Medicine and Health Sciences Commons^™

Assessing The Impact And Cost-Effectiveness Of Covid-19 Testing In Adult Social Care Homes In England, Siyu Chen

Biology and Medicine Through Mathematics Conference

No abstract provided.

The Relationship Between Quality Cost Conversations And Dental Visit Satisfaction: Findings From An Online Survey Of Us Adults, Naa-Amy K. Wayne, Wendy Kutten, Samuel Anokye-Mensah, Bettye Apenteng Phd, Samuel Opoku Phd

Georgia Public Health Association Annual Meeting and Conference

Background. Cost conversations between patients and providers have been identified as vital to patient-centered care. Within the dental care setting, however, the role of cost conversations in enhancing patient experience and outcomes remain unexplored. This study examines the association between the quality of cost conversations between patients and providers on patients’ satisfaction in dental care settings.

Methods. The study was a cross-sectional study using data from 370 US adults who had received dental care in the past 24 months at the time of the survey. Data were collected through an online, self-administered survey in August 2021. The outcome of interest …

Examining The Relationship Between Place And Health In Rural Georgia, Naa-Amy Wayne, Samuel Anokye-Mensah, Wendy Sanwu Kutten

Georgia Public Health Association Annual Meeting and Conference

Background: This cross-sectional study explores the “place effect” on the health of rural residents in Georgia, by assessing the link between rural residents’ satisfaction with their communities and their general health status.

Methods: The study uses data from 789 adults residing in 6 rural counties in Georgia, collected through an online, self-administered survey from October 2021 to April 2022. The outcome of interest was respondents’ self-reported health status measured on a 5-point Likert scale. Respondents' satisfaction with their community was measured as a composite score derived from a validated 4-item scale. Data were analyzed using multivariable ordinal logistic regression that …

The Benefit Of Social Needs Screening By Hospitals, Samuel Anokye-Mensah, Wendy Kutten, Naa-Amy K. Wayne, Samuel T. Opoku, Bettye Apenteng

Georgia Public Health Association Annual Meeting and Conference

Background. Given evidence linking social determinants of health (SDoH) and health outcomes, hospitals are being encouraged to screen and address social needs as part of a holistic approach to care. Due to the cost involved, a lack of reimbursement, and available resources to address SDoH, hospitals’ participation in these efforts have been low. Further, the community impact of hospitals’ social needs screening efforts remains largely uncharacterized. Thus, this study seeks to assess the impact of hospitals’ social needs screening efforts on improving community health and reducing healthcare costs.

Methods. The 2021 American Hospital Association Survey data were used for this …

Invasive Group A Streptococcal Disease In District 2: Detect, Investigate, And Collaborate!, Kailin Chen, Maria Britez, Marie Brown

Georgia Public Health Association Annual Meeting and Conference

Background

Group A Streptococcus (GAS) is a type of bacteria that can cause life-threatening “invasive” (IGAS) infections upon entering body sites that do not normally have bacteria in them. Late 2022, case investigations revealed an increase in reported IGAS within District 2 compared to previous years, with the number of cases peaking in April 2023.

Methods

Reported cases were pulled from 11/01/2022 to 07/31/2023 from the State Electronic Notifiable Disease Surveillance System. Data was entered in Excel and sorted by onset date, hospital admission, and residential county. Descriptive analysis was performed in R for confirmation status, mortality, patient demographics, hospital …

Reducing High-Risk Sexual Behaviors In Adults Males On Preexposure Prophylaxis, Janeika B. Robinson

Georgia Public Health Association Annual Meeting and Conference

In 2012, the United States (US) Food and Drug Administration (FDA) endorsed the antiretroviral agent Truvada as a preventive agent when Human Immunodeficiency Virus (HIV) exposure is likely. In 2019 a second regimen, Descovy was endorsed for the same purpose. These regimens are for individuals with a high-risk chance of contracting HIV through high-risk sexual activities and behaviors (Aguirrebengroa et al., 2021). These antiretrovirals for this purpose are collectively known as Preexposure Prophylaxis (PrEP).

Additional research by Aguirrebengroa et al. (2021) described a lower rate of condom use and a very elevated occurrence of sexually transmitted infections (STIs) in a …

Los Intérpretes Médicos Son Un Derecho, No Un Privilegio, Morgan Uesseler

World Languages and Cultures Senior Capstones

This essay explores medical interpretation as a right, not a privilege. It argues that medical interpretation is a vital service that should be required in all healthcare settings, not just in those that are funded by the government. Themes addressed include the difference between interpretation and translation, face-to-face interpretation versus telecommunication, liabilities and risks associated with untrained and uncertified medical interpreters, and the federal law Title VI of the Civil Rights Act of 1964. Challenges experienced during any medical session are underscored, while giving special focus to limited English proficient Hispanic patients whose healthcare literacy is in Spanish, not English.

Clinical Outcomes For Impella Procedure In Octogenarians, Nonagenarians, And Centenarians: A Retrospective Cohort Study, Tony Elias, Sonika Vatsa, Kyrillos Girgis, Michael Valderrama, Rafail Beshai

Rowan-Virtua Research Day

The Impella, a vital ventricular assist device, has seen extensive use in managing severe heart failure and cardiogenic shock. However, the impact of this procedure on older individuals remains poorly understood. To address this gap, we scrutinized the National Inpatient Sample Database from 2019 to 2020 to elucidate in-hospital outcomes among older patients who underwent the Impella procedure. Among the 8233 patients who underwent Impella insertion, 1389 (16.8%) were in the older population, aged 80 years or older. This subgroup exhibited a higher prevalence of comorbidities such as hypertension, diabetes mellitus, and chronic kidney disease compared to younger patients. Alarmingly, …

Community Healthcare Workers (Chw) High-Risk Stabilization Study: Does The Ability Of Chws At Mobile Covid Clinics To Link Patients With Uncontrolled Diabetes To A Physician Improve Short Term Outcomes?, Mo Hadaya, Venkateswar Venkataraman, Jaimy D. Jabon, Kenneth W. Stagliano, Richard T. Jermyn

Rowan-Virtua Research Day

Uncontrolled diabetes may cause preventable but significant effects. One major preventative measure is early screening; there are hopes that community healthcare workers can increase awareness and screening availability, especially in underserved populations. We hosted and recorded logs of patients at mobile COVID health clinics, educating those with uncontrolled diabetes and connecting them to healthcare. We then looked to see if any patients had improvements in blood glucose to non-diabetic levels. 378 patients were logged, but only 138 were in events that had a significant amount of repeat visits. Twenty-five of them had blood sugar indicative of uncontrolled diabetes. Out of …

Sex Differences In Outcomes Among Patients Undergoing Thoracic Endovascular Aortic Repair (Tevar) Procedure: A Retrospective Cohort Study, Dakota B. Pastore, Tony Elias, Rafail Beshai, Kyrillos Girgis, Maziyar Daneshvar, Keith Anacker

Rowan-Virtua Research Day

Introduction: There is limited data about sex differences in patients undergoing a thoracic endovascular aortic repair (TEVAR) procedure. This study sought to examine the national inpatient sample (NIS) database to describe in-hospital outcomes by gender.

Methods: The NIS was searched for hospitalizations of adult patients who underwent TEVAR in 2019 and 2020. For this cohort, female patients were identified, and pregnant patients were excluded. The primary outcome was inpatient mortality. Secondary outcomes included hospital length of stay (LOS), and total hospital charges (TOTHCG).

Results: This study included 696 patients who underwent TEVAR. 255 (36.6%) females were identified, of which, 7 …

Comparative Analysis Of Health Outcomes In Gastric Cancer: Robotic Vs. Laparoscopic Gastrectomy, Maftuna Kurbonnazarova

Rowan-Virtua Research Day

Exploring the most effective surgical approach for gastrectomy is crucial for determining superior health outcomes in patients. This research compares robotic and laparoscopic techniques with the aim of pinpointing the optimal method, offering valuable insights for improved postoperative well-being.

The Impact Of The Covid-19 Mask Mandate On Effective Communication Between Healthcare Providers And Deaf/Hoh Patients, Antonia J. Conti, Alexa Gingerich

Rowan-Virtua Research Day

During the peak of the COVID-19 pandemic, many countries mandated the use of facial masks in public environments, especially in healthcare settings.[3] While this was beneficial in reducing the spread of the coronavirus disease, it created many challenges for the deaf/HoH community.[4] In particular, it limited effective communication between healthcare providers and deaf/HoH patients. It was found that masks limit word recognition for both deaf/HoH and non-deaf/HoH individuals. Additionally, both surgical and N95 masks hinder word recognition for deaf/HoH individuals and significantly impact communication during medical appointments.

Opioid Prescription Rates Before And After Alto Program And Various Factors Affecting Emergency Department Opioid Prescription Rates, Neel B. Patel, James F. Baird

Rowan-Virtua Research Day

Opioid prescription rates vary between patient population, diagnosis, location, and emergency department characteristics. High prescription rates offer an avenue for potential opioid addiction and overdoses. Alternatives to opioids (ALTO) is a new program already implemented in certain emergency departments to help change opioid prescription rates by introducing new protocols for first line treatments for pain management. With current trends still showing that South Jersey opioids prescription rates are the highest in the state of New Jersey, ALTO was introduced at Inspira Health Network located in South Jersey. This study retrospectively analyzed opioids prescription rates for abdominal pain, renal colic, migraines, …

Is There An Association Between Living In A Rural Area And The Incidence Of Postoperative Complications Or Hospital Readmissions Following Left Ventricular Assist Device (Lvad) Implantation, Compared To Urban Lvad Recipients?, Samrat Gollapudi, Abhiram Gollapudi, Srinidhi Banala, Sheraj Singh, Bhaumik Patel

Rowan-Virtua Research Day

Background: Left ventricular assist devices (LVADs) are utilized as a therapeutic option for patients with end-stage heart failure. While LVAD implantation can significantly improve survival rates and quality of life, the procedure is not without risks, and postoperative complications are common. This review aims to investigate whether there is an association between living in a rural area and the incidence of postoperative complications or hospital readmissions following LVAD implantation, compared to urban LVAD recipients.

Methods: A comprehensive review of the literature was conducted, examining studies that compared postoperative outcomes between rural and urban LVAD recipients. Data were extracted on adverse …

Nutrition And Exercise Resources For Uninsured Patient Populations, Sabrina Marie Paparo, Samantha Plasner, Runi Patel, Wendy Briaguez

Rowan-Virtua Research Day

Proper nutrition and exercise is integral for the prevention and management of chronic diseases such as type two diabetes, hypertension, high cholesterol, and cardiovascular disease. However, health care disparities in the United States, such as lack of access to primary health care, has been an ever growing problem. The purpose of this study is to determine if there is a correlation between being uninsured and having worse health outcomes, and to determine if there is a need for accessible nutrition and/or exercise resources for this population. To conduct this research, a survey was distributed at the Cherry Hill Free Clinic …

Effects Of Obesity On Patients Undergoing Cardiomems Procedure: Retrospective Cohort Study, Tony Elias, Mena Elmalh, Priya Brahmbhatt, Kyrillos Girgis, Taha Syed, Michael Valderrama, Rafail Beshai

Rowan-Virtua Research Day

★ Remote hemodynamic monitoring (CardioMEMs) is becoming increasingly important for management of chronic heart failure patients.

★ There is limited data looking specifically for obese patients who undergo CardioMEMs implantation.

★ We sought to examine the national inpatient sample database to describe in-hospital outcomes for this demographic

Standardization Of Discharge Instructions For Mild Traumatic Brain Injury/Concussion In Children Presenting To Ed: A Qi Project, Niralee K. Rana, Nicole Gerber Md, Michael Alfonzo Md, Snezana Osorio Md, Deborah Levine Md

Rowan-Virtua Research Day

Background: Mild traumatic brain injuries (mTBI) or concussions account for high rates of emergency department (ED) visits. Concussion diagnoses are used less often in young children leading to a variability in parental education and discharge instructions. Lack of discharge guidance may increase parental anxiety, impact recovery, and increase ED visits.

Objectives: To increase the proportion of ED patients discharged with age-appropriate instructions for mTBI by 50% by June 1, 2024, and to determine the impact age-appropriate instructions have on decreasing parental anxiety.

Methods: This observational time series with planned sequential experimentation is in progress at a Pediatric ED affiliated with …

The Effect Of Covid-19 Pandemic On Sanitation Practices And Anxiety In The General Population, Leah Cliatt, Joanna Petrides

Rowan-Virtua Research Day

Background: Illness anxiety and fear of contracting coronavirus increased considerably during the COVID-19 pandemic. The media, being in lockdown, and cyberchondria had the largest impact on the population’s anxiety surrounding illness. While this kind of reaction to illness is expected during the pandemic, there is limited data on post-pandemic illness anxiety levels in the general population. Patients’ perception of disease impacts medicine at every level; medical professionals need to understand the concerns and fears of their patients in order to treat the post-pandemic patient. We hypothesized that sanitation practices and anxiety surrounding illness have not returned to baseline pre-COVID-19 …

Clinical Outcomes For Cardiac Ablation In Octogenarians, Nonagenarians, And Centenarians: A Retrospective Cohort Study, Tony Elias, Mena Elmalh, Kyrillos Girgis, Michael Valderrama, Rafail Beshai

Rowan-Virtua Research Day

Background

Cardiac ablation is a therapeutic intervention aimed at correcting abnormal heart rhythms by disrupting electrical pathways in the heart, using techniques such as radiofrequency or cryoablation. Despite its effectiveness, there is a scarcity of data regarding the outcomes of cardiac ablation specifically among elderly patients. Previous studies have highlighted the complexities and challenges associated with managing cardiac arrhythmias in the elderly population, emphasizing the need for further investigation into treatment outcomes in this demographic.1,2 Therefore, this study aimed to investigate in-hospital outcomes among elderly patients who underwent cardiac ablation using data from the National Inpatient Sample (NIS) Database.

Methods …

What Stigmas Still Exist For Weight Loss Medications?, Abdullah Panah, Phillip Collins

Rowan-Virtua Research Day

Background and Hypothesis:

Medications for weight loss are becoming far more common as more tolerable formulas have come to the market with some medications offering results almost on par with bariatric surgery. However, studies show a stigma still persists around the discussion and perception around using weight loss medications. The authors of this study hypothesized that one of the biggest hurdles patients face for weight loss medications are the stigmas associated with taking these medicines and approaching the topic.

Methods:

This was a survey-based project that consisted of an anonymous, voluntary questionnaire which was provided to patients during their regular …

The Effect Of Medically Tailored Meal Program Length On Malnutrition Risk, Kaitlyn Ann Bartholomew, Jule Anne Henstenburg, Adrian Glass Crafford

Rowan-Virtua Research Day

Introduction: The Metropolitan Area Neighborhood Nutrition Alliance (MANNA) provides medically tailored meals (MTMs) to individuals in the Philadelphia area with nutritional risk and chronic illness (cancers, renal disease, heart disease, diabetes, HIV/AIDS). Registered dietitians prescribe 3 or 6 months of MTMs depending on risk severity. This study investigates the impact of MTM prescription length on malnutrition risk.

Methods: Demographic, health, and program enrollment data for clients who received ≥2 months of MTMs and completed the intake and follow-up Malnutrition Screening Tool (MST) from 2020-2022 were extracted from client records and entered in REDCap. Paired t-tests and chi-square tests were used …

Overcoming Disparities In The Treatment Of Alzheimer’S Disease, Christian Gamboa, Tribhuvan Lanka, Elaine Flowers, Nayarith Lopez

Rowan-Virtua Research Day

Background: Deaths due to Alzheimer’s have been increasing at an exponential rate for the last 24 years, with an astounding 145% increase between the years 2000-2024. Early detection is key to slowing down the rate of decline. Unfortunately, Latino and African American individuals delay seeking care, which predisposes them to worse outcomes. To date, socioeconomic limitations are the main factors leading to delayed care in Latino and African American communities. A service project was developed with the aim of addressing limitations that result in delays to seeking care within Latino and African American communities.

Methods: A systematic review of available …

Clinical Outcomes For Impella Patients Associated With Hyperlipidemia: An Analysis Of The National Inpatient Sample, Tony Elias, Sonika Vatsa, Kyrillos Gamal, Taha Syed, Rafail Beshai

Rowan-Virtua Research Day

The Impella, a ventricular assist device, is crucial for managing severe heart failure and cardiogenic shock. Despite its widespread use, there's scant information on how hyperlipidemia affects Impella patients. To address this gap, we delved into the National Inpatient Sample Database from 2019 and 2020. Our aim was to scrutinize in-hospital outcomes among these patients. We identified 8233 Impella patients, among whom 1012 (12.3%) had hyperlipidemia. Those with hyperlipidemia displayed higher rates of hypertension, diabetes mellitus, and chronic kidney disease compared to their counterparts without hyperlipidemia. Shockingly, in-hospital mortality was notably elevated in the hyperlipidemia group, emphasizing its clinical significance. …

Comparative Analysis Of Acceptance And Commitment Therapy’S Effectiveness In An Intensive Outpatient Program Setting, Efrain Frank Ellin Iii

Electronic Theses and Dissertations

This thesis presents a comparative analysis of acceptance and commitment therapy (ACT) and treatment as usual (TAU) within an intensive outpatient program setting, evaluating their effectiveness in enhancing various dimensions of psychological well-being. Guided by two main research questions, the study investigates whether ACT demonstrates greater or equal effectiveness compared to TAU and if it provides more immediate effects on psychological well-being within three weeks. Utilizing a quasi-experimental design, the research incorporates a comprehensive array of measurement tools to assess outcomes related to anxiety, depression, stress, psychological flexibility, cognitive flexibility, emotion regulation, mindfulness self-efficacy, and life satisfaction among participants. The …

Impact Of Medicaid Redetermination On Underserved Populations In Region 7 States: A Review, Brianna Parr

Capstone Experience

When the COVID-19 Public Health Emergency ended in May of 2023, Medicaid began the process of redetermination across the states and returned to its original eligibility rules. Because of this, the healthcare status of many Americans was affected, resulting in the loss of healthcare coverage for millions of people. Of those who have lost coverage, children make up almost half of the total. This paper assesses the negative effects of Medicaid redetermination on children and other underserved populations in communities across the four states in Region 7 (Nebraska, Iowa, Missouri, and Kansas) and identifies programs that these states can implement …

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Observational Analysis For Predicting Initial Spikes In Testing Volume Of Cohorts Inside And Outside Of A Regional Covid-19 Screening Program, Adam M. Franks, Seth Bergeron, Tammy Bannister, Justin Spradling, Tamara Lowe, Paris Johnson, Rajan Lamichhane, Stephen M. Petrany

Marshall Journal of Medicine

BACKGROUND Containing the highly contagious SARs-CoV-2 pathogen requires a safe and effective screening program. The aim of this observational cohort study is to analyze a regional testing center and identify factors predicting testing rates that direct supply and staffing needs.

METHODS A drive-through SAR-CoV-2 regional testing facility was created. Number of tests and positive results were collected for eighteen months. Data for testing demand was compared to positive results, percent positive rates (PPR), known external factors, and county PPR. Dissimilarities were contrasted with dynamic time warp and a detailed agreement analysis. The Grainger’s test was utilized to assess the degree …

Opioid-Related Emergency Department Visits Before And During Covid-19: Association With Community-Level Factors, Timothy F. Page, Weiwei Chen, François Sainfort, Julie A. Jacko

HCA Healthcare Journal of Medicine

Background

The purpose of the study was to investigate the relationship between community-level variables and emergency department (ED) visit rates before and during COVID-19. The focus was on opioid-related ED visits. Despite large declines in overall ED visits during COVID-19, opioid-related visits increased. While visits for avoidable conditions decreased, the opposite was true for opioid-related visits.

Methods

We combined data from Florida EDs with community-level variables from the 2020 American Community Survey. The outcome measures of the study were quarterly ZIP code tabulation-area-level ED visit rates for opioid-related ED visits as well as visit rates for all other causes. Associations …

Refining Successful Implementation Strategies For The Surgical Safety Checklist In High-Income Contexts: Results Of An International Mixed Methods Study, Meagan E. Elam, Christopher J. Louis, Jonathan Woodson, Nathan Turley, Denisa Urban, Mary E. Brindle, Jacey A. Greece

Patient Experience Journal

The WHO Surgical Safety Checklist (SSC) continues to show inconsistent success in reducing surgical complications in high-income settings. Previous implementation research identified potential barriers and facilitators to success, but it primarily consists of qualitative studies with small sample sizes in limited geographic areas. We conducted a multi-country mixed-methods study of barriers and facilitators to SSC implementation to better inform policies and practices for improving SSC buy-in and use to maximize its impact. This convergent parallel mixed-methods study utilized survey and interview data from surgical team members practicing in five countries. Survey data were analyzed using χ² analysis or Fisher’s …

Comparing The Effects Of The Induction Of Anesthesia With Etomidate To The Induction Of Anesthesia With Midazolam On The Incidence Of In-Hospital Mortality: A Scoping Review, Madison Hayes Bsn, Rn, Ashley Lynch Bsn, Rn, Scott Jamison Bsn, Rn, Mary Joiner Bsn, Rn, Gray Seymour Bsn, Rn, Dwayne Accardo Dnp, Aprn, Crna, Tracy Mcclinton, Dnp, Aprn, Agacnp-Bc, Epb-C

Doctor of Nursing Practice Projects

Purpose/Background

The induction of anesthesia using hypnotic sedatives, such as etomidate and midazolam, is common practice. Etomidate and midazolam are commonly employed in the induction of anesthesia in the septic patient population, each with its unique advantages and drawbacks. This scoping review aims to synthesize evidence on the effects of anesthetic induction with etomidate versus midazolam in adult septic patients, focusing on the incidence of mortality and associated adverse effects during hospitalization. The purpose is to establish a standard of care for anesthetic induction in this population.

Methods

A literature review was conducted from September 2022 to March 2023 utilizing …