Starting With Story, Not Symptom: Narrative Collapse And Cultural Repair In Appalachia, Wayne Coombs Ph.D.

Journal of Appalachian Health

Appalachia’s opioid crisis reflects uneven burdens, especially in distressed coalfield counties, and it cannot be solved by symptom tracking alone. This commentary argues for a narrative shift, starting with story and cultural repair alongside clinical care. Narrative collapse is defined here as the loss of shared, dependable public meaning across groups, not the absence of storytelling in families, churches, and recovery circles. Trauma science suggests that chronic threat reshapes nervous systems across generations, making safety a prerequisite for renewed trust. Drawing on narrative identity research, the piece proposes peer story work as infrastructure that can reduce shame, support treatment engagement, …

The Effect Of A Low-Glycemic Index Diet On Polycystic Ovary Syndrome Symptoms Among University-Aged Women, Angelika A. Gonzalez, Annalise M. Sankar, Noelle D. Nguyen

Department of Nutrition Student Projects

Polycystic Ovary Syndrome is an endocrine disorder among women of reproductive age and is associated with insulin resistance, menstrual irregularities, hyperandrogenism, and metabolic dysfunction. Dietary modifications targeting glycemic response have emerged as a nonpharmacologic approach for PCOS management. However, long-term randomized controlled trials targeting young adult populations remain limited.

The purpose of this study is to evaluate long-term effects of adherence to a low-glycemic index diet on the frequency and severity of PCOS symptoms among female college students ages 18-22. This 12-month randomized controlled trial will recruit participants meeting the Rotterdam criteria from university health clinics. Participants will be randomly …

Coverage, Traits, And Geographic Distribution Of Online Surgeon Reviews: Large-Scale Cross-Sectional Analysis, Michael Geng, Carlos Riveros, Yash B. Shah, Sanjana Ranganathan, Kai Fok, Renil Sinu Titus, Vatsala Mundra, Eusebio Luna Velasquez, Dharam Kaushik, Allan S. Detsky, Angela Jerath, Benjamin N. Breyer, Yusuke Tsugawa, Christopher J. D. Wallis, Raj Satkunasivam

Student Papers, Posters & Projects

BACKGROUND: The use of online physician rating platforms has significantly increased and has been shown to influence physician selection. There are limited data on the use of these platforms for rating surgeons.

OBJECTIVE: In this study, we sought to assess the geographic distribution of and patterns in rating scores of surgeons in the United States. Additionally, we examined rating volumes across different surgical specialties and the association between peer-nominated and patient-initiated ratings on online rating platforms in the United States.

METHODS: We conducted a cross-sectional study by identifying 201,154 surgeons in the United States via the National Plan and Provider …

Digital Touchpoints: Investigating Contact Page Accessibility And Visual Authenticity Within Medical Tourism Health Websites, Alicia Mason, Elizabeth Spencer, Kristen Livingston, Treyton Meyers, Sakshi Bhati, Himika Akram

Faculty Submissions

This study examines two critical digital touchpoints on medical tourism provider (MTP) websites: (1) the accessibility of contact pages which often function as entry points for inquiries, scheduling, and pre-travel coordination, and (2) the authenticity of visual imagery used to shape expectations about care environments, personnel, and technological capacity. A sample of 105 MTPs across all six World Health Organization regions were analyzed using quantitative web accessibility testing and qualitative visual analysis. Results indicate pervasive accessibility errors on contact-page touchpoints and extensive reliance on inauthentic imagery to depict patients, providers, and medical technologies. Together, these practices may distort user expectations …

Caring For Caregivers: A Health Care Marketing Opportunity, Yvette Lynne Bonaparte Dr.

Atlantic Marketing Association Proceedings

No abstract provided.

Identifying Major Sources Of Leptospira Interrogans In San Juan Bay And Río Grande De Loíza Estuaries Of Puerto Rico, Logan Mccullers, Dave Bachoon

Biology Theses

This study evaluated the presence of pathogenic Leptospira interrogans, potential carriers, and environmental factors influencing their occurrence in the San Juan Bay Estuary (SJBE) and Río Grande de Loíza (RGDL) watersheds of Puerto Rico from 2024–2025. Detection of this pathogen from water samples was performed using the lipL32 PCR assay. The likely hosts of L. interrogans were determined using fecal source tracking (FST) assays for human (HF-183), canine (BacCan-UCD), equine (HoF597), and rat mitochondrial DNA NADH dehydrogenase subunit 2 gene (RatMt) markers. In 2024, 91 samples were collected (March: 50; June: 41), and in 2025, 124 samples were collected …

Costs, Demographics, And Causative Agents In Patients Hospitalized For Drug Induced Liver Injury: Trends In A Large Academic Healthcare System, Megan Kozar, Yunisse Gonzalez, Dina Halegoua-De Marzio

Department of Medicine Faculty Papers

PURPOSE: Drug-induced liver injury (DILI) is an uncommon but potentially life-threatening condition. To date, the burden of DILI on a single, large healthcare system has not been investigated, preventing adequate resource allocation. This study aims to quantify DILI-related healthcare utilization within the Jefferson Health System (JHS) and identify case-related factors associated with high resource requirements; such information is crucial to focus efforts toward resource reduction.

PATIENTS AND METHODS: This study characterizes trends of 48 DILI cases within JHS, including demographics, payer status, causative agent, and DILI pattern. These variables were correlated with length of stay (LOS) and cost relating to …

Is Home Birth A Choice? Racial And Geographic Differences In Unintended Home Births In The U.S., Anna De La Paz

Population Health Research Brief Series

Home births that happen without planning or medical support (i.e., unintended home births) carry a higher likelihood of adverse outcomes, such as low birth weight, preterm birth, and hypothermia. This data slice summarizes findings using data from CDC WONDER (2017–2023) on racial, regional, and metropolitan status differences in home births among women ages 15–44 in the U.S. Findings show that unintended home births are disproportionately concentrated among non-Hispanic Black women, with rates varying substantially by region and metropolitan status.

Improving Anesthesia Provider Confidence In The Identification, Management, And Treatment Of Postoperative Delirium, Brittany M. Whistle, Charles Dustin Phelps

Scholars Week

Purpose: Postoperative Delirium (POD) is a potentially devastating complication of anesthesia that is poorly understood by clinical staff leading to poor outcomes for surgical patients. This study is meant to determine if a focused knowledge presentation accompanied by visual aids could increase anesthesia providers confidence in identifying, diagnosing, and treating Postoperative Delirium.

Methodology: Utilizing a statistical model to analyze respondents results on a standardized test administered before and after an informational presentation with visual aids on the topic of Postoperative Delirium.

Results: Results indicated a statistically significant difference between pretest and posttest scores, with a p-value of .002, t(11) = …

Intersecting Determinants Of Health: Correlating Food Insecurity And Sleep Deprivation Across Southern Adventist University Demographics*, Heaven Robles, Jesica Paralafox Ramirez, Kimberly Mongare, Joshua C. Jenkins, Melany Castillo, Philip Chen Dr, Aaron Corbit Dr

Campus Research Month

For university students, social determinants of health such as food security and sleep patterns heavily dictate both health outcomes and academic success. Using a cross-sectional study design, statistical analyses will be conducted using the Jamovi software platform to compare mean sleep durations and food access scores across multiple academic departments and ethnic demographic groups. The study evaluates four primary hypotheses: (1) Consistent food access positively correlates with sleep quality; (2) Food security and sleep metrics vary significantly across academic departments; (3) Systemic ethnic disparities exist in food accessibility; and (4) Underrepresented ethnic groups experience a compounded burden of food insecurity …

Does What Happens In Vegas Increase Pedestrian Safety? A Longitudinal Study On The Effectiveness Of Pedestrian Bridges, Jalen Paulos, Joaquin Miguel Del Mundo, Brock Wentz, Janel Pietryga

Department of Orthopaedics Faculty Research

Urban populations continue to rise and the frequency that pedestrians are exposed to vehicular traffic continues to increase. The result is an increase in automobile versus pedestrian collisions. This study aims to determine the efficacy of pedestrian bridges in reducing the rates of automobile‒pedestrian collisions. Data for all automobile versus pedestrian collisions and injuries from July 1997 through December 2023 at four distinct intersections along Las Vegas Boulevard were retrieved from the Nevada Department of Transportation. These sites were chosen because of their historically high rates of automobile versus pedestrian incidents and the construction of pedestrian bridges at three of …

Geographic Variation In Adrd Prevalence And Mortality And Their Association With Social Vulnerability Across Us Counties: A Spatial Epidemiological Analysis Using Norc And Cdc Svi Data, Dean Kyne

Sociology Faculty Publications

Introduction: Geographic disparities in Alzheimer’s disease and related dementias (ADRDs) remain insufficiently understood at the national scale, limiting efforts to address inequities in dementia burden across USA communities. This study examined county-level variation in ADRD prevalence and mortality and evaluates the association between social vulnerability and these outcomes.

Methods: This cross-sectional ecological study analyzes 2020 county-level ADRD prevalence and all-cause mortality among Medicare beneficiaries from the NORC Dementia DataHub. The analytic sample included 3,108 USA counties in the contiguous USA and the District of Columbia. ADRD outcomes included (1) prevalence of highly likely ADRD and (2) prevalence of all determinations, …

The Cost Of Affordable Healthcare: How Brazil's Sus And Generic Drug Strtegy Produce Structural Inequality And Challenge Global Pharmaceutical Rules, Elena Kössler

Posters - 2026

Affordable healthcare is often seen as a major social achievement, but maintaining low costs involves important trade-offs. Brazil’s Unified Health System (SUS) provides universal healthcare and relies heavily on generic medicines to expand access. This raises a central question: how can a system reduce the cost of healthcare while simultaneously generating new forms of inequality and tension within global pharmaceutical markets? This paper argues that Brazil’s cost-reduction strategy, particularly its reliance on generic medicines, improves affordability but also produces structural trade-offs between equitable access, quality of care, and incentives for pharmaceutical innovation.

Navigating End-Of-Life Decisions: Cultural Considerations For Latine Patients, Michelle Carbajal Hernandez

Honors Capstones

Healthcare professionals face many challenges when communicating terminal illness prognoses for individuals. This responsibility to address a terminal prognosis is further complicated when communicating with Latine patients who may face multiple barriers within the healthcare system and whose cultural preferences influence end-of-life care planning (Carrion, 2010). For example, Latines are less likely to enroll in end-of-life (EOL) care services (e.g., hospice) (Barragan-Carrillo et al., 2022). As well as engage in end-of-life care planning than White Non-Latines (Shen et al., 2016). To understand this hesitancy towards EOL care options, this literature review aims to explore how terminally ill Latine and …

Start With What They Know: Using Motivational Interviewing To Create A Cooking Class, A Culinary Intervention For Teens (Autistic And Non-Autistic), Gwendolyn S. Tedder

LEND Trainee Presentations

Autistic teens are at greater risk for having heart disease and diabetes as adults. Food particularity, sensory issues, fixed mindset, and anxiety over trying new things can slow down their interest in preparing food for themselves. Nurturing basic cooking skills and gently encouraging trying new foods would provide more nutritional options to teens as they move into adulthood. A cooking class preceded by Motivational Interviewing (MI) developed further interest in preparing food afterward in teens, both autistic and non-autistic, and in trying new foods for autistic teens with food concerns.

Obesity In The Rio Grande Valley: Applying An Evidence-Based Public Health Approach, Erika Pineda-Horta

Posters - 2026

What structural and social determinants drive elevated adult obesity rates in the Rio Grande Valley, and what evidence-based interventions can reduce adult obesity prevalence in Hidalgo County by 5% by 2030?

Objective: This study applies an EBPH framework to (1) characterize the burden and structural determinants of adult obesity in the RGV, and (2) propose a culturally responsive, evidence-based intervention targeting adults aged 18+ in Hidalgo County.

Adult obesity is clinically defined as a Body Mass Index (BMI) ≥30 kg/m² in adults aged 18 and older (CDC, 2022). It is a chronic, multifactorial non-communicable disease shaped by structural, social, and …

Regional Inequalities In Healthcare Access And Capacity In Brazil, Elena Kossler

Posters - 2026

The Brazilian health system is one of the largest and most comprehensive universal public health systems, fully funded by the government.

Gynecological Effects Of Sex Trafficking, Tracey Sylvester

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Advancing The Understanding Of Palliative Care In Singapore: Knowledge, Attitudes, Receptiveness, And The Moderating Role Of Media Information-Seeking Preferences, Su Lin Yeo, Angel Lee, Raymond Han Lip Ng, May O. Lwin, Yumin Lin

Research Collection Lee Kong Chian School Of Business

Introduction: Despite the growing demand for palliative care, this specialized medical care remains severely underutilized, with almost 50% of countries worldwide lacking access. Given that misperceptions and stigma continue to hinder progress in healthcare policy, this study aims to examine the relationships between palliative care knowledge, attitudes, and receptiveness to better understand how public health communication can enhance awareness and understanding of the topic in Singapore. Applying the adapted knowledge-attitude-practice (KAP) model, it further extends theory by examining the moderating role of media information-seeking between knowledge and receptiveness.Methods: Mixed-mode surveys involving 1,226 participants (926 online and 300 in-person respondents), representing …

Investigating Social Justice Implications Of Glyphosate Residues In Human Urine, Ananya Malhotra

Electronic Theses, Projects, and Dissertations

Background: Glyphosate, the nominal active ingredient in professional-grade Roundup weed and grass killer, is the most extensively used herbicide globally and in the United States (U.S. Environmental Protection Agency, 2020). An increasing level of concern has surfaced regarding its health consequences, particularly because of contamination of our food supplies. Recent research indicates distressing levels of detection of glyphosate in human blood and urine samples, revealing many instances of frequent human exposure (Conrad et al., 2017; Zhang et al., 2020).Most of the research about exposure is focused on agricultural workers or individuals living in close vicinity to agricultural lands.  Few …

Application Of The Multi-Theory Model To Determine Predictors Of Initiating And Sustaining Stress Management Behaviors In Undergraduate College Students, Bishoy T. Samuel, Joshua Mann, Michael Welsch, Manoj Sharma, Vinayak K. Nahar

Journal of Public Health in the Deep South

Background: Undergraduate college students face stress and concomitant mental health issues that can be mitigated by proper stress management behavior.

Purpose: This article examines the multi-theory model (MTM) of health behavior as a predictor of change in the primary outcomes of initiation and sustenance of relaxation-seeking behavior in undergraduate college students for the purposes of stress mitigation. The two main research hypotheses tested were that (a) participatory dialogue, behavioral confidence, and change in physical environment have statistically significant effects on initiation of behavioral change, and (b) emotional transformation, practice for change, and change in social environment have statistically significant effects …

Farmers Markets And Produce Purchasing Behaviors Among University Faculty And Staff, Kritika Gupta, Laurel Lambert, Jangwoo Jo, Selby Rebecca Entrekin, Georgianna Mann

Journal of Public Health in the Deep South

Background: This study explores produce purchasing criteria (PPC) and produce purchasing frequency (PPF) among university faculty and staff, a population often underrepresented in dietary behavior research.

Purpose: To identify distinct PPC profiles among university faculty and staff and examine how these profiles are associated with PPF and farmers market usage, while also assessing the role of demographic and behavioral factors in shaping these relationships.

Methods: Using a 29-item online survey administered to faculty and staff at a southern United States university (N = 175), three distinct PPC clusters were identified: health/label conscious, utilitarian, and no-specified-criteria consumers. Statistical analyses — including …

Promoting A Culture Of Academic Integrity In The Context Of Artificial Intelligence: Lessons From One School Of Public Health In The Southeast, Gregory Pavela, Lindsay C. Aycock, Mercy Aula, Angela Sullivan, Matthew Fifolt

Journal of Public Health in the Deep South

No abstract provided.

Evaluating U.S. Health Policy Levers Using Difference-In-Differences: Hospital Acquisitions, Global Budgets, And Income Policies, Kola Adegoke

NYMC Student Theses and Dissertations

Abstract

Background: U.S. health policy relies on multiple levers to influence system performance, financial stability, and population health. This dissertation uses a three-paper portfolio to evaluate organizational change (hospital acquisitions), payment reform (Maryland all-payer global budgets), and income-related state policies, applying difference-in-differences (DiD) designs with prespecified diagnostics to support causal interpretation.

Methods: Study 1 examined hospital change-of-ownership (CHOW) acquisitions using a national hospital-year panel from RAND HCRIS (2014–2023), linked to CHOW timing data from 2016–2023. Effects on revenue outcomes were estimated using a staggered difference-in-differences design implemented with the Callaway and Sant’Anna estimator, using doubly robust inverse probability weighting, hospital-level …

Transformational Leadership In Higher Education, Dr. Jewel Hale, Jr., Kristi Apostel

Tapestry: Journal of Research in Education

A crisis can highlight the critical need for resilient leadership within higher educational settings. Educational leaders encounter extraordinary difficulties, ranging from different learning options to prioritizing the well-being of both staff and students, necessitating flexible and innovative methods. By exploring how school leaders apply transformational techniques in actual educational environments, this article addresses the impact of the four I’s of transformational leadership, idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration, on building educator resiliency, sustaining school effectiveness, and promoting student achievement in higher education.

Fierce Leadership-Perspectives Of Black Women Educational Leaders: A Transcendental Phenomenological Study, Janice Taylor, Dianne Reed

Tapestry: Journal of Research in Education

The authors of this transcendental phenomenological study aimed to describe the lived experiences of Black women based on their perceptions, values, and beliefs about the complexities of leadership and the kind of leadership required to succeed in their respective roles, as educational leaders. This study was framed by the adaptive leadership theory. Adaptive leadership recognizes the need for leaders to stay flexible and resilient in fast-paced environments (Nelson & Squires, 2017). The three Black women leaders in this study were fierce adaptive leaders. The information acquired from this study is significant and highlights how Black women educational leaders developed the …

Research Literacy And Research Production Skills As Core Competencies In Leaders, Kk O'Byrne

Tapestry: Journal of Research in Education

No abstract provided.

Evaluating Sensory Sensitivities Among Children With Autism Spectrum Disorder In An Adaptive Gymnastics Program, Aicha Kaouss, Bradley Eppinger, Austin Ebbrecht, Kailash Ram, Kaitlin P. Hardy Md

Knowledge and Creativity Expo

Introduction: Children with autism spectrum disorder (ASD) participate in physical activity at lower rates than their neurotypical peers1. Sensory sensitivities, reported in approximately 75–95% of children with ASD, may contribute to this disparity2. Gymnastics environments involve bright lighting and loud noise, which can precipitate sensory overload. The impact of specific sensory features on participation in adaptive gymnastics remains underexplored.

Methods: A cross-sectional study recruited caregivers of children aged 3–12 years with an ASD diagnosis enrolled in the EVMS Adaptive Gymnastics Program. Caregivers completed the Sensory Experiences Questionnaire–Third Edition (SEQ-3)3 and supplemental survey items on Redcap which assessed environmental triggers and …

Bodies At Risk When Choice Is A Privilege: Women’S Reproductive Healthcare Accessibility And Health Outcomes Since The Dobbs (2022) Ruling, Dallas Bonnet

Undergraduate Theses

Existing literature has well-documented the disproportionate effects of abortion restrictions upon socioeconomically disadvantaged women and women of color. This thesis builds on that work by exploring the relationship between state-level abortion restrictions and women’s self-reported health, as well as state-level infant mortality rates and maternal mortality rates. This project breaks these relationships down into three separate studies: Study 1 investigates the effect that abortion restrictions have on women’s self perceptions of health. Study 2 assesses the impact of abortion restrictions on infant mortality rates. Study 3 inspects the impact of abortion restrictions on maternal mortality rates. The primary independent variable …

Thermal Inequities In Public Parks And Open Spaces In Los Angeles Determined By Remote Sensing, Ashley Agatep, Joshua B. Fisher, Kainani Tacazon, Ambar Rivera, Rossmery Zayas, Reginald Archer, Juan Carlos Ruiz Malagon, Jason A. Douglas

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Urban heat island (UHI) effects are amplified by disparities in community-level cooling infrastructure—such as urban public parks and open spaces (PPOS)—with the most severe impacts occurring in communities that lack sufficient city-wide cooling resources. We found that the underserved community of South Los Angeles, as compared to their neighboring West Los Angeles counterparts, suffers a double burden of inequitable (1) access to and (2) absence of cooling materials and surfaces within these spaces, resulting in significantly hotter temperatures. Identifying these inequities requires high-resolution temporal and spatial mapping of surface temperatures, which has been previously limited. In this community-based participatory research …