Family Medicine Commons^™

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Barrett's Esophagus As A Premalignant Condition; Medical And Surgical Therapeutic Management, Vlad Denis Constantin, Adrian Silaghi, Laura Florentina Rebegea, Stana Paunica, Anca Silvia Dumitriu, Doina Andrada Mihai, Ioana Paunica, Dragos Epistatu

Journal of Mind and Medical Sciences

Barrett's esophagus (BE) represents a special clinical entity, which may have reduced symptoms, but an increased potential for malignant degeneration. The factors that lead to the appearance of Barrett's esophagus are multiple, the most important being gastro-esophageal reflux, as well as smoking and obesity. BE occurs as a result of damage of the esophageal mucosa, caused by acid/basic gastroesophageal reflux and resulting in the transformation of the epithelium from squamous to intestinal type. The diagnosis of BE is primarily based on endoscopic examination. This method has not only a diagnostic role, but also a therapeutic one through the minimally invasive …

Penile Calciphylaxis In An End Stage Renal Disease Patient., Juan Enrique Garcia Lopez, Alain Velazquez Blanco, Aileen Aguilar, Sareena Siyas, Daniel Ibarias Paz, Mays Abdulazeez, Jesus Garza-Tamez, Desmond Adamu

Research Colloquium

Background: Penile Calciphylaxis occurs in about 1–4% of hemodialysis patients worldwide. Associated mortality rates are very high, and hyperparathyroidism is the second most frequently associated disorder. Addressing the resulting metabolic imbalance, and surgical intervention guided by findings of radiological studies may improve quality of life. The pathogenesis is thought to be mediated by vascular smooth muscle cells which differentiate into osteoblast-like cells. Decrease in vascular calcification inhibitory proteins fetuin-A and matrix Gla is found in patients on dialysis causing systemic medial calcification of arterioles, leading to epidermal ischemia, tissue infarction, and ulceration.

Case presentation: 47-year-old male with history of coronary …

About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski

Electronic Thesis and Dissertation Repository

This study explored how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the extent to which concepts from thanatology they intuitively bring in, explicitly bring in, and maybe fail to recognize. To achieve this, constructivist grounded theory (CGT) methodology guided the design, data collection, analysis, and interpretation of the findings, which allowed for iteration across interviews and analysis with existing theories and data in the literature. The CGT design encouraged further engagement with the literature in an ongoing iterative fashion as well as with the analysis of the data. …

Chronic Wound Management; Surgical Therapy And Complementary Nursing With Manuka Honey, Georgeta Paunică-Panea, Sergiu Teodorescu, Aurelia Preda, Laura Elena Gligor, Adrian Silaghi, Vlad Denis Constantin

Journal of Mind and Medical Sciences

Objectives. This study aims to analyze the evolution of chronic wounds treated both surgically and by complementary nursing using Manuka honey. The parameters monitored were: presence/persistence of bacterial infection, the duration of healing, the recovery period and the patients' quality of life. Materials and Methods. The study group and the control group each consisted of 10 patients, aged between 50-60 years, with chronic wounds of various etiologies but without other significant systemic pathologies. Data collection was carried out through anamnesis, physical examination and analysis of medical documents. Results. In the study group, the depth of the wound was reduced rapidly …

Continuity Of Care In Rural Surgical Patients, Sydney M. Cardozo

Family Medicine Clerkship Student Projects

Continuity of care is an integral part of patient care and is important for reducing morbidity and mortality following hospitalizations. Medical errors are common during transitions of care, and are most frequently caused by lack of suitable discharge planning and poor communication between surgical teams, patients, and primary care physicians. This project aims to create a new standardized note template for surgery teams to use when discharging patients, with the goal of augmenting communication and efficiency during transitions of care within and outside the UVM Health Network.

The Importance Of Stigma Theory For Clinical Decisions Related To Diabetic Foot Amputations, Rachael Garcia, Callie Bartkowiak, Alison Nesbitt Do

Clinical Research in Practice: The Journal of Team Hippocrates

The authors examine the unconsidered impact of social stigma theory on the shared clinical decision-making process for a patient with foot osteomyelitis and MRSA bacteremia facing the prospect of an amputation.

Clinical And Biological Factors With Prognostic Value In Acute Pancreatitis, Mihai Faur, Dan Dumitrescu, Dan Sabau, Ciprian Tanasescu, Dan Cretu, Denisa Tanasescu, Vlad Denis Constantin, Calin Mohor

Journal of Mind and Medical Sciences

Acute pancreatitis is an acute inflammatory process of the pancreas, which can remain localized at the level of the gland or can extend to the peripancreatic and retroperitoneal tissues. The use and interpretation of paraclinical examinations at the onset can predict the form of evolution of acute pancreatitis (mild or severe). Depending on the evolution, these data are useful in determining the type of surgical intervention that might be necessary based on severity.

We present a retrospective study consisting of 118 patients diagnosed and hospitalized with acute pancreatitis during 2016-2020 in the Surgery I section of the Sibiu County Emergency …

Innovative Therapeutic Approach To Chemical Burns Produced By Vesicants; An Experimental Study, Cristina Anca Secara, Otilia Liudmila Cinteza, Diana Popescu, Claudia Valentina Popa, Camelia Andreea Hirjeu, Oana Cristina Voinea, Luiza Georgia Serbanescu, Andreea Marilena Pauna, Mihail Tudosie

Journal of Mind and Medical Sciences

Vesicants are compounds that cause severe toxic effects on various tissues. Such chemical action causes tissue necrosis, with clinical expression of skin lesions with a burning character and characteristic blisters. Clinical toxic effects of cutaneous vesicles are correlated with the absorbed dose and exposure time. The goals of the study are to evaluate in vitro the skin toxicity produced by the vesicant chemical compound 2-chloroethyl-ethyl sulfide (CEES), to develop a complex antidote formula, and to optimize the therapeutic efficacy by inclusion in controlled release systems. The experimental protocol aims at the in vitro evaluation of the cytotoxicity of the vesicant …

Peri-Operative Optimization: Social Determinants Of Health, Adam F. Kohutnicki

Family Medicine Clerkship Student Projects

This project investigated how clinicians at a rural Vermont family medicine practice observed various social determinants of health (SDOH) of their patient population affected patients' preparedness for surgery. Two clinicians involved in the community, a practicing family medicine physician and a practicing social worker, were interviewed to collect qualitative data on how various SDOH they have observed through their clinical practice have influenced patients' preparedness for surgery. This information was then utilized to create a "dot-phrase" that clinicians can use as part of a patient's pre-operative visit in the outpatient setting to assess SDOH and plan subsequent targeted interventions to …

Limb Salvage Therapy In Septic Diabetic Foot Ulcer In Patients Unwilling To Undergo Amputation, Luke Hong

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising

Shojaiefard A, Khorgami Z, Larijani B. Septic diabetic foot is not necessarily an indication for amputation. J Foot Ankle Surg. 2008;47(5):419-423. https://doi.org/10.1053/j.jfas.2008.05.005

for a patient with a septic diabetic foot.

Online Assessment In Undergraduate Medical Education: Challenges And Solutions From A Lmic University, Syeda Sadia Fatima, Romana Idrees, Kauser Jabeen, Saniya Sabzwari, Sadaf Khan

Department of Biological & Biomedical Sciences

Background and objectives: The Covid-19 pandemic has caused large-scale disruption in almost all educational programs across the world. Planning and rapid implementation of assessment through an online format presents the next set of novel challenges that must be addressed by academic administrations across the globe.
Methods: This cross-sectional study was conducted between March to August 2020 at the Aga Khan University Medical College. Two hundred medical students of year 1 and 2 participated in the study. We describe the planning, processes, and outcomes of online assessments using video communication platforms conducted at a private university in Pakistan. Standardized protocols were …

Applying A Mixed-Method Approach To Improve On-The-Job Learning And Job Satisfaction In A Cohort Of Interns At A University Hospital, Amna Subhan Butt, Muhammad Shahzad Shamim, M Asghar Ali, Farah Naz Qamar, Irum Qamar Khan, Swaleha Tariq, Syeda Amrah Hashmi, Quratulain Hafeez, Muhammed Tariq

Section of Gastroenterology

Introduction: Job satisfaction is vital for the optimal functioning of medical practitioners. Herein, we report our experience of restructuring the internship program by identifying the gaps, developing, implementing strategies to overcome gaps and sharing the results of the pre-implementation and post-implementation audit, as an example for establishing a system for improving intern's work-based learning and satisfaction in a university hospital setting.
Methods: Using Kern's six-step instructional model, a prospective mixed-method study was conducted at Aga Khan University Hospital. In phase 1 (2013) gaps were identified by evaluating various aspects of the internship program. Strategies were developed and implemented to overcome …

Conference Proceedings: Aurora Scientific Day 2020

Journal of Patient-Centered Research and Reviews

Abstracts published in this supplement were among those presented at the 46th annual Aurora Scientific Day research symposium, held virtually on May 20, 2020. The symposium provides a forum for describing research studies conducted by faculty, fellows, residents, and allied health professionals affiliated with Wisconsin-based Aurora Health Care, a part of the Advocate Aurora Health health system, which publishes the Journal of Patient-Centered Research and Reviews.

Effectiveness Of Home-Based Rehabilitation Program In Minimizing Disability And Secondary Falls After A Hip Fracture: Protocol For A Randomized Controlled Trial, Anum Sadruddin Pidani, Saniya Sabzwari, Khabir Ahmad, Ata Khan, Shahryar Noordin

Department of Surgery

Introduction: Hip fractures are a major health problem globally and are associated with increased morbidity, mortality, and substantial economic costs. Successful operative treatment of hip fracture patients is necessary for the optimization of post-op mobility and functional recovery of the patient. Rehabilitation after surgical stabilization of a hip fracture is crucial in order to restore pre-fracture function and to avoid long-term institutionalization. In particular ongoing exercise which targets balance can prevent up to 40% of falls. Therefore, we have designed a post-discharge home-based physical rehabilitation intervention program to minimize disability and falls in this high-risk elderly population.
Methods and analysis: …

Delirium In Long Term Care Rehabilitation Residents: A Correlational Retrospective Study, Rebecca Lerma-Kjonegaard

Dissertations

Abstract Background: Delirium is associated with devastating outcomes, cognitive loss,

decreased function and an increase risk of mortality which affects patients and places a heavy burden on family and the healthcare system. The purpose of this study was to describe the relationship between select demographics, clinical characteristics, CHART- DEL-derived delirium diagnosis and ICD-10 coded discharge delirium diagnoses among Long Term Care (LTC) rehabilitation residents.

Method: A retrospective correlational design from174 LTC rehabilitation residents age 65 years or older using EMR and hard copy charts. The setting was a Southern California community hospital-based 100-bed LTC. Abstracted data included demographic characteristics (age, …

Family Medicine Resident Education On Perioperative Management Of Patients On Anticoagulation, Hanna Mathers

Family Medicine Clerkship Student Projects

Family Medicine residents at CMMC in Lewiston, Maine manage patients in an outpatient clinic as well as on an inpatient family medicine teaching service. Many patients in the community are anticoagulated for native valve atrial fibrillation and undergo surgical procedures both in the inpatient and outpatient setting. Residents are often asked on to determine the necessity and timing of anticoagulation discontinuation for patients that they see. With patients on newer oral anticoagulants and various degrees of risk, it can be a challenge to make an informed choice. Residents have found that they would feel more confident in perioperative management of …

Development Of A Health Care Systems Curriculum., Zachary Pruitt, Rahul Mhaskar, Bryan G. Kane Md, Robert D. Barraco Md, Mph, Deborah J Dewaay, Alexander M. Rosenau Do, Kristin A. Bresnan Md, Marna R. Greenberg Do, Mph, Facep

Marna R Greenberg DO, MPH, FACEP

Background: There is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution.

Methods: This case study describes the application of a problem-based learning approach to system-based practice medical education. A series of behavioral statements, called entrustable professional activities, was created …

Development Of A Health Care Systems Curriculum., Zachary Pruitt, Rahul Mhaskar, Bryan G. Kane Md, Robert D. Barraco Md, Mph, Deborah J Dewaay, Alexander M. Rosenau Do, Kristin A. Bresnan Md, Marna R. Greenberg Do, Mph, Facep

Bryan G Kane MD

Background: There is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution.

Methods: This case study describes the application of a problem-based learning approach to system-based practice medical education. A series of behavioral statements, called entrustable professional activities, was created …

Development Of A Health Care Systems Curriculum., Zachary Pruitt, Rahul Mhaskar, Bryan G. Kane Md, Robert D. Barraco Md, Mph, Deborah J Dewaay, Alexander M. Rosenau Do, Kristin A. Bresnan Md, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

Background: There is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution.

Methods: This case study describes the application of a problem-based learning approach to system-based practice medical education. A series of behavioral statements, called entrustable professional activities, was created …

Hip Fragility Fractures: Anaemia, Calcium And Vitamin D Supplementation, Iqra Khan, Ambreen Jawaid, Khabir Ahmad, Shahryar Noordin

Department of Family Medicine

Objective: To assess the burden of anaemia and osteoporosis in hip fracture patients, to determine the rate of blood transfusion per-operatively, to assess the use of calcium and vitamin D supplements and the use of anti-osteoporotic medications postoperatively.
Methods: A retrospective study was conducted at Aga Khan University and Hospital (AKUH) between June 2009 and May 2011, and comprised record of patients treated for intertrochanteric and femur neck fractures. Patients with associated pathological, open or long bone fractures were excluded. The main study outcome measures were the use of pre-operative and post-operative calcium, vitamin D, bisphosphonates and management of anaemia …

The Management Of Keloids: Hands-On Versus Hands-Off., James Studdiford, Amber Stonehouse, Marc Altshuler, Elliot Rinzler

Department of Family & Community Medicine Faculty Papers

Keloids are benign fibrous growths that appear in scar tissue. The lesions can be severely disfiguring and early recognition of genetic lesions is crucial. This case report outlines and reviews the important management strategies for these lesions and the requirement for extensive counseling for the patient and their family. Many potential medical and surgical interventions exist. Unfortunately, these lesions tend to recur and overall outcomes remain poor. Given patient susceptibility to disfiguring results, surgical intervention should be used with extreme caution.