Digital Commons Network^™

The Impact Of Wide-Awake Local Anesthesia No Tourniquet Surgery On Distal Radius Fracture Plating, Michael Carey

Bone Bulletin

Introduction

The surgical technique known as wideawake local anesthesia no tourniquet (WALANT) has been widely used in soft tissue hand procedures since 2005.1 A local surgical field block using lidocaine with epinephrine provides local anesthesia and hemostasis via alpha-1 adrenergic agonism without the need for general anesthesia with a tourniquet. In addition to reducing costs related to general anesthesia (GA), WALANT procedures are suitable for American Society of Anesthesiologists Physical Status Classification 4 (ASA 4) high-risk patients, specifically by eliminating anesthesia risks such as nausea, aspiration, pneumonia, and thromboembolism, all while maintaining or improving clinical outcomes compared with the current …

Clinical Uncertainty In Digital Monitoring After Shoulder Arthroplasty, Abhimaneu Pandey

Bone Bulletin

Introduction

Wearable sensor technology and smartphone based care platforms have been identified as promising technologies for postoperative care after joint arthroplasties.^1,2 In fact, in lower extremity arthroplasty, these technologies have already demonstrated their effectiveness in a multitude of randomized trials.^1,2 One recent multicenter RCT with 401 patients undergoing primary total knee arthroplasty (TKA) showed that self-directed rehabilitation using a smartwatch and mobile application (mymobility with Apple Watch, Zimmer Biomet) achieved comparable range of motion and patient-reported outcomes measures (PROMs) to standard post-operative rehab without increasing adverse events.¹ Related evidence also indicates that “episode of care” smartphone applications …

Factors Influencing Piglet Average Daily Gain During The First Week Of Lactation In Hyperprolific Sow Under Tropical Conditions, Yosua Kristian Adi, Preechaphon Taechamaeteekul, Jakavat Ruampatana, Manmueang Malison, Roy Neville Kirkwood, Padet Tummaruk

The Thai Journal of Veterinary Medicine

Birth weight (BW) is a key determinant of average daily gain (ADG) in piglets; however, hyperprolific sow genetics, particularly under tropical conditions, have increased the proportion of low-birth-weight piglets. This study evaluated factors associated with ADG during the first 7 days of lactation within birth weight categories (1.3 kg). A total of 1,185 piglets from 97 litters that survived to day 7 were included. Factors analyzed were cumulative birth interval, birth order, colostrum intake per kilogram of body weight, rectal temperature at 24 h postpartum, sex, intrauterine growth restriction (IUGR), and cross-fostering. Birth weight, cumulative birth interval, birth order, colostrum …

Collaborative Healthcare: Advancing Interprofessional Practice & Education, Volume 16, Number 2, Spring/Summer 2026

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

In this Issue:

• From the Editors
• What Does It Take to Truly Improve Black Maternal Health from an Interprofessional Lens?
• Spotlight on an Interprofessional Clinical Team
• Meet an IPE/IPCP Faculty Champion
• Meet an IPE/IPCP Student Champion

Left-Ventricular Non-Compaction Cardiomyopathy Presenting With Atrial Flutter With Rapid Ventricular Response, Sahil Ghay, Baneet Kaur, J. Armando Talavera, Koushik Sanku, Viky S. Loescher, Julien A. Exposito

Journal of Community Hospital Internal Medicine Perspectives

Left ventricular non-compaction cardiomyopathy (LVNC) is a rare genetic cardiomyopathy characterized by prominent trabeculations and deep recesses that predispose to arrhythmias and heart failure. We describe a 42-year-old man with persistent tachycardia and exertional fatigue found to have CTI-dependent atrial flutter with 2:1 conduction. Transesophageal echocardiography showed severe biventricular dysfunction with an ejection fraction of 15%, and cardiac MRI confirmed LVNC with a non-compacted to compacted ratio of 3.3. After successful ablation and normal coronary angiography, he was diagnosed with LVNC. This case highlights an unusual presentation of LVNC with typical atrial flutter and underscores the value of cardiac MRI …

A Case Of Anti-Srp Immune-Mediated Necrotizing Myopathy Following Suspected Coxsackie B4 Infection: Exploring A Viral Trigger Hypothesis, Marwan Ahmed, Ruba Salameh, Soziema Salia, Brent T. Harris, Christopher J. Haas, Anees Siddiqi

Journal of Community Hospital Internal Medicine Perspectives

Immune-mediated necrotizing myopathy (IMNM) is a rare subtype of idiopathic inflammatory myopathies that can present with rhabdomyolysis. We report a 43-year-old woman with rapidly progressive proximal muscle weakness following a flu-like illness. Laboratory evaluation revealed markedly elevated creatine kinase (22,207 U/L) and transaminases, with positive anti-signal recognition particle (SRP) and Coxsackie B4 antibodies. Muscle biopsy demonstrated extensive necrosis, regeneration, and endomysial lymphocytic infiltration, confirming IMNM. The patient was treated with intravenous methylprednisolone, IVIG, and rituximab, followed by oral steroid taper and mycophenolate. At six-month follow-up, she showed significant clinical and biochemical improvement. This case highlights a potential viral-triggered autoimmune mechanism, …

From Villi To Alveoli: Lung Involvement In Celiac Disease – A Narrative Review, Mateusz Marzec, Patrycja Cecha

Journal of Community Hospital Internal Medicine Perspectives

Background:

Celiac disease (CD) is a chronic, immune-mediated enteropathy triggered by gluten that affects about 1% of the population and may present with extraintestinal manifestations. Pulmonary complications are considered rare and are poorly characterized. Lane-Hamilton syndrome is the best described lung manifestation, but data suggests a broader spectrum of respiratory involvement.

Methods:

We performed a narrative review with structured search strategy of PubMed and Embase (January 1, 1970 – December 1, 2025) using the terms celiac/coeliac and lung, pulmonary, respiratory, hemoptysis, hemosiderosis, alveolar hemorrhage, interstitial lung disease, alveolitis, bronchiectasis …

The Effect Of Empiric Initiation Of Treatment On Outcomes Among Patients Presenting With Extrapulmonary Mycobacterium Tuberculosis Infection In A Community Hospital Setting, Talha Awwal, Faisal Raja Kh, Hanya Awaba, Waseem Anwar, Jinma Ren, Muhammad Aamir Safdar, Saqib Walayat, John J. Farrell

Journal of Community Hospital Internal Medicine Perspectives

Background: Extrapulmonary tuberculosis (EPTB) accounts for ~20% of Mycobacterium tuberculosis infections in Pakistan. Diagnostic delays are common and may worsen outcomes. We evaluated whether empiric treatment initiation improves outcomes among patients with EPTB at a large public hospital in Islamabad, Pakistan. Methods: Retrospective cohort of consecutive EPTB cases at Pakistan Institute of Medical Sciences (January–June 2016). Patients were categorized as clinically diagnosed (symptoms/radiology) or laboratory-supported (histology, microbiology, or biochemical tests). Standard Directly Observed Therapy Short-course (DOTS) based regimens were used. Outcomes were treatment success, failure, loss to follow-up, and mortality; groups were compared using chi-square testing. Results: Of 317 EPTB …

Management Of Skeletal Class Iii Malocclusion With Deep Bite And Moderate Overjet Using Improved Super-Elastic Ti-Ni Alloy Wire (Isw), Wen-Hsuan Lin, Ching-Yu Yang, Yuan-Hou Chen, Jian-Hong Yu

Taiwanese Journal of Orthodontics

A 20-year-old female presented with concerns about poor dental alignment and a tendency to bite on her lip easily. Clinical examination revealed a concave and brachy facial profile, accompanied by a deep overbite and a moderate overjet. Radiographic examination showed skeletal Class III with a low mandibular plane angle. Correction of the deep bite was achieved by using the Improved Super-elastic Ti-Ni alloy Wire (ISW) and Intermaxillary elastics (IMEs). To correct the moderate overjet, interproximal reduction (IPR), the Multi-bend Edgewise Archwire (MEAW) technique, and arch lengthening of the lower arch were applied. The active treatment duration took approximately 54 months, …

Improved Super-Elastic Ti-Ni Alloy Wire For The Treatment Of Skeletal Class Iii Malocclusion With Anterior Crossbite And Missing Lower Molar, De-Lun Zhuang, Yuan-Hou Chen, Jian-Hong Yu

Taiwanese Journal of Orthodontics

This case report describes the use of Improved Super-elastic Ti-Ni alloy wire (ISW), developed by Tokyo Medical and Dental University, in managing a skeletal Class III malocclusion with anterior crossbite and a missing lower molar. A 26-year-old female presented with a chief complaint of poor dental alignment. Clinical and radiographic evaluation revealed Angle Class III malocclusion, anterior crossbite, a missing mandibular first molar (36), and a centric occlusion–centric relation (CO–CR) functional shift, consistent with a skeletal Class III pattern. Treatment involved the use of ISW for leveling and alignment of both arches and correction of the anterior crossbite, while maintaining …

Comparative Evaluation Of Selected Properties Of Tetrahedral Amorphous Carbon (Ta-C) Coated And Uncoated Beta Titanium (Β-Ti) Archwires - An In Vitro Study, Abhinaya Jotheswaran, Kurunji Kumaran Navaneethakrishnan

Taiwanese Journal of Orthodontics

Objective: The development of newer archwires can be achieved either by discovering novel materials or by modifying existing ones. The objective of the present study was to coat beta-titanium (β-Ti) archwires with tetrahedral amorphous carbon (ta-C)/hard carbon and to evaluate selected physical and mechanical properties. Methods: Hard carbon–coated (n = 5) and uncoated (n = 5) β-Ti wires were assessed for surface roughness, wear resistance, load-deflection characteristics, and friction using appropriate testing apparatus under dry in vitro conditions. Results: Compared to uncoated β-Ti wires, ta-C–coated β-Ti wires demonstrated a statistically significant reduction in surface roughness, increased wear resistance, and lower …

Overcoming Igf1r-Mediated Resistance To Oncolytic Hsv1 And Radiotherapy Via Triple Combination Therapy, Alexandra A Miller, Min-Hye Noh, Jin Muk Kang, Jiyeon Kim, Lily Nguyen, Amanda S Kouaho, Grace Nguyen, Minxin Huang, Stephanie M Bean, Joshua Davis, Matthew P Mullarkey, Sunil Krishnan, Zhongming Zhao, E Antonio Chiocca, Tae Jin Lee, Ji Young Yoo

The Brown Foundation: Institute of Molecular Medicine

FDA-approved oncolytic herpes simplex virus-1 (oHSV) therapy has emerged as a promising viro-immunotherapy for solid tumors. However, tumor- and tumor microenvironment (TME)-associated adaptations following viral treatment, such as feedback immune suppression, neoangiogenesis, and enhanced tumor aggressiveness, often hinder complete tumor eradication. A deeper understanding of the molecular mechanisms underlying resistance to oHSV is crucial to enhancing its clinical impact. We recently discovered that oHSV induces Insulin-like growth factor 2 (IGF2) secretion, shaping an immunosuppressive TME. Similarly, radiotherapy (RTx) activates the IGF1/IGF1R and YAP1 signaling pathways, further promoting therapeutic resistance. In this study, we investigated how oHSV-induced Insulin-like growth factor 1 …

Continuous 1:1 Sitter Observation Versus Standard Safety Interventions To Reduce Falls In Hospitalized Adults At Risk, Zainab Williams

Student Scholarly Projects

Practice Problem: Patient falls remain a significant patient safety concern among hospitalized adults, particularly those at high risk. Traditional fall-prevention strategies, including continuous 1:1 sitter observation, require evaluation to determine their effectiveness in reducing falls and fall-related injuries.

PICOT: In hospitalized adult patients at high risk for falls (P), does continuous 1:1 sitter observation (I), compared to standard safety interventions (C), reduce fall rates (O) as measured by reported falls per 1,000 patient days during hospitalization over 12 weeks (T)?

Evidence: Current evidence supports multifactorial fall-prevention programs that combine patient assessment, staff engagement, and proactive nursing interventions through intentional rounding. …

Comparison Of Methods For Defatted Human Milk And Nutrient Composition: An Experimental Study, Kristin Cheng, Gina O'Toole, Stephanie Chang, Richard Chang, John Miklavcic

Food Science Faculty Articles and Research

Background

Human milk is considered the gold standard for infant nutrition; however, it is often discontinued in chylothorax and severe very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency. As an alternative to complete human milk restriction, defatted human milk may be fed, though it may not fully support optimal infant growth and development. This study aimed to assess the micronutrient profile of defatted human milk.

Methods

Human milk was obtained from UCSD Human Milk Research Biorepository (San Diego, CA). Thirty samples representing 10 independent expressions in the morning, afternoon, and evening were pooled for analysis. Fat removal was performed by centrifugation at …

Association Between Occupational Stress, Sleep Quality, And Premature Ejaculation Among Indonesian Information Technology Workers, Muhammad Faisal Ratman, Suryo Wibowo, Muhammad Ilyas, Retno Asti Werdhani, Dewi Yunia Fitriani

Occupational and Environmental Medicine Journal of Indonesia

Introduction Premature ejaculation (PE) is a common sexual dysfunction that significantly impacts quality of life. Occupational stress and poor sleep quality are hypothesized as risk factors, particularly among Information and Technology (IT) workers who experience unique occupational stressors. This study aimed to evaluate the proportion of PE, examine the influence of occupational stress and sleep quality on PE, and determine whether sleep quality mediates the relationship between occupational stress and PE among Indonesian IT workers.

Methods This cross-sectional study involved 89 married male IT workers who completed online questionnaires, including the Premature Ejaculation Diagnostic Tool (PEDT), Perceived Occupational Stress (POS) …

Less Frequent Versus More Frequent Cervical Examinations In Labor: A Systematic Review And Meta-Analysis, Alessandro Petrecca, Benedetta Bina, Chiara Tersigni, Tullio Ghi, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Digital cervical examinations are central to intrapartum care, yet their optimal frequency remains uncertain and is largely based on consensus rather than high-quality evidence.

OBJECTIVES: To compare less frequent versus more frequent cervical examinations during labor in terms of obstetrical, maternal and neonatal outcomes.

SEARCH STRATEGY: We searched Medline, Cochrane Library, EMBASE, PubMed Central, Scopus and ClinicalTrials.gov from inception to August 2025, without language or geographic restrictions. The review was registered in PROSPERO (CRD420251033729).

SELECTION CRITERIA: Randomized controlled trials comparing different frequencies of cervical examinations in term singleton pregnancies during labor were included.

DATA COLLECTION AND ANALYSIS: Two reviewers …

Food And Drug Administration Audit Outcomes And Their Association With Class I And Class Ii Food Recalls, Mark Baker

Walden Dissertations and Doctoral Studies

Foodborne illness and food recalls remain major public health concerns in the United States. Guided by the Theory of Planned Behavior, the purpose of this quantitative secondary analysis was to examine whether Food and Drug Administration (FDA) inspection classifications, warning letters, and prior 24-month inspection frequency were associated with facility involvement in a subsequent Class I or Class II food recall. Question-specific analytic files were created from publicly available FDA administrative records. Eligible records included FDA-regulated food facilities with qualifying inspection or warning letter events and sufficient data to assess recall involvement within a 12-month follow-up period. The final analytic …

Injuries In Children Undergoing Subspecialty Abuse Evaluations Because Of Intimate Partner Violence., M Katherine Henry, Gunjan Tiyyagura, Joanne N. Wood, Jan Leonard, Kristine A. Campbell, Daniel M. Lindberg, Angela N. Bachim, Farah W. Brink, Lori D. Frasier, Nancy S. Harper, Claire Hickey, Natalie Laub, John D. Melville, Hannah Sahud, Philip V. Scribano

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND OBJECTIVES: Intimate partner violence (IPV) and child physical abuse often co-occur, but the frequency and risk factors for abusive injuries in IPV-exposed children remain unknown. Our objectives were to (1) determine frequency of skeletal surveys (SSs) and neuroimaging use because of IPV and their diagnostic value in children aged less than 24 months evaluated by a child abuse pediatrics specialist (CAP) and (2) identify factors associated with performance of and findings on SS and neuroimaging.

METHODS: We conducted a retrospective study of children aged less than 24 months undergoing CAP consultations because of IPV exposure from February 2021 …

Climate Anxiety And Nurses’ Awareness, Motivation, And Behaviors In Addressing Climate-Related Health Risks, Sarah Kaplan

Theses and Dissertations

Background: Climate anxiety, the emotional distress associated with awareness of climate change and its consequences, is an emerging mental health concern that may influence how nurses perceive and respond to climate-related health risks. Climate change is largely driven by emissions of greenhouse gases which radiate and absorb heat. Human-caused climate change is leading to higher average global temperatures and increasing risk to health through poor air quality, changes in vector borne diseases, extreme weather events, and exacerbation and development of physical and mental illnesses. This study contributes to nursing science by examining climate anxiety and climate related health practices among …

Assessing Current Non-Pharmacologic Pain Management Practices For Sickle Cell Disease In Adults, Shreya Kolipaka, Michelle Axe, Charmaine Wright, Stephanie Guarino

Student Papers, Posters & Projects

OBJECTIVES: Both acute and chronic pain caused by sickle cell disease (SCD) is often managed with opioid therapy despite limited evidence for long-term efficacy. Adequately managing SCD pain requires a comprehensive approach, incorporating both pharmacologic and non-pharmacologic interventions. In other conditions, peer-mentored group programs are effective in managing chronic pain; however, their role in SCD is not yet described. Our objective is to understand patients' current pharmacologic and non-pharmacologic SCD management practices as well as further exploring perspectives of pain related to SCD.

METHODS: Participants were interviewed using semi-structured format. Audio-recorded interviews were transcribed. Descriptive statistics and pain management modality …

The Effect Of Part-Time Vs Full-Time Integrated Clinical Education On Student Physical Therapists’ Self-Efficacy And Clinical Reasoning, William J. Buchala

Student Dissertations

Integrated clinical education (ICE) varies across Doctor of Physical Therapy (DPT) programs, particularly in the use of part-time and full-time clinical experiences. Limited research has examined relationships between ICE structure, self-efficacy, and clinical reasoning. The purpose of this quantitative ex post facto study was to examine relationships between part-time and full-time ICE models and self-efficacy and self-assessed clinical reasoning in DPT students. Survey responses were collected from DPT students who had participated in ICE experiences. Self-efficacy was measured using the Physical Therapist Self-Efficacy Scale, and self-assessed clinical reasoning was measured using the Self-Assessment of Clinical Reflection and Reasoning Scale. Independent-samples …

Pacific Rxtracts - July 2026, Pacific Rxtracts

Pacific RxTracts

Articles:

• Tribute: In Memory of Evan Le
• Redefining Influenza Prevention: Phase 3 Trial of an mRNA Influenza Vaccine
• Risk of Non-Vitamin K Anticoagulants in Atrial Fibrillation
• Oral Semaglutide and Cardiovascular Risk: Expanding Its Role in High-Risk Patients
• Baxdrostat for Resistant Hypertension: The Bax24 Phase 3 Trial
• SGLT2 Inhibitors Shown to Normalize Blood Pressure in Patients with Type 2 Diabetes
• Brolucizumab: A New Vision for Treating Proliferative Diabetic Retinopathy
• Mavacamten Comes of Age: FDA Expands Treatment Options for Adolescent Hypertrophic Cardiomyopathy
• Children and Adolescent CKD Management: New Evidence Supports RAAS Inhibitors as First-Line Therapy
• Comparing Survival Outcomes of CDK4/6 Inhibitors plus …

Clinical Practice Guideline To Improve Medication Adherence In Adults With Chronic Conditions In Outpatient Settings, Mulumbwa Chishimba

Walden Dissertations and Doctoral Studies

The Doctor of Nursing Practice project was conducted to develop and assess a clinical practice guideline (CPG) to enhance medication adherence among adult patients with chronic illnesses in an outpatient setting. Adverse health-related outcomes include worsening chronic illness and developing complications, frequent hospital admissions, and rising costs of healthcare services. While some interventions are recommended based on the available literature, most outpatient facilities do not have systematic practices for monitoring and enhancing medication adherence among patients with chronic conditions. The evidence-based question was: What evidence, based on content expert review using the Appraisal of Guidelines for Research and Evaluation II …

Examination Of Maternal Mortality, Mental Health Conditions, And Co-Occurring Factors, Laura Eileen Skaarer

Walden Dissertations and Doctoral Studies

Maternal mortality (MM) continues to be a public health concern in the state of Arizona. There is little to no research investigating the relationship between MM and mental health conditions co-occurring with contributing factors among women who have died in Arizona while pregnant or within 1 year of the end of a pregnancy. The purposes of this quantitative study, guided by the three delays model (3DM), were to examine (a) MM and mental health conditions as the primary underlying cause of death; (b) MM and mental health conditions surrounding death; and (c) significant contributing factors (i.e., discrimination, knowledge, lack of …

Quality Of Life And Depressive Symptoms In Older Adults: Findings From An Integrated Epilepsy Self-Management Data Set, Erica K Johnson, Refugio Sepulveda, Tanya Sprulli, Cam Escoffery, Rakale C Quarells, Molly Mcvoy, Sakshi Priy, Clara Adeniyi, Martha Sajatovic

Faculty, Staff and Student Publications

Background: In the U.S., about one million people with active epilepsy are adults aged 55+. Older adults with epilepsy (OAWE) experience complex health conditions that compromise quality of life (QOL). The contribution of depressive symptom dimensions to health-related QOL remains underexplored in OAWE.

Methods: We analyzed baseline data from 13 epilepsy self-management studies in the CDC-sponsored MEW-DB (Managing Epilepsy Well Database), including adults ages 55 and older (N = 198). The primary outcome was health-related QOL, assessed via the 10-item Quality of Life in Epilepsy scale (QOLIE-10), which was inverse rank normalized (mean = 0, SD = 1). Primary predictors …

Epilepsy-Associated Digenic Variants Affecting An Actin-Mitochondria-Glutamate Pathway Promote Seizure Susceptibility, Mingxi Deng, Hu Chen, Zhijian Yu, Lindsey D Goodman, Haein Kim, Yun Zhao, Sandeep Kumar Dubey, Wen-Wen Lin, Xueyang Pan, Debdeep Dutta, Vishnu Anand Cuddapah, Jill A Rosenfeld, Xi Luo, Zhandong Liu, Joshua M Shulman, Hugo J Bellen

Faculty, Staff and Students Publications

Epilepsy affects approximately 50 million people worldwide, yet more than half of individuals with a presumed genetic cause still lack a molecular diagnosis despite the identification of over 1,000 monogenic epilepsy genes. This diagnostic gap is unlikely to be resolved by improved variant detection alone, suggesting that variants affecting the same biological pathway may combine to cause disease. By studying epilepsy-associated actin regulatory genes, we identified a conserved "actin-mitochondria-glutamate (AMG) pathway". We demonstrate that reduced actin polymerization promotes DRP1-mediated mitochondrial fission, increases reactive oxygen species (ROS) levels, and enhances glutamatergic transmission, leading to seizures. The glial innate immune pathway, a …

From Shortage To Strategy: Optimizing Scarce Resource Allocation In Healthcare, Daniela Duran Cantarino

USF Tampa Graduate Theses and Dissertations

The allocation of scarce medical resources presents one of the most consequential challenges in health care, requiring decisions that balance equity and efficiency under pervasive uncertainty. This dissertation develops optimization-based frameworks for two critical domains, organ transplantation and emergency medical services, and demonstrates how operations research methods can improve upon current practice along both dimensions simultaneously.

In the domain of deceased-donor kidney allocation, two complementary frameworks are proposed. The first is a bi-objective stochastic optimization model that jointly maximizes post-transplant survival (efficiency) and prioritizes candidates with the highest pre-transplant mortality risk (equity), subject to regional chance constraints on graft failure …

Staff Education To Decrease Workplace Violence Through De-Escalation Training In The Emergency Department, Tyrani Anderson

Walden Dissertations and Doctoral Studies

Workplace violence remains a significant issue in healthcare settings, particularly in emergency departments where psychiatric patients may present with aggressive behaviors. Nurses and healthcare staff are frequently exposed to verbal threats, intimidation, and physical aggression, which negatively impact staff safety, job satisfaction, and patient care quality. Despite workplace violence prevention policies, gaps remain in staff preparedness when managing escalating patient behaviors. The purpose of this Doctor of Nursing Practice project was to implement an evidence-based de-escalation training program to improve staff knowledge about managing aggressive psychiatric patients in the emergency department. The practice- focused question was: Can staff education on …

Setting The Stage For Surviving Cancer, Kelly Allen

The Open Journal of Occupational Therapy

Margaret Petersen, theater artist and assistant stage manager of the Grand Rapids Ballet, is featured in the cover art for the Summer 2026 issue of the Open Journal of Occupational Therapy (OJOT). The self-portrait photograph depicts Petersen standing cheerfully on a terrace, dressed as an orange “safety cone” holding onto an IV pole. She takes in some fresh air as she receives her chemotherapy medication at the Lemmen-Holton Cancer Pavillion. Donned in orange coveralls and a modified hat topped with a small traffic cone and the word SAFETY emblazoned across the front, it is the costume she created to wear …

Occupational Therapy's Role In Optimizing Health Using 4ms Framework: Primary Care And Beyond, Nicole Karabas, Lydia Royeen, Bridget Hahn

The Open Journal of Occupational Therapy

As the older adult population in the United States continues to grow rapidly, the health care system faces increasing challenges in meeting their complex needs. A proactive, rather than reactive, approach to health care is necessary to support older adults in maintaining function and well-being. The Age-Friendly Health Systems 4Ms Framework; What Matters, Medication, Mentation, and Mobility, provides an evidence-based model for optimizing care across settings. Occupational therapists are uniquely positioned to implement the 4Ms framework because of their holistic and client-centered approach to evaluation and intervention.

By addressing "What Matters," occupational therapists  align care with individual goals and daily …