Osteopenia and osteoporosis are major contributors to fracture risk in postmenopausal women, driven by accelerated bone loss and lower peak bone mass compared to men. In Southeast Asia, women reach the fracture threshold earlier, and limited access to diagnostic tools such as dual-energy X-ray absorptiometry (DEXA) further delays detection and treatment. This study evaluates the utility of heel ultrasound (HUS) as a low-cost, accessible alternative to DEXA for predicting fracture risk and identifying osteopenia in postmenopausal female subjects for future use in Southeast Asian countries like Indonesia. We compare fracture risk prediction scores generated by Lunar HUS and standard-of-care Lunar DEXA within the same individuals. Additionally, we assess the feasibility of incorporating the FRAXplus questionnaire to identify at-risk patients using anthropometric and clinical history data. Prior studies demonstrate that HUS independently predicts fracture risk, supporting its potential as a screening tool. In this pilot study, concordance between HUS and DEXA outputs is analyzed to determine whether HUS can reliably stratify patients by fracture risk. Our findings aim to support the implementation of HUS combined with FRAXplus as a scalable, cost-effective screening strategy for osteopenia and fracture risk in resource-limited settings, improving early detection and management in underserved populations.

Background: Un/under-housed individuals are more likely to utilize Emergency Departments (EDs) than their housed counterparts, facing higher acuity presentations and longer wait times. Understaffing may complicate provider understanding of their role in treating un/underhoused patients. A well-delineated scope of practice is shown to improve patient care. There is a significant gap in literature regarding emergency department physicians’ perceived and ideal scope of practice when treating un/underhoused patients. Methods: Conducted literature review using PubMed searches (keywords include: “homeless,” “scope of practice”). 66 studies selected and analyzed based on relevance to treatment of un/underhoused patients in EDs. Created qualitative interview, data storage and analysis plan for (3-5) semi-structured interviews with ED physicians working in LA. Planned analysis of key motifs identified from interview notes to follow. Results: Literature review resulted in themes and gaps in knowledge raised in Background. Interview completion and analysis pending. Interview contents and preserved motifs will suggest extent of difference between providers' ideal scopes of practice and actual scopes of practice. Limited interview size and constricted locale may impact result validity. Discussion: Using provider interviews to understand where potential disconnect(s) between their reality and ideal stem from may inform decisions about gaps in care and delineation of roles, potentially ameliorating provider burnout.

The Next Day Clinic (NDC) is an initiative launched by UCLA Health at 2 medical centers to reduce Emergency Department (ED) congestion & avoid unnecessary hospitalizations by redirecting eligible patients to outpatient follow-up care. To evaluate the program’s clinical & operational impact, a randomized encouragement trial was conducted. Patient-reported outcomes & experiences were assessed with validated survey tools. To support data collection, undergraduate students were trained in survey methodology, ethical considerations, & patient communication. Patients initially received surveys via email; those who didn’t respond were called. Surveys were administered in English & Spanish with the support of bilingual students. Proxy survey completion & higher participation incentives were also implemented to improve response rates. Survey completion rates increased substantially once student follow-ups began, rising from 8% to ~40%, increasing with student availability. The findings suggest that including students in survey administration is an effective, scalable strategy to enhance patient engagement & data collection. Response rates declined during academic breaks, reinforcing the impact of student involvement. This approach may help reduce nonresponse bias by reaching patients less likely to respond to electronic surveys alone. Overall, this work highlights the value of integrating students into quality improvement & research initiatives to strengthen data quality & support representative measurement of patient experience.

Substance use disorder (SUD) disproportionately affects unhoused populations in Skid Row, Los Angeles, where structural inequities intensify health risks and limit access to care. This study examines SUD through a political economy framework, moving beyond biomedical and behavioral explanations to analyze how housing instability, systemic barriers, and social conditions shape substance use and treatment access. A literature review was conducted using peer-reviewed articles, government reports, and public health data to assess the prevalence of SUD, existing interventions, and barriers to care among unhoused individuals in Skid Row. Findings indicate high rates of substance use driven by economic instability, limited healthcare accessibility, stigma, and fragmented service systems. While harm reduction strategies and peer-based interventions have shown effectiveness independently, current models often fail to integrate these approaches or address underlying structural barriers. In response, we propose a combined intervention that integrates harm reduction services with peer-based social network support and active care navigation, implemented through an existing service hub in Skid Row. This model aims to reduce overdose risk, increase treatment engagement, and strengthen social support systems. This research highlights the need for comprehensive, multi-level interventions that address not only individual behavior but also the structural determinants of health to improve outcomes for unhoused populations.