Mental and Social Health Commons^™

Golden Steps: A Dance-Based Program To Improve Balance In Older Adults — A Feasibility And Acceptability Study, Ramyr Bognot, Sophia Botelho, Nolan Caberto, Lauren Valerio, Joshua Yu, Jason Zeidman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background

Falls are a leading cause of injury and loss of independence among older adults. Evidence-based programs such as Otago and Tai Ji Quan reduce fall risk, yet barriers to access and adherence remain. Dance-based interventions may offer a practical, enjoyable approach to engage older adults in balance training.

Purpose

This formative pilot study aimed to develop four dance routines grounded in evidence- based balance principles and evaluate their feasibility and acceptability among older adults, including factors influencing enjoyment and willingness to continue participation, to inform future clinical and community implementation.

Methods

Four routines (Polka, Country, Rockabilly, Salsa) were developed …

Multiple Interest Holder Perspectives Of The True Grit Sci Residential Program: A Mixed Methods Program Evaluation, Keara Mcnair

Seton Hall University Dissertations and Theses (ETDs)

Young adults with spinal cord injury (SCI) face significant challenges during the transition to adulthood, including barriers to independence, community participation, and psychosocial adjustment (Ingimarsdóttir et al., 2023; Zebracki et al., 2010). Current rehabilitation models in the United States prioritize short-term physical recovery and offer limited support for the developmental and contextual needs that shape long-term outcomes after SCI, particularly during transitions from inpatient rehabilitation to the community (Anderson et al., 2024; Bryden & Gran, 2024). Community-based programs may help address these gaps, though few have been rigorously evaluated using implementation science frameworks that attend to health equity, contextual influences, …

Stimulant Medications And Bone Health, Christine M Swanson, Julie H Wolfe, Chadi A Calarge

Faculty, Staff and Students Publications

Purpose of review: This review summarizes the potential impact of stimulant medications on bone health, to raise awareness and optimize their safe use.

Recent findings: Stimulant medications can impair bone health through inadequate nutrient/calorie intake and stimulation of the sympathetic nervous system, which regulates bone metabolism. However, their use decreases fracture risk in younger populations ([Formula: see text]25 years old) with attention deficit/hyperactivity disorder (ADHD), likely through reductions in impulsivity and injury. Special care may be needed when fractures occur while using these medications, as recent data suggest psychostimulants are associated with impaired fracture healing. Prescription and non-prescription use of …

Leveraging Multimodal Large Language Models For Fall Risk Reduction In Older Adults In The Home: Proposed Model Design, Justin Do, Vivaswat Suresh, Lily Zhang, Bharvi M. Chavre, Jeremy Cha, Robert S. Pugliese

SKMC Student Presentations and Publications

This research letter proposes a novel model design leveraging natively multimodal large language models to identify fall risks and generate visualizations of recommended home environmental modifications, aiming to improve the accessibility and impact of personalized fall prevention advice for older adults. Through a pilot rating study, this work demonstrates that multimodal large language models can generate safe and actionable advice to reduce fall risk in lived spaces of older adults, and also generate realistic edits based on original images. While this concept needs further testing and clinical comparison, it highlights a promising avenue for further innovation of fall prevention tactics.

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

Values-Based Clinical Ethics: A New Model Of Health And Ethics Consultation For Patients Suffering In Extremis, Adam Trainer

Electronic Theses and Dissertations

This dissertation argues that contemporary clinical ethics is inadequately equipped to support patients suffering in extremis because it relies on an insufficiently discriminating account of health and a constrained model of moral reasoning. Drawing on Bernard Lonergan, it reconceives health as an emergent, multi-layered, heuristic notion shaped by biological, psychological, social, and existential goods. On that basis, it critiques principlism’s global applicability thesis and the undergirding claim that its principles form part of the common morality, arguing that this justificatory structure is philosophically insufficient and practically limited for clinical ethics in cases marked by profound suffering, moral plurality, and normative …

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.

Protecting The Protectors: Supporting Emergency Department Security Officer Wellness: A Brief Conceptual Review And Research Agenda, James A. Espinosa Md, Paul Sarnese, Alan Lucerna

Rowan-Virtua Research Day

Background: Workplace violence in emergency departments (EDs) has been widely studied, yet the occupational wellness of ED security officers has received comparatively limited focused attention in emergency medicine literature.

Objective: To conceptually examine the role of ED security personnel within the emergency care environment and outline a research agenda addressing their wellness.

Discussion: Security officers frequently respond to behavioral crises, assist with restraint events, and help maintain safety for patients, visitors, and staff. These duties include vigilance between events, sudden physical exertion, and exposure to aggression. ED security work often follows a recognizable rhythm: baseline vigilance, rapid escalation response, physical …

Unmasking Neurosyphilis: A Psychotic Presentation With A Hidden Cause, Fazal Choudhary Do, Lalitya Karra Do

Rowan-Virtua Research Day

No abstract provided.

Reframing Emergency Medicine (And Healthcare) Wellness Measures: The Case For Adding Measures Of Physiological Sustainability, Exercise, Restoration, And Meaning, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background

Physician wellness measurement in Emergency Medicine (EM) in particular and in healthcare in general has largely focused on identifying distress states such as emotional exhaustion and depersonalization. Instruments such as the Maslach Burnout Inventory and related derivative surveys have been well-validated and  have played a central role in identifying the scope of burnout across healthcare systems.

Conceptual Framing

While current measures of distress are essential, they may not fully characterize the spectrum of clinician health. In many fields outside healthcare—including occupational health, resilience research, and positive psychology—assessment of well-being includes behaviors and experiences associated with sustained health, such as …

Mental Health Vs Substance Misuse: Predicting Restraint Use In The Emergency Department, Chloe Lafosse Bs, Michael Witt Md, Mph

Rowan-Virtua Research Day

Introduction: Violence in the emergency department affects approximately 30% of hospital staff every 6 months. Presenting complaints may contribute to violence risk, particularly in those with mental health or substance misuse issue where there are heightened risks of cognitive impairment and involuntary holds.

Methods: We conducted a systematic review of literature published between 1957-2025 using multiple databases, identifying studies that observed physical restraint use on adult emergency department patients. All relevant data was recorded and imputed into SPSS for a chi-square test.

Results: Thirteen studies (2019-2025) met inclusion criteria, with sample sizes ranging from 58 to 1,035,522 participants. All studies …

When Individual Implicit Bias Meets Ed System Turbulence: Expanding The Implicit Bias And Cultural Bias Conceptual Frame To Support Reflective Decision Making Through Both Individual Bias Reduction Strategies As Well As System-Level Design Approaches, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background

Cultural and implicit bias have been widely studied as contributors to disparities in healthcare delivery. Prior literature has largely conceptualized bias as an individual-level cognitive phenomenon occurring within clinician–patient interactions. However, emergency departments (EDs) function as complex adaptive systems (CAS), characterized by time pressure, uncertainty, cognitive load, and environmental noise. These conditions may contribute to the expression of implicit bias in clinical care.

Objective

To reframe cultural and implicit bias in the ED as both an individual cognitive property as well as a system-dependent and modulated  phenomenon and to propose that the operational state of the ED influences the …

Preliminary Results From Assessing Medical Students’ Familiarity With Adverse Childhood Experiences (Aces) And Trauma-Informed Care (Tic), Kaylea Shoulders, Portia Tasnim Shaheed, Kartik Kannan, Rachel Silliman Cohen, Beth Cooper, Christine Schroeder, Yahaira Márquez

Rowan-Virtua Research Day

Adverse childhood experiences (ACEs) are highly prevalent and associated with significant long-term health outcomes1; however, physicians often report feeling underprepared to address trauma in clinical care. While medical education increasingly includes exposure to ACEs and trauma-informed care (TIC), limited research has examined how these topics are integrated and experienced within osteopathic medical education (OME). This project aims to assess medical students’ familiarity with ACEs and TIC at Rowan-Virtua School of Osteopathic Medicine and to potentially help inform curricular improvement efforts. This study adapts and extends prior research2 using an anonymous survey administered via Qualtrics. Recruitment targeted medical students across years …

Applying User-Centered Design To Develop A Culturally Sensitive, Low-Calorie Meal Plan For Enhancing Dietary Behavioral Control In Masld, Maya Balakrishnan, Paola Martinez, Brett Deng, Ivonne Arguelles, Crystal Arguelles, Terri L Fletcher, Natalia I Heredia, Myriam Ibarra, Anna Christine Rome

Faculty, Staff and Students Publications

Background: Dietary changes are essential for managing metabolic dysfunction-associated steatotic liver disease (MASLD), yet patients often face barriers related to knowledge, skills, cost, time, and cultural fit.

Aims: The purpose of this paper is to report a process for culturally tailoring a dietary intervention and its application to create a calorie-restricted meal plan for Mexican and Central American patients with MASLD. Guided by the Theory of Planned Behavior and user-centered design, we produced a culturally tailored seven-day structured meal plan aligned with dietary guidelines for MASLD and weight loss.

Methods: We conducted a three-phase, mixed-methods process among Mexican/Central American patients …

Co-Location Of Substance Use Disorder Treatment And Hospital Emergency Departments, Leila Hasan

Honors College Theses

Patients with substance use disorder (SUD) rely heavily on the hospital emergency department (ED) for acute care and are often discharged from the ED without access to long-term recovery resources. This project explores the impact of co-located addiction treatment programs with hospital EDs on recovery outcomes of patients with SUD. A systematic literature review conducted on relevant studies indicates that co-located programs can be effective in increasing treatment initiation and maintenance, reducing ED revisits, and reducing repeated overdose in SUD patients. Programs that were most effective included three key elements: fast linkage of SUD patients to program staff in the …

A Global Prospective Harmonization Framework For Suicidality, Anhedonia, And Obsessive-Compulsive Symptoms In Psychiatric Genetic Studies: A Cross-Continental Study Within The Ancestral Population Network, Ana Diaz-Zuluaga, Jacey Anderberg, Ana Ramirez-Diaz, Andrea Marques, Catherine Rast, Daniel Bustamante, Deborah Jonker, Johanna Valencia-Echeverry, Stella Gichuru, Lukoye Atwoli

Internal Medicine, East Africa

This study aims to prospectively collect harmonized, quantitative, and dimensional psychiatric phenotypes (suicidality, anhedonia, and obsessive-compulsive symptoms) and information on discrimination, stigma, and unfair treatment in up to 27,500 individuals across diverse ancestries and clinical populations for genetic analysis within the NIMH Ancestral Population Network (APN). Five APN projects are participating in the current study (PUMAS-Paisa, PUMAS-NeuroGAP, KOMOGEN-D, LATINO, and SAX-II), spanning recruitment over 15 countries across the Americas, Africa, and Asia. Participants are being enrolled via the recruitment protocols specific to each participating project. The harmonized clinical battery includes the Columbia-Suicide Severity Scale, Snaith-Hamilton Pleasure Scale, and Florida Obsessive-Compulsive …

Social Correlates Of Trauma And Posttraumatic Stress Disorder: The Importance Of Context, Lukoye Atwoli, Linnet Ongeri

Internal Medicine, East Africa

Understanding trauma and posttraumatic stress disorder (PTSD) requires a contextual perspective that considers historical legacies, social environments, and cultural realities. This paper draws on empirical evidence from Kenya and Uganda to demonstrate the limitations of applying trauma frameworks developed in high-income countries to African contexts. Findings from the Orphaned and Separated Children’s Assessment Related to Their Health and Well-Being (OSCAR) study challenge assumptions about care environments. The study reveals higher PTSD rates among orphans in family-based settings compared to institutional care, and highlights the protective roles of religion and social support. The Neuropsychiatric Genetics of African Populations-Psychosis (NeuroGAP-Psychosis) study provides …

Handgrip Strength, Handgrip Endurance And Bmi: A Comprehensive Approach To Health Assessment Among The General Population Of Madikeri, Dr Asha S. Das, Dr Ravikiran Kisan, Dr Suhas Y. Shirur, Dr Narasimha Rai K, Dr Sanjay Bhagoji

Digital Journal of Clinical Medicine

Introduction: Being physically fit is essential for lowering the risk of illness and enhancing longevity. While Body Mass Index (BMI) is frequently used to evaluate body composition, Hand Grip Strength (HGS) and Hand Grip Endurance (HGE) are important indicators of general well-being. Goal: To assess BMI, HGS, and HGE and ascertain how they correlate in a selected group of subjects. Methods: Fifty participants between the ages of 20 and 40 years participated in a comparative cross-sectional study at the Department of Physiology, Kodagu Institute of Medical Sciences, Madikeri. Participants were divided into three BMI groups after anthropometric measurements were taken. …

The Impact Of A Mindfulness Meditation Program On Phq-9 Scores In Eskd Clients At The Dialysis Center, Christi Collins Weaver

Student Scholarly Projects

Practice Problem: Patients undergoing hemodialysis for end-stage kidney disease (ESKD) experience high rates of untreated depressive symptoms, which negatively impact quality of life, treatment adherence, and therefore increased hospitalization and higher mortality rates.

PICOT: In adult patients receiving in-center hemodialysis (P), how does the implementation of a structured mindfulness meditation program (I), compared to usual care (C), affect depressive symptoms as measured by the Patient Health Questionnaire-9 (PHQ-9) (O) over an eight-week period (T)?

Evidence: Current literature demonstrates that depression is highly prevalent among individuals with ESKD and is associated with increased morbidity and decreased treatment adherence. Evidence supports mindfulness …

Non-Diabetic Kidney Disease In A Patient With Type 2 Diabetes Mellitus: A Diagnostic Challenge, Nikhil R, Mahabaleshwar Mamadapur , Assistant Professor, Harshwardhan S Patil

Digital Journal of Clinical Medicine

Background: Diabetic kidney disease (DKD) is the most common cause of end-stage renal disease. However, non-diabetic kidney disease (NDKD) can coexist or mimic DKD, leading to misdiagnosis. Case Presentation: A 46-year-old female with type 2 diabetes presented with vomiting and abdominal pain. Physical examination revealed non-blanching erythematous papules on both lower limbs. Investigations showed uncontrolled diabetes, metabolic acidosis, and active urinary sediment. Absence of diabetic retinopathy prompted renal biopsy, which revealed immune-complex–mediated glomerulonephritis with small-vessel vasculitis. Diagnosis: Immune-complex–mediated glomerulonephritis with small-vessel vasculitis, not consistent with diabetic nephropathy. Management: Supportive care and immunosuppressive therapy were initiated with improvement in renal function. …

Implementing Measurement-Based Care In Virtual Mental Health Services For Rural Veterans: Provider Insights From A Pre-Implementation Evaluation, Amanda Heeren, Kimberly Mccoy, Lindsey Fuhrmeister, Natalie Suiter, Jan A Lindsay, Chloe Hoang, Laura Marsh, John Fortney, Carolyn Turvey

Faculty, Staff and Students Publications

Background

Measurement-Based Care (MBC) uses repeated standardized psychological assessments to monitor treatment progress and guide clinical decision-making. Although MBC improves outcomes when results are discussed collaboratively, adoption across the Veterans Health Administration (VHA) remains below 50%, particularly in virtual and rural settings. This pre-implementation evaluation explored provider perspectives to inform development of a digital MBC workflow for rural tele-mental health settings.

Methods

Using the Alacrity Center’s Discover, Design, Build, and Test model and User Centered Design, we conducted a pre-implementation survey of mental health providers at a VHA Medical Center providing care to rural and highly rural Veterans in South …

Drd2 Rs6276 Polymorphism And Trait Impulsivity In Individuals With Mixed Behavioral And Substance Addictions, Gabriela Zdunek, Remigiusz Recław, Aleksandra Suchanecka, Krzysztof Chmielowiec, Dariusz Larysz, Patryk Ilków, Kinga Łosińska, Jolanta Chmielowiec, Łukasz Jaworski, Anna Grzywacz

Baltic Journal of Health and Physical Activity

Background/Objectives: Impulsivity is a key transdiagnostic trait linked to dysregulated reward processing in both behavioral and substance-related addictions, as recognized in DSM-5. Dopaminergic genes, including DRD2, may modulate individual differences in impulsivity, particularly under conditions of increased addiction vulnerability. This study examined whether the DRD2 Exon 8 rs6276 polymorphism predicts impulsivity levels in men with mixed addictive behaviors compared with healthy controls. Methods: A total of 328 males (128 with mixed behavioral and substance addictions and 200 controls) were assessed. Diagnoses were confirmed using the MINI interview, and impulsivity was measured with the Barratt Impulsiveness Scale (BIS-11). Genotyping of …

Assessing The Association Between Musculoskeletal Injury And Mental Health In Rugby Players-A Cross-Sectional Study, Mordicai Atinga, Jasmit Shah, Sarah Karanja, Mark Lumbasi, Miriam Ndungu, Sarah Kiburi, James Ondiege, Njalalle Baraza

Internal Medicine, East Africa

Background: Musculoskeletal injuries are common among athletes and can negatively affect both physical and psychological wellbeing. Beyond physical disability, injuries have been linked to poor mental health, loss of athletic identity, and increased substance use. In low- and middle-income countries (LMICs), where awareness and management of mental health remain limited, the psychological burden of sports injuries may be underrecognized. Rugby, a physically demanding contact sport, has one of the highest rates of injury, but little is known about how such injuries influence mental health and related outcomes in African contexts. This study explored the relationship between musculoskeletal injuries and health …

Co-Designing An Adolescent Perinatal Mental Health Intervention In Kenya And Mozambique: The Inspire Project, Tatiana Salisbury, Fernando Chissale, Margrette Hanselmann, Evaline Langat, Sarah Kinja, Violet Naanyu, Mark Nyalumbe, Mellan Lilumbi, Lucy Nyaga, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background Interventions to support adolescent perinatal mental health are limited and largely developed for delivery in high-income countries. This study aimed to co-design an intervention to improve mental health outcomes among pregnant and post-partum adolescent girls in Mozambique and Kenya.

Methods 159 adolescent girls (aged 15–19 years) and young women (aged 20–24 years) with experience of a pregnancy during adolescence, their partners and family members, service providers and community influencers were recruited in Kilifi County, Kenya and Moatize District, Mozambique. Those who consented took part in individual interviews, focus group discussions, observations, and workshops to identify key priorities for supporting …

Trauma-Related Compulsions In Obsessive-Compulsive Disorder: Functional Insights From Factor Analysis, Caitlin M Pinciotti, Max Thorsson, Gregor Horvath, Matti Cervin

Faculty, Staff and Students Publications

Resisting obsessive-compulsive disorder (OCD) compulsions is a key predictor of exposure and response prevention (ERP) effectiveness, yet trauma-exposed individuals with OCD endorse more severe compulsions and are more likely to be labelled 'treatment resistant.' Among trauma-exposed individuals, compulsions are theorised to function to prevent future trauma and cope with trauma-related responses. Recent findings suggest that certain compulsions in the context of trauma exposure differentially impact treatment outcomes, yet missing from extant literature is a larger empirically derived conceptualisation for how trauma may impact the underlying function of compulsions. In a sample of 662 adult patients enroled in intensive OCD treatment …

Does The Placenta Predict Depression During Pregnancy? Investigating Hormonal Links In High-Risk Pregnancies, Sonia Cerrillo, Hanne Hoffmann Phd

Posters - 2026

• Perinatal depression is a common disorder that affects maternal and infant well-being.

• Serotonin is an important mood-regulating neurotransmitter, and reduced serotonin signaling has been linked to depressive symptoms.

• Tryptophan (TRP) is the precursor for serotonin, where most TRP is metabolized through the kynurenine pathway.

• TPH supports serotonin synthesis, while IDO and TDO drive kynurenine production.

• During pregnancy, inflammation and stress may shift TRP away from serotonin, creating a placental “tryptophan steal.”

• We examined whether placental DNA methylation of these genes differs in high-risk pregnancies.

• We hypothesized that placental DNA methylation of genes in …

Antipsychotics As Adjunct Therapy In Risk Reduction Of Crisis Admission: An Analysis Of Historical Patient Data, Slawomir Piela, Eduardo Espiridion

Transformative Medicine

Introduction: Antipsychotics are a broad class of medication used in the management of psychotic symptoms in various disorders. In recent years, they have been approved for use as adjunct therapy in patients with treatment resistant depression and bipolar disorder. An outcome of this therapy that has not been extensively investigated is the associated likelihood of crisis events that necessitate admission to an emergency department or crisis center. Methods: In this study, we reviewed historic patient data to determine the association of risk of crisis admission in patients prescribed antipsychotics as adjunct therapy in the context of treatment resistant depression or …

Factors For Successful Craniosynostosis Surgery Gofundme Campaigns, Annarose Taylor, Rena Atayeva, Shikha Trivedi, Phavon Sage, David Park, Brendan Podszus, Jessica Bigner, Yifan Guo

Knowledge and Creativity Expo

Introduction

Craniosynostosis surgery costs can be as high as 100,000 dollars. Even with complete insurance coverage, patients often face large out-of-pocket expenses. Thus, patients seek other financial resources. As a crowdfunding platform, GoFundMe (GFM) is one of those resources. The objective of our study was to identify GFM campaign factors associated with greater fundraising success.

Methods

GoFundMe.com was queried for: craniosynostosis, synostosis, brachycephaly, trigonocephaly, scaphocephaly, and fused skull suture. Included campaigns had patients in the U.S. fundraising for craniosynostosis surgery or related expenses. Excluded campaigns were duplicates, for animals, helmets, charities, or other surgeries. Successful campaigns achieved third quartile of …

Exploring The Relationship Between Behavioral Health Early Prediction Model And Patient Outcomes In The Emergency Department, Karen M. Richendollar, Kathie M. Zimbro

Knowledge and Creativity Expo

Problem: Emergency departments (EDs) are increasingly utilized for mental health (MH) care, often resulting in overcrowding and delayed access to specialized services. A significant proportion of MH patients are discharged without a psychiatric consult, raising concerns about safety and readmission rates. This trend places additional strain on already limited behavioral health resources and contributes to care delays for patients in acute crisis. Moreover, the lack of standardized discharge criteria for MH patients increases variability in care and may compromise patient outcomes. Purpose: This study evaluates the effectiveness of the Behavioral Health Early Discharge Prediction Model (BHEDPM) in identifying MH patients …

A Qi: Implementing Pawss And Ciwa Adherence Challenge In The Psychiatric Emergency Department, Bailey Poler

Providence Nursing Research Conference 2023 – Present

No abstract provided.