Enhancing Primary Care Provider’S Knowledge And Use Of Long-Acting And Oral Naltrexone In The Management Of Opioid And Alcohol Use Disorder, Ariana Juarez-Moncada

Doctor of Nursing Practice Final Manuscripts

Abstract

Objective: This evidence-based project aimed to enhance primary care provider knowledge and prescription rates of naltrexone and long-acting injectable (LAI) naltrexone in a community healthcare setting.

Background: Naltrexone and LAI naltrexone pharmacotherapy is shown to reduce use of alcohol and opioids and improve client retention in patients with alcohol use disorder (AUD) and opioid use disorder (OUD) (Bahji et al., 2020; Morley et al., 2024; Murphy et al., 2022).

Methods: A 30-minute in-service was provided to 14 family practice providers at the clinic. The prescription rate of naltrexone and LAI naltrexone was evaluated for the baseline period of February …

Empowering Recovery: Implementing Ace Screenings To Enhance Care For Patients With Substance Use Disorders, Joshua Wolf

Doctor of Nursing Practice Final Manuscripts

Objective: This evidence-based practice project evaluated the impact of implementing adverse childhood experience (ACE) screenings for patients with substance use disorders (SUDs) in an outpatient community behavioral health clinic.

Background: ACEs are strongly associated with an increased risk of developing SUDs, chronic medical comorbidities, and negative treatment outcomes. Despite consistent evidence supporting the need for identification of ACEs and implementing trauma-informed care, standardized ACE screening is not routinely incorporated into outpatient SUD treatment, potentially limiting the identification of the need for education and referrals.

Methods: The ACE Questionnaire for Adults was implemented during routine psychiatric visits for patients diagnosed with …

Intimate Partner Violence Screening And Awareness Pilot Project, Eleasha P. Partner

Doctor of Nursing Practice (DNP) Projects

Background: In the United States, one in four women experiences intimate partner violence (IPV), highlighting the critical need for improved screening and intervention within the healthcare system. Routine visits in healthcare settings present a significant opportunity for healthcare providers to identify and address IPV.

Local Problem: A primary care family practice clinic in San Leandro, California , currently lacks a standardized evidence-based screening toolkit for IPV.  The absence of such a toolkit creates a gap in practice, leaving patients at risk of undiagnosed IPV and its related consequences.  To address this gap, there is a pressing need for the development …

Advancing School-Based Sexual Reproductive Health Education Through A Fifth-Grade Educator Toolkit, Emira Romero

Doctor of Nursing Practice (DNP) Projects

Background: Although sexual and reproductive health (SRH) education is a critical component of early health literacy and health promotion, educators remain underprepared to deliver this education. Local Problem: A gap analysis conducted at School A, a public elementary school in the San Francisco Bay Area, revealed the absence of a SRH curriculum for their fifth graders. Methods: A Doctor of Nursing Practice (DNP) student-led quality improvement project to introduce a SRH educator toolkit to increase educator confidence and self-efficacy was conducted at School A among fifth grade teachers. Pre- and post-intervention data were collected on implementation day to evaluate the …

Standardizing Preoperative Screening: A Color-Coded Triage Tool Quality Improvement Project, Lyn Green

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Ambulatory surgery centers (ASCs) require effective preoperative screening to ensure appropriate patient selection and minimize day-of-surgery (DOS) cancellations, which affect patient safety, operational efficiency, and financial performance.

Local Problem: In a Northern California ASC serving a racially diverse, predominantly older-adult population with a high burden of chronic diseases, the DOS cancellation rate was 3.84%, exceeding the 2.3% institutional benchmark. Inconsistent preoperative screening contributed to avoidable cancellations.

Methods: A pre- and post-intervention quality improvement design evaluated the effect of a standardized screening tool and staff education on DOS cancellations.

Interventions: The Preoperative Stoplight Tool, a color-coded triage system classifying …

Minimally Invasive Versus Burr Hole Craniostomy For Chronic Subdural Haematoma Evacuation: A Systematic Review And Meta-Analysis, Shaan Patel, Shiva A. Nischal, Angelette Mendonca, Kush M. Kale, Santosh Guru, Pious D. Patel, Kevin Hines, Jack Jallo, Srinivas K. Prasad

Department of Neurosurgery Faculty Papers

BACKGROUND: Minimally invasive surgery (MIS) has emerged as an appealing alternative to burr hole craniostomy (BHC) for chronic subdural haematoma (cSDH), offering reduced operative trauma and anaesthetic exposure. However, whether these procedural advantages translate into comparable outcomes remains uncertain. This systematic review and meta-analysis aimed to compare the safety, effectiveness, and procedural performance of MIS versus BHC for cSDH evacuation, with attention to device-specific outcomes.

METHODS: A systematic search of PubMed, Embase, and CENTRAL (10th November 2025) identified randomised and observational studies directly comparing MIS techniques, including twist-drill craniostomy (TDC), subdural evacuating port systems (SEPS), and YL-1 devices, with BHC. …

Cd11c+ Cd8 T Cells Cause Ifn-Γ-Dependent Autoimmune Neuroinflammation That Is Restrained By Pd-1 Signaling, Daniel Hwang, Gholamreza Azizi, Larissa Lumi Watanabe Ishikawa, Maryam S. Seyedsadr, Arin Cox, Soohwa Jang, Ezgi Kasimoglu, Abdolmohamad Rostami, Guang-Xian Zhang, Bogoljub Ciric

Department of Neurology Faculty Papers

In multiple sclerosis (MS) lesions, CD8 T cells outnumber CD4 T cells, suggesting that they contribute to MS pathology. However, little is known about the role of CD8 T cells in MS, partly due to the prevalent use of experimental autoimmune encephalomyelitis (EAE) models mediated by CD4 T cells, which have limited involvement of CD8 T cells. Importantly, MS and EAE differ in both their distribution of CNS lesions and neurologic deficits, indicating differences in CNS inflammation. MS lesions are more commonly found in the brain, whereas EAE lesions are more frequent in the spinal cord. Additionally, neurologic deficits in …

Soft Power, Arab Media And Sports Mega Events: Coverage Of Fifa 2022 And Lessons For Future Arab Hosting, Lynne Kennedy, Maaira Shahbaz, Ala Al Rajabi

All Works

Sport mega-events (SMEs) increasingly transcend athletic competition, functioning as strategic instruments for national identity formation, statecraft, and soft power projection. This dynamic is particularly pronounced in the Gulf, where Qatar’s successful hosting reignited regional rivalries and attracted unprecedented global scrutiny. While existing scholars have extensively examined Western media portrayals of SMEs, a notable gap remains for academic engagement with Gulf media. Dismissed as state-controlled and analytically lacking, we contend that such media offer a rich site for exploring how small states use media as soft power, to construct and contest legitimacy, identity, and global influence. This analysis suggests how state-aligned …

The Parent Phone Use Regulation Efficacy Scale (P-Pure): Initial Validation And Associations With Problematic Smartphone Use, Self-Regulation, Impulsivity, Mindfulness, And Self-Efficacy, Brandon T. Mcdaniel, Sabrina Uva, Adam M. Galovan

Health Services and Informatics Research

Parents often rely on smartphones in daily life. While smartphones offer benefits, they also present challenges, such as potential distraction and delayed responsiveness. It is also possible that problematic smartphone habits may develop, such as repeated checking or difficulty controlling use. Furthermore, self-efficacy around regulating one’s phone use is tied to the ability to change, meaning self-efficacy could be a key mechanism impacting the effectiveness of interventions regarding problematic phone use. Thus, we developed and explored the validity of the Parent Phone Use Regulation Efficacy Scale (P-PURE) to assess parents’ self-efficacy in managing phone use around their children. We developed …

International Multi-Center Study To Quantify The Effect Of Deep Venous Drainage After Surgical Resection Of Spetzler-Martin Grade Ii-Iii Brain Arteriovenous Malformations, Avi A. Gajjar, Rashad Jabarkheel, Mohamed M. Salem, Basel Musmar, Sandeep Kandregula, Hammam Abdalrazeq, Nimer Adeeb, Assala Aslan, Nathan Ramachandran, Stavropoula Tjoumakaris, Hamza Adel Salim, Adam A. Dmytriw, Christopher S. Ogilvy, Mustafa K. Baskaya, Douglas Kondziolka, Jason Sheehan, Howard Riina, Abdallah Abushehab, Kareem El Naamani, Najib Muhammad, Ahmed Abdelsalam, Natasha Ironside, Deepak Kumbhare, Sanjeev Gummadi, Cagdas Ataoglu, Muhammed Amir Essibayi, Abdullah Keles, Sandeep Muram, Daniel Sconzo, Arwin Rezai, Omar Alwakaa, Pierce Davis, Salem M. Tos, Ufuk Erginoglu, Johannes Pöppe, Rajeev D. Sen, Alan S. Boulos, John C. Dalfino, Christoph J. Griessenauer, Robert M. Starke, Laligam N. Sekhar, Michael R. Levitt, David J. Altschul, Neil Haranhalli, Malia Mcavoy, Hussein A. Zeineddine, Adib A. Abla, Saman Sizdahkhani, Sravanthi Koduri, Michael R. Gooch, Robert H. Rosenwasswer Md, Christopher Stapleton, Matthew Koch, Peng R. Chen, Spiros Blackburn, Ketan Bulsara, Louis J. Kim, Omar Choudhri, Bryan Pukenas, Joshua S. Catapano, Darren Orbach, Edward Smith, Pascal J. Mosimann, Alexandra R. Paul, Pascal Jabbour, Ali Alaraj, Mohammad A. Aziz-Sultan, Aman B. Patel, Amey Savardekar, Christina Notarianni, Hugo H. Cuellar, Bharat Guthikonda, Jacques Morcos, Michael Lawton, Jan-Karl Burkhardt, Visish M. Srinivasan

Department of Neurosurgery Faculty Papers

Deep venous drainage (DVD) is considered a negative prognostic factor in AVM surgery, yet its effect on postoperative functional decline remains incompletely defined. This study evaluates whether DVD predicts worsened functional status after surgical resection of Spetzler-Martin Grade II-III AVMs. This retrospective multicenter study analyzed 129 patients with Spetzler-Martin Grade II-III AVMs across nine centers in North America and Europe who underwent primary surgical resection. We excluded cases with prior endovascular or stereotactic interventions. The primary outcome measured was poor functional status, defined as modified Rankin Scale (mRS) score 3-6 at last follow up. Among 129 patients with Spetzler-Martin Grade …

O-Glcnacylation As A Metabolic Integrator In Cardiovascular Physiology And Disease, Saima Shakil Malik, Xinchun Pi, Liang Xie

Faculty, Staff and Students Publications

No abstract provided.

Targeted Suppression Of Spp1 Inhibits Tumor Invasion And Metastasis In Nrf2 Hyperactivated Cisplatin Resistant Hnscc, Mutsuki Kawabe, Sujuan Yang, Lorena I Gomez-Bolanos, Shiro Takamatsu, Sylvia Flores, Patricia D Castro, Tsung-You Tsai, Arisa Nishikawa Kaga, Kento Okamoto, Mitchell J Frederick, Vlad C Sandulache, Humam Kadara, Jeffrey N Myers, Abdullah A Osman

Faculty, Staff and Students Publications

Background: Cisplatin remains the standard systemic therapy for the definitive treatment of head and neck squamous cell carcinoma (HNSCC), however, resistance to cisplatin continues to be a major barrier to effective treatment, particularly in tumors with NRF2 hyperactivation. Recent studies identify secreted phosphoprotein 1 (SPP1/osteopontin) as a key NRF2 target frequently overexpressed in cancers, where it drives aggressive tumor behavior, metastasis, chemoresistance, and, in some cases, immune suppression. Our recent data highlight SPP1 as one of the top 10 NRF2-upregulated genes in cisplatin-resistant HNSCC. However, its specific role in therapy resistance and metastasis in HNSCC remains unclear. Here, we investigate …

Mapping Rna Structure Assembly And Remodeling In Biomolecular Condensates, Ritwika Bose, Erik W Bergstrom, Sovanny R Taylor, Steven Boeynaems, Joshua A Riback, Furqan M Fazal, Anthony M Mustoe

Faculty, Staff and Students Publications

Biomolecular condensates concentrate RNA and protein machinery that facilitate RNA processing, ribonucleoprotein assembly, and gene regulation. Some evidence supports that condensates can modulate RNA folding, but measuring RNA structure within native condensates remains an unsolved challenge. Here we introduce RAID-MaP, a strategy that combines APEX proximity labeling with dimethyl sulfate (DMS) chemical probing to measure RNA structure within defined subcellular compartments. We applied RAID-MaP to resolve late stages of ribosomal RNA (rRNA) folding within the granular component (GC) of the nucleolus, revealing that both the 18S and 28S rRNAs feature widespread differences in structure compared to assembled ribosomes consistent with …

Comparing Injury Incidence Between Major League Soccer And The English Premier League During The 2024/2025 Season: A Retrospective Cohort Study, William Gadbois, Youssef Salama, Kevin Reck, Scott Mohamed El-Sayed Yaekle

Medical Student Research Symposium

Background

Major League Soccer (MLS) and the English Premier League (EPL) differ substantially in geographic footprint, travel requirements, competition structure, and scheduling. These structural differences may influence player injury risk, yet no study has directly compared injury incidence between the two leagues within the same competitive season. In 2024, MLS introduced a centralized, standardized injury-reporting system that improved transparency and created a unique opportunity for direct comparison with the EPL.

Methods

This retrospective cohort study will analyze all reported time-loss injuries during the 2024 MLS and 2024–25 EPL seasons. Injury data will be collected from publicly available league reports, club …

Electronic Research Notebooks And Partnership Checklists: Fostering Cultured Collaboration In Evidence Synthesis Projects Using Labarchives And Swirl-Sr, Gary Kaplan, Mslis, Ahip, Abby Adamczyk, Mlis, Ahip, Emmett Booth, Mlis, Ahip, Stephanie Roth, Mlis, Ahip

Academic Commons and Scott Memorial Library Staff Papers and Presentations

Background

Librarians providing evidence synthesis services often face project management challenges, from tracking progress on search strategy development to clarifying team roles. Librarians have a variety of tools to address these challenges.¹ We propose using electronic lab notebooks (ELNs), which standardize how scientists record research progress. Institutions have adapted ELNs to protect intellectual property and improve rigor and reproducibility.

Although many published systematic reviews report following guidelines such as PRISMA, they still lack rigor and reproducibility.² Therefore, one of the authors developed the Standards for Working with Research Librarians-on Systematic Reviews (SWiRL-SR) checklist to facilitate collaboration and improve …

Axitinib-Pembrolizumab And Adverse Event Management In Patients With Advanced Renal Cell Carcinoma, Neil Shah, Yaa Ababio, Anthony Eccleston, Dharanija Rao, Scott Kelly, Jane Chang, Sarah Lucht, Caleb Paydar, Bryce Van Doren, Emily Bland, William John, Sarah Giegerich, Jalyna Laney, Bruce Feinberg, Kevin Zarrabi

Kimmel Cancer Center Faculty Papers

IMPORTANCE: Understanding approaches to managing treatment-related adverse events (AEs) in immunotherapy and tyrosine kinase inhibitor-based treatments in a clinical setting is critical for reaching optimal patient outcomes.

OBJECTIVE: To investigate the management of AEs in community practices during first-line axitinib plus pembrolizumab therapy for advanced renal cell carcinoma (aRCC).

DESIGN, SETTING, AND PARTICIPANTS: This study comprised a cross-sectional electronic physician survey and a multisite, retrospective cohort study of the medical records of US patients with aRCC who initiated first-line axitinib-pembrolizumab between April 22, 2019, and January 31, 2024. Data were analyzed from September 18 to December 20, 2024.

EXPOSURE: First-line …

Using The Socio-Ecological Model To Explore Parents' Resilience And Perceptions Of Adverse Childhood Experiences: A Qualitative Study In The Southeastern United States, Maribel G Dominguez, Christine Markham, Andrew E Springer, Louis D Brown

Faculty, Staff and Student Publications

Background: The negative impact of adverse childhood experiences (ACEs) on child development is documented. The parent-child relationship protects against ACEs and improves healthy child development, playing a crucial role in preventing and mitigating ACEs by strengthening parental resilience. However, there is a gap in the literature on our understanding of parental resilience's impact on the parent-child relationship within the social-ecological model (SEM) (i.e., intra- and interpersonal, community, and societal levels). Objective: This study explores parents' perspectives on parental resilience as a protective factor for preventing and mitigating ACEs at every level of the SEM. Method: This study uses a thematic …

A Soft Diet Attenuates Exercise-Induced Increases In Cortical Bone Density And Formation In Long Bones In Growing Mice, Yasuhiro Shimizu, Fatma Rashed, Huan Cao, Yuki Arai, Takashi Ono, Kazuhiro Aoki

Faculty, Staff and Student Publications

Bone and muscle are closely linked through functional interdependence. Training and regular exercise can improve and maintain optimal bone mass and strength. Here, we investigated the effects of exercise combined with soft versus hard diet (pellet) on long bones in mice. Four groups of male C57BL/6J mice (n = 5 per group) were studied: hard diet (pellet) with exercise, soft diet (powdered) with exercise, hard diet (pellet) without exercise, and soft diet (powdered) without exercise. Femur and tibia were analyzed using radiographic, micro-CT, and histomorphometric techniques. Exercise combined with a hard diet significantly increased cortical bone density, mineral apposition rate, …

Evaluating The Association Between Chronic Health Conditions And Caregiver Burden For Male Dementia Caregivers, Dareion D. Hill-Smith

Walden Dissertations and Doctoral Studies

No abstract provided.

Circulating Metabolites Associated With Protection Against Mycobacterium Tuberculosis Infection And Inhibition Of Mycobacterial Growth, Todia P Setiabudiawan, Lika Apriani, Julian Avila-Pacheco, Edwin Ardiansyah, Vinod Kumar, Bachti Alisjahbana, Ayesha J Verrall, Andrew R Dinardo, Agnes R Indrati, Vera P Mourits, L Charlotte J De Bree, Simone J C F M Moorlag, Clary B Clish, Leo A B Joosten, Arjan Van Laarhoven, Krista E Van Meijgaarden, Mihai G Netea, Simone A Joosten, Valerie A C M Koeken, Philip C Hill, Reinout Van Crevel

Faculty, Staff and Students Publications

A significant proportion of individuals who are heavily exposed to infectious tuberculosis patients do not acquire Mycobacterium tuberculosis (Mtb) infection, as detected by an interferon gamma release assay (IGRA). We examined circulating metabolite profiles and metabolic genotypes in 199 heavily exposed IGRA-negative tuberculosis household contacts in Indonesia. Based on differentially abundant metabolites, activity of several pathways including arachidonic acid, arginine and proline, glutathione, and tryptophan metabolism, correlated with a negative IGRA at three months. SNPs near PRODH (involved in arginine and proline metabolism) were associated with circulating proline concentrations and persistently negative IGRA results, while SNPstudys near AFMID (involved in …

Mapping Youth Sexual And Reproductive Health Services In Orleans Parish, Louisiana: A Field-Tested Survey Methodology, Isabelle Jouve, Ryann Martinek, Zoey Ponder, Isabel Arce, Ryley White

Journal of the Louisiana Public Health Association

Background: Fragmented access to sexual and reproductive health (SRH) services is driving a sexual health crisis among the youth population in Orleans Parish, Louisiana. Rates of sexually transmitted infections, HIV, and teen pregnancy continue to rise while SRH education offerings decline. In response to these outcomes, a Sexual Health, Education, and Rights (SHER) Lab team presents a field-tested survey methodology to characterize the landscape of youth-accessible SRH service providers. Methods: In May 2025, the SHER Lab launched an SRH landscape assessment project to survey youth-serving organizations in Orleans Parish, Louisiana. The project team collected comprehensive feedback from community stakeholders to …

In-Use Stability And Device Compatibility Define Clinically Actionable Handling Limits For A Gmp-Produced Attenuated Listeria Monocytogenes Vaccine Expressing Gucy2c, Jagmohan Singh, Taranjot Johar, Vannessa Scully, Scott A. Waldman, Babar Bashir, Adam E. Snook

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Background: Live-attenuated Listeria monocytogenes (Lm) vectors are a clinically validated cancer immunotherapy platform, but translation requires reproducible, clinically realistic workflows for dose preparation and infusion. For live bacterial products, in-use stability and device compatibility can drive dose variability through adsorption, settling, and device losses. Methods: We developed and GMP-manufactured an attenuated Lm vaccine expressing human GUCY2C (Lm-GUCY2C) and performed translational characterization, including construct verification and immunogenicity readouts, and defined the administration-focused in-use stability and device compatibility. Post-thaw stability was assessed in primary cryovials and during preparation and delivery from 250 mL saline infusion bags using standard clinical devices (syringes/needles, filter-free …

The Perijunctional Zone Is A Molecularly Distinct Muscle Subdomain Altered In Duchenne Muscular Dystrophy, Seth G Haddix, Chuansheng Zhang, Yanhong Liu, Juan Oses-Prieto, Alma L Burlingame, Matthew N Rasband

Faculty, Staff and Students Publications

The neuromuscular junction (NMJ) is a well-established model for synapse development, structure, and function. Surrounding the NMJ is a narrow perijunctional zone (PJZ), enriched in muscle-specific voltage-gated sodium channels that prevent synaptic fatigue. Despite this role, the PJZ remains poorly characterized. To determine its molecular composition, we engineered mice to express the biotin ligase TurboID fused to the cell adhesion molecule neurofascin (Nfasc), and that localizes to the PJZ through ankyrin scaffolding proteins. Using proximity proteomics, we identify numerous PJZ-associated proteins, including Perilipin 4 (Plin4), that are highly enriched and clustered at the PJZ. We also perform proximity proteomics on …

Childcare Challenges Among Surgical Trainees And Faculty: A Single-Institution Study, Emma G Burke, Sarah Peiffer, Melissa Koci, Lindsay Dean, Kristy L Rialon, Michele Loor, Alice King

Faculty, Staff and Students Publications

Background: Previous studies have demonstrated the challenges of parenthood in surgical training and careers. However, certain aspects of childrearing for surgeons remain understudied. We aim to leftacterize the complexity and costs of childcare amongst surgical trainees and faculty.

Methods: An anonymous, self-administered survey was conducted within the Department of Surgery at a large academic medical center. Both male and female trainees and faculty were included in the analysis. Chi-square or Fisher's Exact test was performed.

Results: Forty-six respondents provided information about childcare costs, with 37% of respondents being residents or fellows. Trainees worked longer workhours (p = 0.003) than their …

Improving A1c Levels Through An Individualized Diabetes Education Among Patients Living With Type 2 Diabetes, David W. Cardona Jr.

Doctor of Nursing Practice Final Manuscripts

Type 2 diabetes mellitus (T2DM) represents an increasing global health, social, and financial burdens. Nutrition, among other diabetes self-management topics, is a foundational aspect in managing T2DM. Significant knowledge gaps persist among patients regarding the impact of mindful eating habits in relation to euglycemia. Individualized diabetes education focused on healthy eating habits offers a promising strategy to address this gap. The quality improvement (QI) project aimed to evaluate the impact of diabetes education, focused on nutritional awareness, and mindful eating habits on hemoglobin (A1c) levels, weight, and diabetes self-management questionnaire scores (DSMQ-R) were assessed among adults living with T2DM. The …

The Impact Of Translated Phq-9 And Gad-7 Scales On Treatment Recommendations In An Adult Vietnamese Population: A 3-Month Primary Care Evaluation, Vivienne Bui

Doctor of Nursing Practice Final Manuscripts

Depression and anxiety are prevalent yet underdiagnosed in limited-English-proficient (LEP) populations due to language barriers, cultural stigma, and provider bias. Vietnamese-speaking patients are particularly vulnerable to under-recognition in primary care. This quality improvement project evaluated whether implementing Vietnamese-translated Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) tools would improve mental health diagnosis and referral rates. Guided by the Johns Hopkins Evidence-Based Practice Model, a pre–post design was conducted at a San Diego clinic from March 26 to June 26, 2025. Vietnamese-speaking adults (≥18 years) completed translated PHQ-9 and GAD-7 forms during intake. Providers used scores in conjunction with clinical …

Bridging The Vaccine Gap: Multilingual Vaccine Education For Families In Transitional Housing, Isaac Olaes, Alexia Sandoval, Kassandra Solano, Rachael Termure, Sydney Webber, Jordan West, Maya Parman

Nursing Leadership in Community Engagement Projects

As part of a health promotion initiative in the community, our leadership team of seven nursing students is partnering with an agency that supports families experiencing housing instability by providing transitional housing. According to agency staff, some families have limited health literacy regarding vaccinations. Common concerns include illness following a vaccination, perceived risks of autism, and attention deficit hyperactivity disorder. To address these concerns, we have developed a vaccine education binder containing materials in handout form. To accommodate language accessibility, we provided handouts in the four most spoken languages including English, French, Amharic, and Tigrinya. Through this initiative, we aim …

Barriers To Physical Activity Among Community College Students, Erica Keels

Doctoral Dissertations and Projects

The purpose of this qualitative study was to explore the perceived barriers, motivators, and student-identified strategies related to physical activity among students enrolled at a community college located in Northwest Florida. Guided by the Social Ecological Model (SEM), Self-Determination Theory (SDT), Health Belief Model (HBM), and Theory of Planned Behavior (TPB), this study employed a qualitative descriptive design to examine students’ lived experiences and perceptions that influence their physical activity behaviors. Data were collected through an online open-ended survey administered to students aged 18 years and older. A total of 134 students initially accessed the survey, and 126 eligible participants …

Pr Interval Alternans And The Mystery Of Inverse Decremental Conduction, Alyssa Zakala, Mohammed Hussein Kamareddine, Farah Olleik, Ali Keramati, Gan-Xin Yan

Department of Medicine Faculty Papers

CASE SUMMARY: A 73-year-old man with severe aortic stenosis and preexisting right bundle branch block (RBBB) underwent transcatheter aortic valve replacement. Postprocedural day 4 mobile cardiac outpatient telemetry revealed intermittent atrioventricular block. A 12-lead electrocardiogram obtained in the emergency department revealed PR interval alternans with RBBB, with longer PR following longer preceding RP intervals, and shorter PR following shorter RP intervals. He suddenly experienced cardiac arrest due to proximal atrioventricular block, requiring cardiopulmonary resuscitation.

TAKE-HOME MESSAGES: Inverse decremental conduction, known as Yan conduction, demonstrates an inverse relationship between conduction time and frequency of upstream stimulation. Inverse decremental conduction within the …

When Qtc Shrinks After Rhythm Conversion, Mohammed Hussein Kamareddine, Alyssa Zakala, Farid Farkouh, Ibrahim Alameh, Gan-Xin Yan

Department of Medicine Faculty Papers

CASE SUMMARY: An 83-year-old man with a history of atrial fibrillation on amiodarone therapy was admitted for direct-current cardioversion because of recurrent atrial fibrillation with a ventricular rate of approximately 105 beats per minute. Cardioversion successfully restored sinus rhythm. Postcardioversion 12-lead electrocardiography revealed an unexpectedly short QTc of 344 ms despite chronic treatment with a QT-prolonging agent. This finding was attributed to QT hysteresis, reflecting delayed adaptation of ventricular repolarization to the abrupt reduction in heart rate after rhythm conversion.

TAKE-HOME MESSAGE: QT hysteresis can result in transient QTc shortening and has important implications for interpretation of QT intervals during …