Public Health Commons^™

Vape Counseling At Pediatric Practices: The Rethink Vape Toolkit, Paul T. Harrell, Ann L. Edwards, Natasha K. Sriraman, Rebecca J. Slimak, Anisha S. Vanka, Amy C. Paulson, Kelli J. England

Department of Pediatrics Faculty Publications

Introduction:

E-cigarettes (Vapes) represent the most common form of tobacco used by adolescents, with one out of every 29 (3.5%) middle school students and one in every 13 (7.8%) of high school students vaping daily. This project aimed to increase vape screening and prevention education in youth visits at pediatric practices, to increase provider comfort with the topic of vaping, and to evaluate this educational process.

Methods:

A provider training and resource modules (talking points, billing codes, and shareable parent/teen-tailored resources) were developed. Providers (N = 32) completed an anonymous pre/postsurvey regarding their knowledge, comfort levels, barriers, and practices related …

The Impact Of Medicaid Policy Limitations On Access To Eating Disorder Treatment: Uncovering The Consequences Of A System Built To Fail, Meghan Frost

DSW Capstone Projects

Individuals who rely on Medicaid face major barriers when trying to access eating disorder (ED) treatment, reflecting broader patterns of structural disadvantage in publicly funded health care. Research shows delayed diagnosis, limited access to ED specialists, and frequent denials for recommended services. These gaps occur because Medicaid policies do not match the needs of evidence based ED care, resulting in delayed or incomplete care for many individuals with eating disorders.

This issue is highly relevant to social work practice because the policies shaping these barriers are complex and difficult for clients and ED providers to navigate. Social workers across clinics, …

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

Prenatal Exposure To Nicotine And Postpartum Depression: A Systematic Review And Meta-Analysis, Reem Sharaf-Alddin, May Salama, Denise Mckinney, George Saade, Qi Zhang

Health Behavior, Policy & Management Faculty Publications

Purpose: Postpartum Depression (PPD) is the most common mental health complication of childbirth, and has short-term and long-term consequences for mother, child, and the entire family. PPD is a function of several factors. Prenatal exposure to nicotine (PEN) by Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), or Electronic Nicotine Products (ENPs) is a major potential risk factor. This systematic review and meta-analysis aim to summarize and evaluate all evidence regarding the association between PEN and PPD.

Methods: We searched the following databases, PubMed, Medline, Cochrane, EMBASE, and CINHAL, for studies published between Jan.1st ,2000&Sep.19th ,2024, with the outcome PPD. Studies …

Comparison Of Mental Illness Comorbidity Pre-Pandemic Vs. Pandemic-Era And Associations With Clinical And Demographic Characteristics For Virginia Public Hospital Inpatient Discharges With A Substance Use Disorder, Marilyn Bartholmae, Tharidu Gunawardena

Department of Medicine Faculty Publications

The rise in mental illnesses after the COVID-19 pandemic is well documented. However, it is not known whether the rates of mental illness comorbidity increased. The objectives of this study were to compare mental illness comorbidity rates before and after the pandemic among inpatients with SUD and to test associations between mental illness comorbidity, physical illness, and demographics. We used a retrospective cross-sectional design in a sample of inpatient discharges (N = 233,017) at Virginia public hospitals from January 2018 to December 2022. We used Z tests to compare rates of mental illness comorbidity pre- and post-pandemic and Chi-square tests …

Dengue Fever With Normal Platelet Count In A Patient With Β-Thalassemia Trait: A Case Report., Pankaj Kumar Jain, Manoj Seval, Vikas Meena, Rajesh Kumar Yadav

Digital Journal of Clinical Medicine

Dengue fever is an arboviral infection caused by different serotypes of the dengue virus. Generally, it presents with a wide variety of symptoms ranging from undifferentiated fever to dengue shock syndrome associated with thrombocytopenia and hemoconcentration. But in patients with thalassemia, it presents with anemia due to hemolysis, rather than hemoconcentration. Here we present a case of an 18-year-old female diagnosed with Dengue fever with thalassemia trait, who presented with a normal platelet count and moderate microcytic anemia.

When Fever And Thrombocytopenia Are Not Infectious: A Case Of Vitamin B12 Deficiency Mimicking Tropical Fever, Ram Arvind Viswanathan Dr

Digital Journal of Clinical Medicine

Vitamin B12 deficiency is classically associated with megaloblastic anaemia and neurological manifestations; however, atypical presentations continue to pose diagnostic challenges. Fever in association with thrombocytopenia often prompts evaluation for infectious aetiologies such as dengue, malaria, or sepsis, particularly in tropical settings. We report a case of vitamin B12 deficiency presenting with pyrexia and isolated thrombocytopenia, initially suspected to be an infectious illness. Extensive evaluation failed to reveal an infective cause, and subsequent haematological workup demonstrated megaloblastic changes with low serum vitamin B12 levels. Remarkably, the patient showed rapid defervescence and normalisation of platelet counts following parenteral vitamin B12 therapy. This …

The Role Of Physicians In Society: Perspectives From First-Year Mbbs Aspirants, Jesymol Joy, Dr Rashmi S, Amogha Shree, Dr Sunil Kumar D

Digital Journal of Clinical Medicine

Background: Physicians occupy a pivotal role in society as healers and communicators, with ethical leadership embedded in professional practice. In India, this role is evolving in response to changes in healthcare systems, increasing commercialization, and shifting societal expectations. Understanding how medical students perceive the physician’s role at the onset of medical education is vital for early professional identity development.

Objectives: To assess the motivations, perceptions, and values of first-year MBBS students regarding the societal roles, qualities, and responsibilities of physicians.

Methods: A cross-sectional study was conducted among 430 first-year MBBS students at a tertiary medical college in Mysuru, Karnataka, using …

Stones, Bones, And Hormones: A Multisystem Presentation Of Primary Hyperparathyroidism Due To Parathyroid Adenoma, Gadgesh B, Varsha Tandure, Nandini K, Chandana Srinath

Digital Journal of Clinical Medicine

Primary hyperparathyroidism is an endocrine disorder characterized by excessive secretion of parathyroid hormone, most commonly due to a solitary parathyroid adenoma, resulting in hypercalcemia and multisystem involvement [1]. Although many patients are diagnosed incidentally, delayed recognition may lead to severe renal, skeletal, gastrointestinal, and cardiovascular complications.

We report the case of a 44-year-old male who presented with sepsis and acute kidney injury, later found to have hypercalcemia with nephrocalcinosis, chronic calcific pancreatitis, skeletal deformities, and markedly elevated parathyroid hormone levels. Imaging localized a parathyroid adenoma, and the patient underwent successful parathyroidectomy with significant biochemical and clinical improvement.

This case emphasizes …

From Controversy To Comeback: The Renewed Role Of Pralidoxime In Op Poisoning, Dr Sanaa Jain, Dr Savitha V, Dr . Shashidhara K C

Digital Journal of Clinical Medicine

Organophosphorus compounds are commonly used as pesticides in agriculture, but they are responsible for approximately one-third of suicide deaths in Asian countries.The symptoms of organophosphate (OP) poisoning vary over time and are categorized into three phases: Acute Cholinergic Crisis (minutes to 24 hours), Delayed Phase (24 hours to 2 weeks), which may include intermediate syndrome, coma, and extrapyramidal symptoms, and Late Phase (OPIDP). Treatment typically involves Atropine, Pralidoxime, and symptomatic management, including airway support and mechanical ventilation.

Ropinirole-Induced Sleep-Related Behavioral Disturbances And Psychotic Symptoms In Parkinson's Disease: A Case Report, Kareena Arora, Akshatha C. J, Rajesh Raman, Vikrant Arora, Bindu Annigeri, Megha Sadashiv

Digital Journal of Clinical Medicine

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized primarily by motor symptoms such as bradykinesia, rigidity, and tremor. Though commonly associated with motor symptoms but can also present with significant non-motor symptoms such as sleep disturbances, psychosis, and cognitive decline. These symptoms may arise spontaneously or be medication-induced. We present the case of a 53-year-old male with Parkinson’s disease who developed nocturnal behavioural disturbances and psychotic features, likely secondary to dopaminergic agonist medication. Symptom resolution followed adjustment of antiparkinsonian medications and the introduction of antipsychotic medication

Unusual Case Of Pelvic Fracture Urethral Distraction Defect, Varuni Pragya, Madhukesh Rudramurthy, Siddalinga Murthy G

Digital Journal of Clinical Medicine

INTRODUCTION

Urinary bladder ruptures are an uncommon injury, occurring in less than 1% of all blunt abdominal trauma. Extraperitoneal bladder ruptures are generally associated with pelvic fractures and usually managed nonoperatively but open surgery is required when these injuries are associated with additional trauma to structures like prostate and urethra.

CASE PRESENTATION

We report our experience with a 32-year-old male who suffered a head on collision with a four-wheeler while driving a two-wheeler in a road traffic accident. He presented to the hospital with abdominal and pelvic pain, difficulty in passing urine and swelling of the scrotum. His X Ray …

Pulmonary Hemosiderosis In A Young Child Presenting With Recurrent Respiratory Illness And Refractory Anemia: A Case Report, Praveen Das, Ratnapriya Chowdhry, Neha Bhongale, Poonam Wade

Digital Journal of Clinical Medicine

Pulmonary hemosiderosis (PH) is a rare cause of diffuse alveolar hemorrhage in children and often presents with nonspecific respiratory symptoms and refractory iron‑deficiency anemia. We report a 2.5‑year‑old girl with recurrent lower respiratory tract infections, severe transfusion‑dependent anemia, failure to thrive, and persistent bilateral pulmonary infiltrates since infancy. Bronchoalveolar lavage demonstrated hemosiderin‑laden macrophages, confirming pulmonary hemosiderosis. Further evaluation revealed C‑ANCA positivity and PR3‑ANCA negativity, raising suspicion for an ANCA‑associated vasculitis; however, there was no renal, ear‑nose‑throat, or other systemic involvement, and a lung biopsy could not be performed. The child was managed with systemic corticosteroids with clinical improvement. This case …

State Social Benefit Schemes For Women In Continuity Of Psychiatric Care: A Case Report, Mathumitha A, Kishor M. Manohar Rao Professor

Digital Journal of Clinical Medicine

Mental health disorders are a major global public health challenge. The disorders affect over a billion people worldwide, while depressive and bipolar spectrum disorders also contribute substantially to disability and reduced quality of life. According to the World Health Organization, major depression alone affects more than 300 million people globally and is considered a leading cause of years lived with disability. Beyond clinical morbidity, mental illnesses exert a profound economic impact, with depression and anxiety accounting for an estimated USD 1 trillion annually in lost productivity worldwide, while the overall global economic burden of mental disorders is projected to reach …

The Effects Of Abused Drugs On Ferroptosis Pathways: Potential Therapeutic Targets For Substance Use Disorders, Tamara Bouchard, Brooke Russell, Liam Liyang Guo, Tina Nguyen, Yan Cheng, Yan Y. Sanders, Ming-Lei Guo

Department of Biomedical and Translational Sciences Faculty Publications

Substance use disorders (SUDs) remain major public health concerns worldwide, particularly in developed countries. SUDs are characterized by persistent neuroinflammation and synaptic dysfunction in the brain. Despite decades of extensive investigation, the detailed mechanisms underlying SUDs remain elusive. Ferroptosis is a highly regulated cell death process deeply affected by iron metabolism, lipid peroxidation, reactive oxygen species (ROS) production, and antioxidant systems. It has been implicated in multiple neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, and ischemic stroke. Recently, emerging evidence has highlighted the role of ferroptosis in drug-induced pathological changes. Various types of abused substances including alcohol, cocaine, …

Documenting Death: Maternal Mortality And The Ethics Of Care In Tanzania (Adrienne E. Strong 2020), Luluk Oktavia, Megawati Sukarno

Paradigma: Jurnal Kajian Budaya

In recent decades, global efforts to reduce maternal mortality have become a primary focus in health development agendas. However, challenges in providing quality healthcare remain complex, especially in resource-limited countries. Adrienne E. Strong’s book, Documenting Death: Maternal Mortality and the Ethics of Care in Tanzania, offers an ethnographic perspective on the relationship between bureaucratic structures, resource constraints, and healthcare practices in Tanzania. This review examines Strong’s key concepts, such as good enough care, documented care, and fierce care, which highlight the ethical dilemmas faced by healthcare workers in delivering care under administrative pressures and limited facilities. The critique of the …

Associations Between Social Media Usage, Physical Activity And Flourishing In Rural University Students, Anna Dysart, Minu Sara Thomas

Journal of Appalachian Health

Introduction: Most adolescents and young adults report significant use of social media.^1-3 However, there is limited research on the effect of social media use, specifically on physical activity and flourishing.

Purpose: This pilot research study examines the correlation between social media usage and the physical activity and flourishing levels of college students at a rural university in Appalachia.

Methods: The authors conducted a survey including the validated Secure Flourishing Index and Stanford Leisure-Time Activity Categorical Item, containing questions on social media use and demographics. Spearman’s rho was used for nonparametric correlations. Pearson’s correlation was used to determine the correlation …

The Implementation Of Indoor Urban Gardening: A Microgreens Pilot Study In A University Setting, Kathryn Chang, Samantha Brink, Annette Gadegbeku

Transformative Medicine

Introduction: “Food deserts” are geographical areas that lack affordable full-service grocery stores and have higher densities of unhealthy or “fast food” options. These deserts not only exist in communities such as Philadelphia, but also on college campuses. One solution to creating access to fresh vegetables is urban farming, which refers to green areas (i.e. community gardens) that provide places for food to be grown by local residents. Microgreens Health Outreach Project (HOP), aimed to build and implement a small, indoor community garden cart within the Health Sciences Building (HSB) at Drexel University; the organization hoped that this cart would be …

Interventions To Promote Menstrual Health Among Adolescents In Lmic’S: Protocol For A Systematic Review, Precilla Dsilva, Sudhir Prabhu Dr, Prajna Kumari Dr, Baby S. Nayak Dr, Judith Noronha Dr

Manipal Journal of Nursing and Health Sciences

Background: Menarche brings out significant change in each girl’s life. Coping with the discomforts and adopting the body changes becomes a biggest challenge for every teen. Cost effective non pharmacological interventions will help to bring about improvement in the general wellbeing and quality of life in each adolescents life.

Objective: This review aims to determine the different menstrual interventions adopted by adolescent girls residing in Low and Middle Income Countries (LMIC’s). The Review question will be :What interventions are currently available, and how do they contribute in promoting menstrual health among adolescents from LMICs

Methods: This review will include …

Pattern Of Ultra Processed Food (Upf) Consumption And Mental Wellbeing Of Medical Undergraduates Of Chengalpattu District, Tamil Nadu, India – A Cross Sectional Study, Nithin C, Sumedha K, Murugan V

Digital Journal of Clinical Medicine

Abstract:

Background: Nutrition plays a crucial role in the health and development of individuals. In recent years, the rise in ultra-processed food (UPF) consumption, especially among young adults, has been linked to various health issues, including mental health concerns. This study aims to assess the pattern of UPF consumption and its impact on the mental well-being of medical undergraduates in Chengalpattu district, Tamil Nadu.

Methods: A cross-sectional study was conducted among 384 medical undergraduates aged 18 years and above enrolled in three tertiary care teaching hospitals. Data was collected using a questionnaire, which included demographic details, lifestyle factors, a UPF …

Mental Health Stigma: Promoting Compassionate Care In The U.S. Healthcare System, Wuraola R. Awosan, Fredrick O. Akinyosoye, Perseverance N. Moyo, Akuchinyere O. Titus-Okpanachi, Giordana Morales, Emmanuel N. Clottey

Montview Journal of Research & Scholarship

Mental illness-related stigma is a pervasive issue that permeates every facet of psychiatric care. This phenomenon, which manifests at the societal or structural, individual, and public levels, presents a barrier to equitable and compassionate care in the U.S. healthcare system, leading to care avoidance and poor health outcomes. This systematic review aims to synthesize evidence on the forms of mental health stigma within the U.S. healthcare setting and identify strategies that foster compassionate care among healthcare professionals. Following PRISMA guidelines, a methodical search of peer-reviewed literature published between 2015 and 2025 was conducted in three databases – APA PsychInfo, CINAHL …

“In A Relationship”: Can Ai Take The Place Of A Human Relationship?, Hannah Smith

Student Scholar Symposium

This research explores the impact of AI on adolescent development, specifically focusing on how large-language models (LLMs) influence the way adolescents approach and value human connections. While AI can offer some benefits, it cannot fully replace the essential elements of human relationships, such as empathy, creativity, and emotional understanding, which are fundamental to a fulfilled life.

Impact Of An Educational Intervention On Pharmacy Students’ Knowledge, Attitudes, And Confidence Regarding Alcohol And Substance Use Disorders, Lina Itenberg

Student Scholar Symposium

This study examines the impact of an educational intervention on student pharmacists’ knowledge, attitudes, and confidence regarding alcohol and substance use disorders (AUD/SUD) at Lipscomb University College of Pharmacy. Current literature denotes that student pharmacists often feel unprepared to address substance use disorder in practice. This study evaluates whether a targeted educational intervention can enhance student understanding of first-line pharmacological treatments, increase confidence in handling opioid-related emergencies, and improve their ability to educate patients on harm reduction strategies, including naloxone use and opioid overdose risks. Pre- and post-intervention surveys will assess changes in students’ preparedness and identify ongoing concerns about …

Is Ai Replacing Human Mental Health Professionals?, Michiko Ueda

Population Health Research Brief Series

An increasing number of people are turning to generative artificial intelligence (AI) tools and AI-assisted chatbots to manage mental health concerns. This data slice presents findings from a national survey of U.S. adults aged 18-49 (N = 1,805) conducted in October 2025. Among respondents, 35.2% reported using AI tools more than once a week for mental health support. Among those who had ever seen a human mental health professional, 28.4% reported visiting human providers less often since beginning to use AI for the same purpose. The findings suggest that a subset of users may be using AI to replace, rather …

Behind The Badge: Effects Of Stress And Trauma In Policing -- Understanding The Importance Of Evidence-Based Prevention, Early Intervention, And Wellness Programs, Jessica Rolshouse

Master of Arts in Human Services

Law enforcement officers are exposed to occupational stress and trauma routinely and at rates that far exceed the general population. This chronic exposure places them at risk for physical and psychological injury and negative outcomes to include mental health disorders including burnout, anxiety, depression, and PTSD. Prolonged exposure to occupational stress and trauma also increases the risk of suicidal ideation and dying by suicide, the most tragic outcome of the stress law enforcement officers face. This literature review focuses on individual risk factors, occupational stress, and trauma, and the development of mental health disorders in law enforcement officers. It also …

Disaster Risk Reduction In Rural Indonesia: Evaluation Of The Japan Red Cross Program In Pujiharjo Village, Meyralda Dara Adisa, Pujo Widodo, Anwar Kurniadi, Wilopo Wilopo

Preventia: The Indonesian Journal of Public Health

Pujiharjo Village in Malang Regency, Indonesia, is highly vulnerable to natural disasters. In 2021, the Indonesian Red Cross (PMI) partnered with the Japanese Red Cross Society (JRCS) to implement a community-based disaster preparedness program. This study evaluates the program's effectiveness in terms of community participation, institutional support, and alignment with the Sendai Framework for Disaster Risk Reduction 2015–2030. Using a qualitative case study, data were collected through document analysis of Vulnerability and Capacity Assessments (VCA), Community Action Plans (CAP), and local SOPs. Thematic analysis explored disaster risk perception, governance, mitigation investment, and emergency preparedness. The program successfully improved risk awareness, …

Development And Evaluation Of The Sex Positivity Inventory For Counselors, M. Ashley Burks, Jennifer Gerlach, Joshua C. Watson

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

The purpose of the study was to clarify the definition of sex positivity and identify sex-positive attitudes, knowledge, and skills through the development and evaluation of the Sex Positivity Inventory for Counselors (SPI-C). The exploratory factor analysis supported a six-factor, 34-item scale, accounting for 32.9% of the variance within the study. The SPI-C had an excellent internal consistency of 0.96 and consisted of the following factors: 1) Procedural Sex Positivity, 2) Comfortability with Sexuality, 3) Perceived Sex Positivity, 4) Fundamental Sex Education, 5) Sexological Worldview, and 6) Unconditional Positive Sexual Regard. Implications for practice, counselor education, and supervision are discussed.

Asian College Students' Well-Being During A Period Of Rising Anti-Asian Sentiment, Kyuhan Choi, Ying Shi, Maria Zhu

Center for Policy Research

We use a large survey of students in U.S. colleges to study the distinct ways in which the COVID-19 pandemic and accompanying anti-Asian rhetoric shaped the experiences of Asian and Pacific Islanders (APIs). Using a difference-in-differences approach, we find that the pandemic led to Asian students experiencing more discrimination, feeling less safe during the day, and using fewer mental health services compared to White peers. The increase in discrimination and the perceived lower safety are concentrated among East and Southeast Asians, while South Asians were not affected. Despite these effects, we detect no relative deterioration in severe psychological distress or …

Prevalence And Factors Associated With Alcohol And Illicit Drug Use Among Brazilian Youth: A Multicenter Cross-Sectional Study, Emerson Brito, Marina Bessel, Natalia Luiza Kops, Lucas Albrechet-Souza, Flavia Moreno, Alexis Koskan, Thayane Martins Dornelles, Ben Hur Graboski Pinheiro, Suelen Basgalupp, Eliana Wendland

School of Medicine Faculty Publications

This study examined alcohol and illicit drug use among Brazilian youth aged 16 to 25 during the transition to adulthood. A multicenter, cross-sectional survey was conducted between Sep-2016 and Dec-2017 across all 26 Brazilian state capitals and the Federal District. A total of 8,581 participants completed structured interviews on substance use and sociodemographic characteristics. Lifetime prevalence was 71.6% for alcohol and 30% for illicit drugs. Frequent alcohol use was more common among males, while the most used illicit substances were cannabis (27.4%) and cocaine (9.9%). Participants without a partner had higher rates of alcohol and hallucinogen use, while those with …

More Girls In The Classroom Improves Adolescent Mental Health, Monica Deza, Maria Zhu

Population Health Research Brief Series

Mental health challenges are common among adolescents in the United States. This brief summarizes findings from a study using data from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative survey of middle and high school students conducted in 1994-1995. The analysis included over 17,000 students from 133 schools across the United States. The authors find that the mix of boys and girls in a classroom affects adolescent mental health and school satisfaction. When classes have more girls, both boys and girls experience better mental health outcomes. Boys in classes with more female peers are 10% less …