Medicine and Health Sciences Commons^™

Impact Of Covid-19 On The Pre And Post Analytical Clinical Laboratory Testing Processes- A Performance Evaluation Study Using Six Sigma, Sibtain Ahmed, Farhat Jahan, Muhammad Umer Naeem Effendi, Farooq Ghani

Department of Pathology and Laboratory Medicine

Background: The aim of this study was to determine the impact of COVID-19 pandemic on the total testing process using six sigma metrics based on a comparison of pre and during pandemic periods.
Material & methods: The study duration was over 12 months, 6 months before and 6 months after the COVID-19 onset in Pakistan in March 2020 after the recognition of the first case, using quality indicators (QIs). QIs were chosen from a model of QIs recommended by the CAP. Analysis was performed using Six Sigma calculators and QIs were expressed in percentage (%) and Sigma value were computed. …

Severe Hypertriglyceridemia: Care For The Non-Diabetic Patient, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Gastric Sleeve Eras - Use Of Transverse Abdominal Plane (Tap) Blocks And Reduction Of Pain In Laparoscopic Gastric Bypass Patient, Children's Mercy Kansas City

Clinical Critically Appraised Topics

No abstract provided.

Safety And Efficacy Of Oral Anticoagulants In Atrial Fibrillation And Bioprosthetic Heart Valves, Srikanth Yandrapalli, Rahul Gupta Md, Aaqib H. Malik

Research and Historical Works - 2021

No abstract provided.

Who Needs To Be “Burned-Out”? Time For A New Approach To Job-Related Distress, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Burnout is a popular indicator of job-related distress, notably in research on the ill-being of medical professionals. The burnout construct is, however, plagued by definitional and measurement problems. Often unnoticed, these problems undermine findings and conclusions emanating from burnout research. The definitional and measurement problems affecting the burnout construct hamper knowledge growth, waste resources, and impede our ability to make informed decisions and take effective action to support personnel. It is time for occupational health specialists to abandon the idea of burnout and focus on occupational depression.

Occupational Therapy And Treatment Of Sensory Issues Related To Autism Spectrum Disorder: A Literature Review, Elise M. Liddane

WWU Honors College Senior Projects

Occupational therapy highlights the importance of engagement in occupations, or meaningful activities and tasks. Participation in occupations is essential for physical and mental health as well as general well-being. Occupational therapy is commonly utilized in the treatment of autism spectrum disorder (ASD) and has been proven successful when used to treat sensory processing disorders related to ASD in particular. Despite this, Applied Behavior Analysis (ABA) is the most common form of therapy used to treat ASD and is considered the gold standard for this treatment. ABA and OT are not regularly used in conjunction to treat ASD due to differing …

Alterations To The Brain Following Traumatic Brain Injury, Jacqueline Mader

Honors Projects

Traumatic brain injuries (TBIs) have been labeled as a modern-day epidemic, increasing exponentially with the advancement of technology and society. Gaining a better understanding of the cognitive paths, including the chemical and electrical signals of the brain, neural correlates, and possible interventions for TBI patients allows for the best possible outcome for every patient, and allows for the further advancement of care. By revising and reassessing the ways in which TBIs are categorized and described the prognosis for recovery paints a more realistic view for each individual patient case. The symptoms and impairments that may occur post-injury can be monitored …

Hpv Vaccination In The Virginia Context: Demographic Disparities, Patient-Provider Gender Concordance And The Impact Of Changing Recommendations, Isha Patel, Norma M. Benitez, George L. Maxwell, Fabian T. Camacho, Rajesh Balkrishnan

Virginia Journal of Public Health

Objective: Despite its effectiveness in preventing several cancers, there are marked disparities in HPV vaccination initiation and series completion. The present study sought to understand disparities in HPV vaccinations among patients in northern Virginia (ages 9-26) and the impact of patient and provider gender concordance, in lieu of CDC’s vaccine recommendation changes in 2016, which reduced the recommended doses from three to two, in this population. Design: Analyses of electronic medical records collected from 2012 to 2017. Setting: A large health care system in Northern Virginia. Participants: A total of 37,427 patients, ages 9 to 26, were included in analyses. …

Introducing The Vpha Policy Forum, Benjamin P. Barber

Virginia Journal of Public Health

Data before and during the pandemic indicates Virginia's public health system needs reform. This article suggests that reform requires policy change, and it introduces the VPHA forum as a place to examine current policies and explore new ideas. Finally, it encourages policymakers, advocates, and the public to focus on fundamental questions about how public health is financed and delivered in Virginia. Answering these questions is necessary to creating better public health policies - and better health - for all Virginians.

Knowledge Of The Human Papillomavirus Vaccine: An Analysis Using Together For Health Virginia Population Health Survey, Mythili Vigneshwar, Sunny Jung Kim, Carrie A. Miller, Bernard Fuemmeler, Rajesh Balkrishnan

Virginia Journal of Public Health

Purpose: The purpose of this analysis was to identify key predictors which impact knowledge of the Human Papillomavirus vaccine in adults aged 21 to 45 in Virginia.

Methods: Data was collected from the Together for Health Virginia Population Surveys administered by Virginia Commonwealth University and the University of Virginia. Logistic regression was performed on data using the variables sex, age, rurality, race, education, income, occupation, and type of health insurance coverage.

Results: There was a statistically significant positive relationship between knowledge of the HPV vaccine and part-time occupation (OR: 4.288, CI: 1.492-13.325), younger age (OR: 2.31, CI: 1.088-4.905), and …

E-Cadherin Expression And Blunted Interferon Response In Blastic Plasmacytoid Dendritic Cell Neoplasm, Luisa Lorenzi, Silvia Lonardi, Donatella Vairo, Andrea Bernardelli, Michela Tomaselli, Mattia Bugatti, Sara Licini, Mariachiara Arisi, Lorenzo Cerroni, Alessandra Tucci, William Vermi, Silvia Clara Giliani, Fabio Facchetti

2020-Current year OA Pubs

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an aggressive neoplasm derived from plasmacytoid dendritic cells (pDCs). In this study, we investigated by immunohistochemical analysis the expression of E-cadherin (EC) on pDCs in reactive lymph nodes and tonsils, bone marrow, and in BPDCN. We compared the expression of EC in BPDCN to that in leukemia cutis (LC) and cutaneous lupus erythematosus (CLE), the latter typically featuring pDC activation. In BPDCN, we also assessed the immunomodulatory activity of malignant pDCs through the expression of several type I interferon (IFN-I) signaling effectors and downstream targets, PD-L1/CD274, and determined the extent of tumor infiltration …

Chyloptysis As A Delayed Sequela Of Penetrating Thoracic Trauma, Kyle G Mitchell, Hope Feldman, Bryan F Meyers, Mara B Antonoff

2020-Current year OA Pubs

No abstract provided.

The Antifungal Pipeline: Fosmanogepix, Ibrexafungerp, Olorofim, Opelconazole, And Rezafungin, Martin Hoenigl, Rosanne Sprute, Matthias Egger, Amir Arastehfar, Oliver A Cornely, Robert Krause, Cornelia Lass-Flörl, Juergen Prattes, Andrej Spec, George R Thompson 3rd, Nathan Wiederhold, Jeffrey D Jenks

2020-Current year OA Pubs

The epidemiology of invasive fungal infections is changing, with new populations at risk and the emergence of resistance caused by the selective pressure from increased usage of antifungal agents in prophylaxis, empiric therapy, and agriculture. Limited antifungal therapeutic options are further challenged by drug-drug interactions, toxicity, and constraints in administration routes. Despite the need for more antifungal drug options, no new classes of antifungal drugs have become available over the last 2 decades, and only one single new agent from a known antifungal class has been approved in the last decade. Nevertheless, there is hope on the horizon, with a …

Somatic Pik3r1 Variation As A Cause Of Vascular Malformations And Overgrowth, Catherine E Cottrell, Jonathan W Heusel, Meagan Corliss, Michael J Evenson, Carrie C Coughlin, Et Al.

2020-Current year OA Pubs

PURPOSE: Somatic activating variants in the PI3K-AKT pathway cause vascular malformations with and without overgrowth. We previously reported an individual with capillary and lymphatic malformation harboring a pathogenic somatic variant in PIK3R1, which encodes three PI3K complex regulatory subunits. Here, we investigate PIK3R1 in a large cohort with vascular anomalies and identify an additional 16 individuals with somatic mosaic variants in PIK3R1.

METHODS: Affected tissue from individuals with vascular lesions and overgrowth recruited from a multisite collaborative network was studied. Next-generation sequencing targeting coding regions of cell-signaling and cancer-associated genes was performed followed by assessment of variant pathogenicity.

RESULTS: The …

Implementing An Application Programming Interface For Promis Measures At Three Medical Centers, Michael Bass, Christian Oncken, Allison W. Mcintyre, Chris Dasilva, Joshua Spuhl, Nan E. Rothrock

2020-Current year OA Pubs

BACKGROUND: There is an increasing body of literature advocating for the collection of patient-reported outcomes (PROs) in clinical care. Unfortunately, there are many barriers to integrating PRO measures, particularly computer adaptive tests (CATs), within electronic health records (EHRs), thereby limiting access to advances in PRO measures in clinical care settings.

OBJECTIVE: To address this obstacle, we created and evaluated a software integration of an Application Programming Interface (API) service for administering and scoring Patient-Reported Outcomes Measurement Information System (PROMIS) measures with the EHR system.

METHODS: We created a RESTful API and evaluated the technical feasibility and impact on clinical workflow …

Direct And Non-Invasive Monitoring Of Battery Internal State Via Novel Gmi-Idt Magnetic Sensor, Akila Khatun

Dissertations (1934 -)

Efficient battery management systems (BMSs) in rechargeable battery-based systems require precise measurements of various battery parameters including state of charge (SOC), state of health (SOH) and charge capacity. Presently, SOC, charge capacity and SOH can only be indirectly inferred from long-term measurement of current, open circuit voltage (OCV), and temperature using multiple sensors. These techniques can only give an approximation of SOC and often require knowledge of the recent battery history to prevent excessive inaccuracy.To improve the performance of the BMS, an alternative method of monitoring the internal state of Li-ion batteries is presented here. Theoretical analysis of Li-ion batteries …

Processes Used By Mothers In Opioid Recovery To Manage The Needs Of The Maternal-Infant Dyad: A Grounded Theory Study, Nicole M. Mattson

Dissertations (1934 -)

Maternal opioid use during pregnancy and the postpartum period has significant impact on the mother and infant. Maternal well-being and early maternal-infant contact can impact the early attachment and bonding of the dyad. Additionally, the stigma surrounding opioid use in pregnancy can have detrimental effects on the dyad during pregnancy and in the postpartum period. Theory driven nursing interventions to promote mother-infant dyadic care for pairs impacted by maternal opioid use disorder (OUD) are needed. First, it was necessary to understand the current processes used by mothers with OUD to manage the unique needs of their dyad. The purpose of …

Neutralisation Of Sars-Cov-2 Lineage P.1 By Antibodies Elicited Through Natural Sars-Cov-2 Infection Or Vaccination With An Inactivated Sars-Cov-2 Vaccine: An Immunological Study, William M Souza, Michael S Diamond, Et Al.

2020-Current year OA Pubs

BACKGROUND: Mutations accrued by SARS-CoV-2 lineage P.1-first detected in Brazil in early January, 2021-include amino acid changes in the receptor-binding domain of the viral spike protein that also are reported in other variants of concern, including B.1.1.7 and B.1.351. We aimed to investigate whether isolates of wild-type P.1 lineage SARS-CoV-2 can escape from neutralising antibodies generated by a polyclonal immune response.

METHODS: We did an immunological study to assess the neutralising effects of antibodies on lineage P.1 and lineage B isolates of SARS-CoV-2, using plasma samples from patients previously infected with or vaccinated against SARS-CoV-2. Two specimens (P.1/28 and P.1/30) …

Combined Thoracic Endovascular Aortic Repair And Endovascular Aneurysm Repair And The Long-Term Consequences Of Altered Cardiovascular Haemodynamics On Morbidity And Mortality: Case Series And Literature Review, Sherif Sultan, Yogesh Acharya, Mohiey Hazima, Hiba Salahat, Juan Carlos Parodi, Niamh Hynes

2020-Current year OA Pubs

BACKGROUND: Thoracic and abdominal aortic stent grafts are firmer and more rigid than the native aorta. Aortic implanted devices have been implicated in the development of acute systolic hypertension, elevated pulse pressure, and reduced coronary perfusion.

CASE SUMMARY: We report four cases of staged thoracic endovascular aortic repair (TEVAR) and then endovascular aneurysm repair (EVAR). All patients had TEVAR first for thoracic aortic aneurysm and later on developed infra-renal abdominal aortic aneurysm (AAA) that required EVAR. There were three males and one female with a median age of 74.5 years (range 67.5-78.5). None of the patients developed aortic-related major clinical …

Themes, Communities And Influencers Of Online Probiotics Chatter: A Retrospective Analysis From 2009-2017, Santosh Vijaykumar, Aravind Sesagiri Raamkumar, Kristofor Mccarty, Cuthbert Mutumbwa, Jawwad Mustafa, Cyndy Au

Research Collection Lee Kong Chian School Of Business

We build on recent examinations questioning the quality of online information about probiotic products by studying the themes of content, detecting virtual communities and identifying key influencers in social media using data science techniques. We conducted topic modelling (n = 36,715 tweets) and longitudinal social network analysis (n = 17,834 tweets) of probiotic chatter on Twitter from 2009–17. We used Latent Dirichlet Allocation (LDA) to build the topic models and network analysis tool Gephi for building yearly graphs. We identified the top 10 topics of probiotics-related communication on Twitter and a constant rise in communication activity. However the number of …

A New Pediatric Monteggia Fracture Type 4 Variant, Ehab S. Saleh

Articles

Introduction: Monteggia fracture-dislocations are rare and complex injuries that usually involve a fracture of the proximal ulna associated with a proximal radioulnar and radiocapitellar joint dislocations. These injuries comprise

Perioperative Antibiotic Use In Neonatal General Surgery: A Survey Of Apsa Membership, Ashley Williams, Samuel K. Osei, Pavan Brahmamdam, Begum Akay, Diane Studzinski

Conference Presentation Abstracts

Background: Surgical site infections (SSIs) are a significant source of perioperative morbidity. There is limited data regarding antibiotic prophylaxis in pediatrics, and there are no standardized guidelines in neonates. Thus, peri-operative antibiotic use is based on surgeon experience and preference. To explore this knowledge gap, we sought to describe the practice patterns of pediatric surgeons with regard to antibiotic prophylaxis for SSIs in neonatal surgery

Methods: A survey was distributed to the American Pediatric Surgical Association (APSA). Members were asked to respond to 6 hypothetical case scenarios: Tracheoesophageal fistula/Esophageal atresia, Hirschsprung’s disease, Gastroschisis, Congenital diaphragmatic hernia repair, Neonatal intestinal obstruction …

Spiritual Care: The Overlooked Need In End-Of-Life Care, Michael Howard Vrmeer

Doctor of Nursing Practice Scholarly Projects

Background: A number of studies have validated the use of the FICA tool to evaluate a patient’s spirituality. FICA has been helpful in many palliative care settings to screen for spiritual problems that influence the patient's overall health. Aim: The project was a quality improvement initiative with the purpose of implementing the FICA tool as part of the admission assessment to increase chaplain referrals for inpatient palliative care services. Methods: The staff received an in-service on using the FICA questions on admission, and a prompt to complete the screen was placed at each work station in the project setting. Results: …

The Impact Of Nurse Leader Learning Labs On Nurse Managers' Perception Of Leadership Competency In The Acute Care Setting, Carolyn Rivers Swinton

Doctor of Nursing Practice Scholarly Projects

Problem Statement: It is critically important that our nurse managers (NMs) have the leadership skills to support the care team in providing safe care to patients. Historically, nurse managers have received minimal training in the leadership role. Failure to address NMs’ coaching needs can compromise the organization's ability to achieve operational goals. Purpose: The project's primary aim was to improve NMs’ perceptions of leadership competency in the acute care setting through experiential nurse leader learning labs. The secondary aim was to demonstrate that the confident and prepared nurse manager can achieve organizational goals in the acute care setting. Method: There …

The Effects Of Debriefing On Nurse Distress After Perinatal Loss, Russin Marie Kelly

Doctor of Nursing Practice Scholarly Projects

Labor and delivery nurses are the first-line caregivers for women suffering a perinatal loss which involves miscarriage, stillbirth, and infant death. This loss of life can cause nurses’ distress. This project proposes using the PEARLS healthcare debriefing tool as an intervention to decrease distress and improve nurse satisfaction. Before and after the debriefing intervention, a survey allowed the nurse to rate their distress from zero to ten using the distress thermometer and answer questions about job satisfaction. The data analyzed shows that the debriefing intervention decreased nurse distress after perinatal loss compared to the prior practice of no debriefing after …

Expanding The Discharge Bundle To Reduce Preventable Readmission Among Adult Patients With Heart Failure, Leah Caccam Ramos

Doctor of Nursing Practice Scholarly Projects

Individuals with a heart failure (HF) diagnosis have a high risk of readmission following hospital discharge, increasing care costs. In an academic medical center (AMC) in Charleston, SC, the all-patient-related DRG of HF had 576 30-day readmissions for FY 2020, equivalent to a 26.3% readmission rate. This project aimed to decrease the readmission rate of adult patients diagnosed with HF admitted to cardiac units in the AMC by expanding the discharge bundle. The current discharge process is not bundled. The discharge bundle elements include HF education, pharmacy medication reconciliation, medication counseling, and appointment to the HF clinic prior to discharge. …

Improving Hand Hygiene In A Rural Critical Access Hospital, Katherine H. Miller

Doctor of Nursing Practice Scholarly Projects

Hand hygiene adherence is the single most important infection control practice among healthcare workers in United States hospitals. Hand hygiene is cost effective and adherence to protocols can reduce hospital acquired infections and employee illness. While hand hygiene adherence has been shown through research to improve patient safety and reduce hospital acquired infections, adherence to hand hygiene protocols among healthcare workers is poor and improvement efforts lack sustainability. A potential barrier to performing hand hygiene includes failure of healthcare workers to realize they are carrying microbes on their hands and what proper hand hygiene is, whether using soap and water …

2021-10-01_Michiganoverview_Covidvaccinestats, Michigan Department Of Health & Human Services

Michigan COVID-19 Vaccine Data

The COVID Vaccine Dashboard page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/0,9753,7-406-98178_103214-547150--,00.html.

Previously reported numbers of administered vaccine doses may change as new data are received. A possible lag in reporting vaccine doses will result in increases in numbers previously reported.

This report is created by the Michigan Department of Health and Human Services Division of Immunization from data reported to the Michigan Care Improvement Registry (MCIR).

The dashboard contained the tabs Vaccines Delivered, Delivery Trend, Primary Series Doses Administered, Primary Series Doses by Vaccine, Primary Series Doses Metrics, Addtl/Booster, Coverage, …

Testimonios Of Two Latinas In The Academe, Maria G. Bridges

School of Rehabilitation Services & Counseling Faculty Publications and Presentations

No abstract provided.

Potential Savings From Consumer-Driven Health Plans, William Ferguson, Brittany Smith, Jessica Mcnair, Sarah Miller, Bojing Wang, Alberto Coustasse

Management Faculty Research

Consumer Driven Health Plans (CDHPs) have been identified as a high-deductible insurance option that has increased consumer responsibility while healthcare expenditures have decreased. There has been an increasing need of these plans because they can help to control healthcare costs, and the increasing healthcare utilization. As the use of these plans have expanded, educated consumers have become more engaged in their healthcare services and have increased demands for transparency of healthcare costs. The methodology for this study was a literature review using 36 sources. The purpose of this study was to determine if CDHPs have created financial savings by increasing …