Medicine and Health Sciences Commons^™

Using A Transformer Language Model To Curate A Pulmonary Embolism Dataset From The Medical Information Mart For Intensive Care Iv: Mimic-Iv-Ext-Pe, Barbara D Lam, Shengling Ma, Iuliia Kovalenko, Peiqi Wang, Omid Jafari, Ang Li, Steven Horng

Faculty, Staff and Students Publications

Background: Pulmonary embolism (PE) is a leading cause of preventable in-hospital mortality. Advances in diagnosis, risk stratification, and prevention can improve outcomes. Large, publicly available datasets are needed to move research forward, but are lacking in the field of hemostasis and thrombosis.

Objectives: In this study, we experiment using a machine learning language model to automatically add PE labels to a large dataset.

Methods: We extracted all computed tomography pulmonary angiography radiology reports (N = 19,942) from the Medical Information Mart for Intensive Care IV, a database of adult patients who presented to the emergency room or were admitted …

Cdc’S Core Elements To Promote Diagnostic Excellence, Daniel J Morgan, Hardeep Singh, Arjun Srinivasan, Andrea Bradford, L Clifford Mcdonald, Preeta K Kutty

Faculty, Staff and Students Publications

Nearly a decade after the National Academy of Medicine released the "Improving Diagnosis in Health Care" report, diagnostic errors remain common, often leading to physical, psychological, emotional, and financial harm. Despite a robust body of research on potential solutions and next steps, the translation of these efforts to patient care has been limited. Improvement initiatives are still narrowly focused on selective themes such as diagnostic stewardship, preventing overdiagnosis, and enhancing clinical reasoning without comprehensively addressing vulnerable systems and processes surrounding diagnosis. To close this implementation gap, the US Centers for Disease Control and Prevention (CDC) released the Core Elements of …

Interventions To Improve Timely Cancer Diagnosis: An Integrative Review, Mark L Graber, Bradford D Winters, Roni Matin, Rosann T Cholankeril, Daniel R Murphy, Hardeep Singh, Andrea Bradford

Faculty, Staff and Students Publications

Cancer will affect more than one in three U.S. residents in their lifetime, and although the diagnosis will be made efficiently in most of these cases, roughly one in five patients will experience a delayed or missed diagnosis. In this integrative review, we focus on missed opportunities in the diagnosis of breast, lung, and colorectal cancer in the ambulatory care environment. From a review of 493 publications, we summarize the current evidence regarding the contributing factors to missed or delayed cancer diagnosis in ambulatory care, as well as evidence to support possible strategies for intervention. Cancer diagnoses are made after …

Antibiotic Prophylaxis With Urodynamic Studies In Spinal Cord Injury: Assessing Practice Patterns And Outcomes To Guide Future Practice In A Single Center, Du Pham, Bradley Chi, Felicia Skelton, Donna Huang

Faculty, Staff and Students Publications

Context/objective: Despite urinary tract infections (UTIs) being a common problem in patients with spinal cord injuries (SCIs), and a well-known complication of invasive urologic procedures, little consensus exists regarding the standard of care for peri-procedural antibiotic use for SCI patients undergoing urodynamics studies (UDS). Our research seeks to evaluate local antibiotic prophylaxis pattern in SCI patients undergoing UDS, assess incidence of post-procedural UTI, describe local antibiotic resistance trends, and provide antibiotic stewardship considerations to guide future practice.

Design/setting/participants: Retrospective cohort study of SCI patients undergoing UDS from January 2010 to January 2020 at a Veterans Affairs SCI Center. Data on …

Repeat Ascaris Challenge Reduces Worm Intensity Through Gastric Cellular Reprograming, Yifan Wu, Charlie Suarez-Reyes, Nina L Tang, Alexander R Kneubehl, Jill E Weatherhead

Faculty, Staff and Students Publications

Ascariasis (roundworm) is the most prevalent parasitic nematode infection worldwide, impacting approximately 500 million people predominantly in low- and middle-income countries (LMICs). While people of all ages are infected with Ascaris, infection intensity (defined by worm burden) paradoxically peaks in pre-school and school-aged children but then declines with age. The cause of age-dependent Ascaris worm intensity is not well understood but may be dependent on cellular changes in mucosal barrier sites. We have previously found that the gastric mucosa is a critical barrier site for Ascaris infection as ingested Ascaris larvae use acidic mammalian chitinase (AMCase) secreted by gastric chief …

Testing A Benign Multi-Modal Bilingual Intervention To Increase Self-Efficacy, Intentions, And Willingness To Administer A Covid-19 Antigen Rapid Test In A Predominately Hispanic Sample, Uchenna Gbugu

Open Access Theses & Dissertations

Introduction. Testing is one of the most effective methods for reducing the spread of COVID-19. COVID-19 antigen tests can detect proteins from the COVID-19 virus called antigens and produce results within minutes, making them suitable for at-home use. Several factors have been identified as barriers to self-administering a COVID-19 antigen test, including the language of the testing instructions, the cost of testing, and access to tests. Interventions to reduce barriers to self-administering COVID-19 rapid tests are warranted to reduce the spread of COVID-19. The purpose of the present study is to test the impact of a benign multi-modal bilingual intervention …

Finding Strength In The Struggle: The Impact Of Resilience On Life Satisfaction Among Veterans With Mental Illness, Marissa Gonzalez

Open Access Theses & Dissertations

Background: Veterans living with mental illness often face challenges that impact their overall life satisfaction and adjustment to civilian life. While resilience is widely considered a protective factor, limited research has examined its role in conjunction with personality traits, psychosocial factors, and demographic characteristics. Purpose: This cross-sectional study examined the associations between resilience and life satisfaction among U.S. veterans with mental illnesses, while accounting for personality dimensions, demographic variables, and psychosocial factors. Methods: Secondary data from 156 veterans diagnosed with mental illness were analyzed. Hierarchical linear regression was used to assess the relationship between resilience and life satisfaction, controlling for …

Exploring Willingness To Seek Help And Well-Being In Rural Veterans With Health Conditions: A National Rural Health Study, Jimena Isabel Ortiz

Open Access Theses & Dissertations

The population of Veterans in the United States has increased significantly, with a substantial number residing in rural areas. This study aims to highlight and understand the correlation between military service members' physical and mental well-being and the quality/access to care they receive. This study also aims to explore mental health-seeking behaviors, health, and well-being in rural Veterans with health conditions. The study included 400 rural-dwelling Veterans with documented physical and mental health conditions. Data was collected through surveys distributed via various media channels, including social media platforms, and the results demonstrated that willingness to seek psychological help was positively …

An Examination Of Health Coaching As A Developing Profession, Katie Suleta, Jonathan M. Davis

HCA Healthcare Journal of Medicine

Background

Health coaching is a field that is growing in popularity. Health coaching is not regulated and there is no standard for background, education, or training for those acting as health coaches. The purpose of this study was to investigate the burgeoning field of health coaching: who is performing it and common practices.

Methods

A total of 560 health coaching websites were reviewed to record educational backgrounds, recommendations for supplements, and the sale of supplements and/or other wellness products. Multivariable logistic regression was used to test associations between characteristics of health coaches and whether they recommend supplements, sell supplements, or …

Opioid Epidemic In Maine: An Analysis Of Increasing Overdose-Related Deaths Following The Coronavirus, Aysel S. Hamlin

Thinking Matters Symposium

The rate of drug overdose resulting in death doubled in Maine following the COVID-19 pandemic from the onset of the COVID-19 pandemic in late 2019 through 2022. The correlation between increased isolation during the pandemic and overdose death rates sheds a concerning light on the insufficient resources for people struggling with Opioid Use Disorder (OUD) throughout Maine. The increasing trade and access to fentanyl following the pandemic accounted for the majority of drug-related deaths in Maine in 2021 and 2022. This study examines the need for long-term access to drug treatment in rural and urban Maine, both environments with varying …

Contrasting Patients' And Healthcare Professionals' Experience In Hematological Cancer Care Pathway: A Narrative Study, Karine Bilodeau, Cynthia Henriksen, Camilia Aloisio Alves, Charlotte Gélinas-Gagné, Lynda Piché, Jacinthe Pepin, Virginia Lee, Marie-France Vachon, Nathalie Folch, Marie-Pascale Pomey, Nicolas Fernandez

Patient Experience Journal

Hematological cancers represent 10% of cancers diagnosed in Canada. Treatments involve complex care pathways and various modalities as well as the management and monitoring of multiple side effects. There is limited understanding of these pathways from the perspectives of the people living with cancer (PLC) and the healthcare professional (HCP). The aim of this article is to contrast the experiences of PLCs and HCPs in the context of hematological cancer care pathway. Narrative study approach was chosen for this exploratory study. Twenty-one narratives were co-created with PLCs (n = 12) and HCPs (n = 9). A structural and comparative analysis …

What Makes A Hospital Gown Functional? A Comparative Case Study Of Effective Patient-Centered Design Practices In Four (N = 4) Hospital Gowns, Robmarie Lopez

Patient Experience Journal

A hospital gown is essentially a patient uniform. Yet, the typical ``tie in the back'' hospital gown, standard garb for routine medical procedure, can have great influence over key intervention factors like receptiveness to treatment and patient self-esteem. Thus, the goals of this study are two-fold: 1) To understand patient perceptions of the standard hospital gown, and 2) To understand which principles and elements of design underpin effectively functional hospital gown redesign. Aim 1 was assessed via a comprehensive literature review of n = 5 qualitative or mixed-methods studies which surveyed or interviewed patients on their experience with the standard …

Adolescents With Cystic Fibrosis Expressing Their Possible Selves Through Photovoice: A Longitudinal Interpretative Phenomenological Analysis To Prepare A Peer Support Intervention For Healthcare Transition, Maxime Morsa, Adélaïde Vincent-Lardy, Julie Haesebaert, Catherine Llerena, Lucie Pelz, Philippe Reix, Rémi Gagnayre, Quitterie Reynaud

Patient Experience Journal

While the transition from pediatric to adult care has become a field of study and practice focused on preparing the adolescent to ``become an adult with a chronic condition'', we are conducting participatory research to develop, implement, and evaluate a peer-support intervention aimed at supporting transition from pediatric to adult care for adolescents living with cystic fibrosis within two hospital centers in France. In preparation for this intervention, we would like to better understand how peer support could support identity self-determination of the adolescents. We conducted a longitudinal qualitative research using photovoice technique. For one year, 8 French adolescents (15–18 …

Voices From The Journey: Exploring Rehabilitation Experience Of Individuals With Disabilities In A South African Province, Senzelwe M. Mazibuko, Thayananthee Nadasan Dr, Pragashnie Govender

Patient Experience Journal

Background: Globally, 16% of the population is affected by disabilities, with increasing prevalence due to non-communicable diseases and longer lifespans. This group often faces shorter lifespans, poorer health, and greater challenges than non-disabled peers. Rehabilitation services are essential for improving independence, health, and quality of life by facilitating participation in education, work, and social roles. However, in South Africa, particularly in rural areas, providing these services is difficult. Methods: This qualitative study explored the experiences of people with disabilities in KwaZulu-Natal regarding their interactions with rehabilitation services. Six participants were recruited from a private facility using purposive sampling to …

Understanding The Care Experiences And Support Needs Of Uk Adults Treated In Hospital For Meningitis, Harriet Hay, Amy Tallett Dr, Bec Aeddi, Beverley Corbett, Claire Donovan, Jane Blewitt, Juan Abad Madroñero

Patient Experience Journal

Background: Meningitis often results in ongoing and multifaceted after-effects, which can impact many aspects of people's lives, yet relatively little support and follow-up is offered. This study explored post-treatment care experiences of UK adults aged 16 and over following a recent stay in hospital for meningitis. Methods: A survey was designed to ask about hospital discharge, recovery, information provision and aftercare support. The research involved 5 semi-structured, in-depth interviews and a 15-participant online asynchronous focus group. The themes arising from this qualitative stage informed the development of a quantitative 32-item questionnaire which was hosted and promoted online between September 2022 …

Unveiling Patient Satisfaction: Exploring Demographics, Interactions, And Health-Seeking Behavior, Vanessa B. Crowther, Cassandra Shaw-Johnson, Robbya R. Green-Weir, Pia S. Woodley, Marilyn A. Weatherspoon, Errick D. Farmer, Arlesia L. Mathis

Patient Experience Journal

Objective: This study examined the social context of the patient visit (demographics, waiting room experience, patient-provider interaction) and their relationship to satisfaction with the quality of care when seeking medical treatment. It also examined satisfaction as a predictor variable for its effect on three patient behavioral outcomes. Methods: The study was implemented using a cross-sectional quantitative design among adults aged 18 and older. One hundred fifty-eight participants responded to the survey, and the final sample size was n = 147. We employed advanced data analysis, hierarchical regression, three-way ANOVA, linear regression, and logistic regression to examine four outcome variables. Results: …

Effectiveness Of Incident Reporting Tools In Ensuring Patient Safety: A Systematic-Narrative Hybrid Review, Valentina Cerrone, Vincenzo Andretta, Angela Prendin, Bernadette Ilardi, Carloluigi Bonetti, Mario Capunzo, Marco Cascella

Patient Experience Journal

Background: Ensuring Patient Safety in healthcare is essential and requires efficient methods to reduce risks and improve the quality of care. Although incident reporting tools are commonly used to identify possible and actual care failures, their efficacy differs among various environments. The aim is to evaluate the effectiveness of incident reporting tools in enhancing patient safety. Methods: This review employed a combined methodology that integrates systematic and narrative approaches to gain a thorough understanding of incident reporting practices. In accordance with PRISMA guidelines, databases including PubMed, Embase, and Cochrane Library were systematically searched for studies published from January 2013 to …

Patient Perspectives On Implementing A Person-Centered Care System: Experiences From The U.S. Veterans Health Administration's Whole Health System Of Care, Ekaterina Anderson, Renda S. Wiener, Brianne Molloy-Paolillo, Megan Mccullough, Bo Kim, J. Irene Harris, Seppo T. Rinne, Barbara G. Bokhour

Patient Experience Journal

Objectives. Replacing the disease-centered, paternalistic approach in healthcare with a person-centered model has become a widely recognized imperative. However, patients' perspectives on and experiences with real-life efforts to implement this approach to care are rarely studied. We examined this issue at a health system with a prominent record of commitment to implementing person-centered care on the system level – the U.S. Veterans Health Administration (VHA). For over a decade, VHA has been transforming itself into a Whole Health (WH) system of care that is person-centered, holistic, and empowering. Methods. We conducted semi-structured qualitative interviews with 19 patients recruited from a …

My Life, My Story And Life Recovery Among Veterans With Substance Use Problems, Grace Chang Md, Mph, Martha J. Duffy Md, Susan Nathan Md

Patient Experience Journal

Objective: The United States Veterans Health Administration My Life, My Story (MLMS) program is a patient-centered care intervention where veterans are interviewed about their life story and may grant permission to include it in their electronic health record (EHR). Our purpose was to focus on a sample of MLMS narratives from veterans with self-disclosed substance use (SU) from our institution, and to evaluate the potential relationship between their content and a life change for the better, and to compare their content with the EHR. Methods: The narratives were reviewed on 4 domains (past challenge, substance use, experience of a turning …

The Impact Of Learners On Patient Satisfaction In The Orthopedic Setting, Sydney Boike, Kevin Hodge, Lynsey Malin, Timothy Nyangacha, Rebekah Kleinsmith, Megan Reams, Julia Stumpf, Bradley Nelson

Patient Experience Journal

This investigation evaluates the impact of learners and their post-graduate year (PGY) levels on patient satisfaction in the orthopedic outpatient clinic, an area with limited prior research. A retrospective cohort study was conducted using data from July 2020 to December 2022, involving 2,484 patients, with a 39% response rate. Satisfaction was measured via NRC Health surveys, focusing on the likelihood of recommending the provider or clinic based on the presence of learners, categorized as none, present in the clinic, or involved in patient care. Non-parametric statistical analysis revealed significant reductions in satisfaction when learners were involved in care, with top-box …

A Qualitative Study: Patients' Expectation Of Private Hospitals, Sarah Jada, Jessy Jacob, Ahmad Nasrallah

Patient Experience Journal

Objectives: This study was conducted to explore patients' expectations and perceptions of private healthcare facilities, understand the key factors influencing their choice of such facilities, also identify elements that enhance patient satisfaction and loyalty, enabling the development of actionable recommendations to improve patient-centered care in private healthcare settings. Method: A qualitative study using thematic analysis was conducted with 29 patients from various nationalities and backgrounds who received services in private hospitals in Kuwait, including Dar Al Shifa Hospital. Insights were gathered through semi-structured interviews. Results: The study delved into the significant correlation between patients' experience of their healthcare encounters and …

Patient Perspectives On Health Care Utilization At Two Free Clinics – A Qualitative Study, Patrick Fagan, Danny Guillen Perez, Roberta D. Baer, John Petrilli

Patient Experience Journal

Millions of uninsured Americans access health care through free clinics, but their experience with the medical system is understudied. This study sought to understand patterns in free clinic patients' experience with healthcare utilization through qualitative and descriptive analyses. Data were collected through face-to-face, open-ended interviews at two free clinics in an urban Florida community. The clinics included one student-run free clinic and one community-based free clinic. Survey questions were developed based on prior literature and validated through expert consensus and pilot interviews. The interviewers conducted 74 interviews between May 7 and June 10, 2022. Responses were coded by the authors, …

The Patient Ombudsperson's Experience Of Patient Partnership And Mutual Understanding Of Rights, Sanna Ryynänen

Patient Experience Journal

Mutual understanding between the patient and the healthcare professional can be considered a key factor of a positive patient experience in the care relationship. Mutual understanding can be promoted through patient partnership, which, in this personal and professional narrative, the author (a patient ombudsperson, known as patient ombudsman, and researcher of patient experience) describes as participation through patient rights during care. In the relationship between the patient and the healthcare professional (i.e., who acts as a care provider in the patient's care), medical treatment decisions and related patient rights go hand in hand. Even in difficult care situations of mutual …

Beyond The White Coat: Mental Health In The Life Of A Junior Doctor, Araya Gautam

Patient Experience Journal

This article underscores the profound need for a culture that prioritises mental health, especially among doctors navigating their early careers. This personal narrative also highlights the importance of overcoming this and the challenges one can face while trying to do so. A journey of a 30-year-old doctor, as she hurdled along life with the passing of her grandparents and studying for the exam, it looked like a task that was achievable at first, but as time went by anxiety and self-doubts were not easy to navigate. This piece outlines why it is of utmost importance that we as doctor realise …

Escuchame: A Story Of Patient Resilience, Daniel Murillo Armenta, John Paul Braun

Patient Experience Journal

This article is a narrative following a patient's experience through the American Healthcare system. This article is written by a second-year medical student. During this time the individual repeatedly engaged in different specialties of medicine such as neurology, neurosurgery, oncology, emergency medicine, gynecology, and primary care. This narrative demonstrates how certain issues such as healthcare access, patient demographics, defective communication, and general mistrust of the healthcare system negatively impact patient outcomes. As an uninsured immigrant, the patient was in a disadvantaged position when her health problems first began. Due to her lack of insurance, she did not have an established …

Re-Recruitment: An Essential Aspect Of Human Experience, Thom Mayer, David Fessell, Amy Young

Patient Experience Journal

Healthcare staffing is a major issue facing leaders at all levels and is affected by turnover rates in ``The Great Resignation,'' as well as the issue of burnout, moral injury, and turnover. In seeking to deal with defining and making human experience as reality, these factors affect every level, from patient experience to workforce experience to community experience, all of which are related to not just adequate staffing and preventing turnover but doing so with our highest performing ``A Team'' members. Using the tool of re-recruitment of these high-level professionals and team members can be critical to retaining talent, while …

Leading In Turbulent Times: Why Experience Is Essential To Healthcare's Future, Jason A. Wolf

Patient Experience Journal

Healthcare systems around the world and throughout our community are being buffeted from all sides, with higher acuity patients, a vulnerable and stressed workforce, unsure finances and support structures, and even challenges to long-held medical truths. For as much as we traversed a once in a lifetime moment through the pandemic years, the residual effects and social and political sways that followed have woven their ways into healthcare overall. There is great uncertainty. There are rapidly emerging innovations. There are greater tensions in our society which show up in behaviors that impact how we provide care. These issues and more …

Cocreating A Programme To Prevent Injuries And Improve Performance In Australian Police Force Recruits: Consumer, Industry Partner And Researcher Involvement Protocol, Myles Calder Murphy, Andrea R. Bruder, Vanessa R. Sutton, Garth M. Allen, Andrea C.M. Mosler, Jonathan M. Hodgson, Simone Radavelli-Bagatini, Evert L. Verhagen, Joanne Kemp, Caroline Jones, Joletta Belton, Debra Langridge

Research outputs 2022 to 2026

We are conducting a research program to cocreate, implement and evaluate an injury prevention intervention for the Western Australia (WA) Police Force Recruit Training Academy. This programme of research has three primary phases: (1) cocreate an injury prevention intervention for the WA Police Force with WA Force recruits, WA Police Force staff, health professionals and injury prevention experts, (2) implement the injury prevention intervention into WA Police Force Recruit training and (3) evaluate the reach, effectiveness, adoption, implementation and maintenance of the injury prevention intervention. Our research programme includes the involvement of consumers, industry partners and researchers. To ensure collaboration …

Impact Of The Online Nutrition Intervention On Health Indicators For Diabetes, Cardiovascular Disease, And Obesity In Senior Populations, Indira Karibayeva, Padmini Shankar, Gulzar H. Shah

Journal of the Georgia Public Health Association

Background: This study evaluated the effects of an online nutrition intervention program, Food Fitness First, Inc.®, on health indicators for diabetes, cardiovascular disease and obesity among senior center participants.

Methods: Thirty individuals aged over 60 completed the 3-month Food Fitness First program, which included initial counseling and 12 educational sessions utilizing the Diabetes FOOD SPIRAL® book and bifold. Pre- and post-treatment assessments measured various health parameters.

Results: Results showed significant improvements in Favorable Fitness Factor (FFF) score, which encompasses four key domains: Nutrition, Exercise, Health/Disease, and Lifestyle. FFF factor difference was equal to 13.63, with 95% CI [11.22; 16.03;]. …

Knowledge, Attitudes, And Practices Of Adults For Periodic Health Assessment In Al Ahsa, Saudi Arabia, Fatimah Yousef Alhafedh, Rawan Ahmed Almusaileem, Zahraa Hassan Aljaafar, Rayhanah Saleh Alaayesh, Edric Estrella

Makara Journal of Health Research

Background: Regular medical consultation, such as annually or semi-annually for check-ups, especially to diagnose chronic conditions, is essential for health maintenance, particularly in adults. The aim of this study is to analyze the knowledge, attitudes, and practices of adults aged 30 years or older for obtaining periodic professional health assessment in the city of Al Ahsa in Saudi Arabia.

Methods: A cross-sectional study was conducted in a total sample of 472 adults. Multistage sampling was employed, and data were collected using a Google Forms survey and analyzed using JASP and OpenEpi. Descriptive and logistic regression analysis was used …