Medicine and Health Commons^™

Addressing Gaps In Clinical Trial Access For African Americans, Vanessa Veltre, Michael Acevedo, Alexandra Stone, Lydell Lettsome, Brian Stone

Rowan-Virtua Research Day

Background: Clinical trials are essential for generating evidence on the safety and efficacy of new treatments. However, Black Americans remain underrepresented in clinical research, particularly for conditions that disproportionately affect them. This underrepresentation compromises the generalizability of findings and perpetuates health disparities. This study aimed to identify barriers and facilitators to African American participation in clinical trials and to inform culturally sensitive strategies to improve enrollment of diverse populations.

Methods: We developed a 38-question web-based survey, divided into three domains: (1) cultural affinity, (2) trust, and (3) background information. The survey was administered using Jotform, a HIPAA-compliant platform. Participants—Black adults …

Child Sex Trafficking In Pediatrics: From Screening To Comprehensive Care, Victoria Shwe, Tracy Lin, Nicole M. Leopardi

Rowan-Virtua Research Day

Child sex trafficking is a significant issue in New Jersey, with minors making up 22% of trafficking victims in 2023. While screening tools exist to identify at-risk youth, there is a major gap in understanding the steps healthcare providers should take after identification to ensure appropriate care, support, and referrals. Current research highlights the lack of data on the use of trafficking screening tools and the absence of standardized post-screening protocols. Most pediatricians rely on referrals to social services or law enforcement, yet limited coordination between healthcare providers and these agencies complicates effective care. The shortage of child abuse pediatric …

Disparities In Demographics Of Patients Presenting To A Student-Run Free Clinic In South Jersey, Kirsten Carlberg, Sabah Iqbal, Christian Moya Gamboa, Daliza Diaz, Cerena Moreno, Rebecca Moore

Rowan-Virtua Research Day

Medical schools around the country have established free clinics to better serve the underserved patient populations. In this study, we aimed to evaluate demographic characteristics in the patient population at our free clinic, Rowan-Virtua Community Health Clinic (RVCHC), compared to the general population of Camden County. We found a disproportionately higher percentage of black patients at our clinic when compared to the county overall. Addressing these disparities would require targeted outreach to specific patient populations and improved transit access. Future studies should aim to identify RVCHC health outcomes through the management of chronic disease and understanding emergency room utilization.

The Affordable Care Act: Analyzing Rates Of Healthcare Claim Denial, Lauren Sitter

Political Science Theses and Capstones

The United States healthcare industry is an integral aspect of every American’s life. The Affordable Care Act (ACA) in 2010 reformed the healthcare system by expanding coverage to millions of Americans and eliminating claim denials due to pre-existing conditions. It requires participating states to submit transparency data. Despite these reforms, coverage denials continue and vary by plan category, metal level, and among different states. I analyze data from The Kaiser Family Foundation (2023) and The CommonWealth Fund to test the correlation between claim denial and a variety of variables, including state political culture, plan type, metal level, and out-of-pocket costs. …

A Narrative Review Of Military Reverse Triage., Daniel J Hurst

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Military reverse triage has been described at several points in the literature. However, an extensive review of the concept and any gaps that may exist has not been conducted. This narrative review seeks to understand how reverse triage is used in the military literature and how it might be implemented in practice, as well as the documented historical applications of reverse triage.

MATERIALS AND METHODS: Four databases were searched manually for English-language articles: PubMed, SCOPUS, JSTOR, and Worldwide Political Science Abstracts. In addition, a manual search of references, U.S. DoD, and NATO doctrine, as well as other published works …

Covid Cover-Up: Secrecy, Censorship And Suppression During The Pandemic, Brian Martin

Secrecy and Society

During the height of the COVID-19 pandemic, most health authorities, governments, and mass media organizations presented a single official view concerning lockdowns, masking, distancing, and vaccines. The methods used against contrary views can be classified into four types: flooding, ignoring, censoring, and attacking. The method of information flooding involves presenting dominant views in a unified front, overwhelming contrary views by volume and consistency. The method of ignoring includes the absence of research on alternative approaches, failure to report on research contrary to orthodoxy, and not mentioning challenging views. Censoring involves active measures to prevent the circulation of contrary information and …

The Geography Of Care: Rural Versus Urban Caregiver Perspectives On Community Resources For Parkinson’S Disease Management, Rebecca Jones

Murray State Theses and Dissertations

This qualitative study investigated the experiences and perceptions of caregivers for individuals with Parkinson's disease (PD) in rural versus urban settings, with particular emphasis on their access to and utilization of community resources. Through semi-structured interviews with 30 caregivers, the research explored how geographical location impacts caregiving challenges, support systems, and resource accessibility. Using Andersen's Behavioral Model of Health Services Use as a theoretical framework, the study revealed both universal caregiving challenges and location-specific barriers. While all caregivers reported significant emotional burden and healthcare system navigation difficulties, rural caregivers faced distinct challenges related to resource accessibility and specialized care availability. …

The Affordable Care Act And The For-Profit Congregate Care Industry: How Good Policy Intent Turned A Fringe Industry Into A Taxpayer-Funded Multi Billion Dollar Industry, Erin Viehmann

College of Graduate Studies: Theses & Dissertations

The Affordable Care Act significantly transformed the for-profit congregate care (FPCC) industry, which provides residential treatment for adolescents with behavioral and mental health issues. This study analyzes financial records from Universal Health Services (UHS), the largest provider in the industry, to examine how healthcare policy changes and economic conditions affected the industry's growth and funding structure. Through analysis of SEC Form 10-K filings from 2006-2016, the research documents how the ACA's mental health coverage mandates created new revenue streams that enabled dramatic industry expansion. Findings show that following ACA passage in 2010, UHS more than doubled its behavioral health capacity …

The Texas Electorate's Views Of Health Care As A Human Right, Community Health Centers, And Certain Matters Of The Health Care Safety Net, Scott Elphingstone

Graduate Liberal Studies Theses and Dissertations

In a country in which the government does not recognize a right to health care,social safety nets are the last hope for persons without insurance or other means to pay for needed care. In United States, community health centers, hospital emergency rooms, and private charities comprise that safety net. Community health centers offer a practicable alternative for politicians and citizens who want to help improve the lives of persons who struggle to access health care. This dissertation reviews the political history of community health centers from their founding as part of the War on Poverty in the 1960s through Democratic …

Reduction Of Seclusion And Restraint Among Children And Adolescents In An Inpatient Psychiatric Hospital: A Health Policy Analysis, Huma Moez

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Background: Seclusion and restraint (SR) or restrictive intervention in inpatient/ acute psychiatric hospitals, emergency departments, crisis stabilization units, residentials, or group homes is a pressing and an immediate concern in mental health settings, particularly for children and adolescents, for whom SR rates are higher. The Joint Commission and other national organizations have made significant strides in prioritizing the reduction and elimination of SR among children and adolescents due to its negative physical and psychological consequences.

Objective: This DNP project will aim to provide the results of a policy analysis to present evidence-based techniques and a resulting re-envisioned policy recommendation to …

Mortalidad Por Cirrosis En Guatemala 2018: Patrones E Inequidades, Cristian Ramírez, Luis Pablo Méndez-Alburez, María Fernanda Piedrasanta, Alejandro Cerón

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por cirrosis en Guatemala. El propósito es identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir por cirrosis en Guatemala muestra marcadas desigualdades por departamento, las cuales son mayores al comparar por municipio. El riesgo de morir es también más alto en hombres, en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Las medidas de salud pública orientadas a los municipios y grupos en mayor riesgo son de suma importancia para la prevención de muerte por …

Impacting Community Well-Being Through Effective Engagement Using The Seed Method, Carlin Rafie, Emily B. Zimmerman, Angelina Hargrove, Theodora Biney Amissah, Samantha Lee

Journal of Extension

Cooperative Extension can make a significant impact on health in the United States through effective community engagement that focuses on the complex socio-ecological factors that impact health. The Stakeholder Engagement in Question Development Method (SEED Method) employs community based participatory research principles to engage communities in research, problem-solving, and action planning. Projects employing the SEED Method engage community members from diverse backgrounds, create community capacity, result in tangible outcomes, and foment inter-organizational trust and networking. A SEED Toolkit is available on the Extension Foundation Campus site and provides implementation instructions, tools and timelines, and potential applications within Extension.

Health Outcomes Reported By Healthcare Providers And Clients Of A Community-Based Medically Tailored Meal Program, Jessica M Sautter, Jule Anne Henstenburg, Adrian Glass Crafford, Ian Rowe-Nicholls, Victor S Diaz, Kaitlyn Ann Bartholomew, Julia S Evans, Maria R Johnson, Jeffrey Zhou, Deeksha Ajeya

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Medically tailored meal (MTM) programs provide home-delivered meals to people living with serious illness and poor nutritional status. Client outcome studies have found evidence of decreased healthcare utilization and cost savings associated with MTM program participation, and inconclusive evidence of change in health measures. The purpose of this study was to use a novel observational framework to describe the client profile and change in health outcomes using routinely collected health and program data from a community-based MTM program at MANNA (Philadelphia, PA).

METHODS: Clients reported their self-rated health and experiences of food insecurity and malnutrition. Healthcare providers reported clients' …

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

Adultspan Journal

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

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

Adultspan Journal

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

Planetary Health Learning Objectives: Foundational Knowledge For Global Health Education In An Era Of Climate Change, Kathryn H. Jacobsen, Caryl E. Waggett, Pamela Berenbaum, Brett R. Bayles, Gail L. Carlson, René English, Carlos A Faerron Guzmán, Meredith L. Gartin, Liz Grant, Thomas L. Henshaw, Lora L. Iannotti, Philip J. Landrigan, Nina Lansbury, Hao Li, Maureen Y. Lichtveld, Ketrell Mcwhorter, Jessica E. Rettig, Cecilia J. Sorensen, Eric J. Wetzel, Dawn Michele Whitehead, Peter J. Winch, Keith Martin

Earth and Environmental Sciences Faculty Publications

Planetary health is an emerging field that emphasises that humans depend on a healthy Earth for survival and, conversely, that the sustainability of Earth systems is dependent on human behaviours. In response to member demands for resources to support teaching and learning related to planetary health, the Consortium of Universities for Global Health (CUGH) convened a working group to develop a set of planetary health learning objectives (PHLOs) that would complement the existing ten CUGH global health learning objectives. The eight PHLOs feature Earth system changes, planetary boundaries, and climate change science; ecological systems and One Health; human health outcomes; …

Mental Health In Price: A Report On Community Perspectives, Kristen Koci, Jessica Ulrich-Schad

Publications

This report is from a research project conducted at the end 2022 that focuses on mental health in Price. Dr. Kristen Koci conducted interviews in Price to understand community members’ perspectives on and factors affecting mental health in the area. Community leaders from government and local organizations were interviewed along with general community residents, for a total of 27 interviews. The report that follows summarizes themes and perspectives gathered during these interviews.

Impact Of The Department Of Defense Maternity Leave Policy Change On Retention And Postpartum Depression And The Air Force Postpartum Physical Fitness Policy Change On Physical Readiness Outcomes, Minette S. R. Herrick

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Understanding the implications of health policy is paramount to support continued execution and further wide-spread distribution. The Department of Defense has made many recent family friendly policy changes in effort to improve the health and morale of the force. Two such policies were analyzed in this study. The first was the change in maternity leave, in 2016, from allotting women six weeks time off to twelve weeks time off in the postpartum period. The second was executed by the Air Force to permit postpartum women a longer duration for their required physical fitness assessment (an increase from six months to …

Analysis Of Research And Development Trends Of New Drugs, Ping Xu, Li Xu, Ruo-Nan Yang, Wei Li, Kaixian Chen

Bulletin of Chinese Academy of Sciences (Chinese Version)

As an important component in the pharmaceutical innovation, research and development (R&D) of new drugs stands at the forefront of a new round of life science and technology revolution and bioeconomic reform, which is of strategic significance to leading scientific and technological innovation, driving economic development, and improving people’s health and well-being. At present, continuous innovation in cutting-edge technologies, cross-domain integration of disciplines, and digital depth enablement drive active innovation in the field of new drug R&D. Both domestically and internationally, innovative small molecule drugs, antibody drugs, immune cell therapy, gene therapy and nucleic acid drugs are receiving intensive market …

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

Adultspan Journal

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

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

Rowan-Virtua Research Day

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

Exploring Hypertension Prevalence Among Ill-Housed Individuals In Urban Environments, Lia Summer Goldberg, Sameer Shah, Nikhila Archakam, Murod Khikmatov, Kesha Choksi, Anddee White

Rowan-Virtua Research Day

This study explores the interrelations of hypertension, homelessness, and access to healthcare in urban ill-housed populations. It was found that conditions such as heart disease and diabetes significantly exacerbate hypertension, which remains highly prevalent due to the population's limited access to consistent medical care. Homelessness further complicates the management of hypertension due to unstable living conditions, making adherence to treatment and follow-up with healthcare providers challenging. Additionally, factors like higher rates of substance abuse and malnutrition among homeless populations contribute to worsening hypertension, which, if untreated, can lead to severe health crises including heart attacks and strokes.

The research underscores …

Pros, Cons, And The Barriers To Implementing A Universal Healthcare System In The United States, Arpun Shah

Rowan-Virtua Research Day

Background: The United States has the most expensive healthcare system in the world. Despite that, it also has worse health outcomes than that of several other countries. The United States is also the only wealthy/developed country without universal healthcare. Universal healthcare, also known as a single-payer healthcare system, refers to the concept that the government finances and governs healthcare for most, if not all residents of the country. The United States currently has a multi-payer system, which means that healthcare is financed through various sources such as the public and private sectors. Purpose: The purpose of this is …

Competency To Stand Trial Evaluations: Using Vignettes With Patients Who Lack Insight, Katelyn Fuller

James Madison Undergraduate Research Journal (JMURJ)

In the United States, an attorney may request a competency to stand trial evaluation if they are concerned that their client is not mentally fit to adequately participate in their case and defense. Patients found incompetent must undergo treatment for restoration of competency, regardless of their willingness. Clinicians and psychiatrists may use vignettes, or hypothetical scenarios, to help restore competency if the patient lacks insight into their mental illness. While vignettes have been well documented in studying attitudes and awareness, decision making, and identifying mental illness, there is little to no research into their use in psychiatric hospitals due to …

Broken Promises: Prolonged Diminished Quality-Of-Life Among Liberian Ebola Survivors Half A Decade After The 2014-16 West African Outbreak, Jessi Hanson-Defusco, Decontee Davis, Meghana Bommareddy, Zainab Olaniyan

Journal of Social, Behavioral, and Health Sciences

The 2014–2016 Ebola outbreak left thousands of Liberian survivors with severely diminished quality of life. Applying a social determinants framework, this mixed method study investigates to what extent Ebola virus disease (EVD) survivors suffer long-haul psychosocial stress, diminished quality-of-life factors, and the impact of EVD-related service provisions on their ongoing healing. We present the results of a quantitative analysis survey of data collected from 19 Liberian EVD survivors in 2022 using snowball sampling. Additionally, a qualitative analysis of survivor statements helps triangulate key statistical findings and inform causal mechanisms. Survivors report experiencing 5.25 of a total of 7 ongoing stressors …

The Increase Of Allergies In Developed Countries: A Comparison Of The Quality Of Life And Psychosocial Burden Of Individuals With Food Allergies In Switzerland And The United States Of America, Adrienne Ell

Independent Study Project (ISP) Collection

The Hygiene Hypothesis suggests that as societies become increasingly sterile and there is less exposure to microorganisms early in life; consequently, there is an increase in inflammatory autoimmune disorders and allergies due to a maladapted immune system to the new sterile environment. This hypothesis can offer a possible explanation for the observed increase in allergies, specifically food allergies, in developed countries. To explore the psychosocial burden of allergies and evaluate the quality of life this paper will explore the food allergen labeling policies for prepackaged foods, the regulation of allergen information for non-prepackaged foods, and the psychosocial burden food allergies …

From Collaboration To Continuity: Exploring Stakeholder Engagement For Sustainable Global Health Partnerships, Annabelle Falconer

Independent Study Project (ISP) Collection

Global health partnerships have been identified as crucial to achieving the Sustainable Development Goals and targets related to health and wellbeing. Specifically, the Global Fund, UNAIDS Joint Programme, and the World Food Programme are examples of some of the relevant partners currently engaged in this work, filling roles in global health financing, governance, and delivery. Current literature has identified that the effective engagement of stakeholders in partnerships can be crucial in effective project implementation and that global health partnerships during the era of the Millennium Development Goals did impact health outcomes. This research aims to investigate the current strategies for …

Complementariedad En La Comuna De Putre: Reflexiones Sobre El Sistema De Salud Y Los Conocimientos Comunitarios Aymaras, Grace Benish

Independent Study Project (ISP) Collection

In the comuna of Putre, which lies in the XV region of Chile, exists a community and culture unique from the rest of the country. Half of the population identifies as part of the Aymara indigenous group, which according to Chilean law, means that a system of intercultural health must exist in the commune. Our objective included establishing the format in which the intercultural system of health functions nowadays and assessing how well the system serves the community, keeping in mind the history of the commune, barriers to access, community needs, and Aymaran culture. Furthermore, the domination of the Aymaran …

Human Zoo Healthcare At The 1904 World’S Fair, Angel Blake

Undergraduate Research Symposium

Human Zoo Healthcare at the 1904 World’s Fair

Were precautions taken or put into place for the Human Zoo performers at the 1904 World’s Fair? This topic has been overlooked and understudied by historians, there are few articles written and we do not know the true death toll which shows the racism towards these indigenous peoples. The research for this project was conducted at the State Historical Society of Missouri, the St. Louis Mercantile Library, Newspapers.com, Archives.com, St. Louis Public Library, and the Missouri Historical Society, including research on primary sources such as official World’s Fair committee meeting minutes, hospital …

Personalized Trial Ethics And Institutional Review Board Submissions, Joyce P Samuel, Susan H Wootton

Faculty, Staff and Student Publications

The ethical and regulatory oversight of any clinical activity related to human subjects is commonly determined based on its categorization as either clinical practice or research. Prominent bioethicists have criticized the traditional distinctions used to delineate these categories, calling them counterproductive and outmoded, and arguing that learning and clinical practice should be deliberately and appropriately integrated. Personalized trials represent a clinical activity with characteristics that overlap both categories, making ethical and regulatory oversight requirements less straightforward. When the primary intent of the personalized trial is to assist in the conduct of individualized patient care with an emphasis on protecting the …