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Using Discrete-Event Simulation To Balance Staff Allocation And Patient Flow Between Clinic And Surgery In A Pediatric Hospital Setting, John Forbus

Theses and Dissertations

We review the problem of a system-level balanced scheduling scenario. A hospital clinic has a queue for patients needing care. After being seen in clinic, many require follow-up surgery, for which they also wait in a queue. The rate-limiting factor is physician availability for both clinic visits and surgical cases. Much existing work has been done to optimize clinic appointments, as well as to optimize surgical appointments. This novel approach models the entire patient journey at the system level, through both clinic and surgery, to optimize the total patient experience. A discrete-event simulation model of the system is built based …

Shea Position Statement On Pandemic Preparedness For Policymakers: Building A Strong And Resilient Healthcare Workforce, Robin L.P. Jump

Faculty Scholarship

Throughout the COVID-19 pandemic, many areas in the United States experienced healthcare personnel (HCP) shortages tied to a variety of factors. Infection prevention programs, in particular, faced increasing workload demands with little opportunity to delegate tasks to others without specific infectious diseases or infection control expertise. Shortages of clinicians providing inpatient care to critically ill patients during the early phase of the pandemic were multifactorial, largely attributed to increasing demands on hospitals to provide care to patients hospitalized with COVID-19 and furloughs.¹ HCP shortages and challenges during later surges, including the Omicron variant-associated surges, were largely attributed to HCP …

Shea Position Statement On Pandemic Preparedness For Policymakers: Introduction And Overview, Robin L.P. Jump

Faculty Scholarship

Throughout history, pandemics and their aftereffects have spurred society to make substantial improvements in healthcare. After the Black Death in 14th century Europe, changes were made to elevate standards of care and nutrition that resulted in improved life expectancy.1 The 1918 influenza pandemic spurred a movement that emphasized public health surveillance and detection of future outbreaks and eventually led to the creation of the World Health Organization Global Influenza Surveillance Network.2 In the present, the COVID-19 pandemic exposed many of the pre-existing problems within the US healthcare system, which included (1) a lack of capacity to manage a large influx …

Client Perspectives On The Development Of A Rapid Prep Initiative At A Sexual Health Center In New Orleans, Louisiana, Aish Lovett, Rose Luder, Rebecca Lillis, Isolde Butler, Julia Siren, Samuel Gomez, Kevin Kamis, Oluyomi Obafemi, Sarah E. Rowan, Stefan Baral, Meredith E. Clement

School of Medicine Faculty Publications

Uptake of PrEP remains suboptimal, especially in the Southern United States. Same-day or “Rapid PrEP Initiatives” (RPIs) in sexual health centers (SHCs) could facilitate access and overcome barriers to PrEP. We studied the adaptation of an RPI from Denver, Colorado to an SHC in New Orleans, Louisiana. Through focus group discussions (FGDs) with local SHC staff and PrEP providers, we developed a preliminary RPI model. In 5 FGDs with SHC clients referred for or taking PrEP, we gathered adaptation recommendations and feedback on model acceptability, feasibility, and utility. Providers and clients voiced unanimous support for the RPI. Clients favored the …

Barriers To And Facilitators Of Paediatric Medical Device Innovation: A Scoping Review Protocol, Lynn Kysh, Grzegorz Zapotoczny, Lisa Manzanete, Megan Carey, Payal Shah, Francesca Joseph, Haley Kempf, Abu Taher Sikder, Julia Finkel, Usha Thekkedath, Kara Toman, Chester J Koh, Kolaleh Eskandanian, Juan Espinoza

Faculty, Staff and Students Publications

INTRODUCTION: The development of paediatric medical devices continues to lag adult medical devices and contributes to issues of inequity, safety, quality and patient outcomes. New legislation and funding mechanisms have been introduced over the past two decades, but the gap remains. Clinical trials have been identified as a pain point, but components of effective clinical research infrastructure are poorly understood. As part of a multimodal research strategy, the Pediatric Device Consortia (PDC) will conduct a scoping review to better understand infrastructural barriers to and facilitators of paediatric medical device clinical research identified in the health sciences literature.

METHODS AND ANALYSIS: …

Qualitative Risk Analysis On Likelihood Of Foot And Mouth Disease (Fmd) Reintroduction In The Philippines Through The Importation Of Dairy Cattle From Fmd-Free Zones With Vaccination In Brazil, Emerson P. Tapdasan, Kenny Oriel A. Olana

The Thai Journal of Veterinary Medicine

The potential of Girolando cattle from Brazil has generated much interest in the Philippines and the possibility of their importation to contribute to the latter’s dairy industry development has been raised. The most crucial issue that needs to be addressed is the probable introduction of exotic livestock diseases or pathogens of different strains like Foot-and-Mouth Disease virus (FMDv) which might destroy the Philippines’ livestock industry. This study involved only the work required to conduct a preliminary qualitative risk analysis (RA) on the likelihood of FMDv being reintroduced into the Philippines through the importation of Girolando cattle from FMD-free zones with …

Effectiveness Of Empiric Carbapenem Versus Non-Carbapenem Therapy For Extended-Spectrum Β-Lactamase Producing Enterobacterales Infections In Non-Intensive Care Unit Patients: A Real-World Investigation In A Hospital With High-Prevalence Of Extended-Spectrum Β-Lactamase Producing Enterobacterales, Amy Y. Kang, Mary Elkomos, Danny Pham, Michelle Guerrero, Deborah Kupferwasser, Loren G. Miller

Pharmacy Faculty Articles and Research

Objective:

To investigate whether empiric carbapenem therapy, compared to empiric non-carbapenem therapy, was associated with improved clinical outcomes among hospitalized, non-intensive care unit (ICU) patients with extended-spectrum β-lactamase (ESBL)-producing Enterobacterales infections.

Methods:

We performed a retrospective cohort study of adult, non-ICU patients admitted with ESBL-producing Enterobacterales infections. Primary outcome was time to clinical stability from the first empiric antibiotic dose. Secondary outcomes were early clinical response and 30-day all-cause hospital readmission. We used multivariate regression methods to examine time to clinical stability.

Results:

Of the 142 patients, 59 (42%) received empiric carbapenems and 83 (58%) received empiric …

Implications Of The Covid-19 Pandemic On The Management Of Municipal Solid Waste And Medical Waste: A Comparative Review Of Selected Countries, Ahmed Osama Daoud Dr., Hoda Elattar Eng., Gaber Abdelatif Eng., Karim M. Morsy, Robert W. Peters, Mohamed K. Mostafa Dr.

Civil Engineering

No abstract provided.

A One Health Approach To Enhancing Sars-Cov-2 Surveillance, Lauren C. Cybulska

Dissertations and Theses

Background

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the virus that causes coronavirus disease-2019 (COVID-19) in humans, can also infect domestic dogs (Canis lupus familiaris) and cats (Felis catus). Susceptibility and viral transmissibility in these species are concerns for public health due to the spillover risk to humans or other animals. This dissertation uses a One Health framework to explore key issues on this topic. We aim to identify gaps in understanding of SARS-CoV-2 in companion animals and investigate novel surveillance methods through human, animal, and environmental health perspectives.

Methods

Paper 1 provides an in-depth exploration of …

Characterizing The Role Of The Complement Receptor C3ar In Regulating Inflammatory Responses And Mitochondrial Function In Activated Macrophages, Jesse Alan Corcoran

Dissertations and Theses

The complement system is an integral part of the innate immune response, and consists of a series of proteins that are mostly (although not exclusively) synthesized in the liver that circulate in the plasma as inactive precursors, as well as receptors on the surface of immune cells. In immune cells such as macrophages, recognition of pathogens by Toll-like receptors (TLRs) leads to the initiation of inflammation and triggers complement activation through a coordinated sequential enzyme cascade that results in the production of bioactive C3a, which interacts with membrane-bound receptor C3aR to regulate innate immune cell function and outcome of bacterial …

Perception Of Pre-Existing Dm2 Management Among Pregnant Asian Indian Immigrants During Covid-19, Sanya Bedi Grewal

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a chronic disease that exerts a significant burden among communities by increasing healthcare costs, reducing productivity, higher rates for premature mortality, and tangible socioeconomic burden, which overall reduces the quality of life. The purpose of the study was to explore the perception of pregnant Asian Indian immigrants regarding diabetes self-management strategies during the COVID-19 pandemic. Five women were recruited via purposive sampling from Facebook groups. Data were collected via individual interviews using Facebook groups. The health belief model was used to help understand and interpret the findings. Clarke and Braun’s thematic analysis method was used to …

Impact Of Telehealth On Type 2 Diabetes Self-Management During The Covid-19 Pandemic, Nancy Olivo Marshall

Walden Dissertations and Doctoral Studies

The incidence of Type 2 diabetes mellitus (T2DM) is on the rise, particularly among adults aged 18 years and older. Glycosylated hemoglobin (HbA1c) levels are commonly used by healthcare professionals to assess glucose variability; fluctuations are associated with an increased risk of adverse effects. The COVID-19 pandemic highlighted the importance of self-directed management of HbA1c levels through telehealth. The purpose of this retrospective quantitative study was to investigate the effectiveness of self-directed management of HbA1c levels using telehealth among T2DM diagnosed adults at a community health service organization in the northeastern U.S. from December 2018 to 2022. Using multivariate regression …

Perception Of Pre-Existing Dm2 Management Among Pregnant Asian Indian Immigrants During Covid-19, Sanya Bedi Grewal

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a chronic disease that exerts a significant burden among communities by increasing healthcare costs, reducing productivity, higher rates for premature mortality, and tangible socioeconomic burden, which overall reduces the quality of life. The purpose of the study was to explore the perception of pregnant Asian Indian immigrants regarding diabetes self-management strategies during the COVID-19 pandemic. Five women were recruited via purposive sampling from Facebook groups. Data were collected via individual interviews using Facebook groups. The health belief model was used to help understand and interpret the findings. Clarke and Braun’s thematic analysis method was used to …

The Role Of Micrornas In Lung Inflammation After Alcohol And Burn Injury, Connor O'Neal Guzior

Master's Theses

Acute lung injury (ALI) and the subsequent development of acute respiratory distress syndrome (ARDS) are among the leading causes of post-burn morbidity and mortality. MiRNAs are small non-coding RNA molecules that are known to regulate gene expression and help regulate lung homeostasis. In this study, we profiled four anti-inflammatory miRNAs (miR-146a, miR-150, miR-194, and miR-671) in lung tissue following an alcohol and burn injury. We found that miR-146a and miR-671 were significantly downregulated in lungs one day after combined injury, leading to increased lung inflammation and pathology. Biological sex did not have an effect on this pathophysiological process. We also …

Understanding The Relationship Between [Atp], Growth Rate, And Inoculum Effect In Β-Lactamase Producing Bacteria, Ariane R. Kalifa

All HCAS Student Capstones, Theses, and Dissertations

2.8 million Americans are infected with antibiotic-resistant bacteria on an annual basis, leading to increased mortality and morbidity. With the incidence of infection due to antibiotic-resistant bacteria on the rise, it is critical to understand the mechanisms bacteria use to resist antibiotics. The inoculum effect (IE) is a phenomenon that has been observed for many antibiotics and bacterial species. In IE, the density of the bacterial population determines the minimum inhibitory concentration of the antibiotic (MIC) of an antibiotic; as the density of the bacterial population increases, the MIC increases. IE is highly prevalent in bacteria that express β-lactamases where …

Twelve Years Of Drug Prioritization To Help Accelerate Disease Modification Trials In Parkinson’S Disease: The International Linked Clinical Trials Initiative, Camille Carroll

Peninsula Medical School

In 2011, the UK medical research charity Cure Parkinson’s set up the international Linked Clinical Trials (iLCT) committee to help expedite the clinical testing of potentially disease modifying therapies for Parkinson’s disease (PD). The first committee meeting was held at the Van Andel Institute in Grand Rapids, Michigan in 2012. This group of PD experts has subsequently met annually to assess and prioritize agents that may slow the progression of this neurodegenerative condition, using a systematic approach based on preclinical, epidemiological and, where possible, clinical data. Over the last 12 years, 171 unique agents have been evaluated by the iLCT …

Infusion Pump Mobile Application Biomedical Engineering Capstone Project, Leah Smith, Dhruv Patel, Lauren David, Esther Wayntraub, Zhiyin Wu

Undergraduate Research and Engagement Symposium

This project, sponsored by Baxter Healthcare, focuses on developing a user-friendly mobile application for the management of an infusion pump. Aimed at improving patient safety, minimizing manual data entry, and enhancing the overall convenience for healthcare providers, the application features key functionalities such as patient verification, barcode integration, and delivery confirmation. The system facilitates remote monitoring and programming of an infusion pump, offering a seamless integration with existing healthcare protocols and systems, thereby improving the efficacy and safety of medication delivery in clinical settings.

Visionarium, June 2024, Full Issue

International Journal of Emerging and Disruptive Innovation in Education : VISIONARIUM

No abstract provided.

Medmicromaps, A Novel Decision-Tree Guide For Infectious Diseases Differential Diagnoses, And Evaluation Of Pre- And Post-Pandemic User Engagement By Preclinical Medical Students, Jason Ceballos, Tavsimran Luthra, Lucia Garces-Torres, Valerie Lentz, Jack Nelson, Claudia Carceles-Roman, Ian Holyoak, Jane Harrington

International Journal of Emerging and Disruptive Innovation in Education : VISIONARIUM

Background: Medical education has undergone major changes in the past 5 years to adapt to the digital-centered student population with diverse learning preferences. To address the challenges of shifting delivery modalities, multimedia resources were created to provide interactive e-learning material on infectious diseases for year 2 medical students.

Methods: Medical students at a USA-accredited Caribbean medical school were provided with supplemental e-learning materials including animations, illustrations, diagnostic algorithms aka MedMicroMaps, and Case-Based tutorials. Participants were classified by semester and lecture delivery: In-person: Cohort 1 (n=526); Virtual: Cohort 2 (n=651); and Hybrid: Cohort 3 ( …

Forward

International Journal of Emerging and Disruptive Innovation in Education : VISIONARIUM

No abstract provided.

Development Of Next Generation Phage Applications Using -Omics And Machine Learning, Lauren Novak, Kari Clase

The Proceedings of the BIRS Community

Phages are viruses that infect bacteria and use their host machinery to replicate. They are one of the most ubiquitous and diverse biological entities in the biosphere with a long evolutionary history. There is renewed interest in phage therapeutics due to increased levels of antimicrobial resistance (AMR) and decreased numbers of newly developed antibiotics. Phages also have applications in food safety, water quality, biocontrol, vaccines, and the global nutrient cycle. Both bacteria and phages employ internal and external self-defense strategies to outcompete one another which in turn drives genomic evolution. While many phage genomes have been sequenced and annotated, proteomic …

Improving Market Access With A Lean Approach To Quality, Bri'an Bigirwa, Zita Ekeocha, Stephen Byrn, Kari Clase

The Proceedings of the BIRS Community

The veterinary vaccine market in Africa is forecasted to grow at a compound annual growth rate (CAGR) of 13-15%, compared to the US at 4-6% and Europe at 5-7%. In Uganda, and its neighboring countries, the livestock sector is expected to grow significantly over the next few years. BRENTEC is a young start-up company that is keen to enter this growing market. To be competitive in this market, the company has to invest in robust quality systems that enable the manufacturing of high-quality products while keeping production costs low. This has not been the case with the launch of its …

Health On The Move: The Impact Of Migration On Communicable Respiratory And Vaccine Preventable Diseases In Thailand, Attasuda Lerskullawat, Thitima Puttitanun

Journal of Health Research

Background: Given the potential impact of migrants on the spread of communicable diseases, this paper delves into the relationship between migrants and communicable respiratory and vaccine-preventable diseases.

Method: A spatial panel autoregressive model is applied on the provincial level data in Thailand from the period 2016 to 2021.

Results: The results show that the impact of migrants on communicable diseases in the country varies depending on the type of disease. While an increase in migrant numbers is associated with a higher incidence of influenza, the prevalence of hepatitis B is reduced. Additionally, other socio-economic factors, such as GPP per capita, …

Targeting Cancers With Ohsv-Based Oncolytic Viral Immunotherapy, Rakin Tammam Nasar, Ifeanyi Kingsley Uche, Konstantin G. Kousoulas

School of Medicine Faculty Publications

The recent success of cancer immunotherapies, such as immune checkpoint inhibitor (ICIs), monoclonal antibodies (mAbs), cancer vaccines, and adoptive cellular therapies (ACTs), has revolutionized traditional cancer treatment. However, these immunotherapeutic modalities have variable efficacies, and many of them exhibit adverse effects. Oncolytic viral Immunotherapy (OViT), whereby viruses are used to directly or indirectly induce anti-cancer immune responses, is emerging as a novel immunotherapy for treating patients with different types of cancer. The herpes simplex virus type-1 (HSV-1) possesses many characteristics that inform its use as an effective OViT agents and remains a leading candidate. Its recent clinical success resulted in …

Secure Messaging And Telephone Use For Clinician-To-Clinician Communication, Sunny S Lou, Daphne Lew, Laura R Baratta, Elise Eiden, Christine A Sinsky, Thomas Kannampallil

2020-Current year OA Pubs

No abstract provided.

Polyvalent Bacterial Lysate With Potential Use To Treatment And Control Of Recurrent Urinary Tract Infections, Salvador Eduardo Acevedo-Monroy, Luz María Rocha-Ramírez, Daniel Martínez Gómez, Francisco Javier Basurto-Alcántara, Óscar Medina-Contreras, Ulises Hernández-Chiñas, Maria Alejandra Quinones Peña, Daniela Itzel García-Sosa, José Ramírez-Lezama, José Alejandro Rodríguez-García

Health & Biomedical Sciences Faculty Publications

Overuse of antimicrobials has greatly contributed to the increase in the emergence of multidrug-resistant bacteria, a situation that hinders the control and treatment of infectious diseases. This is the case with urinary tract infections (UTIs), which represent a substantial percentage of worldwide public health problems, thus the need to look for alternatives for their control and treatment. Previous studies have shown the usefulness of autologous bacterial lysates as an alternative for the treatment and control of UTIs. However, a limitation is the high cost of producing individual immunogens. At the same time, an important aspect of vaccines is their immunogenic …

Embodying Whole Community Preparedness: A Case Study Of Student-Facing Preparedness Initiatives At Institutions Of Higher Education In The State Of Oregon, Francis Pastorelle

Dissertations and Theses

Over the last two decades, there has been a dramatic increase in natural and manmade disasters. While no community is immune to the risks posed by these large-scale emergencies, colleges, and universities, which are home to numerous vulnerable populations, could be counted among those most at risk. In their current state of overall community preparedness, campuses are not equipped to weather impending dangers; consequently, the impact on students could be disastrous. This study examined preparedness practices at Oregon colleges and universities to better understand how institutions of higher education in the state prepare their students for large-scale emergencies, what challenges …

Judicial Review Of Government Pandemic Responses: Emerging Basic Lines In The Federal Administrative Court's First Judgments, Ferdinand Wollenschläger

Georgia Law Review

This Article analyzes the first rulings of the highest administrative court in Germany regarding measures aimed at curbing the COVID-19 pandemic. It outlines the architecture of fighting the pandemic, its relevance for judicial protection, and the basic lines of the court’s rulings. It also critically evaluates key issues such as: dealing with pandemic situations as a challenge for the separation of powers and judicial review, proportionality, the significance of expert knowledge, and the need for fundamental rights protection via procedures.

The Israeli High Court Of Justice During The Covid-19 Crisis: The Model Of Continuous Judicial Review, Yoav Dotan

Georgia Law Review

In this Article, I seek to review the reaction of the Israeli High Court of Justice (HCJ) to the social and political pressures created by the spread of the virus in Israel amidst a constitutional crisis that Israel went through during 2020- 2021. The HCJ is regarded by many as a strong and interventionist judicial institution. Often, critics argue that the degree of supervision exerted by the HCJ over both the Israeli bureaucracy and the political branches goes way beyond the traditional role of the judiciary, as envisioned by theorists of judicial review. My aim is to use this analysis …

Legal Accountability And Judicial Review During The Covid-19 Pandemic In Aotearoa New Zealand, Dean Knight

Georgia Law Review

The government in Aotearoa New Zealand, like other governments elsewhere, exercised significant and unprecedented power during the COVID-19 pandemic in order to combat the virus and to protect its people. The breadth and depth of the public health response also caused monumental interference in people’s lives. This Article discusses the way judicial review of administrative action was used to hold the government accountable in law for its public health response and provided an avenue for people to pursue grievances. The key phases of the public health response are described, and the types of power exercised are identified. The nature and …