Digital Commons Network^™

Analysis Of The Deborah Sampson Act Of 2020: Improving Women Veterans’ Care, Jessica N. Shipp

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Women Veterans are one of the fastest-growing populations served by the Veterans Health Administration (VHA), yet gaps persist in access to gender-responsive, trauma-informed care. Despite requirements established by the Deborah Sampson Act (DSA) of 2020, implementation remains inconsistent in Women's Health Primary Care Provider (WH-PCP) access, women's mental health (MH) services, military sexual trauma (MST) care, workforce capacity, care coordination, and accountability.

Aim of the Project: The aim was to evaluate the effectiveness, feasibility, equity, and implementation fidelity of the DSA using the Centers for Disease Control and Prevention (CDC) Policy Analytical Framework (POLARIS) and identify evidence-based recommendations to …

Adjunctive Middle Meningeal Artery Embolization After Surgical Evacuation Of Chronic Subdural Hematoma: An Updated Meta-Analysis Of Randomized Controlled Trials, Tallal M. Hashmi, Hafsa Arshad Azam Raja, Zain Tariq, Faizan Ahmed, Niraj Arora, Majid T. Aized, Adeel Saleemi, Ameer E. Hassan, Adnan Qureshi, Osama O. Zaidat

School of Medicine Publications

Background: Middle meningeal artery embolization (MMAE) has emerged as a promising adjunctive treatment for chronic subdural hematoma (cSDH); however, the efficacy and safety of adjunctive MMAE compared with surgery alone remains uncertain.

Methods: We systematically searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials from inception through June 2026. Randomized controlled trials comparing adjunctive MMAE plus surgical evacuation with surgical evacuation alone in patients with cSDH were included. The primary outcome was hematoma recurrence. Pooled odds ratios (ORs) with 95% CIs were calculated using a random-effects model.

Results: A total of eight randomized controlled trials were included. The …

Factor Structure Of The Neuropsychological Battery In The Mexican Cognitive Aging Ancillary Study (Mex-Cog), Lily Kamalyan, Zachary J. Kunicki, Sangha Jeon, Guanyi Yang, Silvia Mejia-Arango, Alejandra Michaels Obregon, Rebeca Wong, Joseph Saenz, Emily M. Briceño, Miguel Arce Rentería

School of Medicine Publications

Objective: The Mexican Cognitive Aging Ancillary Study administers a comprehensive cognitive assessment based on the Harmonized Cognitive Assessment Protocol. To ensure accurate measurement of cognition for older adults in Mexico, we sought to determine the cognitive factor model of the Mexican Cognitive Aging Ancillary Study battery at Wave 1. Method: Participants were 2,042 adults over the age of 55 living in Mexico in 2016, selected from the Mexican Health and Aging Study survey of 2015. We used confirmatory factor analysis to assess and refine a theoretically driven multiple domain hierarchical factor structure. Correlation estimates between cognitive scores and age and …

A Rare Recurring Gain-Of-Function Variant In Bmpr2 Causes Neurodevelopmental Phenotypes In Humans And Flies, Jung-Wan Mok, Carrie L Welch, Haley A Dostalik, Zhi Tan, Ariel Brautbar, Maria Descartes, Erica T Gray, Alejandro Iglesias, Scott D Mclean, Morgan Nutter, Olivia Daugherty, Amber Begtrup, Ingrid M Wentzensen, Yufeng Shen, Damian W Young, Martin M Matzuk, Oguz Kanca, Michael F Wangler, Hugo J Bellen, Wendy K Chung, Shinya Yamamoto

Faculty, Staff and Students Publications

Bone morphogenetic protein receptor type 2 (BMPR2) encodes an evolutionarily conserved serine/threonine kinase that phosphorylates type-1 BMP receptors to mediate intercellular communication upon ligand binding. Loss-of-function variants in BMPR2 are known to cause pulmonary arterial hypertension and other cardiovascular disorders. Here, we report a rare recurrent missense variant in BMPR2 (c.1126G>A [GenBank: NM_001204] [p.Glu376Lys]) identified in six individuals, who all present with neurodevelopmental phenotypes including autism spectrum disorder and global developmental delay. Trio analysis demonstrates de novo occurrence of this variant in at least five of the individuals. Using the fruit fly Drosophila melanogaster, we show that this variant …

Spell: A Scalable Nlp Method Using Regular Expressions And Large Language Models For Clinical Information Extraction, Ricardo Kleinlein, David W Bates, Carolyn Guan, Kathryn J Gray, Vesela P Kovacheva

Faculty, Staff and Students Publications

Background and objectives: Electronic health records (EHRs) contain valuable information for research and decision-making, but much resides in unstructured notes that are challenging to analyze at scale. We developed SPELL (Snippet-Primed rEgex LLM Pipeline), a scalable natural language processing workflow that combines regular-expression-based snippet retrieval with locally hosted large language model (LLM) inference to extract structured variables from large collections of clinical narratives.

Methods: SPELL uses task-specific regular expressions to retrieve short context windows ("snippets") from unstructured texts and applies task-prompted LLM inference on snippets rather than full documents. All processing occurs within institutional computing environments. Accuracy was evaluated on …

Engagement And Weight Change In An Online Weight Management Program In Clinical Settings: An Implementation Project, Heather J Baer, Joann Cho, Richard Fay, Caroline M Apovian, Ashley C Mccarthy, Alexander J Blood, Lipika Samal, Naomi D L Fisher, E John Orav, Matthew Wien, Jorge Plutzky, Jason P Block, David W Bates, Ronen Rozenblum, Michela Tucci, Marian Mcpartlin, Michael Oates, Katherine D Mcmanus, Benjamin M Scirica

Faculty, Staff and Students Publications

Background: There is an urgent need for scalable strategies for treatment of overweight and obesity that can be implemented in clinical settings.

Objective: To implement and evaluate an online weight management program in a large, diverse population of patients.

Design: Clinical implementation project in primary care and specialty clinics.

Participants: Eligible patients were ≥ 20 years old, spoke English or Spanish, and had a body mass index (BMI) of ≥ 30 kg/m2 or a BMI of 25-29.9 kg/m2 plus ≥ 1 cardiovascular risk factor or obesity-related condition.

Intervention: Enrolled patients were encouraged to register for a 12-month digital health program …

Sex-Related Differences In Fingerprint Minutiae Counts Among Secondary School Students In Sagamu, Ogun State, Nigeria, Olukayode Olushola Odubela, Osonuga Ifabunmi Oduyemi, Dr Kazeem Adeyinka Adeboyejo, Opeyemi Abel Bamgbose

AUIQ Complementary Biological System

Background: Dermatoglyphic minutiae are permanent epidermal ridge characteristics widely utilized in forensic identification and biometric science. Previous studies have demonstrated sex-related differences in fingerprint ridge morphology and ridge count, with females generally exhibiting higher ridge count than males. However, quantitative minutiae-based studies among Nigerian adolescents remain limited. This study evaluated sex-related and bilateral variations in fingerprint minutiae among secondary school students in Sagamu, Ogun State, Nigeria. Methods: This cross-sectional analytical study involved 300 apparently healthy students aged 14–18 years, recruited from an initial pool of 318 students assessed for eligibility across Batoro Community Grammar School, Remo Secondary School, and Remo …

Bacterial Biomass As A Versatile Platform For Functional Materials: Structural Insights And Sustainable Applications, Hasan M. Agha

AUIQ Complementary Biological System

Bacterial biomass has emerged as a versatile material with strong potential in environmental, material, and biotechnological applications, as well as broader uses such as bioplastics, packaging materials, and agricultural systems, owing to its rapid growth, controllable production, and surface chemistry enriched with carboxyl, hydroxyl, amino, phosphate, sulfate, and sulfhydryl groups. These features enable multiple interaction mechanisms, including electrostatic attraction, ion exchange, surface complexation, hydrogen bonding, and π –π interactions, supporting applications in pollutant removal, wastewater treatment, composite development, and bioenergy systems. Bacterial biomass can be sourced from natural environments, industrial fermentation, and waste streams, particularly activated sludge, making it compatible …

Effectiveness Of An Integrated Activity-Based And Tele-Monitoring Intervention On Mental Health Literacy And Resilience Among Urban Older Adults In Thailand: A Quasi-Experimental Study, Khunatpakorn Makkabphalanon, Pramote Thangkratok, Jutamast Wongjan, Natchaya Palacheewa

Journal of Health Research

Background: Mental health problems among older adults are a growing public health concern, particularly in urban areas. Mental health literacy can enhance problem recognition, self-help, and help-seeking. This study examined changes in mental health literacy and resilience among urban older adults following an integrated activity-based and tele-monitoring intervention.

Methods: A one-group quasi-experimental repeated-measures study was conducted among 30 adults aged 60 years and older in urban communities in Thailand. Participants received a structured 3-hour activity-based mental health literacy intervention followed by 1 month of tele-monitoring support. Data were collected at baseline, immediately after the intervention, and at 1-month follow-up. Changes …

Burden And Prioritization Of Airborne Diseases In Bogor City, 2024: A Situational Analysis, Tuti Alawiyah, Helda Helda, Menikha Maulida

Jurnal Epidemiologi Kesehatan Indonesia

Indonesia, particularly urban agglomeration areas such as Bogor, continues to face major challenges related to air quality, resulting in an increased risk of airborne disease transmission. This study aimed to assess the burden of airborne diseases and determine health problem priorities in Bogor City using surveillance data from 2022 to October 2024. A descriptive epidemiological study was conducted in Bogor City using surveillance data from 2022 to 2024. Health problem prioritization was performed using the Pan American Health Organization (PAHO)-adapted Hanlon method through structured questionnaires administered to an expert panel consisting of health office officials and heads of primary healthcare …

Factors Associated With Hiv Infection Among People Who Inject Drugs In Jakarta, Igo Cahya Negara, Mondastri Korib Sudaryo, Helwiah Umniyati

Jurnal Epidemiologi Kesehatan Indonesia

HIV infection among people who inject drugs (PWID) remains a substantial public health burden, with Jakarta consistently reporting among the highest PWID-associated HIV prevalence in Indonesia. This study aimed to identify factors associated with HIV infection among PWID in Jakarta, utilizing secondary data from the 2023 Integrated Biological and Behavioral Survey (IBBS 2023). A cross-sectional study design was employed using secondary data from 261 PWID recruited in Jakarta. Bivariate associations were examined using Chi-square tests, and multivariate analysis was performed using modified Cox regression with a constant time parameter to estimate adjusted prevalence ratios (aPR) with 95% confidence intervals. The …

Determinants Of Antiretroviral Therapy Status Among Men Who Have Sex With Men (Msm) Living With Hiv In Greater Jakarta, Leonita Agustine, Mondastri Korib Sudaryo, Helwiah Umniyati

Jurnal Epidemiologi Kesehatan Indonesia

Men who have sex with men (MSM) are a key population contributing to the largest proportion of new HIV infections among the adult population in Indonesia, accounting for 44% of new infections in 2024. However, antiretroviral therapy (ART), as a key intervention in HIV control, remains suboptimal among this group, with previous studies showing that only around 57% of MSM living with HIV in Indonesia were receiving ART. In urban settings such as Greater Jakarta, these gaps may be more pronounced due to complex social and structural barriers to care. This study used a cross-sectional design based on data from …

Psychosocial And Demographic Determinants Of Work Stress Among Lecturers At University X, Natasha Putri Ayu Kayla, Fajaria Nurcandra, Dr. Dyah Utari, Nayla K. Fithri, Siti Norashikin Mohamad Shaifuddin

Jurnal Epidemiologi Kesehatan Indonesia

Occupational stress is a psychological pressure related to work conditions. Psychosocial and demographic determinants may be the influence. Lecturers are white collar workers who have the opportunity to experience occupational stress. The aim of this study is to determine the factors that influence occupational stress among lecturers in X University. This research is a quantitative study with a cross-sectional study design. The sampling technique used is Accidental Sampling. The number of samples used was 132 respondents. The study was conducted in April-June 2024. The Cox Regression Model was used to analyze. The instruments used were The Workplace Stress Scale, Multidimensional …

An Evaluation Of Southern Nevada’S Pediatric Care Ecosystem, David Damore, Tina Quigley, Nick Fiore

Policy Briefs and Reports

In 2024, The Lincy Institute and the Nevada Health and Bioscience Corporation released a report prepared by the consulting firm Tripp Umbach detailing the case for a stand-alone children’s hospital in Southern Nevada. Shortly thereafter, Intermountain Health announced it would build Nevada’s first such facility in Las Vegas, expected to open in 2030. To complement the hospital’s development, The Lincy Institute undertook an independent evaluation of the regional pediatric care landscape. The analysis draws on secondary data and discussions with advocates, health system administrators, practitioners, and providers. The report examines:

• Fiscal, resource, and workforce challenges underlying Nevada’s poor population-level pediatric …

A Spatiotemporal Study Of Environmentally Associated Pulmonary Diseases In Georgia, Jason Raymond Baum

Walden Dissertations and Doctoral Studies

Exposures to particulate dust matter (PM10 and smaller) from aggregate comminution facilities (ACF) can lead to the onset of environmentally associated pulmonary diseases (EAPDs); acute and chronic asthma (Type I allergic hypersensitivity reaction), chronic pulmonary disease, interstitial lung disease (ILD), and lung cancer. In this environmental epidemiological research study, three primary spatial and spatiotemporal research questions related to nonoccupational exposures from 118 facilities across Georgia were evaluated. Secondary data analysis was conducted from the Centers for Disease Control and Prevention’s (CDC) 2018–2023 Behavioral Risk Factor Surveillance System (BRFSS) and the Metropolitan Statistical Areas, Micropolitan Statistical Areas, and Metropolitan Divisions to …

The Effect Of Alpha-Lipoic Acid On Sperm Cryobiology And Post-Thaw Quality Of Sperm In Livestock Species, Kashif Ali Malak, Nazar Ali Korejo, Hira Sajjad Talpur, Asmatullah Kaka, Atif Ali Malak, Muhammad Aqeel, Rasool Bux

Journal of Bioresource Management

The cryopreservation of semen is a prerequisite for artificial insemination, germplasm banking and the global distribution of elite livestock breeding. However, spermatozoa are particularly sensitive to cooling and freezing/thawing processes due to the presence of large amounts of polyunsaturated fatty acids in their plasma membranes and limited cytoplasmic antioxidant stores. An increase in reactive oxygen species, lipid peroxidation, mitochondrial dysfunction, acrosomal injury and DNA fragmentation occurs due to stress associated with cryopreservation, which results in the lowering of motility as well as viability and post-thaw low quality of sperm. Alpha-lipoic acid is a natural disulfide compound that acts as a …

Factors Associated With Adherence To Anti-Tuberculosis Drugs (Atds) In Samarinda, Fahmi Nur Indah Sari, Irfansyah Baharuddin Pakki, Nur Rohmah, Siswanto Siswanto, Muhamad Z. Saefurrohim

Jurnal Epidemiologi Kesehatan Indonesia

Tuberculosis (TB) is an infectious disease that remains a major public health problem in Indonesia. Treatment success is highly dependent on the patient's adherence to taking Anti-Tuberculosis Drugs (ATDs). This study aimed to determine the relationship between perceived susceptibility, severity, benefits, barriers (stigma), cues to action (healthcare workers support), and self-efficacy with adherence to taking ATDs among TB patients in Samarinda City. This study employed a cross-sectional design with a quantitative approach involving 121 TB patients from four community health centers (Puskesmas) in Samarinda. Samples were selected using multistage sampling. Data were collected through structured interviews using questionnaires and analyzed …

Modelling Acute Haemorrhagic Conjunctivitis In East Africa: An Integrated Approach To Transmission Dynamics And Outbreak Response Strategies, Geofrey Wingi Sikazwe

Tanzania Journal of Science

Acute hemorrhagic conjunctivitis (AHC) poses a significant global health risk, with the potential for rapid spread during outbreaks. For instance, a localized outbreak in Yunnan Province, China, recorded infection rates of up to 48%, illustrating how transmission can intensify under favourable epidemiological and environmental conditions. Existing mathematical models of AHC transmission overlook seasonal variations, a critical factor in epidemic spread. This study combines species distribution models (SDMs) and epidemiological modelling to analyse key drivers of AHC in East Africa. We use the SEIR type (Susceptible-Exposed-Infected-Recovered - incorporating waning immunity) framework with temperature-dependent infectivity rate as the key driver of an …

Plasmodium Falciparum Parasite Density And Its Association With Malaria Rapid Diagnostic Test Positivity Among School-Aged Children Across Diverse Malaria Transmission Settings In Mainland Tanzania, Felista Mwingira

Tanzania Journal of Science

Malaria rapid diagnostic tests (mRDTs) are widely used for malaria diagnosis and surveillance; however, their performance is influenced by parasite density. This study assessed the relationship between parasite density and mRDT positivity among school-aged children (SAC) across diverse malaria transmission settings in mainland Tanzania. Data were obtained from 17,131 school-aged children participating in a nationwide malaria survey. Malaria infection was assessed using mRDT and quantitative polymerase chain reaction (qPCR) targeting the Plasmodium falciparum lactate dehydrogenase (PfLDH) gene. Parasite density distributions were examined across demographic, environmental, and epidemiological characteristics. Malaria prevalence was 19.5% by malaria rapid diagnostic test (mRDT) and 19.2% …

Building Health Resilience Against The Threat Of “Jakarta Sinking”: A Scoping Review, Risky Kusuma Hartono, Dewi Shinta

Journal of Indonesian Health Policy and Administration

In Jakarta, land subsidence amplifies flood risks—often described as the city “sinking”—which increases exposure to waterborne and vector-borne diseases, disrupts essential health services, and undermines health system resilience. This review examines how subsidence-induced flood amplification impacts health and its implications for system resilience. This study employs a literature review approach that combines narrative synthesis with scoping-oriented evidence mapping. Peer-reviewed articles in English or Indonesian (2015–2025) were searched across PubMed, Scopus, ScienceDirect, Google Scholar, and Portal Garuda using the following terms: flooding, Jakarta land subsidence, health impacts, and health system resilience. Data on hazards, populations, health outcomes, and resilience functions were …

Biosensor Development In East Africa: A Systematic Review Of Technologies, Applications, Challenges, And Future Directions, Ally Mahadhy

Tanzania Journal of Science

Biosensors integrate biological recognition elements with signal transduction systems to generate quantitative or semi-quantitative analytical information and have applications across healthcare, food safety, agriculture, environmental monitoring, and wildlife health. Despite substantial global advances, biosensor development in East Africa remains poorly characterized. This systematic review, conducted according to PRISMA 2020 guidelines, evaluated published evidence from 1995 to 2025 within a predefined East African Community geographical scope. Eligibility was based on IUPAC-aligned operational criteria requiring an integrated biological recognition element, transduction mechanism, and quantitative or semi-quantitative signal output. Three locally developed biosensors met the criteria: an electrochemical nano-biosensor for schistosomiasis diagnosis in …

Agentic Ai For Clinical Outcomes Research, Population Health Management Analyses With Large Administrative Databases, And Generating Epidemiological Estimates Of Diseases: Feasibility And Validation Study, Daniel Frisch, Michael Fronstin, Carla Zema

Division of Cardiology Faculty Papers

BACKGROUND: There is tremendous enthusiasm for the use of AI in health care because of the ability to analyze existing data for preventative, diagnostic, and treatment support. Agentic AI can feasibly provide access to large real-world datasets for the generation of real-world evidence for health care and clinical applications to health care providers, researchers, and administrators without access to large analytic programming resources.

OBJECTIVE: The objective of this study was to understand the feasibility of using agentic AI for clinical outcome research and population health management. Specifically, this study used an agentic AI evidence-generation platform to obtain epidemiological estimates of …

Pengaruh Metformin Terhadap Prognosis Pasien Kanker Kolorektal Dengan Diabetes Melitus Tipe 2: Sebuah Laporan Kasus Berbasis Bukti, Richie Jonathan Djiu, Wismandari Wisnu

Jurnal Penyakit Dalam Indonesia

Colorectal cancer (CRC) has a high prevalence both globally and in Indonesia, with projections of increasing cases as the prevalence of type 2 diabetes mellitus (T2DM) rises. The complex relationship between CRC and T2DM, including increased risk and complications from chemotherapy, has driven study into the potential of metformin as an anticancer agent, although the existing findings remain varied. This evidence-based case report (EBCR) aimsed to evaluate the role of metformin as a prognostic factor for the survival of CRC patients with T2DM. The journal search was conducted using four databases: PubMed, EBSCOhost, Scopus, and manual searching. By setting inclusion …

Molecular Mechanisms, Evidence Levels, And Translational Prospects Of Natural Products In Non-Small Cell Lung Cancer: A Critical Narrative Review, Sakhawat Hussain, Muhammad Yousif, Habibullah Janyaro, Zahid Iqbat Rajput, Mohammad Farooque Hassan

Journal of Bioresource Management

Non-small cell lung cancer (NSCLC) accounts for approximately 80–85% of lung cancers and remains a major cause of cancer mortality. Molecular heterogeneity, acquired resistance to targeted therapies, immune escape, and treatment-related toxicity continue to limit durable disease control. Natural products and standardized botanical formulations have contributed substantially to anticancer drug discovery and are being investigated as complementary approaches in NSCLC; however, the strength of evidence varies markedly across experimental and clinical settings. This critical narrative review evaluates molecular mechanisms, preclinical evidence, human studies, and translational barriers relevant to natural-product-based interventions in NSCLC. A structured literature update was performed in August …

Antiplasmodial Activity Of Detarium Senegalense J.F.Gmel. (Fabaceae) Stembark Ethanol Extract, Cletus Anes Ukwubile, Hananiya Hamza Milagawanda

Journal of Bioresource Management

Malaria is a persistent public health impediment in sub-Saharan Africa, necessitating an incessant search for new, effective, and low-cost antimalarial agents from medicinal plants. This study was designed to evaluate the antiplasmodial efficacy of the ethanol crude extract of the stembark of Detarium senegalense. Standard methods were employed to identify the major secondary metabolites. In vivo antiplasmodial activity of the extract in Plasmodium berghei-infected mice was carried out as per the standard suppression test. The LD₅₀ was elicited in mice using a standard procedure. Phytochemical analysis revealed the presence of important bioactive components such as alkaloids, flavonoids, …

Reversible Microvascular Ischemia With St-Segment Elevation: An Underrecognized Manifestation Of Antibody-Mediated Rejection In Cardiac Allograft Recipients, Jonathan Ahn, Justin Daneshrad, Liset Stoletniy, Dmitry Abramov

The VAD Journal

Electrocardiographic manifestations of cardiac allograft rejection are often subtle, and stress-induced ST-segment elevation associated with antibody-mediated rejection (AMR) is rarely reported. We describe a 34-year-old heart transplant recipient with progressive exertional angina, nonobstructive coronary disease on angiography, and exercise-induced ST-segment elevation in lead augmented vector right, high-lateral leads I, and augmented voltage left, along with diffuse ST-segment depressions, hypotension, and transient ventricular tachycardia. Concurrent emergence of complement-binding donor-specific antibodies with high mean fluorescence intensity raised concern for AMR, prompting treatment with corticosteroids, plasma exchange, and intravenous immunoglobulin despite the absence of biopsy confirmation. After therapy, symptoms, exercise-induced ischemic electrocardiographic abnormalities, …

Overview Of Glp-1ra Medications, Thomas A.F. Cordaro Pharmd, Sumaiya A. Difaa Pharmd, Amel J. Basil Pharmd

Transformative Medicine

GLP-1 is an incretin hormone that is naturally produced in the body that regulates blood glucose and appetite. The first GLP-1RA that was FDA approved, exenatide, in 2005, originated from the Gila monster and beaded lizard, via the discovery of the exendin-4 peptide. GLP-1RAs function by mimicking endogenous GLP-1 incretin hormone, leading to an increase in glucose-dependent insulin release from beta-cells of the pancreas, decrease in glucagon release, delayed gastric emptying, and satiety. Due to the benefits seen from initiating GLP-1RAs in the market, it sparked interest in numerous studies which proved that certain GLP-1RAs can provide cardiorenal protection. The …

Elite Esports Players And Their Physical Health: A Systematic Review Of Injuries, Musculoskeletal Pain, And Fitness-Related Factors, Michal Steffl, Daniel Opelik, Vladimir Hlinka, Grzegorz Mikrut, Petra Hospodkova

Baltic Journal of Health and Physical Activity

Background: The rapid rise of competitive esports has sparked concerns over the physical health of elite players. Prolonged sedentary behaviour, repetitive movements, and poor ergonomic practices may predispose these athletes to injuries, musculoskeletal pain, and unfavourable body composition. Materials and methods: A systematic review following PRISMA guidelines was conducted by searching Pub-Med, Scopus, EBSCOhost, and Web of Science for cross-sectional studies on physical activity (PA), body composition, physical fitness, and musculoskeletal health in elite esports players. Data from 22 peer-reviewed studies involving 5,035 participants aged 16 to 35 were synthesized. Results: Findings consistently show that esports players engage in lower …

Quality Improvement Project: Enhancing Suicide Recognition Protocols With The Use Of Columbia-Suicide Severity Rating Scale In An Outpatient Mental Health Practice, Pamela Oxley

Doctor of Nursing Practice Projects

Suicide prevention in outpatient mental health settings requires prompt recognition of and an appropriate response to suicide-related concerns, including those initially communicated to administrative staff. Frontline administrative phone staff may first encounter patients expressing suicidal thoughts; however, evidence supports education and standardized processes to facilitate effective recognition and response. At the project site, a practice gap existed in administrative staff preparation and confidence in responding to suicide-related concerns. The quality improvement project addressed this gap through structured, standardized Columbia-Suicide Severity Rating Scale (C-SSRS) education paired with a standardized suicide-risk stratification and escalation protocol. The project aimed to improve administrative staff …

Impact Of Cannabis Use Screening And Early Intervention In Outpatient Psychiatric Settings, Theresa Chibuoke

Doctor of Nursing Practice Projects

Cannabis use can complicate psychiatric assessment, treatment planning, and clinical outcomes, yet standardized cannabis-use screening remains inconsistently implemented in behavioral health practice. This quality improvement (QI) project addressed inconsistent cannabis screening and referral practices in an outpatient psychiatric clinic by implementing a standardized workflow to improve screening documentation to at least 80% and timely referral completion to at least 75%. A quantitative, quasi-experimental pretest-posttest design included 10 outpatient psychiatric providers over six weeks. Lewin’s Unfreeze-Change-Refreeze model guided change, the Plan-Do-Study-Act framework supported implementation, and Donabedian’s Structure-Process-Outcome model guided the project. The evidence-based intervention incorporated provider education, the valid and reliable …