Medicine and Health Sciences Commons^™

Oral Health Behaviors And Oral Health Status In Elementary School Children In East Kalimantan, Indonesia, Lia Hapsari Andayani, Amabelle Elisanditya, Abdul Gani Soulisa, Sri Lestari

Journal of Dentistry Indonesia

Background: Children's oral health can be influenced by various factors, including health behaviors, dietary patterns, and oral health knowledge. This study aimed to determine the correlation between oral health behaviors and oral health status in elementary school children.

Methods: This cross-sectional study involved 182 elementary school children in Bontang, East Kalimantan, taken by convenience sampling. Health behavior data were acquired by 12-item questionnaires based on the WHO guideline. Examination of dental and oral health status was done by using the DMFT Index and OHI-S. Chi-square was used to determine the correlation between oral health behaviors and oral health …

Evaluation Of Drug Use In Inpatient Care: A Retrospective Study At A Tertiary Hospital In Bandung, Indonesia (2024), Aliya Rosyidah Fitrianti, Athoya Delarosa, Husna Muharram Ahadi, Imam Adi Wicaksono, Falerina Puspita

Pharmacology and Clinical Pharmacy Research

Rational drug use is a critical component of improving healthcare quality. However, irrational prescribing remains a significant concern, particularly in developing countries like Indonesia. This study evaluates drug use patterns at a Type B hospital in Bandung using WHO standard: average number of drugs per prescription, percentage of generic drugs, antibiotics, injections, and adherence to the National Formulary. A retrospective, descriptive observational method was applied, using 2024 inpatient Drug Use Evaluation (DUE) data. Findings reveal an average of 3.4 drugs per prescription—slightly above the WHO standard (≤ 3.3); 68.4% of prescriptions used generic drugs (meeting the WHO standard ≥ 59%); …

Comparative Analysis Of The Quality Of Life Of Schizophrenic Patients On Antipsychotic Treatment Between Aripiprazole Monotherapy And Combination Of Risperidone-Clozapine At Mental Hospital In West Java, Taufiqurahman Taufiqurahman, Sani Asmi Ramdani Lestari, Ardilla Kemala Dewi

Pharmacology and Clinical Pharmacy Research

Quality of life (QoL) is a critical outcome measure in schizophrenia management, yet antipsychotic side effects may negatively impact patients' well-being. Objective: This study aimed to compare the QoL of schizophrenia patients receiving aripiprazole monotherapy versus a risperidone-clozapine combination at West Java Mental Hospital. An analytical observational study with a cross-sectional design was conducted at the outpatient clinic of West Java Mental Hospital from March to May 2025. The Indonesian version of the WHOQOL-BREF questionnaire was used to assess QoL. A total of 58 outpatients with schizophrenia who met the inclusion criteria were enrolled, comprising 28 patients in the aripiprazole …

Adherence To Malaria Treatment And Its Associated Factors: A Narrative Review, Lafie Urwatul Wutsqo, Eli Halimah, Sofa Dewi Alfian

Pharmacology and Clinical Pharmacy Research

Malaria is an infectious disease that remains a global health concern, particularly in Asia and Africa. The success of malaria medication largely depends on patients' adherence to the prescribed therapeutic regimen. This article aims to identify the level of adherence to malaria treatment and the factors that influence it, based on observational studies. A narrative review was conducted using the PRISMA approach, involving 12 articles published between 2019 - 2023 from various countries. The results indicate that adherence levels vary widely, ranging from 15.6% to 93.31%, depending on respondent characteristics and the intervention strategies implemented. Factors influencing adherence include patient-related …

Patterns Of Adverse Drug Reactions In Tuberculosis Treatment: A Literature Review, Jasmine R. Aisyah, Ivan S. Pradipta, Widya N. Insani

Pharmacology and Clinical Pharmacy Research

Tuberculosis (TB) treatment is often interrupted by adverse drug reactions (ADRs). However, few studies have thoroughly examined these ADR patterns in TB treatment, and no research has assessed the prevalence of ADRs in specific organs. This narrative review describes the patterns of ADRs in tuberculosis treatment, including how common each type is and its impact on organs across different countries and populations. A structured narrative literature review was conducted to identify relevant original studies published in PubMed database between 2019 and 2025. The search combined Medical Subject Headings (MeSH) and free-text terms related to ``tuberculosis'' and ``adverse drug reactions''. Eligible …

Food Fortification Strategies To Address Micronutrient Deficiencies In Cambodia: A Scoping Review Of Policy Implementation, Industry Capacity, And Public Health Outcomes, Sokha Yem, Sreypeov Tun, Sokunthea Kem

Indonesian Journal of Public Health Nutrition (IJPHN)

Background: Micronutrient deficiencies remain a major public health challenge in Cambodia, with iron deficiency anaemia, iodine deficiency disorders, zinc deficiency, and vitamin A deficiency disproportionately affecting women of reproductive age and children under five. Food fortification—the deliberate addition of essential micronutrients to commonly consumed foods—has been widely recognised as a cost-effective population-level intervention to address nutritional gaps. Objective: To systematically map and synthesise existing evidence on food fortification strategies in Cambodia, focusing on policy implementation, industry production capacity and compliance, regulatory enforcement, and public health outcomes. Methods: A scoping review was conducted following the Arksey and O’Malley methodological framework and …

Staff Education On The Implementation Of Walking Interventions, Cynthia Ononobi

Walden Dissertations and Doctoral Studies

The doctoral project was a staff education project aimed at improving the knowledge of psychiatric nurses on the use of structured walking interventions to manage depression. The practice problem was related to the lack of consistency in the application of walking as a treatment for depression. This gap was significant to address because psychiatric nurses are in the center of behavioral activation, and insufficient knowledge may deny patients the right to potentially valuable, affordable, and nonpharmacological treatment. The practice-based question was: Among psychiatric nursing staff does education on structured walking intervention, compared to standard care, improve staff knowledge and skills …

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 …

Comparison Of Chop And R-Chop For Treatment Non-Hodgkin Lymphoma, Yogyakarta, Indonesia: A Cost-Effectiveness Analysis, Woro Supadmi, Rizky Gustinanda, Lalu M. Irham, Riat El Khair

Pharmacology and Clinical Pharmacy Research

CHOP and R-CHOP are commonly used chemotherapy regimens for Non-Hodgkin Lymphoma (NHL). While R-CHOP has demonstrated clinical benefits, its higher cost raises concerns regarding economic efficiency, particularly in middle-income countries such as Indonesia. This study aimed to compare direct medical costs and clinical outcomes of CHOP and R-CHOP regimens among NHL patients treated at a national referral hospital in yogykarta. A retrospective cohort study was conducted using medical record data of NHL patients who received CHOP or R-CHOP chemotherapy at Dr. Sardjito General Hospital Yogyakarta, between 2020 and 2023, with follow-up extended until April 30, 2025. Clinical outcomes included overall …

Balanced Scorecard In Healthcare Facilities: A Ten-Year Review Of Strategies To Improve Organizational Effectiveness, Larasati Tunggadewi, Sofa Dewi Alfian, Auliya A Suwantika

Pharmacology and Clinical Pharmacy Research

The Balanced Scorecard (BSC) has increasingly been adopted as a strategic performance management framework within healthcare organizations. Evidence from the past decade shows varied implementation outcomes, shaped by institutional readiness, leadership commitment, and the maturity of health information systems. This narrative review synthesizes findings from 47 scientific articles selected through a systematic screening process, covering studies conducted in hospitals, primary health centers, and pharmacy units in Indonesia, Morocco, Iran, China, and other countries. The studies employed case study and descriptive cross-sectional designs using both quantitative and qualitative approaches. Overall, BSC implementation contributed to improvements in service performance across the financial, …

Exploring Protein-Protein Interactions: A Promising Avenue For Biomarker And Anti-Tb Drug Development, Rajwa Dwifauza Suryanto, Maritsa Widati Aqila Rumawan, Imam Adi Wicaksono

Pharmacology and Clinical Pharmacy Research

In 2023, tuberculosis (TB) reached its highest incidence with 8.2 million new cases reported by the World Health Organization (WHO). The virulence of Mycobacterium tuberculosis (MTB) is strongly governed by protein-protein interactions (PPIs) that regulate essential processes such as cell wall biosynthesis, immune evasion, and persistence. This study aims to map and analyze the mechanisms of key PPIs in MTB using a scoping review approach. Data was retrieved from PubChem and related literature with the keyword ``PPIs Network TB''. Our findings highlight crucial PPI-driven mechanisms, including the role of DprE1/DprE2 in arabinogalactan synthesis, VapB4/VapC4 in stress response and self-toxicity, ESX-1 …

Low To Moderate Intensity Home-Based And Online Exercise For Cognitive Health In Older Adults: A Narrative Review, Novita Salim, Melisa Intan Barliana, Anna Meiliana

Pharmacology and Clinical Pharmacy Research

Cognitive decline represents one of the most pressing public health challenges associated with global population ageing, prompting growing interest in accessible and scalable exercise-based interventions. This narrative review synthesizes evidence from 15 randomized controlled trials to compare the cognitive effects of 3 exercise modalities in older adults across varying cognitive and functional profiles: conventional aerobic and resistance training, exergame-based interventions, and dual-task or multicomponent training. Interventions were evaluated on their capacity to improve global cognition, executive function, working memory, and attention, with additional consideration of adherence, supervision format, and implementation feasibility. The evidence consistently demonstrates that dual-task and multicomponent training …

A Systematic Review And Meta-Analysis Finds That Psychological Well-Being Predicts All-Cause Mortality Independently Of Psychological Ill-Being., Max Genecov, David Yeager

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND: Does psychological well-being (e.g. life satisfaction, happiness, meaning in life) predict the length of a person’s life, or are measures of well-being simply assessing the absence of ill-being (depression, loneliness, sadness) and are therefore redundant with ill-being measures? Individual studies have examined this question by measuring and controlling for both well-being and ill-being, but inconsistent findings have been reported. METHODS: A systematic review and random-effects meta-analysis was conducted on the literature of prospective longitudinal studies linking all-cause mortality to well-being. Studies that controlled for ill-being were compared to studies that did not control for ill-being to identify the unique …

Admixture-Informed Polygenic Risk Reporting Using The Eprs Framework, Yu-Jyun Huang, Nuzulul Kurniansyah, Matthew O Goodman, Brian W Spitzer, Jiongming Wang, Adrienne Stilp, Cecelia Laurie, Paul S De Vries, Han Chen, Yuan-I Min, Mario Sims, Gina M Peloso, Xiuqing Guo, Joshua C Bis, Jennifer A Brody, Laura M Raffield, Jennifer A Smith, Wei Zhao, Jerome I Rotter, Stephen S Rich, Susan Redline, Myriam Fornage, Robert Kaplan, Nora Franceschini, Daniel Levy, Alanna C Morrison, Eric Boerwinkle, Nicholas L Smith, Charles Kooperberg, Bruce M Psaty, Sebastian Zöllner, Tamar Sofer

Faculty, Staff and Student Publications

Polygenic risk score values vary with genetic ancestry due to differences in population-specific allele frequencies and linkage disequilibrium patterns. We present a framework to calibrate polygenic risk scores based on ancestral makeup. We propose the "expected polygenic risk score" or ePRS, defined as the expected value of a polygenic risk score based on one's global or local admixture patterns. We further define the "residual polygenic risk score" or rPRS as measuring the deviation of the polygenic risk score from the ePRS. The ePRS reflects the baseline ancestry-driven component of genetic risk, whereas the rPRS isolates an ancestry-agnostic measure of genetic …

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 …

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

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 …

Case Report Of Mixed Liver Injury Following Five Days Exposure To Cefepime In Young Adults, Widyati Widyati, Pandu Harijono, Gunady Wibowo Rencong

Pharmaceutical Sciences and Research

Drug-induced liver injury (DILI) remains a challenge in clinical practice and is still a diagnosis of exclusion. Although it has a low incidence amongst the general population, DILI accounts for most cases of acute liver failure with a fatality rate of up to 50%.

Case : A 56-year-old male was transferred to the Intensive Care Unit (ICU) with fever and severe thrombocytopenia,17,000. The patient was diagnosed with suspected sepsis and potential disseminated intravascular coagulation (DIC). Consequently, the patient was put on cefepime, administered 2g three times daily for over 30 minutes, and combined with amikacin at 1500 mg to be …

Hyperdynamic Microtubule-Based Structural Changes In Monocyte-Derived-Neuronal-Like Cells From Patients With Schizophrenia, Alfredo Bellon, Alonso Cortez-Resendiz, Lauren N Forrest, Omar Elmarasi, Janani Iyer, Anjali Iyer, Chachrit Khunsriraksakul, Dajiang Liu, L Elliot Hong, Therese M Jay, Marie-Odile Krebs, Anne Hosmalin

Faculty, Staff and Student Publications

A consistent postmortem finding in schizophrenia (SCZ) is reduction in dendrites' size. However, neurons with larger dendritic trees have also been encountered. In vitro experiments with neurons and neuronal-like cells coming directly from patients with SCZ showed similar results, evidencing at times more extensions and at others less arborizations. The process of extending and retracting neuronal outgrowths depends on microtubules polymerization and depolymerization. The possibility that microtubule polymerization/depolymerization is related to defects in the neuronal structure comes from several microtubular anomalies reported in SCZ such as its abnormal distribution in the cytoplasm, irregular shape of microtubules and even absence of …

Igg4-Related Disease As An Uncommon Cause Of Myocarditis: A Case Report., Emily Ellis, Sarah Grebennikov, Rodolfo Jose Denadai Benatti

Heart and Vascular Articles

BACKGROUND: IgG-4-related disease (IgG4-RD) is a systemic fibroinflammatory disease that can affect any organ system. Myocarditis is a rare manifestation.

CASE SUMMARY: A 65-year-old woman with clinically diagnosed IgG4-RD, who had recently completed corticosteroid taper, presented with multiple admissions for recurrent chest pain and myocardial injury. Coronary angiography repeatedly showed preserved coronary anatomy, and initial transthoracic echocardiography showed preserved left ventricular systolic function. Subsequent transthoracic echocardiography showed rapid decline in ejection fraction, and cardiac magnetic resonance imaging (MRI) showed myocardial oedema, infarct scar, and patchy non-ischaemic fibrosis. A probable diagnosis of IgG4-RD myocarditis was made clinically based on medical history, …

Clustering Digestive Tract Tumors Using Transcriptomic And Mutation Data, Dwayne G Tally, Polina Bombina, Jake Reed, Jeffrey Kinne, Lynne V Abruzzo, Kevin R Coombes, Zachary B Abrams

2020-Current year OA Pubs

BACKGROUND: Digestive tract cancers, like most other cancers, are usually categorized based on cell or tissue of origin. Molecular clustering based on the transcriptome often produces the same classification.

METHODS: We developed a new method, Newmanization, to reduce underlying tissue signals from transcriptomic analysis. To test our method, we downloaded data on 1635 samples of digestive tract cancers from The Cancer Genome Atlas. The available data includes transcriptomic data by RNA-Seq, as well as binary mutation allele frequency data by whole exome sequencing. We compared, using silhouette widths and visualization by dimension reduction plots, the effectiveness of Newmanized transcriptome and …

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 …