Medicine and Health Sciences Commons^™

Advanced Practice Provider-Physician Collaboration And Medical Staff Governance: A Framework For Patient Safety, Nicholas Testa, Kaysha Hervey, Cynthia Borum

HCA Healthcare Journal of Medicine

The growth of advanced practice providers (APPs) is occurring in parallel with persistent and projected physician shortages. One important solution and increasingly visible response to these workforce challenges is the expanding role of APPs. Strong physician-APP partnerships can help distribute workload, improve access, and support sustainable practice with the delivery of safe, quality patient care. The future of clinical care will depend on effective APP-physician collaboration grounded in sound credentialing, clearly defined supervision and practice expectations, and robust medical staff monitoring programs. We describe the governance and oversight processes in a large health care system to assess and support APP …

A Conceptual Framework For Clinical Quality Oversight In Telehealth-Enabled Home-Based Urgent Care, Taylor Spencer, Jason P. Williams

HCA Healthcare Journal of Medicine

Background

Home-based urgent care serving frail older adults should aspire to high-quality clinical care with optimal patient outcomes. However, monitoring and ensuring this quality can be challenging. For example, telemedicine and value-based frameworks introduce substantial complexity to clinical quality monitoring.

Purpose

We describe the conceptual framework for a multidimensional quality monitoring program within a national home-based urgent care model.

Framework Description

Medical care was delivered via a multi-state home-based primary, palliative, and urgent care practice serving medically complex Medicare Advantage (MA) populations. Our model of care incorporated distributed clinical and operational teams delivering 24/7 care via telephonic triage, video-enabled encounters, …

Bathrooms As A Patient Safety Blind Spot In Emergency Departments: A Narrative Review And Nursing Practice Framework, Carmelo Villani

HCA Healthcare Journal of Medicine

Background

Emergency department (ED) bathrooms preserve privacy and dignity but interrupt direct observation. Risks described across clinical publications and professional guidance include falls, unrecognized deterioration, overdose, hazardous ingestion, infection, inaccessible environments, and unmet elimination needs. This review integrated those risks and translated them into a nursing practice framework.

Methods

For the structured narrative review, PubMed/MEDLINE, CINAHL Plus, and Scopus were searched on July 30, 2026, without date, language, age, or publication-type filters. Backward and forward citation chasing and a targeted search for professional documents supplemented database searching. Publications were categorized by ED relevance and synthesized thematically. Professional guidance was analyzed …

Pharmacovigilance As An Act Of Awareness And Mindfulness, Mahima Silas, Hale Z. Toklu

HCA Healthcare Journal of Medicine

The term “pharmacovigilance” defines the activities related to the collection, detection, assessment, monitoring, and prevention of adverse reactions due to pharmaceuticals. While it is often framed as a technical and regulatory discipline, it can also be understood through a more reflective lens as a form of mindfulness practice. At its core, pharmacovigilance requires a way of thinking that closely mirrors mindfulness, including sustained attention, openness to uncertainty, and deep awareness of human experience. Viewing pharmacovigilance in this way reframes it not just as a safety mechanism, but as a thoughtful, patient-centered approach to medicine.

The Effects Of Pediatric Asthma On Daily Activities And Family Life In Cache Valley, Utah: Exploring Parental Perceptions Of Air Quality, Saeed Ahmad, Mehmet Soyer, Landon Lloyd, Mayu Mecham

Transforming Communities

Asthma is one of the main chronic health conditions affecting children living in Cache Valley, Utah particularly due to poor air quality during the winter season. It is very important to understand how families manage asthma both within and outside the household. Therefore, this research brief highlights how parents are managing pediatric asthma, and how asthma influences daily activities and family life. It is based on a qualitative study that extracted the data from 20 in-depth interviews with parents of asthmatic children. Participants were recruited through purposive snowball sampling. Data were collected through an interview guide that included some basic …

Specialist Perspectives On West Virginia Medicaid Coverage Requirements For Semaglutide: A Qualitative Study Of Perceived Barriers In A Rural State, Yongjia Deng, Katherine Shepherd, Kanith Farah, Jenna Sizemore, Treah Haggerty, Laura Davisson

Marshall Journal of Medicine

Introduction

The WV Medicaid Drug Utilization Review Board approved a policy limiting prescriptions of Wegovy for cardiovascular risk reduction to cardiologists, vascular surgeons, and neurologists or those in consultation with them. This qualitative study explored specialists’ perspectives on the policy and its perceived implications for patient access to care and clinical practice in rural West Virginia.

Methods

To assess the perceived impact of this policy, we conducted semi-structured interviews with eight WV-based neurologists, cardiologists, and vascular surgeons between September 2024 and June 2025, while the original prescribing restrictions were in effect. Interview data were analyzed using thematic analysis to identify …

The Role Of Local Protein Sources In Nutritious And Balanced Complementary Feeding For The Prevention Of Stunting In Infants Aged 6-24 Months, Kysara Aureldy Davonso Matualage, Leonardo Tedjaprasadja, Chy'as Diuranil Astrid Permataputri

Indonesian Journal of Public Health Nutrition (IJPHN)

Stunting remains a major public health problem in Indonesia, with prevalence rates still above national targets. The complementary feeding period (6–24 months) is a critical window for prevention, during which inadequate protein intake significantly contributes to impaired linear growth. Local animal protein sources offer an accessible and sustainable strategy to improve dietary quality. This study aims to review scientific evidence on the role of local animal protein sources in nutritionally balanced complementary feeding for the prevention of stunting in Indonesian infants aged 6–24 months. A literature review was conducted by systematically searching scientific databases for studies published between 2020 and …

Development And Nutritional Evaluation Of Plantain–Soy Composite Flour Blends As Complementary Foods For The Management Of Protein-Energy Malnutrition, Jelili A. Quadri Dr., Azeesat O. Adebiyi-Olabode Dr, Anifat B. Saka Mrs., Debbie M. Esekhade Miss

Indonesian Journal of Public Health Nutrition (IJPHN)

Protein energy malnutrition (PEM) continues to be a critical problem in public health, especially in developing nations where sources of affordable nutrient-dense foods are unavailable. Plantain is one of the staple foods rich in carbohydrates but deficient in protein, while soybeans are protein-rich legumes. A blend of these local foods in composite flour will increase the nutritional value of plantain-based foods without compromising their sensory properties. The objective of this study was to formulate plantain-soy composite flour blends at various substitution rates and determine their composition and sensory characteristics. Unripe plantain and soybean were milled into flour and mixed in …

Factors Associated With The Incidence Of Hypertension In Young Adults (20–24 Years) In Central Kalimantan Province (Analysis Of Ski 2023 Data), Indira Paramesti, Ratu Ayu Dewi Sartika, Diah Mulyawati Utari, Kusharisupeni Joko Suyono

Indonesian Journal of Public Health Nutrition (IJPHN)

Hypertension has been identified as a major public health problem leading to premature death and contributing to the development of various non-communicable diseases. In recent years, it has occurred not only among older populations but also among young adults. Hypertension at a young age can result in earlier organ damage, leading to a more rapid decline in quality of life and productivity. This study aimed to determine the risk factors associated with the incidence of hypertension among young adults aged 20–24 years in Central Kalimantan Province in 2023. A cross-sectional design was employed, utilizing secondary data from the 2023 Indonesian …

A Comparison Of Iron-Folic Acid Supplement Consumption Among Female Undergraduate Students In Health And Non-Health Majors At The University Of Indonesia In 2026, Naila Afifah, Ratu Ayu Dewi Sartika, Triyanti Triyanti, Deasy Martini

Indonesian Journal of Public Health Nutrition (IJPHN)

Iron-Folic Acid Tablets (IFAT) are recommended to prevent anemia among adolescent girls and women of reproductive age. However, IFAT consumption remains a concern among female college students, with previous research reporting differences in non-adherence between female health and non-health students at the University of Jember. This study aimed to analyze IFAT consumption behavior and its associations with residential status, attitudes, mother’s education, IFAT side effects, IFAT accessibility, media, family support, peer support, and healthcare provider support among female undergraduate students in health and non-health majors at the University of Indonesia in 2026. A cross-sectional study with purposive sampling was conducted …

Association Of Chrononutrition Behaviors And Other Factors With Nutritional Status Among Dormitory Students Of Universitas Indonesia In 2026, Hana Maulani Putra, Ratu Ayu Dewi Sartika, Trini Sudiarti, Fathimah Sulistyowati Sigit

Indonesian Journal of Public Health Nutrition (IJPHN)

Overweight and obesity remain major public health concerns in Indonesia and may be influenced by various factors, including chrononutrition behaviors related to meal timing and eating frequency, snacking habits, physical activity, sleep patterns, stress levels, ultra-processed food (UPF) consumption, allowance, and sex. Students living in dormitories may experience lifestyle changes associated with greater independence, which can affect their nutritional status. This study aimed to analyze the association between chrononutrition behaviors and other factors with the nutritional status of dormitory students at Universitas Indonesia in 2026. This cross-sectional study was conducted from April to May 2026. Participants were recruited using purposive …

Dominant Factors Associated With The Risk Of Chronic Energy Deficiency (Ced) Among Pregnant Women In East Nusa Tenggara Province (Analysis Ski Data 2023), Keisa Dwinta Mailova, Triyanti Triyanti, Tria Astika Endah Permatasari

Indonesian Journal of Public Health Nutrition (IJPHN)

Chronic Energy Deficiency (CED) is a long-term condition of energy deficiency resulting from inadequate nutrient intake. CED in pregnant women has negative effects on both maternal and fetal health. East Nusa Tenggara (NTT) Province is one of the regions with the highest prevalence of CED among pregnant women in Indonesia, with national data from 2023 showing a prevalence rate of 28%. This study aims to identify the dominant factors associated with the risk of CED in pregnant women in NTT. The study design is cross-sectional, utilizing secondary data from the 2023 Indonesia Health Survey (SKI), involving a sample of 215 …

Millets As A Preventive Dietary Intervention For India’S Nutrition Transition: A Narrative Review Of Glycaemic And Micronutrient Evidence, Kundan Kaushal, Manisha Upadhyay, Shambhu Nath Dubey, Indrajeet Kumar Jha

Indonesian Journal of Public Health Nutrition (IJPHN)

India’s nutrition profile reflects a nutrition transition rather than a single narrative: a rapidly escalating burden of diet-related non-communicable disease, including an estimated 101 million people with diabetes, coexists with a severe and worsening burden of micronutrient deficiency, with anaemia affecting 57% of women and 67.1% of children. This narrative review examines millets, small-seeded cereals historically marginalised in Indian diets in favour of rice and wheat, as a preventive dietary intervention with plausible relevance to both ends of this transition. Evidence was drawn from peer-reviewed systematic reviews and meta-analyses, national survey data and documented delivery interventions, identified through searches of …

Foundation Models In Healthcare: Pre-Training, Alignment, And Clinical Applications, Arvind Pillai

Dartmouth College Ph.D Dissertations

Foundation models offer an impactful paradigm for healthcare by learning generalizable representations from vast amounts of unlabeled data that can efficiently adapt to a wide range of clinical tasks. This thesis presents five studies organized around three pillars crucial to advance foundation models in healthcare. Pillar I: Pre-training: Chapter I introduces PaPaGei, an open foundation model designed for photoplethysmography (PPG) signals. PaPaGei is pre-trained on large-scale continuous optical data using a morphology-aware self-supervised objective, outperforming general time-series models across diverse clinical tasks while remaining parameter-efficient and robust across skin tones. Pillar II: Alignment: To bridge continuous sensor data and language …

Impact Of Food Insecurity In Urban Underserved Individuals With Substance Use Disorders, Tayler Durant

Walden Dissertations and Doctoral Studies

Food insecurity is a significant social determinant of health linked to negative health practices and health inequities. However, there is a need to examine its links with other substance use behaviors and the different links between income groups. A quantitative, cross-sectional study was used to explore relationships between food insecurity and substance use behaviors among underserved urban adults and to determine income differences. Secondary data were used from the National Health and Nutrition Examination Survey (NHANES) 2021–2023 (N = 8,153). The study was guided by the Health Belief Model (HBM) and the Biopsychosocial Model. Pearson chi-square tests were used to …

Geographic And Social Factors Influencing Pediatric Dental Voucher Use In Rural Central Utah, 2010–2025, Hilary Astle

Walden Dissertations and Doctoral Studies

Children in rural areas face barriers to dental care. Evidence on emergency and preventive dental voucher use in rural populations is limited. This quantitative study examined associations among demographic characteristics, geographic location, referral sources, and emergency and preventive dental voucher utilization in rural Central Utah using secondary administrative data from a dental voucher program. Guided by the social determinants of health framework, this retrospective cohort study used descriptive statistics, Pearson chi-square tests of independence, and multivariable logistic regression to examine dental voucher encounters and subsequent preventive care following emergency voucher use among N = 267 children. Eligible children were 18 …

Prescribing In The Post-Black Box Era: Navigating Fda-Approved And Compounded Hormones For Menopause, Nicole Bray

Lynchburg Journal of Medical Science

This narrative review compares the safety, efficacy, and clinical utility of FDA-approved

versus compounded bioidentical hormone replacement therapies for women in

menopause. A comprehensive literature review was conducted using PubMed for

studies published between 2016 and 2026, with search terms including “bioidentical

hormone replacement therapy,” “compounded hormone replacement therapy,”

“menopause,” “menopausal,” “vasomotor,” “estradiol,” “progesterone,” and

“testosterone,” alongside an analysis of major medical societies' guidelines and leading

menopause telehealth platforms. The findings demonstrate that FDA-approved

bioidentical hormone therapies offer superior pharmacokinetic consistency, rigorous

regulatory oversight, and robust clinical evidence compared to compounded

alternatives, which lack standardized testing and regulatory oversight for …

Building Safer Communities Collaborative: Demographics From A Youth Diversion Pilot Project, Caroline O. Dodson, Antonette Francis-Sheaerer Phd, Amber Singleton, Denise Shaw, Kierra Echols, Jarette Maye, Alexis Tanner, L. Lynette Parker, Ashley Y Williams

Community Health Workers Posters

This community-engaged program in Mobile County, Alabama applies a public health framework using community health workers (CHWs) to deliver wraparound support and address social determinants of health (SDOH) within juvenile diversion. To mitigate youth gun violence through translational implementation, a cross-system referral network was established bridging Strickland Youth Center (the local detention center) and USA Health Systems. Youth placed on informal probation are referred to BSCC and assigned a dedicated CHW for a 6-month intervention comprising 13 structured interactions. From September 2025–September 2026, 49 clients were referred, demonstrating high implementation feasibility with 79.6% program adherence (20.4% attrition). Enrolled youth aged …

Juvenile Delinquency In Alaska, 2019 And 2023, Gabriel Garcia

AJiC Fact Sheets

This fact sheet examines juvenile delinquency in Alaska, documenting changes in substance use and weapon-carrying among high school students and identifying associated risk and protective factors using weighted data from the 2019 and 2023 Alaska Youth Risk Behavior Survey (YRBS).

Use Of The Well-Star Model And Well-Star Graphic In Healthcare, Fidan Korkut-Owen, Zubeyde Akpakir, Dean W. Owen

Journal of Wellness

No abstract provided.

Youth Experience Of Violence In Alaska, 2019 And 2023, Gabriel Garcia

AJiC Fact Sheets

This fact sheet examines youth experiences of dating violence and sexual violence in Alaska, identifying patterns and factors associated with victimization among high school students. Using weighted data from the 2019 and 2023 Alaska Youth Risk Behavior Survey (YRBS), it compares the prevalence of physical dating violence, sexual dating violence, sexual violence by anyone, and forced sexual intercourse.

The Whole Patient: What Fascia Reveals About Pain, Adaptation, And The Case For Treating Together, Kelly Davis Pt, Dpt, Faaompt, Mt

New Orleans Dental Association News

The final piece in this series looks at fascia and the autonomic nervous system — the connective tissue and nerve pathways linking the jaw, neck, and airway into one continuous system — and why both matter to dentistry. Dr. Davis draws on current fascia and pain science research, including work from the 2025 International Fascia Research Congress in New Orleans, to explain how a misaligned bite can travel through this tissue and surface as headaches, how tongue posture and breathwork affect jaw stability, and why complex, chronic cases so often need more than one discipline to make headway. Told partly …

Did Statewide School Smoking Bans Reduce Smoking Rates?, Rachana Bhatt, Peter Hinrichs

Employment Research Newsletter

No abstract provided.

Key Drivers Of Revisit Intention In Dental And Oral Teaching Hospital, Mega Denada Aldila, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Digital transformation in dental and oral teaching hospitals demands strategies that not only ensure clinical quality but also sustain patient loyalty. This study examines the effects of digital storytelling and service quality on outpatient revisit intention at the Dental and Oral Hospital of Universitas Jenderal Soedirman (RSGMP Unsoed), with brand image and patient satisfaction as mediating variables. A quantitative cross-sectional design was applied to 115 outpatients aged ≥18 years who had completed one full episode of dental treatment. After exposure to a standardized digital storytelling video about RSGMP Unsoed, respondents completed a structured Likert-scale questionnaire. Data were analyzed using Partial …

Kepuasan Pasien Terhadap Pelayanan Di Rumah Sakit Pemerintah Dan Rumah Sakit Swasta: Tinjauan Literatur, Bahar Syah, Mardiati Nadjib

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Patient satisfaction is an important indicator for assessing the quality and performance of hospital services as it reflects patients’ experiences through the healthcare delivery process; this study explore how patient satisfaction toward hospital services in public and private hospitals by analyzing 23 selected scientific articles published between 2015 and 2024 and gathered from ProQuest, Scopus, PubMed, and ScienceDirect databases from an initial total of 176 articles founded based on inclusion and exclusion criteria, and the findings indicate that service quality has a significant impact toward patient satisfaction in both types of hospitals, with private hospitals generally demonstrating higher satisfaction levels …

Evaluasi Penerapan Rekam Medis Elektronik Terhadap Kinerja Perawat Di Unit Rawat Inap Rs Grha Permata Ibu Kota Depok Tahun 2025, Ratna Dian Andriani, Dicky Yulius Pangkey, Ahdun Trigono

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Electronic Medical Records (EMR) adoption aims to improve documentation efficiency and nurses’ performance; however, system instability and limited continuous training remain obstacles. This study examined the effects of EMR features and functionality, technical support and training, and users’ perceptions and attitudes on nurses’ performance at Grha Permata Ibu Hospital. This study employed an analytic observational design with a cross-sectional approach, using a quantitative survey conducted among 74 inpatient nurses through a Likert-scale questionnaire. Descriptive analysis, Spearman correlations, and multiple linear regression were employed. Results indicate that features and functionality (X1) have a strong positive association with performance (p = 0.652; …

Efektivitas Implementasi Raspro Terhadap Pola Resistensi Dan Biaya Antibiotik Di Rsud Kabupaten Bekasi, Irmawati Hasan, Helen Andriani

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The increasing use of antibiotics over recent decades has significantly affected global public health, primarily through the emergence of antimicrobial resistance (AMR), which contributes to higher morbidity, mortality, and economic burden. As a regional referral hospital, Bekasi Regency General Hospital faces substantial challenges related to high resistance rates, with multidrug-resistant organisms (MDROs) showing MRSA at 22.22% and ESBL at 40% in 2024. This study evaluated the implementation of the Prospective System Antimicrobial Regulation Program (RASPRO) in relation to resistance patterns, antibiotic cost efficiency, and supporting roles of governance, human resources, and monitoring systems. A quantitative prospective cohort design was applied, …

Kualitas Hidup Pasien Penyakit Gagal Ginjal Kronik Dan Kepuasan Pelayanan Di Unit Hemodialisis Rumah Sakit Alia Depok: Studi Mixed-Methods, Bimo Kusumo, Vetty Yulianty Permanasari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The prevalence of chronic kidney disease (CKD) in Indonesia remains a high-incidence condition and most of it underwent hemodialysis in Hospital. This study aims to analyze the quality of life of patients with chronic kidney disease and satisfaction with services in the hemodialysis unit. This study is a mixed-methods study with a quantitative study using the World Health Organization Quality of Life (WHOQOL-BREF) and Service Quality (SERVQUAL) questionnaires, and a qualitative study with in-depth interviews related to hospital services from both service providers (healthcare professionals) and service recipients (patients). The study found predominantly moderate scores on the WHOQOL-BREF and poor …

Persepsi Dokter Terhadap Kompetensi Perawat Di Rsud Siti Aisyah Lubuklinggau: Analisis Domain Komunikasi, Profesionalisme, Dan Kolaborasi Tim, Novita Purnamasari, Wiku Bakti Bawono Adisasmito

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study analyzes doctors' perceptions of nurses' competencies at Siti Aisyah Regional Hospital in Lubuklinggau across three domains: communication, professionalism, and team collaboration. Doctors' perceptions are important for supporting interprofessional collaboration, quality of patient care, and patient outcomes. The study results are expected to identify competency gaps and provide an evidence-based foundation for developing measurable and effective nurse training programs. The study used a quantitative descriptive design with a cross-sectional approach, with a sample of 24 doctors who evaluated nurses' overall competencies in their work units. Data were collected through a structured questionnaire containing 11 Likert-scale items and were analyzed …

Language-Associated Services, Misinformation, And Covid-19 Vaccine Hesitancy Among Refugee And Immigrant Populations In Pennsylvania, Samuel Elenwo

Walden Dissertations and Doctoral Studies

Limited research has examined misinformation, cultural beliefs, and language accessibility together in relation to COVID-19 vaccine hesitancy among refugee and immigrant adults. Guided by the socioecological model, this quantitative, cross-sectional study analyzed electronic questionnaires from N = 120 consenting Pennsylvania residents aged 18 or older who identified as immigrants, refugees, asylees, or humanitarian parolees and used social media for COVID-19 health information. Pearson correlations and separate multiple linear regression models examined associations with continuous vaccine hesitancy scores, adjusting for age, gender, education, U.S. residency, and weekly social media use. Greater misinformation exposure (B = 0.394, p < .001) and higher cultural-belief scores (B = 0.211, p < .01) were associated with greater hesitancy. Better language accessibility was associated with lower hesitancy (B = −0.365, p < .001). The demographic and social media model explained 21.9% of the variation in hesitancy scores (R² = .219) and was statistically significant, F(15, 104) = 1.94, p < .05, although most variation remained unexplained. Greater weekly social media use was associated with greater hesitancy (B = 0.024, p < .05). Compared with high school/GED education, less than high school education was associated with lower hesitancy (B = −0.672, p < .01); WhatsApp use was associated with lower hesitancy than Facebook use (B = −0.345, p < .05). These findings point to the need for credible, culturally responsive vaccine communication in preferred languages and across relevant online channels. The associations identify communication priorities but do not establish causal effects.