Medicine and Health Sciences Commons^™

A Health Systems Approach To Critical Care Delivery In Low-Resource Settings: A Narrative Review, Stephen A. Spencer, Faustina Excel Adipa, Tim Baker, Ana Maria Crawford, Paul Dark, Dingase Dula, Stephen B. Gordon, David Oliver Hamilton, Dawit Kebede Huluka, Wangari Siika

Anaesthesiology, East Africa

There is a high burden of critical illness in low-income countries (LICs), adding pressure to already strained health systems. Over the next decade, the need for critical care is expected to grow due to ageing populations with increasing medical complexity; limited access to primary care; climate change; natural disasters; and conflict. In 2019, the 72nd World Health Assembly emphasised that an essential part of universal health coverage is improved access to effective emergency and critical care and to “ensure the timely and effective delivery of life-saving health care services to those in need”. In this narrative review, we examine critical …

Organisation, Staffing And Resources Of Critical Care Units In Kenya, Wambui Mwangi, Ronnie Kaddu, Carolyne Njoki Muiru, Nabukwangwa Simiyu, Vishal Patel, Demet Sulemanji, Dorothy Otieno, David Misango, Wangari Siika, Rashan Haniffa

Anaesthesiology, East Africa

Objective: To describe the organisation, staffing patterns and resources available in critical care units in Kenya. The secondary objective was to explore variations between units in the public and private sectors.

Materials and methods: An online cross-sectional survey was used to collect data on organisational characteristics (model of care, type of unit, quality- related activities, use of electronic medical records and participation in the national ICU registry), staffing and available resources for monitoring, ventilation and general critical care.

Results: The survey included 60 of 75 identified units (80% response rate), with 43% (n = 23) located in government facilities. A …

Validation Of The Hierarchical Nature Of The Ao Spine Sacral Classification And The Development Of The Sacral Ao Spine Injury Score, Brian A. Karamian, Gregory D. Schroeder, Mark J. Lambrechts, Jose A. Canseco, Emiliano N. Vialle, Frank Kandziora, Lorin M. Benneker, Rajasekaran Shanmuganathan, F. Cumhur Öner, Klaus J. Schnake, Christopher K. Kepler, Alexander R. Vaccaro

Rothman Institute Faculty Papers

STUDY DESIGN: Global cross-sectional survey.

OBJECTIVE: The objective of this study was to validate the hierarchical nature of the AO Spine Sacral Classification System and develop an injury scoring system.

SUMMARY OF BACKGROUND DATA: Although substantial interobserver and intraobserver reliability of the AO Spine Sacral Classification System has been established, the hierarchical nature of the classification has yet to be validated.

METHODS: Respondents numerically graded each variable within the classification system for severity. Based on the results, a Sacral AO Spine Injury Score (AOSIS) was developed.

RESULTS: A total of 142 responses were received. The classification exhibited a hierarchical Injury …

Cost-Effectiveness Of Hydroxyurea For Sickle Cell Anemia In A Low-Income African Setting: A Model-Based Evaluation Of Two Dosing Regimens, David Teigen, Robert Opoka, Phillip Kasirye, Catherine Nabaggala, Heather A. Hume, Bjørn Blomberg, Chandy John, Russell Ware, Bjarne Robberstad

Paediatrics and Child Health, East Africa

Background and Objective: The disease burden of sickle cell anemia (SCA) in sub-Saharan African (SSA) countries is substantial, with many children dying without an established diagnosis or proper treatment. The global burden of SCA is increasing each year, making therapeutic intervention a high priority. Hydroxyurea is the only disease-modifying therapy with proven feasibility and efcacy suitable for SSA; however, no one has quantifed the health economic implications of its use. Therefore, from the perspective of the health care provider, we estimated the incremental cost-efectiveness of hydroxyurea as a fxed-dose regimen or maximum tolerated dose (MTD) regimen, versus SCA care without …

Music As An Ergogenic Aid During Resistance Training In An Adult Population: A Pilot Study, David R. Boulais

Master of Science in Kinesiology

Music has been found to produce feelings and emotions of power, reduce physical pain, and manage mood and affect. Ergogenic aids are regularly used in the resistance training (RT) setting to help improve performance. While the ergogenic effects of music are widely documented in aerobic exercise, research is lacking in the RT setting. The aim of this study was to examine the possible ergogenic benefits of music during RT workouts. Twelve individuals (mean age in years 49.8 ± 17.5 years) participated in the present online study, with nine female participants (mean age in years 48.2 ± 17.7) and three male …

The Decline Of Physical Activity With Age In School-Aged Children With Cerebral Palsy: A Single-Center Cross-Sectional Observational Study, Jinuk Lee, Min-Hwa Suk, Soojin Yoo, Jeong-Yi Kwon

Health & Human Performance Faculty Publications and Presentations

Maintaining physical activity is important for children with cerebral palsy (CP). This study examined whether age predicted habitual physical activity (HPA) or cardiorespiratory fitness (CRF) in school-aged children with CP and clarified the relationship between HPA and CRF. We utilized cross-sectional data from 39 children with CP (18 girls and 21 boys; mean age 7.44 years; mean body weight 24.76 kg; mean body mass index 15.97 kg/m2; hemiplegic or diplegic CP). The participants wore an accelerometer (ActiGraph) for five days to measure HPA, physical activity energy expenditure (kcal/kg/d), sedentary physical activity (%SPA), light physical activity, moderate-to-vigorous physical activity (%MVPA), and …

The Meaning Of Caring For Patients With Cancer Among Traditional Medicine Practitioners In Uganda: A Grounded Theory Approach, John Baptist Asiimwe, Prakash B. Nagendrappa, Esther C. Atukunda, Grace Nambozi, Casim U. Tolo, Martin Ogwang, Mauda M. Kamatenesi

School of Nursing & Midwifery, East Africa

Traditional medicine practitioners (TMPs) are a critical part of healthcare systems in many sub-Saharan African countries and play vital roles in caring for patients with cancer. Despite some progress in describing TMPs’ caring experiences in abstract terms, literature about practice models in Africa remains limited. This study aimed to develop a substantive theory to clarify the care provided by TMPs to patients with cancer in Uganda. This study adhered to the principal features of the modified Straussian grounded theory design. Participants were 18 TMPs caring for patients with cancer from 10 districts in Uganda, selected by purposive and theoretical sampling …

The Role Of Psychological Safety On Employee Satisfaction And Retention In Healthcare Delivery Settings: A Systematic Literature Review, Jamey Paul

Capstone Experience

The healthcare industry typically has a high rate of employee turnover due to higher job stresses and burnout, lower job satisfaction, and insufficient organizational support and work culture. This turnover has worsened since the onset of the COVID-19 pandemic. Psychological safety, a shared belief by organizational members that the team/unit is safe for interpersonal risk-taking, can be one of the many ingredients that contribute to employee satisfaction and reduce turnover. This systematic literature review explored the role of psychological safety on job satisfaction and retention of healthcare workers in delivery settings by synthesizing the known antecedents and outcomes of psychological …

Treatment Of Chronic Migraine With Botox (Onabotulinumtoxina): Development, Insights, And Impact, Catherine C. Turkel, Sheena Aurora, Hans-Christoph Diener, David W. Dodick, Richard B. Lipton, Stephen D. Silberstein, Mitchell F. Brin

Department of Jefferson Headache Center papers and presentations

Chronic migraine (CM) is a neurological disease characterized by frequent migraine attacks that prevent affected individuals from performing daily activities of living, significantly diminish quality of life, and increase familial burden. Before onabotulinumtoxinA was approved for CM, there were few treatment options for these seriously disabled patients and none had regulatory approval. The terminology and recognition of CM evolved in parallel with the onabotulinumtoxinA clinical development program. Because there were no globally accepted classification criteria for CM when onabotulinumtoxinA was in development, the patient populations for the trials conducted by Allergan were determined by the Allergan migraine team in collaboration …

The Importance Of The First Generic Substitution: Evidence From Sweden, Aljoscha Janssen, David Granlund

Research Collection School Of Economics

We analyze changes in the willingness to substitute from prescribed pharmaceuticals to more affordable generic equivalents in response to the first experience with a substitution. Using Swedish individual-level data of prescribed and dispensed pharmaceuticals, we em-ploy a dynamic event study and an instrumental variable approach to show that an initial substitution reduces the probability of opposing subsequent substitutions by 39 percent-age points. We recommend that policy-makers target patients with a history of opposed substitution and offer additional discounts to promote substitution as long-term savings outweigh one-time costs.

Ethical Considerations Surrounding Vaccine Development During A Public Health Crisis, Syed Arsalan Akhter Zaidi, Kainat Saleem, Rahul Bollam, Bushra Zaidi

Journal of Health Ethics

Epidemics and Pandemics have been plaguing mankind since many centuries, and are a cause of major healthcare expense in modern times. The novel coronavirus pandemic of 2019-2020 spread worldwide faster than many previous pandemics, including EBOLA in 2017. Although personal protective equipment, and social distancing slowed the outbreak, a vaccine is needed to ensure global immunization and to stop this deadly outbreak. Developing a vaccine in times of a public health crisis comes with a lot of ethical considerations, including overlooking proper informed consent, the issue of using placebo in control arm of trials, extended timelines of development of vaccines, …

A Framework For Personal Respiratory Ethics, Ian W. Goddard

Journal of Health Ethics

The Covid-19 pandemic raises the need for an ethical framework that addresses the unique ethical challenges and questions arising from airborne infectious diseases. For example, are we ever ethically obliged to wear a face mask? If so, why and when? The Respiratory Ethics Framework (REF) herein proposes pathways to answers grounded in ethical norms and the moral principles of non-harm, beneficence and respect for personal autonomy. REF is a personal ethics wherein your ethical duty to increase your respiratory hygiene efforts—such as by donning a mask—is proportional to your estimation of an increase in the likelihood that your respiratory effluent …

A Word From The Writing Team (July 2023), Pam Walter, Mfa, Liz Declan, Ma, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Academic Commons Launches New Website
• Publication Spotlight
• Reminders
• First Friday Writing Retreat Hiatus
• Scott Renovations and You
• MS4 Residency Personal Statement Workshops

Sleep Diplomacy: An Approach To Boosting Global Brain Health, Diego A. Golombek, Laura Booi, Dominic Campbell, Walter Dawson, Harris A. Eyre, Brian Lawlor, Agustin Ibanez

Institute on Aging Publications

Sleep diplomacy highlights the urgent need to address the widespread issue of sleep deprivation and its detrimental effects on overall health, particularly brain health and healthy ageing. By providing practical advice on sleep hygiene, healthy schedules, and light exposure, sleep diplomacy aims to promote a comprehensive approach to well-being. Despite the well-established importance of sleep for optimal cognitive function, emotional regulation, and physical abilities, it is often neglected in public and medical recommendations. Our proposed concept of sleep diplomacy also offers practical recommendations to address sleep issues in various settings and populations.

Eco-Anxiety In Undergraduates: An Exploration Of Western Washington University Students’ Beliefs Of And Personal Experiences With Climate Change And Ecological Crisis, Kathryn Lee

WWU Honors College Senior Projects

Objectives: To examine the prevalence, population demographics, and experiential trends of eco-anxiety among undergraduates at a medium-sized university in Washington State.

Participants: 194 undergraduate students at Western Washington University participated in a survey disseminated in April and May of 2023.

Methods: Participants completed an online cross-sectional survey with sociodemographic information. The survey featured questions from three questionnaires: the Eco-Anxiety Questionnaire, a global youth survey published in the Lancet, and a climate anxiety scale addressing negative beliefs and personal experiences of climate change and the ecological crisis. Analyses were performed with SPSS 29.

Results: Findings suggest a high prevalence of eco-anxiety …

Optic Nerve Head Gene Transcription Sequelae To A Single Elevated Iop Exposure Provides Insights Into Known Responses To Chronically Elevated Iop, Diana C. Lozano, Hari Jayaram, William O. Cepurna, Shandiz Tehrani, Lina Gao, Suzanne S. Fei, Dongseok Choi, Elaine C. Johnson, John C. Morrison

OHSU-PSU School of Public Health Faculty Publications and Presentations

Purpose: To clarify the optic nerve head (ONH) gene expression responses associated with a single, axon-damaging exposure to elevated IOP in relation to the composite cellular events previously identified in models of chronically elevated IOP.

Methods: Anesthetized rats were exposed unilaterally to an 8-hour pulse-train controlled elevation of IOP (PT-CEI) at 60 mm Hg, while others received normotensive CEI at 20 mm Hg. ONH RNA was harvested at 0 hours and 1, 2, 3, 7, and 10 days after either CEI and from naïve animals. RNA sequencing was performed to analyze ONH gene expression. DAVID Bioinformatics tools were used to …

Developing And Testing A Clinical Care Bundle Incorporating Caffeine Citrate To Manage Apnoea Of Prematurity In A Resource-Constrained Setting: A Mixed Methods Clinical Feasibility Study Protocol, Grace Irimu, Ferdinand Okwaro, Jesse Coleman, Mary Waiyego, Dorothy Chomba, Millicent Parsimei, Cynthia Shitote, Roseline Ochieng, Jasmit Shah, William Macharia

Paediatrics and Child Health, East Africa

Background Apnoea of prematurity (AOP) is a common condition among preterm infants. Methylxanthines, such as cafeine and aminophylline/theophylline, can help prevent and treat AOP. Due to its physiological benefts and fewer side efects, cafeine citrate is recommended for the prevention and treatment of AOP. However, cafeine citrate is not available in most resource-constrained settings (RCS) due to its high cost. Challenges in RCS using caffeine citrate to prevent AOP include identifying eligible preterm infants where gestational age is not always known and the capability for continuous monitoring of vital signs to readily identify apnoea. We aim to develop an evidencebased …

Implementation Of Rapid Postcode Debrief Tool To Reduce Postcode Stress In Micu Rns: A Quality Improvement Study, Julie Capuson, Elyse Falchek, Elizabeth Harper, Nicole Kotval

School of Nursing Student Presentation Posters

Faculty Chair: Dr. Patricia Speck and Dr. Tami Long
Clinical Mentor: Geri Anne Warman
Presented: DNP Orientation UAB School of Nursing, July 2023

The Impact Of A Colonoscopy Bowel Prep Educational Video On Bowel Prep Outcomes, Tula Jefferson, Lauren Williams-Bryant

School of Nursing Student Presentation Posters

Faculty Chair: Dr. Tedra Smith
Clinical Mentor: Briana Golden
Presented: DNP Orientation UAB School of Nursing, July 2023

The Impact Of Self-Care Education And A Meal Voucher Incentive Program On No-Show Rates At The University Alabama At Birmingham Heart Failure Transitional Services For Adults Clinic, Lauren Lipton, Sara Monson, Jihe Park, Mary Faith Trammell

School of Nursing Student Presentation Posters

Faculty Chair: Dr. Somali Nguyen
Clinical Mentor: Dr. Connie White-Williams
Presented: DNP Orientation UAB School of Nursing, July 2023

Diabetic Training For Nurses Through An Evidence-Based Bundle, Shanteia Beavers Bsn, Rn, Alex Bristow Bsn, Rn, Amanda Houser Bsn, Rn

School of Nursing Student Presentation Posters

Faculty Chair: Curry Bordelon
Clinical Mentor: Emily Guess
Presented: DNP Orientation UAB School of Nursing, July 2023

Decreasing Fall Rates On Unit 75 Medical-Surgical Using Revised Fall Prevention Program, Sierra M. Foster, Brooke L. Johnson, Shelby F. King, Courtney R. Morris, Cassandra A. Wheeler

School of Nursing Student Presentation Posters

Faculty Chair: Dr. Lisa Pair
Clinical Mentor: Sapheria Pollard
Presented: DNP Orientation UAB School of Nursing, July 2023

Conjunctivitis, Neonatal, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Difficult Airway Intubation, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Eating Disorders - Medical Work-Up And Stabilization, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

2023-2024 Pediatric Subspecialty Trainees, Children's Mercy Kansas City

Residents and Fellows Portraits

Photo composites of the graduate pediatric trainees in adolescent medicine, allergy/immunology, child abuse pediatrics, child neurology, clinical neuro-psychology, coagulation, clinical child psychology, clinical child psychology internship, epilepsy, hospice & palliative care, pediatric anesthesiology, pediatric bioethics, neonatal-perinatal medicine, pediatric adolescent gynecology, pediatric cardiology, pediatric EM/child abuse, pediatric critical care medicine, pediatric dentistry, pediatric emergency medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric infectious diseases, pediatric nephrology, pediatric ophthalmology; pediatric optometry, pediatric orthopedic surgery, pediatric otolaryngology, pediatric pulmonology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, sleep medicine, pharmacy, pediatric residency and med/peds residency.

Heavy Menstrual Bleeding, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Blood-Based Versus Stool-Based Biomarker Accuracy In Detection Of Colorectal Cancer And Impact Of Non-Invasive Tests On Patient Participation, Allison Obritsch

Physician Assistant Scholarly Project Papers

Colorectal cancer is a very treatable cancer when detected early, therefore patient adherence and colorectal cancer screening is key to decrease mortality. The purpose of this research and systematic literature review was to determine how the accuracy of blood-based and stool-based biomarkers compared in the detection of colorectal cancer and how noninvasive testing modalities influence patient participation in colorectal cancer screening. Only articles published within the past 10 years were included. A combination of keywords and MeSH phrases to include but not limited to “adherence,” “SEPT9,” “colonoscopy,” “multitarget stool,” and “colorectal cancer” were used to find relevant articles for each …

How Does The Healthcare Professional Determine The Breadth And Depth Of Healthcare To Provide To Patients?: The Personal Exploration Of A Future Healthcare Professional, Tiana N. Tanis

WWU Honors College Senior Projects

This thought paper is the personal exploration of the author in seeking to determine the answer to the question of care to be provided to patients as a future healthcare professional. Utilizing various books written by authorities in bioethics as well as job shadowing experience for perspective, the author distilled down what they believed to be some basic guidelines and considerations to be taken into account when providing patient care. In summary, what aspects of the patient's health the healthcare professional can provide care for is determined by boundaries and conditions the healthcare professional must work within. Within those considerations, …

J Mich Dent Assoc July 2023

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on recognizing mental health concerns in the dental workplace.
• Commentary by a foreign-trained dentist on difficulties in obtaining licensure.
• MDA 2023-04 Continuing Education Course Catalog
• A feature on addressing the current dental assisting workforce shortage.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff …