Digital Commons Network^™

A Risk Score To Predict Recurrent High Intensity Inpatient Resource Utilization For Children With Medical Complexity., Charles Maloy, Jessica L. Bettenhausen, Y Raymond Chan, Leah Jones, Kathryn Kyler, Laura Plencner, Jessica Markham, Jacqueline Walker, Smit Shah, Sian Best, Jonathan Ermer, Shelby Chesbro, Maria Newmaster M.D., Henry T. Puls

Posters

Background Children with medical complexity (CMC) use a greater amount of inpatient resources and stand to benefit from unique care models and coordination. However, hospital resources can be limited, and a better understanding of which CMC are high resource users could improve hospital and staff planning. Objective: To develop a risk score predictive of recurrent high intensity inpatient utilization among CMC. Methods: We conducted a retrospective cohort study of children < 18 years old with ≥3 complex chronic conditions (CCC) discharged from one of 48 children’s hospitals in the Pediatric Health Information System during 2021 and 2022. To reflect CMC typically cared for by a general medical service, children with cardiac procedures, dialysis, oncology, or transplant CCCs, and index hospitalization mortality were excluded. We used multivariable logistic regression to determine factors present on the index hospitalization associated with ≥5 hospitalizations or ≥3 hospitalizations with one lasting ≥25 days within any 365-day period (high inpatient utilization) in 2021-2023. We developed risk scoring system using model coefficients and defined the optimal risk score cutoff to maximize sensitivity and specificity. We then applied the risk score cutoff to children discharged to determine (a) ratio of predicted:actual CMC with recurrent high resource use and (b) the total predicted daily volume on 50th, 75th, and 90th percentile days for each hospital. Results: Of 44,432 included children , 9,596 (21.6%) had high inpatient utilization (Table). Children under 1 year of age had the highest odds of high inpatient utilization (OR 2.26 [95% CI: 2.16, 2.37]) and all CCC and technology groups (except metabolic) met statistical significance (Figure 1). The optimal risk score cutoff was 29 and predicted 17,411 (39.2%) CMC as high inpatient resource utilizers; the predicted:actual ratio of CMC with high inpatient utilization was 1.81. The mean daily census of the 50th, 75th, and 90th percentiles across hospitals was 28 CMC with recurrent high utilization (± 17), 34 (±18), and 39 (±19; Figure2). Conclusions: It is feasible to develop a risk score predictive of recurrent high inpatient utilization among CMC. There is substantial variability in volume of CMC with high utilization between pediatric hospitals. The risk score cutoff values can be modified to suit different applications and institution-specific objectives. These applications could include a dedicated service line or staffing. Alternatively, this could identify patients who would benefit from more formal handoff from inpatient to outpatient providers.

Foreword: Children And Constitutions In The Anthropocene Era, Catherine Smith

Washington and Lee Law Review

In Spring 2025, the Washington and Lee Law Review held its Lara D. Gass Symposium, Children and Constitutions in the Anthropocene Era. It consisted of a keynote address by Julia Olson, Co-Executive Director and Chief Legal Counsel of Our Children’s Trust, and three panels: “Children, Climate Change, and State Constitutions”; “The U.S. Constitutions and the Meaning of ‘We the [Young] People’”; and “Youth-Powered Litigation and Global Constitutionalism.” The heavily attended Symposium was a tour-de-force in the field of children’s rights.

As climate chaos mounts, young people around the world are pressing courts to reconceptualize the meaning of liberty, equality, and …

The Back Page: Commentary: Going Non-Par: My Perspective, And 10 Lessons I’Ve Learned, Robert Antolak Dds

The Journal of the Michigan Dental Association

Dr. Robert Antolak shares his experience and ten lessons from transitioning his dental practice to a non-participating (non-par) status with insurance in January 2025, driven by declining reimbursements and the need to prioritize patient care. He highlights the unfairness of lower PPO reimbursements for newer dentists. Key lessons include securing a trusted coach, early patient communication, building a financial safety net, ensuring full team buy-in, committing with faith, tightening billing systems, frequent patient reminders, advocating for patients, creating an in-office payment plan (not percentage discounts), and clearly articulating the "why". Though revenue initially dropped, he anticipates full recovery, aiming to …

The Effect Of An Interdisciplinary Project On Students’ Understandings Of Mathematical Interdisciplinarity: A Qualitative Action Research Study, Jaime Krause

Theses and Dissertations

The siloed nature of education has likely caused some high school students to not recognize the interdisciplinary nature of mathematics, leading them to misunderstand its relationship to other subject areas. A misunderstanding of mathematical interdisciplinarity can cause issues when these students approach interdisciplinary problems later in life. The purpose of this study was to observe, investigate, and analyze the ways in which students understand mathematical interdisciplinarity following a collaborative and interdisciplinary project. I implemented a descriptive qualitative action research approach to determine how a collaborative interdisciplinary project on NASA technology in a high school mathematics course affects students’ understandings of …

Childhood Obesity Body Mass Index And Gut Microbiome: A Cluster Randomized Controlled Pilot Feasibility Study, Marilyn Frenn, Nita Salzman, Vy Lam, Mary Holtz, Andrea Moosreiner, Mauricio Garnier-Villarreal, Maharaj Singh

College of Nursing Faculty Research and Publications

Background:

Prebiotic fiber has been examined as a way to foster gut bacteria less associated with obesity. Tests of prebiotic fiber in reducing obesity have occurred mainly in animals, adults, and Caucasians when the highest obesity rates are in African American and Latinx youth. Response to prebiotic fiber is determined by the pre-existing intestinal microbiota. The type of microbiota varies based on diet and physical activity (PA), so it is important to examine acceptability and response to prebiotic fiber in those most at risk for obesity.

Methods:

This cluster randomized controlled feasibility trial included an online program designed to improve …

The State Of The Science Of Natural Family Planning: A Report From Nfp Scientists’ Meeting Held In Orlando, Fl, September 4, 2024, Michael D. Manhart, Richard J. Fehring

College of Nursing Faculty Research and Publications

A one-day meeting was held as a pre-conference to the Catholic Medical Association Annual Educational event in 2024. A panel of eighteen physicians, scientists, and researchers involved in NFP work was convened to review the available evidence in four topical areas: (i) evidence for effectiveness of NFP methods to postpone and achieve pregnancy, (ii) evidence for effectiveness in the postpartum and perimenopause transition periods, (iii) evaluate the current state of technology in NFP (specifically app and quantitative hormone monitoring), and (iv) evidence examining the impact of NFP on marital relations. In each topical area, the panel worked to reach a …

Using Meta-Analysis: What Exercise Helps Kids With Excess Weight The Most?, Marilyn Frenn

College of Nursing Faculty Research and Publications

No abstract provided.

Crosssections, Summer 2025, University Of Northern Iowa. Department Of Physics.

CrossSections

Contents:

A Message from the Department Head, Dr. Paul Shand --- 1
Department Happenings --- 3
Faculty Profile - Takeshi Yasuda --- 7
Student Profile - Brandon Schmidt --- 8
Student Research --- 9
Student Focus --- 10
Physics Education --- 13
Alumni Profile - Roger Burkhart --- 14
Alumni News - Sterling Hartman --- 16
New Physics --- 17

Black Steel In The Hour Of Chaos: Hip-Hop And The Carceral State In The East San Francisco Bay Area, William Maclane Hull

Theses and Dissertations

“Black Steel in the Hour of Chaos: Hip-Hop and the Carceral State in the East San Francisco Bay Area” explores the histories of urban redevelopment and deindustrialization, racialized poverty, police and the carceral system, and hip-hop culture in Oakland and other parts of the eastern San Francisco Bay Area. It explores East Bay politics and urban development in the 1900s, which resulted in the flight of industries and wealthy white residents to the suburbs and the erosion of public services. Black community organizations and funk music alike articulated the damages done by these processes in the 1960s. Subsequently, politicians and …

Editing Japan: Pornography Commentary As Postcolonial Revenge In China's Digital Sphere, Yichi Zhang

Theses and Dissertations

This study examines how Chinese male audiences reconstruct postcolonial masculinity through the consumption and reinterpretation of Japanese pornography. By analyzing commentary videos produced by "Team Strawberry," I argue that this phenomenon constitutes a symbolic revenge against Japan's historical dominance. Through degrading Japanese female performers and mocking Japanese culture and male actors, Chinese viewers invert colonial hierarchies, transforming sexual consumption into a nationalist project. However, this mimicry of colonial violence ultimately reinforces patriarchal structures rather than subverting them, while also framing nationalism through sexual conquest that mimics collective historical trauma. The re-editing and mocking of Japanese pornography by Chinese content creators …

Causal Neuro-Symbolic Artificial Intelligence: Synergy Between Neuro-Symbolic And Causal Artificial Intelligence, Utkarshani Jaimini

Theses and Dissertations

Understanding and reasoning about cause and effect is innate to human cognition. In everyday life, humans continuously engage in causal reasoning and hypothetical retrospection to make decisions, plan actions, and interpret events. This cognitive ability allows us to ask questions such as: “What caused this situation?”, “What will happen if I take this action?”, or “What would have happened had I chosen differently?” This intuitive capacity to form mental models of the world, infer causal relationships, and reason about alternative scenarios, particularly counterfactuals, is central to our intelligence and adaptability. In contrast, current machine learning (ML) and artificial intelligence (AI) …

Investigating The Ecology Of The Homeless Court: The Promise Of Quasi-Experimental And Statistical Learning Methods, Dylan Wong

Theses and Dissertations

Interactions with the legal system are a crucial factor in maintaining homelessness. Difficulties in addressing legal issues are barriers to accessing services and finding employment and housing. Across the United States, the homeless court is an emerging legal program that has been developed to break this cycle, but they appear to face numerous capacity and coordination problems. Few empirical and systematic investigations have been conducted on homeless court programs. Further, previous studies of homeless courts focus their process and outcome measures on the priorities of the legal system. An investigation into the ecology, or environmental context, of homeless persons would …

Increasing Professional School Counseling Advocacy Skills For The Practicing Secondary School Counselor, Beverly Denise Mccullough

Theses and Dissertations

This problem of practice addresses increasing Professional School Counselor (PSC) advocacy skills for the practicing secondary school counselor. Improvement science is the framework used to help solve this problem. The PSC improvement team consisted of a team of seven licensed professional school counselors, all with career experience in the secondary school setting. The team began their work with the goal of understanding the current system by participating in an initial empathy interview. Immediately after the empathy interview was concluded, each committee member completed an initial assessment of the School Counselor Self Advocacy Questionnaire (SCSAQ) to be used as an initial …

Structure-Activity Relationships Of Isothiourea And Silicon Phthalocyanine Catalysts, Christian J. Harrison

Theses and Dissertations

Efficient organic synthesis often relies on improving catalyst designs and investigating reaction mechanisms to accomplish feats such as high stereoselectivity, low catalyst loadings, and performing sustainable chemistry. Within the field of organocatalysis, intermolecular interactions between a catalyst and a substrate are a large contributing factor to the control of a reaction, including rate and selectivity. Investigating mechanisms can provide information on the type of intermolecular interactions occurring in the reaction, aiding future reaction and catalyst development. This dissertation will explore two recent projects and how probing intermolecular interactions through simple modifications provides information useful for new catalyst designs and properties. …

Medico-Legal Study Of Sudden Death Among People Younger Than 40 Years In Baghdad, Kauthar Maree, Saad Kareem

Iraqi Postgraduate Medical Journal

Background: Sudden death is a significant global public health concern affecting individuals under 40. Understanding sudden death dynamics is crucial for addressing health and legal implications. Exploring epidemiology, causes, and risk factors is essential for implementing preventive measures, healthcare policies, and forensic practices.Objective: To identify the causes of sudden death among individuals under 40 in Baghdad. To assess the impact of lifestyle and family history contributions and examine the patterns of age, sex, and gender in sudden death cases within this particular demographic group.Methods: A cross-sectional study was conducted on 69 medico-legal cases involving individuals under the age of 40 …

An Exploration Of The Effect Of Covid Restrictions On Maternity Care In Uganda, Hellen Kyakuwaire, Grace Edwards, Ahmed Mohammed Sarki

Journal of Asian Midwives (JAM)

Background: Uganda responded aggressively to the worldwide spread of COVID-19 by imposing a total lockdown, which forbade movement of the whole population, including pregnant women and other vulnerable groups. This phenomenological study explored pregnant women’s experiences during the total lockdown in Uganda and identified factors that influenced the quality of healthcare for pregnant women during the lockdown.
Methods: Thirty-two newly delivered women were selected across a wide geographical area to represent rural and urban areas. The sample was selected from women who had given birth at the selected health facilities from March 18, 2020, to April 30, 2020. …

The Effects Of Midwifery Students’ Simulation Training In Perineal Repair: A Quasi-Experimental Study, Zahra Sadat Pajohideh, Solmaz Mohammadi, Fatemeh Keshmiri, Azam Honarmandpour, Azam Jahangirimehr

Journal of Asian Midwives (JAM)

Background: The decrease in normal deliveries and episiotomies in midwifery practice has reduced the experience of midwifery students in perineum repair. This study examined the effect of perineal repair simulation training on the clinical skills of midwifery students by designing, implementing and evaluating simulation models in procedural education.
Methods and materials: This quasi-experimental study was conducted on 60 midwifery students in intervention and control groups at Shoushtar, Iran, from September 2018 to August 2021. The intervention group received simulation training before entering the formal clinical education courses, while the control group took part in workplace-based training. The clinical repair skills …

The Impact Of The Covid-19 Pandemic On Maternity Care Services: Lived Experiences Of Midwives In Indonesia, Mergy Gayatri, Oluwadamilare Akingbade, Indhar Wahyu Wira Harjo, Adepegba Folasade Rebecca, Salako Faith Adebola

Journal of Asian Midwives (JAM)

Background: There have been fundamental changes in global maternity care in response to the COVID-19 pandemic across the globe. However, there are limited studies in Indonesia that have explored the changes experienced by midwives in various health facilities during the COVID-19 pandemic.
Method: A qualitative phenomenological study was conducted among midwives with at least three years of clinical experience in midwifery practice and practicing at different levels of healthcare. Semi-structured interviews were conducted through WhatsApp or Phone calls, as face-to-face interviews were impossible during the pandemic. Data were analyzed using thematic analysis.
Results: In total, 24 midwives …

The Relationship Between Sleep Quality And Physical Fitness Toward The Menstrual Cycle In High School Students, Surya Adi Saputra, Raja Mohammed Firhan Bin Raja Azidin, Alifia Candra Puriastuti, Dessy Amelia, Zumroh Hasanah, Anggi Renawati

Journal of Asian Midwives (JAM)

Background: Sleep is essential for maintaining physical fitness and overall health, as it helps the body recover from intense physical activity and maintains endurance. Physical fitness is determined by heredity, gender, age, body composition, activity, and exercise. Adequate sleep positively impacts overall health, while poorer sleep can negatively affect the body. Teenagers often prefer excessive screen time and oversleep, which can affect their sleep quality. Physical fitness is related to physical activity, and the more often an individual engages in physical activities, the better their fitness. This condition can also impact reproductive health, as hormonal disorders can affect the menstrual …

Knowledge, Attitudes, And Practices Of Healthcare Workers Regarding Early Childhood Development: A Mixed-Methods Study At Secondary Care Maternal And Child Care Hospitals In Karachi, Pakistan, Sarosh Hirani, Shelina Bhamani, Hajra Malik, Samira Lakhani, Adeeb Kanji, Khairunnissa Hooda

Journal of Asian Midwives (JAM)

Introduction: Early childhood development (ECD) is a critical period that lays the foundation for a child's future growth and overall well-being. Healthcare settings play a significant role in shaping these developmental outcomes. However, there is limited research evaluating healthcare professionals' knowledge, attitude, and practices on ECD in Pakistan. This study aims to assess the awareness, attitudes, and practices of healthcare providers working in secondary hospitals regarding ECD.
Methods: A sequential explanatory mixed-methods approach was used. The study initially recruited healthcare workers, including physicians, nurses, trainees, and midwives from two secondary care hospitals. Participants completed the Caregiver Knowledge of Child Development …

Peer Mentorship Of Midwifery Faculty In Bangladesh: A Process Evaluation, Pronita Raha, Joy Kemp, Farida Begum, Rowsan Ara, Vibhavendra S. Raghuvanshi, Nabila Purno, Daniel Novak, Hoque Emdadul Hoque

Journal of Asian Midwives (JAM)

Development of midwifery faculty is key to strengthening quality midwifery education. This article presents a process evaluation of a peer mentorship programme, implemented between 2021 and 2023, for around 370 midwifery faculty in Bangladesh, including 40 newly deployed faculty. 20 peer mentors, prepared by international midwifery faculty, conducted quarterly visits to public midwifery education institutions (MEIs) to provide mentorship support to midwifery faculty and to monitor the quality of midwifery education. A digital community of practice was also created. Data were collected with a checklist based on the World Health Organization (WHO) midwifery educator competencies and entered into a digital …

Effects Of World Health Organization’S Educational Interventions On Clinical Competency Of Community Midwives In Managing Postpartum Hemorrhage, Afifah Abu-Ul-Hayat, Sarfaraz Masih, Madiha Mukhtar

Journal of Asian Midwives (JAM)

Background: Postpartum hemorrhage (PPH) is considered to be one of the most important causes of maternal mortality especially in low resource countries such as Pakistan. Community midwives (CMWs) have a very important role in the provision of midwifery care and their clinical competency are very crucial for the handling of PPH. This study evaluates the effect of a World Health Organization (WHO)-based educational intervention on the clinical competency of CMWs in Hazara Town, Quetta, in managing PPH.
Objective: This study aimed to determine the effectiveness of a WHO based educational intervention on improving the clinical competency of CMWs in managing …

Perceptions Of Risky Sexual Behavior Among Female Students: A Qualitative Analysis Of Contributing Factors, Consequences, And Prevention Strategies, Leila Bozorgian, Fatemeh Ansari, Fatemeh Janipour, Solmaz Mohammadi

Journal of Asian Midwives (JAM)

Background: Risky behaviors among young people are a significant concern for societies worldwide, leading to physical and psychosocial damage. Despite efforts to raise awareness about such risky behaviors over the past two decades, their prevalence continues to rise. Therefore, this study aimed to explain perceptions of the prevalence of risky sexual behaviors among female students.
Methods: A qualitative descriptive study using a conventional content analysis approach was conducted from August to mid-September 2024 in Yasoj, Iran. The study participants were selected using purposive sampling. The data were collected using semi-structured interviews conducted with 18 female students. Data collection …

Development And Validation Of Risk Assessment Tools For Hypertensive Disorder In Pregnancy, Vanitha K, Hepsibah Sharmil, Vijayalakshmi Kandasamy

Journal of Asian Midwives (JAM)

Aims and Background: Hypertensive disorders in pregnancy (HDP) have significant impact on both mothers and newborns leading to complications such as Eclampsia, Preterm delivery, Renal and cardiac problems, Intra Uterine Growth Retardation (IUGR) and Intra Uterine Fetal Death (IUFD). Early screening of hypertensive disorders in pregnancy is essential in the prevention and management of these complications. This research study aims to develop and validate a risk assessment tool for hypertensive disorders in pregnancy.
Materials and methods: A mixed-method research was carried out from December 2023 to December 2024 consisting of two steps. Step one involved the development of …

Arete Newsletter - 2025 - Issue 1, Liberty University

Arete Newsletter

Summer 2025

The Guardian The Month Of July 2025, Wright State Student Body

The Guardian Student Newspaper

News articles from The Guardian for the Month of July 2025. The Guardian is the official student-run newspaper for Wright State University. It has been published regularly since March of 1965.

Nsu Library Link - Summer 2025 - Volume 2.1, Nova Southeastern University

NSU Florida Link Newsletter

No abstract provided.

Thematic Hotspots And Strategy Analysis Of International Ai Regulatory Texts Based On Lda Models, Taitian Mao, Yihe Peng

Journal of Scientific Information Research

[Purpose/significance]This article conducts an in-depth exploration of international artificial intelligence (AI) regulatory policies and gains insights into the regulatory focuses and trends of various countries, with the aim of providing valuable references for global AI governance strategies.

[Method/process] This paper applies the LDA topic clustering analysis method to conduct an in-depth study of twenty-seven international policy documents. The aim is to accurately identify the topics, analyze the key theme words, and further reveal the regulatory hotspots in the field of artificial intelligence.

[Results/conclusion] The study reveals six core regulatory themes: systemic risk assessment, ethical and legal regulation, social impact governance, …

Research On The Evaluation Of Information Ecological Environment Quality For Online Health Communities, Qingwei Li, Yan Xu, Xueqin Zhao

Journal of Scientific Information Research

[Purpose/significance] To evaluate the information ecological environment quality of online health communities, reveal the problems existing in the information ecological environment quality of online health communities, and put forward specific suggestions, in order to provide reference for the healthy development of online health communities.

[Method/process] Firstly, the evaluation index system of online health community information ecological environment quality was constructed through literature investigation and expert investigation. Secondly, AHP is used to construct the evaluation index hierarchy model of online health community information ecological environment quality and calculate the weight of each index. Finally, the fuzzy comprehensive evaluation method is used …

Research On Traditional Family Values Incorporating Data Enhancement And Transfer Learning, Qiaoling Chen, Hao Wang, Xiaomin Li

Journal of Scientific Information Research

[Purpose/significance] This research conducts in-depth exploration and knowledge discovery of ancestral hall couplets, a critical carrier of traditional family ethics, to facilitate their adaptive inheritance in contemporary society while introducing innovative perspectives and methodologies to the field.

[Method/process] We constructed a hierarchical classification system for traditional family values by synthesizing academic consensus, then developed the Annotation Keyword Data Enhancement(AK-DA-SKB-TC) model using idiomatic allusions with annotated keywords as source data and couplets as target data. Leveraging transfer learning, we achieved automated family tradition classification for couplets, followed by rigorous reliability validation. Multi-dimensional analysis of classification results uncovered evolutionary patterns and contextual …