Digital Commons Network^™

Faktor Yang Berhubungan Dengan Lama Rawat Inap Pasien Demam Berdarah Dengue Di Rumah Sakit Islam Nahdlatul Ulama Demak, Akhmad Safi’I, Solikhatur Rohmah, Muhammad Zulfikar Asumta, Abdul Aziz, Masruroh Hasyim, Zulfa Khusniyah, Mukhamad Rajin

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Dengue Hemorrhagic Fever (DHF) is an acute infectious disease that often requires hospitalization with a variable length of stay (LOS). Several factors have been shown to influence LOS; however, findings from previous studies conducted in different hospitals remain inconsistent. This study aimed to analyze the association between age, gender, platelet count, hematocrit level, and leukocyte count with LOS among patients with DHF at Nahdlatul Ulama Islamic Hospital (RSI NU) Demak. This study employed a cross-sectional design using medical record data from 64 hospitalized patients with DHF admitted between January and May 2025, selected through purposive sampling. The sample eligibility criteria …

Waste Analysis Of Outpatient Waiting Time In The Obstetrics And Gynecology Polyclinic (Ob-Gyn) On Lean Healthcare Approach At X General Hospital Jember, Widian Almas Zatin, Dwi Prijatmoko, Firman Firman

Preventia: The Indonesian Journal of Public Health

In outpatient services, waiting time is one indicator of the quality of hospital services and can influence patient satisfaction. The research aims to analyze the waste of outpatient waiting time at the OB-GYN polyclinic of X General Hospital, Jember, using a lean healthcare approach. The case study for this research used a mixed-methods exploratory sequential design. Data were collected through observation, structured interviews, reviewing the standard operating procedures and the service flow, and distributing questionnaires to identify critical waste. The sequence of services was analyzed using Value Stream Mapping to identify value-added, non-value-added, and waste. Process Cycle Efficiency (PCE) was …

Association Of Lifestyle, Nutritional Status, And Eating Habits With Academic Performance Among Adolescents, Lulu'ul Badriyah, Farah Paramita, Rachmy Rosyida Ro'is, Shanica Yohana Veronica, Alifia Meida Indrayati, Randy Gustawan

Preventia: The Indonesian Journal of Public Health

Health is an important factor in determining academic performance. This study aims to analyze the relationships between lifestyle, nutritional status, eating habits, and academic achievement among high school students. The study used a cross-sectional design with a sample of 131 students from four schools in Malang City, Malang Regency, Batu City, and Pasuruan Regency. Data were collected through interviews, anthropometric measurements, and the SQ-FFQ and IPAQ questionnaires. Analysis was performed using the Chi-Square test. The results showed that most respondents slept less than 8 hours (58.8%), used smartphones for ≥ 8 hours per day (50.4%), had moderate physical activity (52.7%), …

Extracellular Vesicles In Adult Acute Myeloid Leukemia, Haniatul Qomariya, Fitrotin Azizah, Yetti Hernaningsih

Folia Medica Indonesiana

Acute Myeloid Leukemia (AML) is an aggressive hematologic malignancy marked by uncontrolled expansion of immature myeloid cells and disruption of normal hematopoiesis. Beyond genetic abnormalities, accumulating evidence demonstrates that leukemic progression is strongly shaped by intercellular communication within the bone marrow niche. Extracellular vesicles (EVs), including exosomes and microvesicles, have emerged as key mediators of this communication, transporting bioactive molecules that influence leukemic cell behavior, immune responses, and treatment sensitivity. This systematic review synthesizes current findings on EVs in adult AML, focusing on their biogenesis, molecular cargo, roles in disease pathogenesis, diagnostic and prognostic relevance, and therapeutic potential. Following PRISMA …

Spatio-Temporal And Determinants Of Hiv Incidence Among Msm In Jember Kidul, Indonesia, Siswi Wijayanti, Budi Utomo, Musofa Rusli

Folia Medica Indonesiana

Human immunodeficiency virus (HIV) remains a major public health issue, particularly among men who have sex with men (MSM), who are estimated to have more than 20-fold higher risk of HIV infection than the general population. In Indonesia, MSM are disproportionately affected, with surveillance data showing steady annual increases. In Jember Regency, East Java, HIV cases have risen over the past decade, with MSM contributing significantly to new diagnoses. Despite available therapy and prevention programs, transmission persists, suggesting geographic and social factors play a role. Spatio-temporal analysis using Geographic Information Systems (GIS) and spatial statistics such as Moran's I and …

The Pivotal Role Of Artificial Intelligence In Optimizing Pharmaceutical Formulation And Delivery, Ali Khidher Abbas, Mustafa M. Noori, Ibtihal Abdulkadhim Dakhil, Mohammed Hussain Al-Mayahy

Al-Esraa University College Journal for Medical Sciences

Artificial intelligence (AI) has emerged as a transformative technological paradigm within the pharmaceutical sciences, offering innovative and forward-looking solutions to surmount the inherent limitations associated with conventional drug development, formulation design, and therapeutic delivery systems. Traditional pharmaceutical methodologies frequently entail protracted development timelines, extensive experimental procedures, and substantial financial expenditures, particularly within the domains of formulation optimization and drug delivery design. The integration of AI-driven technologies – encompassing machine learning (ML), deep learning (DL), artificial neural networks (ANNs), and predictive analytics – has considerably accelerated pharmaceutical research by refining decision-making processes, alleviating experimental burden, and enhancing formulation efficiency. The present …

Some Pathogenic Agents Isolated From Gento-Urinary Tract Of Females Patients In Baghdad Area, I. M. Al-Saqur, A. N. Al-Thwani, E. M. Abdul Ameer, S. W. Abd-Al-Zhra, M. K. Sahan, H. S. Ferman, A. A. Hassan, H. M. Hassan

Al-Esraa University College Journal for Medical Sciences

The Urinary Tract Infection (UTI) represents a significant global health burden and the pathogens which inhibit the geneto - urinary Tract (GUT) of women cause devastating consume. In this study investigation UGT were carried out through examination of 186 women (183 married and 65 unmarried) who attended Damascus Private Medical Center-Baghdad, through the period from the beginning of January 2023 to the end of August 2023. Detection were conducted according to the standard methods after macroscopically and macroscopically examination of u samples. The results, indicated that 121 (65.05%) were infected and married women had high infection (78.86%) than the unmarried …

Endophytic Actinobacteria: Deciphering Therapeutic And Industrial Potential, And Prospects Of Genome Mining In Novel Products Discovery, Yusra Waheed, Rabia Shahdin, Imran Sajid

Journal of Bioresource Management

Endophytic actinobacteria are a diverse group of Gram-positive bacteria with high G+C content, which inhabit plants’ internal tissues, and represent a significant yet underexplored reservoir of bioactive secondary metabolites. In host plants, a remarkable repertoire of metabolites, including broad-spectrum antibiotics, anticancer, antiviral, antifungal, antioxidant, and immunomodulatory compounds, is synthesized by these microbial allies, carrying significant medicinal and agricultural potential. These endophytes, in contrast to their soil relatives, have developed unique biosynthetic gene clusters (BGCs) strongly influenced by plant-associated factors, leading to the production of structurally novel metabolites. In recent years, the advances in genome mining, metagenomics, and metabolomics have accelerated …

Activities Of Daily Living Limitations In Middle-Aged And Older Adults With Joint Disorders And Osteoporosis: Indonesia Longitudinal Aging Survey 2023, Desfalina Aryani, Mufti As Siddiq As Siddiq M. Irzal, Agustina Sianipar

Jurnal Epidemiologi Kesehatan Indonesia

Population ageing is associated with an increasing prevalence of limitations in activities of daily living. Joint disorders and osteoporosis are common health problems among older adults and may begin to emerge during middle age, potentially accelerating functional decline. However, studies examining the association between these conditions and limitations in activities of daily living in Indonesia remain limited. This study aimed to analyse the association between joint disorders and osteoporosis and limitations in activities of daily living among middle-aged and older adults in Indonesia. This study employed a cross-sectional design using data from the Indonesia Longitudinal Aging Survey (ILAS) 2023. The …

Glucose-Lowering Effects Of Epigallocatechin Gallate And Metformin In Diabetic Zebrafish Models: A Systematic Review And Meta-Analysis, Dinda Ayu Permatasari, Abdul Khairul Rizki Purba, Maftuchah Rochmanti, Rizky Alvian Adi Kurniawan, Shilvi Haliza Pratiwi

Folia Medica Indonesiana

Metformin is widely recognized as an effective glucose-lowering agent for type 2 diabetes mellitus, while epigallocatechin gallate (EGCG) has exhibited promising antidiabetic and antioxidant properties in experimental settings. This systematic review and meta-analysis aimed to assess the impact of EGCG and metformin on blood glucose concentrations in diabetic zebrafish models and to synthesize the related metabolic and mechanistic findings. The protocol was registered with PROSPERO (CRD420261461237) and the review was conducted in accordance with PRISMA 2020 guidelines. Comprehensive searches were performed in PubMed/MEDLINE, Scopus, Web of Science, and Embase for in vivo zebrafish studies published from January 2010 to August …

Promoting The Hpv Vaccine Across The League Of Arab States: A Scoping Review Of Interventions, Basil H. Aboul-Enein, Patricia J. Kelly, Fatmah Almoayad, Teresa Keller

College of Nursing Faculty Papers & Presentations

INTRODUCTION: This scoping review examined existing interventions designed to promote and educate about HPV vaccination in the league of Arab states (LAS).

METHODS: Following PRISMA-ScR guidelines and using a PICOS-informed approach, a comprehensive search was conducted across 16 databases to identify peer-reviewed intervention studies published between 2010 and August 2025.

RESULTS: Twenty-two studies met the inclusion criteria. Most interventions originated from Egypt and Saudi Arabia and were delivered in academic or clinical settings using short, didactic, one-group pre-post designs. Only a few studies incorporated behavioral theories, digital modalities, or multi-component strategies. Nearly all studies reported short-term improvements in HPV-related knowledge …

Application Of Toast Criteria, Comorbidities And Outcomes In Patients With Ischemic Stroke: Multicenter Collaboration In The Dominican Republic, Ryna Then, Maria Muñoz, Cristina Ramos, Marcos Mota, Priscilla Sepulveda, Lisa José, Luis Suazo, Francisco Mendez, Yahaira Franco, Cosme González Villamán, Acela Gonell, Violiza Inoa, Gillian Gordon Perue, Manuel Colomé-Hidalgo, Nadja García

Einstein Health Papers

INTRODUCTION: Stroke is a leading cause of neurological-related death in the Caribbean. The Dominican Republic has among the highest stroke-related mortality rates in the Americas. We aimed to determine ischemic stroke etiologies, characterize comorbidities, and describe outcomes in the Dominican Republic using the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification.

METHODS: We analyzed a multicenter quality registry between January 2022 and October 2024. Statistical analyses included Mann–Whitney U and Kruskal–Wallis tests with Bonferroni correction, chi-square tests, and Spearman correlation.

RESULTS: The most common stroke subtype was undetermined etiology (54.8%), followed by large artery atherosclerosis (17.2%) and cardioembolism …

Kelelahan Kerja, Kualitas Tidur, Dan Pengetahuan Mengemudi Defensif Sebagai Faktor Risiko Perilaku Defensive Driving Pada Pengemudi Grabcar Malang, Elisa Lutfiyah Azizah, Dian Puspitaningtyas Laksana, Marji Marji, Agung Kurniawan

National Journal of Occupational Health and Safety

Online transportation activities contribute to the increasing volume of vehicles, particularly GrabCar drivers in Malang City, which has the potential to worsen traffic congestion. Identification results showed that GrabCar drivers experienced drowsiness while driving and work fatigue due to the habit of working at night and for more than eight hours per day, accompanied by limited understanding related to defensive driving. This study aimed to determine the effect of work fatigue and knowledge, as well as differences in sleep quality scores, on defensive driving behavior. This study employed an observational analytic design with a cross-sectional approach involving 87 GrabCar drivers …

Enhancing Research Communication With Visual Tools, Sonya Fogg

Library Class: Lunch & Learn

Understand the role of visual communication in medical research. Distinguish between data visualizations, infographics, and visual abstracts. Identify best practices and some resources and tools for creating effective visuals.

Antiseizure Drug Adherence In Pediatric Patients With Epilepsy And The Associated Factors In Saudi Arabia, Ola A Shawky, Shaima A Althoubaiti, Reham M Alkahtani, Amirah S Alharthi

Neurosciences

Objectives: To assess the prevalence of adherence to antiseizure medications and related factors in Saudi Arabia. Pediatric epilepsy presents significant challenges to the well-being and quality of life of children. Adherence to antiseizure medication is associated with better outcomes.

Methods: This study was carried out using a cross-sectional methodology to determine the prevalence of antiseizure medication adherence among children with epilepsy aged ≤ 17 years in Saudi Arabia. Data were collected between July and September 2024 via an online self-administered questionnaire, using convenience sampling through social platforms (Telegram and WhatsApp). Medication adherence was assessed using the MMAS-8 and categorized as …

Marshallese Female Caregivers’ Intention To Seek Pediatric Care For Their Children, Ages 2–5, With A Body Mass Index At Or Above The 95th Percentile, Living In Northwest Arkansas, Madicyn Huddleston Freeman

Walden Dissertations and Doctoral Studies

No abstract provided.

Wearable Sensor Technology And Biomechanical Gait Analysis In Post-Stroke Rehabilitation: A Review With Implications For The Saudi Healthcare System, Abdullah H. Alzahrani

Neurosciences

Stroke remains a major cause of disability worldwide, with gait impairment affecting up to 80% of survivors and contributing to long-term dependence, fall risk, and reduced quality of life. In Saudi Arabia, stroke incidence is rising, with a significant burden on younger populations and disparities in access to post-stroke rehabilitation services. Conventional gait analysis tools rely on expensive, specialized laboratory equipment, which limits their availability in low-resource and rural settings. Recent advances in wearable sensor technologies, including inertial measurement units, pressure insoles, and electromyography systems, offer portable, scalable, and cost-efficient options for assessing gait in real-world environments. These systems can …

Lupus Vulgaris On The Left Arm Mimicking A Skin Tumor: A Case Report, Dwi Indria Anggraini, Nuriasani Yukendri, Indri Windarti

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Lupus vulgaris (LV) is a rare, paucibacillary form of post-primary cutaneous tuberculosis, accounting for 1.5% of all extrapulmonary tuberculosis cases globally. LV may arise via hematogenous spread, lymphatic route, or contiguous dissemination. The present case highlights the importance of considering LV in patients with chronic and atypical skin lesions, particularly in tuberculosis-endemic areas.

Case Illustration: A 17-year-old female presented with a 2-month history of a solitary, tender, erythematous nodule on the left arm. Initially suspected as a skin tumor, the lesion was surgically removed and tested for biopsy. One month postoperative, a new lesion developed precisely at the same …

Components Of Skin Boosters: A Therapeutic Role In Dermatologic Conditions, Ita Anggraini, Yuwandita Tamara Putri Dermawan, Eka Komarasari, Prima Kartika Esti

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: The term “skin booster” is commonly referred to in dermatology. These products may comprise several components, including exosomes, secretomes, chitosan, polydeoxyribonucleotide, platelet-rich plasma, and hyaluronic acid. In today’s world, the use of such products is not confined to aesthetic purposes; they are also used to treat several other skin conditions. This review paper highlights the role of “skin booster" components for different skin disorders based on their in vitro, in vivo, and clinical studies.

Discussion: “Skin boosters” are bioactive agents typically administered into the dermal layer. Understanding the mechanisms of each component is important because their applications extend beyond …

Exploring Pediatric Leprosy In An Endemic Area: Case Series Of Eight Patients In Indonesia, Gitalisa Andayani Adriono, Tri Rahayu, Sri Linuwih Sw Menaldi, Nelfidayani Nelfidayani, Retno Sulistyo Wardani, Kahlil Gibran, Malika Sabrina Yunifananda, Kartika Qonita Putri, Yunia Irawati

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Leprosy remains a significant public health concern in endemic regions such as Indonesia. Children are particularly vulnerable due to their naive immunity and close familial contacts. This study aims to report cases of pediatric leprosy in Lembata, Indonesia, focusing on clinical characteristics and associated risk factors.

Case Illustration: A case series of eight pediatric patients (<15 >years) diagnosed with leprosy was conducted during a community-based screening program in Lembata, Indonesia, in 2022. Of 140 individuals examined, 8 were children. Most patients were male (6/8) with a mean age of 11.75 years. Multibacillary (MB) leprosy predominated (7/8), and a history …

Online Rights Defense Among Chinese Americans Against Racial Aggression In The U.S. During The Covid-19, Fangzhu Lu, Wenshan Jia

Communication Faculty Articles and Research

Purpose

This study investigates how Chinese American communities responded to heightened racial discrimination during the COVID-19 pandemic by utilizing social media platforms to safeguard their civil rights, articulate collective concerns, and mobilize resistance against racial aggression.

Methodology

Through qualitative case study analysis, the research examines the social media activities of six advocacy organizations, including three X accounts (WashTheHate, Chinese for Affirmative Action, Asian Americans Advancing Justice) and three Instagram accounts (Stop AAPI Hate, Stop Asian Hate, Advancing Justice: AAJC). The analysis focuses on the content strategies and communication mechanisms employed to counteract racial hostility.

Findings

The selected organizations used social …

Implementasi Lean Management Untuk Efisiensi Pengelolaan Linen Dan Kesesuaian Standar Pencegahan Dan Pengendalian Infeksi Di Rsu X, Rionugrah Sari, Alih Germas Kodyat, Apri Sunadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Linen management is an important process in hospitals that is directly related to service quality and Infection Prevention and Control (IPC) efforts. This study aimed to analyze the implementation of Lean Management in linen management at the laundry unit of RSU X and to evaluate its contribution to improving process efficiency and strengthening IPC practices. The study employed an operational research design with a qualitative approach through observation, in-depth interviews, and document review. Data analysis was conducted using Value Stream Mapping, waste identification based on the eight waste concept, and root cause analysis using the 5 Whys method. The results …

Community Perceptions And Hospital Selection In Depok: A Comparative Study Of Rsud Anugerah Sehat Afiat And Competitors Based On The 5a Framework, Iva Nur Faridah, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

RSUD Anugerah Sehat Afiat (ASA) Depok faces challenges in enhancing service utilization and competitiveness as a public hospital in the increasingly competitive healthcare environment of eastern Depok City. This study aimed to identify factors influencing community preferences in hospital selection and to determine appropriate positioning strategies for RSUD ASA. A mixed-methods case study design was employed. Quantitative data were collected from 132 respondents aged over 25 years who had visited four hospitals included in the study, using structured questionnaires. Qualitative data were obtained through in-depth interviews with eight key informants representing RSUD ASA management. Data analysis was based on five …

Pengetahuan Dan Motivasi Meningkatkan Penggunaan Aplikasi Mobile Jkn Pada Pasien Bpjs Di Instalasi Rawat Jalan Rsd Idaman Banjarbaru, Salbia Putri Kanzha Khairunnisa, Raziansyah Raziansyah, Fahriadi Fahriadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The development of digital health services encourages the use of the Mobile JKN application to enhance access and service efficiency for BPJS participants. However, its utilization remains inconsistent due to limited knowledge of its functions and low motivation to use it. This study examined the relationship between knowledge and motivation with the use of the Mobile JKN application among BPJS patients at the Outpatient Installation of RSD Idaman Banjarbaru in 2025. This study employed a quantitative approach with a cross-sectional design. The population comprised 10,478 BPJS patients, while the sample consisted of 100 outpatient BPJS patients who used the Mobile …

Gambaran Administrasi Rekam Medis Semi-Digital Berdasarkan Pendekatan 5m Dan Poac Di Rsu X Kota Depok Tahun 2025, Dewi Shinta, Risky Kusuma Hartono, Malihah Ramadhani Rum

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Medical record administration is an essential component in supporting healthcare service quality. During the transition toward Electronic Medical Records (EMR), many hospitals still use semi-digital systems that combine conventional and electronic processes. This study aimed to describe semi-digital medical record administration at RSU X, Depok City, based on the Man, Money, Material, Method, and Machine (5M) management elements and the Planning, Organizing, Actuating, and Controlling (POAC) management functions. This study employed a descriptive qualitative approach through in-depth interviews and observations involving five informants. The results showed that the semi-digital system operated through the parallel use of physical medical records and …

Exfoliative Cheilitis Treated With Homoeopathic Medicine Nitricum Acidum: A Case Report, Dinesh Sura, Niharika Shaw, Rubina Bashir, Chintamani Nayak

Indian Journal of Research in Homoeopathy

Introduction: Exfoliative cheilitis is an uncommon, persistent inflammatory disorder that impacts the vermilion border of the lips, characterised by ongoing peeling, dryness, and occasional bleeding. The condition can be resistant to conventional treatment and often causes significant emotional distress. Case Summary: A 16-year-old male presented with chronic dry, scaly eruptions on his lips, accompanied with a burning sensation and bleeding for the past 8 months. He reported anxiety about his appearance and also about his father's health. Based on a thorough evaluation of his overall symptoms and repertorial analysis, he was prescribed a single dose of Nitricum acidum 200C. By …

Athletic Training Preceptors' Accuracy In Assessing Ai-Generated Clinical Scenarios Aligned With Caate Educational Standards, Elisabeth (Beth) Shoulders

Graduate Theses, Dissertations, and Capstones

Athletic training preceptors play a critical role in clinical education by evaluating student competence; however, little is known about their preparedness to assess competency-based standards, particularly when using emerging tools such as artificial intelligence (AI). The purpose of this study was to examine preceptors’ accuracy in applying Commission on Accreditation of Athletic Training Education (CAATE) standards and classifying student proficiency within AI-generated clinical scenarios, and to determine whether accuracy differed based on preceptor characteristics.

This quantitative, cross-sectional study included Board of Certification-certified athletic trainers who had served as preceptors within the past five years (N = 68). Participants completed an …

Closing The Gaps: Reforming Maryland Controls On Veterinary Antimicrobial Distribution, Samantha Capaldo, Kerry Mcclaughry

Journal of Food Law & Policy

Antimicrobials have been used in livestock and other food animals in the United States (“U.S.”) since the late 1940s. An antimicrobial is “[a]ny natural, synthetic, or semisynthetic substance that can eradicate or prevent the growth of microbes,” including “[a]ntibacterial, antifungal, antiparasitic, and antiviral medications.” Antimicrobial use in food animals is subject to a complex statutory and regulatory framework at both the state and federal levels. Antimicrobial use in food animals has been widely criticized for contributing to antimicrobial-resistant bacterial infections in humans. In response to this criticism, the U.S. Food and Drug Administration (“FDA”) and several states, including Maryland, have …

Proceedings Of The 25th International Symposium On Adapted Physical Activity: Easy Read Edition Of The Symposium Proceedings, Catherine Carty, Niamh Cronin, Ian Coleman Horgan, Stuart Dodd, Jack Dowling, Lydia Murphy, Alex Nicholls, Yann O'Carroll, Robbie O'Neill, Meabh Rohan, Brandon Rumian, Diarmuid O'Connor, Eamonn Carroll, Gerard O'Carroll, Jasmin Richter, Mary Shanahan, Aaron Doherty, Sasha Fitzgerald, Katie Lyons, Katie Mahoney, Afeefah Memon, Conor Moriarty, Adrian O'Sullivan, Dylan Shine, Michelle Enright, Phil Mcsweeney, Sophie Casey

Publications

This book is the Easy Read Proceedings of the 25th International Symposium of Adapted Physical Activity (ISAPA 2025), hosted by Munster Technological University under the Patronage of UNESCO. A small number of printed books are available in MTU libraries, and there is a digital version available online on the South West Open Research Deposit.

The Roots Of Sexual Violence In Utah: A Framework For Understanding Harm, Susan R. Madsen

Marketing and Strategy Faculty Publications

Sexual violence in Utah is not an anomaly, a private tragedy, or the result of individual deviance. It is a patterned, predictable outcome of cultural norms, social systems, and power structures that shape how people understand gender, authority, and worth. Despite Utah’s reputation for strong families, close‑knit communities, and deep religious commitment, the state continues to report higher‑than‑national‑average rates of rape, child sexual abuse, and other forms of gender‑based harm. These realities demand a deeper understanding of why violence persists—and what can be done to prevent it.

This white paper synthesizes decades of national and international research, Utah‑specific data, and …