journal of Clinical Medicine

Background: Traumatic injuries to the genitalia are uncommon due to the mobility of the penis and scrotum. Penile fracture is a relatively rare condition arising from disruption of tunica albuginea with rupture of the corpus cavernosum. In order to ensure that such an injury is not missed, it is necessary to have a high index of suspicion to diagnose this condition.

Result: Patient underwent an emergency repair of penile fracture.

Conclusion: We hereby, report a rare case of accidental, non-masturbatory, self-inflicted penile fracture which was diagnosed promptly based on clinical assessment, confirmed radiologically and managed surgically, resulting …

Case Series On Consultation-Liaison Psychiatry In Pain Abdomen With School Refusal Among Children, Jatin Kumar, Aditya Takiar, Kishor M, Sudhamshu K.C, Anil Kumar M.G., Prashanth S.N

Digital Journal of Clinical Medicine

Chronic abdominal pain is one of the most common causes of school refusal in children often leading to multiple hospital visits and expenses. This study was done to assess the psychiatric morbidity underlying functional gastrointestinal complaints in children presenting to paediatric surgery unit. We conducted a prospective case series (N=11; ages 8–13) of children referred from Paediatric Surgery between June and December 2025. All these children presented with idiopathic abdominal pain and a significant period of absence from school. These children were evaluated for any organic causes through the use of various investigations including imaging studies and were referred to …

Evaluating The Efficacy Of Vertical Integration In Training Undergraduate Medical Students Under Competency Based Medical Education Curriculum, Pratham Mehta, Yashika Sharma, Kishor M, Arun M

Digital Journal of Clinical Medicine

Background: The National Medical Council in the Indian Medical Graduate guidelines to enhance learning, recommends Vertical and Horizontal Integration. Vertical integration may be defined as a curricular strategy that aligns para-clinical and clinical teaching across time with a view to enhancing relevance and application of knowledge. The present study is an attempt to test whether vertical integration of Forensic Medicine and Psychiatry is associated with greater short-term learning gains and improved student perceptions compared with conventional didactic lectures.

Methods: With Institutional and Ethics Committee clearance, a two-phase quasi-experimental study was performed across two consecutive academic cohorts (Phase 1, …

Psychometric Evaluation Of A Novel Measure Of Trauma-Related Cannabis Use To Cope, Sage E. Hawn, Terrell A. Hicks, Christopher Latourrette, Anita Thomas, Daniela Chaname, Sarah Ehlke, Abigail Powers Lott

Psychology Faculty Publications

Background: Posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) are commonly comorbid and are associated with many negative public health outcomes. One plausible explanation for this comorbidity comes from a self-medication framework, which suggests people use cannabis to cope with PTSD symptoms. Despite theoretical and empirical evidence for PTSD-related cannabis use to cope, no measure of this construct exists.

Objective: We sought to address this gap by developing and validating a novel measure of PTSD-specific cannabis self-medication, which we have termed the Trauma-Related Cannabis Use to Cope (TRCU) questionnaire.

Method: The psychometric properties of the TRCU and how it …

Mitochondrial-Targeted Therapies In Traumatic Brain Injury: From Bench To Bedside, Sidra Tabassum, Silin Wu, Chang-Hun Lee, Bosco Seong Kyu Yang, Aaron M Gusdon, Huimahn A Choi, Xuefang S Ren

Faculty, Staff and Student Publications

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality worldwide, with limited effective therapeutic options currently available. Recent research has highlighted the pivotal role of mitochondrial dysfunction in the pathophysiology of TBI, making mitochondria an attractive target for therapeutic intervention. This review comprehensively examines advancements in mitochondrial-targeted therapies for TBI, bridging the gap from basic research to clinical applications. We discuss the underlying mechanisms of mitochondrial damage in TBI, including oxidative stress, impaired bioenergetics, mitochondrial dynamics, and apoptotic pathways. Furthermore, we highlight the complex interplay between mitochondrial dysfunction, inflammation, and blood-brain barrier (BBB) integrity, elucidating how these …

Quality Over Quantity: Doula Perspectives On Equity, Access, And Quality Of Care In Black Maternal Health Outcomes, Terry-Ann E. Lynch

West Chester University Graduate Theses, Dissertations, and Final Projects

Black maternal mortality in the United States is a public health crisis. There are a plethora of reasons as to why maternal and fetal deaths disproportionately impact Black women. From a public health perspective, health disparities are an area of concern in marginalized communities, with Black maternal mortality being a risk factor. “According to the Centers for Disease Control and Prevention (CDC), in 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6)” Maternal Mortality Rates in the United States, 2021” …

Home-Based Transcranial Direct Current Stimulation Treatment For Major Depressive Disorder: A Fully Remote Phase 2 Randomized Sham-Controlled Trial, Rachel D Woodham, Sudhakar Selvaraj, Nahed Lajmi, Harriet Hobday, Gabrielle Sheehan, Ali-Reza Ghazi-Noori, Peter J Lagerberg, Maheen Rizvi, Sarah S Kwon, Paulette Orhii, David Maislin, Lucia Hernandez, Rodrigo Machado-Vieira, Jair C Soares, Allan H Young, Cynthia H Y Fu

Faculty, Staff and Student Publications

Transcranial direct current stimulation (tDCS) has been proposed as a new treatment in major depressive disorder (MDD). This is a fully remote, multisite, double-blind, placebo-controlled, randomized superiority trial of 10-week home-based tDCS in MDD. Participants were 18 years or older, with MDD in current depressive episode of at least moderate severity as measured using the Hamilton Depression Rating Scale (mean = 19.07 ± 2.73). A total of 174 participants (120 women, 54 men) were randomized to active (n = 87, mean age = 37.09 ± 11.14 years) or sham (n = 87, mean age = 38.32 ± 10.92 …