Digital Commons Network^™

How Should Technology-Dependent Patients' Care Be Managed Collaboratively To Avoid Turfing?, Emma Cooke, Holland Kaplan

Center for Medical Ethics and Health Policy Staff Publications

Technology-dependent patients require interventions (eg, tracheostomies, gastrostomy tubes, or total parenteral nutrition) to survive. Such patients are commonly "turfed" between general services or from subspecialty to general services within the hospital. This case commentary proposes several explanations for why technology-dependent patients are particularly susceptible to turfing, including clinicians' lack of familiarity with managing patients' technology, bias and ableism, and quality-of-life quandaries. It also addresses ways to combat turfing of technology-dependent patients and proposes educational strategies for managing common problems in the care of technology-dependent patients.

Acute And Chronic Kidney Injury During Therapy For Pediatric Acute Leukemia: A Report From The Leukemia Electronic Abstraction Of Records Network (Learn), Wendy Hsiao, Yimei Li, Kelly Getz, Lusha Cao, Edward Krause, Mark Ramos, Judy Lee, Maria Monica Gramatges, Karen R Rabin, Michael E Scheurer, Richard Aplenc, Michelle Denburg, Tamara P Miller

Center for Medical Ethics and Health Policy Staff Publications

Children with acute leukemia are at increased risk of kidney injury. Using electronic health record data from three centers between 2010 and 2018, this study retrospectively described acute kidney injury (AKI) and chronic kidney disease (CKD) prevalence in children with acute lymphoblastic or myeloid leukemia (ALL, AML) using Common Terminology Criteria for Adverse Events (CTCAE) and Kidney Disease Improving Global Outcomes (KDIGO) definitions. AKI during therapy was 25% (ALL) and 32% (AML) using CTCAE, versus 84% (ALL) and 74% (AML) using KDIGO. CKD prevalence was low and Grade 1/Stage 2. Further investigation is needed to optimally define kidney injury in …

Idiographic Coping Outcomes In Youth With Autism Spectrum Disorder And Co-Occurring Anxiety: Results From The Taasd Study, Lesley A Norris, Jonathan C Rabner, Eric A Storch, Jeffrey J Wood, Connor Kerns, Adam B Lewin, Brent J Small, Philip C Kendall

Center for Medical Ethics and Health Policy Staff Publications

Versions of cognitive behavioral therapy (Coping Cat, CC; Behavioral Interventions for Anxiety in Children with Autism, BIACA) have shown efficacy in treating anxiety among youth with autism spectrum disorder. Measures of efficacy have been primarily nomothetic symptom severity assessments. The current study examined idiographic coping outcomes in the Treatment of Anxiety in Autism Spectrum Disorder study (N = 167). Longitudinal changes in coping with situations individualized to youth fears (Coping Questionnaire) were examined across CC, BIACA and treatment as usual (TAU) in a series of multilevel models. CC and BIACA produced significantly greater improvements than TAU in caregiver-reported coping. Youth …

Depressive Symptoms In Autistic Youth With Anxiety Disorders, Rebecca L Greenberg, Andrew G Guzick, Sophie C Schneider, Saira A Weinzimmer, Minjee Kook, Amanda B Perozo Garcia, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Objective: Anxiety and depression often coexist in youth and share overlapping symptomatology; however, little is known about the comorbidity of anxiety and depression in autistic youth. This study explores (1) the frequency of depressive symptoms among autistic children with clinically significant anxiety, (2) clinical variables that may be associated with elevated depressive symptoms, and (3) whether pretreatment depressive symptoms predict cognitive behavioral therapy (CBT) outcomes for anxiety.

Method: Children aged 7 to 13 years (N = 87) and their parents participated in a randomized controlled trial comparing 2 versions of a parent-led, telehealth-delivered CBT program. Parents and children completed a …

Intrinsically Disordered Regions Are Poised To Act As Sensors Of Cellular Chemistry, David Moses, Garrett M Ginell, Alex S Holehouse, Shahar Sukenik

2020-Current year OA Pubs

Intrinsically disordered proteins and protein regions (IDRs) are abundant in eukaryotic proteomes and play a wide variety of essential roles. Instead of folding into a stable structure, IDRs exist in an ensemble of interconverting conformations whose structure is biased by sequence-dependent interactions. The absence of a stable 3D structure, combined with high solvent accessibility, means that IDR conformational biases are inherently sensitive to changes in their environment. Here, we argue that IDRs are ideally poised to act as sensors and actuators of cellular physicochemistry. We review the physical principles that underlie IDR sensitivity, the molecular mechanisms that translate this sensitivity …

Responding Well To Spiritual Worldviews: A Taxonomy For Clinical Ethicists, Trevor M Bibler

Center for Medical Ethics and Health Policy Staff Publications

Every clinical ethics consultant, no matter their own spirituality, will meet patients, families, and healthcare professionals whose spiritualities anchor their moral worldviews. How might ethicists respond to those who rely on spirituality when making medical decisions? And further, should ethicists incorporate their own spiritual commitments into their clinical analyses and recommendations? These questions prompt reflection on foundational issues in the philosophy of medicine, political and moral theory, and methods of proper clinical ethics consultation. Rather than attempting to offer definitive answers to these questions, this essay prompts readers to consider their own answers to these questions. Specifically, it offers a …

Optimizing Tissue Oxygenation In Reduction Mammoplasty: The Role Of Continuous Diffusion Of Oxygen: A Feasibility Pilot Randomized Controlled Trial, Alejandro Zulbaran-Rojas, Rasha O Bara, Myeounggon Lee, Areli Flores-Camargo, Ramkinker Mishra, Sebastian Winocour, Alastair Thompson, Bijan Najafi

Center on Aging Staff Publications

Introduction: Bilateral reduction mammoplasty (BRM) aims to alleviate macromastia-related symptoms in women. This procedure involves a T-Junction suture at the medial inframammary fold that encompasses 12%-39% of wound breakdowns mainly due to reduced perfusion. Continuous diffusion of oxygen (CDO) may enhance breast tissue oxygenation to prevent such complication. We explored the feasibility of this therapy.

Methods: A 4-wk feasibility-pilot randomized controlled trial of women undergoing BRM was conducted. By internal randomization (left/right side), participants received standard of care (SOC) in one breast using topical skin adhesive, while their other breast received SOC + CDO at the T-junction covered by a …

Re-Analysis And Meta-Analysis Of Summary Statistics From Gene-Environment Interaction Studies, Duy T Pham, Kenneth E Westerman, Cong Pan, Ling Chen, Shylaja Srinivasan, Elvira Isganaitis, Mary Ellen Vajravelu, Fida Bacha, Steve Chernausek, Rose Gubitosi-Klug, Jasmin Divers, Catherine Pihoker, Santica M Marcovina, Alisa K Manning, Han Chen

Faculty, Staff and Student Publications

Motivation: statistics from genome-wide association studies enable many valuable downstream analyses that are more efficient than individual-level data analysis while also reducing privacy concerns. As growing sample sizes enable better-powered analysis of gene-environment interactions, there is a need for gene-environment interaction-specific methods that manipulate and use summary statistics.

Results: We introduce two tools to facilitate such analysis, with a focus on statistical models containing multiple gene-exposure and/or gene-covariate interaction terms. REGEM (RE-analysis of GEM summary statistics) uses summary statistics from a single, multi-exposure genome-wide interaction study to derive analogous sets of summary statistics with arbitrary sets of exposures and interaction …

Will You Go The Distance? A Satisfaction Survey Of Telemedicine In Sexual Medicine, Gal Saffati, Taher Naeem, Jordan Kassab, Daniela Orozco Rendon, Charles Green, Larry I Liphsultz, Mohit Khera

Faculty, Staff and Student Publications

BACKGROUND: The success of telemedicine depends on patient satisfaction with the care that they receive, which is impacted by the ease of use of the technology, quality of the connection, and perceived effectiveness of care.

AIM: The study sought to evaluate patient satisfaction with telemedicine services in a high-volume andrology clinic.

METHODS: We included all patients who had a telemedicine appointment between January 1, 2020, and August 22, 2022. Demographic information was gathered, and a satisfaction survey was conducted using REDCap software. Data were grouped into 2 age categories, with ≥50 years as the cutoff (19-50 years; >50 years). The …

Precision Therapy For A Medically Actionable Atp1a3 Variant From A Genomic Medicine Program In An Underserved Population, Cara P Ford, Rebecca O Littlejohn, Ryan German, Blake Vuocolo, Jose Aceves, Liesbeth Vossaert, Nichole Owen, Michael Wangler, Carrie A Schmid

Duncan NRI Faculty and Staff Publications

Background: Genomic medicine is revolutionizing the diagnosis of rare diseases, but the implementation has not benefited underrepresented populations to the same degree. Here, we report the case of a 7-year-old boy with hypotonia, global developmental delay, strabismus, seizures, and previously suspected mitochondrial myopathy. This proband comes from an underrepresented minority and was denied exome sequencing by his public insurance.

Methods: After informed consent was obtained, buccal cells from the proband were collected and whole exome sequencing was performed. Illumina Dragen and Emedgene software was used to analyze the data at Baylor Genetics. The variants were further intepreted according to ACMG …

Firearm Injury Among People Experiencing Homelessness: Cross-Sectional Evidence From A National Survey Of United States Emergency Departments, Nathaniel A Dell, Michael G Vaughn, Christopher P Salas-Wright

2020-Current year OA Pubs

OBJECTIVES: Persons experiencing homelessness (PEH) are at high risk for violent victimization. This study leverages unique data from a national study in the United States of America to provide estimates of non-fatal firearm injury among PEH and to describe the contexts related to injury, such as substance use, intent of the injury, and precipitating interpersonal factors.

STUDY DESIGN: Cross-sectional.

METHODS: Data from the 1993-2020 National Electronic Injury Surveillance System-Firearm Injury Surveillance Study (NEISS-FISS) were used to describe the context and characteristics of non-fatal firearm injury among PEH aged 16 years or older. Homeless status and substance use data were extracted …

Monitoring External Workloads And Countermovement Jump Performance Throughout A Preseason In Division 1 Collegiate Women’S Basketball Players, Michelle Van Dyke

Electronic Theses and Dissertations

Monitoring external workloads and countermovement jump performance may be useful for coaches. PURPOSE: The purpose of this study was to determine the effects of external load on player performance as measured by a CMJ and specific blood biomarkers throughout the preseason. METHODS:10 female division 1 basketball athletes had PlayerLoad^TM (PL) monitored for all mandatory basketball training during six weeks of the preseason and CMJs were performed weekly. Blood biomarkers were collected before preseason and at the end of preseason. Data were analyzed via the Catapult Sport software (Openfield, Catapult, Innovations, Melbourne, VIC, Australia) to quantify all participant …

Community College Students' Perceptions Of Sense Of Community And Instructor Presence In The Online Classroom, Marla Cartwright

Electronic Theses and Dissertations

The purpose of this non-experimental, comparative, quantitative study was to determine if there were significant differences between the perceptions of male and female community college students about the importance of sense of community (SoC) in online classes and sense of instructor presence (IP) at eight southern, public, community colleges using survey data. It was the intent of the study to determine if there were significant relationships of students’ perceptions of the presence of sense of community in online classes among factors of age, race, grade point average, cumulative credit hours, credential type, major area of study, and number of previous …

Professional Collaboration In Small Rural Schools: Teacher Perceptions Of The Role Of School Administrators, Brian A. Bettis

Electronic Theses and Dissertations

The purpose of this phenomenological, qualitative research study was to examine teachers’ perceptions of school administrators’ support of collaborative planning in small rural schools. Although there has been much research conducted on teacher collaboration through Professional Learning Communities, there has been little documentation of teacher collaboration in small rural schools (DuFour et al., 2020; Hansen, 2015; Moore, 2018). This research study examined teachers’ perceptions of collaboration and the role that school administrators play in the work to establish, support, and maintain collaborative teaming structures.

Data collection strategies included individual interviews of practicing teachers, serving in small rural schools. Analysis of …

Household Information Records Organizer, Andrea Schmutz, Amanda Christensen, Melanie Jewkes, Melanie Dabb, Vincenza Vicari-Bentley, Alicia Nelson-Bell, Stacey Abbott

All Current Publications

This guide is a systematic approach for keeping track of important documents and financial records to stay organized, save time searching for information and make it easier to cope with emergencies.

The Family Strength Wheel: A Strength-Based Visual Tool For Families, Genese Clark

Journal of Extension

In 2017, data was collected from 59 African-Americans living in the northeastern United States to investigate the saliency of six family strength domains. The study results highlighted an emerging domain, Leadership, and led to the development of a visual family strength tool adapted from DeFrain's (2002) American Family Strength Inventory for family practitioners. With a supplemental worksheet, the Family Strength Wheel provides a self-rating scale illustrating baselines for strength-based family functioning while simultaneously showing benchmarks for improvement. The Family Strength Wheel offers immediate insight into individuals' perceptions of their family's functioning, opening areas for dialogue between family members and practitioners.

Intercultural Competency Development Model For Extension Professionals: Expert Consensus Using The Delphi Technique, John M. Diaz, Cody Gusto, K.S.U Jayaratne, Lendel Narine, Colby Silvert, Cecilia Suarez, Celina Wille

Journal of Extension

To address concerns about the applicability of existing intercultural competence models to the Extension context, we aimed to develop a systematic intercultural competence framework tailored for Extension professionals through a collaborative and consensual process. A three-phased Delphi approach was utilized with a panel of 36 intercultural competence experts in Extension across academic disciplines to identify and finalize competencies thought to be necessary across career phases. The panel agreed upon 54 competencies in total with 13 competencies to develop in the first year, 37 competencies to develop in the first three years and four competencies in years two through seven.

Evaluating Physical Activity Resources To Support Health Equity In Arizona, Kathryn M. Orzech, Theresa A. Legros, Laurel Jacobs, Gregory Goodman, Ryan Lang

Journal of Extension

We evaluated physical activity (PA) resources in lower-income Arizona communities to support the Supplemental Nutrition Assistance Program – Education (SNAP-Ed) in pursuing equitable policy, systems, and environment (PSE) interventions. In 2017, 71 PA resources across 10 counties (65% parks) were rated using the Physical Activity Resource Assessment (PARA) tool. Accessibility was high, but condition scores and attractiveness varied across resources, with no rural/urban differences. Results suggest that Extension SNAP-Ed staff can be agents of change by assessing resource condition where physical activity health inequities may exist and then convening partners to begin to address needed changes.

Maximizing Dietary Knowledge And Behavior Through A Teens As Teachers Approach, Anaderi Iniguez, Erica L. Doering, Elizabeth H. Weybright

Journal of Extension

The teens as teachers model is a promising approach to impact teen behavior. The current study evaluated dietary knowledge and behavior among teen teachers participating in a 4-H youth development program (N = 46; Mage = 15.5 years; 67% female; 48% Hispanic; 38% White Non-Hispanic, 14% Other). A paired sample t test was conducted on pre-and post-program surveys to identify significant improvements in dietary knowledge and behaviors. Findings suggest teens as teachers is generally effective in promoting healthy dietary knowledge and behavior. We recommend this approach be disseminated within Extension 4-H youth development healthy eating active living programming.

Lasofoxifene Versus Fulvestrant For Er+/Her2- Metastatic Breast Cancer With An Esr1 Mutation: Results From The Randomized, Phase Ii Elaine 1 Trial, M P Goetz, N A Bagegni, Et Al.

2020-Current year OA Pubs

BACKGROUND: Acquired estrogen receptor alpha (ER/ESR1) mutations commonly cause endocrine resistance in ER+ metastatic breast cancer (mBC). Lasofoxifene, a novel selective ER modulator, stabilizes an antagonist conformation of wild-type and ESR1-mutated ER-ligand binding domains, and has antitumor activity in ESR1-mutated xenografts.

PATIENTS AND METHODS: In this open-label, randomized, phase II, multicenter, ELAINE 1 study (NCT03781063), we randomized women with ESR1-mutated, ER+/human epidermal growth factor receptor 2 negative (HER2-) mBC that had progressed on an aromatase inhibitor (AI) plus a cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) to oral lasofoxifene 5 mg daily or IM fulvestrant 500 mg (days 1, 15, and 29, …

Programmable And Reversible Integrin-Mediated Cell Adhesion Reveals Hysteresis In Actin Kinetics That Alters Subsequent Mechanotransduction, Zheng Zhang, Guy M Genin, Et Al.

2020-Current year OA Pubs

Dynamically evolving adhesions between cells and extracellular matrix (ECM) transmit time-varying signals that control cytoskeletal dynamics and cell fate. Dynamic cell adhesion and ECM stiffness regulate cellular mechanosensing cooperatively, but it has not previously been possible to characterize their individual effects because of challenges with controlling these factors independently. Therefore, a DNA-driven molecular system is developed wherein the integrin-binding ligand RGD can be reversibly presented and removed to achieve cyclic cell attachment/detachment on substrates of defined stiffness. Using this culture system, it is discovered that cyclic adhesion accelerates F-actin kinetics and nuclear mechanosensing in human mesenchymal stem cells (hMSCs), with …

Associations Of Awake Prone Positioning-Induced Changes In Physiology With Intubation: An International Prospective Observational Study In Patients With Acute Hypoxemic Respiratory Failure Related To Covid-19, Luis Morales-Quinteros, Raffaele Scala, João Manoel Silva, Antonio Leidi, Alexandre Leszek, Rodrigo Vazquez-Guillamet, Sergi Pascual, Ary Serpa-Neto, Antonio Artigas, Marcus J Schultz

2020-Current year OA Pubs

INTRODUCTION: Awake prone positioning has the potential to improve oxygenation and decrease respiratory rate, potentially reducing the need for intubation in patients with acute hypoxemic respiratory failure. We investigated awake prone positioning-induced changes in oxygenation and respiratory rate, and the prognostic capacity for intubation in patients with COVID-19 pneumonia.

METHODS: International multicenter prospective observation study in critically ill adult patients with COVID-19 receiving supplemental oxygen. We collected data on oxygenation and respiratory rate at baseline, and at 1 h after being placed in prone positioning. The combined primary outcome was oxygenation and respiratory rate at 1 h. The secondary endpoint …

The State Of Integrated Disease Surveillance In Seven Countries: A Synthesis Report, A C K Lee, B G Iversen, S Lynes, A Rahman-Shepherd, N A Erondu, Mishal S. Khan, A Tegnell, M Yelewa, T M Arnesen, E S Gudo

Community Health Sciences

Objectives: Integrated disease surveillance (IDS) offers the potential for better use of surveillance data to guide responses to public health threats. However, the extent of IDS implementation worldwide is unknown. This study sought to understand how IDS is operationalized, identify implementation challenges and barriers, and identify opportunities for development.
Study design: Synthesis of qualitative studies undertaken in seven countries.
Methods: Thirty-four focus group discussions and 48 key informant interviews were undertaken in Pakistan, Mozambique, Malawi, Uganda, Sweden, Canada, and England, with data collection led by the respective national public health institutes. Data were thematically analysed using a conceptual framework that …

Support, Networks, And Relationships: Findings From A Mixed-Methods Evaluation Of A Mentorship Programme For Early Career Women Researchers In Sexual And Reproductive Health And Rights, Muhammad Asim, Peter Muriuki Gatheru, Joy J. Chebet, Mehr G. Shah, Anna Thorson, Vanessa Brizuela

Community Health Sciences

Low research output among women researchers in health research has been linked to inadequate mentorship opportunities for early career women researchers and particularly in sexual and reproductive health and rights (SRHR) field. Mentorship has been recognized as a contributor to strengthening research capacity and as beneficial for both mentors and mentees. Women researchers oftentimes experience negative impacts of organizational and structural gender inequities related to formal and informal mentoring. In 2020, the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction at WHO launched a mentorship programme for early career SRHR women researchers from low- and …

Transferability Of Tsetse Habitat Models Between Different Regions In Kenya And Rwanda, Stella Gachoki, Anton Vrieling, Thomas A. Groen, Andrew Skidmore, Daniel Masiga

All Peer-Reviewed Publications

Accurate and reliable information on the distribution of tsetse habitats is crucial for the effective management of African Trypanosomiasis in sub-Saharan Africa. However, conducting large-scale surveillance of tsetse flies to develop distribution maps is impractical due to vast areas infested and limited resources available. To address this challenge, we evaluated the applicability of tsetse habitat models developed in the intensively sampled Shimba Hills National Reserve in Kenya for both the wet and the dry season, to two other regions in Kenya (Ruma National Park and Nguruman Conservancy) and one region in Rwanda (Akagera National Park). The models utilized satellite-based estimates …

Microsporidia Mb In The Primary Malaria Vector Anopheles Gambiae Sensu Stricto Is Avirulent And Undergoes Maternal And Horizontal Transmission, Godfrey Nattoh, Brenda Onyango, Edward Edmond Makhulu, Diana Omoke, Lilian Mbaisi Ang’Ang’O, Luna Kamau, Maxwell Machani Gesuge, Eric Ochomo, Jeremy Keith Herren

All Peer-Reviewed Publications

Background: The demonstration that the recently discovered Anopheles symbiont Microsporidia MB blocks malaria transmission in Anopheles arabiensis and undergoes vertical and horizontal transmission suggests that it is a promising candidate for the development of a symbiont-based malaria transmission-blocking strategy. The infection prevalence and characteristics of Microsporidia MB in Anopheles gambiae sensu stricto (s.s.), another primary vector species of malaria in Kenya, were investigated. Methods: Field-collected females were confirmed to be Microsporidia MB-positive after oviposition. Egg counts of Microsporidia MB-infected and non-infected individuals were used to infer the effects of Microsporidia MB on fecundity. The time to pupation, adult sex ratio …

Companion Crops Alter Olfactory Responses Of The Fall Armyworm (Spodoptera Frugiperda) And Its Larval Endoparasitoid (Cotesia Icipe), Emmanuel Peter, Amanuel Tamiru, Subramanian Sevgan, Thomas Dubois, Segenet Kelemu, Kerstin Kruger, Baldwyn Torto, Abdullahi Yusuf

All Peer-Reviewed Publications

Background: The fall armyworm (FAW), Spodoptera frugiperda, is a devastating invasive pest and a threat to food security in Africa, with yield losses of 20–50%. Recent studies highlighted the importance of cereal crops such as maize and sorghum as the most preferred host plants for FAW oviposition. In the current work, we investigated the olfactory responses of FAW and its key larval endoparasitoid Cotesia icipe to odours from the preferred host (maize) in the presence of six potential companion crops including beans, groundnut, sweet potato, greenleaf- and silverleaf desmodium, and cassava. We hypothesized that odours released by companion crops in …

Isoliensinine From Cissampelos Pariera Rhizomes Exhibits Potential Gametocytocidal And Anti-Malarial Activities Against Plasmodium Falciparum Clinical Isolates, Jackson M. Muema, James M. Mutunga, Meshack A. Obonyo, Merid N. Getahun, Ramadhan S. Mwakubambanya, Hoseah M. Akala, Agnes C. Cheruiyot, Redemptah A. Yeda, Dennis W. Juma, Ben Andagalu, Jaree L. Johnson, Amanda L. Roth, Joel L. Bargul

All Peer-Reviewed Publications

Background: The unmet demand for effective malaria transmission-blocking agents targeting the transmissible stages of Plasmodium necessitates intensive discovery efforts. In this study, a bioactive bisbenzylisoquinoline (BBIQ), isoliensinine, from Cissampelos pariera (Menispermaceae) rhizomes was identified and characterized for its anti-malarial activity. Methods: Malaria SYBR Green I fluorescence assay was performed to evaluate the in vitro antimalarial activity against D6, Dd2, and F32-ART5 clones, and immediate ex vivo (IEV) susceptibility for 10 freshly collected P. falciparum isolates. To determine the speed- and stage-of-action of isoliensinine, an IC50 speed assay and morphological analyses were performed using synchronized Dd2 asexuals. Gametocytocidal activity against two …

Characterization Of Tungiasis Infection And Morbidity Using Thermography In Kenya Revealed Higher Disease Burden During Covid-19 School Closures, Lynne Elson, Abneel K. Matharu, Naomi Riithi, Paul Ouma, Francis Mutebi, Hermann Feldmeier, Jürgen Krücken, Ulrike Fillinger

All Peer-Reviewed Publications

Background: Tungiasis is a neglected tropical skin disease caused by the sand flea Tunga penetrans. Female fleas penetrate the skin, particularly at the feet, and cause severe inflammation. This study aimed to characterize disease burden in two highly affected regions in Kenya, to test the use of thermography to detect tungiasis-associated inflammation and to create a new two-level classification of disease severity suitable for mapping, targeting, and monitoring interventions. Methods: From February 2020 to April 2021, 3532 pupils age 8–14 years were quasi-randomly selected in 35 public primary schools and examined for tungiasis and associated symptoms. Of the infected pupils, …

Case Sampling Vs Universal Review For Evaluating Hospital Postoperative Mortality In Us Surgical Quality Improvement Programs, Vivi W Chen, Alexis P Chidi, Tracey Rosen, Yongquan Dong, Peter A Richardson, Jennifer Kramer, David A Axelrod, Laura A Petersen, Nader N Massarweh

Faculty, Staff and Students Publications

IMPORTANCE: Representative surgical case sampling, rather than universal review, is used by US Department of Veterans Affairs (VA) and private-sector national surgical quality improvement (QI) programs to assess program performance and to inform local QI and performance improvement efforts. However, it is unclear whether case sampling is robust for identifying hospitals with safety or quality concerns.

OBJECTIVE: To evaluate whether the sampling strategy used by several national surgical QI programs provides hospitals with data that are representative of their overall quality and safety, as measured by 30-day mortality.

DESIGN, SETTING, AND PARTICIPANTS: This comparative effectiveness study was a national, hospital-level …