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Response To: A Telehealth Explosion: Using Lessons From The Pandemic To Shape The Future Of Telehealth Regulation, Joanna Sax

Texas A&M Law Review

In A Telehealth Explosion: Using Lessons from the Pandemic to Shape the Future of Telehealth Regulation, published in the Texas A&M Law Review, Professor Deborah Farringer tackles the critical issue of the efficacy and implementation of telehealth, using our experience(s) of telehealth during the COVID–19 pandemic as the guide. This is important, as Professor Farringer acknowledges, because while telehealth advocates pre-date the pandemic, barriers prevented the implementation of telehealth in a widespread manner. These barriers included a concern about fraud and a question as to whether telehealth visits could provide effective outcomes compared to in-person visits. Professor Farringer …

Evolution Or Revolution In Telehealth Regulation, George Horvath

Texas A&M Law Review

A frequently repeated adage, attributed to a wide range of authors and orators, holds that a serious crisis should never be allowed to go to waste. The moment in which we find ourselves renders this adage particularly timely. Responses to one of the defining crises of our age—the COVID–19 pandemic—have mostly been reactive. This includes the responses of multiple actors involved with telehealth. Congress, federal regulators, state legislatures, state regulators, private insurers, and health care providers, confronting the challenges of the pandemic, have responded by making ad hoc adjustments to the regulation and use of telehealth. Moving the conversation beyond …

Prediction Of Body Fat Percentage Based On Anthropometric Measurements Using Data Mining Approach, Hamsa Amro, Prof. Mohammed Awad

Journal of the Arab American University مجلة الجامعة العربية الامريكية للبحوث

In recent years, heart disease, diabetes, and some types of cancers have been reported as some main causes of death in most countries of the world, and obesity, which is often attributed to excess body fat, is one of the most common risk factors for these diseases. To make the vast amounts of data produced by health care information systems useful to the potential, the researchers applied knowledge discovery through predictive modeling. This study used anthropometric measurements as input data to different data mining techniques to predict body fat percentage. Fisher’s Method of Scoring was used to select the most …

Measuring The Quality Of Postgraduate Physician Assistant Fellowship/Residency Programs With A Surgical Focus, Lesley Davies, Jacqueline Guarino, Caitlin Justus, Cassandra Mueller Pa-C, Ryan Krasnosky, Jordan Rodriguez, Angelo P. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction

Postgraduate programs for PAs provide formal postgraduate training for clinical specialty areas. These programs are intended to provide intense specialty training in various fields, as well as to standardize education beyond the entry level. The purpose of this descriptive study was to determine if there are consistent trends or clear differences in program length, approach to training, validation of learning, and accreditation through the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) for postgraduate programs with a surgical focus in the United States.

Methods

This study is a non-experimental and descriptive research design. Program directors were mailed …

Deep Convolutional Neural Networks For Accurate Diagnosis Of Covid-19 Patients Using Chest X-Ray Image Databases From Italy, Canada, And The Usa, Amgad A. Salama, Samy H. Darwish, Samir M. Abdel-Mageed, Radwa A. Meshref, Ehab I. Mohamed

The University of Louisville Journal of Respiratory Infections

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), famously known as COVID-19, has quickly become a global pandemic. Chest X-ray (CXR) imaging has proven reliable, fast, and cost-effective for identifying COVID-19 infections, which proceeds to display atypical unilateral patchy infiltration in the lungs like typical pneumonia. We employed the deep convolutional neural network (DCNN) ResNet-34 to detect and classify CXR images from patients with COVID-19 and Viral Pneumonia and Normal Controls.

Methods: We created a single database containing 781 source CXR images from four different international sub-databases: the Società Italiana di Radiologia Medica e Interventistica (SIRM), the GitHub Database, the …

Consultation/Liaison Psychiatry During Covid-19, Robert Frierson, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

Consultation/liaison psychiatrists care for people with co-existing medical and psychologic difficulties. The coronavirus pandemic is stressful for patients and their psychiatric caregivers. Patients have lost support systems and harbor fears about exposing family to the virus. COVID-19 sometimes exacerbates previous psychiatric conditions, while diminishing intimacy with physicians. Everyone is oversaturated with COVID-19-related news focusing on rising concerns about the illness and about jobs, school, and housing insecurities.

The psychiatrist maintains a hospital presence despite fear of contracting the disease. Challenges include addressing staff morale, evidencing empathy despite telecommunication devices, and treating anxiety, depression, sleep phobias, post intubation flashbacks, COVID-19-induced cognitive …

Access Barriers To Telehealth, Quynh Chau, Amita Behuria Pathak, Daniel Turner, Jacquelyn Cheun, Carl Noe

SMU Data Science Review

Abstract. Telehealth has long been touted as an efficient and cost-effective way to deliver health care services to patients. The COVID-19 global pandemic hastened the adoption of this technology in the United States. Despite its promises, telehealth as a technology-based model of health service delivery has also highlighted access to care inequities in the form of uneven utilization across various patient demographics. This research uses machine learning and publicly available data sources to describe telehealth utilization based on social determinants of care. The implications of this application can be used to inform health care providers of how to target efforts …

A Telehealth Explosion: Using Lessons From The Pandemic To Shape The Future Of Telehealth Regulation, Deborah Farringer

Texas A&M Law Review

From board rooms, to classrooms, to Saturday Night Live skits, the video conferencing app Zoom became a seemingly overnight sensation as a way to connect while businesses were shuttered and individuals were forced to stay at home when the coronavirus pandemic erupted in the United States in March 2020. From 10 million daily users in December 2019 to over 200 million daily users by March 2020, the company founded in 2011 became a market leader as the country tried to figure out how to continue business as usual—to the extent possible—during the global pandemic. While hospitals prepared for the onslaught …

Realist Evaluation Of The Early-Stage Implementation Of A Smartphone-Based Disease Surveillance Project In Two Armed-Conflict Communities In Nigeria, Bashir M. Mustapha, Samuel C. Avemaria Utulu

The African Journal of Information Systems

We investigate the early-stage implementation of a smartphone-based acute flaccid paralysis (AFP) surveillance project in communities experiencing armed conflicts in Nigeria. We aim to expose factors influencing the early-stage implementation of smartphone-based AFP surveillance in two rural communities experiencing armed conflicts in Northern Nigeria. Thus, exploring “what works, for whom and under what contextual conditions?” in the early-stage implementation of a smartphone-based AFP surveillance project, given the involvement of multiple stakeholders. We adopted stakeholder theory as a lens to guide the study. We adopted a qualitative case study method, realist philosophy, semi-structured interview, participatory observation, and thematic data analysis. The …

"More Accessible And Easier To Deal With": A Qualitative Inquiry Of Leaders' Perceptions Of The Evolving Roles And Responsibilities Of Advanced Practice Providers At Texas Medical Center, Athena Krasnosky Msn, Aprn, Cpnp, Jessie Marcet-Gonzalez Msn, Aprn, Cpnp, Jordan Rodriguez Bs, Natalie Cormier Smith Msn, Aprn, Np-C, Brenda Chesley Msn, Aprn, Cpnp-Ac/Pc, Linda Brock Msn, Aprn, Cpnp, Heena Narsi Prasla Msn, Aprn, Cpnp, Geran Barton

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Background. With over 10 million patient encounters a year at Texas Medical Center (TMC), Advanced Practice Providers (APPs) are being incorporated into health care delivery models. Moving beyond the narrow “scope of practice” debates that frequently surface when talking about APPs, this inquiry instead seeks to broaden the discussion and take a more comprehensive view of how APPs are being incorporated into health care delivery models that span across several TMC institutions.

Methods. This study uses a thematic analysis study design to analyze structured interviews collected from a small convenience sample of Advance Practice Provider Program Directors at Texas Medical …

J Mich Dent Assoc November 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• Cover stories with a “Focus on Advocacy: Helping Dentistry Succeed”, including “MDA Dental PAC: What It Is and Why It Matters “, “2021 Advocacy Success — and More to Come “, and “Dental Programs Maintained in 2021-22 State Budget”.
• A feature article on “The Anishinaabe Dental Outreach Program”.
• A feature article, “How Your Website and …

A Research Framework For Evaluating Next Generation Sequencing In Community-Acquired Pneumonia, Ashley M. Wilde, Elena Swingler, Sarah E. Moore Pharmd, Brian C. Bohn Pharmd, Matthew Song Pharmd, Bcidp, Ruth Carrico, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Parapharyngeal Schawannnoma. Case Report, Enrique Moyano Navarro, Manuel Inostroza Fernández, Pedro Sotelo Jiménez, Ethel Vargas Carrillo, Alan La Torre Zúñiga, Luis González Domínguez

Revista de la Facultad de Medicina Humana

Parapharyngeal tumor lesions present a low incidence, representing between 0,5 and 0,8% of all head and neck tumors. Approximately 80% show benign behavior. The uniqueness of these lesions derives from their complex anatomical situation and the symptoms with which they usually appear, being in most cases nonspecific and almost always derived from the compressive effect produced by the lesion on the oropharynx and the oropharynx. Schwannomas of the parapharyngeal space are very rare tumors that originate from the sheath of schawnn, generally slow growing, and are usually asymptomatic. Treatment is surgical, often complex due to the anatomical location. The case …

Atrial Fibrillation That Required Cardioversion In The Post Anesthetic Recovery Unit In Ambulatory Surgery. A Case Report, Miryam Céspedes Morón, Ruiz Roque Rosina, Chipa Ccasani Fredy

Revista de la Facultad de Medicina Humana

In recent years, the profile of patients who can undergo ambulatory surgery procedures in independent ambulatory surgical centers has changed. It is very important to consider the availability, skills and experience of the care staff, as well as the integral study of the patient, the resolution capacity of these centers and evaluations with quality care indicators to obtain optimal results. The present case was of a 34-year-old male, first presentation of rapid and symptomatic atrial fibrillation documented in the immediate postoperative period. Patient care, diagnostic strategy and treatment were described, since the patient required electrical cardioversion.

Jaw Region Endometriosis: Case Report, Katherine L. Contreras Gala, Mónica Villafuerte Rozas

Revista de la Facultad de Medicina Humana

Introduction: Endometriosis is a chronic gynecological disease, which refers to the presence of endometrial glands and stroma outside the uterine endometrium. This entity has a frequency of 10 to 15% in women of reproductive age, and its most common site of presentation is the ovary. At the extrapelvic level, the most common location is the gastrointestinal and genitourinary location. However, it can occur in any location. Presentation: The case of a 40-year-old female patient with a face tumor in the mandibular region is described, presenting with a disease time of 2 years. Among the important antecedents, two months before the …

Shock Cryptic, Emerging Diagnostic, Ricardo Garcia Ayala, Sandra Soto Ticse, Stephany Matos Santiváñez, Allison Ortiz De Orue

Revista de la Facultad de Medicina Humana

Cryptic shock is a poorly identified clinical entity, it still describes a patient with signs of tissue hypoperfusion without affecting blood pressure. In the emergency department, it is important to identify signs of hypoperfusion and evaluate various hidden sources of infection by taking a complete medical history, a thorough physical examination, and if necessary advanced imaging. It is necessary to conclude that the importance of the timely diagnosis of this clinical entity helps to significantly improve the prognosis.

Clinical Performance Of A New Prediction Rule Of Systemic Loxoscellism. Case Report, Rafael Pichardo-Rodriguez, Marcos Saavedra-Velasco, Cesar Sánchez-Alvarez, Juan J. Bracamonte-Hernández, Abel Aldave-Visurraga, Oscar Ruiz-Franco

Revista de la Facultad de Medicina Humana

Systemic or cutaneous-visceral loxoscelism is the most severe clinical presentation of loxoscelism. Currently there is no validated laboratory diagnostic method that allows us to confirm the presence of this disease in the face of arachneism. However, there is a clinical prediction rule (CPR), which allows us to predict the evolution of a bite towards a systemic condition and which would be useful in emergency rooms. We present the case of a woman who developed the systemic picture of loxoscelism to whom a new CPR was applied for the early detection of systemic loxoscelism, presenting adequate performance for early evaluation in …

Cotard Syndrome In Recurrent Depressive Disorder: Case Report, Héctor Ocampo, Richard J. Febres-Ramos, Sheron Arestegui, Rosa Bravo, Danitza Cardenas

Revista de la Facultad de Medicina Humana

The Cotard Syndrome, also known as delirium of negation or nihilistic delirium, was described by the French neurologist, Julius Cotard, on June 1880. From that time until the end of the 20th century, in scientific literature, approximately 100 cases were reported that presented symptoms of depression, anxiety, nihilist delusions concerning the body and existence, hypochondriacal and immortality delusions, as well as auditory and visual hallucinations. We present the case of a female patient, 73-years old, from Ayacucho, with a history of sexual assault at the age of 12 and suicidal attempts on 2 occasions, diagnosed with depression at 40 years …

Posner – Schlossman Syndrome: Case Report, Diego J. Mamani Maquera, Nahuel Pantoja Dávalos

Revista de la Facultad de Medicina Humana

Introduction: Posner - Schlossman Syndrome (PSS) is a rare disease, more prevalent in men between 20 and 50 years old, characterized by recurrent attacks of anterior uveitis and ocular hypertension. Clinical case: We report the case of a 42-year-old patient with a single eye. He came to the consultation presenting decreased visual acuity, photophobia, halos around the lights, and intense pain in his left eye. The ophthalmological examination revealed inflammatory signs in the anterior segment, elevated intraocular pressure and damage to the optic nerve. Medical treatment was started with corticosteroids and topical antiglaucoma drugs, oral acetazolamide and intravenous mannitol, obtaining …

Hantavirus In The Peruvian Jungle: A Systematic Review Of Series And Cases Reported, Marcos Saavedra-Velasco, Alvaro Oyarce-Calderón, Natalia Vargas Herrera, Rafael Pichardo-Rodriguez, Carlos M. Moreno-Arteaga

Revista de la Facultad de Medicina Humana

Hantavirosis is a zoonotic infection transmitted mainly by rodents. In Peru, a lethality of 40–60% is calculated in inhabitants of the Peruvian Amazon jungle, especially in Loreto. Despite this, this disease continues to be under-diagnosed despite the fact that it represents a serious problem for public health in Latin America. We present a sistematic revision of case reports and seris of cases of Hantavirus infection in the Peruvian jungle. The most important characteristic of the cases presented are mean age 25.7 years, predominance of females (5/6), clinical presentation of headache, myalgias, nausea and vomiting (6/6) and unfavorable evolution to acute …

The Social Representations Of Patients Of Quechua Origin With Type 2 Diabetes About Their Disease And Treatment In Two Hospitals In Cusco, Ramón Figueroa-Mujica, Guisela Yábar-Torres

Revista de la Facultad de Medicina Humana

Objectives: To achieve an approximation the social representations of patients about their disease. and about its treatment. Methodos: This is a qualitative study on social representations based on the interpretive paradigm and through an in-depth interview, for which a guide of topics or categories was used, based on the objectives of the study. The study population was made up of patients treated in the Endocrinology Units of the Antonio Lorena and Regional Hospitals of Cusco, diagnosed with type 2 diabetes and of Quechua origin evidenced by their mother tongue. The sample is non-probabilistic for convenience, the representativeness of the discourse …

Knowledge And Attitudes About Organ Donation In Students Of Health Sciences From A National University Of Lambayeque - 2019, César Cabrejos-Montalvo, Katherine Ipanaqué Muñoz, Ana Vásquez Del Castillo

Revista de la Facultad de Medicina Humana

Objective: Determine the level of knowledge and attitudes about organ donation and xenotransplantation in students of a National University of Lambayeque. Methods: The sampling carried out was probabilistic of a simple random type and the sample was made up of 100 university students. An observational, descriptive and cross-sectional study was conducted to assess levels of knowledge and attitudes about organ donation. A survey of 20 dichotomous key questions was applied. Results: 53 women (53.0%) and 47 (47.0%) men were interviewed. It was observed that 76% do not know about the Law on the Promotion of Solidarity Donation of Human Organs …

Association Between Educational Level And Knowledge On Transmission Of Hiv/Aids In Adolescent Women In Peru-Endes 2019, Nathalie Amado-Cornejo, Consuelo Luna-Muñoz

Revista de la Facultad de Medicina Humana

Introduction: Knowledge about the transmission of HIV in adolescent women is important due to the great risk of contracting said infection. Objectives: To determine the association between the educational level and knowledge about the transmission of HIV in female adolescents according to the ENDES year 2019. Methods: Quantitative, observational, retrospective, cross-sectional and analytical study based on the public availability data of the ENDES 2019. Results: Of the 4 668 women in the age range of 15 to 19 years. 30.6% had adequate knowledge about HIV and 69.4% had inadequate knowledge. No association was found between educational level and level of …

Epidemiological Statistics Of Adolescent Suicide During Confinement Due To The Covid-19 Pandemic In Ecuador, Andres J. Guarnizo Chávez, Nathaly A. Romero Heredia

Revista de la Facultad de Medicina Humana

Objective: To present the characteristics of adolescent suicide, during the period of connement due to pandemic in 2020 in Ecuador, in order to satisfy the mental health needs of this age group with their knowledge. Method:Observational, descriptive, cut-off study It was carried out. Cross-sectional retrospective, with information from the database of violent deaths of the Ministry of Government, from March 17 to September 13, which lasted the state of emergency. The analysis was carried out by province, sex, age, suicide method and frequency in days after the occurrence of the event. The suicide mortality rate (per 100,000 inhabitants) was estimated …

Factors Associated With Depression Anxiety And Stress In The Context Of Covid-19 Pandemic In Police Officers Of Metropolitan Lima, Peru, Katherine D. Apaza-Llantoy, Lucy E. Correa-López

Revista de la Facultad de Medicina Humana

Objectives: To determine the factors associated with the development of depression, anxiety and stress in the context of the COVID-19 pandemic in police officers in Lima, Peru. Methods: Analytical cross-sectional study conducted in 210 police officers who were administered the Depression Anxiety and Stress Scale-21 (DASS-21) in October 2020, as well as a form, via Google Forms, to obtain sociodemographic and clinical data. A bivariate and a multivariate analysis were performed using crude and adjusted prevalence ratios, with a confidence interval >95% and a significance level of p≤0.05. Results: Depression, anxiety and stress prevalence rates were 11.43%, 10% and 7.62%, …

Validation Of The Predictive Criteria Of High Risk For Choledocholithiasis Of The American Society For Gastrointestinal Endoscopy, 2010: Experience Of A Colombian Caribbean Center, Willfrant J. Muñoz-Murillo, Ivan D. Lozada-Martinez, Amileth Suarez-Causado, Maria P. Bolaño-Romero, Maria M. Rodriguez-Gutierrez, Yelson A. Picón-Jaimes

Revista de la Facultad de Medicina Humana

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) has become the gold standard for diagnosis and treatment of choledocholithiasis. The American Society for Gastrointestinal Endoscopy (ASGE) in 2010 proposed stratifying patients into 3 risk levels; however, studies have found controversial results about the predictive parameters of these diagnostic criteria. The objective of this study is to determine the performance of the high-risk predictive criteria of the ASGE 2010 in the diagnosis of choledocholithiasis in a Colombian Caribbean population. Methods: Retrospective cross-sectional study, which included patients with suspected choledocholithiasis, and who were taken for evaluation by ERCP, meeting the criteria proposed by the ASGE …

Whatsapp Assessment For Communication And Organization Of Group Work In Resident Physicians, Luisa E. Villar Meza, Hugo F. Gutiérrez Crespo, Juan P. Matzumura Kasano

Revista de la Facultad de Medicina Humana

Introduction: New communication technologies allow new opportunities to optimize medical work. Objective: To determine the assessment of WhatsApp for communication and organization of group work among resident physicians during a healthcare management course. Methods: Descriptive, prospective, cross-sectional study. The population consisted of 140 resident physicians who participated in a healthcare management course in 2019 and 2020. A non-probability convenience sample of 132 participants was obtained. We applied the instrument to assess WhatsApp for regulating group work, through the dimensions “WhatsApp for organizing group work” and “WhatsApp as a communication system for group work”, with a reliability of 0.92. Based on …

Correlation Between Mortality Due To Covid-19, Wealth Index, Human Development And Population Density In Districts Of Metropolitan Lima During 2020, Zalia E. Dorregaray-Farge, Alonso Soto, Jhony A. De La Cruz Vargas

Revista de la Facultad de Medicina Humana

Objectives: To determine the correlation between mortality from COVID-19 and the percentage of poverty and the district Human Development Index (HDI) in the department of Lima. Methods: Ecological observational correlation study. The population were patients who died from COVID-19 in metropolitan Lima. All deceased patients reported in the open database of the Ministry of Health were included. The dependent variable was the mortality from COVID-19 calculated by dividing the number of deaths by the total population of the districts and the independent variables were the percentage of poverty and HDI. A secondary analysis was performed evaluating the fatality from COVID-19. …

Association Between Prenatal Care And Peripartum And Postpartum Maternal Obstetric Complications. Endes 2017 To 2019, Angela Méndez, Estefany Morales, Willer Chanduví, Pedro M. Arango-Ochante

Revista de la Facultad de Medicina Humana

Introduction: Obstetric complications are an important cause of maternal morbidity and mortality, with prenatal control (PNC) being a strategy for their adequate prevention and treatment. Objective: To determine the association between adequate CPN and peripartum and postpartum maternal obstetric complications. Methodology: Quantitative, observational, retrospective, cross-sectional and analytical study, based on information from the ENDES 2017-2019. Results: A sample of 41,803 mothers was analyzed, 21,0% and 28,7% had peripartum and postpartum complications respectively, furthermore, it was found that not having a quality NPC (PR = 1.20; 95% CI = 1.14-1.27), residing in metropolitan Lima (PR = 1,38; 95% CI = 1,27-1,49) …

Relationship Between The Approval Of The Adoption Of Children By Homosexuals And The Attitude Towards Homosexuality Among Medical Students And Graduates, Marco A. Tipula Mamani, Lincol M. Cruz Aquino, María I. Vásquez Suyo, Maritza D. Placencia Medina

Revista de la Facultad de Medicina Humana

Introduction. Due to changes in the composition of the family and society, the adoption of children by homosexuals is becoming more frequent. It has been found that opposition to this request is often associated with homophobia. In Peru, no studies exist on these aspects. Objective: To determine the correlation between adoption approval and attitude towards homosexuality in medical students and graduates, Lima, Peru. Method: The observational and cross-sectional study was carried out. 205 people over 21 years of age participated. The Attitude Toward Homosexuality Scale (EAH-10) and the question “Should homosexual couples be allowed to adopt children like heterosexual couples?” …