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Impact Of Palliative Care Consultation On Clinical Interventions And Outcomes In A Medical-Surgical Community-Based Intensive Care Unit, Manjot S. Malhi, Jude Tabba, Aunie M. Danyalian, Michele Iguina, Daniel Zapata, Raiko Diaz, Dionne Morgan, Daniel Heller, Sanaz Kashan, Mauricio Danckers

HCA Healthcare Journal of Medicine

Background

Integrating palliative care into intensive care unit (ICU) practice is an essential component of comprehensive patient management, ensuring that critical interventions are aligned with patient-centered care objectives. This study aims to evaluate the impact of palliative care consultation (PCC) on clinical interventions, patient outcomes, and decision-making processes in a community-based medical-surgical ICUs.

Methods

We conducted a prospective, observational, single-center cohort study of critically ill adult patients in a community-based medical-surgical ICU. Patients were grouped by the presence (PCCP) or absence (PCCA) of palliative care consultation. Primary outcomes included differences in clinical interventions (mechanical ventilation, vasoactive medications, renal replacement therapy, …

The Culture Cure: Behavioral Supervision And The Regulation Of Financial Institutions, David B. Lourie

Mercer Law Review

This Article advances a normative claim: U.S. financial regulators must move beyond primarily adversarial, enforcement-driven models and adopt behavioral supervisory tools—particularly elements of culture assessments—to proactively help guide ethical firm conduct and mitigate systemic risk. Importantly, the proposal here is incremental and resource-efficient. Many recommendations place the onus on firms to assess and demonstrate their culture, while regulators set expectations, review outputs, and selectively verify findings. The framework proceeds in progressive stages—beginning with voluntary, partnership-based initiatives, moving toward light-touch integration within existing examinations, and scaling only where persistent governance weaknesses or systemic risks warrant closer attention. This tiered approach reflects …

Choosing China: Unpacking The Motivations Of International Students Through A Case Study In Shanghai, Yu Zhang, Tian Qin, Xiaoqiao Zhang

Health Care Administration Faculty Research

The internationalization of higher education continues to accelerate with globalization, making China one of the top host nations for international students. This qualitative case study took place at a university in Shanghai, with 76 international students from 20 countries enrolled in the same English-taught engineering program. This research explored the motivations of international undergraduate students pursuing degree programs and their overall experience in China. The research reveals four main factors that shape students’ decision-making: academic reputation, social network influence, affordability, and safety. Additionally, many students identified academic difficulties even as they acknowledged the benefits of studying in China. This study …

Requesting Less, Winning More: A Plaintiff Strategy To Eliminate Low-Value Anchors, Emily V. Shaw, Jade E. Larson

Mercer Law Review

Picture this: You are a plaintiffs’ lawyer representing a permanently injured client in a high-stakes lawsuit. You think you can earn millions of dollars for your client based on their injuries—but something is holding you back: your client’s past medical bills. To date, she has only had to pay around $20,000. You worry that this fact might make your request for several million dollars in non-economic damages seem excessive to a jury. So, you make a plan: on the eve of trial, you withdraw your request for economic damages and stick to only requesting non-economic damages in the millions. There …

Achieving And Sustaining Treatment Targets In Rheumatoid Arthritis: A Retrospective Cohort Analysis In Indonesia, Fara Fauzia, Rudy Hidayat, Suryo Anggoro Kusumo Wibowo, Sumariyono Sumariyono, Faisal Parlindungan, Anna Ariane, Johanda Damanik, Abirianty Priandani Araminta, Suci Damaratri

Kesmas

Achieving and sustaining low disease activity (LDA) and remission in rheumatoid arthritis (RA) remains challenging. This study examined the rates and predictors of LDA/remission and sustained LDA/remission in an Indonesian RA cohort. A retrospective study of newly diagnosed adult patients attending a rheumatology clinic in 2020-2021 was conducted. Patients were followed for 12 months to evaluate achievement of LDA/remission, defined as DAS28-ESR ≤3.2, and those meeting the target were observed for an additional 12 months to evaluate sustained LDA/remission. Cox regression was used to identify predictors of time to LDA/remission and loss of LDA/remission. Of 166 participants, 91 (54.8%) achieved …

Factors Associated With Antiretroviral Therapy Adherence In Patients With Hiv At A Public Hospital In Central Jakarta, Indonesia, Kareena Sari Fatimah, Laily Hanifah, Chandrayani Simanjorang, Nayla Kamilia Fithri

Kesmas

Patients with human immunodeficiency virus (HIV) are required to take antiretroviral therapy (ART) to suppress the virus. However, suboptimal adherence remains a critical barrier that can lead to treatment failure and persistent transmission risks. This study aimed to identify factors associated with ART adherence in patients with HIV. This quantitative study with a cross-sectional design consisted of patients with HIV aged >18 years who received care at the voluntary counseling and testing clinic of a public hospital in Jakarta, Indonesia. Purposive sampling was used. This study used HIV care and ART overview forms as instruments. Data were analyzed using multiple …

Addressing Health Inequities For People With Intellectual And Developmental Disabilities In The Hospital Through Partnerships In Nurse Training, Suzannah Iadarola, Amanda Laprime, Samantha Hochheimer, Tabby Anvari, Carrie Baker, Jacqueline Goodman

Developmental Disabilities Network Journal

People with intellectual/developmental disabilities (IDD) deserve the same access to quality healthcare yet are at increased risk of medical and/or psychiatric conditions as compared to the general population. Patients with IDD have less health satisfaction, shorter life expectancy, less access to preventative care, higher chronic health conditions, overuse of certain medications, and increased mortality. This population and their caregivers report high levels of dissatisfaction with emergency/inpatient care. Nurses also express frustration with lack of training, limited resources, and competing priorities.

We developed the Advancing Supportive Care through Education for Nurses on Disability (ASCEND) Program, to build the capacity of inpatient/Emergency …

Cv: Dena Hinkle (Nursing), Dena Hinkle

Nursing Department Faculty Curricula Vitae

No abstract provided.

Bridging The Intention-Implementation Divide In Generative Ai Adoption: An Integrated Model Of Psychological, Behavioral And Social Drivers, Mohamed Walid Mohamed Lotfy Abdallah

USF Tampa Graduate Theses and Dissertations

This dissertation examines the gap between professionals’ intentions to use Generative Artificial Intelligence (AI) and their actual adoption behavior in workplace settings. Although Generative AI offers substantial potential to improve efficiency and performance, concerns about control, misuse and organizational risk have led to inconsistencies between intended and enacted use. Motivated by this misalignment, the study investigates the psychological, behavioral and social mechanisms that shape the intention-implementation divide. Drawing on an integrated framework combining the Theory of Planned Behavior and the Technology Acceptance Model, alongside personality traits, the research conceptualizes adoption as a phase-specific process involving evaluative, motivational and volitional components. …

A Comparative Effectiveness Trial For Universal Psychosocial Screening With The Psychosocial Assessment Tool (Pat) Across 18 Childhood Cancer Programs In The United States: Adoption, Penetration, And Health Equity, Lamia P. Barakat, Michele A. Scialla, Nithyasri Ramaswamy, Janet A. Deatrick, Kamyar Arasteh, Eric Sandler, Shannon N. Hammer, Anne E. Kazak

Department of Pediatrics Faculty Papers

BACKGROUND: Universal, systematic psychosocial screening in childhood cancer assures care matched to need and achieves a Standard of Psychosocial Care. It is accomplished inconsistently due to barriers at the family, provider, and institution level, potentially contributing to disparities in care and outcomes. We conducted a comparative effectiveness trial of two implementation strategies of an established measure (Psychosocial Assessment Tool; PAT3.0) across 18 children's cancer programs to identify strategies that resulted in higher levels of screening in English and Spanish (penetration, health equity). We also examined uptake at the institution level (adoption).

METHODS: Sites were randomized to Strategy I (web-based training …

Frequency And Self-Reported Outcomes Of Transcranial Magnetic Stimulation For Obsessive Compulsive Disorder In The U.S. And Latin America, Jacey L Anderberg, Javier Vargas-Medrano, Diana Sotelo, Demi Kourtesi, Renee M Frederick, Josselyn S Muñoz, Dayan Berrones, Vanessa Zavala Cruz, Peter Thompson, Silvina Tonarelli, Andrew D Wiese, James J Crowley, Eric A Storch

Faculty, Staff and Students Publications

Introduction: Obsessive compulsive disorder (OCD) affects about 1-2% of the global population, with roughly 30% of patients not responding to first-line treatments. Transcranial Magnetic Stimulation (TMS) has some support for treatment-resistant OCD but global use is unclear.

Methods: This study describes the frequency with which TMS was reported to be received among a large cohort of individuals who self-identified as Latino-Hispanic in Latin America and the United States. Among 3,391 participants, 76 (2.2%) had completed TMS for OCD.

Results: Recipients who received TMS exhibited more severe current and lifetime OCD symptoms compared to non-recipients. On average, participants underwent 22.61 TMS …

Merritt-Putnam Symposium | Tumor-Associated Epilepsy And Epilepsy-Associated Tumors: Exploring The Bidirectional Crosstalk Between Tumors And Seizures, Benjamin Deneen, Catherine A Christian-Hinman

Faculty, Staff and Students Publications

Links between cancerous and noncancerous brain tumors and epilepsy have long been recognized. However, recent clinical and preclinical studies emphasize that not only do tumors impinge on surrounding brain tissue in ways that promote hyperexcitability and epileptogenesis, but that neural activity also influences tumor progression. In this review, inspired by the Merritt-Putnam Symposium of the 2025 meeting of the American Epilepsy Society, we present a cross-disciplinary dialog between cancer and epilepsy research, including discussion of tumors and epilepsies that are more prominent in pediatric versus adult populations. First, we discuss the neuropathology, genetics, and surgical outcomes of epileptogenic brain tumors, …

Marital Satisfaction And Social Media Use: A Comparative Study Based On Addiction Levels, Fatma Ayhan, Elif Arık, Merve Gülsüm Saçan, Zehra Sevim, Esme Arguç

Makara Human Behavior Studies in Asia

In recent years, the widespread use of social media platforms has raised questions about their impact on marital relationships. This study examined the relationship between marital satisfaction, social media use, and certain sociodemographic characteristics. This descriptive and cross-sectional study comprised 461 individuals residing in Turkey who had been married for at least one year. Data were collected using the Bergen Social Media Addiction and Marital Satisfaction Scales. Statistical analyses included t-tests, analysis of variance, and multiple linear regression analysis. Social media addiction was high among 16.5% of the participants. Marital satisfaction was higher among males, those who married at age …

Recognizing Structural And Social Determinants Of Health In The Diagnosis And Care Of Dementia, Shana D Stites, Sharnita Midgett, Nisha Patel, Kimberly Halberstadter, Rosalie Schumann, Marissa L Streitz, Yidan Shi, John C Morris, Jason Flatt, Crystal M Glover, Dawn Mechanic-Hamilton

2020-Current year OA Pubs

Structural and social determinants of health are environmental conditions that affect individuals' health and functioning across the life course. These determinants are salient factors at the apex of individual psychology, community variables, and larger sociological factors, exerting prominent effects on individuals' wellbeing. The National Institute on Aging seeks to understand their influence on aging and Alzheimer's disease. We propose that the benefits of doing so may reach beyond knowledge of disease mechanisms - it may also improve clinical outcomes. We describe efforts introducing structural and social determinants of health data into the national network of Alzheimer's disease research centers. We …

An Interoperable Vaccine Record: A Roadmap To Realization, Paul G Biondich, Yang Gong, Dean F Sittig

Faculty, Staff and Student Publications

Objectives: The objectives of this study were to educate the healthcare professional and the general public about interoperable vaccine records by elaborating on its definition, why we need one, what the challenges are, and what progress has been made in this direction.

Methods: The vaccination practices and vaccine record-keeping in the Nordic countries, the UK, and the USA are used as examples to demonstrate the necessity of interoperable vaccine records. The authors' expertise and experience in interoperability, medicine, and HealthIT, along with the literature, informed this paper's content, structure, and organization. Real-world examples and scenarios illustrate the reality …

A Glimpse Into The Impact Of Physical Activity On Linear Growth In Children And Adolescents Through Activity Restrictions Accompanying The Covid-19 Outbreak, Yi-Chun Lin, Wen-Ling Liao, Chung-Hsing Wang, Fuu-Jen Tsai

BioMedicine

Background: Linear growth in children and adolescents, a key health indicator, is influenced by various factors, including physical activity (PA). The COVID-19 lockdown in Taiwan created a unique opportunity to examine the effect of PA restrictions on growth.

Methods: This retrospective cohort study was conducted at two hospitals in central Taiwan. The study included 72 children and adolescents (26 males, 46 females) who attended a growth clinic. Height and weight measurements were recorded in three stages: pre-lockdown, during lockdown, and post-lockdown. Growth rates were compared across stages using paired t-tests.

Results: The average growth rate was lowest during lockdown (0.0181 …

Supporting Evidence-Based Responses To Emotional Needs In Emphysema (Serene): Protocol For A Randomized, Open-Label Mechanistic Trial Comparing Coping Skills Training And Disease-Specific Education For Depressive Symptoms Conducted In United States Health Systems, Joanna L. Hart, Daniel Carter, Chloe Hinton, James Grilli, Lily A. Brown, Nora Brier, Yingying Lu, Casey Whitman, Michael O. Harhay, Michael Sims, Carmen Alvarez, Lisa R. Miller-Matero, C. Virginia O'Hayer

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND: Depressive symptoms and anxiety are highly prevalent among people with chronic obstructive pulmonary disease (COPD), strongly associated with poor outcomes, and rarely recognized or treated. Integrating families into interventions may amplify supportive care treatment effects and overcome common challenges, yet this strategy is understudied. The Supporting Evidence-based Responses to Emotional Needs in Emphysema (SERENE) trial's main objective is to identify the mechanisms through which a family-partnered Coping Skills Training (CST) reduces depressive symptoms among patients with COPD, testing five putative mechanisms: family relationship quality, patient and caregiver self-efficacy, patient loneliness, and caregiver psychological distress.

METHODS: SERENE will enroll 375 …

Comparison Of The Mars And Xgboost Algorithms For Predicting Body Weight In Kalahari Red Goats, Louis Thobela Tyasi, Cem Tirink, Kwena Mokoena, Hasan Önder, Uğur Şen, Demet Çanga Boğa, Tolga Tolun, İsmai̇l Gök, Yüksel Aksoy, Lütfi̇ Bayyurt, Ömer Faruk Yilmaz

Turkish Journal of Veterinary & Animal Sciences

Estimating goat body weight from morphometric traits is essential for growth monitoring, health management, and welfare. Accurate weight informs nutrition, clinical interventions, and mating decisions. In this study, the MARS and XGBoost algorithms were used to estimate the live weight of Kalahari Red goats based on body measurements. A dataset containing body length (BL), birth type (single, twin, or triplet), withers height (WH), rump height (RH), and heart girth (HG) information for 200 goats was used in the training and testing of the models. The performances of the models were evaluated with the goodness-of-fit criteria. XGBoost showed a performance of …

Encapsulation Of Cannabidiol In Chitosan-Stabilized Argan Oil Nanoemulsion As A Potential Dermal Drug Delivery System For Psoriasis Treatment, Yousra Mdarhri, Vinicius De-Monte-Vidal, Camila De-Almeida-Perez-Pimenta, Selene Cuello-Rodríguez, Ahmed Touhami, Fakhita Touhami, Mohamed Chabbi, Victoria Díaz-Tomé

Physics & Astronomy Faculty Publications

Background: Cannabidiol (CBD), a non-psychoactive compound derived from Cannabis sativa, exhibits therapeutic potential for various conditions, including inflammation, pain, and skin disorders, making it a promising candidate for the topical treatment of psoriasis. However, its poor water solubility and instability limit its therapeutic efficacy. This study focuses on the development and characterization of CBD-loaded nanoemulsions using argan oil as the lipid phase, with and without a chitosan coating, which serves as a stabilizing and functional biopolymer. Methods: Nanoemulsions (NE) and chitosan-stabilized nanoemulsions (CS-NE), both without CBD (serving as controls), and CBD-loaded variants (CBD-NE and CBD-CS-NE) were prepared and characterized for …

Expansion Of A Self-Guided Curriculum And Validation Of A Self-Assessment Tool For Ocular Examination Skills, Maria Lee, Irene Pak, Aryan Chaychian, Isabell Kassaye, Adam Alyafaie, Neeti Parikh, Madeline Yung

Journal of Academic Ophthalmology

Background: Public interest in vision health is growing, yet ophthalmology remains underemphasized in medical education due to time constraints associated with in-person instruction.

Purpose: To demonstrate effectiveness of self-guided e-learning modules for ocular examination skills and to determine whether self-assessments can reliably assess medical student proficiency in these skills.

Methods: Medical students at a single institution participated in a skills workshop. Group 1 completed self-guided modules for visual acuity, confrontational visual field testing, pupil examination, and extraocular motility evaluation. Group 2 completed a self-guided module for the slit lamp anterior segment examination. Afterward, each student completed a …

A Scarring Experience: Pelvic Floor Rehabilitation As A Palliative Approach In Colorectal Cancer Survivorship, Aryan Dowlatshahi, Mary Garcia, Leanne Jackson

Cancer Survivorship Research Retreat

This is a case study and discussion of pelvic floor rehabilitation in its palliative utility specifically for colorectal cancer survivorship which will be presented at the MD Anderson Survivorship Research Retreat conference.

When Systems Fail: The Impact Of Protocol On Physician Moral Distress, Aya Dudar

Clinical Research in Practice: The Journal of Team Hippocrates

Physicians often face the decision between following rigid hospital protocol and doing the right thing for the patient, creating moral distress and contributing to burnout. This letter describes a case in which an elderly patient with COVID-19 pneumonia and a DNI order developed worsening hypercapnia and required noninvasive ventilation. Despite clinical appropriateness, hospital policy prohibited BiPAP use in obtunded patients due to aspiration risk - even when the resident offered continuous bedside monitoring. This case highlights the ethical tension that arises when rigid hospital policies prevent physicians from making real-time exceptions in appropriate situations. Empowering physicians to make context-driven decisions …

The Impact Of Simulation-Based Education On Novice Nurses’ Knowledge Of Pressure Injury Prevention, Michelle "Mikki" Cantu

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries remain a significant patient safety concern in acute care settings despite the availability of evidence-based prevention guidelines. Novice nurses, who often have limited clinical experience and exposure to wound care education, may be less prepared to consistently identify risk factors, accurately stage pressure injuries, and implement appropriate preventive strategies. Simulation-based education offers an experiential learning approach that supports the translation of evidence-based knowledge into clinical practice. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the effectiveness of simulation-based education in improving novice nurses’ knowledge of pressure injury identification and prevention. The …

Quality Improvement Project: Enhancing Self-Efficacy Through Inacsl Standards Training, Amy Bortner

Doctor of Nursing Practice Projects

Simulation-based education (SBE) is a widely used instructional strategy in nursing curricula; however, formal training for faculty and staff who implement it may be inconsistent or limited. Current literature supports the need for structured, evidence-based training to ensure effective use of simulation-based education and promote best practices in teaching and learning. The Doctor of Nursing Practice (DNP) project aims to improve perceptions and self-efficacy regarding the use of the International Nursing Association of Clinical Simulation and Learning (INACSL) standards, which guide simulation education. Driven by Kurt Lewin’s change theory and Jeffries Simulation Theory, twelve volunteers completed the Faculty Attitude and …

Feasibility, Acceptability And Implementation Of A Whole-Family Mental Health Intervention For Displaced Adolescent Girls In Colombia: A Mixed-Methods Pilot Randomized Controlled Trial, Ilana Seff, Arturo Harker Roa, Byron Powell, Natalia Cordoba, Carolina Rodriguez, Julianne Deitch, Elvia Tamaity Ariza Pena, Feven Gebrekidan, Lindsay Stark

2020-Current year OA Pubs

Adolescent girls affected by displacement face substantial mental-health risks. The Sibling Support for Adolescent Girls in Emergencies (SSAGE) is a 12-week, gender-transformative, family-based program designed to improve adolescent girls' mental health in humanitarian settings. This mixed-methods pilot randomized controlled trial (RCT) assessed SSAGE's feasibility, acceptability and potential effects among 186 Venezuelan migrant and Colombian returnee families in Colombia. Adolescent girls aged 13-19 years, their male siblings and caregivers participated in parallel sessions on gender dynamics, communication and relationships. Implementation outcomes drew on the Mental Health Implementation Science Tools (acceptability and feasibility subscales), attendance records and qualitative interviews. Analyses followed an …

Quality Improvement Project: Provider Knowledge Improvement For Care Of The Severely Hypertensive Obstetric Patient, Victoria Abramowitz

Doctor of Nursing Practice Projects

Gaps in confidence among emergency department (ED) and maternal child health services (MCHS) staff negatively impacts effectiveness and timeliness of response to high acuity obstetric emergencies, such as severe obstetric hypertension. The purpose of this quality improvement project was to evaluate the impact on provider self-efficacy with the implementation of evidence-based education and standardized procedures for severe obstetric hypertension management, aimed at evaluating the degree of success of increasing provider confidence. The project was guided by Lewin’s change theory and Donabedian’s structure-process-outcome theoretical framework. With a quasi-experimental design and the PDSA implementation framework, 20 staff from both the ED and …

Quality Improvement Project: Impact Of National Culturally And Linguistically Appropriate Services (Clas) Standards Education On Behavioral Health Providers’ Self-Efficacy, Zita Anigbou

Doctor of Nursing Practice Projects

Health disparities among culturally and linguistically diverse populations continue to negatively affect access to and quality of behavioral health care. Limited provider education on the National Culturally and Linguistically Appropriate Services (CLAS) Standards contributes to communication barriers, reduced therapeutic engagement, and lower provider confidence. The purpose of this quality improvement project was to evaluate the impact of evidence-based CLAS Standards education on behavioral health providers’ self-efficacy in delivering culturally and linguistically appropriate care. Guided by Lewin’s Change Theory and the Health Equity Implementation Framework, a quantitative pre-test–post-test quasi-experimental design was used. A convenience sample of three behavioral health nurse practitioners …

Implementation Of A Standardized Suicide Risk Screening Protocol Using The Columbia-Suicide Severity Rating Scale (C-Ssrs) In An Outpatient Mental Health Clinic, Kemisola Ebietomiye

Doctor of Nursing Practice Projects

The outpatient mental health clinics across the United States lack consistent suicide risk assessment methods. This project developed standardized procedures which used Columbia-Suicide Severity Rating Scale (C-SSRS) assessment together with provider education and electronic health record systems to evaluate how these elements impacted provider self-efficacy and their ability to record screening results. The project used a pre-post design to examine (n=24) psychiatric providers at an urban outpatient clinic through the combined methods of Lewin's Change Theory and the Plan-Do-Study-Act framework. The General Self-Efficacy Scale measured provider self-efficacy, and structured EHR audits tracked documentation rates pre- and post-implementation over six weeks. …

Quality Improvement Project Standardizing Simulation In Nursing Education: A Faculty Training Initiative, Andrea Reyes

Doctor of Nursing Practice Projects

Simulation-based education is essential in nursing programs as clinical placement opportunities decline. However, inconsistent faculty preparation can compromise the quality of simulation delivery. The purpose of this quality improvement project was to implement and evaluate a standardized simulation faculty training initiative to determine its impact on nursing faculty's confidence in simulation facilitation. Guided by the Jeffries Simulation Framework and Lewin’s Change Theory, a quasi-experimental pre-post design was used to examine changes in faculty confidence following participation in a training program aligned with national standards and guidelines. Faculty confidence was measured using the Simulation Educator Needs Assessment Tool (SENAT) administered pre- …

Quality Improvement Project: Use Of The Behavioral Risk Assessment Tool To Enhance The Utilization Of The Behavioral Emergency Response Team, Joseph Sindhu

Doctor of Nursing Practice Projects

Workplace violence is a global challenge, and nurses often encounter patient aggression. The purpose of this quality improvement project was to enhance the use of a behavioral assessment tool derived from the Brøset Violence Checklist and the Behavioral Emergency Response Team (BERT) to de-escalate workplace violence. This project aimed to improve behavioral assessment documentation and BERT use in a critical care unit by 30% within 5 weeks. Guided by the Donabedian Model theoretical framework and Lewin's Change Theory, the project employed a quasi-experimental, pretest-posttest design in an advanced heart failure unit with full-time nurses as participants. The Plan-Do-Study-Act (PDSA) framework …