Digital Commons Network^™

Extrapulmonary Small Cell Carcinoma Presenting As Bilateral Papilledema, Hyponatremia, Encephalitis, Seizures, Crmp5-Igg Reactivity, And Prominent Anterior Tubular Perivascular Spaces, Ramsis Benjamin, Drew Thomas, Nina Mourao, J. Judd Fite, Brianna Woodliff, Shubhank Goyal

School of Medicine Publications

Background: Paraneoplastic syndromes that affect both the optic disc and the brain parenchyma typically harbor antibodies directed toward CV2/collapsin response-mediator protein 5 (anti-CRMP5), amphiphysin, Ma antigen 2 (Ma2/Ta), and Yo. The most common cancers linked to anti-CRMP5 antibodies include small-cell lung carcinoma (SCLC), followed by thymoma, renal cell carcinoma, and thyroid papillary carcinoma. A long-held belief explains papilledema as related to increased pressure within the subarachnoid space or the microvascular capillaries, but intracranial pressures within the normal standard range may exist in a person with a paraneoplastic syndrome and papilledema. The glymphatic system, a central waste-clearance conduit, may play a …

The Effect Of Education Using The Lecture Method And Puzzle Games On The Level Of Knowledge And Attitude Toward Balanced Nutrition Among Students Of Sdn Pakintelan 01 In Gunung Pati District, Semarang City, Erlin Nurlina, Syifa Qolbiyah Nasir

Indonesian Journal of Public Health Nutrition (IJPHN)

Fulfilled nutritional needs play an important role at school age. The beginning of nutritional problems occurs due to knowledge factors, so it is necessary to implement efforts to provide information about balanced nutrition. Nutrition education research using lecture and puzzle game methods was conducted at SDN Pakintelan 01 aimed at determining changes in the level of knowledge and attitudes of students regarding balanced nutrition. The type of research is Quasy Experiment and uses a pretest-post test design with control group design. The sampling technique uses stratified random sampling. The number of samples of the control group given education (lecture method) …

Fiber Content, Total Sugar, And Glycemic Index Of Jackfruit Seed And Pigeon Pea Flour Snack Bar, Dhiyaa Septi Kirana, Tesa Rafkhani

Indonesian Journal of Public Health Nutrition (IJPHN)

Diabetes Mellitus (DM) in Indonesia is the 7th leading cause of death. Diets high in sugar and glycemic index, and low in fiber are known to trigger hyperglycemia. Snack bars high in fiber and low in glycemic index are known to reduce blood glucose levels. This research aims to determine a snack bar formulation made from jackfruit seed and pigeon pea flour and analyze fiber content, total sugar, and glycemic index value. This study used a completely randomized design analyzing three different proportions of jackfruit seed and pigeon pea flour, namely F1 (30%:70%), F2 (40%:60%), and F3 (50%:50%) with two …

The Relationship Between Consumption Frequency And Energy Intake Of Ultra-Processed Food And Obesity Based On Body Fat Percentage Among Fph Ui Students In 2025, Sarah Keisya Budiargo, Triyanti Triyanti, Asih Setiarini, Dieta Nurrika

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is the accumulation of excessive body fat and increases the risk of various non-communicable diseases. Obesity prevalence among FPH UI students based on health examination data in 2022-2024 has reached 13.6%, exceeding the public health concern threshold and requiring more accurate measurement than Body Mass Index. This study aimed to determine the relationship between ultra-processed food (UPF) consumption frequency and energy intake with obesity incidence based on body fat percentage among 147 FPH UI students in 2025. This cross-sectional study utilized the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) based on NOVA classification to assess UPF intake. Body fat percentage was …

The Relationship Between Parenting Styles And Breakfast Habits With Adolescent Eating Behavior, Nailul Nufarohah, Siti Soraya, Hilda Carmitha Panjaitan

Indonesian Journal of Public Health Nutrition (IJPHN)

Adolescence is a critical transitional period requiring adequate and balanced nutrition to support optimal physical growth and psychosocial development. However, unhealthy Eating Behaviors such as skipping breakfast, consuming unbalanced diets, and frequent intake of foods high in sugar, salt, and fat are still commonly observed. Parenting styles and breakfast habits are considered important factors influencing adolescents’ Eating Behavior. This study aimed to analyze the relationship between parenting styles and breakfast habits with Eating Behavior among adolescents. This study employed a quantitative approach with a cross-sectional design conducted at SMK Negeri 62 Jakarta, South Jakarta. The population consisted of 578 active …

The Relationship Between Obesity Among Children And Adolescents With Dietary Intake And Physical Activity: A Scoping Review, Devi Dwi Yolani, Tania Okta Wardhani, Rani Aqilah Ni’Matul Maula, Almira Sitasari, Tri Siswati

Indonesian Journal of Public Health Nutrition (IJPHN)

Childhood and adolescent obesity remain a significant public health issue worldwide. This review summarizes research on the relationship among obesity, physical activity, and diet. This study aims to investigate the relationship between children's and adolescents' obesity, their physical activity levels, and diet. A scoping review was conducted by assessing 81 research journal articles from 2014 to 2023 from electronic databases such as Google Scholar and PubMed. The search strategy used Boolean operators as follows: (“child*” OR “adolescent”) AND (“obesity”) AND (“diet” OR “food intake”) AND (“physical activity”), selected based on the inclusion criteria of children and adolescents aged 1-18 years …

Integrating Nutrition Education To Improve The Effectiveness And Sustainability Of Makan Bergizi Gratis Programs, Akifa Laila Rusyda, Dewi Firda Sari, Ida Fransiska Pandiangan, Putri Mulifajar Gintings

Indonesian Journal of Public Health Nutrition (IJPHN)

The Makan Bergizi Gratis (MBG) program represents Indonesia's strategic effort to strengthen human capital by addressing malnutrition among school-aged. However, evidence suggests that school feeding alone is insufficient without structured nutrition education to promote sustained behavioral change. The present study examines opportunities and feasibility for embedding nutrition education within MBG implementation. Two-stage design was performed, including curriculum content reviews and qualitative case study design. A systematic curriculum content analysis was conducted across the school-based curriculum (KTSP) (2006), K-13 curriculum (2013 – 2017), and the Merdeka curriculum (2022 - present), using predefined nutrition competencies and behavioral domains as analytical frameworks. Purposive …

Improving Reflective Practice And Care Consistency In The Mental Health Connect Line: Addressing Compassion Fatigue Through A Quality Improvement Initiative, Chloe Parkin

South West Clinical School Journal

#400WORDS: QUALITY IMPROVEMENT REPORT

The Lived Experience Of Vicarious Trauma In Specialist Nurses Facilitating Organ Donation: A Narrative Review, Sharon Johnson, Kevin Hambridge

South West Clinical School Journal

#400 words: knowledge and action

The Use Of Thickener In Dysphagia Management: An Evaluation Of Current Practice, Morgane Griffiths

South West Clinical School Journal

#400WORDS: EVIDENCE INFORMED CHANGE PROJECT

Improving Reflective Practice And Care Consistency In The Mental Health Connect Line: Addressing Compassion Fatigue Through A Quality Improvement Initiative, Lauren Collier, Chloe Parkin

South West Clinical School Journal

#400WORDS: QUALITY IMPROVEMENT REPORT

Multicultural, Trauma‑Informed Feeding Protocols For Children With Spd In Student‑Led Ot Clinics, Matt Crummel

Capstone Projects

This capstone project aims to develop and implement feeding protocols for children with sensory processing disorders in a student-led occupational therapy clinic, emphasizing trauma-informed care and multicultural practices. By creating evidence-based interventions and fostering interdisciplinary collaboration, the project seeks to enhance therapeutic outcomes while providing OT students with hands-on learning experiences. OT is a healthcare profession that enhances individuals’ independence in daily activities through personalized interventions targeting physical, sensory, and cognitive skills. Student-led OT clinics offer a valuable learning environment where students work under licensed clinicians to provide therapeutic care.

Sensory processing disorders (SPD) significantly impact feeding behaviors, often leading …

Evaluation Of A Wearable Wireless Respiratory Monitoring System (Rms) For Detecting And Predicting Clinical Deterioration, Shreya Kolipaka, Jeffrey I. Joseph, Do

Student Papers, Posters & Projects

Introduction & Objectives

- Mortality within 30 days after major surgery is the third leading cause of death worldwide.¹

- Post-operative adverse events leading to mortality include pneumonia, respiratory failure, sepsis, kidney failure, pulmonary embolism, and major cardiac events.^2,3

- Early warning signs of clinical deterioration are commonly missed due to infrequent clinical assessments, delaying timely diagnosis and intervention.^2,4

- On the general hospital floors, vital signs are monitored every 4 to 8 hours, suggesting patients could be unmonitored 96% of their hospital stay.¹

- Changes in respiratory rate (RR) are the earliest and most sensitive …

Inconsistent Post-Fall Follow-Up And Documentation In A Skilled Nursing Facility, Brooke Beier

Celebrating Scholarship and Creativity Day (2018-)

Falls remain a significant safety concern in skilled nursing facilities and are associated with increased morbidity, hospitalization, and loss of independence among older adults. While fall prevention strategies are widely implemented, inconsistent post-fall follow up and incomplete documentation can negatively impact residents and the facility. At a moderate-sized skilled nursing facility in central Minnesota, a review of recent fall reports identified inconsistencies in post-fall follow-up documentation, as well as gaps in staff education and the absence of a clearly defined post-fall documentation policy. The facility experienced 44 resident falls in the month of January alone, highlighting the urgency of addressing …

Implementation Of Positive Reinforcement To Promote Staff Adherence To Bowel And Bladder Plans At A Long-Term Care Facility, Alfonso Segura Sanchez

Celebrating Scholarship and Creativity Day (2018-)

Background: Bowel and bladder plans (BBPs), also known as toileting programs, are individualized restorative nursing programs that have strategies to promote continence in residents and reduce the negative consequences of incontinence (Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual Version 1.20.1, 2025). Purpose: Senior nursing students implemented positive reinforcement in a quality improvement (QI) project to reduce rates of incontinence and inconsistent adherence to BBPs at Elim Wellspring, a skilled nursing facility for long-term care in Princeton, MN. According to the Minnesota Department of Human Services and Minnesota Department of Health, the most recent report on quality indicators for …

Mislabeling And Inappropriate Analysis Render Interpretations From “The Effect Of The Participatory Heat Education And Awareness Tools (Heat) Intervention On Agricultural Worker Physiological Heat Strain: Results From A Parallel, Comparison, Group Randomized Study” Unreliable, Chelsi M Webster, Yasaman Jamshidi-Naeini, Lilian Golzarri-Arroyo, Colby J Vorland, Zachary J Schlader, Blair D Johnson, David B Allison

Faculty, Staff and Students Publications

No abstract provided.

Inherited Tbx4 Frameshifting Variants Predicted To Escape Nonsense Mediated Decay In Two Families With Variable Phenotypes, Including Lethal Lung Developmental Disorders, Shruti A Pande, Hiuling Chan Joiner, Przemyslaw Szafranski, Tomasz Gambin, Michelle Wright, Qian Wang, Maiah Walters, Jan M Friedman, Jessica Saunders, Nicholas Avdimiretz, Cornelius F Boerkoel, Nahir Cortes-Santiago, Gail Deutsch, Pawel Stankiewicz

Faculty, Staff and Students Publications

Background: Pathogenic variants involving the transcription factor TBX4 gene have been associated with various skeletal and pulmonary abnormalities, including lethal lung developmental disorders (LLDD).

Methods: Whole-genome sequencing (WGS) with AI-powered platform for variant detection and interpretation followed by Sanger sequencing targeted variant segregation analysis were used. Reverse transcription quantitative PCR (RT-qPCR) and immunohistochemistry (IHC) studies were performed to assess gene and protein expression levels, respectively.

Results: We describe two unrelated families with intrafamilial variability in the TBX4 phenotypic expressivity, including LLDDs. WGS analyses revealed two frameshift variants, c.1019del; p.(Arg340GlnfsTer40) in the penultimate exon and c.1167dup; p.(Arg390GlnfsTer30) in the last exon …

Enhancing Provider Engagement Through Peer-To-Peer Coaching: The Provider Ambassador Program, Jason Vallee, Jodi Stewart, Sam Verkhovsky, Steve Del Giudice, Janet Aug, Amanda Higgins, James Perry, Alice Kennedy, Brant Oliver

Patient Experience Journal

Provider burnout and disengagement are associated with diminished patient satisfaction, reduced clinical quality, and adverse organizational outcomes. Peer-to-peer coaching has emerged as a promising, scalable intervention to support provider engagement and improve the patient care experience. This study evaluates the effectiveness of the Provider Ambassador Program, a structured peer-to-peer coaching initiative designed to improve patient satisfaction by enhancing provider communication, professional behavior, and patient engagement skills. A pre-post quasi-experimental design was used to assess changes in provider CG-CAHPS ``Provider Overall'' top-box scores following coaching. Eligible providers (n = 83) across five BLANK Health locations were identified based on top-box scores …

A Hybrid Coaching Model In A Multi-Center Networked Care Experience Learning Collaborative, Elizabeth Rizzo, Victoria Adams, James Perry, Nicole Szalay, Samuel Verkhovsky, Megan Morse Holthoff, Alice Mae Kennedy, Brant Oliver

Patient Experience Journal

Coaching teams and leaders conducting quality improvement (QI) has shown to be an effective method for project success. Our coaches were well versed in Lean Six Sigma and IHI Model for Improvement methods. Certified Lean Six Sigma Blackbelts coaches were assigned to project teams. Routine participation in project team meetings and one-on-one coaching sessions reenforced tools necessary to complete improvement work. Additionally, coaches met with one another to discuss their methods, work through challenges, and celebrate successes. Fourteen improvement teams led work in Care Experience related projects. Eleven project leaders certified in Lean Six Sigma methodology through the Value Institute …

Documentation And Dashboard Driven Quality And Safety Improvement In Interpreter Services For Limited English Proficient Patients, Richard T. Dillehay, Samuel Verkhovsky, Andrew Bohm, Harley Friedman, Dawn Welshman, Ann Morong, Vidya Karthikeyan, Jessica Dampier, Amanda Racine, Brant Oliver

Patient Experience Journal

Limited English Proficiency is known as an independent driver of disparities in patient's access to healthcare and their healthcare outcomes. The Joint Commission standards require that health systems document language services delivery to patients with limited English proficiency in a systematic way. Our health system had not historically utilized a methodical system for documenting language services utilization prior to the launch of this initiative. By utilizing a Lean Six Sigma approach, a project team comprised of leaders from interpreter services, operations, data analytics, and data informatics codesigned an Epic SmartForm data collection instrument and series of Tableau dashboards to monitor …

``We'll Be Right With You'', Improving Patient Experience With Complaint Management Within A Learning Health System Collaborative, James J. Perry, Mackenzie Hahn, Angela Kmiec, Brant J. Oliver

Patient Experience Journal

An improvement team at Cheshire Medical-Dartmouth Health participated in the Care Experience Collaborative aimed at enhancing the patient and workforce experience. Utilizing a hybrid Lean Six Sigma DMAIC approach alongside modified Institute for Healthcare Improvement learning techniques, local teams were coached by quality improvement specialists. The project's focus was on improving the complaint management process to boost hospital ratings and recommendations. Initial assessments revealed significant inefficiencies, such as delays in response times and poor tracking of complaint resolutions. Implementing a new digital monitoring system in conjunction with standardized training resulted in substantial improvements: complaint resolution times decreased by 53%, while …

From Talking The Talk To Walking The Walk: Reflection On Dartmouth Health's Care Experience Week, Rosie Bartel, Corey Kimpson, Tanya Lord, Victoria Lyons, Tony Serge, Brant Oliver

Patient Experience Journal

This article explores the participation of expert members from the Beryl Institute's Global Patient and Family Advisory Board (GPFAB) during Dartmouth Health's Care Experience Week, under the theme ``From Talking the Talk to Walking the Walk.'' This week aligns with the national Patient Experience Week. The Patient Family Advisor (PFA) presenters and authors of this article have shared their lived experience locally, nationally, and internationally through conferences, webinars, podcasts, videos, blogs, white papers, journal articles, books, and in many other ways for and as PFA members of a multitude of healthcare organizations co-create change that improves outcomes for all human …

Improving Human Experience In Health Care: Leveraging ``Humanistic Learning Health Systems'' To Accelerate Change At Scale, Brant J. Oliver, Jason A. Wolf

Patient Experience Journal

Included in a special segment in this issue of the Patient Experience Journal, are a series of reports on improving HX in healthcare supported by a humanistic LHS– the Dartmouth Promise Partnership Coproduction Learning Health System in New Hampshire, USA. Promise is a strategic partnership between a medical school and a multi-center rural academic health system. It integrates translational science education and research, data informatics, and scaled and networked humanistic applied change initiatives. One of these initiatives is the Care Experience Collaborative, a multi-center improvement initiative across the health system focused on improving HX. This special segment includes five reports …

Patient Engagement In Developing Radiology Patient Education Materials, T Arleo, Harrisd Harrisd, J Hislop, J Moon, H Li, N Kadom

Patient Experience Journal

Purpose: This initiative aimed to engage patients in the process of developing patient education materials (PEM) on the major imaging modalities at our institution. Materials and Methods: PEM were created for computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), fluoroscopy, and radiography. Content was sourced from various sources, consolidated into a draft, and iteratively updated: They were simplified using a ChatGPT-4.0 prompt designed to achieve a 7th grade reading level; they were reviewed for accuracy by subject matter experts (SME); they were assessed for readability and understandability using the Flesch-Kincaid Grade Level (FKGL) and the Patient Education Materials Assessment …

Utilization Of Visual Metaphors For Improving Health Literacy, Kadir Alp Özler, Morgan Dressel, Madeline Weiner, Robert D Lucito, Alice Fornari

Patient Experience Journal

Health education is practiced in patient encounters via verbal communication and educational pamphlets. However, these techniques are faulty and do not provide true patient comprehension of their conditions and treatments reform is necessary to prevent the mortality and hospitalization rates that are linked to poor health literacy. Visual aids and metaphors are individually known to be powerful educational tools. A student organization at Stony Brook University, Artists in Medicine, has sought to synergize these tools to create visual metaphors artwork that links everyday concepts to patient illnesses to facilitate comprehension of this information. For example, one project “Aortic Dissections” depicts …

Patient Experience (Px) In Low- And Middle-Income Countries (Lmics): A Scoping Review, Yara Abou Harb, Geoffrey A. Silvera

Patient Experience Journal

Patient Experience (PX) is a growing subject in the healthcare industry due to its association with improved clinical outcomes, patient safety, and business motives. While PX is well studied in high income countries, little is known about the state of PX in Low and Middle-income countries (LMICs). Objective: The study aims to examine literature on PX and related concepts in LMICs. Methods: This study executes a PRISMA literature review of academic databases (Ovid Medline, CINAHL, EMBASE and Google Scholar) as well as hand searching of PX related websites from 2005 to 2024. Results: 67 references met search criteria. Four themes …

Multilevel Factors Shaping The Patient Experience With Health Services In Torbat Heydarieh, Iran, Fatemeh Pourhaji, Mohammad Hossein Delshad

Patient Experience Journal

Background: One of the main aims of public health is to ensure that health services are used and available. However, access alone does not guarantee a positive patient experience, which is critical to achieving optimal health outcomes and ensuring health equity. Aims: The objective of this study is to analyse in a comprehensive way the multiple factors influencing the patient experience and subsequent use of healthcare services by households in Torbat Heydarieh, Iran, by examining the independent and interactive contributions of individual, household and environmental (community) determinants using THUMS data. Methods: This analytical study, which covered a 1-year period, looked …

Factors Influencing Patient Satisfaction In Health Services: A Cross-Sectional Study In The Holy City Of Najaf, Ahmed Abdul Hasan Mohsin, Lamees A. Abdul-Lateef, Noor Ismeal Nasser

Patient Experience Journal

The healthcare system in the city of Najaf works to improve the quality of services provided to patients. Since patient satisfaction serves as a key measure of service quality, this study was designed to identify the potential factors that influence satisfaction within these facilities. cross-sectional study was conducted for 300 patients using public healthcare services in Najaf. the selection of patients based on the stratified random sampling across hospitals and primary health centers. Data were collected using a 24-item structured questionnaire that measured four domains: accessibility, staff attitude, service quality, and physical environment, rated on a four-point Likert scale. The …

Nursing Staff Attitude Towards Nurse-Physician Collaboration In The Neonatal Intensive Care Unit In Al Ahsa City, Saudi Arabia, Makarim Taqi Al Helal, Yaqoub Yousef Al Mousa

Patient Experience Journal

Objective: Effective nurse-physician collaboration is fundamental to ensuring quality healthcare delivery, particularly in Neonatal Intensive Care Units (NICUs), where patient outcomes rely heavily on coordinated teamwork. This study aimed to assess nursing staff attitudes toward nurse-physician collaboration in NICUs, examine the influence of demographic and professional characteristics, and provide evidence-based recommendations to strengthen interprofessional collaboration. Methods: A quantitative, non-experimental, cross-sectional survey was conducted from April to June 2024 in the NICU of Maternity and Children's Hospital, Al Ahsa, Saudi Arabia. A total of 180 nurses with at least one year of NICU experience participated. Data were collected using the …

Do Allied Health Professionals' Workplace Experiences Affect Their Decisions To Stay? A Quantitative Investigation Into The Relationship Between Wellness And Employee Retention In United States Hospitals, Dina Jarjees, Lihua Dishman

Patient Experience Journal

Allied Health Professionals (AHPs) are university-trained practitioners with specialized skills essential for preventing, diagnosing, and treating health conditions. AHPs play a vital role in comprehensive healthcare, including hospitals, where they comprise a significant portion of the workforce and recurrent health expenditures. However, AHPs experience considerable burnout and emotional distress, negatively impacting retention. This issue worsens workforce shortages and limits access to care, which jeopardizes patient safety. This national, cross-sectional, quantitative study examined the relationship between AHPs' wellness dimensions (physical, emotional, mental, social, and spiritual) and AHPs' retention in United States hospitals. A self-developed survey instrument included 10 demographic and 25 …