Digital Commons Network^™

How To Assess Ventricular Function By Fetal Echocardiography: Expert Guidance From The Fetal Heart Society., S R Patel, Nitin Madan, L Eckersley, Z Roytman, M Perez, L Gindes, L K Hornberger

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Current Practices And Variations Among Pediatric Severe Asthma Programs In The United States-The North American Severe Pediatric Asthma Consortium., Kristina Gaietto, Nadia Krupp, Avani V. Shah, Erhan Ararat, Samantha H. Averill, Sachin Baxi, Matejka Cernelc-Kohan, Jeffrey M. Chambliss, Heather De Keyser, Monica Federico, Bob Geng, Akilah A. Jefferson, Parisa Kaviany, Lila C. Kertz, Kirsten Kloepfer, Allyson Larkin, Sydney Leibel, Tanya Martinez-Fernandez, Samira Naime, Robert D. Pesek, Dinesh K. Pillai, Deepa Rastogi, Katherine Rivera-Spoljaric, Kristie R. Ross, Franziska J. Rosser, Tregony C. Simoneau, Jade Tam-Williams, Kelan G. Tantisira, William Anderson, Jonathan M. Gaffin, Theresa W. Guilbert, Erick Forno

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Severe and difficult to treat asthma in children is a complex condition causing significant morbidity and associated healthcare costs. While treatment guidelines exist for severe asthma, optimal treatment approaches for the pediatric population are less well established. Furthermore, best practices regarding real world management and implementation of guidelines for the severe pediatric asthma population are lacking. In order to provide care for this population, institutions around the United States have developed multidisciplinary severe pediatric asthma programs (SPAPs). In recent years, the North American Severe Pediatric Asthma Consortium (NASPAC) was established as a mechanism for SPAPs to collaborate and share …

Quality Improvement Project To Reduce Wait Time For Pediatric Gastrointestinal Procedures., Jennifer Colombo, Nicholas Clark, Laura E. Shroyer, Dustin J. Hahn, Jonathan Patterson, Kenneth Sam

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Delays in care can lead to poor health outcomes and suboptimal patient and family experiences. We aimed to reduce the average wait time for gastrointestinal endoscopic procedures (procedure request to procedure completion) from 145 to 15 days (a 90% reduction) within 4 months (November 2023 to March 2024).

METHODS: A3 problem-solving methodology was used. The primary intervention was a multiday, multidisciplinary improvement workshop. Outcome measures included (1) procedure request date to procedure completion date, and (2) favorable patient satisfaction score for timeliness of access to care. Process measures included (1) procedure request date to date procedure scheduled by staff, …

Clinical Ethics Training Needs Among Pediatricians And Pediatric Residents In Ethiopia: Conference-Based Cross-Sectional Survey., Betelehem Kassa, Addishiwot Melesse, Eyob Kebede Etissa, Bitseat W. Haile, Atnafu Mekonnen Tekleab, Stephanie Kukora

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pediatricians encounter ethically challenging cases in clinical practice throughout the world. In Ethiopia, ethically distressing pediatric cases are heightened by limited resources, lack of ethical frameworks to guide clinical care and withdrawal of supportive therapies, absence of child protection laws, and dearth of trained ethics consultants or institutional ethics committees providing clinical ethics consultation. Ethics training remains limited in undergraduate medical programs and absent in the resident curriculum at most institutions.

METHODS: A survey of Pediatric Residents and Pediatricians attending the Ethiopian Pediatric Society's 24th Annual Conference on March 2023 was conducted using a self-administered, clinical ethics needs assessment. …

How To Tell A True Food Allergy From An Intolerance, Sarah Gubara, Aarti Pandya

Pediatrics in Practice: A CME Podcast

This episode explains the key history elements and symptom timeline that differentiate an IgE-mediated food allergy from an intolerance or sensitivity, so clinicians and parents can make safer, evidence-based decisions. Aarti Pandya, MD, Medical Director of the Food Allergy Center at Children’s Mercy, reviews symptom patterns, timing and red flags for anaphylaxis. Learn about food allergy testing, IgE-mediated food allergy, anaphylaxis action plan, epinephrine auto-injector, food intolerance and when testing is truly warranted.

Click here to stream the podcast episode.

Cyberbullying Perpetration: A Systematic Review Of Global Prevalence, Profiles, Antecedents, Consequences, And Interventions, Ysabel A. Guevarra, K. T. A. Sandeeshwara Kasturiratna, Charlotte K. Y. Lee, Andree Hartanto

Research Collection School of Social Sciences

The anonymity afforded by cyberspace enables individuals to engage in harmful online behaviours, most notably cyberbullying perpetration, which has become a pressing social and psychological concern worldwide. Despite extensive research on its antecedents, outcomes and interventions, insights into cyberbullying perpetration remain scattered, highlighting the value of a comprehensive synthesis to capture its multifaceted nature. This systematic review synthesised findings from 54 meta-analyses, comprising 314 effect sizes (Sample size: Range = 3273–1,479,614, Mdn = 46,604) across diverse populations worldwide. Results indicate that approximately one in ten individuals engage in peer cyberbullying, with even higher prevalence in partner-directed forms such as cyber …

Proteogenomics Of Hypertrophic Cardiomyopathy Reveals Subtype-Specific Therapy, Ke Ma, Jie Yang, Hongchang Guo, Ping Li, Xiaowei Li, Zhujun Dong, Jing Zhang, Congcong Zhang, Pengli Yang, Chongpei Hua, Shuolin Zhu, Guoqing Li, Jianchao Zhang, Ningyu Ding, Jizheng Wang, Xin-Liang Ma, Zhuofeng Lin, Jianzeng Dong, Yang Li, Yulin Li

Department of Emergency Medicine Faculty Papers

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a heterogeneous disease with diverse prognosis. The underlying mechanisms remain unknown, resulting in limited risk stratification and therapeutic strategies. This study aimed to elucidate molecular subtypes of HCM through integrated proteogenomic analysis and explore subtype-specific therapeutic strategies.

METHODS: We conducted an integrated proteogenomic analysis of 132 patients with HCM using myocardial samples, incorporating whole-exome sequencing, RNA sequencing, and proteomics. Unsupervised clustering was used to identify HCM subtypes, which were validated in heart tissues and human induced pluripotent stem cell-derived cardiomyocytes from 2 independent HCM subsets. Subtype-specific signatures and pathways were explored, and their causal link …

State And Regional Variation In Access To Pediatric Extracorporeal Membrane Oxygenation., Allan M. Joseph, Andrew J. Lautz, Carlie N. Myers, Ranjit S. Chima, Juan P. Gurria, Shafee Salloum, Wendy Hasson, Matthew P. Malone, Jenna Miller, Reanna Smith, Maya L. Dewan

Manuscripts, Articles, Book Chapters and Other Papers

Extracorporeal membrane oxygenation (ECMO) is only available in specialized medical centers. We conducted a geospatial analysis and found state- and region-level variation in the supply of ECMO centers, and the number of children who had access to ECMO. These findings may help target areas for the development of new ECMO programs.

Between Burn And Graft: Evaluating Outpatient Management In Pediatric Burn Patients, Nicholas A. Long, Alexa Cumming, Ananya Sampathkumar, Taylor Sweeney, Emma K. Young, Douglas J. Fox, Joan C. Bruce, Allen Huang, Owen N. Ferriola, Erin M. Morris, Anna Sabu Kurian, Jeannette M. Joly, Carleen V. Cuevas, Kuojen Tsao, Natalie A. Drucker

Summer Research Program Abstracts

No abstract provided.

Comparison Of Refractive Accuracy Of Iolmaster 700, Lenstar Ls 900, And Anterion For Iol Power Calculation, Travis Williams Md Ms, Mena Kozman Md, Siddhant Patil, Leon Toursarkissian, Ahmad Kheirkhah Md

Summer Research Program Abstracts

No abstract provided.

Assessing Hpv And Hpv Vaccine Awareness And Perception Amongst Undergraduate Students, Maura Hawkins

Honors Theses

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections in the United States. Vaccination rates remain low among college-aged students despite an effective vaccine being available. This study investigates HPV and HPV vaccination-related knowledge, beliefs, and perceptions among undergraduate students to inform targeted intervention strategies. Participants included undergraduate students (n = 19) who attended one of three focus groups conducted in April 2025 at the University of South Alabama. Structured interview guides explored HPV knowledge, perceived risk and severity, attitudes towards vaccination, autonomy in health decision-making, trust in health information sources, and preferred educational strategies. Discussions were …

Fractured Focus: Understanding Stress In Second-Year Radiologic Science Students Across Alabama, Kelsi Clotfelter

Honors Theses

Higher education is a period of rapid transition and growing responsibility, where stress often becomes a routine part of students’ lives. In health professional programs, the combined demands of intensive coursework and clinical training can intensify emotional strain and negatively affect overall well-being. Radiography students experience uniquely high levels of academic, clinical, and emotional stress due to the simultaneous demands of didactic coursework, competency-based clinical training, and high-stakes professional expectations. A cross-sectional mixed-methods study was employed to evaluate the prevalence, sources, and perceived impact of stress among second-year radiography students across multiple Alabama institutions with the goal of identifying strategies …

Implementing A Professional Wellness Session To Foster Improvement In Oncology Nurse Retention And Well-Being, Connie Tran

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement (QI) project was to implement chaplain-led professional wellness sessions to improve the well-being of nurses on an oncology pilot unit.  Aims were to increase nurse retention by 5%, decrease staff absenteeism by 3%, and improve Perceived Stress Scale (PSS) scores by 10%, and Professional Quality of Life (ProQOL) scores by 10% from baseline.

Background

The emotionally taxing nature of oncology patient care creates a high-pressure environment, which can lead to turnover. Literature has shown that allowing staff to pray, debrief and engage in peer support groups to discuss work-related stressful encounters reduces stress …

Improving Physiologic Monitoring Adherence During Behavioral Emergencty Sedation In A Prehospital Ems System, Jared Aucoin

Doctor of Nursing Practice Final Project Abstract

Abstract

Purpose:

This quality improvement (QI) project evaluated whether provider education and standardized documentation improved adherence to evidence-based physiologic monitoring during behavioral emergency sedation in a prehospital EMS setting.

Background:

Behavioral emergencies are common and often require rapid chemical sedation, with risks of hypoxia, hypercapnia, and cardiovascular instability. At baseline, inconsistent adherence to recommended monitoring and documentation of end-tidal carbon dioxide (EtCO₂) and pulse oximetry (SpO₂) presented an opportunity to improve patient safety.

Methodology:

This QI project educated current adult behavioral emergency protocol in a prehospital EMS setting, re-emphasizing standardized documentation and evidence-based monitoring practices. Utilizing Plan-Do-Study-Act (PDSA) through pre- …

Use Of Information Technology Tools In The Area Of Occupational Health And Safety In Polish Workplaces – Results Of A Survey, Dariusz Smoliński

Studia i Materiały Wydział Zarządzania Uniwersytet Warszawski

Purpose: The aim of this article is to analyse the level of implementation of digital technologies in the digitalisation of occupational health and safety (OHS) management in Poland and to identify the factors influencing the adoption of digital tools by OHS specialists. The research questions posed are: to what extent do OHS services use software; which organisational factors affect the adoption of digital tools supporting the work of OHS services; and which barriers hinder implementation? The study also sought to assess the differences in the level of digitalisation tool implementation according to the size of workplaces and the professional experience …

Reducing Missed Opportunities For Crc Screening Via Provider Reminder System In A Primary Care Setting, Komfort Cofield

Doctor of Nursing Practice Projects

Background: Although highly preventable with screening, colorectal cancer (CRC) continues to be a major source of illness and mortality in the United States. Healthcare providers at the Doctor of Nursing Practice (DNP) project site inconsistently ordered CRC screening for eligible patients due to deficiencies in the point-of-care reminder system. These system failures created missed opportunities for CRC prevention and reduced compliance with established practice guidelines.

Purpose: This DNP project aimed to implement and evaluate a CRC screening checklist given to patients at appointment check-in, serving as a reminder for providers to order appropriate screening tests.

Project Design: Using the National …

Addressing Hypertension Medication Non-Adherence Through The Use Of Reminders And Morisky Medication Adherence Scale In Adults Diagnosed Within The Past Year In A Rural Primary Care Clinic, Amanda M. Weaver

Doctor of Nursing Practice Projects

Background: Adherence to antihypertensive medications is essential for decreasing long-term consequences of uncontrolled hypertension, including stroke, kidney failure, and cardiovascular diseases. However, nonadherence is a widespread problem among patients diagnosed with hypertension. In patients who have been diagnosed with hypertension in the past year, more than half stop taking their medications. Mobile health interventions, such as text message or telephone reminders, are a low-cost way to improve medication adherence.

Purpose: The purpose of this Doctor of Nursing Practice project is to examine how a weekly text message or telephone reminder impacts medication adherence among patients taking antihypertensives in a rural …

A Multifaceted Approach To Human Papillomavirus (Hpv) Vaccine Uptake Among Adolescents Ages 10-14 In A Public Health Clinic, Amy T. Norris

Doctor of Nursing Practice Projects

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a leading cause of several preventable cancers. Although the HPV vaccine is safe, highly effective, and routinely recommended for adolescents, vaccination rates remain below national targets, particularly in rural and public health settings. Multiple internal and external factors contribute to low HPV vaccination rates in public health settings.

Purpose: The Doctor of Nursing Practice quality improvement project aimed to increase HPV vaccine uptake through the implementation of a multifaceted, evidence-based intervention.

Project Design: Guided by Pender’s Health Promotion Model and the Reach, Effectiveness, Adoption, …

Reducing Asthma-Associated Absenteeism At A School-Based Health Center Using Asthma Control Test (Act) Scoring, Concetta Terry

Doctor of Nursing Practice Projects

Background: Asthma is a common chronic condition that can lead to increased school absences and lower academic performance. A needs assessment at a rural school-based health clinic identified gaps in care for students with asthma and high absenteeism rates.

Purpose: This Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce asthma-related absences by personalizing care using Asthma Control Test (ACT) scoring.

Project Design: Using a pre- and post-intervention design, this DNP quality improvement project followed the Plan-Do-Study-Act (PDSA) framework to evaluate the impact of implementing the ACT on asthma-related absenteeism in a rural school-based health center. The project …

Reducing Missed Appointments In An Ambulatory Infusion Center, Jacqueline G. Jones

Doctor of Nursing Practice Projects

Background: Missed appointments at ambulatory infusion centers (AIC) continue to be a problem, even with improved scheduling systems and care coordination efforts. Nationally, missed appointment rates average 10%–12%, and in Central Alabama, the rate is 11.7%. However, one local AIC has a much higher missed-appointment rate of 17.8%. Missed appointments lead to wasted facility resources, increased healthcare costs, and interruptions in infusion therapies.

Purpose: This Doctor of Nursing Practice project used live reminder calls to help lower missed appointments in an AIC. The goal was to improve attendance, reduce missed appointments, and maintain consistent care.

Project Design: Over ten weeks, …

Improving The Accuracy Of Medication Reconciliations For Medicare Advantage Patients At A Primary Care Clinic Using An Interdisciplinary Team, Sallie Mann

Doctor of Nursing Practice Projects

Background: Medication-related problems (MRPs) are a significant and often preventable cause of patient harm, particularly among older adults with complex medication regimens. In primary care settings, inaccurate or incomplete medication reconciliations contribute to adverse drug events, avoidable hospitalizations, increased healthcare costs, and reduced patient satisfaction.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate whether implementing an interdisciplinary medication reconciliation process using the Medications at Transitions and Clinical Handoffs (MATCH) Toolkit would improve reconciliation accuracy in Medicare Advantage patients aged 65 and older in a primary care clinic.

Project Design: This DNP project used the …

Optimizing Workflow In Advanced Gastroenterology: An Initiative To Improve Turnaround Times, Aundrea Prewitt

Doctor of Nursing Practice Projects

Background: Procedure room turnaround time in advanced gastroenterology is defined as the interval between one patient exiting the procedure room and the subsequent patient entering. Prolonged turnaround times contribute to decreased operational efficiency, delays in care delivery, and suboptimal resource utilization. Current facility turnaround time is 39 minutes, and there is no standardized policy to guide the turnaround process.

Purpose: The purpose of this quality improvement project was to develop a standardized operating procedure that guides policy change in advanced gastroenterology through implementing a sustainable turnaround process that reduces procedure room turnaround time.

Project Design: The quality improvement initiative used …

Evaluating The Accuracy Of Face2gene Phenotyping Tools In South African Children With Neurodevelopmental Disorders, Hendrike Mcdonald, Zandrè Bruwer, Michal Zieff, Emma Eastman, Brigitte Melly, Rizqa Sulaiman-Bardien, Karen Fieggen, Shahida Moosa, Charles Newton, Amina Abubakar

Institute for Human Development, East Africa

Objectives Computational phenotyping tools, like Face2Gene, are increasingly used to support genetic diagnosis by analysing facial features. These tools perform well in Global North populations but are less accurate in other groups. This study aimed to assess the performance of Face2Gene’s DeepGestalt, FeatureMatcher, and D-Score in South African children with neurodevelopmental disorders (NDDs) and unaffected controls.

Methods Facial photographs of 301 children from the NeuroDev South Africa study were analysed including 36 children with NDDs with a confirmed molecular diagnosis, 176 with NDDs without a confirmed molecular diagnosis, and 89 controls. Diagnostic accuracy of DeepGestalt and FeatureMatcher was assessed by …

Exploration Of The Vein To Vein Blood Transfusion System In Three Kenyan Counties: A Qualitative Study, Linda Barnes, Jennifer Makin, Jose Paiz, Jana Macleod, Cindy Makanga, Tecla Chelagat, Alejandro Munoz-Valencia, Ejemai Eboreime, Robert Kaburu, Carolyne Njoki

Anaesthesiology, East Africa

Background Severe shortages of blood for transfusion are a persistent global health crisis, with the burden disproportionately concentrated in low-income countries. Diverse stakeholder perspectives on blood availability might inform improvements. We aimed to use a comprehensive approach to identify the challenges, facilitators, and innovations within the blood transfusion continuum (BTC) in three different Kenyan settings.

Methods In this qualitative study, we interrogated the BTC in Siaya, Nakuru, and Turkana counties as part of the Pathways for Innovation in Blood Transfusion Systems in Kenya (PITS Kenya) mixed methods research study. We used purposive sampling, and through interviews and focus group discussions, …

Cross-Ancestry Polygenic Risk Scores Enhance Alzheimer's Disease Risk Prediction In Multiethnic Cohorts, Meri Okorie, Caroline Jonson, Alexis Oddi, Patricia Castruita, Brian Fulton-Howard, Kristine Yaffe, Jennifer Yokoyama, Chinedu Momoh, Shea Andrews

Brain and Mind Institute

INTRODUCTION Genome-wide association studies (GWAS) have identified 80+ genetic loci associated with Alzheimer's disease (AD), enabling the development of polygenic risk scores (PRS). However, the predictive accuracy of PRS in diverse populations remains low. Here, we evaluated the predictive accuracy of single-, multi-, and cross-ancestry AD-PRS models across multi-ancestral populations.

METHODS We used AD GWAS summary statistics from European, African, Admixed American, and East Asian populations to construct AD-PRS for each target population. Model performance was assessed by estimating odds ratios, R2, and area under the curve.

RESULTS The cross-ancestry Bayesian PRS model demonstrated the highest predictive performance in non-European …

Not Just A Pediatric Condition: Down Syndrome Across The Lifespan., Emily Haury, Jacqueline Kitchen, Brenda Rogers

Manuscripts, Articles, Book Chapters and Other Papers

With increasing life expectancy for individuals with Down Syndrome (DS), there are growing numbers of adult DS patients needing care from primary care physicians who are knowledgeable regarding their health needs and risks. The Global Down Syndrome Foundation (GDSF) Medical Care Guidelines for Adults with Down Syndrome identify important areas of focus: mental health, dementia, diabetes, cardiovascular disease, obesity, osteoporosis, atlantoaxial instability, hypothyroidism and celiac disease. Additionally, there are unique considerations regarding cancer risk and screenings, as well as vaccination. Young adults with DS should have a structured transition from pediatric to adult care like any patient with chronic illness …

Histologic Evaluation Of Late Burn Scars With And Without Dermal Substrate, Melaina Barbe, Daniel Magallanes, Sigrid A. Blome-Eberwein Md

Research Scholars

No abstract provided.

Analysis Of Physicians Who Trained And Remain At Lehigh Valley Healthnetwork, Partof Jefferson Health: Factors Influencing Satisfaction And Retention, Michela Biondi, Terri Vian, Joseph E. Patruno Md

Research Scholars

No abstract provided.

Patient Ratio Impact On Patient Safety In The Emergency Department, Erin Griffin Rn, Rhonda Leavitt Rn

Nurse Residency

How does high patient to nurse ratios effect patient outcome and satisfaction compared to lower nurse to patient ratios?

Implementation Of Acute Pain Management Protocols And Effect On Rescue Opioid Administration During Ed Stay, Victoria Nordbeck Rn, Avegail Avila Rn, Sarah Durocher Rn, Isabel Dimek Rn

Nurse Residency

In patients presenting with acute pain processes in the emergency department, how does the implementation of acute pain protocols compared to standard opioid based therapies affect needs for rescue medication and overall length of stay?