Medicine and Health Sciences Commons^™

The Balm Framework Of Clinical Excellence: An Adoptable Model For Sub-Saharan Africa., Taoreed Adegoke Azeez

Digital Journal of Clinical Medicine

Clinical excellence is the ability to provide rigorous, evidence-based, and rewarding care to the right patients. The BALM (brilliance, attitude, leadership, and materials) framework is a novel model for adjudicating clinical excellence. There are a few models and frameworks for evaluating clinical excellence, but each has its flaws and does not consider the peculiarities of economically-challenged regions such as sub-Saharan Africa. Coincidentally, such low-resource areas have an urgent need for a framework to assess clinical excellence because of their low health-related indices. The five-step mode of professional excellence is a well-recognised tool and was the model upon which the BALM …

Alkaptonuria Presenting With Back Pain: A Diagnostic Dilemma, Arnav Salar, Dyuksha Arora, Mahabaleshwar Mamadapur

Digital Journal of Clinical Medicine

Alkaptonuria is a rare inborn error of metabolism due to a deficiency of homogentisate 1,2 dioxygenase, resulting in homogentisic acid accumulation in tissues. It is characterised by homogentisic aciduria, ochronosis, and arthritis. We hereby discuss a 46-year-old male who presented with progressive lower back pain and polyarthralgia for ten years, initially diagnosed as ankylosing spondylitis. Characteristic skin pigmentation, ochronosis, and radiological findings led to the correct diagnosis of alkaptonuria. This case highlights the importance of considering alkaptonuria as a differential diagnosis for chronic back pain and arthritis, mainly when sacroiliac joints are spared, and ochronosis is present. While no cure …

Knowledge, Attitudes, And Practices Among Health Care Professionals In A Tertiary Care Teaching Hospital, Mysuru, Rakesh M, Dr Sunil Kumar D, Dr Shwethashree M, Kodeeswaran M, Aradhya M. Gowda

Digital Journal of Clinical Medicine

ABSTRACT

Background: Biomedical waste (BMW) refers to waste generated during the diagnosis, treatment, or immunization of humans or animals, posing risks to health and the environment if not managed properly. Proper knowledge, attitudes, and practices (KAP) among healthcare professionals are essential for effective BMW management. This study assessed the KAP of healthcare workers regarding BMW in a tertiary care teaching hospital.

Methods: A cross-sectional study was conducted among 149 healthcare professionals at a private medical college from April 10 to May 10, 2023. Participants were selected using simple random sampling, including consultants, postgraduates, interns, nursing staff, laboratory technicians, and housekeeping …

The Pros And Cons Of Systematic Review And Meta-Analysis: Methodological Insights And Future Directions, Malik Maaz Ahmad, Imran Ahmed Khan, Harish Chandra Tiwari

Digital Journal of Clinical Medicine

Systematic reviews (SR) and meta-analyses (MA) are the highest level of evidence in the hierarchy of scientific evidence which aggregate data from various studies, offering a comprehensive overview of a particular topic. This approach reduces the influence of isolated studies that may have small sample sizes or unique biases, leading to more robust conclusions. By combining data from multiple studies, the overall sample size is increased enhancing the statistical power and precision of the results. The value of SR and MA is often compromised by the poor quality of the primary studies they include, which can lead to misleading conclusions. …

Exploring The Elective Experience: A Review Of The "Adult Psychiatry" Elective At A Medical College, Dyuksha Arora, Kishor M

Digital Journal of Clinical Medicine

This review delves into the motivations, experiences, and perceived advantages and disadvantages of undertaking the 'Adult Psychiatry' as an elective at JSS Medical College. Experiences from four students, two from the 2019 batch and two from the 2020 batch, provide a comprehensive overview of their elective.

A Rare Case Of Early Onset Vitamin B6 Dependent Epilepsy, Rohit Thorat, Qudsiya Ansari, Kailas Randad, Vinaya Singh, Akash Sarkate

Digital Journal of Clinical Medicine

Pyridoxine dependent epilepsy (PDE) is a rare seizure disorder which manifests in neonatal period, but can be manifested in early infancy also. Seizures are seen in the first month of life in the classical form, but in the atypical form they don't show up until later in life, sometimes as late as three years old. It has an autosomal recessive inheritance caused by mutation in ALDH7A1 gene, causing deficiency of alpha-aminoadepic semialdehyde dehydrogenase commonly known as antiquitin (ATQ). Its deficiency leads to accumulation of metabolites, which causes deficiency of functional form of pyridoxine. The seizures are non-responding to antiepileptic medications, …

Clozapine And Modified Electroconvulsive Therapy (M-Ect) In Treatment Resistant Schizophrenia (Trs) – A Case Report, Kareena Arora, Kishor M, Murali M R, Suhas K Mr

Digital Journal of Clinical Medicine

Schizophrenia is psychiatric disorder affecting less than 1% of population that can be devastating, characterized by positive, negative and cognitive symptoms. This can lead to significant functional impairment. Despite intensive and ongoing research, outcomes from best-practice treatment are often suboptimal. Unfortunately, not all the patients respond to antipsychotic medications. Overall estimates suggest that one-fifth to one-half of patients have treatment resistant schizophrenia (TRS).

TRS include failure sequential trial of two different antipsychotics with sufficient dose, duration and adherence as a minimum criterion. TRS represents major clinical challenge.

Clozapine is the only drug approved for TRS as it is the drug …

Osteochondroma At Unusual Location Causing Deformity (Metacarpal): A Rare Case Report, Pranshu S. Panwar, Prakash M, Purushothama Sastry, Gurumurthy B, Punith N, Ravi H. S

Digital Journal of Clinical Medicine

INTRODUCTION: Osteochondroma is benign tumors of bone which usually occurs in long bones. Common locations proximal tibia, distal femur and proximal humerus. Metacarpals are rarely affected.

Case Report: Patient, 10 years old/boy came to JSS hospital with complaint of swelling and deformity over left hand for 2 years. After relevant clinical examination and radiological investigation, patient was diagnosed with synostoses of 5^th metacarpal with 4^th metacarpal. Patient was taken up deformity correction and intra-op patient was diagnosed as exostoses of 5^th metacarpal. Post-op radiograph was taken. After 1-month ex-fix was removed. After 4 months follow up, deformity …

Internet Gaming Disorders Amongst Medical Undergraduates In Tamil Nadu, India - A Cross Sectional Study, Rejee Sneha Ebanezer, Sumedha K, Murugan V

Digital Journal of Clinical Medicine

Abstract

Background: Internet Gaming Disorder (IGD) or internet-related gaming addictions are characterized by severely impaired control over gaming affecting routine activities, followed by several psychological, physical and social issues. Budding medical undergraduates who are future health professionals might have positive effects on their studies and career goals when saved from internet gaming addictions. Hence, this study aimed to identify the proportion of medical undergraduate students and interns with internet gaming disorders studying in a private medical college and tertiary care hospital.

Setting: A tertiary care Hospital and Medical College, Tamil Nadu, India

Study design: Cross – sectional study.

Participants: Medical …

High Stakes And Hidden Risks: A Case Series On Pathological Gambling In Context With Affective Disorders And Substance Abuse, Avni Gupta, Namita Deka, Mahesh Kumar

Digital Journal of Clinical Medicine

Background: Pathological gambling is a non–substance-related addictive disorder, characterized by persistent preoccupation with gambling, impaired control, and continuation despite negative consequences. It is associated with financial losses, social and occupational dysfunction, and psychiatric comorbidities, including affective and substance use disorders. Although international prevalence estimates range from 1–2%, research in India remains limited, particularly with the rise of online gambling.

Methods: We report a case series of three individuals presenting to a tertiary-care psychiatry outpatient department with pathological gambling. Clinical assessments included detailed psychiatric evaluation, mental status examination, and psychometric assessments using the Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory …

Acceptability Of Anal Human Papillomavirus Home Self-Sampling And Clinician Sampling Among Sexual And Gender Minority Individuals In Milwaukee, Wisconsin: The Prevent Anal Cancer Self-Swab Study, Jenna Nitkowski, Anna R Giuliano, Tim Ridolfi, Elizabeth Chiao, Maria E Fernandez, Vanessa Schick, Michael D Swartz, Jennifer S Smith, Alan G Nyitray

Faculty, Staff and Student Publications

Purpose: Anal cancer has disproportionately high incidence among sexual minority men. We compared acceptability of home versus clinic human papillomavirus (HPV) anal swabbing.

Methods: The Prevent Anal Cancer Self-Swab Study recruited sexual and gender minority individuals in Milwaukee, Wisconsin. Eligible participants were randomized to a home or clinic arm. Home participants received a mailed anal HPV self-sampling kit. Clinic participants attended a clinic appointment where a clinician collected an anal HPV swab. We examined acceptability (overall thoughts, comfort with method, pain, and future willingness to swab) of home versus clinic swabbing using postswab survey responses.

Results: A total of 191 …

Like, Comment, Subscribe, And Share: An Investigation Of Emerging Adults’ Lived Experiences Of Relationship Information On Social Media, Marquitta Fields

Antioch University Dissertations & Theses

This qualitative study explores how emerging adults engage with relationship education content on social media platforms and the implications for promoting accessible myself in the personal lived experiences of participants while removing listener preconceptions, identifying psychological structures that explain their interactions with relationship content. The findings reveal that emerging adults use a variety of social media platforms, including Instagram, TikTok, Reddit, Facebook, Pinterest, and YouTube, to consume relationship information. Participants prioritize content that is authentic, relatable, and derived from personal experiences over generic or impersonal advice. They value content that encourages healthy communication, self-reflection, and personal growth. The study also …

Social And Structural Determinants Of Health As Predictors Of Covid-19 Vaccine Hesitancy Among Older Adults In The United States, Kingsley Kalu

College of Graduate Studies: Theses & Dissertations

Background: Although vaccination is one of the greatest accomplishments in public health, some people, especially older adults, are reluctant to take vaccines. This study examined the association between the social and structural determinants of health and COVID-19 vaccine hesitancy among older adults in the United States.

Methods: Secondary data from the Health and Retirement Study (HRS) was used. The HRS participants were 65 years and older, and the sample size was 2311. Multinomial multivariable logistic regression models were conducted for this study.

Results: The study shows that social determinants of health (marital status, educational level) and structural determinants of health …

Social Networks As Predictors Of Musculoskeletal Injury In U.S. Army Soldiers (Snap-Mski), Kristen L. Zosel

Theses and Dissertations

INTRODUCTION: Musculoskeletal injuries (MSKIs) are the leading cause of medical non-readiness among U.S. Army Soldiers, costing the Military Health System an estimated $4.7 billion annually in direct and indirect costs. Current MSKI mitigation efforts focus on individual attributes such as body mass index and gender. However, emerging research highlights the significance of social ties on health outcomes and behaviors. This study examined the patterns of MSKI within military social networks and how social interactions, along with health behaviors such as sleep, physical activity (PA), and diet, co-occur in Soldiers with and without MSKI. METHODS: Phase 1 involved a cross-sectional sociocentric …

Prevalence And Patterns Of Cardiovascular Risk Factors In Young Hypertensive Patients, *Raghu V S R Tanuku Dr., Major Venkata Shree Krishna Dr., Sreedhar Tanuku Dr

Digital Journal of Clinical Medicine

Hypertension ranks among the top ten causes of mortality, with around 4% attributed to hypertensive complications. High salt intake, Type 2 diabetes, smoking, elevated serum lipids, a sedentary lifestyle, a diet heavy in saturated fat, genetic predisposition, as well as stress are among the factors that contribute to hypertension. Hypertension affects about 1 billion people worldwide, with considerable differences between populations and ethnic groups [2]. The Framingham Heart Study indicates that a person's lifetime risk of developing hypertension is 90% if they are normotensive at age 55. According to the NHANES IV (4th National Health and Nutrition Examination Survey), the …

– Foreign Body Ingestion In Children(<12 Years) At A Tertiary Care Hospital: A Retrospective Cohort Study Studying Role Of Socioeconomic Status And Parental Supervision., Khyati Gupta, Gargi Rekhawar, Anisha Jain, Vishal D. Sawant, Sushma Save

Digital Journal of Clinical Medicine

Background- Foreign body ingestion is a long-standing problem concerning pediatric population. We aim to evaluate the correlation between the median time interval between ingestion of foreign body and arrival to the hospital with socioeconomic factors, effect of parental supervision and number of children in the family. We also aim to find out the deciding factors for proper selection of method of removal of ingested foreign bodies.

Methods- The data was collected from patient’s admission files, medical and endoscopic records. Chi-square test was used to calculate the corelation of time since ingestion with the socioeconomic status of family, method of removal …

“The Study Of Correlation Of Diet Pattern And Anemia In Pregnant Women In A Tertiary Care Hospital In Mysuru-A Prospective Study”, Soniya Pal, Dr Mamatha S Professor And Head Of The Department, Shiva S Dr, Anupama Marnal B A Dr

Digital Journal of Clinical Medicine

No abstract provided.

Assessing Discharge Knowledge For Caregivers Of Newborn (Using Video Discharge Instructions As An Adjunct To Standard Written Instructions) In Covid Period – A Randomized Controlled Trial, Jayesh Yadav, Khyati Gupta, Vishal D. Sawant

Digital Journal of Clinical Medicine

Background: Studies have demonstrated that caregivers of newborn frequently face challenges in comprehending the instructions provided to them upon discharge. Video discharge instructions provide a clear and concise message and can potentially alleviate factors which have an impact on comprehension of caregivers like illiteracy, communication barriers and limited physician time. We aim to assess the impact of incorporating video-based discharge instructions on caregivers' comprehension of newborn care and post-discharge follow-up, specifically in the context of the COVID-19 pandemic.

Methods: Caregivers of newborn in the COVID times were randomized into written only and written with video discharge instruction groups; …

Comparison Of Empathy And Compassion Fatigue Among Mental Health And Non-Mental Health Professionals: A Cross-Sectional Study, Fathima Fiza K T, Anil Kakunje, Ashwini Dinkar

Digital Journal of Clinical Medicine

Background:

Empathy refers to the ability to understand and comprehend others' thoughts and emotions as if it's their own, evoked by witnessing and connecting to the other person’s emotional state. Compassion fatigue, a consequence of an empathetic reaction, is the mental and physical tiredness resulting from being a witness to the suffering of others. It can result in negative consequences ultimately affecting the quality of treatment. The purpose of the study was to compare the level of empathy and compassion fatigue among mental health, and non-mental health professionals.

Methods

A comparative cross-sectional study was conducted over one year using 88 …

A Previous Thyroidectomy- The Culprit Of Laryngospasm Several Years On!, Vyshnavi Sriram, Ashwini N, Chillara Meena

Digital Journal of Clinical Medicine

Laryngospasm is the sustained closure of the vocal cords resulting in partial or complete loss of airway patency. Among the several causes of laryngospasm, history of total thyroidectomy performed several years back, though reported, is a rare occurrence. We present here the case report of a lady with an uneventful intra operative course of a laparoscopic cholecystectomy who developed stridor and laryngospasm in the immediate post operative period. Evaluation revealed unilateral vocal cord palsy and hypocalcemia. Compensated unilateral recurrent laryngeal nerve palsy and asymptomatic hypocalcemia can exist in patients who have undergone total thyroidectomy and can result in stridor several …

Assessing Laryngectomy Patient Education On Youtube: Investigating Quality And Reliability, Matthew E Lin, Oluwatobiloba Ayo-Ajibola, Carlos X Castellanos, Jonathan West, Neil Luu, Ian Kim, Niels C Kokot

Faculty, Staff and Student Publications

OBJECTIVE: This study aimed to characterize the quality of laryngectomy-related patient education on YouTube and understand factors impacting video content quality.

STUDY DESIGN: Cross-sectional cohort analysis.

SETTING: Laryngectomy-related videos on YouTube.

METHODS: YouTube was anonymously queried for various laryngectomy procedure search terms. Video quality was evaluated using the validated DISCERN instrument which assesses treatment-related information quality. Descriptive statistics were used to characterize our cohort. Univariate and multivariable linear regression were used to assess factors associated with increased DISCERN score. Significance was set at

RESULTS: Our 78-video cohort exhibited moderate levels of engagement, averaging 13,028.40 views (SD = 24,246.93), 69.79 likes …

Optimizing The Community Health Worker (Chw) Program In Belize And Understanding Its Unique Intermediary Position Within The Health System: Perspective From The World Health Organization (Who) Health Systems Approach, Andrei R. Chell

Electronic Theses & Dissertations (2024 - present)

Human resources for health (HRH) are the backbone of a well-functioning and resilient health system. Issues related to HRH recruitment, retention, planning, leadership and governance have been amplified by the coronavirus disease 2019 (COVID-19) pandemic and have posed additional and unprecedented challenges in many countries. Community health workers (CHWs) in particular, are uniquely positioned to be frontline health care workers (HCWs) that are considered a vital link between communities and the formal health system. Globally, the benefits of CHW programs have been well documented, and there is substantial evidence of the efficacy and effectiveness of these programs. However, countries are …

Food Insecurity And Eating Disorders In College Students: Two Scoping Reviews, Barbara Jan Goldman

UNF Graduate Theses and Dissertations

Objective: These scoping reviews explore the broad body of research post-secondary students experiencing food insecurity and eating disorders, to identify trends and gaps to inform future research.

Methods: Three search engines (PubMed, Web of Science, and CINHAL Full Text) were systematically searched for articles reporting on food security status in U.S. college students for manuscript one and post-secondary students experiencing food insecurity and maladaptive eating behaviors or eating disorders for manuscript two.

Results: One-hundred and sixty studies met inclusion criteria for manuscript one. Emerging high-risk student characteristics include gender non-conforming (GNC) and non-binary, financial independence in college, and pregnant and …

Gambian Mothers Lack Obstetric Danger Sign Knowledge, But Educational Intervention Shows Promise, Kara Shannon, Jocelyn Burridge, Brodus Franklin, Sheena Bhushan, Susan Hilsenbeck, Elena V Petrova, James N'Dow, Ibezimako Iwuh, Sharmila Anandasabapathy, Jeffrey P Wilkinson

Faculty, Staff and Students Publications

BACKGROUND: The Gambia has the 12th highest maternal mortality rate in the world, with 80% of deaths resulting from avoidable causes. Unawareness of pregnancy danger signs (DS) has been shown to be a barrier to seeking obstetric care, while app-based education intervention has shown promise.

OBJECTIVE: We aim to assess patient awareness of DS, identify barriers to awareness, and evaluate potential for implementing smartphone-based technologies for education.

METHODS: A cross-sectional semi-structured survey was administered to Gambian women (n = 100) across five hospitals/health centers. Data and informed consent were collected via an online survey portal. Analysis included bivariate analysis and …

Improving Patient Self-Advocacy And Communication With Providers Through Diabetes Self-Management Education: Analyses From A Randomized Controlled Trial, Brenna Owens Kirk

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: West Virginia (WV), a rural state in Appalachia, has the highest type 2 diabetes mellitus (T2DM) prevalence in the United States. Open communication in the patient-provider relationship is an integral part of comprehensive chronic disease management. This is especially true for patients living with T2DM, a disease that requires many complex, daily self-management activities and is associated with increased emotional distress. However, patients living with T2DM are often reluctant to openly share their concerns regarding self-care with their provider. This study aimed to test the effectiveness of the Diabetes and Hypertension Self-Management Program (DHSMP), a 12-week group lifestyle …

Music As A Determinant Of Health Among First Nations People In Australia: A Scoping Narrative Review, Brigitta Scarfe, Kristy Apps, Naomi Sunderland, Phil Graham, Brydie Leigh Bartleet, Glenn Barry, Darren Garvey, Rae Cooper, Clint Bracknell

Research outputs 2022 to 2026

Issue Addressed:

While social determinants frameworks are still popular in research about First Nations health in Australia, a growing body of research prefers cultural determinants of health models. Cultural determinants models provide a holistic, strength-based framework to explain connections between health and contextual factors, including the potential role of music and its impact on social and emotional well-being. Given the growing international recognition of links between music, health, and wellbeing through bodies such as the World Health Organisation, this article examines whether and how music practices are acknowledged in First Nations determinants of health literature.

Methods:

We conducted a scoping …

Rationale, Design, And Baseline Characteristics Of Participants In The Health@Nus Mhealth Augmented Cohort Study Examining Student-To-Work Life Transition: Protocol For A Prospective Cohort Study, Xin Hui Chua, Sarah Martine Edney, Andre Matthias Müller, Nicholas A. Petrunoff, Clare Whitton, Zoey Tay, Claire Marie Jie Lin Goh, Bozhi Chen, Su Hyun Park, Salome A. Rebello, Alicia Low, Janelle Chia, Daphne Koek, Karen Cheong, Rob M. Van Dam, Falk Müller-Riemenschneider

Research outputs 2022 to 2026

Background: Integration of mobile health data collection methods into cohort studies enables the collection of intensive longitudinal information, which gives deeper insights into individuals’ health and lifestyle behavioral patterns over time, as compared to traditional cohort methods with less frequent data collection. These findings can then fill the gaps that remain in understanding how various lifestyle behaviors interact as students graduate from university and seek employment (student-to-work life transition), where the inability to adapt quickly to a changing environment greatly affects the mental well-being of young adults. Objective: This paper aims to provide an overview of the study methodology and …

Factors Affecting Clinician Readiness To Adopt Smart Home Technology For Remote Health Monitoring: Systematic Review, Gordana Dermody, Daniel Wadsworth, Melissa Dunham, Courtney Glass, Roschelle Fritz

Research outputs 2022 to 2026

Background: The population of older adults worldwide continues to increase, placing higher demands on primary health care and long-term care. The costs of housing older people in care facilities have economic and societal impacts that are unsustainable without innovative solutions. Many older people wish to remain independent in their homes and age in place. Assistive technology such as health-assistive smart homes with clinician monitoring could be a widely adopted alternative to aged-care facilities in the future. While studies have found that older persons have demonstrated a readiness to adopt health-assistive smart homes, little is known about clinician readiness to adopt …

Estimating Cardiorespiratory Fitness In Older Adults Using The International Physical Activity Questionnaire, Kelsey R. Sewell, Jeremiah J. Peiffer, Shaun J. Markovic, Belinda M. Brown

Research outputs 2022 to 2026

Introduction:

Non-exercise estimates of cardiorespiratory fitness hold great utility for epidemiological research and clinical practice. Older adults may yield the greatest benefit from fitness estimates due to limited capacity to undergo strenuous maximal exercise testing, however, few of the previously developed non-exercise equations are suitable for use in older adults. Thus, the current study developed a non-exercise equation for estimating cardiorespiratory fitness in older adults derived from the widely used International Physical Activity Questionnaire (IPAQ).

Methods:

This study was a secondary analysis of baseline data from a randomized controlled trial. Participants were community-dwelling, cognitively unimpaired older adults aged 60–80 years …

Impact On Help-Seeking Behaviours Of A Campaign Perceived To Decrease Stigma And Increase Openness Around Mental Health, Robert J. Donovan, Catherine F. Drane, Ziggi I. Santini, Geoffrey Jalleh

Research outputs 2022 to 2026

Issue Addressed: There is considerable evidence that public stigma around mental illness inhibits help-seeking for mental health problems. Hence there have been many interventions and campaigns designed to reduce stigma around mental illness. However, as far as could be ascertained, none of these stigma reduction interventions has reported any substantial impact of reducing stigma on people's mental health help-seeking behaviours. The aim of this paper is to report on the impact of the Act-Belong-Commit positive mental health promotion Campaign on help-seeking via increasing perceived openness around mental health and reducing perceived stigma around mental illness. Methods: State-wide computer assisted telephone …