Digital Commons Network^™

Statistical Analysis Of Biomedical Data With Measurements Subject To Below The Limit Of Detection, Clifford James Crafford

Electronic Theses and Dissertations Archive

Epidemiology has become increasingly concerned with measurements subject to detection limits, by which, values below this limit become left-censored. Traditional methods for handling such approaches have been found to be effective, provided necessary assumptions and conditions are met for the methods to work appropriately. However, when such conditions fail to be met or assumptions are incorrect, the effect this has on the method’s performance becomes serious. One such method is multiple imputation, which relies on assuming the distribution of the measurements when imputing quantities below the level of detection. As the reliance on the assumption can prove very strong in …

Aga Khan University

University press releases and calendars

No abstract provided.

Pakistan: Bringing The Nursing Profession Back To Health

University press releases and calendars

No abstract provided.

Nursing In Pakistan

University press releases and calendars

No abstract provided.

Partnership, Collaboration, And Co-Production To Improve Patient Experience Beyond Conducting Surveys – Lessons From The Quebec Model, Canada, Marie-Pascale Pomey, Catherine Wilhelmy, Myriam Fournier-Tombs, Vincent Dumez, Cécile Vialaron, Monica Nelea Iliescu, Karina Prevost, Simon Courtemanche, Louise Normandin, Geneviève David

Patient Experience Journal

Objective: The objectives of this article are to present how, in the province of Quebec (Canada), healthcare and service partnerships have been implemented, to take stock of the current situation and to suggest ways to continue strengthening the model over the coming years, in Quebec and elsewhere in the world. Methods: Three methods were mobilized: (1) a review of the literature and reports published in recent years on implementations of partnerships in Quebec; (2) a survey sent to the persons responsible for partnerships in Quebec’s health and social services establishments; and (3) a working committee comprised of patient experts, partnership …

Peer Mentoring, Camaraderie, And Support (Pmcs) Of Southern New Jersey: Suicide Prevention Using Human Experience And Social Determinants Of Health, Ali A. Poorani, Matthew Jacobs, Patrick Carney, Jaclyn Tomasetti

Patient Experience Journal

Suicide prevention is a high priority for Veterans Health Administration (VHA). Recent data show an increase in suicide rates, especially among Veterans that had not used VHA health services and nor had received any VHA benefits. Meanwhile, data collected for the past two decades reveals a decline in suicide rates among Veterans who were recent VHA users with mental health or substance use disorders. The objective of the Peer Mentoring, Camaraderie, and Support (PMCS) Program was to explore novel ways to reengage and reintegrate Veterans into their earned VA healthcare benefits, and examine the effectiveness of this new initiative by …

“All Together”: A Case Study Demystifying Patient And Public Involvement (Ppi) In Brief Psychological Interventions Within A Community Mental Health Service For Adults In The Uk, Molly H. Nadel, Katherine Parkin, Stephanie Casey, Rachel Maciag, Alice Xie, Mu-Yin Chang, Youngsuk Kim

Patient Experience Journal

The importance and value of involving patients and the public in the decision-making processes within services designed to support them, and research projects aimed at understanding and improving those services, have long been established. This is often referred to as Patient and Public Involvement (PPI). However, establishing good quality involvement work in practical terms is often less well understood and therefore, the uncertainty surrounding this can lead to hesitation by clinicians in practice. In this paper, we will share our lessons learned and the practical outcomes of PPI when applied in an NHS community mental health service for adults. We …

The Implementation Of A Telehealth Patient Advisory Council In A Network Of Federally Qualified Health Centers, Jessica Korins, Lisa Schaffer, Nandini Shroff

Patient Experience Journal

Patient input is recognized across the healthcare field as essential for tailoring innovations and quality improvement initiatives to meet the needs of intended patient populations. This paper describes the implementation of a patient advisory council (PAC) established to provide feedback on telehealth innovations and quality improvement initiatives at a network of federally qualified health centers (FQHCs) in New York State (NYS). We report on the implementation process, success and challenges, and reflections shared by PAC members regarding their experiences.

Understanding Online Reviews Of Geriatricians: Correlations Within A Dataset Of 53,210 Physician Reviews, Yizhong Wu, Eric Reuben Smith, Nick Shaffer, Hanh Dieu Trinh, Becky Powers

Patient Experience Journal

Introduction: Online reviews are increasingly influential in how patients find and choose physicians. Patients appreciate the transparency of online reviews, and they offer an avenue for physicians to receive feedback. This cross-sectional study aims to provide insight into correlations between provider level information such as wait times or physician demographics, and the reviews patients submit online for geriatricians.

Methods: ParseHub software was used to extract and pool data from 6,631 provider profiles categorized under “geriatric medicine” on the popular open-source physician review website Healthgrades.com. Physician race or ethnicity was modeled by profile last name based on 2010 US census data. …

Family-Centered Care In Pediatric And Neonatal Intensive Care Units: A Systematic Review Of Effects On Parental Satisfaction And Length Of Stay, Vincenzo Andretta, Valentina Cerrone, Veronica Strini, Angela Prendin

Patient Experience Journal

Background: Family-centered care (FCC) is essential in pediatric and neonatal intensive care units (PICUs), potentially increasing parent satisfaction and reducing length of hospital stay, but evidence of its effectiveness is inconsistent. Objective: To assess the effects of FCC interventions on parent satisfaction and length of hospital stay in PICUs. Methods: A systematic review was conducted, with 17 studies meeting the established inclusion criteria. The McMaster tool was used to assess the methodological quality of studies, along with an assessment of risk of bias. Results: The review identified a wide range of FCC interventions, including promoting parental …

I Felt More Confident That It Would Work For Me: A Grounded Theory Of Person-Centered Interprofessional Collaboration Based On Patients’ Lived Experiences, Katherine Hope Morgan, Cristina S. Barroso, Kathleen Conroy Brown, Michael R. Bleich, Soghra Jarvandi, Elizabeth B. Strand, Shaun Rowe

Patient Experience Journal

Interprofessional collaboration (IPC) is considered the highest standard of practice for delivering care to patients with multiple, complex, and chronic conditions. Despite reported benefits of IPC, the voice of the care receiver and how or whether they experience IPC is underexplored. Our objective was to examine patients’ experiences with IPC in two rural primary care settings in the U.S., where the burden of multiple chronic conditions (MCCs) is coupled with lower life expectancies and reduced access to care. We used a semi-structured interview to assess patients’ experiences within 72 hours after an IPC healthcare visit. This study, conducted in two …

Role Of Patient-Reported Measures (Prms) In Addressing Ethical Challenges During Telemedicine Consultation: A Narrative Review, Asiya Attar, Kasturi Shukla

Patient Experience Journal

Introduction: Telemedicine has revolutionized medical care delivery by emphasizing on Patient-Centred Care (PCC). Patient Reported Measures (PRMs) can assist in providing PCC since it assesses the treatment outcomes and patient experience. However, using PRMs is not just limited to gauging clinical efficiency; it can also play a role in addressing the ethical challenges in telemedicine. Yet this aspect of PRMs remains underexplored. Method: Literature search was conducted using a combination of keywords from the Google Scholar, Scopus, and Web of Science databases. 126 peer-reviewed journal articles in English from 2015 to 2024 were screened, and 34 relevant full-text …

Understanding Patient Experiences: A Qualitative Study On Communication And Cultural Competence In Multiple Sclerosis Care, Vaishnavi Sridharan, Charee Thompson, Rola Mahmoud, Minnatallah N. E. Eltinay, Chungyi Chiu

Patient Experience Journal

Objective: Effective communication is crucial in multiple sclerosis (MS) care, influencing patient satisfaction, self-management, and health outcomes. This study explores the experiences of people with MS (PwMS) regarding communication with healthcare providers and between providers within healthcare systems. Methods: This qualitative study analyzed open-ended responses from 590 participants in a national cross-sectional survey. Thematic content analysis was conducted to explore MS patients’ experiences with healthcare communication and care delivery. Results: Three major themes emerged: (1) Patient-provider communication, where 62.9% of participants reported positive experiences, citing responsiveness and empathy, while 37.1% noted issues such as inattentiveness and rushed consultations. (2) …

“Why Should Anyone Want To Make Things Better For Me Particularly?” – A Qualitative Exploration Of Care Opinion And Nhs Care Improvements, Emma Berry, Zoe Skea, Marion K. Campbell, Louise Locock

Patient Experience Journal

Care Opinion is an online platform which enables people to share anonymous feedback (known as “stories”) about their experiences of UK healthcare. In Scotland, this platform has official government backing, though healthcare organisations are not obliged to use it. Care Opinion staff review and edit these stories, acting as moderators. Healthcare staff are invited to respond to stories and are encouraged to use it for healthcare improvement. However, the number of changes made and registered on the platform is relatively small. This paper brings together findings from interviews with story authors (those sharing experiences), NHS staff and Care Opinion moderators …

Psychosocial Dimensions Of Living With Hep B: Notes From The Field: The Lived Experience Of A Mother Raising A Daughter With Hepatitis B, Julie Gerhardt

Patient Experience Journal

What follows is based on the interweaving of three points of view each of which contributes to an understanding of the experience of living with Hepatitis B: (i) as the mother of a daughter who was diagnosed with HBV at 5 months and who still, at age 22, carries traces of the surface antigen in her blood; (ii) as a participant in the Hepatitis B Foundation’s (HBF) “Storytellers” program in which those impacted by the disease meet with others to share experiences and narrate a short video posted on the HBF website; and (iii) as a PhD research psychologist-turned-psychoanalyst interested …

My Husband Didn’T Have To Die: A Doctor Reflects On All That Went Wrong With Her Husband’S Care In One Of The Nation’S Top Medical Centers, Joanna A. Cooper

Patient Experience Journal

The outcomes of complex care are never predictable. Despite this, reflecting on my husband’s care and his untimely death, I am certain that his fate would have been different with better communication, attention to detail, collaboration, and measures of curiosity, humility, and compassion.

Holding Space: An Effective Intervention For When Hope Wanes, Annette Lane, Marlette Reed, Rose Schroeder

Patient Experience Journal

Holding space is a person-centered, non-judgmental approach to working with clients. This approach goes beyond listening to client concerns; it entails deep listening and being present, developing trust with clients, and helping them connect goals with values. Within this brief account, the concept of holding space is described. What it is and is not is explained. Examples of holding space are woven throughout in order illustrate this concept. Finally, implications for professionals are provided.

The Art Of Diagnosis: How To Actively Participate In Your Healthcare, Vladislav Ilin, Daniel J. Morgan, Brad Peckler

Patient Experience Journal

Diagnosing illness is one of the most complex and error-prone aspects of healthcare, yet patients are rarely equipped with the knowledge or tools to engage in the process actively. This article demystifies diagnosis by explaining how doctors formulate differential diagnoses, the limitations of medical testing, and the cognitive and systemic factors that contribute to diagnostic errors. Drawing on real-world examples, the article highlights the crucial role of clear communication and collaborative decision-making between patients and clinicians. It offers practical, evidence-based strategies for patients to prepare for consultations, communicate their symptoms effectively, and ask key questions that promote accurate diagnosis. By …

Taking Time And Making Space For Patient And Caregiver Partners, R. Hamilton, L. Hives

Patient Experience Journal

Patient and caregiver engagement is a paramount element to ensure the voice of lived experience is integrated and prioritized in research. However, what it looks like to actually participate in authentic patient and caregiver engagement can be challenging without understanding the experience of our patient and caregiver partners. I had the honour of interviewing a patient and caregiver partner who bestowed rich guidance about what it means to deliver excellent patient and caregiver engagement in research. Themes of the interview included taking time to collaborate, being mindful and giving gratitude, actively listening to partner voices, leading alongside patient and caregiver …

From Fear To Hope: How Communication Transformed Our Pregnancy Journey A Personal Narrative On The Critical Role Of Healthcare Communication In Patient Experience, Valan. P, Pulidindi Venugopal

Patient Experience Journal

This article emphasises the transformative potential of compassionate healthcare communication, particularly in the context of pregnancy loss. This personal narrative illustrates how varying communication approaches can significantly alter patient experiences, transforming anxiety-laden medical encounters into empowering partnerships with healthcare providers. A ten-month journey through pregnancy after a devastating miscarriage revealed the profound impact of communication quality on both clinical outcomes and emotional healing. The narrative contrasts three distinct communication environments: dismissive administrative systems that induce unnecessary stress, insensitive support staff during vulnerable moments, and a physician whose empathetic approach fundamentally transforms the entire pregnancy experience. Through a detailed examination of …

Why We Need A Patient-Centered Innovation Renaissance: A Horizontal And Vertical Integration Of Knowledge To Transform Care Pathways, Pieter Vandekerckhove, Benjamin H.L Harris, Louis J. Koizia, Ashok Handa, Chris Brainard, Steven Howard

Patient Experience Journal

We are at a pivotal moment. The future of healthcare innovation can no longer be defined solely by technological advancement or institutional efficiency. While digital tools, therapies and platforms continue to evolve, they must be embedded within a broader transformation, one that places the human experience at the centre of how we design, deliver and evaluate care. This patient-centred renaissance calls for the integration of both horizontal and vertical forms of knowledge: connecting services across the care continuum. From the literature and our experience, an unexpected byproduct of co-production with patients in health innovation and care delivery is a reduction …

“Those Boxes Do Not Hold Me”: Using Narrative Health Experiences Research To Learn From Patients And Care Partners Beyond Surveys, Rachel Grob, Barbara Warren, Erika Cottrell, Njeri Grevious, Sara Knight, Mark Schlesinger, Kate Clegg Smith, Nancy Pandhi

Patient Experience Journal

Stories are fundamental to how we understand individual beliefs and experiences, as well as collective mindsets and institutional practices. Volunteered narratives are abundant, especially on the interweb. We in the health experiences research community, however, are challenged to develop effective, equitable approaches to moving beyond surveys by hearing and responding to not just dominant voices, but also those whom research has historically ignored, silenced, or objectified. In this commentary, we describe one such approach: the Database of Individual Patient Experiences (DIPEx) methodology as adapted by the Health Experiences Research Network (HERN) for use in the U.S. context since 2015. We …

Mastering The Art Of Listening: The Human Experience Superpower, Jason A. Wolf

Patient Experience Journal

As human beings we do not live in isolation. Our existence is framed in the context of others. We are a part of families and teams, communities and countries; all which provide us with ideas and information, most delivered through the interactions we have with others. The very definition of experience itself conveys this as it opens with the words, “the sum of all interactions.”¹ Every experience that we have is impacted by interactions with others. This give and take of connection is the breath of our humanity. Through it we transfer thoughts and beliefs, words and emotions. Moments …

More, Better Nurses

University press releases and calendars

No abstract provided.

Paediatric Fixed Drug Eruption: A Case Report Of Ofloxacin As The Culprit, Ambika Nand Jha, Varsha Ratan Gaikwad, Rabia Alam, Shivanshu Sharma, Ashok Kumar Gupta

Chulalongkorn Medical Journal

Ofloxacin, a second-generation fluoroquinolone, is a relatively rare but documented cause of fixed drug eruption (FDE), a localized cutaneous hypersensitivity reaction marked by recurrent, well-demarcated erythematous patches or macules that may develop into blisters upon re-exposure to the offending agent. The underlying mechanism is immune-mediated, involving T-cell activation, cytokine release, and keratinocyte apoptosis. A 5-year-old boy weighing 15 kg was prescribed Ofloxacin syrup (7.5 ml twice daily) and Paracetamol suspension (5 ml twice daily) for suspected enteric fever. Within two days, he developed several annular erythematous lesions on his hands and back, associated with intense itching, raising suspicion of a …

Neutrophil-To-Lymphocyte, Monocyte-To-Lymphocyte, And Platelet-To-Lymphocyte Ratio In Acute Hospitalized Patients With Schizophrenia, Apichan Dangrungroj, Mayteewat Chiddaycha

Chulalongkorn Medical Journal

Background: Schizophrenia has been increasingly linked to inflammation. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) have emerged as potential indicators of systemic inflammation.

Objectives: The objectives are to compare NLR, MLR, and PLR between patients with schizophrenia and healthy controls, and to investigate the factors associated with NLR. Methods: This retrospective study included 102 sex- and age-matched patients hospitalized with schizophrenia and control subjects. NLR, MLR, and PLR were calculated from the Complete Blood Count (CBC) results and compared between groups. Sociodemographic data and clinical characteristics were analyzed using multiple linear regression to identify …

Comparison Of Blood And Urinary Ketamine Profiles Among Different Causes Of Death In Thai Postmortem Cases, Supanida Leungsukjaroen, Sunitda Khawthong, Peerayuht Phuangphung

Chulalongkorn Medical Journal

Background: Ketamine is a substance that is commonly abused, especially in young adults. Blood and urinary ketamine profiles are important for the interpretation of causes of death. Objective: To compare blood and urinary ketamine profiles between different causes of death in Thai postmortem cases.

Methods: A cross-sectional study was conducted in 40 Thai postmortem cases whose urine samples tested positive for ketamine. Sex, age, cause of death, manner of death, blood alcohol concentration (BAC), and concomitant drugs found with ketamine in subjects were recorded for each case. Blood and urinary ketamine and its two metabolites (norketamine and dehydronorketamine …

The Comparison Of Lung Shunt Fraction Calculation Using Tc-99m Maa Planar And Spect/Ct Imaging For Y-90 Radioembolization, Nut Noipinit, Thunyaluk Sawatnatee, Benchamat Phromphao, Peangtawan Ratsameechot, Sutida Thiambandit, Tanawat Sontrapornpol

Chulalongkorn Medical Journal

Background: The evaluation of hepatopulmonary blood vessels with Technetium-99m macroaggregated albumin (Tc-99m MAA) scintigraphy before radioembolization with Yttrium-90 (Y-90) microspheres is a test to assess and prevent radiation pneumonitis. It was determined by the lung shunt fraction (LSF) which was calculated from a planar and SPECT/CT images. This study aimed to compare of LSF calculation from Tc-99m MAA planar and SPECT/CT images for Y-90 radioembolization treatment of liver tumors. Methods: A total of 64 patients (42 men and 22 women, mean age 64 ± 12.5 years) who underwent Tc-99m MAA scanning between 2015 and 2022 were enrolled. LSF was calculated …

Prevalence Of Carbapenem-Resistant Klebsiella Pneumoniae In King Chulalongkorn Memorial Hospital, 2019-2023, Napawan Punakabutra, Thanittha Wongkejkit, Nopphon Wuthinantiwong, Tanittha Chatsuwan

Chulalongkorn Medical Journal

Background : Carbapenem-resistant Klebsiella pneumoniae(CR-KP) poses a significant threat to global public health, contributing to high rates of morbidity and mortality.

Objective : The aim of this study was to investigate the prevalence of CR-KP isolated at King Chulalongkorn Memorial Hospital from April 2019 to December 2023, focusing on its distribution across varoius hospital units, including in-patient (IPD), out-patient (OPD), emergency (ER), and intensive care units(ICU).

Methods : A total of 8,983 K. pneumoniae isolates from patients aged > 15 years at King Chulalongkorn Memorial Hospital between April 2019 and December 2023 were studied. The antimicrobial susceptibility to carbapenems was …

Dual Role Of Triphala Extracts In Breast Cancer Therapy: Enhanced Paclitaxel Cytotoxicity By Ethanolic Extract And Cytoprotection By Aqueous Extract, Supamas Charucharana, Poonlarp Cheepsunthorn Ph.D., Chalisa L. Cheepsunthorn Ph.D.

Chulalongkorn Medical Journal

Background: Combining antioxidants with chemotherapy is an emerging strategy to reduce chemotoxicity in normal cells. Triphala (TPL), a polyphenol-rich Thai herbal formulation, has shown promise in enhancing chemotherapy efficacy, but its interaction with paclitaxel (PX) in breast cancer treatment remains underexplored.

Objective: This study evaluates the effects of aqueous (TPL-w) and ethanolic (TPL-a) TPL extracts combined with low-dose PX on breast cancer cells and non-tumorigenic mammary epithelial cells.

Methods: The bioactive components of TPL-w and TPL-a were identified using high-performance liquid chromatography (HPLC). Thiazolyl blue tetrazolium bromide (MTT) and chloromethyl 2′,7′-dichlorodihydrofluorescein diacetate (CM-H₂DCFDA) assays assessed cell viability and …