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Patient Self-Management: Tools And Barriers, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

In his issue introduction, the editor-in-chief of the Journal of Patient-Centered Research and Reviews comments on the theme of patient self-management of chronic diseases and the related articles published therein. Illnesses such as cardiovascular disease, diabetes, epilepsy, arthritis, asthma, and obesity often require patients to administer their own medication daily or adhere to strict dietary restrictions. Progress is being made on the process of implementation and evaluation of patient self-management tools in primary care practices. Barriers to self-management tool implementations in clinics, as well as their use by individual patients, must be understood and addressed.

Increasing Colorectal Cancer Screening Among Hispanic Primary Care Patients: Re-Aim Analysis., Beth Careyva M.D., Melanie B. Johnson Mpa, Randa D. Sifri Md, Melissa Dicarlo Mph, Ms, Kyle Shaak Bs, Alicia Rivera, Liselly Diaz, Andrea Barsevick, Rosa Anderson-Deortiz, Evelyn T. Gonzalez Ma, Amy Leader Drph, Mph, Anett Petrich Rn, Msn, Anna Quinn Mph, Ryt, Brian Stello Md, Ronald E. Myers Phd

Beth A. Careyva, M.D.

Context: Hispanic adults experience disparities in rates of colorectal cancer (CRC) screening. This RE-AIM analysis encompassed a multilevel decision support and navigation intervention (DSNI) for CRC screening. Interim findings were previously presented; we now aim to share the final analysis, particularly for effectiveness and implementation. Objective: Apply RE-AIM framework to a completed randomized controlled trial of a CRC screening intervention for Hispanic adults Setting: Five primary care practices Patients or Other Participants: Potential participants included a sampling frame of 2,720 screening-eligible patients, ages 50-75, Hispanic ethnicity, without history of CRC and polyps. 400 participants were enrolled. Intervention/Instrument: Decision support and …

Repeat Crc Screening After Standard And Decision Support And Navigation Interventions Among Hispanic Primary Care Patients., Melanie B. Johnson Mpa, Beth Careyva M.D., Melissa Dicarlo Mph, Ms, Kyle Shaak Bs, Sarah Hegarty Mphil, Evelyn T. Gonzalez Ma, Anna Quinn Mph, Ryt, Randa Sifri Md, Brian Stello Md, Ronald E. Myers Phd

Beth A. Careyva, M.D.

No abstract provided.

The Association Between Doppler Measures Of Cardiac Function And Outcomes In Patients With Left Ventricular Ejection Fraction ≤ 40% Undergoing Noncardiovascular Surgeries, Yang Shi, Rachel Pedersen, Matthew Rappelt, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan

Aurora Heart Failure / Transplant Faculty

Background: Preoperative risk assessments of individuals who undergo major noncardiac surgery have focused on ischemic heart disease. Information on how to assess the noncardiac surgical risks for patients with depressed cardiac function, as seen in heart failure, is sparse. Echocardiography is routinely performed in patients with depressed cardiac function and is an accepted standard cardiac assessment. Transthoracic echocardiography (TTE) provides strong independent prognostic implications in a wide range of cardiovascular conditions.

Purpose: To identify the echocardiographic parameters associated with outcomes among patients undergoing major noncardiac surgery.

Methods: A retrospective single-institution investigation identified 1,770 patients who underwent one or more major …

Mechanisms Of Left Ventricular Thrombus Formation In Heart Failure With Reduced Ejection Fraction: Novel Insights From Two-Dimensional Speckle Tracking Echocardiography, Dhruv Chawla, Tracy Hammonds, Tadele Mengesha, Matt Umland, Khawaja Afzal Ammar, Vinay Thohan

Aurora Heart Failure / Transplant Faculty

Background: Patients suffering from heart failure with reduced ejection fraction (HFrEF) are at increased risk for left ventricular (LV) thrombus and subsequent thromboembolism, yet anticoagulation is not routinely recommended for left ventricular ejection fraction (LVEF) alone. We sought to determine the role of two-dimensional speckle tracking echocardiography (2D-STE) to quantify regional changes in cardiac function associated with LV thrombus, which may prospectively guide anticoagulation.

Purpose: Help enable cardiovascular clinicians to use 2D-STE to evaluate regional strain patterns among patients with HFrEF with and without LV thrombus. Our results suggest that statistically lower regional longitudinal strain patterns in a well-matched cohort …

Echocardiographic Predictors Of Admission Among Patients With Heart Failure With Reduced Ejection Fraction, Chi C. Cho, Yang Shi, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan

Aurora Heart Failure / Transplant Faculty

Background: Congestive heart failure afflicts 5.7 million people in the United States with annual incidence of 600,000 and mortality of 280,000. Heart failure accounts for greater than 1 million hospitalizations annually and the single largest inpatient Medicare expense. As the U.S. population ages and greater emphasis is placed on population health as a means to bend projected health care expenditures, large health care organizations will need to develop algorithms to identify patients at high risk with heart failure and possibly preempt hospitalizations. Doppler echocardiography is routinely performed in clinical assessment of severe heart failure.

Purpose: We sought to determine echocardiographic …

Advanced Heart Failure Treatment Options Among The Elderly, German Guzman-Gutierrez, Yang Shi, Matthew Rappelt, Arshad Jahangir, Vinay Thohan

Aurora Heart Failure / Transplant Faculty

The aging human population has emerged as a critically important factor in health care, not only due to the unique physiologic and pathologic processes associated with aging but also because of the evolution of medical and surgical therapies that have increased quality and quantity of life. Heart failure is a disease found most commonly among older populations in whom it is associated with high morbidity and mortality. Heart failure disproportionately affects the elderly, and it stands to reason that the most terminal stage, known as advanced heart failure (AHF), is more common among the elderly. Despite limited data, treatment options …

Telepsychiatry: Access In Rural Areas, David P. Paul Iii, Brianna Washington, Annie Robinson, Mike Tonnie, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Rural areas have experienced higher than average healthcare workforce problems, especially concerning limited access to mental health services. Telepsychiatry may provide at least a partial solution, as it has improved access and quality of care available in rural environments despite implementation problems. As technology continues to advance access, telepsychiatry will also need to strengthen making access more readily available. Additional research is required to identify modalities and diverse methods that can be used to increase access to mental health services further and improve outcomes in rural and underserved areas.

The Continuing Epidemic Of Hepatitis C In The United States: The Case Of West Virginia, David P. Paul Iii, Neha Botre, Maggie Phillips, Jumana Abboud, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Hepatitis C virus (HCV) is one of the most significant public health problems currently facing the U.S. If it is left untreated, the likelihood of sustaining a treatment response decreases. While early identification has been identified as a critical focus in trying to obtain better health outcomes, new drug treatments appear quite promising.

A Scoping Review Of The Associations Between Mental Health And Factors Related To Hiv Acquisition And Disease Progression In Conflict-Affected Populations, Erica Koegler, Erica Koegler, Caitlin E. Kennedy

Erica Koegler

Magnetically Focused Proton Irradiation Of Small Volume Radiosurgery Targets Using A Triplet Of Quadrupole Magnets, Patrick Mcgee, Grant Mcauley, Andrew Wroe, James M. Slater, Jerry D. Slater

Grant McAuley, PhD

Proton therapy is an advantageous choice for the irradiation of tumors in proximity of critical structures due to rapid dose fall off and high dose deposition at target compared to dose at the surface of the patient (ie, peak-to-entrance dose ratio (P/E)). However, with target fields below 1.0 cm, as often encountered in proton radiosurgery, multiple Coulomb scattering (MCS) broadens proton beams leading to diminished P/E advantages and reduced dose delivery efficiency (DDE). Magnetic focusing tends to counteract MCS and is a promising method to reduce these undesirable effects. The purpose of this research is to investigate the advantages of …

Tobacco Smoke Exposure Is An Independent Predictor Of Vitamin D Deficiency In Us Children, Benjamin U. Nwosu, Philip Kum-Nji

Benjamin U. Nwosu

IMPORTANCE: The role of tobacco-smoke exposure on serum vitamin D concentration in US pediatric population is not known. We hypothesized that tobacco smoke exposure would increase the prevalence of vitamin D deficiency in US children.

METHODS: Representative national data were accessed from the National Health and Nutrition Examination Survey (NHANES) 2009-2010 databank on 2,263 subjects of ages 3 to 17 years. Subjects were categorized into two groups based on their age: children, if <10 >years; and youth if 10 to 17 years. Descriptive and multiple logistic regression analyses were conducted to determine the effect of serum cotinine-verified tobacco smoke exposure on …

Proteomic Profiling Of Serum Derived Exosomes From Prostate Cancer Patients, David Turay

David Turay, MD

Touted among the major achievements in the diagnosis and management of Prostate cancer (PCa) in the past few decades has been, the dramatic decline of men with advanced/metastatic PCa at diagnosis coupled with a significant improvement ( >90%) in the five and ten year survival rates of the disease. Non-palpable PCa (potentially clinically treatable disease) now accounts for 70-80% of all newly diagnosed cases of PCa. Preceding these changes by about a decade was the introduction of Prostatic Specific Antigen (PSA) into clinical practice; first as biomarker for monitoring response to therapy and subsequently as a complementary screening tool. It …

Implementation Of Aset Skin Safety Guideline By Lehigh Valley Health Network Committee Improves Extended Eeg Related Skin Breakdown, Jo Ann Coryell R. Eeg T, Cnim, Alexis Gerber R. Eeg T. Cltm, Sameh Morkous Md, Faan

Sameh Morkous, MD, FAAP, FAAN

No abstract provided.

Sex And Gender In Emergency Medicine: An Innovative Elective And Toolkit For Incorporation Into Trainee Education., Lauren Walter Md, Gillian A. Beauchamp Md, Rebecca Barron Md, Mph, Tracy E. Madsen Md, Scm, Marna R. Greenberg Do, Mph, Facep, Alyson J. Mcgregor Md, Ma

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Sex Specific Analysis Of The Vulnerable Elders Survey As A Predictor Of Falls., Rebecca Brown Md, Marna R. Greenberg Do, Mph, Facep, Bryan G. Kane Md, Robert D. Barraco Md, Mph, Jeanne L. Jacoby Md

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Sex Differences In Adverse Drug Reactions And Adverse Drug Events In Older Adults: A Retrospective Review Of National Poison Data System Cases 2007-2016., Gillian A. Beauchamp Md, B Zane Horowitz Md, Esther K. Choo Md, Mph, Marna R. Greenberg Do, Mph, Facep, Daniel A. Spyker Md, Phd

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

No Sex-Specific Differences In Preference Of Management Options To Prevent Elderly Falls, Marna R. Greenberg Do, Mph, Facep, Jeanne L. Jacoby Md, Robert D. Barraco Md, Mph, Bernadette Glenn-Porter Bs, Kyle Durics Bs, Ryan Day Md, Victoria Goodheart Do, Danielle Mills Md, Alexander Youngdahl Do, Bryan G. Kane Md

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Implementing 5s Methodology To Maximize Flow And Efficiency In Shelter-Based Student Clinic., Seth Vanzant, Andre Lee, Lauren Walheim, Anne Laverty, Preethi Rajan, Aleksandra Bacewicz, Elizabeth Beaty, Cristina Calogero, Amy B. Smith Phd, Susan E. Hansen Ma, Marna R. Greenberg Do, Mph, Facep

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Gender Differences In Emergency Medicine Resident Self-Assessment Of Clinical Teaching, Alan R. Cherney Md, Amy B. Smith Phd, Charles C. Worrilow Md, Kevin Weaver D.O.,Facoep, Dawn M. Yenser, Jennifer E. Macfarlan Mph, Marna R. Greenberg Do, Mph, Facep, Bryan G. Kane Md

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Sex Differences In Intentional Exposures Among Adolescents And Adults: A Retrospective Review Of National Poison Data System (Npds) Pharmaceutical Exposures 2007-2016, Gillian A. Beauchamp Md, B Zane Horowitz Md, Esther K. Choo Md, Mph, Marna R. Greenberg Do, Mph, Facep, Daniel A. Spyker Md, Phd

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Incorporating Sex And Gender Into Culturally Competent Simulation In Medical Education (Poster)., Gillian A. Beauchamp Md, Alyson J. Mcgregor Md, Ma, Esther K. Choo Md, Mph, Basmah Safdar Md, Alexander M. Rosenau Do, Marna R. Greenberg Do, Mph, Facep

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Sex Differences In Pediatric Exploratory Exposures: A Retrospective Review Of National Poison Data System (Npds) Exposures 2007-2016, Gillian A. Beauchamp Md, B Zane Horowitz Md, Esther K. Choo Md, Mph, Marna R. Greenberg Do, Mph, Facep, Daniel A. Spyker Md, Phd

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Gender Differences In Effectiveness Of The "Timed Up And Go" (Tug) Test As A Screening Tool For Geriatric Fall Risk Assessment., Richard Chow Do, Marna R. Greenberg Do, Mph, Facep, Jeanne L. Jacoby Md, Robert D. Barraco Md, Mph, Bryan G. Kane Md

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Outcomes Of Pulmonary Embolism In A Tertiary Setting., Nicole Stansbury, James K. Wu Md

James K. Wu, M.D.

No abstract provided.

A Retrospective Analysis Of The Outcomes Of Extracorporeal Cardiopulmonary Resuscitation (Ecpr)., Rachel Wills, Kennedy Gallagher, James A. Burke Md, Tim S. Misselbeck Md, James K. Wu Md

James K. Wu, M.D.

No abstract provided.

Creatinine Trends In Transcatheter Aortic Valve Replacement Patients., Sydney Pickering, Taryn Samet Md, Raymond L. Singer Md, Mmm, James K. Wu Md

James K. Wu, M.D.

No abstract provided.

Comparison Of Survival Indicators Between Myocardial Infarction Patients And Septic Patients Who Received Veno-Arterial Extracorporeal Membrane Oxygenation, Niharika Boinpally, Kennedy Gallagher, Allison Eisenhauer Pa-C, Michael Healy, Kristina Postko Pa-C, James K. Wu Md

James K. Wu, M.D.

No abstract provided.

Sex Specific Analysis Of The Vulnerable Elders Survey As A Predictor Of Falls., Rebecca Brown Md, Marna R. Greenberg Do, Mph, Facep, Bryan G. Kane Md, Robert D. Barraco Md, Mph, Jeanne L. Jacoby Md

Bryan G Kane MD

No abstract provided.

Gender Differences In Emergency Medicine Resident Self-Assessment Of Clinical Teaching, Alan R. Cherney Md, Amy B. Smith Phd, Charles C. Worrilow Md, Kevin Weaver D.O.,Facoep, Dawn M. Yenser, Jennifer E. Macfarlan Mph, Marna R. Greenberg Do, Mph, Facep, Bryan G. Kane Md

Bryan G Kane MD

No abstract provided.