Medicine and Health Sciences Commons^™

Clinical Decision Support Capabilities Of Commercially-Available Clinical Information Systems, Adam Wright, Dean F Sittig, Joan S Ash, Sapna Sharma, Justine E Pang, Blackford Middleton

Faculty, Staff and Student Publications

BACKGROUND: The most effective decision support systems are integrated with clinical information systems, such as inpatient and outpatient electronic health records (EHRs) and computerized provider order entry (CPOE) systems. Purpose The goal of this project was to describe and quantify the results of a study of decision support capabilities in Certification Commission for Health Information Technology (CCHIT) certified electronic health record systems.

METHODS: The authors conducted a series of interviews with representatives of nine commercially available clinical information systems, evaluating their capabilities against 42 different clinical decision support features.

RESULTS: Six of the nine reviewed systems offered all the applicable …

Advances In Progenitor Cell Therapy Using Scaffolding Constructs For Central Nervous System Injury, Peter A Walker, Kevin R Aroom, Fernando Jimenez, Shinil K Shah, Matthew T Harting, Brijesh S Gill, Charles S Cox

Faculty, Staff and Student Publications

Traumatic brain injury (TBI) is a major cause of morbidity and mortality in the United States. Current clinical therapy is focused on optimization of the acute/subacute intracerebral milieu, minimizing continued cell death, and subsequent intense rehabilitation to ameliorate the prolonged physical, cognitive, and psychosocial deficits that result from TBI. Adult progenitor (stem) cell therapies have shown promise in pre-clinical studies and remain a focus of intense scientific investigation. One of the fundamental challenges to successful translation of the large body of pre-clinical work is the delivery of progenitor cells to the target location/organ. Classically used vehicles such as intravenous and …

Retention Of A Well-Fixed Acetabular Component In The Setting Of Massive Acetabular Osteolysis And Pelvic Discontinuity: A Case Report, Murat Pekmezci, James Keeney, Amanda Schutz, John C. Clohisy

Open Access Publications

No abstract provided.

Development And Formative Implementation Of A Nutrition Assessment And Peer Education Program Based On Dietary Analysis At A California State University, Janay Jelso

Master's Theses

A healthy diet has been established as a key component contributing to an individual’s quality of life. Statistics show that the diet of Americans needs improvement (Guenther et al., 2007) indicating possible lack knowledge of what healthy eating behaviors are. There is an abundance of nutrition misinformation available to the consumer (American Dietetic Association, 2002a). Dietary interventions that provide credible education based on readiness to change behaviors and goal setting have been successful in increasing awareness of what healthy eating behaviors are and changing existing behaviors over time (Ammerman et al., 2002; Evans & Sawyer-Morse, 2002; Gambera et al., 1995; …

Foreign Body Or Foreign From Body--Congenital Unilateral Lobar Hypoplasia Of Lung, Heeramani Lohana, Syed Rehan Ali, Shakeel Ahmed

Department of Paediatrics and Child Health

We report a rare case of congenital unilateral hypoplasia of the lung without any other anomaly at Aga Khan University Hospital. A 7-month-old male infant presented in emergency room with respiratory distress. There was no history of cough and wheeze. X-ray revealed left sided non homogenous opacity along with right sided hyperinflation. A suspicion of foreign body was made on chest X-ray but bronchoscopy was deferred in view of bilateral equal air entry and absence of wheeze. CT scan showed left upper lobe hypoplasia. Child recovered with supportive therapy and was discharged home. To the best of our knowledge unilateral …

Comparing Risk Scoring Systems Beyond The Roc Paradigm In Survival Analysis, Hajime Uno, Lu Tian, Tianxi Cai, Isaac S. Kohane, L. J. Wei

Harvard University Biostatistics Working Paper Series

No abstract provided.

Should Schizoaffective Disorder Be Dropped From Dsm V, Amresh Srivastava

Psychiatry Presentations

No abstract provided.

Coverage And Payment For Prescription Drugs Under Medicare Part B: A Complex Patchwork, Amanda Cassidy

National Health Policy Forum

As part of the diverse discussions around health care reform, many have looked to refining Medicare payment systems as a way to give health care practitioners and providers greater incentives to deliver care more efficiently, and thus slow health care spending growth. Understanding how Medicare currently pays for Part B services, including drugs covered under Part B, is essential to understanding the potential impact of these types of reforms. Most items and services covered under Part B, including most Part B drugs, are paid individually, which means practitioners and providers generally receive more payments for providing more services. Some reform …

Effects Of Genetic Deficiency Of Cyclooxygenase-1 Or Cyclooxygenase-2 On Functional And Histological Outcomes Following Traumatic Brain Injury In Mice, Matthew L. Kelso, Stephen W. Scheff, James R. Pauly, Charles D. Loftin

Pharmaceutical Sciences Faculty Publications

BACKGROUND: Neuroinflammation contributes to the pathophysiology of acute CNS injury, including traumatic brain injury (TBI). Although prostaglandin lipid mediators of inflammation contribute to a variety of inflammatory responses, their importance in neuroinflammation is not clear. There are conflicting reports as to the efficacy of inhibiting the enzymes required for prostaglandin formation, cyclooxygenase (COX) -1 and COX-2, for improving outcomes following TBI. The purpose of the current study was to determine the role of the COX isoforms in contributing to pathological processes resulting from TBI by utilizing mice deficient in COX-1 or COX-2.

RESULTS: Following a mild controlled cortical impact injury, …

Distinction Of The Memory B Cell Response To Cognate Antigen Versus Bystander Inflammatory Signals, Micah J. Benson, Raul Elgueta, William Schpero, Michael Molloy, Weijun Zhang, Edward Usherwood, Randolph J. Noelle

Dartmouth Scholarship

The hypothesis that bystander inflammatory signals promote memory B cell (B_MEM) self- renewal and differentiation in an antigen-independent manner is critically evaluated herein. To comprehensively address this hypothesis, a detailed analysis is presented examining the response profiles of B-2 lineage B220 + IgG + B_MEM toward cognate protein antigen in comparison to bystander inflammatory signals. After in vivo antigen encounter, quiescent B_MEM clonally expand. Surprisingly, proliferating B_MEM do not acquire germinal center (GC) B cell markers before generating daughter B_MEM and differentiating into plasma cells or form structurally identifiable GCs. In striking contrast to …

Medical School Watercooler Newsletter - August 30,2009, Lindsey Lyle

Watercooler Newsletter

This is the August 30, 2009 edition of the Frederick P. Whiddon College of Medicine - Watercooler

Contents Include

• Harvard Cardiac Researcher to Kick Off DSS
• International Academy Honors USA Researcher
• USA Folate Researchers Uncover the Limitations of a Very Good Thing
• USA Digestive Health Center Offers Novel Hemorrhoid Treatment

A Comparative Study Of The Genotype Mtbdrplus® Assay Against A Standard Culture Method For Diagnosis And Drug Susceptibility Testing Of Tuberculosis, Peris W. Thamaini

Master of Medicine in Clinical Pathology

Background: Nearly one-third of the global population, i.e. two billion people, is infected with Mycobacterium tuberculosis and is at risk of developing the disease. More than eight million people develop active tuberculosis (TB) every year, with about two million dying from the disease annually. Diagnosis of tuberculosis inKenya remains dependent on smear microscopy. New methods of TB diagnosis are needed which have better accuracy and are still cost effective. Molecular methods of TB diagnosis have come under investigation in a lot of studies recently. However, they have their own limitations including the inability to differentiate between active organisms and dead …

Operations Research Methods For Optimization In Radiation Oncology, M Ehrgott, Allen Holder

Mathematical Sciences Technical Reports (MSTR)

Operations Research has a successful tradition of applying mathematical analysis to a wide range of applications, with one of the burgeoning areas of growth being in medical physics. The original application was in the optimal design of the influence map for a radiotherapy treatment, a problem that has continued to receive attention. However, operations research has been applied to other clinical problems like patient scheduling, vault design, and image alignment. The overriding theme of this article is to present how techniques in operations research apply to clinical problems, which we accomplish in three parts. First, we present the perspective from …

Automatic Detection Of Slip-Induced Backward Falls, Jian Liu, Thurmon E. Lockhart

Computer Sciences and Electrical Engineering Faculty Research

Falls are the leading cause of injury deaths among people 65 years and older. The National Safety Council reported that in 2005, 17,700 Americans met their death by falling, and of these deaths, the majority (over 80%) were people over 65 years of age [1]. It is certainly desirable to avoid the fall accidents altogether through developing a comprehensive fall prevention program [2]. However, in case of unavoidable falls, an effective injury-prevention technology is critical to minimize/reduce fall-related physical injuries. Recently, the concept of wearable airbag [3] emerged as one viable and promising injury-prevention approach.

Schroeder, Ralph Louis, 1885-1976 (Sc 1971), Manuscripts & Folklife Archives

Manuscript Collection Finding Aids

Finding aid only for Manuscripts Small Collection 1971. Letter, 14 February 1930, from Ralph Louis Schroeder, a physician, to Dorothy Blocher, Owensboro, Kentucky discussing details about automobiles and the furniture and equipment in his office. Also includes a brief biography of Schroeder.

Safe Emergency Management Of Acute Ischemic Stroke: An Academic Community Hospital Decade Experience, John Castaldo, Richard S. Mackenzie Md, Peter J. Barbour Md, Lorraine Spikol, Yevgeniy Isayev, Yuebing Li Phd, Gary Clauser Md, John Margraf Md, Glenn Mackin Md, Faan, Facp, David Richardson, Gavin C. Barr, Jr. Md, Donna Jenny, Susan Nevada, Claranne Mathiesen

Department of Emergency Medicine

No abstract provided.

Risk Of Contrast Induced Nephropathy In Hiv Patients Receiving Radiographic Contrast At Three Aga Khan Hospitals, Sitna A. Mwanzi

Master of Medicine in Internal Medicine

Aim: To study the influence of HIV infection on the development of contrast induced nephropathy in patients receiving radio contrast material Design: Prospective cohort study Patients and setting:One hundred and twenty five (125) HIV positive patients and one hundred and fifty five (155) HIV negative patients selected from in and out patient departments of the Aga Khan University Hospital, Nairobi and Aga Khan Hospitals in Mombasa and Kisumu, were evaluated for the study between August 2008 and August 2009. Methodology: Eligible patients undergoing radiological evaluation requiring the use of radio contrast material were consecutively recruited for the study after which …

Imagining A World Without Huntington's, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Knowledge, Attitudes And Practices Regarding Gemstone Therapeutics In A Selected Adult Population In Pakistan, Sidra Ishaque, Taimur Saleem, Waris Qidwai Dr

Department of Family Medicine

Background: Gemstones have been in use as part of alternative and complementary medicine for years. However, our understanding of the perceived healing powers of gemstones is limited. An extensive literature search revealed that there is a dearth of validated information on this subject. This study was therefore undertaken to explore the various aspects of the knowledge, attitudes, and practices of the public towards gemstone therapeutics.
Methods: A survey was performed in the Community Health Centre of a tertiary care teaching hospital in Pakistan. Data collection was done via a face-to-face interview based on a structured, pre-tested questionnaire. Participants included all …

Disruption Of Histone Modification And Carm1 Recruitment By Arsenic Represses Transcription At Glucocorticoid Receptor-Regulated Promoters, Fiona D. Barr, Lori J. Krohmer, Joshua W. Hamilton, Lynn A. Sheldon

Dartmouth Scholarship

Chronic exposure to inorganic arsenic (iAs) found in the environment is one of the most significant and widespread environmental health risks in the U.S. and throughout the world. It is associated with a broad range of health effects from cancer to diabetes as well as reproductive and developmental anomalies. This diversity of diseases can also result from disruption of metabolic and other cellular processes regulated by steroid hormone receptors via aberrant transcriptional regulation. Significantly, exposure to iAs inhibits steroid hormone-mediated gene activation. iAs exposure is associated with disease, but is also used therapeutically to treat specific cancers complicating an understanding …

Stimulus Bill Implementation: Expanding Meaningful Use Of Health It, Rob Cunningham

National Health Policy Forum

The American Recovery and Reinvestment Act authorizes an estimated $38 billion in incentives and supports for health information technology (IT) from 2009 to 2019. After years of sluggish health IT adoption, this crisis-driven investment of public funds creates a unique opportunity for rapid diffusion of a technology that is widely expected to improve care, save money, and facilitate transformation of the troubled U.S. health system. Achieving maximal effect from the stimulus funds is nevertheless a difficult challenge. The Recovery Act strengthens the federal government’s leadership role in promoting health IT. But successful adoption and utilization across the health system will …

Penilaian Kualitas Pelayanan Puskesmas Dengan Model Donabedian: Studi Kasus Puskesmas Di Kota Depok, Dian Ayubi

Kesmas

Perkembangan struktur sosio-demografi penduduk dan infrastruktur Kota Depok yang pesat berpengaruh terhadap masalah kesehatan yang semakin kompleks. Pada era desentralisasi, Dinas Kesehatan Pemerintah Kota Depok dituntut memberikan pelayanan kesehatan masyarakat yang berkualitas antara lain melalui pelayanan kesehatan tingkat primer di puskesmas. Penelitian ini bertujuan menganalisis mutu pelayanan puskesmas dan hubungan struktur dan proses terhadap hasil pelayanan puskesmas, kepuasan pelanggan. Survey di rumah responden dilakukan pada bulan Maret 2004, dalam wilayah kerja enam puskesmas kecamatan di Kota Depok. Populasi adalah semua penduduk yang bermukim di wilayah kerja Puskesmas Kecamatan se-Kota Depok. Sampel adalah 300 rumah tangga yang tersebar di setiap kelurahan …

Pengaruh Kemiskinan Keluarga Pada Kejadian Pneumonia Balita Di Indonesia, Rizanda Machmud

Kesmas

Pneumonia merupakan penyakit infeksi saluran pernapasan akut yang menjadi kausa utama kematian balita. Di Indonesia, pada akhir tahun 2000, angka kematian balita akibat pneumonia diperkirakan 4,9/1000 balita. Faktor sosio-ekonomi berkontribusi besar terhadap penyakit saluran pernapasan. Tujuan penelitian ini adalah mengetahui faktor sosio-ekonomi yang paling berpengaruh terhadap pneumonia pada balita. Penelitian dengan dengan disain krosseksional ini menggunakan sumber data sekunder Benefit Evaluation Study (BES) II oleh Pusat Penelitian Kesehatan Universitas Indonesia bekerja sama dengan Proyek Intensifikasi Pemberantasan Penyakit Menular, Departemen Kesehatan. Sampel diambil berdasarkan multilevel statistical frameworkdari 7.170 ba-lita pada 10.900 rumah tangga di 27 kabupaten di tujuh provinsi. Metode analisis …

Makanan Etnik Minahasa Dan Kejadian Penyakit Jantung Koroner, Grace Debbie Kandou

Kesmas

Penyakit jantung koroner yang menjadi kausa utama kematian di seluruh dunia merupakan masalah kesehatan masyarakat yang penting di seluruh dunia, termasuk Indonesia dan Sulawesi Utara. Kebiasaan makan yang dipengaruhi oleh faktor budaya, adat istiadat, agama dan kepercayaan berperan penting dalam proses kejadian penyakit. Penelitian ini bertujuan mengetahui pengaruh kebiasaan makan etnik Minahasa terhadap kejadian penyakit jantung koroner. Penelitian di RSU Prof. Dr. R.D. Kandou ini menggunakan disain studi kasus kontrol dengan ukuran sampel 128 kasus dan 128 kontrol. Data frekuensi makan dikumpulkan dengan Food Frequency Quationnaire (FFQ). Makanan etnik Minahasa ditentukan berdasarkan 41 jenis makanan yang dikompositkan. Asam lemak jenuh …

Masyarakat Depok Memilih Fogging Yang Tidak Dimengerti, Tri Krianto

Kesmas

Sampai kini, demam berdarah dengue masih menjadi masalah kesehatan yang utama di Kota Depok. Hal tersebut terlihat pada jumlah kasus yang terus meningkat dan semua kelurahan sudah berkembang menjadi daerah endemis demam berdarah dengue yang dapat dicegah dengan mengendalikan vektor. Upaya pembersihan sarang nyamuk PSN 3M Plus adalah teknologi yang disarankan untuk mengendalikan kejadian demam berdarah dengue, tetapi belum mendapat dukungan pelaksanaan dari masyarakat. Studi ini bertujuan untuk menggali informasi tentang pengetahuan, sikap dan praktek masyarakat dalam pengendalian vektor demam berdarah dengue di Kota Depok. Hasil studi menunjukkan bahwa pengetahuan dan partisipasi masyarakat dalam pengendalian vektor DBD masih rendah, dan …

Online Piece-Wise Linear Approximation Of Numerical Streams With Precision Guarantees, Hazem Elmeleegy, Ahmed Elmagarmid, Emmanuel Cecchet, Walid G. Aref, Willy Zwaenepoel

Cyber Center Publications

Continuous “always-on” monitoring is beneficial for a number of applications, but potentially imposes a high load in terms of communication, storage and power consumption when a large number of variables need to be monitored. We introduce two new filtering techniques, swing filters and slide filters, that represent within a prescribed precision a time-varying numerical signal by a piecewise linear function, consisting of connected line segments for swing filters and (mostly) disconnected line segments for slide filters. We demonstrate the effectiveness of swing and slide filters in terms of their compression power by applying them to a reallife data set plus …

Today - August 24, 2009, Loma Linda University

TODAY

Inside this issue:

-- The J.M. Long Foundation sponsors simulation center pharmacy in Centennial Complex
-- Medical Center receives 5-star rating
-- LLUMC ophtalmology center opens at Riverwalk in the Riverside/Corona area
-- SCE gives grant to ‘Si Se Puede’ program
-- SD and SPH study dental caries in Redlands children
-- Chaplain services offers divorce recovery group
-- Take a historical and futuristic tour of Loma Linda University
-- School of Public Health names Alumnus of the Year
-- Save the date for the LLU Family Medicine Residency Fair
-- How Nathan Andrade lost a limb, but gained a …

Medical School Watercooler Newsletter - August 23, 2009, Lindsey Lyle

Watercooler Newsletter

This is the August 23, 2009 edition of the Frederick P. Whiddon College of Medicine - Watercooler

Contents Include

• Medical Simulation labs

Calcium Homeostasis And Cone Signaling Are Regulated By Interactions Between Calcium Stores And Plasma Membrane Ion Channels., Tamas Szikra, Peter Barabas, Theodore M. Bartoletti, Wei Huang, Abram Akopian, Wallace B. Thoreson, David Krizaj

Journal Articles: Ophthalmology

Calcium is a messenger ion that controls all aspects of cone photoreceptor function, including synaptic release. The dynamic range of the cone output extends beyond the activation threshold for voltage-operated calcium entry, suggesting another calcium influx mechanism operates in cones hyperpolarized by light. We have used optical imaging and whole-cell voltage clamp to measure the contribution of store-operated Ca(2+) entry (SOCE) to Ca(2+) homeostasis and its role in regulation of neurotransmission at cone synapses. Mn(2+) quenching of Fura-2 revealed sustained divalent cation entry in hyperpolarized cones. Ca(2+) influx into cone inner segments was potentiated by hyperpolarization, facilitated by depletion of …

Relating Visual To Verbal Semantic Knowledge: The Evaluation Of Object Recognition In Prosopagnosia, Jason J. S. Barton, Hashim-M Hanif, Sohi Ashraf

Section of Neurology

Assessment of face specificity in prosopagnosia is hampered by difficulty in gauging pre-morbid expertise for non-face object categories, for which humans vary widely in interest and experience. In this study, we examined the correlation between visual and verbal semantic knowledge for cars to determine if visual recognition accuracy could be predicted from verbal semantic scores. We had 33 healthy subjects and six prosopagnosic Patients first rated their own knowledge of cars. They were then given a test of verbal semantic knowledge that presented them with the names of car models, to which they were to match the manufacturer. Lastly, they …