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Reducing Benzodiazepine Use For The Treatment Of Insomnia And Supporting Nonpharmacological Therapies, UnChan Pyon 2019 University of Vermont

Reducing Benzodiazepine Use For The Treatment Of Insomnia And Supporting Nonpharmacological Therapies, Unchan Pyon

Family Medicine Clerkship Student Projects

Most medical organizations recommend against the use of benzodiazepine use for the treatment of insomnia, especially in the elderly. However, the percentage of the adult population on benzos increase with age: 7.5% in adults ages 51-64; 9% in adults over 65. Alternative therapies for insomnia, including online CBT, require more commitment than taking a medication so many patients opt for medication. This project aims to increase awareness of benzodiazepine use for insomnia and provide support for nonpharmacological therapies.


Survey Of Sensory Diet Use Among California Occupational Therapy Practitioners, Morganne Peterson, Allison Hunt, Emily White 2018 Dominican University of California

Survey Of Sensory Diet Use Among California Occupational Therapy Practitioners, Morganne Peterson, Allison Hunt, Emily White

Master's Theses and Capstone Projects

The purpose of this study was to examine the use of sensory diets in the field of occupational therapy. This study investigated the use of sensory diets among California occupational therapy practitioners. A mixed-methods design was used to collect data through an online survey. The survey was sent out to members of the Occupational Therapy Association of California (OTAC) and received 98 respondents within one month. Participants worked among various clinical settings and implemented sensory diets with various client populations. Practitioners reported using terms such as “sensory strategies,” “sensory tools,” and “sensory supports” which indicates an overall misunderstanding associated with ...


Resilience And Protective Factors In Older Adults, Jessica McClain, Katelyn Gullatt, Caroline Lee 2018 Dominican University of California

Resilience And Protective Factors In Older Adults, Jessica Mcclain, Katelyn Gullatt, Caroline Lee

Master's Theses and Capstone Projects

Evidence suggests resilience promotes successful aging in place and protective factors promote resilience. This study sought to investigate whether or not the combination of three protective factors, physical health, social support, and self-efficacy are all of equal importance in predicting resilience among Marin County older adults, or if some individual protective factors have a greater impact on resilience than the others. Fifty-eight participants ages 62 and higher were recruited from senior community programs and personal contacts. Four self-report questionnaires were completed by the participants in this exploratory, cross-sectional, quantitative design. SPSS was used for a descriptive and multivariate analyses to ...


Evaluating The Effectiveness Of A Formal Dementia Care Training Program: Abilities Care Experts™, Carmen Joaquin, Michelle D'Amato, April Perez, Louiza Alexandria Villarina, Sophie E. Miller 2018 Dominican University of California

Evaluating The Effectiveness Of A Formal Dementia Care Training Program: Abilities Care Experts™, Carmen Joaquin, Michelle D'Amato, April Perez, Louiza Alexandria Villarina, Sophie E. Miller

Master's Theses and Capstone Projects

Overview: Abilities Care Experts™ (ACE™) is an educational training program for nursing staff who care for individuals with dementia in skilled nursing facilities (SNF). The objective of the program is to provide the nursing staff with knowledge, and methods to engage residents’ remaining abilities in order to maximize occupational participation using a stage-specific dementia care approach. ACE™ training has yet to be evaluated for effectiveness in a controlled study design.

Objectives: This study sought to evaluate the effectiveness of the ACE™ training.

Design: The study employed a quantitative, cross-sectional, quasi-experimental design.

Participants: A total of 29 CNAs, 13 ACE™ trained ...


Inequalities In The Use Of Secondary Prevention Of Cardiovascular Disease By Socioeconomic Status: Evidence From The Pure Observational Study., Adrianna Murphy, Benjamin Palafox, Owen O'Donnell, David Stuckler, Pablo Perel, Khalid F. AlHabib, Alvaro Avezum, Xiulin Bai, Jephat Chifamba, Romaina Iqbal 2018 London School of Tropical Medicine, London, UK.

Inequalities In The Use Of Secondary Prevention Of Cardiovascular Disease By Socioeconomic Status: Evidence From The Pure Observational Study., Adrianna Murphy, Benjamin Palafox, Owen O'Donnell, David Stuckler, Pablo Perel, Khalid F. Alhabib, Alvaro Avezum, Xiulin Bai, Jephat Chifamba, Romaina Iqbal

Community Health Sciences

BACKGROUND:

There is little evidence on the use of secondary prevention medicines for cardiovascular disease by socioeconomic groups in countries at different levels of economic development.

METHODS:

We assessed use of antiplatelet, cholesterol, and blood-pressure-lowering drugs in 8492 individuals with self-reported cardiovascular disease from 21 countries enrolled in the Prospective Urban Rural Epidemiology (PURE) study. Defining one or more drugs as a minimal level of secondary prevention, wealth-related inequality was measured using the Wagstaff concentration index, scaled from -1 (pro-poor) to 1 (pro-rich), standardised by age and sex. Correlations between inequalities and national health-related indicators were estimated.

FINDINGS:

The proportion ...


Tobacco Dependence Treatment In The Emergency Department: A Randomized Trial Using The Multiphase Optimization Strategy., Steven L Bernstein, James Dziura, June Weiss, Ted Miller, Katrina A Vickerman, Lauretta E Grau, Michael V Pantalon, Lorien Abroms, Linda M Collins, Benjamin Toll 2018 George Washington University

Tobacco Dependence Treatment In The Emergency Department: A Randomized Trial Using The Multiphase Optimization Strategy., Steven L Bernstein, James Dziura, June Weiss, Ted Miller, Katrina A Vickerman, Lauretta E Grau, Michael V Pantalon, Lorien Abroms, Linda M Collins, Benjamin Toll

Prevention and Community Health Faculty Publications

Background

Tobacco dependence remains the leading preventable cause of death in the developed world. Smokers are disproportionately from lower socioeconomic groups, and may use the hospital emergency department (ED) as an important source of care. A recent clinical trial demonstrated the efficacy of a multicomponent intervention to help smokers quit, but the independent contributions of those components is unknown.

Methods

This is a full-factorial (16-arm) randomized trial in a busy hospital ED of 4 tobacco dependence interventions: brief motivational interviewing, nicotine replacement therapy, referral to a telephone quitline, and a texting program. The trial utilizes the Multiphase Optimization Strategy (MOST ...


Use Of Point Of Care Outcomes Data Facilitates Quality Improvement In Palliative Care, Pippa Blackburn, Sarah Aranha, Claire Johnson, Jane Healey, Samuel F. Allingham, Margaret Bird, Ann Yeomanson 2018 University of Wollongong

Use Of Point Of Care Outcomes Data Facilitates Quality Improvement In Palliative Care, Pippa Blackburn, Sarah Aranha, Claire Johnson, Jane Healey, Samuel F. Allingham, Margaret Bird, Ann Yeomanson

Pippa Blackburn

The Supportive and Palliative Care Unit (SPCU), Eastern Health is the largest in-patient palliativecare unit in Victoria, with 32 beds and a diverse interdisciplinary team. The unit provides specialist palliative care for an average of 800 patients with a life-limiting diagnosisannually. In 2016, the Supportive andPalliative Care Unit (SPCU) at Eastern Health identified an opportunity to review the SPCU’s clinicalassessment processes and utilisethe benchmarked reports providedby the Palliative Care OutcomesCollaboration to report patient outcomes.


Effect Of A Brief Patient Communication Teaching On Both Attendee And Non-Attendee Family Medicine Residents., Dilip Nair, Adrienne Mays, Mohit Harsh 2018 Marshall University

Effect Of A Brief Patient Communication Teaching On Both Attendee And Non-Attendee Family Medicine Residents., Dilip Nair, Adrienne Mays, Mohit Harsh

Adrienne M. Mays

Physician-patient communication skills are important for physicians to acquire. Teaching skills is thought to require attendance by learners but this is difficult in graduate medical education settings. We asked if an educational intervention on physician-patient communication was associated with a "spill-over" effect to non-attendees in the same family medicine residency program.

We surveyed residents regarding communicating instructions to patients before the intervention and one month later, regardless of their attendance. Residents’ assessment of their patients’ understanding increased significantly post-intervention only if non-attendees were included.

This pilot study suggests a beneficial “spill-over” effect to non-attendee residents that warrants further study.


A Rare Case Of Paradoxical Left Sided Endocarditis Through Patent Foramen Ovale., George M. Yousef, Paul I. Okhumale, Haytham Aljoudi, Silvestre Cansino 2018 Marshall University

A Rare Case Of Paradoxical Left Sided Endocarditis Through Patent Foramen Ovale., George M. Yousef, Paul I. Okhumale, Haytham Aljoudi, Silvestre Cansino

Silvestre P. Cansino

A 36 -year old woman IV drug abuser admitted with Right-Sided Infective Endocarditis (RSIE) as demonstrated by transthoracic echocardiogram. Patient was admitted 8 weeks later with recurrence of symptoms, moreover signs of systemic embolization were noted. Transthoracic and Transesophageal Echocardiograms revealed tricuspid valve vegetation, severe tricuspid regurgitation, left atrial mass, Patent Foramen Ovale (PFO), severely dilated right atrium and prominent Chiari's network. Systemic embolization included brain and Left iliacus abscesses. Patent Foramen ovale is the proposed mechanism leading to extensive systemic embolization in the present case.


A Rare Case Of Asystole During A Laparoscopic Appendectomy In A Young Patient, Rachit Gupta, George Yousef, Melissa Lester 2018 St George's, University of London, London, UK

A Rare Case Of Asystole During A Laparoscopic Appendectomy In A Young Patient, Rachit Gupta, George Yousef, Melissa Lester

Melissa Lester, DO

Laparoscopic surgery has become the mainstay of treatment for uncomplicated appendicitis cases. We describe a case of a 29 year old male with a pertinent past medical history of poorly controlled hypertension who was undergoing a routine laparoscopic appendectomy for confirmed appendicitis and developed bradycardia and subsequent asystolic cardiac arrest approximately one hour into the operation. Urgent cardiopulmonary resuscitation and intravenous (IV) atropine were required to reinitiate sinus cardiac rhythm. While the patient was admitted to the intensive care unit for close monitoring following his operation, he ultimately had an uncomplicated postoperative period and an unremarkable cardiac work up and ...


A Rare Case Of Asystole During A Laparoscopic Appendectomy In A Young Patient, Rachit Gupta, George Yousef, Melissa Lester 2018 St George's, University of London, London, UK

A Rare Case Of Asystole During A Laparoscopic Appendectomy In A Young Patient, Rachit Gupta, George Yousef, Melissa Lester

George M. Yousef

Laparoscopic surgery has become the mainstay of treatment for uncomplicated appendicitis cases. We describe a case of a 29 year old male with a pertinent past medical history of poorly controlled hypertension who was undergoing a routine laparoscopic appendectomy for confirmed appendicitis and developed bradycardia and subsequent asystolic cardiac arrest approximately one hour into the operation. Urgent cardiopulmonary resuscitation and intravenous (IV) atropine were required to reinitiate sinus cardiac rhythm. While the patient was admitted to the intensive care unit for close monitoring following his operation, he ultimately had an uncomplicated postoperative period and an unremarkable cardiac work up and ...


A Rare Case Of Paradoxical Left Sided Endocarditis Through Patent Foramen Ovale., George M. Yousef, Paul I. Okhumale, Haytham Aljoudi, Silvestre Cansino 2018 Marshall University

A Rare Case Of Paradoxical Left Sided Endocarditis Through Patent Foramen Ovale., George M. Yousef, Paul I. Okhumale, Haytham Aljoudi, Silvestre Cansino

George M. Yousef

A 36 -year old woman IV drug abuser admitted with Right-Sided Infective Endocarditis (RSIE) as demonstrated by transthoracic echocardiogram. Patient was admitted 8 weeks later with recurrence of symptoms, moreover signs of systemic embolization were noted. Transthoracic and Transesophageal Echocardiograms revealed tricuspid valve vegetation, severe tricuspid regurgitation, left atrial mass, Patent Foramen Ovale (PFO), severely dilated right atrium and prominent Chiari's network. Systemic embolization included brain and Left iliacus abscesses. Patent Foramen ovale is the proposed mechanism leading to extensive systemic embolization in the present case.


Effect Of A Brief Patient Communication Teaching On Both Attendee And Non-Attendee Family Medicine Residents., Dilip Nair, Adrienne Mays, Mohit Harsh 2018 Marshall University

Effect Of A Brief Patient Communication Teaching On Both Attendee And Non-Attendee Family Medicine Residents., Dilip Nair, Adrienne Mays, Mohit Harsh

Dilip Nair

Physician-patient communication skills are important for physicians to acquire. Teaching skills is thought to require attendance by learners but this is difficult in graduate medical education settings. We asked if an educational intervention on physician-patient communication was associated with a "spill-over" effect to non-attendees in the same family medicine residency program.

We surveyed residents regarding communicating instructions to patients before the intervention and one month later, regardless of their attendance. Residents’ assessment of their patients’ understanding increased significantly post-intervention only if non-attendees were included.

This pilot study suggests a beneficial “spill-over” effect to non-attendee residents that warrants further study.


Intra-Articular Tranexamic Acid During Total Knee Arthroplasty, Ahmed F. Khan 2018 Beaumont Hospital- Wayne

Intra-Articular Tranexamic Acid During Total Knee Arthroplasty, Ahmed F. Khan

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent conversation regarding bleeding risk prior to total knee arthroplasty in an elderly patient with chronic kidney disease.


Cognitive Behavioral Therapy For Patients With Psychogenic Non-Epileptic Seizures, Andrew Brown 2018 Wayne State University School of Medicine

Cognitive Behavioral Therapy For Patients With Psychogenic Non-Epileptic Seizures, Andrew Brown

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Goldstein L., Chalder T., et al. Cognitive-behavioral therapy for psychogenic non-epileptic seizures: A pilot RCT. Neurology. 2010;74(24):1986-1994. doi: 10.1212/WNL.0b013e3181e39658


Pediatric Obesity: Influence On Drug Dosing And Therapeutics, Barbara Ameer PharmD, MBA, BCPS, FCP, Michael Weintraub MD 2018 Rutgers – Robert Wood Johnson Medical School

Pediatric Obesity: Influence On Drug Dosing And Therapeutics, Barbara Ameer Pharmd, Mba, Bcps, Fcp, Michael Weintraub Md

Department of Medicine Faculty Papers

Obesity is an ongoing global health concern and has only recently been recognized as a chronic disease of energy homeostasis and fuel partitioning. Obesity afflicts 17% of US children and adolescents. Severe obesity (³120% of the 95th percentile of BMI-for-age, or a BMI of ³35 kg/m2) is the fastest growing subgroup and now approaches 6% of all US youth. Health consequences (e.g., type 2 diabetes, coronary heart disease) are related in a dose-dependent manner to severity of obesity. Since therapeutic interventions are less effective in severe obesity, prevention is a high priority.

Treatment plans involving combinations ...


A Common Pain In Pregnancy With An Uncommon Cause, Jennifer Baima, Amrit V. Vinod, Mathew J. Most 2018 University of Massachusetts Medical School

A Common Pain In Pregnancy With An Uncommon Cause, Jennifer Baima, Amrit V. Vinod, Mathew J. Most

Orthopedics and Physical Rehabilitation Publications and Presentations

Case Diagnosis: We present a case of a patient with hip pain during pregnancy determined to be pigmented villonodular synovitis (PVNS).

Case Description: A 41-year-old woman presented with 9-months of persistent atraumatic left hip pain localized to the groin that had started in her second trimester of pregnancy. Five months after delivery at presentation to clinic, her symptoms had progressively worsened to require a cane for ambulation.

On exam, hip range of motion was limited: flexion to 90o, external rotation to 20o, and internal rotation to 10o. She had groin pain with internal and external rotation. She ...


Positioning Of Patients For Pelvic Radiation: Variability Across Treatment, Mashhood Ahmad Bodla, Alexander Lukez, Lauren O'Loughlin, Jennifer Baima, Janaki Moni 2018 University of Massachusetts Medical School

Positioning Of Patients For Pelvic Radiation: Variability Across Treatment, Mashhood Ahmad Bodla, Alexander Lukez, Lauren O'Loughlin, Jennifer Baima, Janaki Moni

Orthopedics and Physical Rehabilitation Publications and Presentations

Objectives: We aimed to determine the variability in position of the pelvis for patients while receiving daily radiation treatments for pelvic malignancies.

Design: Therapeutic radiation targets lymph nodes that lie along the curvature of the sacrum. Any change in pelvic tilt could inadvertently move these targets in or out of the radiation field. This variability has clinical significance both to target cancerous lymph nodes and avoid healthy sacrum.

To better understand this variability, we observed trends in the change in the sacral slope. This measurement was chosen because it is an objective radiographic finding, there is no significant difference between ...


Nonoperative Approach To Treatment Of A Gluteus Medius Tear, Jason Yang, Alexander Lukez, Lauren O'Loughlin, Jennifer Baima 2018 University of Massachusetts Medical School

Nonoperative Approach To Treatment Of A Gluteus Medius Tear, Jason Yang, Alexander Lukez, Lauren O'Loughlin, Jennifer Baima

Orthopedics and Physical Rehabilitation Publications and Presentations

Case Diagnosis: We present two cases of atraumatic gluteus medius tear.

Case Description: Patient 1 is a 58-year-old female with right gluteal and hip pain. On physical exam, there was focal tenderness in the right gluteal area with pain on external rotation of the right hip and an antalgic gait.

Patient 2 is an 82-year-old male status-post left gluteus medius repair with subsequent revision. Since the surgery, the patient continued to have episodic left hip pain and suffered multiple falls. Physical exam demonstrated limited left hip abduction and tenderness of the iliopsoas muscle.

Both patients exhibited a sedentary lifestyle and ...


Occupational Exposure To Hiv In A Developing Country: Assessing Knowledge And Attitude Of Healthcare Professional Before And After An Awareness Symposium, Samina Ismail, Safia Awan, Rubaba Naeem, Sarfraz Siddiqui, Badar Afzal, Bushra Jamil, Uzma Rahim Khan2 Uzma Rahim Khan2 Uzma Rahim Khan2 2018 Aga Khan University

Occupational Exposure To Hiv In A Developing Country: Assessing Knowledge And Attitude Of Healthcare Professional Before And After An Awareness Symposium, Samina Ismail, Safia Awan, Rubaba Naeem, Sarfraz Siddiqui, Badar Afzal, Bushra Jamil, Uzma Rahim Khan2 Uzma Rahim Khan2 Uzma Rahim Khan2

Department of Anaesthesia

Objective:

Health care providers (HCPs) are at risk of occupational exposure to HIV infection. In developing world these exposure occur due to general lack of awareness, education and structured training of HCPs. The objective of the study was to asses if continuing medical education symposium can be used as an effective educational tool to improve attitude, awareness and knowledge regarding occupational exposure to HIV infection. This quasi-experimental study was conducted among HCPs from Karachi, Pakistan. After assessing the baseline knowledge, awareness, and attitude by means of pretest; HCPs were reassessed with posttest after an education symposium on occupational exposure to ...


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