Medicine and Health Sciences Commons^™

Predictive Factors Of Success In The First Radioactive Iodine Treatment For Graves’ Disease, Pinyaporn On-Ekkasit

Chulalongkorn Medical Journal

Background: Initial treatment options for Graves’ disease are radioactive iodine (RAI) treatment, antithyroid drugs (ATDs), and surgery. RAI is effective and the definitive treatment for Graves’ disease.

Objective: To evaluate factors associated with success in the first RAI treatment for Graves’ disease.

Methods: A total of 89 patients who received the first RAI treatment for Graves’ disease between September 2016 and January 2021 were retrospectively reviewed. Thyroid function outcome was evaluated within one year after RAI treatment. Logistic regression analysis was performed to identify factors associated with success after RAI treatment.

Results: The success rate of the first RAI treatment …

The Effectiveness Of A Multimodal Preoperative Anxiety Intervention On Postanesthetic Emergence Delirium In Preschoolers, Thitima Veeraburus

Chulalongkorn Medical Journal

Background: Preoperative anxiety has been reported as one of the major contributors to emergence delirium (ED) in preschoolers.

Objective: This study investigated the effectiveness of multimodal preoperative anxiety intervention (MPreop-AI) in reducing the incidence and severity of ED in preschoolers.

Methods: A prospective study, posttest only nonequivalent groups design, was conducted in 44 children aged 2 - 6 years scheduled for tonsillectomy and/or adenoidectomy under sevoflurane anesthesia. They were equally allocated into two groups. The usual preoperative preparation group (control group) received narrative preoperative education, parental presence, and self-selected toy. The MPreop-AI group received 2-Dimensional (2D) animation modeling-based information, an …

Racial Disparities In Palliative Care Utilization In The Covid-19 Pandemic, Margaret S. Bove, Benjamin Huber, Myles Hardeman, Daniel Harris, Areeba Jawed, Amber Comer

Medical Student Research Symposium

BACKGROUND

Palliative care is a vital resource for the critically or terminally ill. It has myriad benefits such as improved quality of life, reduced depressive symptoms, and decreased scarce resource utilization. Self-identified Black/African patients, however, are less likely to utilize advanced care directives or engage in hospice/comfort care measures and are more likely to prefer intensive treatment at the end of life. There is no research, however, on how the COVID-19 pandemic may have affected these trends.

METHODS

A retrospective cohort study of patients who experienced in hospital mortality or in hospital hospice due to COVID-19 between March 2020 – …

Investigating Racial And Ethnic Healthcare Disparities In Screenable Ob/Gyn-Related Cancers, Lara Laughrey

Annual Research Symposium

This is a scoping review of peer-reviewed literature addressing healthcare inequity based on race and ethnicity with a specific focus on Ob/Gyn-related management and treatment of screenable cancers.

Panorama Of Human Embryo-Derived Cells In Biomedicine And Progress In Their Research And Regulation, Jianchao Gao, Yaojin Peng, Wei Wei, Shuang Lu, Chenyan Gao

Bulletin of Chinese Academy of Sciences (Chinese Version)

Since the establishment of the first human diploid cell line derived from aborted fetal tissue in the 1960s, human embryoderived cells have been widely used in biomedical field and significantly contributes to improving human health. In recent years, human pluripotent stem cells, including human embryonic stem cells (hESCs), have shown great therapeutic potential in regenerative medicine, and thus received great attention from governments and the public. However, due to various factors such as history, culture, religious beliefs, ethics and morality, research and application involving human embryo-derived cells have been controversial worldwide. This study explores the history and progress of human …

How To Respond To Racist Patients: Recommendations From A Literature Review, Benjamin Caplan Ba (4th Year Medical Student), Jocelyn Mitchell-Williams Md, Phd

Cooper Rowan Medical Journal

Introduction: Dealing with racist patients is not uncommon, and these interactions can sever the therapeutic alliance, as well as leave providers feeling isolated, dehumanized, and ashamed. Investigation of published recommendations for handling these situations can give victims, peers, and institutions the tools necessary to prepare, protect, and support providers through these challenging encounters.

Methods: This paper is a literature review. For inclusion in this review, studies must have met the criteria of providing recommendations for healthcare providers or institutions on how to deal with racist patients. Excluded articles did not include recommendations on how to handle such situations or did …

How Does Covid-19 Vaccination Affect Long-Covid Symptoms?, Ali Akbar Asadi-Pooya, Meshkat Nemati, Mina Shahisavandi, Hamid Nemati, Afrooz Karimi, Anahita Jafari, Sara Nasiri, Seyyed Saeed Mohammadi, Zahra Rahimian, Hossein Bayat, Ali Akbari, Amir Emami, Owrang Eilami

Department of Neurology Faculty Papers

OBJECTIVE: The current study aimed to identify the association between COVID-19 vaccination and prolonged post-COVID symptoms (long-COVID) in adults who reported suffering from this condition.

METHODS: This was a retrospective follow-up study of adults with long-COVID syndrome. The data were collected during a phone call to the participants in January-February 2022. We inquired about their current health status and also their vaccination status if they agreed to participate.

RESULTS: In total, 1236 people were studied; 543 individuals reported suffering from long long- COVID (43.9%). Chi square test showed that 15 out of 51 people (29.4%) with no vaccination and 528 …

Birds, Bats And Minds. Tales Of A Revolutionary Scientist: Donald R. Griffin. Volume Three, Carolyn A. Ristau

eBooks

In this three-volume biography, we revisit the life and accomplishments of the revolutionary scientist, Donald R. Griffin. He encountered a lifetime of initial hostile resistance to his ideas and studies; now they are largely accepted. He and a colleague discovered the phenomenon of echolocation used by bats to navigate and capture insects, proposed that birds navigate guided by such cues as the sun and stars, and suggested that animals are likely aware, thinking and feeling beings. Forty interviews with his colleagues and friends help us understand the young emerging scientist and the mature researcher. We learn about his and others’ …

Innovative Virtual Wellness Interventions At An Academic Medical Center: A Pilot Feasibility Study, Ritika Baweja, Michael Hayes, Aditya Joshi, Raman Baweja

Journal of Wellness

Introduction: There is generally a concerning likelihood of burnout in healthcare workers. Given the impact of COVID-19 on healthcare workers, our institution identified the need for wellness interventions to foster adaptive functioning and mitigate burnout. The purpose of this pilot project was to assess the feasibility of virtual holistic interventions like meditation, art, laughter therapy and dance and their impact on overall well-being of physicians and advanced practice providers (APPs).

Methods: A series of 12 virtual sessions (art therapy, dance therapy, mindfulness-based practices/meditation and laughter therapy) were offered to providers over a 6-month period. Participants completed an online survey reporting …

A Life-Threatening Emergency Exacerbated By Untreated Mental Illness In A Low-Barrier Health Center, Brendan J. Prast, Byron Marshall

Journal of Maine Medical Center

Introduction: We report on a patient with untreated severe mental illness who presented with a life-threatening emergency: retained products of conception and hemorrhage.

Clinical Findings: A female patient experiencing homelessness developed life-threatening hemorrhage. Her mental illness impaired effective communication and treatment.

Clinical Course: The patient presented with fatigue, vaginal bleeding, and known retained products of conception. Her active mental illness complicated the situation as it limited effective communication and treatment due to delusions. She requested only treatment for an infectious cause of her symptoms. She refused most interventions and had a self-directed discharge from the hospital. Throughout this process, we …

Locating Liability For Medical Ai, W. Nicholson Price Ii, I. Glenn Cohen

Articles

When medical AI systems fail, who should be responsible, and how? We argue that various features of medical AI complicate the application of existing tort doctrines and render them ineffective at creating incentives for the safe and effective use of medical AI. In addition to complexity and opacity, the problem of contextual bias, where medical AI systems vary substantially in performance from place to place, hampers traditional doctrines. We suggest instead the application of enterprise liability to hospitals—making them broadly liable for negligent injuries occurring within the hospital system—with an important caveat: hospitals must have access to the information needed …

Intentional Parenthood, Contingent Fetal Personhood, And The Right To Reproductive Self-Determination, Laura Hermer

University of Michigan Journal of Law Reform

This Article argues that intent should govern legal parenthood, regardless of the method of conception, the person’s biological or genetic relationship to the resulting embryo/fetus, or the person’s gender. This proposition is not new. This Article adds to scholarly discourse by extending the concept: Intent should not just determine parenthood, but also fetal rights. When a pregnant person establishes their procreational intent (or lack thereof) prior to birth, then both the existence (or lack thereof) of legal protections for the embryo/fetus and the gestator’s rights and duties (or lack thereof) should flow from this intent. Non-gestating gamete contributors would do …

Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau

Theses and Dissertations

Complementary Health Approaches (CHAs) encompass a diverse range of practices which are often used both independently and alongside conventional medical treatments. Understanding how graduate students training in different fields perceive CHAs is important because these professional trainees will go on to occupy roles as healthcare practitioners, researchers, policy makers, and consumers. This study used sequential rank agreement methods (Ekstrøm, Gerds, & Jensen, 2019) to investigate variations in perceptions of CHAs in a sample of graduate students (N = 416) from 140 possible training programs. Ratings of CHA familiarity, perceptions of CHA legitimacy, and willingness to recommend CHAs were compared …

Early Onset Colorectal Cancer: Research, Trends & Challenges, Sarah E. Smith

Capstone Showcase

Early onset colorectal cancer (EOCRC) incidence and mortality are rising in a global trend, contrasting with improvements seen in late-onset colorectal cancer (LOCRC). EOCRC appears to differ in presentation, histology, and pathology from LOCRC painting concerns of a more aggressive tumor profile. With incidence steadily climbing, there is still lacking awareness and guidance on screening for EOCRC. This article aims to provide background on EOCRC including epidemiology, risk factors, and traits, as well as to explore methods for adjusting provider screening criteria to combat this concerning trend.

Assessing Disparities In Culturally Competent Care In Ethnic Burn Patients, Min Kang

Nursing | Student Research Posters

One of the most debilitating injuries one can suffer is a burn. It is even worse when certain individuals can not access the high quality care such as immigrants. With immigration rates increasing over the last several decades, these populations often lack the proper medical care that they deserve. The overarching theme in this population is that they face challenges in attaining positive patient outcomes due to cultural differences.

• Lack of Culturally Competent Care in Burn Care
• Addressing Cultural Safety and Quality of Care in Burn Injury Management
• Analyzing Disparities in Access to Culturally Competent Burn care

Exploring The Impact Of Caffeine, Alcohol, And Opioids On Intraocular Pressure: A Comprehensive Analysis Of Short-Term And Long-Term Effects On Vision, Jake Prieto

CMC Senior Theses

Coffee, alcohol, and opioids are addictive drugs commonly used in modern society, yet their impact on ocular health remains ambiguous. This systematic review aims to elucidate this ambiguity by examining their effects on intraocular pressure (IOP). Utilizing IOP as a metric, both short-term and long-term effects are evaluated across individuals with irregular IOP levels and healthy subjects. Furthermore, the study analyzes choroidal thickness as an additional measure to reinforce or challenge the findings regarding IOP, leveraging the inverse relationship between the two metrics concerning elevated IOP-related illnesses, such as open-angle glaucoma (OAG).

A comprehensive literature search was performed through Google …

Abortion Disorientation, Greer Donley, Caroline M. Kelly

Articles

The word “abortion” pervades public discourse in the wake of Dobbs v. Jackson Women’s Health Organization. But do we know what it means? Not only do law and medicine define it differently; state legislatures have codified wildly different definitions of abortion across jurisdictions. Our analysis exposes inherent ambiguities at the boundaries of the term, particularly as abortion intersects with other categories that we often think of as distinct: pregnancy loss, ectopic pregnancy, and other forms of medically necessary care. By juxtaposing statutory text next to real people’s experiences of being denied care in states with abortion bans, we reveal …

Are Embryos Or Fetuses Brain Dead? Implications For The Abortion Debate, Greer Donley

Articles

Most state abortion definitions exclude the removal of a dead fetus, attempting to distinguish miscarriage and abortion care. But what does “dead” mean at the earliest stages of potential life? There is a consensus at the end of life that death not only encompasses the cessation of cardiac activity, but also brain death. This symposium essay considers whether life can exist before brain life begins and how that might impact the abortion debate. The most rudimentary brain waves cannot be detected in an embryo before roughly the eighth week of pregnancy; the capacity for feeling and consciousness begin much later. …

To Till And To Keep: Following The Ethical Imperative To Care For Creation Through Gender Exploration And Expression, Phoebe Carstens

Obsculta

In light of the recent USCCB document regarding 'the Moral Limits to Technological Manipulation of the Human Body,' this essay explores an alternative, transgender-affirming ethical framework drawn from Pope Francis's Laudato si’. Within this framework, gender-affirming care is presented as fulfilling the call to care for creation through exploration and cultivation of the self.

Bioethics And A Theology Of Vulnerability, Carrie Oneil-Smith

Obsculta

This essay looks at how a theology of vulnerability can contribute to ethical decision-making in an increasingly secular society. Relationality, power dynamics and scriptural justifications are considered, as well as early contributions made to this nascent field of Christian thought. This essay was written for a class on Health Care Ethics taught by Dr. Mary Ann Kish.

Reproductive Rights And Medico-Legal Education Post-Dobbs: A Fireside Chat, Michael S. Sinha, Anna Krotinger, Maya A. Phan, Louise P. King

All Faculty Scholarship

The Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization was a pivotal moment that reshaped the landscape of abortion policy and delivery of abortion care in the United States. To create a space for critical reflection on the implications of Dobbs for the teaching and learning of abortion care in both medical and legal education, the authors engage in a dialogue highlighting the varied perspectives of professionals and professionals-in-training in both the medical and legal professions. As new attacks on reproductive autonomy continue at both state and federal levels, we foreshadow a tumultuous landscape for abortion policy …

On The Discontinuation Of Enteral Feeding In Head And Neck Cancer: A Case Report, Kyle Fisk, Ana Sanchez

HCA Healthcare Journal of Medicine

Introduction

The goal of palliative care is to preserve the quality of life or patient “comfort” in patients with serious diseases. Palliative care providers serve a wide range of patients: from those who seek curative treatment to those who are actively dying. Given this range, palliative care must mirror the dynamic goals of the patient at different stages of life and treatment. Throughout these stages, a goal of the palliative care provider would be to avoid hastening death; however, this often leads to clinical decisions that directly pit the patient’s comfort against the patient’s life span. This is most salient …

Is Racial Diversity Important When Applying To Jmu Pa Program?, Gaelyn E Young, Deonte J. Hope

Physician Assistant Capstones, 2020-current

The Physician Assistant profession is predominantly female and Caucasian. In order to increase the diversity of the profession at the level of the workforce, it is necessary to examine PA programs' role as the entryway into the profession. To that end, this evaluation aimed at surveying current and future PA students at James Madison University to understand whether racial diversity of both the program's cohort and/or its faculty was a factor in their decision to apply and/or attend the school.

End Of Life In The Ed – Brain Death And Organ Transplantation, Madison Cohen, Donald Penney

The Journal of Integrated Primary Care

Every year thousands of Americans die awaiting an organ transplant. While our knowledge and experience with organ transplantation has only improved, organ availability continues to be a major issue due to a lack of suitable donor organs. A large population of organ donors are those who have been clinically diagnosed as brain dead. Brain death is defined as the irreversible loss of all brain and brainstem functions. Despite brainstem functions being lost, mechanical ventilation and perfusion techniques allow for proper organ maintenance. This gives brain-dead individuals a unique opportunity to serve as multiple organ donors. However, due to mistrust of …

Introduction: Conversations On Abortion Rights And Bodily Autonomy In The Eighteenth Century And Today, Vicki Barnett Woods, Manushag N. Powell

ABO: Interactive Journal for Women in the Arts, 1640-1830

This piece serves as an introduction to the discussions of bodily autonomy and reproductive rights, revised from roundtable presentations held at ASECS 2023. This collection of essays contributes to the resounding responses of frustration and anger toward the overturning of Roe v. Wade. The collection was written and presented by eighteenth-century scholars who have a comprehensive knowledge of the eighteenth-century legal, social, and medical histories that center around reproductive rights and bodily autonomy.

New Dentists’ Most-Asked Legal Questions, Dan Schulte Jd

The Journal of the Michigan Dental Association

This feature addresses new dentists' most frequently asked legal questions, offering concise answers to guide them. Topics include licensing requirements, dental record maintenance, accommodations for hearing-impaired and non-English proficient patients, the enforceability of covenants not to compete, the necessity of written employment agreements, responding to bad dental work, reporting suspected abuse, prescribing drugs to friends and family, contract terms with dental plans, and handling suspected employee theft. The article emphasizes the importance of understanding legal aspects to navigate a dental career successfully.

Formalizing The Faustian Bargain Within The Healthcare Domain: An End-Of-Life Approach., Rachel Appel

Electronic Theses and Dissertations

A Faustian Bargain refers to an individual making a “deal with the devil,” exchanging something moral or sacred for an unattainable earthly good. The Faustian Bargain has been used to describe a ubiquitous social dilemma inherent to human civilization: exchanging individual liberty for public goods (e.g., security) provided by societal leaders and governments (Ostrom, 1980). Research on Faustian Bargains often examines tradeoffs between outcome utility (i.e., value derived from the outcomes of a decision) and procedural utility (i.e., value derived from being involved in the decision process (e.g., Frey et al., 2004). Much of the research on Faustian Bargains has …

Projecting, Persuading, & Protecting: A Mixed Methods Analysis Of Adult Children’S Predictions Of Parents’ Quality-Of-Life Valuations In Serious Illness States, Jessica Hahne

Arts & Sciences Electronic Theses and Dissertations

Older adults often face complex serious illness decisions and involve their adult children as shared or surrogate decision makers. However, previous research asking family members to predict older adults’ treatment preferences in serious illness situations typically shows poor concordance with older adults’ actual preferences. In the current mixed methods analysis, we surveyed older adults (n = 38) on their health state valuations in five serious illness scenarios. Two of their adult children (n = 76) predicted their parent’s preferences. Families also participated in a semi-structured conversation to discuss their preferences and predictions.

Quantitative analyses showed that parents’ average valuations were …

Promoting Mammography Screenings In African American Women: Media, Church, And Health Providers, Lasonya Little, Debra C. Wallace, K.Jay Poole

Journal of Health Disparities Research and Practice

Due to the underutilization of screening mammography, African American women (AAW) are more likely to experience negative health outcomes after receiving a late-stage breast cancer diagnosis than White Women (WW). The purpose of this article is to examine the roles of the media, health community and the African American church and pastor and their potential impact in AAW screening decisions. Fifteen AAW, ages 45 and older, were invited to participate in a semi-structured interview. Most women agreed the African American pastor and church as well as the health community, and media are an integral part of their lives. Therefore, specific …

The 14-Day Rule For In Vitro Human Embryo Research Requires Adjustment: From A Comprehensive Perspective Of Science, Ethics And Policy Research, Xiao Lu, Ming Zhao, Huihui Liu, Tianqing Li, Tao Tan, Weizhi Ji

Bulletin of Chinese Academy of Sciences (Chinese Version)

Since it was proposed, in vitro human embryo research had been following the 14-day rule, which limited in vitro research on human embryos within 14 days after fertilization. With the advancement in embryo culturing technology, this ethical rule has been greatly challenged. In 2021, the International Society for Stem Cell Research (ISSCR) recommended a conditional extension of the existing time limit in ISSCR Guidelines for Stem Cell Research and Clinical Translation, hence the international scientific community has restarted the debate on the 14-day rule. This study systematically analyzed the historical background and controversies of the 14-day rule ethical regulation of …