Digital Commons Network^™

Directly Comparing Handoff Protocols For Pediatric Hospitalists, Elizabeth H. Lazzara, Robert Riss, Brady Patzer, Dustin C. Smith, Y. Raymond Chan, Joseph R. Keebler, Sarah D. Fouquet, Evan M. Palmer

Publications

BACKGROUND AND OBJECTIVES: Handoff protocols are often developed by brainstorming and consensus, and few are directly compared. We hypothesized that a handoff protocol (Flex 11) developed using a rigorous methodology would be more favorable in terms of clinicians’ attitudes, behaviors, cognitions, or time-on-task when performing handoffs compared with a prevalent protocol (Situation Background Assessment Recommendation [SBAR]).

METHODS: Using a between-groups, randomized control trial design (Flex 11 versus SBAR) during a pilot study in a simulated environment, 20 clinicians (13 attending physicians and 7 residents) received 3 patient handoffs from a standardized physician, managed the patients, and handed off the patients …

Understanding Teamwork In The Provision Of Cancer Care: Highlighting The Role Of Trust, Elizabeth H. Lazzara, Joseph R. Keebler, Soosi Day, Deborah Diazgranados, Minggui Pan, Michael A. King, Shin-Ping Tu

Publications

Team science research has indicated that trust is a critical variable of teamwork, contributing greatly to a team’s performance. Trust has long been examined in health care with research focusing on the development of trust by patients with their health care practitioners. Studies have indicated that trust is linked to patient satisfaction, adherence to treatment, continuity of care, and improved outcomes. We explore the construct of trust using a case example of a patient who received a surgical procedure for a precancerous polyp. We apply the principle of trust to the case as well as present the literature on trust …

A Complex Systems Framework Approach Towards Multidisciplinary Tumor Boards, Rahul Salla, Robert Pahle, Ashish Amresh

Publications

Multidisciplinary tumor boards (MTBs) are universally recommended and have been used in treatment of late stage cancers. Tumor boards have the advantage of including all the stakeholders in the decision making process and improving quality of care, however several studies have pointed to their lack of efficiency and tend to be lackluster while not producing the desired benefits for the participants. In this paper we present the design of a web based immersive framework for collaborative decision making that has the potential to improve several inefficiencies in conducting tumor boards and improve overall clinical outcomes. We present the design of …

Electronic Cigarettes In The Indoor Environment, Cheri Marcham

Publications

"E-cigarettes should be considered a source of volatile organic compounds (VOCs) and particulates in the indoor environment that have not been thoroughly characterized or evaluated for safety."--NIOSH

Interleukin-17a Promotes Cd8 T Cell Cytotoxicity To Facilitate West Nile Virus Clearance, Amber M. Paul, Dhiraj Acharya, Penghua Wang, Jianfeng Dai, David Gate

Publications

CD8 T cells are crucial components of immunity and play a vital role in recovery from West Nile virus (WNV) infection. Here, we identify a previously unrecognized function of interleukin-17A (IL-17A) in inducing cytotoxic-mediator gene expression and promoting CD8 T cell cytotoxicity against WNV infection in mice. We find that IL-17A-deficient (Il17a/) mice are more susceptible to WNV infection and develop a higher viral burden than wild-type (WT) mice. Interestingly, the CD8 T cells isolated from Il17a/ mice are less cytotoxic and express lower levels of cytotoxic-mediator genes, which can be restored by supplying recombinant IL-17A in vitro and in …

Hazcom 2012, Cheri Marcham

Publications

This presentation reviews changes to the OSHA Standard called HazCom 2012. Old and new definitions for "health hazards" are discussed as well as labeling requirements.

Design, Implementation And Evaluation Of A Game-Based Intervention Targeting Latino Children For Improving Obesity Outcomes, Ashish Amresh, Rahul Salla, Madhumita Sinha, Rebecca Birr

Publications

This paper presents the design, implementation and evaluation of a hybrid clinic plus home based intervention targeting Latino children to improve obesity outcomes. The intervention applies motivational game based learning and behavior change theories during design. Latino American children are the main target group for this study as they have significantly high obesity rates due to socio-economic conditions and lack of awareness. There have been several interventions that have targeted game based strategies in the clinic to promote health outcomes and some have even targeted obesity problems, however to our knowledge this is the first effort that adds an inhome …

Application Of Bioinstrumentation In Developing A Pressure Suit For Suborbital Flight, Pedro Llanos, Erik Seedhouse

Publications

This presentation features Embry-Riddle Aeronautical University's U-2 pressure suit. Built to be light and cost-effective, this suit is comfortable, comes in multiple sizes, operates in pressures up to 5 PSID, has an active airflow-based cooling system, and features bio-instrumentation to measure heart rate, breathing rate, skin temperature and other vitals.

An Ultrasensitive Electrogenerated Chemiluminescence-Based Immunoassay For Specific Detection Of Zika Virus, Amber M. Paul, Dhiraj Acharya, Pradip Bastola, Linda Le, Estenfani Fernandez, Michael S. Diamond, Wujian Miao, Fengwei Bai

Publications

Zika virus (ZIKV) is a globally emerging mosquito-transmitted flavivirus that can cause severe fetal abnormalities, including microcephaly. As such, highly sensitive, specific, and cost-effective diagnostic methods are urgently needed. Here, we report a novel electrogenerated chemiluminescence (ECL)-based immunoassay for ultrasensitive and specific detection of ZIKV in human biological fluids. We loaded polystyrene beads (PSB) with a large number of ECL labels and conjugated them with anti-ZIKV monoclonal antibodies to generate anti-ZIKV-PSBs. These anti-ZIKV-PSBs efficiently captured ZIKV in solution forming ZIKV-anti-ZIKV-PSB complexes, which were subjected to measurement of ECL intensity after further magnetic beads separation. Our results show that the anti-ZIKV-PSBs …

A Review Of Studies Of Ventilation And Indoor Air Quality In New Homes And Impacts Of Environmental Factors On Formaldehyde Emission Rates From Composite Wood Products, Francis (Bud) Offermann, Cheri Marcham

Publications

• While increasing outdoor air ventilation rates does reduce the indoor concentrations of air contaminants with indoor sources, the actual reductions in concentrations can differ significantly from those calculated with the assumption of a constant indoor emission rate.
• The ratio of actual to predicted concentration reductions for the low to high outdoor air ventilation modes ranged from 0.59 for formaldehyde to 1.37 for benzaldehyde.
• Increases in emission rates for compounds such as formaldehyde are consistent with mass transfer theory for emissions from materials such as composite wood where mass transfer is limited by gas-phase diffusion across the boundary layer.
• Decreases in …

Development And Use Of A Tablet-Based Resuscitation Sheet For Improving Outcomes During Intensive Patient Care, Wasif Bokahri, Vimla L. Patel, Ashish Amresh, Ayan Sen

Publications

Data documentation from resuscitation events in hospitals, termed "code blue" events, utilizes a paper form, which is institution-specific. Problems with data capture and transcription exists, due to the challenges of dynamic documentation of patient, event and outcome variables as the code blue event unfolds. We hypothesize that an electronic version of code blue real-time data capture would lead to improved resuscitation data transcription, and enable clinicians to address deficiencies in quality of care. To this effect, we present the design of a tablet-based application and its use by 20 nurses at the Mayo Clinic hospital. The results showed that the …

Highlighting Trust In The Provision Of Cancer Care, Elizabeth Lazzara, Joseph Keebler, Soosi Day, Deborah Diazgranados, Minngui Pan, Mike King, Shin-Ping Tu

Publications

Slides:

• Patient Case
• Definition & Explanation of Trust
• Application of Trust to Cancer Case
• Implications for Clinical Care
• Implications for Research

Aiha White Paper: Electronic Cigarettes In The Indoor Environment, Cheri Marcham

Publications

This presentation covers the effects of different volatile organic compounds released by electronic cigarettes which can cause health problems. More research on the effects of electronic "smoke" should be conducted on the generally recognized as safe (GRAS) ingredients in electronic cigarette exhaust.

Aiha White Paper Findings: Emissions, Exposures And Health Risks, Cheri Marcham

Publications

Part of Seminar 51: Electronic Cigarettes: An Emerging Issue for ASHRAE.

• Introduction to e-cigarettes
• Components and potential health effects
• Current regulatory status
• AIHA white paper findings and recommendations
• ANSI/ASHRAE 62.1 and addenda

Impact Of Electronic Health Records On Patient Outcomes, Lilian Ndifon, Jude E. Edwards, Leila Halawi

Publications

With the passing of the HITECH Act, EHRs have come into prominence and sharper focus, due to efforts by the government to push for a national adoption of EHRs into our healthcare system. This push for a national adoption of EHRs is based on the premise that it will help improve the quality delivery of health care services and reduce costs. However, this push for a “national adoption” has experienced mixed results. This study was designed to assess the impact of EHRs post-2009, the year of the HITECH Act, to review some of the key contributing factors to this mixed …

Design And Commissioning Of A Community Scale Solar Powered Membrane-Based Water Purification System In Haiti, Shavin Pinto, Yung Wong, Kyle Fennesy, Yan Tang, Marc Compere

Publications

This paper presents the design and commissioning of a solar powered water purification system at the Ryan Epps Home for Children (REHC) in Michaud, Haiti. This system supplies clean drinking water to the 200 children who live and go to school at REHC and also to the community in the form of a micro-business. This micro-business is the mechanism for income generation for sustainable system operation. The purifier uses a three stage filtration system with a disc-type sediment filter, a 0.1 micron ultrafiltration membrane, and an ultraviolet light for disinfection. The backwash cycle extends the life of the ultrafiltration membrane …