Digital Commons Network^™

Improving Clinical Practice Using Clinical Decision Support Systems: A Systematic Review Of Trials To Identify Features Critical To Success, Kensaku Kawamoto, Caitlin A. Houlihan, E. Andrew Balas, David F. Lobach

School of Medical Diagnostics & Translational Sciences Publications

Objective To identify features of clinical decision support systems critical for improving clinical practice. Design Systematic review of randomised controlled trials.
Data sources Literature searches via Medline, CINAHL, and the Cochrane Controlled Trials Register up to 2003; and searches of reference lists of included studies and relevant reviews.
Study selection Studies had to evaluate the ability of decision support systems to improve clinical practice.
Data extraction Studies were assessed for statistically and clinically significant improvement in clinical practice and for the presence of 15 decision support system features whose importance had been repeatedly suggested in the literature.
Results Seventy studies …

Simulations Of Nanopore Formation And Phosphatidylserine Externalization In Lipid Membranes Subjected To A High-Intensity, Ultrashort Electric Pulse, Q. Hu, R. P. Joshi, K. H. Schoenbach

Bioelectrics Publications

A combined MD simulator and time dependent Laplace solver are used to analyze the electrically driven phosphatidylserine externalization process in cells. Time dependent details of nanopore formation at cell membranes in response to a high-intensity (100kV∕cm), ultrashort (10ns) electric pulse are also probed. Our results show that nanosized pores could typically be formed within about 5ns. These predictions are in very good agreement with recent experimental data. It is also demonstrated that defect formation and PS externalization in membranes should begin on the anode side. Finally, the simulations confirm that PS externalization is a nanopore facilitated event, rather than the …

Deference, Denial, And Exclusion: Men Talk About Contraception And Unintended Pregnancy, Scott D. Johnson, Lindy B. Williams

Rhetoric and Communication Studies Faculty Publications

Individual in-depth interviews were conducted with 20 men, ages 21-48, who have fathered at least one unintended pregnancy. The goal of the interviews was to explore the experiences of these men with unintended pregnancy, their communication with partners and others, contraceptive beliefs and practices, their relationships with their partners, and the outcomes and consequences of the unintended pregnancies. This essay describes results derived from their comments regarding their contraceptive practices and the pregnancy-outcome decisions, with thematic analysis used to identify prominent themes from participant comments. Two strong themes, "deference" and "denial," and one lesser theme, "exclusion," emerged from participant responses. …

Oncolog, Volume 50, Number 01, January 2005, Rachel Williams, Dawn Chalaire, Caren E. Blinka, Angelina Esparza, Allen W. Burton Md

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• New Perspectives on Brain Metastasis
• Out of the Darkroom
• Equity and Health
• House Call: Blood and Platelet Donors Give Life
• DiaLog: Cancer Pain Control in the New Millennium, by Allen W. Burton, MD, Section Chief, Cancer Pain Management Department of Anesthesiology and Pain Medicine

The Role Of Aromatase Inhibitors In Ameliorating Deleterious Effects Of Ovarian Stimulation On Outcome Of Infertility Treatment, Mohamed Fm Mitwally, Robert F. Casper, Michael P. Diamond

Wayne State University Associated BioMed Central Scholarship

Abstract

Clinical utilization of ovulation stimulation to facilitate the ability of a couple to conceive has not only provided a valuable therapeutic approach, but has also yielded extensive information on the physiology of ovarian follicular recruitment, endometrial receptivity and early embryo competency. One of the consequences of the use of fertility enhancing agents for ovarian stimulation has been the creation of a hyperestrogenic state, which may influence each of these parameters. Use of aromatase inhibitors reduces hyperestrogenism inevitably attained during ovarian stimulation. In addition, the adjunct use of aromatase inhibitors during ovarian stimulation reduces amount of gonadotropins required for optimum …

Continuity Of Patient Care Among Family Practice Patients At A Teaching Hospital, Waris Qidwai, J Rehman, M Khan, Iqbal Azam

Department of Family Medicine

No abstract provided.

Characteristics Of Smokers And Their Knowledge About Smoking At A Teaching Hospital In Karachi, Waris Qidwai, N Zahid

Department of Family Medicine

Objective: To study the characteristics of smokers and their knowledge about smoking, among Family Practice Patients, at a teaching hospital in Karachi, Pakistan. Main outcome measures: Age at starting smoking, duration and number of cigarettes smoked, started smoking under influence of friends, colleagues, family members or self motivation, number of friends and colleagues who smoked, whether smoking is unhealthy, and actual chance of harm to an individual due to smoking is very rare or not.
Results: One hundred patients who visited Family Practice Center were interviewed. Sixty one percent were young married men, well educated and either student, …

Manuscripts Categorization And Their Accreditation, Jamshed Akhtar, Saba Sohail

Department of Radiology

No abstract provided.

Healing During Physician-Patient Consultation, Waris Qidwai, Ss Ali, S Ayub, S Ayub

Department of Family Medicine

OBJECTIVE: To determine the patient perceptions regarding healing during a physician-patient consultation.
DESIGN: A questionnaire-based survey.
PLACE AND DURATION OF STUDY: Family Practice Center of the Aga Khan University Hospital, Karachi, Pakistan, in June 2004.
PATIENTS AND METHODS: A questionnaire was designed that included the demographic profile of patients comprising age, gender, education and occupation as well as questions in line with the study objective. It was administered to 111 patients, visiting outpatient department of the hospital. Participants were explained the study objective, a written consent was taken and full confidentiality was assured.
RESULTS: The mean age of …

African American Breast Cancer Health Disparities, Theresa Lynn Gaul

Honors Program Theses

Health disparities are "the differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions that exist among specific population groups in the United States" (National Cancer Institute [NCI], 2002). Racial and ethnic minorities experience serious disparities in health access and outcomes. Disparities in the burden of death and illness experienced by African Americans in particular, as compared with our nation's population as a whole, are particularly striking. There are a variety of factors contributing to these inequalities. The purpose of this report is to examine these factors and the consequential effects on the African American's …

Paediatric Palliative And Supportive Care: Caring For Life: The Needs Of Children And Families In Western Australia, Leanne Monterosso, Linda Kristjanson, Marianne Phillips, Sue Rowell

Research outputs pre 2011

Palliative care is the relief of symptoms, regardless of their impact on the underlying disease process. The philosophical underpinning of current international paediatric palliative and supportive care models is that palliative and supportive care should be offered to all children with life threatening or chronic illnesses/disabilities with complex care needs. This approach allows the integration of cure-directed treatment and palliative care. allowing children to benefit from both philosophies of care. In Australia, there is increasing recognition of the need for the development of appropriate paediatric palliative care services, especially in Western Australia where supportive care services for children with life-limiting …

Medium From Irradiated Cells Induces A Dose Dependent Expression Of Mitochondrial Changes And Bcl2 Responses In Unirradiated Human Keratinocytes, Paula Maguire, Carmel Mothersill, C. Seymour, Fiona Lyng

Articles

Exposure of unirradiated human keratinocytes to irradiated cell conditioned medium (ICCM) is known to cause a cascade of events that leads to reproductive death and apoptosis. This study investigates the effect of ICCM on clonogenic survival, mitochondrial mass and BCL2 expression in unirradiated keratinocytes. Exposure to 5 mGy, 0.5 Gy and 5 Gy ICCM resulted in a significant decrease in clonogenic survival. Human keratinocytes incubated with ICCM containing an antioxidant, N-acetylcysteine, showed no significant decrease in clonogenic survival. HPV-G cells incubated with ICCM containing a caspase 9 inhibitor showed no significant decrease in clonogenic survival when the ICCM dose was …

Genetic Networks Controlling Retinal Injury, Felix R Vazquez-Chona, Amna N Khan, Chun K Chan, Anthony N Moore, Pramod K Dash, M Rosario Hernandez, Lu Lu, Elissa J Chesler, Kenneth F Manly, Robert W Williams, Eldon E Geisert

Faculty, Staff and Student Publications

PURPOSE: The present study defines genomic loci underlying coordinate changes in gene expression following retinal injury.

METHODS: A group of acute phase genes expressed in diverse nervous system tissues was defined by combining microarray results from injury studies from rat retina, brain, and spinal cord. Genomic loci regulating the brain expression of acute phase genes were identified using a panel of BXD recombinant inbred (RI) mouse strains. Candidate upstream regulators within a locus were defined using single nucleotide polymorphism databases and promoter motif databases.

RESULTS: The acute phase response of rat retina, brain, and spinal cord was dominated by transcription …

Outcome Of Home Mechanical Ventilation, N Salahuddin, K Haider, Sj Husain, S Siddiqui, Fazal Hameed Khan, R. Manasia

Department of Anaesthesia

OBJECTIVE: To determine the outcome of patients discharged home on portable ventilator.
DESIGN: Descriptive study.
PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi from January 2000 to December 2004.
PATIENTS AND METHODS: All ventilator-dependent patients discharged home were contacted. Survivors were administered the EQ-5D Quality-of-Life instrument. SPSS version 13 was used to analyze data.
RESULTS: Eleven patients were discharged home on invasive ventilation. Mean age was 49 years (range 10-98 years). Cause of ventilatory failure were cervical spine trauma in 36%, primary neurological disease in 27%, critical illness neuropathy and respiratory failure in 18% …

Drug Related Critical Incidents, F A. Khan, M Q. Hoda

Department of Anaesthesia

Drug related incidents are a common form of reported medical errors. This paper reviews the critical incidents related to drug errors reported from the main operating theatre suite in a teaching hospital in a developing country from January 1997 to December 2002. Each report was evaluated individually by two reviewers using a structured process. During this period, 44 874 anaesthetics were administered; 768 critical incidents were reported, 165 (21%) of which were related to drug errors. Underdosage, side-effect/drug reaction and syringe swap were the most common. A total of 76% were classified as preventable; 56% due to human error and …

Édouard Glissant : Du Dé-Lire Verbal Au Discours Maîtrisé, Katell Colin-Thébaudeau

Présence Francophone: Revue internationale de langue et de littérature

This article questions the experience of delirium of the character of Marie Celat and places it in relation to the violence of identity and cultural alienation linked to the history of the West Indies. Using the word “Odono” as a pretext, which was transmitted to the character by a family tale, the text tackles the problem of the identity and origin of the subject. In Marie Celat’s delirium, the reference to “Odono” opens the way for diverse positions on the subject of enunciation, stretching the historical truth into an a-temporal, a-spatial, “out of chronology” event. The words juxtapose each other …

Medical Education Digest, Vol. 6 No. 6 (November 15, 2004), Nova Southeastern University

Medical Education Digest

No abstract provided.

Dynamic Mechanical (Brush) Allodynia In Cluster Headache, Avi Ashkenazi, William B. Young

Department of Neurology Faculty Papers

Cutaneous allodynia is the perception of pain when a non-noxious stimulus is applied to normal skin. It has been described in patients with migraine. Cutaneous allodynia is caused by sensitization of central nervous system neurons that receive convergent sensory input from both skin and intracranial structures. This phenomenon has not been previously described in patients with cluster headache. Although migraine and cluster headache (CH) may share some clinical features, the pathogenesis of these two primary headaches is different. The aim of this study was to examine the occurrence of dynamic mechanical (brush) allodynia (BA) in patients with CH.

Com Outlook Fall 2004, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Cystic Breast Lymphangioma, S N. Waqar, H Khan, S F. Mekan, N Kayani, A J. Raja

Department of Biological & Biomedical Sciences

No abstract provided.

Patterns Of Tuberculosis In The Central Nervous System, Soobia Raza, Aliyah Sadaf, Faisal Fecto, Rushna Pervez Ali, Muhammad Ehsan Bari, Ather Enam

Medical College Documents

Tuberculous involvement of central nervous system (CNS), although not very frequent, results in severe morbidity. Tuberculosis (TB) is endemic in developing countries but even in developed countries, after an initial decline up until 1980’s, incidence of TB is on the rise. The AIDS epidemic, emergence of multi-drug resistant strains and immigration of people from endemic areas are some of the factors significantly contributing to this increase. Consequently, the burden of central nervous system tuberculosis has increased significantly worldwide.

Medical Education Digest, Vol. 6 No. 5 (September 15, 2004), Nova Southeastern University

Medical Education Digest

No abstract provided.

Revisiting Vaccine Hesitancy, Barriers And Motivators To Obtaining A Flu Vaccine In A New Covid-19 Pandemic World, Ann M. Mayo Rn, Dnsc, Faan, Steffanie R. Cobler Np

School of Nursing and Health Science: Faculty Scholarship

Purpose

To describe and compare patient perceived barriers and motivators and decision-making conflict between two groups of hospitalized patients, those who receive flu vaccines and those who do not.

Data Sources

Data collection during 2003 included extracting data from databases and mailing two surveys to 436 discharged patients. One hundred eight (108) patients participated in the study.

Conclusions

Top barriers included fear of side effects from vaccine (35%) and fear of contracting the flu (30%). Top motivators for obtaining a flu vaccine included previous vaccination (93%) and provider recommendation (62%). Barriers, motivators and patient decisional conflict differed depending upon patient …

Vital Signs, Fall 2004, Boonshoft School Of Medicine

Vital Signs

A twenty-seven page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Academic Performance Of Psychiatrists Compared To Other Specialists Before, During, And After Medical School., Frederick S. Sierles, Michael Vergare, Mohammadreza Hojat, Joseph S. Gonnella

Department of Psychiatry and Human Behavior Faculty Papers

OBJECTIVE: This study was designed to compare psychiatrists with other physicians on measures of academic performance before, during, and after medical school.

METHOD: More than three decades of data for graduates of Jefferson Medical College (N=5,701) were analyzed. Those who pursued psychiatry were compared to physicians in seven other specialties on 18 performance measures. Analysis of covariance was used to control for gender effect.

RESULTS: Compared to other physicians, psychiatrists scored higher on measures of verbal ability and general information before medical school and on evaluations of knowledge and skills in behavioral sciences during medical school, but they scored lower …

Incidental Intrarenal-Pelvic Hydatid Cyst Discovered During Percutaneous Nephrolithotomy (Pcnl), G M. Nandwani, S R. Biyabani, A Memon

Section of Urology

No abstract provided.

Medical Education Digest, Vol. 6 No. 4 (July 15, 2004), Nova Southeastern University

Medical Education Digest

No abstract provided.

Com Outlook Summer 2004, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

The Ultrastructure Of The Olfactory System In Two Species Of Short-Tailed Shrews, Blarina Brevicauda And Blarina Carolinensis, Lisa Johnson Byrum

Theses and Dissertations in Biomedical Sciences

Several studies of the fine structure of the olfactory system of rodents have been conducted, but very little research has been done on members of the Insectivora. The olfactory systems of the northern short-tailed shrew, Blarina brevicauda, and the southern short-tailed shrew, Blarina carolinensis, were examined by light and electron microscopy. These shrews were live trapped in the vicinity of Norfolk, Virginia throughout all months of the year. Olfactory tissues were processed following standard transmission and scanning electron microscopy protocols. The olfactory system structures investigated included the olfactory epitheliumlmucosa (OEM), main olfactory bulb (MOB), accessory olfactory bulb (AOB), …

Roger W. Anderson, Phd, Oral History Interview, May 18, 2004, Roger W. Anderson Phd, Lesley W. Brunet

Interview Sessions

Major Topics Covered:

• Career at MD Anderson
• The history of the Pharmacy Division
• Integrating pharmacists within departments at MD Anderson including Nursing and Developmental Therapeutics
• Pharmacist's role in improving chemotherapy drugs and safety monitoring