Medicine and Health Sciences Commons^™

Improving Provider Confidence In Suicide-Risk Screening Through Training On A Safe-T-Guided Pathway At Intake, Shukairo Mack Baker

Doctor of Nursing Practice Projects

Evidence supports structured suicide-prevention education, but inconsistent pathway use at outpatient intake prompted this quality improvement project to evaluate provider confidence. The aim was increased confidence after training on a Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) guided pathway. Donabedian's structure, process, and outcome model and the Awareness, Desire, Knowledge, Ability, and Reinforcement change model guided implementation through one Plan, Do, Study, Act cycle. A single-group pre-test and post-test design involved seven clinicians at one hybrid outpatient behavioral health clinic. All available eligible staff (100%) completed a 2.5-hour training and both surveys. The Suicide Risk Assessment Confidence Scale was administered …

Biosensor Development In East Africa: A Systematic Review Of Technologies, Applications, Challenges, And Future Directions, Ally Mahadhy

Tanzania Journal of Science

Biosensors integrate biological recognition elements with signal transduction systems to generate quantitative or semi-quantitative analytical information and have applications across healthcare, food safety, agriculture, environmental monitoring, and wildlife health. Despite substantial global advances, biosensor development in East Africa remains poorly characterized. This systematic review, conducted according to PRISMA 2020 guidelines, evaluated published evidence from 1995 to 2025 within a predefined East African Community geographical scope. Eligibility was based on IUPAC-aligned operational criteria requiring an integrated biological recognition element, transduction mechanism, and quantitative or semi-quantitative signal output. Three locally developed biosensors met the criteria: an electrochemical nano-biosensor for schistosomiasis diagnosis in …

Modelling Acute Haemorrhagic Conjunctivitis In East Africa: An Integrated Approach To Transmission Dynamics And Outbreak Response Strategies, Geofrey Wingi Sikazwe

Tanzania Journal of Science

Acute hemorrhagic conjunctivitis (AHC) poses a significant global health risk, with the potential for rapid spread during outbreaks. For instance, a localized outbreak in Yunnan Province, China, recorded infection rates of up to 48%, illustrating how transmission can intensify under favourable epidemiological and environmental conditions. Existing mathematical models of AHC transmission overlook seasonal variations, a critical factor in epidemic spread. This study combines species distribution models (SDMs) and epidemiological modelling to analyse key drivers of AHC in East Africa. We use the SEIR type (Susceptible-Exposed-Infected-Recovered - incorporating waning immunity) framework with temperature-dependent infectivity rate as the key driver of an …

Plasmodium Falciparum Parasite Density And Its Association With Malaria Rapid Diagnostic Test Positivity Among School-Aged Children Across Diverse Malaria Transmission Settings In Mainland Tanzania, Felista Mwingira

Tanzania Journal of Science

Malaria rapid diagnostic tests (mRDTs) are widely used for malaria diagnosis and surveillance; however, their performance is influenced by parasite density. This study assessed the relationship between parasite density and mRDT positivity among school-aged children (SAC) across diverse malaria transmission settings in mainland Tanzania. Data were obtained from 17,131 school-aged children participating in a nationwide malaria survey. Malaria infection was assessed using mRDT and quantitative polymerase chain reaction (qPCR) targeting the Plasmodium falciparum lactate dehydrogenase (PfLDH) gene. Parasite density distributions were examined across demographic, environmental, and epidemiological characteristics. Malaria prevalence was 19.5% by malaria rapid diagnostic test (mRDT) and 19.2% …

Reversible Microvascular Ischemia With St-Segment Elevation: An Underrecognized Manifestation Of Antibody-Mediated Rejection In Cardiac Allograft Recipients, Jonathan Ahn, Justin Daneshrad, Liset Stoletniy, Dmitry Abramov

The VAD Journal

Electrocardiographic manifestations of cardiac allograft rejection are often subtle, and stress-induced ST-segment elevation associated with antibody-mediated rejection (AMR) is rarely reported. We describe a 34-year-old heart transplant recipient with progressive exertional angina, nonobstructive coronary disease on angiography, and exercise-induced ST-segment elevation in lead augmented vector right, high-lateral leads I, and augmented voltage left, along with diffuse ST-segment depressions, hypotension, and transient ventricular tachycardia. Concurrent emergence of complement-binding donor-specific antibodies with high mean fluorescence intensity raised concern for AMR, prompting treatment with corticosteroids, plasma exchange, and intravenous immunoglobulin despite the absence of biopsy confirmation. After therapy, symptoms, exercise-induced ischemic electrocardiographic abnormalities, …

Overview Of Glp-1ra Medications, Thomas A.F. Cordaro Pharmd, Sumaiya A. Difaa Pharmd, Amel J. Basil Pharmd

Transformative Medicine

GLP-1 is an incretin hormone that is naturally produced in the body that regulates blood glucose and appetite. The first GLP-1RA that was FDA approved, exenatide, in 2005, originated from the Gila monster and beaded lizard, via the discovery of the exendin-4 peptide. GLP-1RAs function by mimicking endogenous GLP-1 incretin hormone, leading to an increase in glucose-dependent insulin release from beta-cells of the pancreas, decrease in glucagon release, delayed gastric emptying, and satiety. Due to the benefits seen from initiating GLP-1RAs in the market, it sparked interest in numerous studies which proved that certain GLP-1RAs can provide cardiorenal protection. The …

Wolff-Parkinson-White Pattern: Recognition Of Ventricular Pre-Excitation And Risk Stratification, Devi Parvathy Jyothi Ramachandran Nair, Badri Aryal

Transformative Medicine

Background: Wolff-Parkinson-White (WPW) pattern is characterized by ventricular pre-excitation through an accessory atrioventricular pathway. Although often asymptomatic, some pathways carry a risk of tachyarrhythmia and sudden cardiac death.

Case Description: A 45-year-old man with hypertension, polysubstance use, and bipolar disorder presented with altered mental status following suspected substance intoxication. His course was complicated by hypoxic respiratory failure requiring intubation and a large right basal ganglia hemorrhage requiring surgical evacuation. During hospitalization, an abnormal ECG prompted Cardiology consultation. The ECG demonstrated sinus rhythm with a short PR interval, delta wave, and widened QRS complex, consistent with ventricular pre-excitation. He had …

Hands Up! A Case Of Bilateral Luxatio Erecta, Madison Heck Do, Henry Kramarski Do, Adam Sigal Md

Transformative Medicine

Background:  An inferior shoulder dislocation, luxatio erecta, is a rare phenomenon that is seen in approximately 0.5% of shoulder dislocations; the incidence of bilateral luxatio erecta is even more uncommon. They can often be mistaken for anterior shoulder dislocations.

Case Description: This case report discusses the rare occurrence, identification and management of bilateral luxatio in a 48-year-old man after he dove 6 feet from a bridge and into a body of water.

Discussion: The pathognomonic presentation is a patient arriving with an arm hyper-abducted above the head with flexed elbows and pronated forearms. There are several concomitant injuries that can …

Elite Esports Players And Their Physical Health: A Systematic Review Of Injuries, Musculoskeletal Pain, And Fitness-Related Factors, Michal Steffl, Daniel Opelik, Vladimir Hlinka, Grzegorz Mikrut, Petra Hospodkova

Baltic Journal of Health and Physical Activity

Background: The rapid rise of competitive esports has sparked concerns over the physical health of elite players. Prolonged sedentary behaviour, repetitive movements, and poor ergonomic practices may predispose these athletes to injuries, musculoskeletal pain, and unfavourable body composition. Materials and methods: A systematic review following PRISMA guidelines was conducted by searching Pub-Med, Scopus, EBSCOhost, and Web of Science for cross-sectional studies on physical activity (PA), body composition, physical fitness, and musculoskeletal health in elite esports players. Data from 22 peer-reviewed studies involving 5,035 participants aged 16 to 35 were synthesized. Results: Findings consistently show that esports players engage in lower …

Beyond Electromyography: A Systematic Review And Meta-Analysis Of Ai Enabled Wearables For Neuromuscular Assessment In Sports Medicine And Rehabilitation, Dariusz T. Skalski, Michał Spieszny, Łukasz Jaworski, Marcin Żak, Artur Terbalyan, Marlena Stawiarska, Wirginia Likus, Adam Maszczyk

Baltic Journal of Health and Physical Activity

Background: Conventional laboratory based EMG systems constrain neuromuscular assessment to controlled environments, limiting ecological validity in sport and rehabilitation. While AI enabled wearable sensor systems, including surface EMG (sEMG), high density EMG (HD-EMG), inertial measurement units (IMUs), and multimodal configurations, have expanded ambulatory monitoring capabilities, no prior meta-analysis has quantitatively synthesized their agreement with laboratory grade comparators or examined the moderating roles of sensor class and task domain. Objective: To determine the overall agreement between AI enabled wearable neuromuscular systems and laboratory benchmarks; to examine sensor class and task domain as moderators of measurement fidelity; to evaluate multimodal gain over …

When Should You Repeat A Child's Cbc?, Mike Smith, Sara Mcelroy

Pediatrics in Practice: A CME Podcast

"I found an unexpected abnormal CBC — should I repeat it or refer?" This episode focuses on repeat testing and early steps for abnormal CBCs. Sara McElroy, MD, pediatric hematologist at Children's Mercy explains when mild changes can be safely rechecked versus urgent referral. She covers transient marrow suppression with infection, lab artifact and repeat timing (about 4–6 weeks), the role of return precautions, and when to escalate to hematology or the ER.

Click here to stream the podcast episode.

The Effects Of C-Arm Positioning On The Accuracy Of Acetabular Reorientation In A Periacetabular Osteotomy Surgical Model, Cameron S. Baller

Summer Research Program Abstracts

No abstract provided.

Evaluation Of Disaster Mitigation Policy Implementation And Public Health Integration Through The “Sipatokkong” Program In Strengthening Tourism Village Resilience, Nurul Azisah Sahrani, Andi Alif Raihan Analta

Journal of Indonesian Health Policy and Administration

Disaster risks in tourism villages are increasing, generating multidimensional impacts on environmental, economic, institutional, and public health. In late 2024, Mattabulu Tourism Village experienced an 83% decline in tourist visits following a series of disasters, disrupting tourism activities and weakening local governance capacity. This study uses a qualitative case study design to evaluate disaster mitigation policy implementation through the “Sipatokkong” Program. Evaluation applied four Organisation for Economic Co-operation and Development–Development Assistance Committee (OECD-DAC) criteria: relevance, effectiveness, impact, and sustainability, operationalized through policy implementation, street-level bureaucracy, and collaborative governance frameworks. Data were obtained from five documents and non-participatory field observations conducted …

Quality Improvement Project: Improving Nurse Confidence In Managing Patient Aggression Using The Brøset Violence Checklist And Team-Based Strategies, Grace Amakulor

Doctor of Nursing Practice Projects

Workplace violence remains a concern in psychiatric nursing, particularly when changes in patient behavior are not recognized early or communicated consistently. This quality improvement (QI) project was conducted at a psychiatric recovery center in Central Ohio after identifying a practice gap in aggression risk assessment and response. The purpose was to implement and evaluate a multicomponent aggression-management approach using the Brøset Violence Checklist (BVC), structured team huddles, and individualized aggression care plans. The aim was to improve nurse confidence (primary outcome) and reduce aggressive behavioral incidents (secondary outcome) over four weeks. Bandura’s Social Cognitive Theory and Lewin’s Change Theory guided …

Quality Improvement Project: Telehealth Follow-Up After Psychiatric Hospital Discharge, Ikemi Echeng

Doctor of Nursing Practice Projects

The period following psychiatric hospitalization is a high-risk transition during which inconsistent communication, delayed follow-up, and poorly coordinated referrals can create gaps in continuity of care. This quality improvement project addressed inconsistent post-discharge follow-up processes in a community outpatient mental health clinic. The purpose was to implement staff education and a structured workflow incorporating the Agency for Healthcare Research and Quality Discharge Phone Call Tool to improve staff confidence, telehealth follow-up, and referral coordination over eight weeks. A quantitative, quasi-experimental, one-group pre- and post-intervention design was used. Staff confidence was measured with Grundy’s C-Scale, and telehealth follow-up and referral activities …

Impact Of Cannabis Use Screening And Early Intervention In Outpatient Psychiatric Settings, Theresa Chibuoke

Doctor of Nursing Practice Projects

Cannabis use can complicate psychiatric assessment, treatment planning, and clinical outcomes, yet standardized cannabis-use screening remains inconsistently implemented in behavioral health practice. This quality improvement (QI) project addressed inconsistent cannabis screening and referral practices in an outpatient psychiatric clinic by implementing a standardized workflow to improve screening documentation to at least 80% and timely referral completion to at least 75%. A quantitative, quasi-experimental pretest-posttest design included 10 outpatient psychiatric providers over six weeks. Lewin’s Unfreeze-Change-Refreeze model guided change, the Plan-Do-Study-Act framework supported implementation, and Donabedian’s Structure-Process-Outcome model guided the project. The evidence-based intervention incorporated provider education, the valid and reliable …

Quality Improvement Project: The Impact Of Provider Education On Antipsychotic Medication Side Effects, Anthony Emego

Doctor of Nursing Practice Projects

Weight gain is a frequent and clinically relevant side effect of antipsychotic medication. A needs assessment at the project site found that roughly 55% of patients on an antipsychotic treatment had clinically significant weight gain, and providers had no formal training on how to prevent and manage this. The purpose of this quality improvement project was to determine if a provider-focused educational intervention is effective in increasing provider confidence and decreasing antipsychotic-induced weight gain in adult psychiatric patients. This quantitative, one-group pre-post design utilized Lewin's Change Theory and Bandura's Social Cognitive Theory. It was conducted at an outpatient psychiatric clinic …

Quality Improvement Project: Improving Psychiatric Provider Confidence In Prescribing Long-Acting Injectable (Lai) Antipsychotics Through A Structured Education Program, Emile Bihnyuy

Doctor of Nursing Practice Projects

Schizophrenia is a disorder that affects about 24 million people globally and needs regular antipsychotic drug management to prevent relapse. Although long-acting injectable (LAI) antipsychotics are associated with better adherence to and fewer relapses than oral antipsychotics, their use is underutilized in outpatient psychiatric care. This quality improvement project aimed to increase psychiatric providers' confidence in the prescribing of LAIs by implementing a structured 12-week education program in an outpatient psychiatric clinic in Texas. The implementation was guided by the Iowa Model of Evidence-Based Practice and the change process informed by Lewin's Change Model. Four psychiatric providers completed the modified …

Quality Improvement Project: The Impact Of Proper Utilization Of Suicidal Ideation Screening Tools, Anuoluwapo Bode-Oloye

Doctor of Nursing Practice Projects

Suicide remains a significant public health concern, emphasizing the importance of consistent and evidence-based suicide risk assessment in outpatient mental health settings. The purpose of this Doctor of Nursing Practice quality improvement project was to determine how the provider’s implementation of the Columbia Suicide Severity Rating Scales (CSSRS) according to the recommendations of the Substance Abuse and Mental Health Services Administration would impact the confidence and the rate of completion of suicidal screening tools (Columbia Suicide Severity Rating Scales) compared to current clinic policy in an outpatient mental health clinic for over twelve weeks. This project used Lewin’s change model …

Quality Improvement Project: Improve Patient Show Rate For Appointments At The Outpatient Diabetic Clinic, Smitha Mathew

Doctor of Nursing Practice Projects

Missed appointments disrupt diabetes management, delay treatment, and waste healthcare resources. This quality improvement project evaluated whether patient-centered scheduling, staff education, and multimodal communication reduced no-show rates among adults with diabetes. The Plan-Do-Study-Act model provided the theoretical and implementation framework, while Kotter’s Eight-Step Change Model guided practice change. The uncontrolled preintervention-postintervention project occurred from January through July 2026 in a hospital-based outpatient diabetes clinic. The evidence-based intervention included 45-minute staff education, scheduling based on patients’ preferred days and times, verifying contact information and communication preferences, sending telephone and text reminders, and re-engaging patients the same day after missed appointments. Appointment …

The Impact Of Provider Education On Medication Adherence In An Outpatient Psychiatric Clinic: A Quality Improvement Project, Tina Ezeh

Doctor of Nursing Practice Projects

Medication adherence is important in psychiatric care, as nonadherence can contribute to poor health outcomes and increased use of healthcare services. A needs assessment at an outpatient psychiatric clinic identified inconsistent medication adherence education, with only 30% of providers routinely providing education and 20% using a structured approach. The purpose of this quality improvement project was to evaluate structured provider education, with the aim of assessing changes in provider confidence and the frequency of medication adherence education over eight weeks. Kotter’s 8-Step Change Model guided project implementation, while the Donabedian Model was used for project evaluation. A quantitative, one-group pretest-posttest …

Quality Improvement Project: Evaluating The Impact Of An Emotional Support Program For Nurses In A Rural Outpatient Clinic, Tosheta Brown Greenfield

Doctor of Nursing Practice Projects

Nurse burnout is a persistent, well-documented threat to workforce sustainability and patient safety, with rural nurses at heightened risk due to chronic understaffing, geographic isolation, and limited access to organizational support. The purpose of this quality improvement project was to implement and evaluate an eight-week Emotional Well-Being Support Program (EWSP), with the aim of reducing burnout and perceived stress among nurses working in a small rural primary care clinic. Guided by Lewin's Change Model and the Iowa Model of Evidence-Based Practice, the project used a quasi-experimental pre-test/post-test single-group design with four participating nurses. Burnout was measured using the Maslach Burnout …

Quality Improvement Project: Providing Evidence-Based Practice Education On Administering The Edinburgh Postnatal Depression Screening During Visits Once Per Trimester And Postpartum, Megan Keeney

Doctor of Nursing Practice Projects

Perinatal depression (PND) is prevalent worldwide and frequently remains undetected and untreated due to inconsistent screening. At the project site, the Edinburgh Postnatal Depression Scale (EPDS) was administered postpartum only, without standardization. This quality improvement project implemented evidence-based provider education and a revised EPDS protocol, screening once per trimester and postpartum, to increase PND identification, provider self-confidence, self-efficacy, and behavioral health referral rates. This project was guided by Lewin’s Change Theory and the Donabedian framework. A quantitative pre-post design was used with nine providers in an outpatient women’s health clinic, alongside a retrospective and post-implementation electronic health record (EHR) review. …

Quality Improvement Project: Enhancing Suicide Recognition Protocols With The Use Of Columbia-Suicide Severity Rating Scale In An Outpatient Mental Health Practice, Pamela Oxley

Doctor of Nursing Practice Projects

Suicide prevention in outpatient mental health settings requires prompt recognition of and an appropriate response to suicide-related concerns, including those initially communicated to administrative staff. Frontline administrative phone staff may first encounter patients expressing suicidal thoughts; however, evidence supports education and standardized processes to facilitate effective recognition and response. At the project site, a practice gap existed in administrative staff preparation and confidence in responding to suicide-related concerns. The quality improvement project addressed this gap through structured, standardized Columbia-Suicide Severity Rating Scale (C-SSRS) education paired with a standardized suicide-risk stratification and escalation protocol. The project aimed to improve administrative staff …

Quality Improvement Project: Assessing Healthcare Providers’ Confidence, Familiarity, And Implementation Of The Audit-C Screening Tool For Alcohol Use Disorder In Adults With Depression In Primary Care, Babatunde Thanni Shittu

Doctor of Nursing Practice Projects

In depressed adults, alcohol use disorder (AUD) is a clinically meaningful comorbidity whose existence may go unnoticed unless a systematically introduced practice of conducting standardized alcohol-use screening is implemented. The current quality improvement (QI) project evaluated the use of the Alcohol Use Disorders Identification Test-Consumption (AUDI-C) in order to improve the capacity of healthcare providers to diagnose co-occurring AUD and integrate standardized screening into healthcare. Guided by the Knowledge-to-Action (KTA) framework and Kotter’s Change Model, the project aimed to improve provider familiarity, confidence, self-efficacy, screening, documentation, and referral practices. A pretest–posttest design was implemented with 13 licensed healthcare providers in …

Individual Host Variation In Single-Cell Responses To Enteroaggregative Escherichia Coli Infection Modeled With Human Colon Organoids, Ling Qiu, Tajhal D Patel, Hannah E Jones, Cristian Coarfa, Anthony W Maresso

Faculty, Staff and Students Publications

Enteroaggregative Escherichia coli (EAEC) is a leading cause of diarrhea worldwide. Interestingly, EAEC disease outcomes vary dramatically among infected individuals, ranging from asymptomatic colonization to acute and chronic diarrhea. While previous research has focused on EAEC virulence factors, emerging evidence suggests that host genetic and cellular background may be equally important in determining disease susceptibility. To understand host-driven disease heterogeneity, we performed single-cell RNA sequencing on human colon organoids (HCOs) derived from three healthy adult donors following EAEC 042 infection. Surprisingly, despite comparable EAEC adherence across donors, we observed striking donor-specific responses to infection at multiple levels. A total of …

Eeg-Emg Coupling And Functional Neuroplasticity In Elite Combat Athletes: Effects Of Neurofeedback Training On Corticomuscular Coherence And Performance, Alicja Markiel, Kinga Łosińska, Marcin Żak, Adam Maszczyk

Baltic Journal of Health and Physical Activity

Background: Neurofeedback training has gained attention as a neuroplasticity based intervention for athletic performance, yet pathways linking cortical oscillatory modulation to neuromuscular adaptation and strength remain poorly characterized in elite combat athletes. Objective: This study examines whether EEG neurofeedback targeting sensorimotor alpha upregulation and frontal theta/delta modulation enhances cortico-muscular coherence, neuromuscular function, and maximal strength in elite MMA athletes. Methods: Thirty elite male MMA athletes (n = 10/arm) were randomized to intensive neurofeedback (E20G, 20 sessions), abbreviated neurofeedback (E15G, 15 sessions), or sham control. EEG spectral indices, EMG parameters (RMS, MF, iEMG, onset latency), beta band CMC, and maximal strength …

A Real-World Characterization Of Patients Receiving Biologics For Type 2 Inflammatory Diseases In A Tertiary Rhinology Practice, T. Blaise Marshall, Matthew Lelegren, Joseph K. Han, Kent Lam

Eastern Virginia Medical Journal

Background: Biologic therapies, such as omalizumab, mepolizumab, dupilumab, and benralizumab, are increasingly used in the treatment of various type 2 inflammatory diseases, including chronic rhinosinusitis with nasal polyposis (CRSwNP), asthma, and atopic dermatitis. While these biologic therapies have demonstrated efficacy and safety in their respective clinical trials, real-world characterization of the use of biologic therapies provides insight into how these treatments are prescribed and utilized among the general population.

Objective: We aim to characterize the patient population in a single tertiary otolaryngology practice that is receiving biologic therapies for all type 2 inflammatory diseases.

Methods: We conducted a retrospective chart …

An Introduction To The Philosophy Of Medicine, Debate, And Civil Discourse, Victor Saenz Phd

History of Medicine Seminar

No abstract provided.

Intimate Partner Violence And Child Wasting Across Countries: An Ecological Cross-Sectional Study, Wanri Lumbanraja, I Ketut Kasta Arya Wijaya, Ruben Cornelius Siagian

Journal of Indonesian Health Policy and Administration

Intimate partner violence (IPV) is a public health issue that can affect the well-being of women, their families, and the child-rearing environment. Meanwhile, wasting in under-five children reflects acute malnutrition linked to food insecurity, infectious diseases, poverty, and access to healthcare services. This study aimed to analyze the relationship between the prevalence of IPV among women in the past 12 months and the prevalence of wasting in children under the age of five at the national level. This study addresses the gap in cross-national research, which remains limited in linking IPV as an indicator of social vulnerability with wasting as …