Staff Education To Prevent Falls In Long-Term Care Facilities, Shekinah Gleason

Walden Dissertations and Doctoral Studies

In this staff education initiative, I focused on fall prevention in long-term care facilities (LTCFs) by reinforcing the Morse Fall Scale fall risk assessment tool. Falls in LTCFs are a significant concern, leading to injuries, hospitalization, and declining residents' quality of life. The practice problem stems from insufficient staff training, contributing to inadequate patient care and an increased risk of falls. The practice-focused question was used to explore whether education about fall prevention measures and guidelines improves long-term care nurses’ knowledge and intent to follow these guidelines; a total of 23 participants were involved in this project. Pre- and post-education …

Staff Education On Medicaid And Medicare Programs, Angela R. Smith

Walden Dissertations and Doctoral Studies

Case managers at the practice site are responsible for helping older and disabled clients receive services from Medicare and Medicaid. The gap in practice was that case managers were failing to recognize the benefit and eligibility differences between these federal and state-run programs. Case managers must be well-informed regarding these programs to effectively manage their clients’ care. The goal of this project was to plan, implement, and evaluate a staff education program on Medicare and Medicaid services. The practice-focused question centered on whether participants demonstrated increased knowledge about Medicare and Medicaid services available to Waiver Program clients. The theoretical framework …

Circus-Specific Extension Of The 6th International Consensus Statement On Concussion In Sport, David Munro, Stephanie Greenspan, Joanna Nicholas, Melanie I. Stuckey

Research outputs 2022 to 2026

While sport-related concussion (SRC) is a known risk in circus arts, no published guidelines exist to guide post-concussion return to circus, contributing to inadequate management in this population. The Concussion in Sport Group (CISG) published the 6th international consensus statement in 2023, providing updated guidance and assessment tools for the management of SRC. Sport and dance organisations have adapted these recommendations for their specific settings. The aim of this extension statement was to extend the CISG guideline to the circus arts training and performance context. Development included a review of literature, creation of the initial drafts by the working group, …

Time To Treatment In Pediatric Patients With Repeated Episodes Of Status Epilepticus, Jennifer V Gettings, Iván Sánchez Fernández, Anne Anderson, J Nicholas Brenton, Afra Can, Justice Clark, Raquel Farias Moeller, Howard P Goodkin, Yi-Chen Lai, Mohamad A Mikati, Lindsey A Morgan, Edward Novotny, Adam P Ostendorf, Juan Piantino, James J Riviello, Kumar Sannagowdara, Robert C Tasker, Dmitry Tchapyjnikov, Mark S Wainwright, Angus Wilfong, Korwyn Williams, Bo Zhang, Tobias Loddenkemper, Marina Gaínza-Lein, Pediatric Status Epilepticus Research Group (Pserg)

Duncan NRI Faculty and Staff Publications

Objective: To compare pediatric patients who presented with repeated status epilepticus episodes to patients with a single episode of status epilepticus and identify distinguishing clinical factors.

Methods: Retrospective analysis of a multicenter, prospective observational cohort of pediatric patients with status epilepticus between 2011 and 2019.

Results: Out of 504 status epilepticus episodes in 420 patients, 50 patients (10.3%) had repeated episodes of status epilepticus. The only predictor of repeated status epilepticus was a prior diagnosis of epilepsy. There was no difference in time to treatment with the first benzodiazepine in patients presenting with their first status epilepticus episode compared to …

Revisiting Traumatic Intracerebral Hemorrhage In The Context Of Enrich: Illustrative Cases, Erik Werheim, Brendan Mcshane, Zachary Sokol, Theodore Hannah, Robert Ziechmann, Phillip Villaneuva

Department of Surgery Faculty Papers

BACKGROUND: Traumatic intracerebral hemorrhage (tICH) is a common form of intracranial hemorrhage after traumatic brain injury (TBI). The role of surgical intervention in tICH remains a subject of discussion. Recent trials, such as Early Minimally Invasive Removal of Intracerebral Hemorrhage (ENRICH), have shown the efficacy of minimally invasive clot evacuation for non-tICH for hemorrhages with volumes of 30-80 mL. The generalizability of ENRICH to tICH remains unclear; however, it demonstrates the need for rigorous studies evaluating the efficacy of surgical intervention in tICH versus medical management.

OBSERVATIONS: Here the authors present 2 cases of tICH, both in the dominant temporal …

Dna Repair And The Contribution To Chemotherapy Resistance, Ksenija Nesic, Phoebe Parker, Elizabeth M Swisher, John J Krais

2020-Current year OA Pubs

The DNA damage response comprises a set of imperfect pathways that maintain cell survival following exposure to DNA damaging agents. Cancers frequently exhibit DNA repair pathway alterations that contribute to their intrinsic genome instability. This, in part, facilitates a therapeutic window for many chemotherapeutic agents whose mechanisms of action often converge at the generation of a double-strand DNA break. The development of therapy resistance occurs through countless molecular mechanisms that promote tolerance to DNA damage, often by preventing break formation or increasing repair capacity. This review broadly discusses the DNA damaging mechanisms of action for different classes of chemotherapeutics, how …

The Impact Of Narratives And Active Video Games Among Black And Hispanic Children With Overweight And Obesity: A Randomized Controlled Trial, Amy S Lu, Tom Baranowski, Tiago V Barreira, Amy Fleischman, Melanie C Green, Shirley Y Huang, I-Min Lee, Lynne L Levitsky, Farzad Noubary, Debbe Thompson

Children’s Nutrition Research Center Staff Publications

Background: Overweight and obesity disproportionately affect Black and Hispanic children who also play more video games. Narratives, coupled with home-based active video games (AVGs), may enhance PA and mitigate these disparities. This study tested the effect of narrative-enhanced home-based AVGs among predominantly Black and Hispanic children with overweight and obesity.

Methods: This 6-month three-group RCT recruited 135 children aged 7-14 from pediatric clinics in Boston, MA (January 2020 - May 2022) during the COVID-19 pandemic. Participants were randomized into: [Narrative + AVG], receiving an Xbox/Kinect with six AVGs interspersed with a narrative animation Ataraxia (72 episodes over six months), which …

Portal Vein Obstruction In Pediatric Liver Transplant Patients: An Evaluation Of Self-Reported Management Practices., Lydia Sieben, Bader A. Alfares, Ruben H. De Kleine, Barbara E. Wildhaber, Thomas Casswall, Greg Nowak, Martin Delle, Denise Aldrian, Valeria Berchtold, Georg F. Vogel, Piotr Kaliciński, Malgorzata Markiewicz-Kijewska, Adam Kolesnik, Jesús Quintero, María Mercadal Hally, Mauricio Larrarte King, Paolo Marra, Michela Bravi, Domenico Pinelli, Mureo Kasahara, Seisuke Sakamoto, Hajime Uchida, Vidyadhar Mali, Marion Aw, Stéphanie Franchi-Abella, Emmanuel Gonzales, Florent Guérin, Guillermo Cervio, Julia Minetto, Sergio Sierre, Martín De Santibañes, Victoria Ardiles, Jimmy Walker Uño, Helen Evans, David Duncan, John Mccall, Steffen Hartleif, Ekkehard Sturm, Jai V. Patel, Marumbo Mtegha, Raj Prasad, Cristina T. Ferreira, Luiza S. Nader, Marco Farina, Catalina Jaramillo, Manuel I. Rodriguez-Davalos, Peter Feola, Amit A. Shah, Phoebe M. Wood, Michael R. Acord, Ryan T. Fischer, Bhargava Mullapudi, Richard J. Hendrickson, Rajeev Khanna, Viniyendra Pamecha, Amar Mukund, Khalid Sharif, Girish Gupte, Simon Mcguirk, Gilda Porta, Winita Hardikar, Marco Spada, Tommaso Alterio, Giuseppe Maggiore, Marisa Beretta, Rudi A J Dierckx, Reinoud P H Bokkers, Hubert P J Van Der Doef, Portal Registry Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND AIMS: Portal vein obstruction (PVO) is a known complication after pediatric liver transplantation (pLT). Effective management strategies are crucial in improving patient outcomes. This study investigated the various practice patterns related to PVO management to clarify the degree of consensus on the diverse facets of care involved in addressing PVO after pLT.

METHODS: A self-reported evaluation was conducted using a scanned, paper-based survey among specialized pLT centers participating in the Portal vein Obstruction Revascularization Therapy After Liver transplantation (PORTAL) registry. The survey consisted of 30 questions covering the current practices regarding PVO, including experience, team composition, follow-up and …

Regulation Of Kynureninase By Estrogen Stimulation In Estrogen-Receptor Positive Breast Cancer, Alexis Berger

NYMC Student Theses and Dissertations

Breast cancer remains the second leading cause of death in women worldwide, with estrogen receptor (ER)-positive subtypes comprising over 70% of cases. Endocrine therapies, such as tamoxifen, are the primary treatment for ER-positive breast cancer; however, resistance inevitably develops, highlighting the need for alternative therapeutic strategies. Growing evidence suggests that the kynurenine pathway plays a significant role in breast cancer progression and metastasis. The kynurenine pathway metabolizes 95% of the amino acid tryptophan, generating metabolites such as kynurenine, kynurenic acid, 3-hydroxykynurenine, and ultimately Nicotinamide Adenine Dinucleotide (NAD). To better understand the impact of estrogen signaling on the kynurenine pathway, kynureninase …

Steps Toward Clinical Validation Of Exhaled Volatile Organic Compound Biomarkers For Hypoglycemia In Persons With Type 1 Diabetes., Mark Woollam, Paula Angarita-Rivera, Sanskar Thakur, Ali Daneshkhah, Amanda P Siegel, Dana S Hardin, Mangilal Agarwal

Ambulatory and Primary Care Articles

Persons with type 1 diabetes (T1D) must track/control their blood glucose (BG) levels to avoid hypoglycemic events (BG <  70 mg/dL), which in the most severe cases can lead to seizures or even death. Canines may lead the way toward innovative testing solutions, as they can be trained to identify hypoglycemia simply and noninvasively by smelling exhaled volatile organic compounds (VOCs). To identify breath-based biomarkers of hypoglycemia, samples were collected during two consecutive summers at a diabetes camp (Cohort 1 and Cohort 2), and VOCs were analyzed by gas chromatography-mass spectrometry. Conserved VOCs between the two cohorts were identified, but individual VOCs alone had low accuracies for detection. Therefore, supervised multivariate statistical analysis was undertaken to identify a biosignature in the training data set (Cohort 1) that could detect hypoglycemia with higher accuracy (sensitivity = 94.8%/specificity = 95.0%). When this model was blindly tested on Cohort 2, hypoglycemia was classified with sensitivity = 90.0%/specificity = 89.9%. Ultimately, this study makes strides toward clinical validation through verifying biomarkers of hypoglycemia in hundreds of breath samples. These results may be translated to design a sensor array that could be integrated into a portable breathalyzer to increase glycemic control in persons with T1D.

An Exploratory Pharmacogenetic Pilot Study Of Two Reverse Transcriptase Inhibitors, Tenofovir Alafenamide Fumarate And Tenofovir Disoproxil Fumarate, Derek E. Murrell, Benjamin C. Kennard, Maria E. Bertoni, David B. Cluck, Jonathan P. Moorman, Stacy D. Brown, Keshang Wang, Michelle M. Duffourc, Sam Harirforoosh

Pharmacy Faculty Articles and Research

Background and Objectives

The nucleoside reverse transcriptase inhibitors tenofovir alafenamide fumarate and tenofovir disoproxil fumarate are frequently employed in treating human immunodeficiency virus. Further, each form of tenofovir requires laboratory monitoring to determine efficacy and tolerability among patients. This study sought to investigate the relationship, if any, of single nucleotide polymorphisms (SNPs) and selected clinical parameters.

Methods

The study population, predominantly Caucasian males with a median age of 53.0 years [interquartile range 46.0–59.0], was assayed for genetic variations using an iPLEX ADME PGx Pro v1.0 Panel.

Results

Although several SNP relationships were found with both forms of tenofovir, many of …

Integrating An Sms Text Reminder Program For Smi Patients To Combat Provider Appointment No-Shows, Philip Spreter Bsn

Doctor of Nursing Practice Final Manuscripts

Abstract

We are in the digital age in all avenues of life, especially healthcare. The standard of care is no longer just a paper reminder card and a call from the office to confirm the patient is going to make it in the week of their appointment. Cards get lost and more people are screening their phones due to a rise in robocalls and scams, which is leading to more people corresponding via text. This is why text-based reminders are now the new, preferred standard for reminding patients of their appt. With that said, there appears to be a deficit …

Distinct Brain Age Gradients Across The Adult Lifespan Reflect Diverse Neurobiological Hierarchies, Nicholas Riccardi, Alex Teghipco, Sarah Newman-Norlund B.S., M.A., Roger Newman-Norlund Ph.D., Ida Rangus, Chris Rorden, Julius Fridriksson Ph.D., Leonardo Bonilha

Faculty Publications

‘Brain age’ is a biological clock typically used to describe brain health with one number, but its relationship with established gradients of cortical organization remains unclear. We address this gap by leveraging a data-driven, region-specific brain age approach in 335 neurologically intact adults, using a convolutional neural network (volBrain) to estimate regional brain ages directly from structural MRI without a predefined set of morphometric properties. Six distinct gradients of brain aging are replicated in two independent cohorts. Spatial patterns of accelerated brain aging in older adults quantitatively align with the archetypal sensorimotor-to-association axis of cortical organization. Other brain aging gradients …

Mpox 2022 To 2025 Update: A Comprehensive Review On Its Complications, Transmission, Diagnosis, And Treatment, Rajesh Yadav, Anis Ahmad Chaudhary, Ujjwal Srivastava, Saurabh Gupta, Sarvesh Rustagi, Hassan Ahmed Rudayni, Vivek Kashyap, Sanjay Kumar

School of Medicine Publications

Monkeypox virus (Mpox virus) is a zoonotic orthopoxvirus that has gained increased global attention due to recent outbreaks. The current review reports the latest update of Mpox cases from 25 February 2022 to 29 April 2025. It also evaluates the possible major complications in human life caused by Mpox. In early 2022, more than 40 countries reported Mpox outbreaks. As of 12 June 2024, the global case count for the 2022–2023 Mpox outbreak was 97,281 confirmed cases, in 118 countries. The World Health Organization (WHO) declared the Mpox virus, a zoonotic disease, a public health emergency of international concern (PHEIC) …

Cone Beam Ct Dose Optimisation: A Review And Expert Consensus By The 2022 Estro Physics Workshop Igrt Working Group, Lydia J. Wilson, Andria Hadjipanteli, Daniella E. Østergaard, Evelien Bogaert, Kirstie F. Brown, Rianne Dejong, James Earley, Magali Edouard, Marina Khan, Josh Lindsay, Jessica Van Der Himst, George X. Ding, Tim Wood, Marianne C. Aznar, Nuria Jornet, Georgios Ntentas

Department of Radiation Oncology Faculty Papers

Image guided radiotherapy (IGRT) using kilovoltage cone-beam CT (CBCT) has become an indispensable tool to ensure the geometric accuracy of radiotherapy treatment delivery. Although significant technical advances have been made in reducing imaging dose, the repeated imaging procedures can still accumulate significant dose to healthy tissues. Despite the widespread use, we still lack clear guidance for optimisation and widely accepted frameworks for evaluating the quality and suitability of CBCT imaging protocols. To address this gap, the 2022 European Society for Radiotherapy and Oncology (ESTRO) Physics Workshop focused on image-quality and imaging-dose optimisation for IGRT using CBCT. This publication represents a …

Discovery Of Drug Transporter Inhibitors Tied To Long Noncoding Rna In Resistant Cancer Cells; A Computational Model -In Silico- Study, Mohanad Diab, Amel Hamdi, Feras Al-Obeidat, Wael Hafez, Ivan Cherrez-Ojeda, Muneir Gador, Gowhar Rashid, Sana F. Elkhazin, Mahmad Anwar Ibrahim, Tarek Farag Ismail, Samar Sami Alkafaas

All Works

Chemotherapeutic resistance is a major obstacle to chemotherapeutic failure. Cancer cell resistance involves several mechanisms, including epithelial-to-mesenchymal transition (EMT), signaling pathway bypass, drug efflux activation, and impairment of drug entry. P-glycoproteins (P-gp) are an efflux transporter that pumps chemotherapeutic drugs out of cancer cells, resulting in chemotherapeutic resistance. Several types of long noncoding RNA (lncRNAs) have been identified in resistant cancer cells, including ODRUL, MALAT1, and ANRIL. The high expression level of ODRUL is related to the induction of ATP-binding cassette (ABC) gene expression, resulting in the emergence of doxorubicin resistance in osteosarcoma. lncRNAs are observed to be regulators of …

The Cgas/Sting Pathway: Friend Or Foe In Regulating Cardiomyopathy, Weiyue Wang, Yuanxu Gao, Hyun Kyoung Lee, Albert Cheung-Hoi Yu, Markus Kipp, Hannes Kaddatz, Jiangshan Zhan

Duncan NRI Faculty and Staff Publications

Inflammation is a central hallmark of cardiomyopathy, where misdirected immune responses contribute to chronic myocardial dysfunction. Among the emerging molecular mechanisms implicated in this process, the cyclic GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING) signaling pathway has garnered increasing attention. Acting as a key cytosolic DNA sensor, the cGAS/STING pathway orchestrates inflammatory responses triggered by microbial infections or endogenous cellular stressors such as autophagy and apoptosis. Despite its pivotal role, the precise molecular mechanisms regulating this pathway and its role in cardiomyopathy-associated inflammation remain poorly understood and subject to ongoing debate. To address this scientific gap, we first reviewed key …

Low Cd25 In Alk+ Anaplastic Large Cell Lymphoma Is Associated With Older Age, Thrombocytopenia, And Increased Expression Of Surface Cd3 And Cd8, Shuyu E, L Jeffrey Medeiros, Hong Fang, Shaoying Li, Guilin Tang, Sa A Wang, Wei Wang, C Cameron Yin, M James You, Swaminathan P Iyer, Luis Malpica, Lianqun Qiu, Zhenya Tang, Qing Wei, Pei Lin, Jie Xu

Faculty, Staff and Student Publications

Background/objectives: Anaplastic lymphoma kinase (ALK)-positive (+) anaplastic large cell lymphoma (ALCL) is known to express CD25, but its significance has not been well studied.

Methods: In the present study, we identified 54 ALK+ ALCL patients with CD25 results available and investigated the significance of CD25 expression levels.

Results: Forty-two (78%) cases had high CD25 expressions, whereas low CD25 expressions were found in 12 (22%) cases. Compared with ALK+ ALCL patients with CD25-high neoplasms, patients with CD25-low neoplasms were older (median: 40 years vs. 29 years, p = 0.01) and more often had thrombocytopenia (40% vs. 0%, p = 0.02). Between …

The Relationships Among Orthorexia Nervosa, Perfectionist Tendencies And Academic Achievement In Nutrition And Dietetics Students, Sophia Grace Owens

Master's Theses

Eating disorders can cause a disturbance in how the health of food is viewed (Cerniglia et al., 2017). If a person has disturbances in their eating behaviors that can cause harm to their health, but the behaviors do not fit into the criteria of a specific eating disorder, they fall into the category of a disordered eating pattern (Academy of Nutrition and Dietetics, 2018). Because of the stress the college environment can cause students, some college students may cling to anything they can control, which may be reflected in their dietary habits. Orthorexia Nervosa (ON), a disordered eating pattern, is …

Leading Change For Transgender And Gender Diverse Healthcare: Assessing Organizational Readiness, Braxten Lovett

Dissertations

Background: Transgender and gender-diverse (TGD) individuals face persistent stigma and systemic discrimination across multiple societal domains, with healthcare settings—intended as safe spaces—often being among the most harmful. Despite increased visibility of TGD populations and growing research on their health inequities, inclusive healthcare remains insufficiently addressed by many healthcare leaders, adding to the urgency to advance equitable, inclusive care. Additionally, structural cisnormativity and binary gender frameworks continue to perpetuate misinformation, erasure, and health disparities. Addressing these entrenched barriers requires systemic reform rooted in cultural humility, inclusive practices, and a commitment to dismantling cisnormative bias within healthcare delivery and policy. This study …

Targeting Neuronal Nitric Oxide Synthase (Nnos) As A Novel Approach To Enhancing The Anti-Melanoma Activity Of Immune Checkpoint Inhibitors, Anika R. Patel, Shirley Tong, Kate Alison Lozada, Amardeep Awasthi, Richard B. Silverman, Jennifer Totonchy, Sun Yang

Pharmacy Faculty Articles and Research

Background and Objectives: Neuronal nitric oxide synthase (nNOS) overexpressed in melanoma plays a critical role in disease progression. Our previous studies demonstrated that nNOS inhibitors exhibited potent anti-melanoma activity and regulated PD-L1 expressions in the presence of interferon-gamma (IFN-γ). However, the role of nNOS in the melanoma immune response has not been well defined. Methods: Changes in gene expression profiles after nNOS inhibitor treatment were determined by transcriptomic analysis. A melanoma mouse model was used to determine the effects of nNOS inhibition on peripheral T cells and the in vivo anti-tumor activity of combining nNOS inhibitors with immune …

Parent’S Health Literacy And Stress Level In The Inpatient Pediatric Setting, Tina C. Smith

Dissertations

Purpose: This study examined the relationship between parent health literacy and stress levels during their child’s inpatient hospitalization.

Background: In 2019, over five million pediatric hospitalizations occurred in the United States. Parents are central to their child’s care, but stress and sociodemographic factors may hinder their ability to understand and apply health information. This study explored how stress and other variables impact parent health literacy during hospitalization.

Methods: A cross-sectional design included a demographic survey, the Perceived Stress Scale (PSS-10), and the Newest Vital Sign (NVS). Bivariate analyses (Chi-square, t-tests) and logistic regression were used to assess …

Improving Equity In Women's Stroke Outcomes, Lindsay M. Warner

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project is to review research-based evidence evaluating the inequities in women’s stroke research and treatments and how this effects women’s stroke outcomes. This paper sought to identify current recommendations for improving sex equity for women’s stroke research and identify further areas of policy change to ensure that women’s health outcomes are prioritized in this historically underrepresented population.

Background: An area of critical importance to society is the significant cause of gender-based inequity in healthcare and research. Historically medical research has primarily involved males and the findings have been …

Life In The Fast Lane: Improving Patient Intermittent Fasting Compliance, William C. Moreo

Doctor of Nursing Practice Final Manuscripts

Background: In the United States, 2 in 5 adults are obese. The U.S. spends approximately $147 billion annually on healthcare related to obesity. Intermittent Fasting (IF) has emerged as an evidence-based, safe, and cost-effective approach to weight loss. When instructed correctly, it has been shown to improve patient BMI and total weight over a short-term duration.

Purpose of the Project: The purpose of this study was to determine the effectiveness of a standardized time-restricted eating (TRE) intermittent fasting education protocol for primary care providers (PCP) and its impact on their confidence levels in managing patients. This project aims to enhance …

Why Throughput Is Group-Put, Edward Sales

Doctor of Nursing Practice Final Manuscripts

Introduction: University of California San Francisco (UCSF) Saint Mary’s Health, has two hundred forty licensed beds to utilize for patient care, ninety one that can be used for inpatient medical surgical patients. Throughput is a challenging issue, especially at Unit seven west which houses thirty beds. Post op surgical orthopedic patients, medical surgical patients from the emergency department (ED), intensive care unit (ICU), and telemetry downgrades are waiting for inpatient beds, which causes delays in care and increases length of stay.

Background: Unit seven west is a surgical ortho floor with a high admission census consisting of three to ten …

Improving Social Drivers Of Health Screening In An Inpatient Setting For Sdoh Data, John P. Lussier

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose

Title of the Project: Improving Social Drivers of Health Screening in an Inpatient Setting for SDoH Data

Purpose: This evidence-based practice project aimed to increase social drivers of health (SDoH) screening compliance by redesigning the workflow to distribute responsibility between nursing and case management, ultimately improving identification and referral of patients with supportive service needs.

Background: Screening for SDoH needs facilitates the provision of appropriate supportive services. The existing workflow required nurses to conduct initial screening in five domains (Housing Stability, Utility Difficulties, Food Insecurity, Interpersonal Safety, and Transportation Needs), with positive responses triggering additional investigative questions. These …

Crisis Without Cops: Trauma-Informed Mental Health Care For Bipoc Communities, Amanda Carson

Doctor of Nursing Practice Final Manuscripts

This policy paper advocates for a structural transformation in mental health crisis response, moving beyond police-led interventions toward trauma-informed, community-rooted models grounded in public health and equity. Drawing on Critical Race Theory (CRT), neuroscience, and program evaluations of models like CAHOOTS, 988, Denver’s STAR, and Durham’s HEART, it examines how systemic racism, institutional mistrust, and implicit bias contribute to disproportionate harm for BIPOC individuals. The paper highlights the effectiveness of peer-led, culturally responsive alternatives that reduce force, hospitalization, and disengagement from care. Using Kingdon’s Multiple Streams Framework, it proposes actionable, scalable policy strategies supported by recent federal momentum, including the …

Optimizing Psychiatric Care Through Pharmacogenomics: An Evidence-Based Program To Increase Multi-Gene Pharmacogenomic Testing And Provider Competence In Mental Health Settings, Marc Boulanger

Doctor of Nursing Practice Final Manuscripts

Objective: This scholarly project aimed to enhance psychiatric providers' competency, confidence, and knowledge in the PHASER pharmacogenomic (PGx) testing program at the VA San Diego Healthcare System.

Background: PGx testing enhances psychiatric care by enabling precise medication management tailored to a patient’s genetic profile, improving treatment effectiveness and reducing adverse drug reactions. Despite demonstrated clinical utility, adoption of PGx remains limited due to provider knowledge gaps. This project addresses these gaps through targeted education.

Methods: Two educational modules, developed with input from the PHASER site-lead, aimed to enhance provider knowledge and confidence in PGx. Module one introduced the PHASER program …

Implementation Of A Tracheostomy Discharge Education Class For Nicu Nurses, Todd N. Chamoy

Doctor of Nursing Practice Final Manuscripts

Infants who are ventilator-dependent or have anatomic anomalies of their airway frequently require tracheostomy placement prior to discharge from the hospital in order to be cared for safely at home. At this large quaternary children’s hospital in Southern California, preparing these infants for discharge after tracheostomy placement has not been the role of the NICU nurse. There was no system in place on how to train caregivers, and the NICU staff felt unprepared. Evidence supports use of intensive educational programs to improve nurse knowledge and skills of tracheostomy care, allowing NICU nurses to provide improved care and pre-discharge teaching.

A …

Suprathel Burn Dressing Versus Standard Care: Impact On Hospitalization Duration And Post- Discharge Outpatient Visits, Isaac Awolola

Doctor of Nursing Practice Final Manuscripts

The aim of this evidence-based project is to determine the effectiveness of Suprathel a synthetic, one-time application, wound dressing that acts as a temporary skin substitute, particularly effective for partial-thickness burns and deep dermal burns vs, the standard of either Polysporin or Santyl, Xeroform, gauze on the frequency of outpatient (OP) visits after a patient’s discharge. A secondary aim of this project was to investigate whether Suprathel burn dressing significantly decreases the length of stay (LOS) for patients with second-degree burns involving < 20% total body surface area (TBSA). The results showed that the use of Suprathel dressings resulted in a shorter hospital stay 7.05 vs 9.35 days with a higher number of outpatient visits 5.47 vs 2.69 visits, compared to conventional dressings. The use of Suprathel dressings as a standard practice reduces inpatient hospitalization but increases outpatient visits and resource utilization. The use of Suprathel dressings shortens the length of hospitalization and may augment patient comfort, and decrease overall healthcare costs associated with hospitalization. Due to the reduction in need for painful daily dressing changes, Suprathel dressings constitute a potentially preferred option in burn care and could thereby influence treatment protocols and enhance patient outcomes.

Keywords: Wound care, Suprathel dressing, total body surface area, Outpatient Visits, Second-degree Burn, Length of stay, Gauze