PURPOSE: The purpose of this quality improvement initiative was to increase adherence to follow-up appointments in patients with diabetes mellitus for prevention of diabetic foot ulcers. PARTICIPANTS AND SETTING: The sample comprised 33 adults with diabetes mellitus being cared for at an outpatient wound care clinic affiliated with a large metropolitan hospital in the state of Mississippi, located in the Southern United States. APPROACH: This quality improvement approach used the Plan-Do-Study-Act method. Educational flyers and verbal instruction were provided to enhance adherence to preventive nail care and follow-up appointments. The goal for this quality improvement initiative was to increase adherence with preventive nail care and follow-up care. OUTCOMES: Participants were provided with educational flyers and verbal instruction that emphasized the importance of follow-up clinic appointments, which promoted increased attendance at follow-up appointments. The proportion of patients who did not attend follow-up appointments fell from 9.2% prior to the intervention to 5.8% after its introduction. IMPLICATIONS FOR PRACTICE: This quality improvement initiative positively impacted practice at a local wound care clinic in Mississippi resulting in a clinically relevant reduction in no-show follow-up visits when compared to the previous year.

ZaKeia Williams O'Braint; Catherine R. Stepter; Brandi Lambert. Preventive Nail Care Among Diabetic Patients. Journal of Wound, Ostomy & Continence Nursing 2022, 49, 559 -563.

ZaKeia Williams O'Braint, Catherine R. Stepter, Brandi Lambert. Preventive Nail Care Among Diabetic Patients. Journal of Wound, Ostomy & Continence Nursing. 2022; 49 (6):559-563.

ZaKeia Williams O'Braint; Catherine R. Stepter; Brandi Lambert. 2022. "Preventive Nail Care Among Diabetic Patients." Journal of Wound, Ostomy & Continence Nursing 49, no. 6: 559-563.

A carotid body tumor is typically a benign mass and can have a low malignant potential. It can grow in between, attach to, or surround the internal carotid artery and external carotid artery in the neck. If this mass grows too big, it can compress the two arteries, causing problems in getting blood flow to the brain. The purpose for this sonography examination was to evaluate a patient with the following symptoms: dizziness, facial nerve injury, and sensorineural hearing loss. The carotid body tumor is a highly vascular tumor. This sonography examination provides a good opportunity to teach the importance of the use of color Doppler and proper documentation of this pathology that is often incorrectly documented with improper settings. This case reviews a 69-year-old Caucasian male with a carotid body tumor. The sonographic features, prevalence, common symptoms, prognosis, and treatments of the carotid body tumor are reviewed.

Elizabeth Nevle. Sonography of a Carotid Body Tumor: A Case Report. Journal of Diagnostic Medical Sonography 2020, 36, 501 -505.

Elizabeth Nevle. Sonography of a Carotid Body Tumor: A Case Report. Journal of Diagnostic Medical Sonography. 2020; 36 (5):501-505.

Elizabeth Nevle. 2020. "Sonography of a Carotid Body Tumor: A Case Report." Journal of Diagnostic Medical Sonography 36, no. 5: 501-505.

High‐speed video and electric field change data are used to describe the first 5 ms of a negative cloud‐to‐ground flash. These observations reveal an evolution in character of the luminosity and electric field change pulses as two branches of the leader separately transition from initial leader to propagating as a negative stepped leader (SL). For the first time reported, there is evidence of weak luminosity coincident with the initiating event, a weak bipolar pulse 60 μs prior to the first initial breakdown (IB) pulse. During the IB stage, the initial leader advances intermittently at intervals of 100–280 μs, in separate light bursts that are bright for a few 20‐μs frames and are time coincident with IB pulses. In the intervals between IB pulses, the initial leader is dim or invisible during the earliest 1.8 ms. Within 2 ms, the leader propagation begins transitioning to an early SL phase, in which the leader tip advances at more regular intervals of 40–80 μs during relatively dim and brief steps which are coincident with SL pulses having short duration, small amplitude, and typically unipolar waveform. These data indicate that when the entire initial leader length behind the lower end begins to remain illuminated between bursts, the propagation mode changes from IB bursts to SL steps, and the IB stage ends. The results support a hypothesis that the early initial leader development occurs in the absence of a continuously hot channel, thus the initial leader propagation is physically unlike the self‐propagating SL advance.

Maribeth Stolzenburg; Thomas C. Marshall; Sumedhe Karunarathne. On the Transition From Initial Leader to Stepped Leader in Negative Cloud‐to‐Ground Lightning. Journal of Geophysical Research: Solid Earth 2020, 125 .

Maribeth Stolzenburg, Thomas C. Marshall, Sumedhe Karunarathne. On the Transition From Initial Leader to Stepped Leader in Negative Cloud‐to‐Ground Lightning. Journal of Geophysical Research: Solid Earth. 2020; 125 (4):.

Maribeth Stolzenburg; Thomas C. Marshall; Sumedhe Karunarathne. 2020. "On the Transition From Initial Leader to Stepped Leader in Negative Cloud‐to‐Ground Lightning." Journal of Geophysical Research: Solid Earth 125, no. 4: .