Digital Commons Network^™

The Explorative Of Eating Behavior, Quality Of Life And Related Factor In Bariatric Surgery Patients, Shih-Ting Lo, Shu-Fen Wu, Yu-Rong Hsu, Tien-Chou Soong

International Nursing Research Congress (INRC)

Background: Obesity is now recognized as one of the most important public health issues worldwide. Bariatric surgery is the most durable weight-loss solution for patients with morbid obesity. However, adopting healthy eating behaviors is essential for successful weight loss and improving health-related quality of life.

Purpose: This study aimed to assess the association between eating behaviors and health-related quality of life (HRQOL) and examined influencing factors among patients after bariatric surgery.

Methods: The cross-sectional study design was adopted with convenience sampling conducted at bariatric center in Southern Taiwan. A total of 296 morbid obesity patients were recruited. Data were collected …

Nurses' Understanding Of Lgbtq+ Populations: A Needs Assessment, Danielle Brochu

International Nursing Research Congress (INRC)

Background: Recent literature illustrates the lack of nursing knowledge regarding health considerations specific to the LGBTQ+ population, both among nursing students and registered nurses (Medina-Martínez et al., 2021). A systematic review of the evidence by Sherman et al. (2023) concluded that formal education on this topic remains limited, as a comprehensive method to providing this education to nursing staff and other healthcare providers has yet to be identified. From a higher education standpoint, many pre-licensure BSN/RN students report a lack of formal education on caring for LGBTQ+ populations and have little exposure to this population in the clinical setting (Morris …

Auditory Hallucinations As Patients' Allies: Challenges For Psychiatric Nurses In Clinical Care, Su-Chen Lo, Jia-Min Li, Chiu-Yueh Yueh Yang

International Nursing Research Congress (INRC)

Background: Auditory hallucinations are a prevalent positive symptom in schizophrenia, with 20-60% of patients experiencing them even with regular medication. Nurses' expertise in managing these hallucinations directly influences symptom stability. Nurses who feel overwhelmed by handling auditory hallucinations may also consider leaving the profession. Thus, understanding psychiatric nurses' experiences and challenges in managing auditory hallucinations is valuable.

Aim: To explore psychiatric nurses' experiences in caring for patients with auditory hallucinations.

Methods: This qualitative study included 39 nurses (10 male, 29 female) across four psychiatric hospitals. Three rounds of focus group interviews were conducted weekly from June to August 2024, and …

Bridging The Gap: Opportunities And Barriers In Diabetes Self-Management Education, Paul R. Boy, Sorina Long, Manpreet Sidhu, Barbara Roces, Dante Anthony Tolentino

International Nursing Research Congress (INRC)

Diabetes self-management education and support (DSMES) programs are essential for navigating the complexity of diabetes management, yet engagement in these programs is poor.^1,2 A gap remains in understanding AAs' DSMES engagement due to the exclusion of their perspectives and the tendency to treat them as a monolithic group,³ missing nuanced experiences. This lack of understanding prevents the creation of interventions to improve DSMES engagement among AAs. Therefore, this study aimed to describe the determinants of DSMES engagement among AAs with T2DM. We used an interpretive descriptive qualitative approach to explore how AAs engage with DSMES programs. We conducted …

Factors Affecting Person-Centered Care, Da Gyeon Lee, Mi Young Choi

International Nursing Research Congress (INRC)

Purpose: This study aimed to identify the mediating effects of compassionate competence and nurse-parent partnership on the relationship between nursing professionalism and person-centered care among pediatric nurses.

Methods: A survey was conducted among 181 pediatric nurses working in nine hospitals in regions C and J in Korea. The data were collected in April and May 2024 and analyzed using SPSS 26.0 and the PROCESS macro program.

Results: The results showed a positive correlation between person-centered care and nursing professionalism (r=.64, p<.001), compassionate competence (r=.78, p<.001), and pediatric nurse-parent partnership (r=.82, p<.001). Furthermore, compassionate competence and pediatric nurse-parent partnership had a serial dual mediating effect on the relationship between professionalism and person-centered care.

Conclusion: To improve person-centered care in pediatric nursing, a strategy should be developed to strengthen professional nursing …

Addressing Provider Burnout With Ai Scribe Technology In Mental Health Practice Settings, Dillon Boland, Kayla Harvey

International Nursing Research Congress (INRC)

Background: Burnout is on the rise and contributes to critical patient care errors, poor patient perception of care, and a reduction in provider life satisfaction^1,2. Some primary causes of burnout among healthcare providers are the escalating administrative burdens and extensive screen time associated with electronic health records (EHR) and other documentation tasks³. AI-assisted charting has shown promising results in improving provider satisfaction, increasing time with patients, reducing administrative workload, reducing EHR interface time, increasing patient satisfaction, and reducing provider self-reports of fatigue and dread⁵.

Purpose: This project aims to examine the effect of the …

The Physical Activity Effect On Lowering Blood Pressure In Adults: A Meta-Analysis Of Rct Studies, Talato Kabore, Tanja Baum Low, Kay Yang, Taqialdeen Zamil

International Nursing Research Congress (INRC)

Background: Prehypertension is a silent major contributor to the world's burden of cardiovascular diseases. Individuals with prehypertension may progress to cardiovascular diseases (Barone Gibbs et al., 2021; Nesnawy et al., 2024; Kariuki et al., 2024). Different combinations of physical activity interventions lowered blood pressure among prehypertensive adults worldwide. Therefore, this meta-analysis evaluated the pooled effects of multiple physical activity interventions on reducing blood pressure among prehypertensive adults.

Methods: A meta-analysis performed sixteen RCT studies. Among the 1,419 adult participants, 881 men and 538 women. Random effects models were used to evaluate heterogeneity in the study. A funnel plot and a …

Lgbtqia+ Identifying Parents' Experiences Of Bias And Discrimination In Pediatric Healthcare, Nakayla Renae Figgins, Ashley Apple

International Nursing Research Congress (INRC)

Despite advancements aiming to promote better inclusion of LGBTQIA+ identifying individuals in our nation, there still remains to be a great deal of discrimination towards this population, particularly within our healthcare system. LGBTQIA+ individuals in our nation still presently continue to face discrimination across different aspects of society (Medina and Mahowald, 2024).

The purpose of this study is to examine the experiences of LGBTQIA+ parents in pediatric healthcare settings and the ways in which those experiences impact LGBTQIA+ parents' trust in their children’s healthcare providers. In order to better address the needs of LGBTQIA+ parents within our nation’s healthcare system, …

Political Science And Education Policy: A Florida Student's Perspective On Pedagogical Partnership, Ben Gordon

Teaching and Learning Together in Higher Education

No abstract provided.

Care First, Aaniyah Alexander

Teaching and Learning Together in Higher Education

No abstract provided.

Cultivating Critical Hope: Reflections On Pedagogical Partnerships In Higher Education, Austen Morris

Teaching and Learning Together in Higher Education

No abstract provided.

Practice Patterns In The Management Of Pemphigus – An International Survey Study, Idy Tam, Gabriela Cobos, Zachary M. Schwager, Erin X. Wei

The Lahey Journal

Introduction: Anti-CD20 therapy (rituximab) has emerged as an effective and disease modifying treatment for pemphigus, especially in early disease. However, significant variability exists around the clinical application of this therapy.

Methods: In this survey-based study among bullous disease experts, we investigated practice patterns surrounding the use of rituximab in the management of pemphigus. Anonymized surveys were sent to physician members of the internation Pemphigus and Pemphigoid Foundation. Topics of inquiry included the use of rituximab first line in newly diagnosed pemphigus, rituximab dosing regimen, use of concomitant steroid sparing agents, criteria for retreatment, and the use of antimicrobial prophylaxis.

Results: …

Instagram In The Clinic: A New Challenge For Patient–Physician Communication, Jayashree Ravikumar

Journal of Community Hospital Internal Medicine Perspectives

This letter reflects on a growing trend observed in clinical practice: patients increasingly consult social media for guidance on various medical conditions before visiting their physicians. The piece highlights the opportunities and risks associated with this behavior, particularly in community hospital settings, and emphasizes the importance of clinician guidance and digital health literacy

Elevated Creatine Kinase As A Marker For Aggressive Gi Malignancy, Ramya Vasireddy, Joseph Atarere, Jeffrey Iding, Abhinav Sankineni

Journal of Community Hospital Internal Medicine Perspectives

Klatskin tumor is a rare and aggressive biliary malignancy with a poor prognosis. We present a 72-year-old male with a history of COPD and severe non-ischemic cardiomyopathy who presented with jaundice, pruritus, and fatigue. Laboratory findings revealed marked hyperbilirubinemia and elevated liver enzymes, along with significantly increased creatine kinase (CK). Imaging studies and ERCP confirmed the diagnosis of perihilar cholangiocarcinoma, Bismuth class III, with adenocarcinoma pathology. Despite palliative stent placement, the patient’s bilirubin levels remained elevated, and CK peaked at 45,000 units/L. Due to his advanced disease and comorbidities, he was not a candidate for surgical or systemic therapy and …

Unveiling An Uncommon Complication: Pleural Effusion Secondary To Pioglitazone Use, Ranjana Chimauriya, Abhinandan Chittal, Khalid Malik, Tiffany Dumont, Christopher James Haas

Journal of Community Hospital Internal Medicine Perspectives

Pioglitazone, a peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist, is used in the treatment of type 2 diabetes mellitus by reducing insulin resistance. While peripheral edema and fluid retention are well-documented adverse effects, isolated pleural effusion in the absence of heart failure is rare. We present the fourth reported case of a woman in her 60s with type 2 diabetes who developed recurrent left-sided pleural effusion after the initiation and dose escalation of pioglitazone. The effusion resolved completely following discontinuation of the drug. This case underscores the importance of early recognition of drug-induced pleural effusion and timely cessation of the offending …

Severe Hyponatremia Presenting With Mild Symptoms And Multifactorial Etiology, Nathaniel Lin, Muhammad Cheema, Usman Fahim, Abdullah Ali, Andrew Weber

Journal of Community Hospital Internal Medicine Perspectives

Hyponatremia is a common electrolyte disturbance; however, serum sodium level of 99 mEq/L without severe symptoms or known duration is rare and noteworthy. We report a case of an 87-year-old female who presented with fatigue, decreased appetite, and mild emesis for the past 2 days in which blood work revealed a serum sodium level 99 mEq/L. The etiology of hyponatremia in an elderly patient may be complex due to higher likelihood of co-morbid medical conditions. Additionally, syndrome of inappropriate antidiuretic hormone (SIADH) can pose a diagnostic challenge as fewer than 50% of patients have typical lab results that confirm the …

An Incredible Impact Of Antibiotics On Leukostasis, Ranjana Chimauriya, Chiranjibi Mainali, George John Pyrgos, Christopher James Haas

Journal of Community Hospital Internal Medicine Perspectives

Leukostasis is characterized by respiratory or neurological issues in the context of hyperleukocytosis, secondary to elevated blood viscosity and WBC plugs (aggregates of mature leukocytes or leukemic blasts physically obstructing the microvasculature leading to impaired tissue perfusion and organ dysfunction).It is rare in Chronic Lymphocytic Leukemia (CLL) unless WBC > 500,000/µL. A 67-year-old female presented with severe respiratory distress and altered mental status. She was diagnosed with Streptococcus pneumoniae meningitis and pneumonia. Laboratory diagnostics demonstrated hyperleukocytosis (WBC >440,000/µL) and CLL confirmed by flow cytometry. Imaging showed bilateral acute brain infarcts. After 12 days of antibiotic therapy, her WBC dropped to 40,000/µL, …

Bilateral Pulmonary Embolism With Bi-Atrial Cardiac Thrombi Entrapped In A Patent Foramen Ovale, Denise Mourad, Fahd Eissa Mohamed, Yashi Ballal, Elie Mrad, Natasa Petreska, Sachin Singh, Paritharsh Ghantasala

Journal of Community Hospital Internal Medicine Perspectives

Bi-atrial thrombi with bilateral pulmonary embolism (PE) through a patent foramen ovale (PFO) is rare and life-threatening, requiring urgent management due to embolization risk. We present a 53-year-old female with left lower extremity extensive deep vein thrombosis (DVT), bilateral PE, and bi-atrial thrombi straddling a PFO. She underwent thrombectomy, PFO closure, and pulmonary embolectomy but later experienced recurrent DVT and PE. Anticoagulation was limited due to bleeding risk given a recent neurosurgery. Literature lacks clear guidelines for managing such cases necessitating individualized treatment. This case highlights the complexity of bi-atrial thrombi with PFO and the need for further research to …

Novel Treatments For Adolescent Vaping Cessation: Are We There Yet?, Jasleen Kaur, Amanda Rossi, Sofia Adams, Mariginder Singh Varowal, Lakshit Jain, Mohsin Raza, Zouina Sarfraz

Journal of Community Hospital Internal Medicine Perspectives

E-cigarette use among adolescents is a growing public health concern, driven by discreet designs, appealing flavors, and social influences. Despite high addiction rates, most teen users express a desire to quit, though evidence-based cessation tools remain limited. Behavioral interventions, including tech-based programs like This Is Quitting and smokeSCREEN, show promise. Pharmacotherapy, particularly varenicline, may support quitting, though its role in adolescents is still under investigation. Pediatricians must address this issue through empathetic, multifaceted approaches that combine education, behavioral support, and emerging treatments to curb early nicotine dependence and its long-term health consequences.

Malabsorption Of Thyroid Hormone After Small Bowel Resection, Nathaniel Lin, Marilyn Temkin, Ella Rosenbloom, Alan Kaell

Journal of Community Hospital Internal Medicine Perspectives

Hypothyroid patients on stable long-term oral levothyroxine (T4) dosage are at risk of developing overt hypothyroidism after small bowel (SB) resection. This can happen despite equivalent peri-operative intravenous (IV) supplementation and resumption of preoperative oral T4 dosage when post-operative oral medication is tolerated. This situation is not specifically addressed in any of the major guidelines for T4 oral replacement in this setting and may be underrecognized, leading to diagnostic and management challenges.

Methotrexate Toxicity Management In Polymyalgia Rheumatica: A Case Report, Devi Meghana Kotharu, Sai Diksha Vutukuru, Prafullkumar Patel, Athmananda Nanjundappa, Sumanth Kumar Bandaru

Journal of Community Hospital Internal Medicine Perspectives

Methotrexate (MTX) is an anti-folate drug with anti-inflammatory and anti-proliferative properties. Low-dose methotrexate (10-25mg/week) is widely recognized as a safe and effective treatment for various autoimmune disorders. While toxicity from low dose methotrexate is uncommon it can lead to severe complications like pancytopenia. We present a case of a 68-year-old male with a history of steroid-resistant Polymyalgia Rheumatica on methotrexate (20 mg weekly) and prednisone. He presented to the emergency room with oral mucosal lesions and reduced oral intake. Upon evaluation, he was found to have pancytopenia and transaminitis, raising concern for methotrexate toxicity. Treatment included folinic acid rescue therapy …

Thyrotoxicosis Triggering Takotsubo Cardiomyopathy And Acute Coronary Syndrome: A Case Of Severe Cardiovascular Manifestations In Hyperthyroidism, Raiyan Ali, Nathaniel Lin, Taha Siddiqui, Mohit Sharma

Journal of Community Hospital Internal Medicine Perspectives

Hyperthyroidism can lead to serious cardiovascular complications, including arrhythmias, high-output heart failure, and myocardial ischemia. Thyrotoxicosis, a hypermetabolic emergency, may mimic or exacerbate acute coronary syndrome (ACS) and, though rare, has been associated with takotsubo cardiomyopathy. We present a case of a 54-year-old thyrotoxic female without significant cardiovascular history who presented with atypical chest pain complicated by both takotsubo cardiomyopathy and myocardial infarction. This case not only emphasizes the diagnostic challenge posed by thyroid-induced cardiac dysfunctions but also highlights the importance of multidisciplinary management in these patients.

Fecaloma In Chronic Opioid-Induced Constipation: A Fatal Case Of Stercoral Colitis, Claudia Georges, Simardeep Singh, Eskandar Alex Yazajiadepartment Of Medicine, Medstar Health Georgetown University (Baltimore) Program, Baltimore, Md, Usa

Journal of Community Hospital Internal Medicine Perspectives

Stercoral colitis (SC) is a rare and potentially lethal condition characterized by severe colonic inflammation resulting from fecal impaction. This disorder is more prevalent among the elderly and vulnerable groups, especially those on chronic opioids. Our case study involves a 56-year-old male with a history of chronic opioid use who faced an acute colonic obstruction due to longstanding constipation. Despite receiving surgical treatment, the patient dies from ischemic bowel complications and multiorgan failure. The case accentuates the complexities of diagnosing and treating stercoral colitis, highlighting the critical need for early identification and proactive therapeutic intervention to prevent fatal outcomes.

Investigation Of The Optimal Length Of Discharge Summaries In Care Transitions: A Cross-Sectional Study, Taku Harada, Shintaro Kosaka, Aki Morishima, Seitaro Iguchi

Journal of Community Hospital Internal Medicine Perspectives

Introduction

Discharge summaries are essential documents that support continuity of care during patient transitions between inpatient and outpatient settings. They help ensure that crucial clinical information is conveyed accurately and completely. However, while their clinical significance is well established, there is little consensus on the optimal format, particularly in terms of length and structural clarity. Excessively brief summaries may omit key details, while overly lengthy ones can hinder efficient information transfer. Despite varied suggestions in the literature—ranging from half a page to four pages—empirical data on physician preferences are limited.

Methods

We conducted a cross-sectional, web-based survey among physicians who …

Fluid Resuscitation Choice And Its Effect On Plasma Chloride And Acute Kidney Injury In Severe Acute Pancreatitis: A Randomized Study Of Normal Saline Vs. Balanced Crystalloids (Physiomax), Mandip Singh Bhatia, Ritu Attri, Ashok Kumar Pannu, Atul Saroch, Saurabh C Sharda, Neeraj Singla, Sakshi Mehta

Journal of Community Hospital Internal Medicine Perspectives

Background: Acute pancreatitis (AP) is a potentially fatal gastrointestinal condition, often associated with organ failure and acute kidney injury (AKI). Early fluid resuscitation with Normal saline (NS) may lead to hyperchloremia and AKI, which prompted interest in using balanced crystalloids. However, the optimal choice of crystalloid fluid remains uncertain. This study aimed to compare the effects of NS versus Physiomax on plasma chloride levels and AKI incidence during early resuscitation in patients with predicted severe AP (pSAP).

Methods: A single-center, prospective, randomized study was conducted between November 2022 and December 2023 at PGIMER, Chandigarh, India. 112 patients with pSAP were …

Reassessing D-Dimer Cut-Offs For Pulmonary Embolism: A Path Toward Safer And More Cost-Effective Diagnosis, Amer Abu-Shanab, Montaser Alrjoob, Zain Albdour, Alaa Alkhatib, Apurva Ketkar, Ahmad Al-Alwan, Charmee Vyas, Husam Bader, Sohini Sarkar, Doantrang Du

Journal of Community Hospital Internal Medicine Perspectives

Background

Pulmonary embolism (PE) is a life-threatening condition requiring early and accurate diagnosis. The Wells and Geneva scores, along with D-dimer testing, are key tools in assessment. However, the standard D-dimer cut-off of 0.5 mg/mL, while highly sensitive, has low specificity, leading to excessive imaging. This study examines whether modifying the D-dimer threshold can improve diagnostic efficiency and reduce unnecessary testing.

Methodology

This retrospective study analyzed 878 patients who underwent computed tomography pulmonary angiography (CTPA) at Monmouth Medical Center from January 2022 to December 2023. Statistical analysis, including ROC curve assessment, was conducted using IBM SPSS, with significance set …

Role Of Addiction Medicine Consultation Service In A Community Hospital: Evaluation Of The Novel Service, Srikrishna Varun Malayala, Wesley Cervantes Perez, Rukshar Thapa, Archie Madan, Kushagar Singla, Pragyat Singh, Pelash Kumar, Akshay Thaper

Journal of Community Hospital Internal Medicine Perspectives

Objectives: Fewer than 2,500 physicians nationwide are certified in addiction medicine. Inpatient addiction hospitalist services have been shown to improve patient outcomes, but their capabilities and impact are underexplored in community hospitals. This study evaluates the role of an addiction medicine hospitalist service in enhancing patient outcomes in two community-based hospitals.

Methods: A retrospective chart review was conducted on patients who received care from addiction medicine service in two hospitals. The data were collected within the first 120 days of the establishment of service. The reason for consultation, substances used, types of management, impact on transition of care, readmissions and …

The Impact Of Covid-19 On Alcohol-Related Morbidity And Mortality: A Multicenter Study, Abhinav K. Rao, Erica Paulos, Nancy Crossley, Don C. Rockey

Journal of Community Hospital Internal Medicine Perspectives

Background:

During the COVID-19 pandemic, there was a rise in alcohol (ethanol) use nationwide. In this study, we investigated the effect of COVID-19 on alcohol-related hospital outcomes.

Methods:

Deidentified claims data spanning 2018 through 2022 from HCA’s Enterprise Data Warehouse (South Atlantic Division) were examined. The population included adults aged > 18 years who had an encounter at an HCA facility and a diagnosis of alcohol use disorder or alcohol-related illnesses. Two time frames were evaluated: 2018-2019 (pre- COVID-19) and 2021-2022 (COVID-19). Statistical analyses were performed to evaluate LOS, home discharge, and mortality.

Results:

Of the 72,575 patients (26,678 during the …

Practical Pre-Rotation Resources Enhance Knowledge And Attitude Towards Discharge Planning For Medical Students, Ho-Man Yeung

Journal of Community Hospital Internal Medicine Perspectives

Interdisciplinary discharge planning is known to be a difficult subject for medical students to comprehend given its convoluted nature. There is no standardized curriculum for students and there is a large variety between every inpatient rotations. Internal Medicine in particular sees variety of patients with unique psychosocial challenges. We previously proposed tools that are simple and specifically designed for learners and students including pyramid of discharge needs and disposition flow chart. Our current work examines the efficacy of using these resources by fourth year medical students during their subinternship rotation. Between May and September 2023, 54 students completed the rotation. …

Educational Development For New Gme Programs At Community Hospitals: Process, Outcomes And Recommendations, Ebun O. Ebunlomo, Christine Ford, Kamilla Guinn, Lauren Irwin

Journal of Community Hospital Internal Medicine Perspectives

Introduction: Changes in the U.S. healthcare system have led to graduate medical education (GME) programs expanding beyond academic medical centers to community hospitals. Direct-care physicians at these hospitals are now responsible for supervising trainees, requiring them to develop new skills in education. This article describes how our educational development office collaborated with community hospital GME program directors to pilot faculty development programming to integrate community hospital physicians into trainee education.

Methods: We met with program directors for two GME community programs, reviewed topics that would be most helpful to clinicians who are unfamiliar with education, and organized workshops …